Helena helps conceal Lila Bayard’s pregnancy by fabricating a case of bog cough, a familiar seasonal illness feared for its potential to spread in the city’s lower levels. Using vivimancy, Helena creates convincing rashes and a violent cough, leading Matron Pace to diagnose Lila and place her in isolation in the Alchemy Tower. The cover story protects Lila while also keeping Luc, whose lungs remain damaged, away from her despite his distress.

Seeking knowledge about pregnancy, Helena searches medical texts in Pace’s records office and is caught. Pace first assumes Helena may be pregnant, prompting Helena to reveal that Maier sterilised her by ligature as one of the Falcon’s conditions for becoming a healer. Pace is shaken and challenges Helena’s insistence that the choice was acceptable, forcing Helena to confront how thoroughly she has trained herself to live only for usefulness and survival.

Pace then reveals that she already knows Lila is pregnant, because Helena’s false symptoms did not match the true progression of bog cough. Rather than expose the secret, Pace gives Helena a medical text on gestation and tells her that Lila will need the best care Helena can provide. The exchange turns Pace from a potential threat into an uneasy ally in hiding and managing Lila’s pregnancy.

As Luc increasingly assumes leadership, Ilva’s health rapidly fails, though Helena finds no specific illness beyond age and exhaustion. The war continues without decisive advantage until Luc leads another attack on the West Island and captures a warehouse. Inside, the Resistance finds tanks filled with dead Resistance prisoners whose bodies are still warm; a gas had been released into their masks moments before rescue, killing them all.

Among the few captives is a female Warden, Elsbeth Mandl, who refuses to answer questions. Because Mandl is Luc’s prisoner, Crowther cannot secretly torture her, so he brings Helena to use the information-extraction method Kaine taught her. Mandl recognises Crowther from an orphanage and mocks Helena as another specially useful woman, suggesting both women were shaped and exploited by violent systems.

Helena uses vivimancy to manipulate Mandl’s nerves, hormones, and memories, forcing information from her despite Mandl’s resistance. Helena learns the prisoners in the tanks are kept alive and physically maintained as “fresh” bodies for the Undying, test subjects, and longer-lasting thralls, with documents linking requests to Artemon Bennet. The process horrifies Helena, and although Crowther is satisfied, Helena leaves shaken and regretful while Mandl calls her a traitor.