Why exactly do some spike removals kill (dual eye, or central spike) but most don’t?
For the same reason that a bullet through one part of the body will kill you, but getting shot somewhere else won’t. The physical form of a person who has undergone a Hemalurgic transformation is no longer what we think of it. The direct connection to Preservation starts keeping them alive. (Imagine stapling someone’s soul to another person’s soul, their life essence, then stapling that to the power of creation itself, giving you a conduit directly to power, letting you leech it and steal it.) That power keeps you alive, despite the wounds. Some of the time, the other staples are enough to keep you alive, even if one is pulled out. Others are too important.
If you are viewing this on github.io, you can see that this site is open source. Please do not try to improve this page. It is auto-generated by a python script. If you have suggestions for improvements, please start a discussion on the github repo or the Discord.