Alright. So this this is a story I've been wanting to tackle for quite a while, but always chickened out when I started it. Finally, my friends convinced me to go for it, and I'm having one of them beta for me because I want this to be completed with the utmost quality I can manage, due to its intense nature and deep exploration of the fma universe. This is going to cover everything from human transmutation to state certification.

As an author, I am not typically known for disturbing imagery, but this story will contain a fair share. As such, I want to be clear right here that there will be more mature content in this story than my readers are accustomed to. Of course, none of this is to scare you away; fma is just a darker franchise than my other fandoms.

So anyway, some warnings for this chapter (and story as a whole) include descriptive gore and medical procedures, and some language.

Oh yeah, and this would be a deadly drinking game for the word "blood" XD

With that out of the way, I sincerely hope you enjoy this story, as it's my most ambitious endeavor yet! Let's get started :D

(Update 8/26/22: edited chapter to improve flow and cohesion)

Ch 1: At the Brink

When Winry comes home alone from the market, Pinako thinks nothing of it.

The eleven year old sets the paper grocery bags on the table, including the two the Elrics shoved into her hands. "Ed and Al said they'd be here for dinner, but they had something they had to do at their house first. And Ed said they'll have a surprise for us when they get here," Winry says matter of factly, pulling vegetables out of the bags.

"Did he now?" Pinako says. "If it's another weird transmutation, I'm going to throw it in the fire." She chuckles; the Elrics have made a name for themselves giving her… unique alchemy-made gifts. Pinako moves to join Winry with the groceries. "I'm making the boys' favorite stew tonight. Care to help when it's time?"

"Of course." After half an hour of playing fetch with Den, Pinako calls Winry back inside to start dinner.

The grandmother and granddaughter work on the stew, and in an hour, it's ready. Pinako has poured as much milk as possible into the pot; it's the only way she can get Edward to consume it, and the best part is, he has no idea how much she uses. If he knew… he'd never eat another spoonful. Pinako finds herself chuckling again as she fills Winry's bowl.

"Shouldn't we wait for Ed and Al?" Winry asks when Pinako serves her.

"Those boys will be along. Eat up while it's hot, child."

Winry can't argue with this. She devours her stew, and halfway through, Pinako joins her. They finish up and wash their dishes, with still no sign of the Elrics.

"Where do you think they are?" Winry asks, brows furrowing in concern.

"You know Ed and Al. They probably got caught up reading again and didn't even see the sun set."

Winry hums noncommittally, not quite convinced but unwilling to contradict her grandmother. She goes upstairs to get her book, and when she comes back downstairs, Granny is sitting in her favorite rocker, a book in one hand and pipe in the other, Den curled up at her feet.

Suddenly, the dog bolts upright, whimpering.

"Whatsa matter, Den?" Pinako pokes the dog with her foot. But Den continues whimpering, sounding more and more mournful with each breath. "Take her outside, Winry."

Winry does, confused as to what could have spooked her so bad. Den never whimpers like that… but as Winry looks in the direction of her friends' home, she shudders. It looks like it's about to rain, electricity almost palpable in the air. A shudder runs through her body, and Den yelps as if in pain. Winry can't explain why... but for no particular reason... it feels like something terrible is happening at this very moment. She shuts the door, leaving Den still whining outside.

She puts on her pajamas and brushes her teeth, then comes back to the main level to get a glass of water. "I'm going to go to bed, Grandma. Tell those stupid Elric brothers not to be so late next time."

Winry goes into the kitchen and turns on the tap, grabbing a glass from the cabinet.

Bang! Bang! Bang!

Winry startles, the glass crashing to the floor and scattering shards at her feet. Who would be banging at the door this time of night?

"Granny! Granny! Help!"

It's Al. Hysterical, yes, but definitely Al.

Pinako answers it, and Winry hears the thump of the book she was reading hit the floor, followed by a gasp. Winry rushes into the main room, seeing her grandmother staring wide-eyed at the door. The girl turns to look for herself…

...and a scream catches in her throat.

There's a massive suit of armor on the front stoop, but that's not what's scariest. It's what it's holding: clutched in the armor's grasp is Edward, devoid of color and soaked in blood.

"Please. Help him. He's gonna bleed to death."

It's Al's voice again. But where is he? His words sound echoey, almost like he's inside the armor. But that's impossible; Al is ten years old, and far too small to be in there.

"Please!"

"Al…?" Winry asks quietly. The armor reacts violently to her mentioning of the name, sputtering and whining. It's definitely him… but how?

Breaking out of her shock, Pinako rushes forward, ushering Al inside. The armor shoves its way in, nearly breaking the doorframe in its panic, and the Rockbells finally get a glimpse at the source of all the blood. Ed's right arm and left leg are gone. Not there. Missing.

Pinako curses, ordering Al (the armor really is Alphonse, isn't it?) to put Ed on the table. It's nowhere near ideal, but if they don't do something this second, he's going to bleed out.

...If he's not already dead.

Pinako pushes that thought away.

"Winry! Go get Surgical ready!" Pinako barks. Winry stands frozen, eyes locked on the blood running across the table and dripping off the edge. How is there so much? "Now, girl! Run!" Tears streaming down her cheeks, the eleven year old runs toward the medical side of their house.

Pinako tears Ed's shirt off, tossing the blood soaked garment on the floor. There's so much… severed arteries, no doubt. She grabs the nearest clean item of clothing, which happens to be her apron, and ties it as a makeshift tourniquet around Ed's chest. She then takes one of her kitchen towels and ties that onto his leg. That should keep until they can finish setting up.

"Alphonse, pick up your brother and follow me!"

The suit of armor does as told, clumsily scooping the older boy into its arms as they run to the nearest surgical suite. Pinako tells Al to put Ed on the bed inside, while Winry is rushing around, powering on monitors and placing tools within reach while tears stream down her cheeks. The moment Ed is out of his grasp, Al begins screaming inconsolably, begging them to save his brother, his words growing more and more hysterical with each passing second. Winry tries to calm him down, saying they're going to help, they won't let Ed die, but her voice is just as hysterical as Al's and isn't helping. In the chaos, Winry rams into the armor, sending it toppling backwards. Its head flies off, revealing nothing- for God's sake, nothing!- inside. Winry screams, and Al screams, and Pinako looks at them and nearly keels over right there. She forces down her terror with Alphonse's apparent absence and orders him out of the room, all while he's sobbing with no body in sight.

What is happening?

"Winry!" Pinako forces herself to focus back on Edward. "I need your help, girl!" Pinako puts her fingers to Ed's neck, feeling for a pulse. It's there, and she's honestly surprised. "We've gotta stop the bleeding. He's alive, but I don't know how much more his body can take." Winry, still sobbing, nods and starts putting together an IV. Pinako unties her makeshift tourniquet on Ed's shoulder, seeing a basic gauze bandage underneath, entirely soaked through with blood. She grits her teeth and removes it.

His shoulder is an absolute mess. She can see each muscle, tendon, and nerve around his shoulder socket. Severed vessels are still trying to pump blood to an arm that's no longer there, and she can see the muscle twitching as his nerves try to communicate. The bones that make up his shoulder- scapula, acromion, clavicle- are all perfectly in place, as if his humerus was simply ripped out and everything else left untouched. She's never seen anything like it.

She takes a bottle of distilled water, flushing out any dirt and particles she sees in the wound. Then, she flushes it with a water-antiseptic mix. There's undoubtedly things she's missing, but she doesn't have any time to worry about that right now. The fluid is making the blood flow worse, washing away any clots that had a chance to form. They need to stop it, before he runs out entirely.

She yells for Winry to fetch their blood clotting powder. Once she has it, she dumps it over the wound. There's so much blood, soaking into the mattress and in his clothes and hair, and who knows how much he lost on the trip over. The Rockbells have never had to do transfusion before, and although Pinako has the equipment for emergencies, she doesn't want her first time completing the procedure to be in such a dire situation. She prays he can make it without one, but keeps the possibility in the back of her mind.

Pinako moves to Ed's leg, finding another gauze wrap soaked through. His leg looks much the same as his shoulder; femur, muscle, nerves, all perfectly aligned until they simply cease to exist. The edge is almost jagged, as if something hacked away at it like a butcher carving meat until it got what it wanted. How did this happen? Pinako cleans out and dumps more powder over this wound too.

While the powder does its job, Pinako checks on Winry's progress. She has Ed hooked up to two IVs, one with fluids and the other with drugs, and is working on taking his temperature.

"What's the read?"

"95.8," Winry answers.

That's not good; he's not getting enough oxygen through his blood to stay warm. Pinako looks at his face, his lips and eyelids faintly blue; it wasn't like that when they first laid him down, and that's not a good sign. "Get him on some oxygen." Winry starts work on this, and Pinako goes back to his shoulder. The powder has stopped most of the bleeding, and there doesn't appear to be any other contaminants inside. Luckily, it also looks like there's enough skin to get it closed, unlike on his leg. She ties off his nerves and blood vessels, then begins the process of suturing. "Okay, Winry, I'm going to put a few guide stitches in, and I need you to take care of his shoulder." Winry makes a small sound. "You can do it, girl. You've helped me with plenty of patients."

"But- but… Ed…" Winry whimpers. Edward isn't just some patient. He's her friend, and she can't imagine working on him. "I- I can't…"

"I know it's Ed, Winry, and believe me, I don't like it either. But you want to help him, don't you?" Winry nods. "Then come over here and stitch him up."

After taking a few gulping breaths, Winry changes her gloves and starts working on Ed's shoulder, and that's when Pinako knows the girl is going to be a master engineer and surgeon someday. If she can push through her emotions and operate on one of her best friends, she can do anything.

Pinako moves to Ed's leg. This is going to be harder; there's nothing she can use to close this wound without getting it from somewhere else, not to mention the fact that the way the bone is severed has very likely been letting blood mix with marrow. She doesn't even want to consider the kind of effects that might have in the future, so she decides to focus on the present. She's going to have to take a graft from his right leg if there's any hope of getting the wound closed.

About halfway into their operation, Edward goes completely into shock. Pinako notices the first signs of seizure, and tells Winry to stop her work so they can focus on keeping him safe.

"What's wrong with him?" Winry asks, sounding faint.

"Mild seizure. Help me keep his head still," Pinako replies, and Winry pales further. She knows all about shock induced seizure, but has never seen one before. It only lasts for twenty seconds, but feels like an eternity, and when it's over, Winry sees something that makes her blood freeze.

"Grandma! Grandma, he's not breathing-" she chokes out, hands shaking so badly she has to hold onto her apron.

Pinako's heart sinks, her body going numb. "How close are you to finishing his shoulder?"

"Just over half."

"Okay. You're going to have to intubate him. I have too much open wound over here to stop."

Winry nods, and with trembling hands, she pushes their smallest tubing down Ed's throat and connects it to the oxygen machine. She flips a few switches, changing the setting from simple air flow to induced breathing. She checks his pulse, terrified there won't be anything. There is, and her eyes flutter shut, knees nearly giving out as she feels the weak beat beneath her fingers. She's never seen anyone look so dead and still be alive; he's completely drained of all color, unmoving, and cool to the touch. If she couldn't feel his pulse with her own fingers, she wouldn't believe he was still there. As much as it terrifies her, she knows if he'd gotten here even a minute later, he would be dead. And even as it is, she knows the ventilator is the only thing keeping him alive right now; he wouldn't be breathing without it.

Pinako is horrified as well. She gives herself a moment to watch Ed's chest rise and fall with the machine, before forcing herself to focus back on her operation. "Let's finish this fast, Winry, I don't know how much more stress he can take." Somehow Pinako keeps her voice steady, even though she's entirely terrified at the thought of losing Ed. She swallows her fear; even if he doesn't make it, she can't let it be because she didn't try her damndest to save him.

Pinako works quickly to get his leg finished, and then goes and gets the supplies for blood transfusion, just in case. Luckily, the only donor bags her practice receives are O-, which can be given to anyone. She checks his blood pressure, a sinking feeling in her stomach. He's just lost too much blood; she'll have to go through with it if he has any chance of making it through the night. She feeds another needle into his arm, setting up a steady flow of donor blood while Winry finishes up cleaning his wounds.

Two hours after the Elrics' arrival, the Rockbells finish their operations.

Finally able to breathe again, Pinako checks the IVs, pleased with what Winry put in. Painkillers, sedatives, fluids… even in her panic she knew just what to do. She checks his breathing tube, retakes his temperature, and thoroughly examines him for any other injuries. She's dumbfounded; apart from the missing limbs, there's not a scratch on him. How could he have two limbs torn off and be entirely uninjured anywhere else? How did this happen?

"Grandma?"

Pinako looks over at Winry. Adrenaline settled, the girl looks much too young to have done what she just did. She bunches up fistfuls of her surgical apron, splattered with far too much blood, eyes locked onto her cold, still friend.

"Is Ed going to die?"

Pinako doesn't know how to answer that. There's a very real possibility he won't make it through the night if he doesn't stabilize soon. But instead, she chooses to give Winry the child's answer. "Of course not." She knows Winry is too smart to accept that at face value; the eleven year old knows more about the practice of medicine than most adults. But even so, Pinako sees a small flicker of relief in the girl's eyes.

"Yeah. He… he can't die." She shifts uncomfortably. "What about Al?"

Pinako almost forgot about that behemoth armor. She doesn't want to leave Ed, but she really should go find the other Elric brother and make sure he's okay. "I'm not sure, Winry. Stay here, and yell if anything changes with Ed."

Pinako sheds her bloodstained apron, leaving Surgical and going back into the main house. She walks upstairs, seeing the door to the room the boys share is closed. She knocks softly. "Alphonse, I'm coming in."

The suit of armor is sitting on the floor by Edward's bed, facing a small toy on the pillow. Pinako recognizes it from when the boys were just learning alchemy, and Al made a terrifying stuffed animal, a cross between half sheep and half rack of lamb chops. The Elrics soon turned that malformed toy into a tradition, trying to out-prank each other with alchemy, and the infamous mutant sheep became the symbol of their progress.

"Alphonse?" Pinako approaches carefully. She's not exactly sure what to make of the boy, and that includes what he's capable of. She's still not entirely sure it's even Alphonse, and that thought scares her.

"I put the sheep on his pillow this morning," Al's voice says, and it slightly relieves her; only Al would know about that tradition.

"Al…"

"I'm so sorry, Granny."

Pinako takes a deep breath, the question feeling heavy on her tongue, but entirely necessary. "What did you two do?"

Al whimpers, turning the armor's helmet away.

"Alphonse. What happened that put the two of you in such states?"

"We… we didn't mean it," Al whispers. His words sound like he's crying, but Pinako isn't sure how. "We just… we just wanted to see Mom again."

Pinako's gut freezes. "Al…" she begins, tone deadly serious. "Did you try to bring your mother back to life?"

Al's crying noise continues.

"Alphonse Elric, did you try to resurrect Trisha?"

"Y-yes."

Pinako's hands curl into fists. She knows next to nothing about alchemy, but everyone, no matter how inept in the field, knows what human transmutation is. It's forbidden amongst alchemists, because the nature of messing with human life is considered evil, even to them. And now, her own adoptive grandsons have attempted it.

"What happened?" Pinako demands.

"We… we've been planning it for years. And we thought… We thought today would be the day. But it went wrong. It went so wrong, Granny…"

"What happened to you, Alphonse?"

"I don't know exactly… we touched the circle, but it just felt wrong and then everything started flashing and these little hands came out and grabbed us. I tried to get to Brother but it was like I was being torn apart. Then I woke up in this armor. I… I don't know where my body went…"

"So you're really empty then…" The words sound unbelievable coming out of Pinako's mouth. She looks the younger Elric over, brain not willing to comprehend what her eyes are seeing.

"When I woke up, Brother was on the floor, and he was bleeding really bad. I didn't know what to do, so I found some bandages and came here."

"Your brother is missing an arm and a leg, Alphonse."

"I- I know…" The crying noise starts again. "Is he gonna die? Please, tell me he's not gonna die…"

"He made it through the worst of it," she replies, even though she honestly doesn't know. But she doesn't think any of them could handle thinking about the alternative right now.

"I don't know what to do, Granny."

"I don't know either, Al. You two really messed up, didn't you? But…" Pinako hesitates a moment before putting a hand on the cold metal armor. It sends a chill down her spine, and she fights the urge to pull away. "I'm glad you're alive."

"Am I alive? I can't even tell anymore…" Al says meekly. He shifts, holding his hands out, and even though she can't be sure, Pinako is pretty certain he's looking at them. "I can't feel or smell or taste anything. I can just hear and see, and it's so late but I'm not even tired or hungry at all. I'm… I'm really scared."

"Yes, Al, I'm positive you're alive. I'm talking to you, ain't I?"

"I'm just so confused…"

"We'll figure it out together, don't you worry." Despite him saying he can't feel, Pinako rubs her hand up and down his arm. "I need to go now, Al, and check on your brother. Will you be okay?" The armor nods after a moment. "Okay."

Pinako shuts the door behind her, making her way back to Surgical, where Winry is watching over a half-dead eleven year old.

"I think he's stabilizing," she says, wrapping her arms around herself. "His temperature is up, and blood pressure is improving. But I tested his breathing and it's still really erratic, so I kept the ventilator on."

"Okay. Well keep him intubated overnight just to be safe, and then we'll get a nasogastric line in. I don't want to risk it tonight," Pinako replies, gently rubbing Winry's back. She's more proud of the girl than she'll ever know.

Winry says nothing else; she's emotionally and physically exhausted. She stands, wavering for a moment as dull blue eyes look over her mutilated friend, eyes lingering on the pair of bloodstained bandages.

"I'm going to stay and watch him until I'm sure he's stable. Alphonse is upstairs in his room. Go on to sleep, Winry."

Winry doesn't want to leave, but she's just too tired. She hugs her grandmother, then heads out the door with dragging feet.

Pinako looks back at Edward, at all the tubes and bandages and machines. He doesn't even look like himself; missing limbs aside, there's just something too alien about the situation that she can barely bring herself to believe the boy in the bed is the same one she sent off to the market this afternoon. It still doesn't feel real, but it is, and she has to do everything she can to help him. She watches the artificial rise and fall of his chest, and to the tune of machinery, drifts off to sleep.

And there's our start! I suppose I should mention that this story is BH/manga compliant but does take bits and pieces from 2003 as well.

I hope you all enjoyed the first chapter, and will join me for the next one!

~PrinRue