Everyone who spends time near the River Stush has to deal with them. They are the price locals pay for rich soil and plentiful fishing. A nuisance, yes, but no more so than floods, earthquakes, malaria, or any other objectively terrible thing humans have gotten used to. The few who die are mourned, but their loss is made up for by the complete absence of famine from living memory.
The growths root deeply in muscle before the “fruit” appears. It has a hard outer skin, and squishy, yellow-green flesh within, hence the name. They cause a deep aching pain in the body, which can be managed by clipping the growths each morning to keep them small. They’re sensitive enough that clipping is extremely painful, but leaving them unclipped for even a few days allows them to grow to an unmanageable size. The baseline pain threshold of the locals has thus been set to inhuman heights. As far as they’re concerned, outlanders are all pansies.
New growths appear now and again, a few inches apart. They mostly grow on the back, belly, and the upper half of the arms and legs. Removing them completely is a difficult and dangerous process, but necessary for those who’ve got too many sprouts, or whose growths have migrated to an area where they may do serious damage, such as the chest, hands, feet, or head. Fortunately, there’s the River Doctor.
She’s a kindly old woman, well into her ’70s, traveling up and down the river with her tongueless apprentice and her bag of tools. She spends a few weeks in each town, removing what growths need it, and ensuring everyone heals up well before loading her river yacht with the grateful town’s foodstuffs, and moving on to the next settlement. The trip back and forth takes most of the year. She disappears for a few months each winter before starting her journey again after the spring thaw.
It is lamentably inevitable that she lose a few patients each year. What doctor does not? She insists on keeping the bodies for autopsy, which everyone agrees is reasonable. No one is crass enough to question the saintly doctor. Before her, things were much worse.
In truth, the River Doctor has rarely ever lost a patient. The gourd growths are trivially easy to remove for anyone with the right tools and basic surgical training. No, the ones who “die” are simply those with the most promising fruit. In the bowels of her yacht are metal cages where the ‘dead’ are kept drugged and docile until the winter, when she takes her boat down the sea coast to the manse of the Mad Marquis.
Beneath this imposing cliffside villa is a dungeon where the growths are fostered in an ideal environment, clipped only when they’ve achieved a full and painful bloom. The Marquis enjoys them as a delicacy. The enlightened mind can’t be bothered by the trifles of human suffering. If a good meal means turning people into immobile clusters of gourd growths, it’s a small price to pay. The Marquis even operates a small and secret market for other discriminating elites enlightened enough to share his philosophy.
Eventually the unchecked growths always kill their host, but not before producing one final fruit, which always sprouts from the top of the head. Pale blue in color, the Marquis believes it contains the victim’s soul. Whether or not that’s true, there’s no denying that consuming these blue fruits is an experience that defies description. One never quite knows what to expect.