Katia's monster card from the previous floor, a bird with the skull of a child, named for the baby she lost.
When the dream opens and Katia realizes where she is, saying no, please, not this, a bird appears on her shoulder. It is a bird with the skull of a child, and it rubs its small, ghoulish head against hers in a gesture of comfort. This is the card she drew on the previous floor, and its name is Annie.
The bird stays with her through the memory. Its hand, like Katia's, is fused to Carl by The Second Connection. It caws when Fannar appears in the hospital doorway, and again when Katia tells Carl she loves him and Donut more than Daniel. As they watch the memory, Katia reaches up and strokes the bird, saying that the baby Annie was like her in that way. All alone.
A small bird whose head is the bare skull of a human child, ghoulish but affectionate, perched on Katia's shoulder and spreading its wings when it caws.
Katia's card companion and living memorial to the child she could not adopt.