Soon after Ed and Al's mother recovers from her near-fatal illness, Winre and Ed become a couple. Their relationship changes the course of Ed's life. Ed decides to become a medical doctor, inspired by his mother's illness and Winre's encouragement and mechanical excellence. Ed studies alchemy as a hobby on the side sometimes with Al, though not practicing it. He mostly studies it as a way to spend time with Al and encourage him. Winre and Ed's mother find it to be a waste of time but tolerate it, as Ed still manages to become the youngest student ever to be accepted into medical school. Ed lives in a dorm near where Al still lives with his mother.
Ed has been treating a homeless child named Len from time to time. Len sometimes stays with Ed's mother but is unappreciative and complains about whatever type of facilities or food they offer. Len often remarks that Al's choice of alchemy is a better path, and that Ed has wasted potential. When Ed has to remove Len's left leg to save him from a deadly infection, Len becomes bitter, and later begins studying alchemy.
One day Al finds Len practicing an alchemy ritual in a guest house on Al's mother's property. Al warns him that it isn't safe. Len says, "I want to get my leg back!" Ed is visiting, and hears the ruckus and runs in as Len is already staring at a swirling portal. Len has offered minerals, metals, and salt, but Truth says it isn't enough. Len pleads, "Take thirty years off my life-I just want my leg!"
Truth counters with, "I'll come back in thirty minutes, and take his leg," pointing at Al. Have it ready, or I'll have to take it by force."
Al is unconscious. Ed asks, "What...what is going to happen?"
Len stammers.
Ed grabs Len's shoulders, and asks, "What did you see?!"
Len explains what the vision told him.
Ed runs out of the building, leaving Len in a silent daze. Ed comes back with Winre and whatever tools were available: huge pruning shears, towels, sheets, rope, and a knife. He glares at Len and says nothing. He removes Al's leg with Winre's help, placing the soft tissue and bones in a metal box, as Len just watches in shock. The portal reappears, and the portal absorbs the remains of Al's leg as a new leg begins to form where Len's was missing.
Ed bandages Al's leg and carries him to his mother, partly wrapped in a blanket so the leg isn't visible. His mother looks panicked and asks, "What happened to Alphonse, and what were those flashing lights and sounds?"
Ed says, "I had to remove Al's leg to save him from Death."
"I don't understand...Al was sick?"
"No, from the being, Death. Or 'Truth' or whatever."
"That's not part of your profession, Ed. What do you mean?"
Ed shouts, "I can't explain it any other way! We're going away for a while."
On his way home with Winre, Ed discovers that Len is also walking away. Ed just glares at him, and Len continues walking away in silence. Len never comes back to Ed's mother's house to complain about the food, the bed, the shower, or anything else. Ed doesn't speak to his mother very often after that. Ed decides to end his medical studies and delve into alchemy.
Ed and Al continue their lives as alchemists, except with different motivations. They want to discover the meaning of their experience, and the identity of their father. They have a little more to go on regarding their father since their mother is still alive, but she doesn't like to talk about it and won't say much. She is also colder toward Ed after the event with Alphonse, though Ed believes her attitude is unfair. Though Ed is also practicing alchemy now, Alphonse is more skilled, having had a head start. In his obsession, he eventually creates an automail lower leg. Al's achievement and experience in the human transmutation event help him become the youngest state alchemist at age 15.