Prologue
Before the Doorway
West Virginia, 1952
Dr. Elias stood at the edge of the operating theater, arms folded, eyes fixed on the woman at the table. Walter Freeman didn’t work like a surgeon. He worked like an artist. Like a man so practiced at killing something inside a person that it no longer felt like violence.
The pick slid in clean, just above the eye and beneath the ridgeline of the brow. Freeman tilted the handle with a casual grace and for a fraction of a second, Elias swore he heard a whisper… maybe. A rustling like dry leaves twisting through a tunnel. Or a breath being pulled backward; not exhaled but, stolen.
Steel on steel.
One tap. Then another. And a third.
The woman didn’t scream. Didn’t flinch; her fingers twitched, then stilled.
Freeman smiled, twisted the tool, and said nothing.
The orderlies wheeled her away before the blood dried.
Elias stood still, his pulse low and electric. The smell of alcohol and skin clung to the air. He had read the journals. He’d spoken to others. But this—this was holy. The rhythm. The silence. The certainty.
Freeman turned, wiping the pick on his sleeve. “You ready to try it yourself?”
Elias didn’t speak. He just stepped forward and took the instrument. It was warm. Alive, almost. And it pulsed beneath his grip like something that had chosen him back. The smell changed. Not just antiseptic and blood—something richer. Like copper cooked in sunlight. It hit him behind the teeth, and for a blink, he felt… chosen.
The light above the table rippled a moment. Like something invisible had passed through the room and left the air breathing more than normal.
The drive home was long, narrow, slick with night.
He didn’t bother washing the blood off his cuffs. It would fade. What mattered had already been absorbed, and he was prepared to pay it forward like the others before.
The road bent like a spine, shoulders of forest crowding the blacktop. The headlights flickered once. Something moved at the tree line—but the shadows held.
He rolled the window down. The air smelled like iron.
He made the call from the hallway phone. No one was around. Just the echo of old voices in tile and plaster.
Nurse Dunn answered on the second ring.
“It’s Elias.”
A pause. She didn’t speak, but he could hear the breath behind the line.
“I’ve seen it now,” he said. “The rhythm. The quiet. It’s…cleaner than I imagined.”
Still nothing from her.
He smiled.
“There’s a new way, Dunn. We’ll begin soon. I’ll need you ready.”
He hung up before she could answer, though she never did.
He stood there a while longer, fingers resting on the receiver.
Then he whispered—not to the line, not to himself, but to the space between:
“They’ll thank us.”
Stage 1
The moment came like it always did: sudden, loud, without warning.
"Restrain him," Nurse Dunn barked, her voice sharp as metal.
The patient twisted against the hands that grabbed him, his muscles firing wild. Two orderlies wrestled him down, arms bent backward, knees cracking against tile.
"I said I don’t need no goddamn treatment!" he spat, voice raw, throat already fraying.
Dunn leaned in, her breath cold against his ear. “You’re not in charge here, soldier. We are.”
He jerked, and tried to bite her, snapping up air instead of skin.
They dragged him, not gently. He caught one last glimpse of a window at the end of the hall—sunlight falling on the sill like it had forgotten this place.
"Fuck you!" he screamed. "You can't fucking hold me here! I have family that needs me!"
But even as the words left him, something inside hollowed.
He thought of the letter they returned unopened. The one he wrote in ink that smudged from shaking hands. His daughter used to twist her hair when she was nervous—he remembered that. But the photo of her, the one he kept folded behind his ID tag, had been taken from him at intake. He asked about it once. They said it must’ve been misplaced.
No new photo was ever sent. They hadn’t written. Hadn’t visited.
They weren’t coming back.
The door slammed behind him.
The lock clicked.
And the ghosts returned.
His fingers twitched, head snapping sideways in a motion too fast and sharp. A compulsion.
They had words for what was wrong with him—paranoia. Hallucinations. Borderline something. They always needed a box for people like him to reside within.
But they didn’t feel what he felt.
He muttered low to the air around him, to the walls that seemed to pulse when no one was looking, and tonight, they inhaled him. A soft vacuum of breath, like the stone itself was trying to taste his thoughts.
And in that second, he felt it, not behind the wall, but beneath it, maybe inside of it.
Deeper. Waiting.
"I see you. I know you. I ain’t like the rest of them. You hear that? I ain’t gone yet."
He pressed his forehead to the wall. The stone was cool. Solid. Real.
His breath slowed, but the whispers started again. They always did. Gentle. Crooked and close to the ear.
“They’re gonna cut you,” the voices warned. “Gonna make you quiet. But you don’t gotta go quiet, no sir.”
He shook his head. No. He wasn’t gone. He wasn’t like the others.
He had survived worse.
He remembered the war: sand, heat, his own blood. A medic praying beside a corpse that no longer had a jaw. A voice whispering “hold on” through broken teeth.
Then—
A woman’s scream. A scalpel. A child’s shoe floating in a jar.
But that wasn’t his memory.
That was someone else’s.
He didn’t remember the boat ride home, or the discharge. Just waking up here, in this place, and the smell of bleach in the pillows.
He wasn’t crazy. Just...broken in ways they didn’t understand.
The dreams came again, as they always did.
Blood—dripping upward from the ceiling, crawling across the walls like red spiders. Photographs flickered in and out of focus. Faces smiled. Then screamed.
He saw the medic’s face again, but this time it was that fucking Dr. Elias with his mouth moving.
“This won’t hurt a bit,” it said. And then laughed.
The hallway stretched long and wrong, each door revealing things with no eyes, just mouths.
The tunnel returned.
He always saw the tunnel.
It breathed.
It watched.
And this time, it fed. Not on flesh. On memory. A cold unraveling that tasted like something he’d once promised to forget.
And then, it spoke:
“Soon, you will be here with us all soon.”
He jerked awake.
But the nightmare didn’t end.
The shadows in his room clung like cobwebs, pulling at the corners of the light. The sliver of hallway brightness stretched long and bent around the floor in angles that didn’t exist.
He sat up.
He was already in restraints.
The orderlies came without words.
Didn’t look at him like a man. Just meat for the ledger.
They marched him down the hallway like a dog to the vet.
Outside the doctor’s office, they dropped him into a chair.
The vinyl stuck to the back of his neck. His wrists ached in the restraints.
The walls here smelled like cold meat and ammonia. The kind of smell that outlasts a body.
He could hear something behind the door.
Voices.
Morbid. Slow.
"Can he eat it afterward?" A pause. A wet laugh. "Can he watch in a mirror?"
He stiffened.
He knew that voice.
It was the preacher.
The one who said he’d eaten his congregation during confession. Who used to own a bookstore. Who used to recommend poetry. Quiet man. Said the Psalms were underrated.
The door opened.
And the preacher came out.
He smiled, wide and wet. Pupils as big as dinner plates. His teeth… were they red? Or was that just the light? No, it had to be blood, yes, they were covered in platelets of someone else, he was sure of it.
The orderlies held him like he was sacred now. Like they were proud.
Like he was fixed.
No.
Not fixed.
Changed.
Anointed.
The preacher didn’t speak. He just looked at the patient and smiled, like he already knew what came next.
They talked to the shadows when they thought no one listened.
He knew this.
He’d heard them—her voice, low and smooth, like honey scraped from rusted tin; his voice, tighter, preacher-slick, always whispering to someone else in the room. Someone who wasn’t there.
But he was there.
He was always there.
The halls had holes, and the holes had voices. You just had to know where to put your ear.
He used to press his head to the vents and listen between the static of the radiator and the hum of the lights.
Sometimes the shadows whispered his name before the staff did.
He’d seen the drawer. The one in Dunn’s quarters.
The jar inside of it filled with floating wristbands, rings, a locket that looked just like Mary-Anne’s.
Mary-Anne who used to hum when she peeled oranges.
Mary-Anne who stopped humming after the second snowfall.
They said she died. He wasn’t so sure.
He’d seen the files, too.
Names scratched out in pencil. Scribbles beside dates.
“Quiet now.”
“Delivered.”
“Useful.”
No one ever asked what that meant.
And the scalpel—still red along the teeth. Not blood anymore. Just memory.
But that stain didn’t wash out.
Not with bleach. Not with fire.
He knew this.
Because he tried.
She walks like she owns the silence.
Nurse Dunn.
No first name. No past. Just that look on her face like she already knows how you’re going to die and she’s bored of waiting for it.
Her steps don’t creak. Her keys don’t jingle.
She appears.
She watches.
And when she does smile—God help you—it’s not with her mouth.
It’s with her eyes.
That dry shimmer, like a cat watching a mouse, remember, it has bones.
He swears once—once—he saw her talk to something inside the wall.
No joke. Lights were on. She was alone.
But she turned and spoke to the air like it was her shift supervisor.
Said something like:
“I found another. He’s cracked wide open already.”
Then she nodded.
Like it answered.
And Elias—
No, not Doctor Elias. That’s a title for someone who heals.
Just Elias now. Like a thing that used to be a man.
He doesn’t walk normal anymore.
His feet don’t make the right sound on tile.
Like he’s floating, just a little.
For him, gravity’s a formality he’s willing to ignore.
He talks to the corners and the shadowy figures they maintain.
Keeps the window closed even when it smells like meat in his office.
His fingernails are too clean.
You ever seen a man with nails that clean in a place like this?
That’s not science. That’s something else.
And when he speaks, it’s never to you.
It’s over you. Through you.
Like you’re the echo and he’s just listening for the real sound.
Once—swear to God—he looked right at me and said:
“Tomorrow, we will find out if you’re chosen.”
Didn’t even blink. Just turned back to his files and hummed something that sounded like a hymn made wrong.
The asylum itself, always breathing.
Walls expand when no one's walking and exhaling when it has churned out another corpse for the field with headstones.
Pipes gurgle when no one flushes.
It’s not the building.
It’s the thing inside it.
The machine.
He doesn't know what it wants, but he knows what it eats:
Names.
Stories.
People who used to hum when they folded towels.
Now they just sit.
Stare.
Sway sometimes.
He watches them.
He keeps a count.
He’s the only one still keeping a count.
They say he’s crazy.
But crazy is just what they call you when your truth doesn’t fit their structure.
He’s not wrong.
He’s just ahead of schedule.
Stage 2
He tried to speak, but the words caught in his throat like teeth. He wasn’t strapped down yet, but it didn’t matter. He was already gone, already erased—the shape of his name softening inside his skull like paper in water.
It felt like a moment he’d seen before—staring out the asylum’s windows in winter. He used to watch the others vanish that way. Quietly. Without notice.
Taken by the stone. The cement. The iron. Then rot.
Taken by the shadows between the walls.
He sat restrained, last in a line of bodies. The hallway reeked of iodine and something fouler—like old blood cooked under light.
Tap. Tap. Tap.
A hammer, in rhythm. Somewhere beyond the door.
He tried not to count. Lost track after five.
The others came back wheeled and still, their eyes cloudy, their mouths open like they’d tried to scream something but forgot how.
Then it was his turn.
The lights in the surgical room burned too bright.
Antiseptic bit his nose. Steel gleamed.
Elias stood at the center, sleeves rolled and gloved, the ice pick in hand like a conductor ready to begin.
"This will be quick," he said. Not to him. Not to anyone. Just… said it.
They strapped him down.
He fought, once. Weak. Just enough to prove something to himself.
But the leather held. And Elias’s shadow leaned long over the table.
The pick touched his skin. The edge of his tear duct.
"This angle is crucial," Elias whispered.
Nurse Dunn nodded emotionlessly.
The hammer tapped.
Once.
He thought of his daughter’s braid, the way she used to hum when brushing it. He couldn’t remember her name now. Couldn’t remember the song. Just the braid. Just the sound.
Then again.
Then harder.
Crack.
A bloom of heat behind the eye. A pull. A pop. Pressure.
Then—
Weightlessness.
He hovered above his body.
Dunn grinned. The straps were undone. They wheeled him out, but his spirit didn’t follow.
He turned.
The hallway was full of them. Ghosts. Waiting.
Some watched. Some wept. Others grinned with a smile so big they didn’t know what to do with it. One crouched in the corner, it was huge, faceless, hungry.
He backed away. The air was heavy and metallic.
He looked down at his body, wheeled away like laundry.
He wasn’t tethered anymore. Not to pain. Not to breath.
But he wasn’t free either.
He realized this wasn’t heaven. It wasn’t hell.
He understood.
This was what came after.
It was what waited behind silence.
He found the guards, still smug in their white coats.
He tipped their coffee. Watched the stain bloom across one’s chest like rot.
Knocked their papers skyward.
They panicked.
He laughed. Not because it was funny. Because it felt like something. The first feeling he’d had in weeks.
Then the hunger came.
A gnawing behind the ribs of his ghost, if such a thing existed.
He followed the nurse.
Ready to hurt her. Ready to make her know.
But her desk stopped him.
Files.
Names he remembered. People who vanished.
And that jar, tucked just so—wristbands, trinkets, tokens.
This wasn’t punishment.
It was routine.
A system.
A trade.
Then came the shadow. Not a shadow. A presence.
The corners thickened. Curled toward him.
He ran.
Time stopped mattering as it passed quickly around him.
Snow fell.
The air outside didn’t care what happened inside.
Days. Weeks. The taste of winter, then spring.
And then he saw Elias.
The doctor moved like he had somewhere sacred to be.
He followed.
Through halls that didn’t exist.
To a door that wasn’t supposed to be there.
Then stairs.
Then earth.
The tunnel was ancient. Built before the institution. Before maps. Before names.
The floor was covered in cracked tile and blood.
The walls were carved by fingers that wanted out.
And then—
The chamber opened before him.
Darkness.
Spiraling.
Breathing.
Calling.
He heard it say, come home.
And he felt himself slip.
Part of him fell into the abyss.
And it held him.
A thousand unseen hands gripped what was left. Not his body. His story. His sound.
Upstairs, his body took a final breath. Sagged like meat cooling.
He was gone.
But not free.
Never free.
The chamber pulsed. The darkness spun, bent light into lies.
And something moved.
The creature.
It didn’t emerge. It unfolded.
Like ink spreading in water. Like a cathedral blooming upside down.
Its skin was wet with the memory of screams. Black that shimmered purple and green in light that wasn’t there.
Tendrils swam around its torso—slow, searching, trying to remember how to touch.
Hands that were too large. Fingers that were too many.
And the eyes.
Not arranged like ours.
Not blinking at the same time.
They looked through things.
Through him.
And then—
The voice.
Not spoken. Felt.
A language built from absence.
It filled him with truths that erased others.
He forgot what his daughter’s laugh sounded like.
He forgot her name.
He forgot he had ever been held.
He forgot he was ever loved.
Only one memory clung stubborn:
Her hair in the wind. Summer grass. Her turning to wave.
And then—nothing.
Elias knelt.
Held out the bag.
Wristbands. Bones. Trinkets. Bits of soul.
Offerings.
The creature took them.
Then—
Offered something back.
Something wrapped in shadow.
Maybe a name. Maybe a gift.
Maybe just permission to go deeper.
Elias grinned.
His voice, smoother than before:
"We will have more for you soon."
And then—
Silence.
Not the absence of sound.
The devouring of it.
Darkness stretched in all directions.
And the machine was fed.
Again.
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