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It seems as if Johnny took in too much smoke during his rescue efforts during the fire. Ponyboy and Dallas leave with only a few scratches and burns, but Johnny arrives at the hospital pale and unconscious due to the fact that a large beam clobbered him in the church; this also means that he suffered a horrible head injury. Smoke inhalation and a bad concussion could be precursors to lack of oxygen and internal bleeding, not to mention the fact that brain injuries can be worse if there is blood-clotting that cuts off circulation throughout the body or to the brain itself. As a result, Johnny does die because of his injuries, whereas Ponyboy and Dallas remain to fight the big rumble with the Socs.
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