Kicking a dead horse here, but an early terminal diagnosis that he has refused to elaborate about still remains the most fitting explanation for the mysterious "worst day ever" just a few short years ago, his later speedrunning what could have been a normal midlife crisis into a ditch like there's no tomorrow, his even later exhibiting little to no effort toward rebuilding and growing a sustainable career as opposed to just clinging to enough of a platform to settle scores with a few enemies with what little time he has left, and his even later displaying more and more symptoms like the blue fingers, beet-red nose, legs suddenly "forgetting how to walk," and now this patchy mange.
As if that wasn't enough, last night there was that bizarre moment that @Something Awful pointed out where he couldn't even muster his usual fake, forced jovial response to a particular superchat and instead his expression gets more and more glum, to the point of even visibly choking up and swallowing as if struggling to hold back tears at the superchat's somber reminder of his mortality, followed by a long awkward pause. It seemed worth clipping, and if you look close you just can't unsee it:
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Yeah yeah yeah, of course the counterargument will always be that he wouldn't stay silent about it and would surely milk it for pity points, but just as easily he might prefer to portray a brash persona with a sense of invincibility just to make sure followers continue to feel invested long-term, and/or as a cope to distract himself from the reality of what's coming. In that case he may never break the news even in later stages like Lead Attorney or Scott Adams did, and may just up and kick the bucket one day without telling anybody like how Norm MacDonald took the secret to his grave to immortalize his "I didn't know he was sick" bit.
The only question left at this point is differential diagnosis. The patchy mange from radiation treatment around the head, the overall mental decline, and the legs "forgetting to walk" would all line up well with a brain tumor, not quite so aggressive as a glioblastoma which would have taken him out mere months after the "worst day ever," and perhaps just along the lines of an oligodendroglioma that unfortunately would take years to get the damned job done. On the other hand, due to the prior history of heat rashes I'd still lean more toward some sort of autoimmune etiology. Granted, it's
never lupus, but rheumatoid arthritis has been known to contribute to such "patchy" alopecia areata, and is also strongly associated with rheumatoid vasculitis that can lead to both the red nose and blue fingers that everyone was so quick to blame on whippets. That still leaves out the legs forgetting to walk, but if the guy's genes are so fucked that his own immune system is attacking his tissues in all these other ways, it wouldn't be surprising if it set its gunsights on his brain next with a case of multiple sclerosis to deliver the coup de grace, as there is
a positive correlation making dual diagnosis of RA and MS common in the same patient. I prefer this scenario solely for the poetic justice, as all the times he talked shit about Johnny Krutches can be followed by someday needing to borrow his nickname.
Wildcard: his somber reaction could have been from pondering the creeping mortality of someone close, such as Kayla. In that event I'm putting my money on late-onset Huntington's Disease, for its explanation of the disturbingly contorted facial expressions, sanpaku eyes, eventual reluctance to have her seen in public, and above all,
rampant hypersexuality.
