Agony is a level 45^^^ heroic that is linked with two other named terror wraiths, Despair (45^^) and Doom (45^). Agony drops the Ill-Fated Cleric Journal as a body drop. Examine this journal to receive the quest. Note that after this, the journal will no longer drop for you.
The respawn rate of Agony is approximately 22 minutes if you kill all three named wraiths. However, if you just kill Agony and leave at least one of the other two named wraiths alive (for example, by running away), the respawn time is faster (around 5 minutes). Therefore, if you need the journal for more than one character, it is advised you kill just Agony and not the rest of the encounter.
Historically, the named Agony spawn had placeholder (PH) groups, where the PH spawn time was 13 minutes, often with 2-4 PH groups between Agony spawns. One group of placeholders used to wander up and down the west side of the lake. However, the placeholders were removed as part of GU53.
Obtain the blood of "the Despoiler". Hukulan the Despoiler spawns at the top of the main stairs near the zone entrance, in one of the two columned areas between the two dividing walls. ( 48, 24, -25 ) /waypoint 47.5, 24, -25.
Obtain the blood of "the Cenobite". Kaxor the Cenobite spawns on the eastern temple to the side of the main temple in the middle where Venekor spawns. ( -55, 41, -107 ) /waypoint -55, 41, -107.
Obtain the blood of "the Torturer". Tzugaax the Torturer spawns downstairs in the Torturer Area. ( 64, 0, 2 ) /waypoint 64, 0, 2 or ( -45, 0, 5 ) /waypoint -45, 0, 5 or ( 38, 1, 48 ) /waypoint 38, 1, 48 or ( -38, 0, 1 ) /waypoint -38, -0, 1
Kill 40 random lizardmen. These have to be killed in Cazic-Thule. Lizardmen in the Feerrott don't count.
Find the Fountain of Fear ( 0, 27, -228 ) /waypoint 0, 27, -228 and receive an update. This starts a 1 hour timer. The update is found in the water at the back of the northernmost and largest pyramid. To get there go to the top of the pyramid then descend the northern stairs where the ring event takes place and from there jump down to the lower pool of water, be careful not to jump too far and overshoot.
Once you get inside the Chamber of the Keeper, stand between the 4 idols and examine the Congealed Blood Sphere you received from the Basin of Ba'Kur. Before you examine the Sphere, zoom your camera out and look for the idol which glows when the sphere is examined.
Use the highlighted idol to spawn Gorfuzod the Keeper (level 50 Heroic ^^^). Clicking the incorrect idol will spawn 4 linked harbingers of fear (level 50 Heroic ^^^), even after Gorfuzod is dead. These mobs do not give experience. If you no longer have the Congealed Blood Sphere try each idol once until you get the desired spawn, when you zone it it locks to a specific random idol until you zone out.