In any city, in any country in the world, go to any mental institution or hospital and tell the attendant that you wish to see the "Holder of the Anvil". A moment, an hour, an eon will pass as you see the world's every failure reflected in his eyes. You will see the ending of things—daughters tearing strips of flesh from their mothers with hooks of steel and bone, fathers feasting on the eyes of their sons—and you will know that you have given them their torment. Their anguish will be your own and the only way to escape is to let your cry join theirs, but give no sign that you know this or the attendant will turn away and all hope with him.
An eon, an hour, a moment will pass and the attendant will drop his eyes in defeat, turn, and open the door behind him. Follow him with care; he is treacherous and will leave you in dark places where your screams will never be heard, your bones never found. At the end of this path, when the skulls of infants crunch beneath your feet, you will find a young man chained to a ragged iron slab. Your guide will turn and offer you a hammer in one hand, a blade in the other.
If you take the blade, you will abandon your search and you should beg for a quick end. It will not be given. You should take the hammer, and when you do, drive it into the young man's head with all the strength you have and more. Although he is innocent, allow no mercy, for mercy has abandoned you.
Cover the skulls at your feet in the gore and the blood. When their debt has been paid you will be delivered back to your world outside of the asylum. The hammer will still be in your hand; the blood will never wash off. Its thirst has been satisfied for now.
That hammer is Object 53 of 538. It will only be used once more, to split the world and find the secret heart that beats within. Pray that yours will not be the hand that wields it.