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As Keiichi lies inside his house on his futon, he quickly jerks upright when he realizes that if he never killed Teppei, then that means Satoko still lives under his abuse. His resolve setting back in, Keiichi picks up the axe inside a storage room by his house—Satoshi’s bat was found to be missing earlier. Keiichi begins to move toward his bike when he stops. However, after stopping, he hears an extra footstep following him just as Rena had described Satoshi’s condition days ago. Believing it to be Satoshi, Keiichi checks behind him to see nothing but the wall of his house. He shakes off the ominous feeling, and as he points the axe at the fading sun (as grey clouds gradually cover it up) he says “Do what you want! I don't care anymore!”
He comes to a stop behind the cover of a tree nearby the house of Hōjō Teppei. Keiichi notes that the motorcycle the uncle owned is gone, because—just like the baseball bat—Keiichi had left the bike in the Onigafuchi Swamp the night he thought he became a murderer. Finding the door left unlocked, Keiichi steps inside past shoes of Satoko and Teppei, the now bandaged-up weapon in his right hand. However, when he peers into one of the rooms, he finds the television left on, bottles and trash strewn across the floor, as well as last night’s dinner (he judges from the date on the container, which is June 20, 1983). He is discouraged when he finds two portions inside the dinner indicating that Teppei is indeed alive.
Keiichi looks about for Satoko when he hears the water in the bath running, which is odd for it is early in the morning according to Keiichi. Seeing the vast amount of steam, he understands that the bath had been left on since last night—with Satoko inside. He finds her through all the steam, and she is barely conscious naked, but counting “Five thousand…thirty…seven…Five thousand…thirty…eight…” Keiichi gasps when he sees her, and quickly pulls her out and tells her to be okay. Satoko waked up and saying, "Keiichi... Is that...you? Keiichi then helps her out with a wet towel and says “You're gonna be alright. Because I'm here to save you. Your Nii-Nii won't let anything else happen to you. I promise.” She continues to count, to which he inquires how high she intends to count to. Satoko replies that she is counting to ten thousand, and Keiichi asks her why she would do such a thing. She answers: “My uncle forced me to”. It is at this moment that Keiichi starts screaming and becomes out of control. He goes on a rampage through the house with his axe, opening, kicking, or tearing down walls to find Satoko's uncle and make him pay for what he has done to her. Every door is open and there is no sign of Teppei. "Where-where the hell did he go?!" Keiichi thought.
The scene changes to the Irie Medical Clinic, as a calmer Keiichi approaches the building carrying a weakened (but conscious) Satoko on his back from the forest. They see police cars out near the front entrance, and Keiichi sets Satoko on the grass while he goes to see what is happening. She weakly complains about him leaving her with only her bath towel on, to which he answers “If you're stong enough to be sarcastic, you'll be fine.” A policeman named Komiyama is shown questioning a doctor (but not Irie). The doctor replies to his questions by describing the death of a person who appeared to be suffering from an acute overdose of sleeping pills. Komiyama responds into his radio by calling it suicide, and the doctor reveals that is indeed Irie that has died. The detective leaves as Keiichi overhears something about a “Search for Detective Ōishi”.
Satoko pulls up beside Keiichi, and asks what is going on. He tells her what he has heard, and she believes it to be a lie. He expresses regret over the situation, and she inquires as to why he would apologize. Keiichi tells her about when he cursed Irie by telling him to die. Keiichi believes when he curses someone, they die. Satoko wipes her eyes and tells Keiichi it isn’t his fault. Satoko says she will go to Rika’s house to get some clothes.
Carrying her up the steps of to the Furude Shrine, Keiichi discusses the topic of Takano’s death, Irie’s suicide, and Ōishi’s disappearance with Satoko. He tells her how he cursed them all, and they all have had terrible misfortunes befall them. When he begins to talk about Satoko’s uncle, she requests he stop. However, he tells her that he killed her uncle. He explains, “Satoko, on the night of the Cotton Drifting festival...I saw your uncle and I killed him. So that's why, I don't understand why he keeps coming around, he should be dead. It doesn't make sense.” Satoko tells Keiichi to let her down, and he does. Answering him about his acts of cursing, she calls them all coincidences, and asks him to go home and rest.
As Satoko leaves to Rika’s house to get her cloths on, Keiichi spots a gathering of crows near the offering box of the shrine. Reaching the top of the steps, he views a ghastly scene: Rika's body has been ripped of its clothes and its flesh, covered with crows and blood. Keiichi is beyond confusion, as he never wished for this. He also says that "This didn't happen" and "It can't be real." The scene ends with Keiichi screaming with his hands in the air (the image of Keiichi screaming is actually quite notable).
He scatters the birds with his axe, and eventually swings so crazily that the hatchet leaves a cut in the side of the donation box and slides away from the scene in the pool of blood that has formed from Rika’s body. Keiichi picks the bloodied handle back up, and disperses the rest of the birds. He freezes in his shock staring at the corpse, when suddenly he turns to find Satoko staring at him—alone, in front of Rika’s gory corpse, with a blood-stained axe in hand. She screams, and Keiichi tries to explain he isn’t responsible for her death. Satoko calls him a murderer, and takes off into the forest. Keiichi follows her (with the axe, probably not realizing he is still holding it) and yells after her that he could never kill Rika. She says how could he ever hope to be her Nii-nii, and describes how at one point she was lonely until Keiichi transferred and the days became bright. She continues to ramble as she sways back in forth in the suddenness of the events that have occurred. Keiichi continues to follow her, denying it.
This continues until they reach a bridge. Satoko trips, and Keiichi catches up to her. She angrily stares back at him and calls him murderer again. He replies that he doesn’t know what is happening either, and that he knows for sure he did not kill Rika. She asks him why he has the axe, and he quickly tosses it over the bridge into the water below. Believing she could still be killed by him with his bare hands, Satoko doesn’t trust him. Keiichi asks what he should do, and she responds, “Put your hands over your head and turn around.” She continues: “Regardless of what's happen... I still believe you're not a bad person (she begins to step towards him). I think the most likely answer is something bad has decided to possess you.”
Satoko recounts one time when she climbed atop one of the shrine buildings while playing a game of hide-and-seek with Rika and some other kids, years ago. When she climbed to the roof, she fell inside the storehouse (that Takano, Keiichi, and Shion had snuck into in Watanagashi-hen) and discovered the statue, tools, and other items that assembled to make Hinamizawa’s “Oyashiro”. Satoko tries to get out of the storehouse, but as she gets out she ends up breaking the arm of the deity’s statue. The flashback changes to Rika being led by her father away from the building as she cries "It wasn't me!" Rika ends up receiving lashes with a switch as punishment, while a regretful and guilty Satoko watches from afar.
Back in the present, she claims that ever since that incident, “And it was after that... when the world I knew... suddenly became very strange to me.” She calls this present situation she and Keiichi have led themselves to Oyashiro’s curse. She bases this theory on her desecration of the statue and abandoning Rika to the punishment she deserved. Satoko calls these the reasons why her parents died, why her aunt died, and why Satoshi ran away. She goes on to blame the curse for Keiichi being “possessed” and for Rika’s death, crying as she speaks. Keiichi denies it, and says it isn’t about the curse. He begins to turn towards her, but, like in the classroom before, she pushes her hands forward and Keiichi flies into the air, hanging by one of the ropes supporting the bridge. Satoko yells at him to “Die, murderer! I want him back! I want my Nii-Nii! I want him back, Keiichi!”
She begins to shake the bridge back and forth, and Keiichi gradually starts to lose his grip on the rope. She claims she won’t “give in” to whatever is “possessing” Keiichi, which she believes to be the curse. Keiichi pleads her to trust him, as he claims his only wish is for her to be happy. Satoko (most likely in a LV4 or LV5 state of Hinamizawa syndrome) curses the evil spirit for pretending to be Keiichi until the end. As her screams come, as his tears fall, he loses his grip and falls down into the water. His voice narrates his death: “That was it. The last thing she ever said to was "Fall!' Such a sad and pathetic ending. What happend to those beautiful, warm, Hinamizawa days? Where did they all go? Or more accurately, where did they go wrong? As I fell, I wished for one last thing: and that wish made very well for death. Death to everything in Hinamizawa. Everything that had gone wrong.”
The last scene is in a diner of some sort in a city, with a news report coming on a television in a corner of the ceiling. The reporter calls it a disaster that took place during June 21 and June 22. “…It seems that a poisonous volcanic gas has erupted from somewhere in the Hinamizawa district.” He says every household has been destroyed in the ensuing catastrophe. He confirms the death toll as topping a thousand, and a truck is shown piled with body bags. The reporter receives a note, and he announces that there is one survivor of the Great Hinamizawa Disaster who has just been admitted to the hospital-- was named Maebara Keiichi. The television suddenly shuts off, and the people watching the diner wondered why it chose to break all of the sudden.