Preface
When it comes to factions in Bloodborne, the Choir might be considered the most underutilized. Compared to the School of Mensis, they certainly don’t play as up front a role in the game’s plot. That said, I would argue that their presence is felt even in their absence. Indeed, anonymity is part of the point. It wouldn’t do for the secret puppet masters to make a spectacle of themselves. Their work is something that needs the door cracked open. But I think the bigger factor is that we are seeing the Healing Church in decline; the puppet masters have no strings. The Choir, and its physical absence during all this chaos, is a symptom of a deeper problem, proof of the rot in its very foundation.

First Movement
The Orphanage in Upper Cathedral Ward was originally the stage for studies and experiments, at least according to the description of the key to its front entrance. This is an obvious tie-in to the Research Hall, though the two facilities are in different locations. The Orphanage Key is solely used to exit the main building and take a bridge to the Grand Cathedral’s rooftop garden. Since this garden can only be accessed from behind the Orphanage’s main gates, we can consider it an extension of the institution and thus overlapping with the previous experiment building — the use of the same multi-eyed creature statues reinforces that impression. Yet the Research Hall in the Hunter’s Nightmare lacks this path back to the Orphanage, suggesting that the institution is much more recent. In short, as the experiment building was being decommissioned, the orphan house was being constructed. In saying all this, the underlying point of the key’s description is plain to see: after finished experimenting on the adults, the Healing Church elected to take in their children.
Key to the gates of the Orphanage, birthplace of the “Choir”.
The Orphanage, which was under the Cathedral’s care, was once the stage for studies and experiments, and the young orphans eventually became the secret brains of the Treatment Church.
It is the birth of the “Choir”, a higher-rank faction which split the church in two.
True, countless sons and daughters had likely lost their parents in the course of the Church’s hidden research. The youngest would have ended up on the streets, creating a hunger and poverty problem for all to see. But never to let a good opportunity go to waste, the blood ministers took those orphaned kids under their care. This show of philanthropy was sure to make a good impression on Yharnam’s populace. But the clerics obviously weren’t taking such young children into their custody out of the goodness of their heart or remorse for what they had done. Rather, what better opportunity was there to ensure the Healing Church’s future? The text for the orphans’ later apparel notes that they inherit their thinking from Byrgenwerth, and there is only one source for that education in Yharnam. With the cathedral directly supervising the facility, the Orphanage would function more as an indoctrination center, brainwashing the children to carry on the experimental research done on their parents.
The church founders operating out of the cathedral were still housing themselves up there with the orphans. Whether in the Orphanage building or elsewhere, the experimenters had undoubtedly been living somewhere near the Research Hall. And as we can see, the cathedral’s bridged clocktowers have remained to this day. Not everything from the old experiment building has been demolished, with ways for the cathedral’s staff to visit the Astral Clocktower. They would live in the upper stratum with ready access to both the Orphanage and their old study facilities. This allowed a heavy hand in molding the orphans’ nubile minds, imparting everything the Byrgenwerth clergy had learned; the shrouded statues impart the subtle propagandizing in raising the children. They had undoubtedly aimed to groom the perfect assistants, and succeeded, perhaps a little too well.
Also, Church Town’s Upper Stratum is the residence of the old church leaders.
The orphans eventually became clerics themselves, dressing in white robes and blindfold caps like their tutors and calling themselves the Choir. Although the English description to the Orphanage Key claims that they are a faction which split from the Church, the Japanese text merely claims that they split it in two. The Choir are authoritative members, specifically the “secret brains” of the Healing Church. With this comes ominous implications. If they are the brains to the operations, what about the Byrgenwerth scholars who trained them? Despite Alfred’s hearsay, there are no sign of the original leaders in the Upper Ward, only the Choir; they are the “upper stratum” both figuratively and literally, as elucidated in item descriptions. This is odd since if all the old guard had died, whether in the course of their work or of natural causes, this would be public knowledge to hunters like Alfred and thus no need for the Choir to keep its contributions secret. In other words, the orphans’ position reeks of foul play.

The groundwork for the Choir was laid with the discovery of the Great Isz Chalice, the first brought out of the labyrinth since the blood ministers’ Byrgenwerth days. Being the group’s cornerstone, its retrieval was probably done at the behest of their masters, letting the young apprentices risk death or madness within the deepest depths of the ruins in their place. This is reinforced by the Loch Shield, whose description notes its provision to Isz tomb prospectors after its Research Hall use had ended. Whether acquiring the chalice was the Church’s specific objective or simply part of a broader scavenging probe, it nonetheless gave the orphans a chance to prove themselves, and prove themselves they did. The chalice shows that they reached Isz at the bottom and returned. But contact with Isz means contact with the cosmos, which the Isz Root Chalice description attests they did eventually realize.
One of the Holy Grails that breaks a seal of the underground ruins. Great Holy Grails in particular open secret parts of the ruins.
The Great Holy Grail of Isz, which became a cornerstone of the Treatment Church’s higher-rank faction, the “Choir”, was the first great Holy Grail brought above ground since the time of Byrgenwerth, and ultimately let them meet Ebrietas.
Diving into the secret labyrinth likewise seems to have rekindled interest in Ludwig’s defunct Holy Blades. The Orphanage has direct passage to the top of the church workshop, a chest with their radiant badge there to investigate as soon as inquisitive orphans walk inside. Male members of the Choir display a preference for Ludwig’s Holy Blade, and their other weapons or hunting tools are made with a similar silver-colored metal. This affirms the orphans’ interest in the church’s first hunter. In fact, why wouldn’t they look into their predecessor who emerged from Isz a hero wielding “holy” power? Surely, they could learn from his discoveries. And this combined with their own experience in the underground ruins seems to be what led them to the sudden realization detailed in the note on the workshop’s top floor: the Cosmos is in the sky.

The Cosmos is in the sky. -the “Choir”
Emblem of a member of the higher-rank faction of the Treatment Church the “Choir”. Its eye is modeled on the cosmos.
It is said that the “Choir’s” realization once came to them abruptly.
In other words, the cosmos is only just overhead of us who are on the ground, is it not?
Apparently, the old masters weren’t keen to share their knowledge about the stars — assistants didn’t need to know all the details. But this new generation found out on their own, and they doubtless weren’t happy about being kept in the dark. If nothing else, it conveys that the church elites had no plans to share transcendence with peons. And if these events are where the Choir found its identity, then the intentions of the so-called “holy song unit” (聖歌隊) are clear. A church choir typically sings to praise God or petition His aid. In context of the Healing Church, the goal is to beseech the Great Ones for guidance to their own enlightenment. And as the “star eye hunter emblem” (星の瞳の狩人証) they crafted illustrates, they knew to look up toward the night sky when they did — the Bloodborne: Design Works even lists them as the homophonous “star song unit”. (星歌隊) Organizing finally highlights the orphans’ divide with their mentors when they ostensibly share the same goal.

In short, the newly-formed Choir in all likelihood deposed the old upper echelon. While karmic, their betrayal probably wasn’t motivated by revenge for their family. All of the Choir’s actions suggest that they have taken the Healing Church’s true mission to heart. Indeed, the orphans were brainwashed to think of the inhuman experiments on their own parents as merely data. Why wouldn’t they take the same cold, clinical stance towards their teachers? The blood ministers evidently have nothing more to teach them, and like true descendants of Byrgenwerth, they too hoped to graduate from being students. If their masters wish to hoard the secrets to true enlightenment for themselves, then fair enough; so do they. But if the old guard will no longer be of any practical use, why shouldn’t the new blood assume direct control? It is only rational.
Oratorio
Once the old leadership was destroyed, the monster it created easily stepped into the vacuum. Recall that this conflict would be isolated to the Upper Ward. For the rest of the clergy down below, it would simply look like the old researchers were relaying orders through their assistants. And since the orphans alone now held the keys to their stratum, there was no chance of their coup being discovered. All they need do was perform the basic functions of their predecessors, like regulating the Church’s Pthumerian servants or special supplies — items made available for purchase with their badge include poison knives, blue elixers, sedatives, and beast blood pellets. The only wrinkle would be the need to elect a new Vicar, but if Amelia is any indication, this was hardly an issue. So long as the gold pendant continued to be passed down, anyone could fill the role. They just needed to pick someone reliant on the “old councilors” for guidance. The Vicar may be the face of the Church, but it is the Choir who have actually been calling the shots.
Key that seals the Church Town Upper Stratum.
There are two higher-rank factions in the Treatment Church, with the “Mensis School” and “Choir” based in the Hidden Town and Upper Stratum respectively.
Thus, this key draws one near the “Choir”.
We can thus blame the orphans for many of the recent happenings involving Healing Church policy, from Hemwick to Old Yharnam to the Forbidden Woods. But the Choir apparently doesn’t care about the collateral damage. Their primary focus is the advancement of their academic studies. Many coffins have been brought up to the Orphanage and set up on stands inside, implying that the dead which the Church has been collecting were being mainly transferred to the Choir instead of Hemwick. This isn’t just a pit stop either, as towers of black smoke uniquely billow from the foster home — the only reason for so much burning would be that the orphans have been taking it upon themselves to cremate the cadavers. Why go to the added trouble? Perhaps it is simply to make the beast-warding incense the Upper Ward supplies. Or perhaps it is because they don’t want anyone, even gravekeepers in the hinterlands, to see what has been done to the bodies.
The statues of many-eyed abominations shrouding their forms litter the Orphanage, conveying a simple truth: the Choir, like their masters, recognized the many failures it would take to achieve the enlightenment they sought. Their hunter badge and the items associated with it likewise demonstrate how the shadow leaders were no different from other high-ranking clerics in white; they loved examining bodies through hands-on experience in surgery. As the description for their blindfold cap illuminates, they trace their origins to Willem, but not their path forward. Their Byrgenwerth mentors instructed them on blood’s incredible potential, with the high-quality ritual blood found in the Orphanage proving they concurred. And with the added privacy of their HQ, we can only imagine how they mutilated and twisted the dead to satisfy their inquiries before shuffling the resulting horrors into a furnace. Or perhaps not, for we see the Choir’s handiwork upon the living as well.
Apparel of the “Choir”, the Treatment Church’s upper stratum.
The “Choir” are both higher-rank clergymen of the Treatment Church and academics who inherit their thinking from Byrgenwerth.
The hat’s eye covering is proof that they have a direct line from Provost Willem. Even if they have now changed paths.
As noted earlier, the Choir is behind the taboo research previously performed in the Forbidden Woods. And given that so many of the drugs used in that research aren’t normally in the possession of anyone below the upper stratum, they were probably coordinating with the village directly. It is no coincidence that the kin created there resemble Research Hall patients, except far more polished — the orphans did have all the previous trial-and-error data to learn from. As added implication, the stray Pthumerians within the cave linking the Forbidden Woods to Iosefka’s Clinic have shackles on their limbs as well as bells around their necks. This implies that the Choir restrained and enthralled the giants like its other Pthumerian servants. In other words, clerics of the upper stratum planned to come through the cave regularly enough to want safe passage; a giant could even ferry them across its poisonous waters. Without a doubt, the Choir were at the forefront in establishing this secret means to access the woods.
This new route is all thanks to the Iosefka’s Clinic, however. By all appearances, the clinic was digging a new grave in its cemetery when the cave was uncovered. The tomb was then tossed aside with its tombstone and ladders were placed to get down and investigate, a fair number of the bodies from the old graveyard appearing to have been dredged up in the process. This auspicious accident came to the Choir’s attention around this time, at which point they pursued the path to its inevitable conclusion — circumventing their own ban in the process; so as to prevent others from learning their new little secret, the gates to this part of the cemetery have been kept locked. In fact, the orphans were likely so quick to take over the exploration because they were already keeping an eye on the clinic.
By the time we reach Oedon Chapel, Iosefka has been replaced with an imposter. Although this fraud dresses like her and wields nothing unusual for a high-ranking cleric, she knows how to formulate blue elixers and cast arcane arts associated with the Choir. We can therefore be certain of the imposter’s background, which explains the experiments. Infiltrating the clinic reveals the same bloathead kin. One lies dead on an operating table, portions like the left hand still human. The Communion rune in the chest beside it plus the sole, empty wheelchair just down the hall suggests that it is the blood minister who treated us. The other stands near Iosefka and her imposter’s place at the door in a daze, the blood vial it carries indicating it to be the real doctor. Sending anyone to the clinic as she asks will likewise swell the number of kin, all verifiably those same refugees. After realizing she has been discovered, the fake offers her blue elixers to continue as her willful accomplice. From then on, she openly calls her patients subjects for “clinical trials”, (治験) with plans to use the “old blood” on later ones.
… Oh, you… Still safe. I’m so glad. I received the trial subject not too long ago. This time, I plan to try the old blood. Anyway, It’ll be a significant clinical trial. And it’s thanks to you. Here, the reward. It’s specially-made. After all, you’re now a comrade. Right, isn’t that so? Eheh… Eheheheh…
The Choir has undoubtedly been covertly monitoring this clinic, presumably because the blood treatment facility lies outside the Cathedral Ward. This made it ground zero for any new developments with live subjects, so having a plant to observe is a matter of course. While it is still a point of interest, the Choir’s attention seems to have since been preoccupied by the discovery of the cavern. From there, they enslaved the giants, made contact with the village, and began using it to facilitate illicit work. The reason? Aside from needing more dogs for hunt night, it enabled them to continue researching with taboos without raising Yharnam’s suspicions. The outlying village won’t disrupt the status quo in the capital and isn’t bound by the same scruples. The villagers the Choir were admitting as clerics could therefore experiment without limitation or risk to their masters. The locals would be turned to beasts or bloatheads, and no good citizen back home would ever know.
All of this shows that the starry-eyed Choir wasn’t abandoning Willem’s water theory. Rather, the group followed their educators in using water as a means to overcome the barrier separating them from the stars. The Great Lake rune acquired from one corpse at the Orphanage proves efforts to understand water’s arcane potential, as does Rosmarinus — “Ocean Dew” in Latin. The latter in particular has undergone modifications since its Research Hall iteration, removing the extraneous Flamesprayer igniter and remodeling it with the orphans’ favorite silvery metal. It might even still serve the same purpose in the Choir’s own experiments, though it has clearly been co-opted for its utility in battle. Either way, the orphans similarly recreated the Research Hall experiments, making men more attune to celestial communication by turning them into kin whose heads were bloated with water. This made understanding kin just as important. And with their interest taken directly from both Byrgenwerth and Isz, it was perhaps inevitable then that they too come face-to-face with Ebrietas.
One of the Karel characters which phoneticize inhuman voices. It has been given the meaning of “lake” since it resembles the rippling surface of water, and boosts all damage cut of those who memorize it.
Large amounts of water are a divide that protects sleep, and thus an augur of mysteries. O one who seeks, aim for beyond them.
Special weapon that the “Choir”, the Treatment Church’s upper stratum, uses.
Makes Quicksilver Bullets containing blood a special catalyst and continually sprays a mysterious fog.
The mysterious fog which coincides with singing voices is, in other words, the grace of the stars. “O fair maiden, are you crying?”
Crescendo
The Great Isz Chalice’s Japanese description specifies the cup “ultimately” allowing them to meet the abandoned Great One, implying some time had passed since first acquiring the chalice and bringing it above ground. Indeed, Gremia is a tomb prospector seen in the Isz dungeon, his use of Rosmarinus proving both Choir membership and a later date for diving into the gods’ graves. Between his additional use of Ludwig’s Holy Blade and his original name being “Sir Gremia”, (サー・グレミア) we can infer that he is particularly enamored with Ludwig and his chivalric renaissance. This is probably what motivated the man to finally dive into Isz, follow in his idol’s footsteps. And where else can we summon him except on the same layer as Ebrietas? Moreover, it is the layer where we also find him hostile. This indicates that Gremia eventually went mad down there, but from what? Perhaps the layer’s maddening Great One, aggressive as she is to anyone she comes across; we need only try approaching her for ourselves as proof.
However, Gremia has no qualms with helping us slay Ebrietas in the dungeon, a stark contrast from how the Choir’s subsequent interactions with her play out. This makes it unlikely to have been their fateful meeting. Gremia and his fellow orphans may have already been aware of the abandoned Great One. Access to the Forbidden Woods also means access to Byrgenwerth, and the presence of Yurie — dressed in the Choir uniform and carrying Rosmarinus and blue elixers — shows that the Upper Ward is well aware of that fact. In that case, they would have every opportunity to stumble upon Willem’s own study of Ebrietas. Gremia likewise knows how to conjure the Augur of Ebrietas arcane art, likely as a result of tracking the Great One throughout Isz for who knows how long. But if the Choir planned to make contact with the genuine article, they couldn’t simply go to her, as Gremia’s failed attempt well demonstrates. She would have to come to them instead.
The Altar of Despair resides in a large cavern underground based on the light shining in from a hole above, presumably the same source for the water flooding the place. Although difficult to spot due to the rubble, there is an actual altar at the far back, far simpler but not too dissimilar from the one in the Grand Cathedral — it even has a leafless tree as backdrop, though comparably younger. This altar is likewise preceded by church flooring, columns, and statues adding an air of gravitas to the location, but they have all fallen into ruin from neglect. And yet, this minimally-renovated cave is where we first find Ebrietas, with the Choir’s chalice in her possession. By all indications, the Great One came to acquire the cup in the cavern, which likewise implies that it somehow connects to the ruins — much like the similar subterranean cave in the Forbidden Woods. In fact, that was in all likelihood by design. A chalice’s value lies in blood rituals, so this must have been the Isz Chalice’s purpose until Ebrietas was lured up to the altar.
Replacing the lift to the Research Hall, the Grand Cathedral has built another to the subterranean altar as part of the interior balcony. While we can only enter said balcony through a window in-game, it must be somehow accessible to any member of the upper stratum, allowing them to literally watch over the cathedral’s daily operations. In that case, why build effectively a second church beneath the main one, and so deep underground? Moreover, why only give this holy place for the clergy elite the minimal furnishings, not to mention no upkeep? The answer is because the church and its altar had but one purpose: bring Ebrietas out of the labyrinth. The Healing Church accomplished that objective, so its disrepair over time has gone ignored. It now only need house the Great One, a specimen the Choir would want access to. The ritual altar was the stage with the Isz Chalice as the bait, and Ebrietas took it.
Between their bargaining chip and Rom, the Choir got their desired outcome. The specimen from Isz doesn’t show any hostility to our presence in her “prison”, nor any signs of restraint; she has been perfectly willing to be there coexisting with humans. With Ebrietas now more cooperative, the orphans could study one of the gods and her phantasms with ease. And study they did, for we can find pearl slugs among the corpses in the Orphanage. These newly-hatched slugs double to imply attempts at cultivating such arcane mollusks, giving them the plethora on hand needed to more thoroughly research their power. As a result of this arcane research, every member of the Choir was able to learn how to summon a portion of Ebrietas, making the Augur the faction’s signature arcane art. Extensive study of the phantasms led to other, similar developments, though not always the original intention.
We acquire A Call Beyond from a corpse hanging over the Grand Cathedral balcony. The menu graphic depicts a phantasm, having undergone a radical metamorphosis. It has grown additional tendrils and glows neon green with the core of its body manifesting the dark of space with all of its stars — one in particular more strongly radiating from the phantasm’s pinched head growing especially large tendrils. The Choir’s experiments clearly included connecting Ebrietas’ slivers with the cosmos and isolating a specific star. The phantasm was then used as a medium to make a “call to the beyond”, (彼方への呼びかけ) only the Great One rebuffed this attempt at contact: the star explodes, releasing arcane energy in various directions. The experiment thus ended in failure, the phantasm referred to with the same terminology as the Research Hall’s Living Failures. However, the Church’s brains thought to manipulate some of the arcane blasts from the explosion toward a target, turning their botched secret ceremony into another hunting technique.
One of the secret rites of the Treatment Church’s upper stratum the “Choir”.
Once, the Treatment Church touched the higher-plane darkness via phantasms and tried communicating with the star world of the far beyond, but it all ended in vain.
In other words, this is a failed work, but the ritual coincided with the small explosion of a star and became a special power of the “Choir”. Truly, failure is the mother of success.
Such experimental rituals seem to be the origin for other hunting tools like the Choir Bell. Rather than use sound for dimensional crossing like other bells, this “holy song bell” (聖歌の鐘) uses its timbre to beckon Great Ones. Ringing the tool causes the surrounding area to swirl with arcane energy, its trails revealing the starry cosmos in their wake. While only brief, it shows that the Choir achieved a similar bridge to the cosmos as A Call Beyond, and to better effect. Standing within the arcane energy rouses the vitality in blood to heal injuries instead of inflict damage. We can see how this also built upon principles from Rosmarinus, whose mist produces singing which the Choir identifies as the stars’ divine favor. The orphans were definitely making inroads into exchanging talk with their gods. Kin were a means to set the stage, but more ethical methods might have been developed by investigating further. If only they could.

Special hunting tool of the Treatment Church’s upper stratum the “Choir”. They modeled it on the mysterious bells whose timbres cross planes.
This small, silver-colored bell’s timbre ultimately doesn’t cross planes, but it exerts the power to live and a healing effect to all cooperators.
Coda
As the Choir’s research progressed, so too did their cold war with the School of Mensis. Edgar is a spy for the Choir, armed with the same Ludwig’s Holy Sword and Rosmarinus setup as Gremia but wearing the Byrgenwerth uniform to blend in as a member of the rival faction. The spook presumably followed Micolash and his ilk inside the then newly-created Nightmare of Mensis where we now cross paths. If the man had infiltrated the group at their home base in Yahar’gul before the ritual with Mergo, then it is only natural for him to take part in the ritual and continue monitoring Mensis from within the Nightmare. However, it appears that neither Edgar nor the Choir expected this development.
In the rafters of the Nightmare church’s foyer, away from prying eyes, hides a chest with the Choir Bell, undoubtedly belonging to Edgar. The location is an excellent vantage point to observe people coming into the church and drop down on them. If more allies visited, Edgar could readily retrieve the bell and rendezvous with them, providing all the support in intelligence or battle needed for the facility ahead. But none of this has come to pass. Someone implicitly cornered and killed by two giant lost children in the lead-up to the church carries the Eye rune. Aside from foreshadowing the cause of the frenzy down there, it suggests that the would-be infiltrator had contact with Ebrietas — in other words, likely a member of the Choir. There was no chance of the cavalry arriving to back him up anytime soon, so Edgar stashed away a tool which now only risks exposing his true allegiance. This would not have happened had the Choir been more aware of the School’s plans — that is what sending in an intelligencer was for. But in the wake of this incident, the orphans have caught on and reacted accordingly.

Yurie is stationed guard over entrance to Willem’s Lunarium at Byrgenwerth. The only purpose this serves is to protect Rom, and the note on the nearby couch details orders to that effect. If the message is for Yurie, then the Choir knows that the spider is keeping Yahar’gul’s rituals hidden from Flora and wants to keep it that way. Yharnam has already suffered through the “enlightening truth” of the Paleblood moon once, and the Choir couldn’t afford to lose control over what is left. Yurie was most likely chosen as Rom’s first line of defense due to her particular skill, being one of the few members to know A Call Beyond — perhaps it was fate, given that her name can be written with the kanji for reason, logic, and blessing. (由理恵) While this is arguably still a meager effort, Mensis has nonetheless failed to get past it. Granted, not without trying.
The spider hides all the rituals. Do not reveal them. None need comprehend the enlightening truth.
The Choir, much like the Church, is falling apart. A uniformed member with the key to their home sits tied to the chair within a Yahar’gul prison cell, apparently having been captured, tortured, and killed by Mensis — possibly by electrocution if the Tiny Tonitrus stored in a nearby chest is any indication. Edgar is encountered hostile with sedatives in his possession, implying that the spy succumbed to the Nightmare’s madness despite his best efforts — why else get in our way whilst displaying his Choir weapons so openly? Even in the Forbidden Woods, the death of all loyal clerics in the village affirms that the orphans overplayed their hand. With Yharnam burned or in rebellion, the Choir has essentially been trapped in their sanctum on high, mobbers practically banging at their doors in the church workshop.
The growing constraints explain the Choir’s current situation. Following their predecessors’ example once again, the orphans have buried their bloathead creations behind the Astral Clocktower to form another lumenflower garden. We see the kin rise out of the ground there, but the flowers haven’t even bloomed yet, hence it is called a “star flower grass garden” (星輪草の庭) instead. We can thereby infer that they were only freshly planted, especially compared to the tree garden seen in the Hunter’s Nightmare — it is unlikely that the clocktower bridge is even being used this time. Indeed, concept art portrays the garden in bloom, making the event’s absence very much intentional. Falling back on such an old method is odd considering all the Choir’s attempts at alternatives after luring in Ebrietas. However, it is sensible when considering their current lack of time and resources to continue testing. This is do or die, which is reaffirmed by the true nature of their seedbeds.
Defeating the Celestial Emissary in the garden awards the highest quality Communion rune we can acquire outside the Chalice Dungeons, implying that the emissary and its ilk were high-ranking clerics. As added evidence, we can find two more of these bloatheads just outside the lift to the Altar of Despair. Unlike the Forbidden Woods experiments, these kin aren’t in possession of blue elixers, or any items for that matter. This implies the kin to not be products of experiments who needed to be put under anesthesia. But who would consciously choose to be subjected to such a transformation? The experimenters, of course. Choir members are the only ones with access to the garden and the cathedral’s balcony. They are the only ranking clergy who actively seek metamorphosis. They are therefore the ones being made conduits to make contact, with the help of the Astral Clocktower. The two located away from the garden indicate that more were on the way to be planted, but the mass transformations appear to have quickly gotten out of hand.
The Orphanage is filled with nothing but corpses, brainsuckers, and scourge beasts. The latter are unique in that they possess glowing blue eyes, no bandages, notably strong resistance to physical and blunt attacks, and incredibly weak resistance to thrust attacks; the same qualities as kin. From this, we can infer that some of the Choir had an incredibly negative reaction to the blood rituals, degenerating into beasts even while gaining some ascendant qualities — cut content reaffirms the possibility, with plans for a Great One beast named “Silver Beast, Fauna” (銀の獣 ファウナ) who Loran’s silver beasts would be kin to. To a lesser extreme are those whose heads didn’t become bloated with brain fluid but instead starved for it. The rest who hadn’t yet transformed were attacked by these monsters, one brainsucker chowing on its dead victim as soon as we enter. The madman’s knowledge and frenzied coldblood retained by other bodies betrays their mental fortitude as such horrors ran rampant.
Some who went mad seem to have survived long enough to exit the side entrance and set up camp. But, the broken stone railing around the campfire suggests a serious scuffle, likely with the scythe-wielding church servant now guarding the side entrance — we do see that the Pthumerians have begun their nighttime patrols upon our arrival. Based on the many carrion crows surrounding a lone madman’s corpse below the railing, the campers were killed from being knocked down and all but one devoured by the scavengers. Another stands on the second floor terrace performing the Make Contact gesture toward the Astral Clocktower, his tattered Choir robes and mummified body indicating imperfect success — curiously, the corpse gives us the prompt to “talk” to learn the gesture, though this might simply be an oversight by the developers. Two other corpses outside the main entrance face the Grand Cathedral prostrated in prayer, and they aren’t alone.
A myriad of “star children” (星の子ら) wriggle all over the Upper Ward outside the Orphanage. Most of these tiny kin slither as close as they can to the cathedral from their location, reaching onto the railings or clasping their tentacles together in apparent prayer. In that cathedral, another faces the lift to the Altar of Despair. And down it, a few others watch Ebrietas from afar. These kin too are undoubtedly the Choir. The frenzy their touch inflicts and madman’s knowledge their minds possess lays fault for their diminutive form on overloading on arcane wisdom. And from their behavior, we can infer that they are petitioning their god on Earth for an intervention. Their last-ditch efforts evidently had less than desired results. But this goddess is currently grieving over her now dead friend at the altar and will not pay them any mind. So, helpless, they simply wait and pray.
To be fair, this situation isn’t that far removed from their target. The Choir, like Ebrietas, look up for signs from the stars. As before with their Byrgenwerth mentors, the hope is that the Great Ones above will implant the kin buried in the garden with phantasms, the purpose of which is depicted in the new statues encircling the perimeter. Each portrays human skulls sunken into the burgeoning womb area of a grotesque entity resembling Flora, as if to signify man becoming one with the Great Ones of Isz and being reborn as their offspring — children of the stars, if you would. In short, the Choir have primed themselves for their next childhood and pray that the gods will guide their thinking the rest of the way. Willem might weep at the pathetic state of his ideological grandchildren, but their piety may have been rewarded.
Apparel of the “Choir”, the Treatment Church’s upper stratum.
The “Choir” are both higher-rank clergymen of the Treatment Church and academics who inherit their thinking from Byrgenwerth.
They look up to the sky along with an abandoned Higher One and search for signs from the stars. For that is undoubtedly the path that will lead to transcendent thinking.
As mentioned earlier, the Upper Cathedral Ward is home to a “messenger from the star world” (星界からの使者) among all the bloatheads rising from the lumenflower garden. The boss initially looks no different from the other kin, only acting evasive rather than hostile. However, damaging it eventually causes the creature to curl up and gather arcane energy, starry lights drawing together to momentarily form a cosmic sky before exploding as the creature grows to gargantuan size. At this juncture, the boss begins attacking with its arms and legs, and its head eventually springs forth numerous tendrils as the battle progresses. We see the other Choir creations very rarely manifest the same protrusions enabling them to shoot arcane energy, but this giant can additionally pray to empower its kind with more HP. And unlike the Living Failures, the game’s achievements describe the Celestial Emissary not as a failed-to-be Great One but the genuine article. The stars have clearly answered the Choir’s call, elevating a guide with whom their transcendent evolution might see some measure of success.
Some have suggested that the Choir’s rituals were derailed by us bringing about the red moon, pointing to the similar mayhem in Yahar’gul. It is true that we cannot visit the Upper Ward before this incident. However, we can spy the corpse with A Call Beyond hanging over the balcony since first entering the Grand Cathedral, long before the red moon. This means that the chaotic events involving the Choir were already occurring before nightfall at the latest, and is likely partially to blame for the Church’s breakdown in administration on the day we arrive. This is why Yurie is dubbed the “last learner”. (最後の学び手) By the time we encounter her at Byrgenwerth, she is the lone member of the Choir both still human and sane — or would be, if not for the existence of Iosefka’s imposter. However, one can argue if that one even still considers it her affiliation at this point.
Encore
The clandestine member of the Choir embodies all of their worst traits. She makes humans her pawns or guinea pigs with sadistic glee. She plays whatever part or bargains whatever deal needed to coax cooperation. And the moment you become useless, she wants nothing to do with you. But whereas the Choir Bell conveys some solidarity amongst the orphans, lifelong allies working toward a mutual goal together, the imposter shows no such affinity. As to be expected of a member, the fake Iosefka believes her work supersedes all else, looking down on men and beasts incapable of understanding its importance. But, she later admits to thinking herself as uniquely special, believing that she alone will be “chosen” to ascend to godhood. And while the rest were getting desperate enough to jump to the final step, this psychopath among psychopaths wanted to continue with the clinical trials, up and abandoning her fellows in the upper stratum for the town clinic they had been monitoring.
But, it’s unfortunate. I thought we could build a good relationship. If you understand the significance of what you just saw, won’t you simply turn back? Then you’ll help me, I’ll help you out, and we’ll go back to our original relationship.
There are still not enough trial subjects. There might be few people who aren’t beasts now, but if they do exist, please. Because we must go beyond our foolishness. You understand, don’t you? It is of truly profound significance. Eheh… Ehehe…
… Honestly, what a disappointing man… I have no use for you now. Go die on the side of the road somewhere…
Damned fool who knows nothing…
Indeed, the imposter had likely been planning her takeover well before the day of our adventure. She had already seeded herself as staff by the time we wake from our sickbed given that the clinic is locked up after we first leave. Brought with her are numbing mists, a disabling agent churchmen don’t typically carry outside the Cathedral Ward — and useful for incapacitating the lay person, nonetheless. And most notably, the clinic has no beast-warding incense on the night of the hunt, forcing Iosefka to constantly mind the doors just to make sure no one “infected” breaks in and spread the disease further. The Healing Church’s own facilities have been abandoned with Yharnam, beasts allowed to kill Iosefka’s precious patients undeterred. But, a member of the Choir would know this decision was made and wants the lead staff distracted so she can operate more freely on just such a night.

The imposter’s reason for targeting Iosefka’s Clinic is obvious. As the biggest blood ministration facility in town, it was stocked with all the materials and equipment needed for experiments, and her position gave her all the intelligence and authority required to begin her subterfuge. The predator targeted the easiest prey, the wheelchair-bound old man, first. The blood minister was apparently incapacitated in the hall before his body was dragged to the back room farthest from anyone else. But his subsequent death and incomplete transformation imply that the experiment was interrupted — the Choir and the imposter have had too many success cases before and after to be making such a basic blunder. In all likelihood, she was caught in the act and forced to contend with Iosefka, who was ultimately incapacitated and experimented on herself. It wasn’t even necessarily the good doctor who discovered her.
Iosefka refuses to open the clinic’s doors for us on account of her other patients, but we see none of the sort during our infiltration, even as corpses. That being said, we enter from a window haphazardly converted into a doorway as part of some ongoing rooftop renovations. Opening this back path, we are met with a brainsucker and a corpse possessing madman’s knowledge. Climbing the ladder to the rooftop then brings us face-to-face with a great many carrion crows. These stuffed birds can barely hover off the ground for a few moments, meaning that they must have eaten their fill from up there. And with no other obvious threats around, this large number of bodies must have been killed by those same crows, implying that the victims were weak and unarmed. What were such people doing on the rooftop? Fleeing the clinic, considering their one point of entry. In other words, they were the patients, prescribed beast blood if the pellets we can extract from the crows’ gullets are any indication. This confirms that the Choir woman was present and treating the sick when they took flight.
With all this in mind, it is easy to imagine a random patient stumbling upon the bad doctor while looking for staff, making a big enough fuss at the horrors for Iosefka to overhear. The Choir woman would then have to prioritize the bigger threat and confront the good doctor. Their safety compromised, the patients would likely make their escape, perhaps at Iosefka’s direction. But if the Church’s brain made sure to do battle around the doors Iosefka guarded, their normal route would be blocked off. In that case, the patients would have no choice but to try taking the back route. Unfortunately for them, the birds lay in wait and swarmed the group. Two managed to make it through and head down the ladder, only to be impeded again by a locked cemetery gate courtesy of the Choir. To double their misfortune, one then succumbed to the blood and transformed into a brainsucker, which drove the onlooker mad. Once that kin killed the madman, the infiltrator lost all of her research subjects.
This explains why the researcher goes so far as to replace Iosefka at the front door. She hadn’t planned to experiment on just a couple of staff, and so switched gears from isolating the existing inhabitants to luring in new ones. If anyone came by looking for treatment, she could invite them in without raising suspicions. And if bleeding hearts visited, she could feign concern about doing nothing to help and request we direct others to her. She moved her “clinical trial room” (治験室) as Design Works concept art calls it upstairs likely to play it safe, but once they were let in and drugged, she was free to do whatever — this time, without distraction. Oddly enough, providing her with more test subjects proves irrelevant. Even if no one is sent her way, the imposter will still see the same results when finally applying her research to herself. Perhaps the appearance of the red moon influenced her decision, but she is ultimately satisfied with the outcome.

Killing the imposter before the red moon nets us Oedon’s Writhe, a rune she probably learned to help with identifying the first wrigglings of eyes within the brain — based on her later dialogue, her brain fluid has manifested those first squirms. More importantly, it is only during the red moon that the imposter also possesses an eye cord. Its description in particular highlights Willem’s pursuit of the cords for eyes within and higher-plane thinking, the very aim of Choir members like the imposter. Combined with her dialogue to that effect, and it suggests that the bad doctor didn’t acquire this from some infant Great One like the others but produced it within her own body. Simply put, the Choir has once again seen some degree of success in their methods. The imposter might even complete her rebirth as a superior being if left alone. However, if we are hoping to achieve our own enlightenment, it might be more prudent to cut her next childhood short.
… Ahh, I feel so awful… Do you understand? I, have come this far at last, I can see it… I knew it, only I am different. I’m no beast. That’s why… ahh, I feel so awful… I’m chosen… Do you understand? It’s squirming within my head… I’m so happy… Heeheehee, heeheeheeheehee…