Seventeen-year-old Justin's anemic blood is a blessing. Or a curse. It all depends on who you ask. To most of the immortal Vie, his blood is a scourge: untouchable and useless. To some Vie, his blood is a drug. To Justin, it’s something that gets him in a lot of trouble. Being poisoned by a Vie is just one example. His sister getting kidnapped is another. Whether it’s being coerced by a deluded cult leader, or negotiating with Alex—an Vie scientist addicted to Anemie blood—Justin struggles to keep every mutated drop of blood he’s got. His fight for survival gets more complicated when he meets Alex’s slave, Cara. Despite coming from different worlds, they’re both prisoners, at risk of being drained by a hungry Vie any moment. When she risks her own neck to help Justin find his sister, he's left with a terrifying choice. Saving what's left of humanity. Saving his sister. Saving the girl he loves. Or sticking a stake in Alex’s chest. Justin can't decide which option will get him killed first.

After escaping the long reach of the immortal Vie, seventeen-year-old Justin and human ex-slave Cara must face new challenges in the wilds outside the city wall. Dotted with pockets of hostile Anemie communities, the wilds are just as dangerous as the city. So when Cara is injured, Justin must seek help from the very group he wants to avoid. On top of that, Alex—who promised to let Justin back in the city when the time was right to rescue his sister, Sammie—gets killed in the final Anemie raid, all televised and hosted by TV personality Vincent Marks. Footage from the explosion plays in Justin’s mind while he tries to balance keeping Cara safe, befriending sharpshooter Sparrow, and winning over the witch healer, Nauro, all while trying to figure out the Anemie leader, Lawton’s, secrets. Turns out, there’s much more to the Anemies than Justin ever knew. They’ve found a way to trade their drug-like blood to addicted Vie in return for supplies. But the tenuous relationship shatters when Justin’s secret gets out—his blood can age the immortal Vie. It’s the weapon the Anemies’ leader, Lawton, has been waiting for, and he intends to use every last drop. Lawton forces Justin to join him—or Cara will pay the price. Justin accepts Lawton’s terms, but the move brings Anemies and Vie closer to war.