20: SCARLET

In a flashback seven years before the main events, thirteen-year-old apprentice surgeon-in-training, and his father's son, is called upon to save a five-year-old girl named, who has suffered a severe head and leg injury from a fall. Though he successfully stops the bleeding through emergency cauterization and tourniquet work, he discovers she is already dead—her head wound was ultimately fatal. This marks the beginning of his internal conflict about the path of medicine.

The chapter opens with a young, thirteen-year-old having recently lost his mentor and citylord, responding to a crowd gathering around an injured child. A girl named has fallen and is bleeding severely from a compound fracture in her leg. Though her father pulls away from in panic, the surrounding men hold him back, knowing the boy is her best hope for survival. Using quick thinking and his training, manages a field tourniquet and performs emergency cauterization of the severed artery using a heated knife, successfully stopping the flow of blood. However, upon completing his work, he realizes that the child's head wound had never been bleeding because she was already dead. Her chest is motionless. The crowd falls silent as her father, collapses in grief. An hour later, sits on the surgery steps in tears, wrapped in sorrow and self-recrimination despite his successful technical work. His father, , arrives and inspects his work, praising his son's composure and technique under pressure. insists that the child lost blood too quickly and that nothing more could have been done. He attempts to comfort by suggesting that a healer must learn when to care and when to let go, warning that grows calluses over time. rejects this sentiment, unwilling to accept such emotional distance as the price of medicine.