Chapter 5: The Cost of Last Breaths

The screaming at the barricaded ambulance bay doors changed by the minute.

At first it had been panic—high, ragged, indiscriminate, a hundred throats sawing at the same terror. Then anger had taken it. Fists pounded sheet metal. Someone had hurled a cinder block hard enough to leave a spiderweb crater in the reinforced glass. After that came bargaining, prayer, threats, sobbing, and finally the ugliest sound of all: people trying to be quiet because they had realized noise brought things out of the dark.

Evan stood in the corridor above the bay and listened to all of it through the blood-slick smell of antiseptic, old floodwater, and opened bodies.

The hospital groaned around him like a ship trying not to sink.

Extension cords snaked over cracked tile. Emergency lanterns painted the walls in jaundiced bands. Every few seconds the light in the chapel at the center of St. Mercy pulsed through the open double doors at the far end of the hall, a faint gold heartbeat pushing back the red, infernal glow rising from the city outside. The temporary safe-zone core had settled inside the chapel altar like a coal from heaven. It kept the nearest hallways from sealing over with dungeon flesh. It held the temperature ten degrees above freezing. It stopped the worst of the whispering.

It also drank mana like a drowning man inhaled air.

And Evan was almost empty.

He scrubbed one hand over his mouth, felt the crust of somebody else’s blood crack against the stubble on his knuckles, and looked down at the translucent blue pane still hovering in the corner of his vision.

Class Resource Unlocked: REQUIEM

Requiem is generated through threshold acts aligned with Mortuary Saint authority.

Primary Sources:

— Shepherding the dying to a peaceful end

— Preserving life at the brink of death

— Sanctifying remains

— Binding willing dead to protective purpose

Warning: Waste of the dying incurs spiritual instability.

He had seen the message ten minutes ago and still hated every word of it.

Threshold acts. Peaceful end. Waste of the dying.

The System had found a way to take the work he had spent fifteen years doing with gauze, compressions, and tired hands and turn it into fuel.

Below him, a woman shrieked his name.

Not because she knew him. Because the crowd outside had learned quickly who was deciding who got in.

“Ward!” someone bellowed. “Please! Please, my son’s bleeding out!”

“You let us die and you’re dead when those doors open!” another voice screamed.

“There’s things in the parking structure!”

Then came automatic gunfire from somewhere across the street—short, panicked bursts—and the crowd outside the bay broke into a fresh wave of screaming.

Evan flinched toward the sound on instinct before he forced himself still. He had spent half his life running toward gunshots, collapses, pileups, apartment fires. Running first, thinking second. That was how people like him got turned into old trauma stories or body bags. Or both.

Footsteps slapped behind him.

“Tell me you got good news,” Dana said.

She looked like she had been pulled through barbed wire and smoke and then handed a rifle as consolation. Her dark hair had escaped its tie and stuck damply to her cheeks. One sleeve of her security jacket was ripped to the shoulder. Dried black gore crusted the metal flashlight clipped to her vest. In the hard fluorescent spill from the nurses’ station, her eyes looked more exhausted than afraid, which somehow felt worse.

Evan angled the status pane toward her even though he knew she couldn’t actually read it. “I got rules.”

“I was aiming higher than rules.”

“Yeah. Me too.”

Dana stared at his face for a second, reading the answer there anyway. “How bad?”

“The chapel core’s stable for maybe another hour at current drain. Less if that red rupture in radiology spreads.” He swallowed. “I’ve got a new resource. Requiem. It fills when I save people on the edge.”

“That sounds almost merciful.”

“Or when I help them die.”

The silence that followed was brief and absolute, as if the whole corridor had inhaled and not yet exhaled.

Dana’s jaw tightened. “Of course it does.”

“There’s more.” He hated himself for the relief he felt at saying it out loud, like naming filth made it easier to hold. “Sanctifying remains generates some. Binding willing dead too. Protective purpose, whatever that means.”

Dana looked toward the chapel doors, where a volunteer in pink scrubs was carrying IV bags like holy offerings. “You can weaponize corpses better now.”

“Apparently.”

“Can you do it fast enough to matter?”

Evan thought of the stretcher in triage room three where a teenager was drowning in his own blood around a punctured lung. Of the maintenance worker with his abdomen opened hip to hip by one of the dog-things in the loading dock. Of the elderly man in pediatric recovery whose heart kept trying to quit from shock every time the building trembled.

He thought of the crowd outside. The screaming. The locked doors.

“I don’t know,” he said.

Dana gave one sharp nod, as if uncertainty itself could be filed into a category and carried. “Then find out. Because we’ve got maybe twelve people who can still stand on a barricade, three of them can’t shoot, one is fourteen, and if those doors come down before dawn, nobody in this building sees sunrise.”

She moved to go. He caught her arm.

“How many dead?” he asked.

“Inside?”

He nodded.

“Nine since lockdown. Four in the lobby fighting. Two in overflow. One from the ruptured stairwell. Two bled out waiting for treatment.” Her voice roughened on the last sentence. “Outside? I stopped counting.”

Evan released her.

“Keep the volunteers moving,” he said. “Anybody with compression training goes to triage. Anybody who can’t stomach blood guards the chapel perimeter. Nobody crosses the boundary line with a weapon unless I say so.”

“And the people at the door?”

He looked through the narrow observation pane down to the bay. Bodies pressed shoulder to shoulder against the barricades. Faces white with reflected emergency lights. A man holding a little girl so tightly she cried every time he shifted his grip. A woman cradling her own forearm, which hung by a flap below the elbow. Two teenagers trying to hold a rolling gurney steady while the patient on it convulsed.

Each pair of eyes turned up as if they could feel him there.

Choose.

The old paramedic reflex in him wanted a triage tag, a clean protocol, something standardized and blameless. Black. Red. Yellow. Green. Save who you could. Spend resources where outcomes existed. Do not drown on a single case while five salvageable patients die beside you.

That had always sounded rational from a textbook. It never sounded rational when a mother looked at you and asked why her boy wasn’t getting oxygen.

“The worst ones first,” he said.

Dana blinked. “That’s backwards if we’re trying to maximize—”

“I know what it is.” His voice came out flatter than he meant. “The brink fills the resource. If I can stabilize enough of them, maybe I can feed the chapel, maybe I can raise more defenders, maybe I can keep the hospital from tearing open.” He looked at her. “And if I can’t save them—”

Dana held his gaze. Finished it for him.

“Then they don’t go to waste.”

The words lay between them like something with bones.

She gave a single curt nod and headed for the stairs, barking orders before she was halfway down.

Evan stood alone for one heartbeat more, listening to the renewed pounding on the doors below.

If this is what the class wants, then fine. But every breath is getting counted.

He went down into triage.

St. Mercy’s ambulance bay had become a slaughterhouse wrapped in procedure. Nurses’ stations were stripped for supplies. Plastic privacy curtains had been ripped down and used as floor tarps. Folding chairs, overturned crash carts, and steel instrument tables formed a crooked intake lane from the barricaded doors to the old imaging hallway. Overhead, one of the fluorescent fixtures flickered in a seizure rhythm that made everyone look already dead.

The volunteers had learned fast. The moment Dana shouted, they opened the left-side wicket just wide enough to drag a stretcher through while two men with riot shields braced the gap. Cold night air and the smell of burning gasoline poured inside with the first patient. Then blood. Then the noise.

“GSW abdomen!” a teenager in a varsity jacket yelled as he and another boy wrestled the gurney through. “He was talking a minute ago—hey, hey, no, stay with me—”

“Bitten arm! She’s losing it!” someone shouted behind them.

“My daughter can’t breathe!”

“Please!”

“Please!”

The begging became structure only because Evan forced it to. He grabbed a grease marker off a supply cart and wrote numbers across people’s blankets and shirts and foreheads. One. Two. Three. His old voice came back from muscle memory: loud, clipped, leaving no room for argument.

“If they’re breathing and bleeding, here. If they’re unconscious but warm, against the wall. If they’re dead, they do not block this lane. Do not make me trip over your grief.”

Some of them hated him instantly for it. Good. Hatred moved faster than despair.

The gunshot wound came first. Male, maybe thirty, entry low right quadrant, probable internal hemorrhage, belly distended, skin waxing gray. He clutched Evan’s sleeve with astonishing force.

“Don’t let me die,” he whispered.

Evan knelt, hands already moving. “Name.”

“Luis.”

“Luis, look at me.” He pressed gauze deep, found the pulsing leak by feel, and the world narrowed to pressure, pulse, breath rate. “You keep looking at me and you keep breathing like I’m charging you money for each one, okay?”

Luis made a raw, desperate laugh that broke into a groan.

Evan opened himself to the class instinct he had been resisting all night.

It was not like reaching for mana. Mana had felt external, ambient, a field to draw from if he aligned himself right. This was intimate. Wet. Warm. He felt the fraying edge of the man’s life under his palms the way he might once have felt a thread slipping through torn cloth. There was terror there, pain, a memory-flash of headlights on wet asphalt, the iron taste of blood in the mouth. At the center of it all was a pressure like breath trapped in a locked room.

Skill Available: Last Rites of Delay

Expend Requiem to suspend terminal cascade for a brief duration.

He had no Requiem yet.

“Not helpful,” he muttered.

“What?” the boy assisting him asked.

“Nothing. Keep pressure here. Harder.”

The boy did. Luis screamed.

On the next gurney, the woman with the nearly severed forearm was trying very hard not to cry. Mid-forties, work boots, grease under the nails, shock held at bay by sheer temper. Her hand was white and cold below the flap of tissue.

“You got a surgeon?” she asked.

“No.”

“Then tell me if I’m keeping the arm.”

“No.”

She hissed through her teeth once. “Fine. Do the rest fast.”

He found himself almost smiling. “What’s your name?”

“Marta.”

“Marta, I need your permission.”

“To save my life?”

“To take the arm if the System gives me a way to stop you bleeding out.”

She looked at the ruin below her elbow, then back at him. “If you ask me twice, I’m punching you with the other one.”

Consent. Clear. Immediate.

Something in his vision stirred.

Threshold recognized.

Action aligned: preserving life at the brink.

A tiny silver thread curled into existence at the edge of his sight. It sank into the black well he somehow understood to be Requiem.

One point. Maybe less than a point. A taste.

Evan sucked in a breath. “Dana!” he shouted. “Need any cutting tools you’ve got that are still sterile enough to lie about!”

The next fifteen minutes became a machine made of pain.

He clamped, packed, tied off, improvised tourniquets, improvised chest seals, improvised authority. He put a teenager named Cam on oxygen from a scavenged cylinder and talked him through the bubbling suck in his chest until the boy’s eyes stopped rolling white. He had a retired veterinarian named Suresh help him needle-decompress an old woman whose ribs had collapsed inward after a parking garage stampede. He wrapped, splinted, ordered, cut away clothing, barked for saline, cursed at people who froze, thanked people who didn’t. Every time someone hovered at the precipice and did not immediately fall, another thin pull of cold-warm energy threaded into him.

Requiem accumulated like candle drippings. Slow. Sticky. Precious.

It was not enough.

Never enough.

The little girl with breathing trouble turned out to be no more than six. Croupy wheeze, soot in the nostrils, probably smoke inhalation from whatever building had burned to the east. Her father shook so badly he kept dropping the nebulizer mask.

“I can’t do this,” he choked. “I can’t—I can’t watch her—”

“Then don’t watch,” Evan snapped, shoving the mask back into his hands. “Help. Hold that there. Count with her.”

The man stared.

“Count,” Evan said again, sharper.

“One,” the father whispered.

The girl’s eyes, glassy and huge, fixed on his face.

“Two,” she rasped.

By “seven,” her breathing had eased enough to stop sounding like she was inhaling through a straw full of nails. Another strand of Requiem slid into place.

Evan did not let himself feel relief. Relief was a leak.

Then the maintenance worker from the loading dock crashed.

He was maybe fifty, broad-shouldered under his blood-soaked work shirt, with a silver St. Christopher medal tangled in the hair on his chest. The laceration across his abdomen had already ruined him. Intestine bulged through the packed towels. His pulse fluttered like a trapped moth. A volunteer doing compressions nearby glanced over once and then away, as if refusing eye contact might postpone the verdict.

Evan knew that wound. Knew exactly how impossible it was in these conditions.

The man’s eyes tracked him anyway. “Doc?”

“Not a doctor.”

“Close enough.” His lips twitched pink with blood. “Hurts.”

Evan checked what was left of his pulse. Found almost nothing.