The tenth floor was alive with screaming.
Not human screams—though those would have been easier. These were reality itself tearing, the sound of wrong, the noise that plays when the universe's code breaks. Elara covered her ears, but the screaming came from inside her skull.
"Welcome to the floor of other people," the Echo said, appearing beside her. "Every person you've ever hurt. Every consequence you've tried to ignore. They've been waiting."
The floor was an endless hospital corridor lined with doors. Each door had a name plaque. Elara recognized every single one.
PATIENT 4722 - MARCUS WILHELM
PATIENT 4819 - JENNIFER TATE
PATIENT 4823 - DAVID SUMMERS
The ones she'd "eased" with extra morphine.
The screaming intensified. The doors rattled.
"They're not dead," the Echo said. "Not here. Here, they remember what you stole. The extra days, weeks, months they might have had. The goodbyes they never got to say. The choice you took from them."
"I was trying to help—"
"No. You were trying to play god. There's a difference."
One door burst open. A man stumbled out—Marcus Wilhelm, the first one. Radiation burns covering his body, but his eyes clear, aware, accusing.
"I wanted to see the sun one more time," he said. "Just once. I asked the nurses. They said maybe tomorrow. But you didn't give me tomorrow, did you, Dr. Kane?"
Elara backed away. "You were suffering. You asked me to end it—"
"I asked for more pain medication. Not death. There's a difference, and you knew it. But it was easier for you. Easier to write off the dying than to sit with their suffering."
More doors opened. Jennifer Tate, who'd wanted to write letters to her son. David Summers, who'd been waiting for his daughter to arrive from Boston. Others, each with their stolen tomorrows, their abbreviated dreams.
"I thought I was being merciful," Elara whispered.
"Mercy requires permission," Jennifer said. "You gave us murder and called it mercy because it eased your conscience."
The Echo moved between them. "The tenth floor's lesson: your intentions don't absolve you. Every road to hell, paved with good intentions. You know this. You've said it to patients. But you never applied it to yourself."
New doors appeared, these with different names: THOMAS KANE. COLLEAGUE #1: DR. PATRICIA REEVES. COLLEAGUE #2: DR. JAMES MORRISON.
"No," Elara said. "They're alive. They're not—"
"Not dead. Just damaged by you. The tenth floor doesn't discriminate between types of harm."
Thomas emerged from his door, looking exactly as she remembered him on the day she'd signed the divorce papers. Tired. Hurt. Trying to be brave.
"I loved you," he said simply. "I wanted to fight for us. But you'd already left. Long before the papers, you'd checked out. And when I asked why, when I begged you to talk to me, you diagnosed me instead. Made my pain about my inadequacy rather than our relationship."
"I was trying to help you see—"
"You were using your degree as a weapon. Every conversation became therapy. Every disagreement became my pathology. You didn't want a husband, Elara. You wanted a patient you could fix and control."
Dr. Patricia Reeves stepped out next, Elara's former colleague, the one she'd undermined to get the promotion.
"You leaked my patient notes to the board," Patricia said. "Destroyed my career. And when I confronted you, you said it was for the good of the program. That I wasn't fit to lead. But it wasn't about fitness. It was about ambition. Mine or yours—you made sure it was yours."
More emerged: friends pushed away, patients misdiagnosed when Elara was too tired to care, nurses blamed for her mistakes, a sister who'd needed support during her own crisis but found Elara too busy climbing.
The corridor filled with people Elara had hurt while believing she was good.
"I never meant—" she started.
"Intention is not impact," the Echo interrupted. "You're a psychiatrist. You know this. The tenth floor is where you stop hiding behind good intentions and face the actual damage you've caused."
The screaming grew louder. The people moved closer. Not threatening—worse. Waiting. Expecting something.
"What do you want?" Elara shouted.
"Acknowledgment," Marcus said. "Just once, admit it wasn't mercy. Admit you were scared and tired and played god because it was easier than being human."
"I was scared," Elara admitted, tears streaming. "I was so scared and exhausted and I didn't know how to sit with death without controlling it."
"Admit you destroyed your marriage," Thomas said.
"I destroyed our marriage. I couldn't be vulnerable, so I made you the patient and me the doctor. I'm sorry."
One by one, she acknowledged each person, each harm, each moment where she'd chosen her comfort over their humanity.
With each admission, a door closed. A person faded.
But the screaming didn't stop.
"Why are they still screaming?" Elara asked the Echo.
"Because there's one door left," the Echo pointed to the end of the corridor. "The door you've been avoiding since the seventh floor."
The name plaque read: SARAH KANE - AGE 7
"No," Elara breathed. "She's not—I didn't hurt her—"
"Didn't you? The tenth floor shows all harm, Dr. Kane. Especially the harm we cause through absence."
The door opened.
But the chapter doesn't end there. What emerged from Sarah's door wasn't what Elara expected.
It was herself.
Seven years old, crying, holding a photograph of parents who were too busy to notice her disappearing.
"You know what you did to Sarah," young Elara said. "The same thing your parents did to you. Chose work over presence. Chose achievement over attention. And when she needed you most, you ran to the sanctuary of work, of saving others, of being anywhere but with her."
The truth hit harder than any Echo's revelation.
Elara hadn't just failed Sarah in Chicago.
She'd been failing her for seven years.
The eleventh floor stairs appeared, glowing with cold blue light.
"Can I go back?" Elara asked. "Can I fix it?"
"The eleventh floor will answer that," the Echo said. "If you're brave enough to learn what's real."