how does Almond create tension in shapter 24 of Skellig

Skellig isn’t where they left him, though: they find him almost all the way up the first flight of stairs to the attic. He is exhausted, pained, and wants to go higher. They carry him up to a bedroom and give him a pillow, dishes, aspirin, cod-liver oil, beer, a sandwich, and chocolate. Some tears slip from Skellig’s eyes