In Advent Children, we find out that many people have been infected with tainted Lifestream, which has caused them to become afflicted with a new disease termed “Geostigma.” Those with Geostigma are weakened, with areas of their bodies bruised and bleeding black ichor.
Of the main party, only Cloud Strife becomes infected with Geostigma. Why?
The answer upends the claim that Cloud was happy and content to live a “normal life” with Tifa and his family of friends, and that Cloud is only depressed and leaves Seventh Heaven to live in Aeris’s church because he is afraid of spreading the potentially-contagious disease to his found-family. The truth is, Geostigma is a symbol for mental health, and Cloud’s illness runs deeper than Geostigma itself.
In the Advent Children movie itself, it’s unclear who catches Geostigma or why, though many seem to believe it is contagious (and thus are children with “the stigma” stigmatized and avoided). While speaking with Rufus, Kadaj explains it like this:
The stigma. But you know all about that, sir. Mother’s memetic legacy lives on in the Lifestream and makes it happen.
Kadaj, Advent Children
Mother has given me a very special gift: the power to fight, against a planet that torments humanity! She gave this gift to all her children. That’s right. You and I are brethren: brothers and sisters chosen when we inherited Mother’s memetic legacy through the Lifestream. But… the planet doesn’t approve of that at all. It’s doing everything it can to hold us back. That’s why it’s racking our bodies with pain and filling out hearts with doubt.
Kadaj, Advent Children
Kadaj calls it the “memetic legacy” of Jenova, but argues that the pain from the disease is due to the Planet, or natural Lifestream, resisting the tainted Lifestream.
We don’t find out more about the specifics of Geostigma until On the Way to a Smile – Nojima’s novel that serves as an official prequel to the movie.
In Case of Denzel, Denzel reports to Reeve his earliest encounters with those afflicted with Geostigma, and Reeve muses on rumors at the time of what exactly the disease was.
Back then, no one knew anything about the stigma. Everyone the Lifestream touched started oozing that dark slime, and then died. People said you could get infected by touching it. No one had figured that it was actually the remnants of Jenova corrupting the Lifestream. Not that is would have made a difference, knowing.
Reeve, Episode Denzel
Denzel, however, is our first proof that the disease doesn’t spread from skin-to-skin contact. He doesn’t catch it after coming into contact with several individuals who are stigma-positive. He acquires it when he falls into despair and thinks “I really don’t want to die!”
Yuffie Kisaragi is the next protagonist to explore Geostigma in her chapter, and she investigates it with surprising sophistication. She is able to ascertain that Geostigma can spread through contact with tainted water – but only when the victim was overtaken by the fear of dying.
1. Be cautious of all sources of water. Try boiling all water before drinking and washing.
Case of Yuffie, On the Way to a Smile
2. Do not think about how you are going to die.
Geostigma, the world began to call it. The strange dark water was the vector. Theillness entered people’s bodies when they had given up, when their will to live had failed them.
Case of Yuffie, On the Way to a Smile
But it is Rufus’s story (Case of Shinra) that makes the final conclusion. Now-former President Rufus falls victim to Dr. Kilmister, a scientist studying Geostigma with human guinea pigs. An injured, but unafflicted Rufus is kept in an underground cave as a prisoner with other victims who are already suffering Geostigma. Rufus never catches it until the cave floods, and he finally experiences the fear of death.
Later, Dr. Kilmister concludes his research with the following hypothesis: individuals become infected with Geostigma when they are suffering severe emotional distress. This can be a frightening, near-death experience, or the traumatic loss of a loved one.
The first people to contract the disease were those directly exposed to the Lifestream. He had discovered this in the early stages of his research through interviewing patients, Kilmister explained smugly.
Episode Shinra, On the Way to a Smile (page 180)
“The others, whose symptoms appeared later, had something else in common. They were suffering severe emotional distress. In almost all cases, they had lost a loved one or had a near-death experience of their own, and they had gone through a period of intense contemplation of death.
Lost a loved one or had a near-death experience? Which one sounds like Cloud?
Cloud is always having near-death experiences, but “fear of death” doesn’t sound like him. Note that he did not become infected with Geostigma until only several months prior to the start of Advent Children, so this had nothing to do with the terrifying sight of Meteor ripping up the city of Midgar.
During that time after Meteor and before he catches Geostigma, Cloud led a relatively peaceful life, if emotionally isolated. He lived in the new Seventh Heaven with Tifa, Marlene, and Barret (until Barret left for a journey) and worked as a courier. He rescued Denzel, who was infected with Geostigma just prior to meeting him, and seems to have a good relationship with the children. His friendship with Tifa, however, is strained.
Aeris’s mother Elmyra asks Cloud to deliver a bouquet of flowers to Aeris’s resting place in the Forgotten City. Tifa wonders if revisiting the place where he lost Aeris will “tear fresh wounds in his heart” – and she’s right. That evening, Cloud is found drinking alcohol, and broods to Tifa that he wants to drink alone, causing her to snap at him.
The fact that he couldn’t protect Aerith tormented Cloud – that she knew. He was trying to get over that and live. But if he went back to the place where she had left him forever, wouldn’t the grief and regret just tear fresh wounds in his heart?
That night after closing, Cloud was drinking for a chance. His glass was empty. After thinking it over, Tifa topped it off.
Episode Tifa (On the Way to a Smile)
“Mind if I join you?” She had things to say.
“I wanna drink alone.”
Cloud’s response robbed Tifa of her better sense, and the words abruptly came out: “Then drink in your room.”
Tifa, struggling with her romantic feelings for Cloud, carefully asks Cloud if he loves her. Cloud won’t even answer, and then explains that he has “a problem.”
“Do you love me?”
Episode Tifa (On the Way to a Smile)
Suddenly, his eyes opened, and he looked at her groggily.
“Hey Cloud. Do you love Marlene?”
“Yes. I just don’t know how to act around her sometimes.”
“But we’ve been together for a long time now.”
“Maybe I need more than just time.”
“…And what about you and me?”
Cloud didn’t answer.
“Sorry,” said Tifa. “I don’t know why I’m asking these things.”
“Don’t be sorry. It’s… my problem.” Cloud shut his eyes again.
“We could make it ours.”
Tifa waited for him to say something, but he never answered.
What exactly is Cloud’s “problem”? We find out what – or who – it is.
“Did you fix the problem?”
Episode: Tifa
“What problem?”
“Your problem.”
“Oh…”
Cloud was clearly deep in thought.
“If you don’t want to tell me, don’t.”
“I can’t explain it well…” Cloud searched for the right words. “I didn’t fix the problem. I don’t think I’ll ever fix the problem. I can’t make somebody unlose their life.”
The chapter seems to end on a note of optimism, with Cloud hoping that by raising Denzel – whom he believes was brought to him by Aeris – he can achieve a sense of retribution. But yet in the final paragraph, Tifa tries to call Cloud, only for the number to go to his answering machine – meaning he is still isolating.
Cloud also must come to terms with losing his best friend, Zack, so is Aeris really the loved one Cloud is grieving about losing? Official materials surrounding Advent Children make that very clear.
Two years have passed since she returned to the Planet, and Aerith still lives on in the hearts of her friends who saved the Planet. Especially in Cloud, to whom she is a symbol of “the sin of failing to protect a loved one,” and the main factor in him closing off his heart.
10th Anniversary Ultimania, page 52
“Can sins ever be forgiven?” – Cloud asks this to Vincent, who mutters a brief answer. For both of them, “I couldn’t protect my loved one” is the sense of guilt that they carry, so their words resonate with weight.
Final Fantasy VII 10th Anniversary Ultimania, page 72
The Forgotten City is tied to Aerith throughout the film. Here, CLoud is constantly reminded of her no matter how painful it is for him.
Advent Children Reunion Files
Since Sephiroth exists, Aerith must also exist. There was no doubt about that one. The incredible guilt Cloud feels because of what happened to Aerith can only be lifted by forgiveness from Aerith herself.
“It is my sin that I couldn’t protect my loved one” – under this assumption, Cloud closes off his heart. What will the reunion with Aeris bring him?
10th Anniversary Ultimania, Cloud’s profile
“I… think I want to be forgiven. Yeah, I just want to be forgiven.” (English: “I think I want to be forgiven. Mm.. More than anything.”)
The Dirge of Cerberus guide also makes it clear that Aeris is the one that Cloud has felt intense guilt about, not Zack.
Although Cloud continued to harbor feelings of guilt concerning Aerith’s death, his triumph over Kadaj in FINAL FANTASY VII: Advent Children helped him find resolution and move on with his life.
Dirge of Cerberus Guide
Thus is the mystery solved. Cloud became infected with Geostigma because he was already suffering emotional despair due to losing Aeris. His depression in Advent Children isn’t due to Geostigma – he has Geostigma due to his depression.
Though he tried to live a happy, peaceful life, his mental illness worsened to a critical point – and the real meaning of Geostigma in Advent Children isn’t about the “memetic legacy of JENOVA” – it’s about trauma.
And at the center of all of his sadness is his grief for his lost loved one, Aeris Gainsborough.
Earth & Sky: A Cloud x Aeris Love Story 
Cloud’s healing from Geostigma, which happens at Aerith’s church through ‘Lifestream water’, is also very important. Clear water has always been associated with Aerith in Advent Children (e.g. Aerith leaving Cloud a ‘voicemail’ in the water, Marlene saying “Is it her?” at a splash of water, Tifa saying “Somehow, I knew you were there. Thank you” to a drop of water, a drop of water with Aerith’s voice saying “Let’s go, Cloud.”). Therefore it’s safe to say that Aerith healed Cloud from Geostigma both literally, through water, and metaphorically, since she is the one who was at the heart of emotional despair and now Cloud realized that he was forgiven by Aerith and was reunited with her in spirit.
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