Before The Doctor's Reckoning, Dr. Cyrus Darian was the physician everyone counted on.

Weeks later, he vanished without a trace.

A Note from the Author

Dear Reader,

If you've already read The Doctor's Reckoning, I think you'll enjoy seeing Cyrus Darian back in action before the events of the novel, when he was still practicing medicine in a small Virginia town.

But if you're new to my writing, this short story is a great way to meet Cyrus and get a feel for the kinds of stories I love to tell.

You see, Cyrus isn't some larger-than-life hero. He's a regular guy. A little on the short side, a devoted husband and father, and someone who would do just about anything for his family. He doesn't have superpowers or extraordinary physical abilities. What he does have is a sharp mind, years of medical experience, and a knack for improvising solutions when things seem hopeless.

I've always been fascinated by a simple question: What would happen if an ordinary person, someone like you or me, suddenly found himself in extraordinary circumstances? How would he react? What could he accomplish with nothing more than his knowledge, ingenuity, and determination?

That question was really the inspiration behind both this short story and The Doctor's Reckoning.

This story stands on its own, so you don't need to have read The Doctor's Reckoning to enjoy it. But if you find yourself wanting to know what happened to Cyrus afterward, that's where his story continues.

I hope you enjoy it.

Arsheeya Mashaw

Chapter 1

Residents had gathered along Main Street for Corlen’s annual Halloween parade. A picturesque town of just five thousand people, Corlen was nestled in Virginia’s beautiful Shenandoah Valley, nearly an hour’s drive from the nearest larger community. Night had fallen, and the downtown storefronts glowed beneath strings of orange lights. Carved pumpkins flickered in shop windows, and the chilly October air carried the smell of freshly popped kettle corn from a vendor near the courthouse. Children in Halloween costumes crowded the sidewalks, scrambling after candy tossed from the brightly decorated floats.

Dr. Cyrus Darian stood near the curb with his wife, Juliette, watching the festivities. He spotted one of his son Freddie’s friends, dressed as Darth Vader, struggling to collect a handful of candy that had landed near his feet. Every time the boy bent down, his oversized helmet slipped forward, blocking his view. Cyrus chuckled as the boy finally gave up, pulled off the helmet, and scooped up the candy.

“Daddy, look what I got!” Samira called, tugging at his sleeve.

Cyrus turned toward his daughter Samira, who stood beside him in a pink princess costume, her tiara sitting crookedly on her head. She proudly held up a miniature candy bar before dropping it into her plastic pumpkin. Beside her, Freddie, dressed as Spider-Man, was busy inspecting his own collection. Juliette stood nearby, smiling as she watched the children enjoying themselves.

“Daddy, look!” Freddie shouted, holding up his bucket. “I've got more than Samira!”

“That's because you're stealing all the good stuff,” Juliette said, laughing. “Why don't you give your sister a chance?”

“I'm not stealing! They threw it to me!”

Samira frowned and held up a single piece of candy. “I got a Snickers!”

Cyrus grinned. “Well, I think Samira wins. Quality over quantity.”

“That's not fair!” Freddie protested.

Juliette slipped her arm through Cyrus's and leaned against him as another float approached, this one decorated like a haunted house, with teenagers dressed as zombies throwing handfuls of candy toward the crowd.

“Remember when Halloween meant going to a party instead of standing on a sidewalk watching our children fight over chocolate?” she asked.

“I vaguely remember those days. I also remember sleeping until noon on Saturdays.”

“Now there's a fantasy.”

Cyrus laughed and squeezed her hand.

He loved moments like this, when the demands of his medical practice seemed far away and he could simply enjoy being a husband and father. Juliette looked beautiful in her jeans and cream-colored sweater, her long dark hair falling loosely over her shoulders. Freddie was practically vibrating with excitement, and Samira had begun waving enthusiastically at every passing float, apparently convinced that the more she waved, the more candy she'd receive.

He had wanted to practice somewhere he could raise a family. Corlen had given him that. Juliette was also a family physician, and together they made up two of the six doctors serving the entire county. It was a rewarding career, but lately Cyrus couldn't shake the feeling of being overwhelmed. Between seeing patients, hospital rounds, nursing home visits, and endless paperwork, there never seemed to be enough hours in the day. Even at home, his mind wandered back to work. Sometimes he wished he could escape his responsibilities for just a few days, but then he'd look at Juliette and the kids and feel guilty for wanting anything more from a life that was already so good.

“Daddy, look! A Hershey's!” Samira shouted, pointing toward the street.

She had spotted a miniature chocolate bar near the curb and was making a determined effort to retrieve it before several older children reached the same conclusion.

Cyrus stepped forward and gently pulled her back, then scooped up the candy himself.

“Here you go, princess.”

She beamed and dropped it into her pumpkin.

A cheer went up farther down Main Street as the high school marching band approached, followed by a large float decorated in the school's colors. Football players and cheerleaders stood along the sides, waving to the crowd.

Near the back of the float stood Dr. Greg Hale, one of Cyrus's fellow family physicians and the high school football team's longtime volunteer doctor. Greg wore a ridiculous orange-and-black witch's hat and was enthusiastically tossing candy into the crowd.

When he spotted Cyrus, he waved.

“Hey, Darian! You working today or actually taking a day off?”

“Don't give him any ideas!” Juliette called back.

Greg laughed and threw a handful of candy directly toward Freddie and Samira, who dove after it with delighted shrieks.

Cyrus waved back. “See you Monday, Greg!”

The float rolled past, and Cyrus turned to watch his children inspect their latest haul.

Then he heard an engine revving.

At first, he barely registered the sound. There were plenty of engines in the parade, from old tractors to motorcycles and pickup trucks hauling decorated trailers.

But this one was different.

The engine roared again, louder this time, followed by the sharp squeal of tires.

Cyrus looked up.

A pickup truck towing another Halloween float had suddenly accelerated, closing the distance between itself and the football team's float ahead. The driver appeared to be struggling with the steering wheel, and the trailer behind him had begun swaying from side to side.

For a moment, Cyrus couldn't understand what he was seeing. Vehicles in a parade moved barely faster than walking speed.

This truck was accelerating.

And it was heading straight toward Greg Hale's float.

Chapter 2

The pickup slammed into the rear of the float with a deafening crash, crushing the wooden platform and sending several passengers tumbling onto the pavement. The driver appeared to have lost control entirely. Even after the impact, the truck's tires squealed as it continued accelerating, pushing the wreckage down Main Street until the trailer behind it jackknifed across the road.

Cyrus watched in horror as the float carrying Dr. Greg Hale lurched sideways. Greg had been standing near the back, waving to the crowd only moments earlier. Now he was airborne, his arms flailing as he disappeared over the railing.

The pickup finally struck a parked car with a deafening crunch and came to a stop. For a moment, the entire street seemed stunned into silence.

Then the screaming began.

People were running in every direction. A woman shouted for someone to call 911, while a man near the wreckage struggled to pull a child away from a collapsed section of the float. The marching band had stopped playing, and several musicians stood frozen in the street, their instruments hanging uselessly at their sides.

Cyrus instinctively started toward the accident, then stopped. Freddie and Samira were standing beside him, staring at the wreckage. Samira had dropped her candy bucket and was beginning to cry.

He looked at Juliette. She was already scanning the scene, her expression changing from shock to the focused concentration he recognized from years of working alongside her.

"We need to get over there," she said.

"I know, but the kids—"

“Cyrus!” a familiar woman's voice called from behind him.

He turned to see their neighbor, Mrs. Patterson, hurrying toward them. She lived two houses down and had known Freddie and Samira since they were born.

"I'll take the children," she said, reaching for Samira's hand. "You two go help those people."

Cyrus felt an immediate wave of gratitude. It was one of the things he loved most about living in Corlen. In a small town, neighbors looked after one another, often without being asked.

He crouched in front of Freddie and Samira.

"Listen, guys. Mommy and Daddy need to go help some people who got hurt. You're going to stay with Mrs. Patterson for a little while, okay?"

Freddie nodded solemnly. Samira reached for her mother, who bent down and hugged her.

"We'll see you soon, sweetheart," Juliette promised.

Cyrus kissed both children and turned toward the accident.

"Let's go."

They ran together down Main Street.

As they approached the wreckage, the extent of the disaster became clearer. Several spectators were lying on the pavement, while others sat against storefronts clutching injured arms or legs. A teenage boy in a torn football jersey staggered past Cyrus, blood running down the side of his face.

Near the overturned section of the float, a woman was kneeling beside someone trapped beneath the wooden framework. She looked up as Cyrus approached.

"Please! My husband's under there!"

Juliette reached her first and crouched beside the wreckage.

"Cyrus, go ahead," she called. "I've got this."

He nodded and continued toward the place where he'd seen Greg fall.

The physician was lying on his back near the curb, partially surrounded by broken pieces of the float. His face was pale, and his left leg was bent awkwardly beneath him. A dark stain had spread across the pavement near his hip.

"Greg!"

Cyrus dropped to his knees beside him.

Greg opened his eyes. "Well, this wasn't exactly how I planned to spend Halloween."

Cyrus was relieved to hear his voice. Greg was in his early fifties, a respected family physician who had practiced in Corlen for more than twenty years. He was also one of Cyrus's closest friends.

"You're supposed to stay on the float, Greg. That's generally how parades work."

"Thanks. I'll remember that next time."

"Don't move. Let me take a look at you."

Cyrus began a rapid primary survey. Greg was breathing without obvious difficulty, and his pulse was strong, although faster than Cyrus would have liked. He was alert and answering questions appropriately.

"Any trouble breathing?"

"No. Just hurts like hell."

"Where?"

"Mostly my backside. I think I landed on something."

Cyrus carefully examined the exposed areas of Greg's body, then looked beneath him as best he could without moving his spine. Blood was soaking through the back of his pants near the right buttock. A large tear in the denim exposed a deep, ragged wound, and bright red blood was spurting from it with each beat of his heart.

"Well, I've got some good news and some bad news," Cyrus said.

"Let's hear the good news."

"You're still alive."

Greg winced. "And the bad?"

"You're going to have a hell of a time sitting down for a while."

"Very funny."

Cyrus placed a hand against the side of Greg's head to keep his neck aligned.

"Seriously, Greg, you took quite a fall. I don't want you moving until we've checked your spine. Any neck pain?"

"No," Greg replied.

Cyrus continued his neurological examination, checking sensation and movement in Greg's arms and legs. Everything appeared normal.

For now, there were no obvious signs of nerve damage, but the mechanism of injury concerned him. Greg had been thrown from a considerable height, and even without neck pain, a cervical fracture was possible. That could mean permanent paralysis or even death.

He turned his attention back to the wound. The bleeding was substantial, and he needed to get it under control quickly.

"Juliette!" he called.

She was several yards away, helping a man who had been pinned beneath part of the float.

"Yeah?"

"Can you come here for a second?"

She looked toward another bystander who was helping her. "Keep holding pressure right there. Don't let go."

Then she hurried over.

"What do you have?"

"Looks like a penetrating wound to the right buttock. He’s bleeding. I need something absorbent to help dress around it."

Juliette looked at the injury. "Have you got any gauze?"

"Not yet. Hey, you wouldn't happen to have a tampon in your purse, would you?"

She stared at him. "A tampon?"

"Yeah."

"You want a tampon?"

"Preferably an unused one."

Greg opened one eye. "What the hell are you two talking about?"

Juliette was already opening her purse.

"Honestly, Cyrus, sometimes I wonder about you."

She produced a wrapped tampon and handed it to him.

Cyrus tore open the package and pressed the tampon into the long, narrow wound, hoping it would help control the bleeding. Juliette helped him maintain firm pressure while a nearby spectator brought over a first-aid kit. Cyrus added gauze over the wound and secured it with a pressure bandage.

Greg grimaced as Cyrus secured the dressing, but the bleeding appeared to be slowing. Cyrus checked his pulse again. It was still faster than he liked, raising concerns about how much blood Greg might have lost and whether he had sustained other injuries in the fall.

Someone tapped Cyrus on the shoulder. He turned to find Ray, one of the local paramedics whom he'd known for years.

"Hey, Doc. We just loaded Dr. Stone's patient into the ambulance. You need anything over here?"

Cyrus glanced around, realizing how completely he'd tuned out the chaos while working on Greg. Ambulances had come and gone, and most of the critically injured patients were already on their way to the hospital.

"Yeah, I need to get Greg to the ED. He's lost a fair amount of blood, and I'm worried about a possible cervical spine injury. Can you take him?"

Ray shook his head. "Sorry, Doc. Both our ambulances are already committed, and we've still got patients to transport. Dispatch is sending another unit from the next county, but it'll be a while."

Cyrus considered his options. The hospital was barely five minutes away, and he didn't like Greg's rapid pulse. Waiting for another ambulance could cost them valuable time.

"Then I'll take him myself. But I need a backboard, a cervical collar, and someone to help me get him secured properly."

Ray nodded. "Let me grab what you need. I've got another set in the truck."

He returned carrying a rigid spine board, a cervical collar, and head immobilization equipment. He handed everything to Cyrus.

"Thanks, Ray."

“Good luck, Doc. I’ll let the ED know you’re coming,” he said as he ran back to his ambulance.

Cyrus looked around for someone to help and spotted Linda, a nurse from his clinic who had brought her son to the parade.

"Linda! Can you give me a hand?"

She hurried over, immediately recognizing Greg. "Oh my God. What happened?"

"I'll explain later. Right now, I need your help getting him onto this board."

Working together, they fitted Greg with the cervical collar and carefully transferred him onto the spine board, taking precautions to keep his head and neck aligned. Once he was secured, Cyrus began looking for someone with a vehicle large enough to transport him lying flat.

Greg groaned as they lifted him. "God, my ass is killing me."

"That's because you've got a tampon barely stopping the bleeding from your butt," Cyrus replied.

"You're never going to let me forget this, are you?"

"Not a chance."

Once Greg was secured, Cyrus and Linda carried the board to the back of an old Ford F-150 pickup that a local resident had offered. They carefully lowered Greg into the truck bed. It wasn't an ideal way to transport someone with a possible spinal injury, but with the hospital only five minutes away and no ambulances available, Cyrus felt it was their only option.

Cyrus climbed into the truck bed beside Greg while the owner got behind the wheel.

"Straight to the emergency entrance," Cyrus told him.

The pickup pulled away from the curb.

Greg shifted his eyes toward him. "So, how bad is it?"

"The wound's deep, and I don't like how much blood you've lost. We'll need imaging to see what else might be injured."

"Think I'll need surgery?"

"Possibly. Let's get you to the hospital first."

Greg sighed. "You know, I've spent twenty years telling those football players to be careful on the field. And here I am getting taken out by a Halloween float."

Cyrus checked his pulse again. It remained rapid, and Greg's skin felt cool beneath his fingers. He was concerned about the possibility of internal bleeding, particularly given the way Greg had landed, but without imaging there was little more he could determine.

The pickup turned onto the street leading to the hospital.

Greg was quiet for a moment. "Hey, Cyrus?"

"Yeah?"

"My hands feel funny."

Cyrus looked at him. "What do you mean, funny?"

"I don't know. Kind of tingly. Like they're falling asleep."

A cold sensation settled in Cyrus's stomach. "Both hands?"

"Yeah. Mostly my fingers."

Cyrus leaned closer, careful not to disturb the cervical collar. "Greg, I want you to squeeze my fingers."

He placed two fingers into Greg's right hand.

Greg tried to close his grip.

It was noticeably weak.

Greg’s other hand was the same.

He looked toward the driver. "How much farther?"

"Just turning into the hospital now."

Cyrus turned back to Greg, who was staring at him with growing concern. "What's going on?"

Cyrus glanced at the cervical collar, then at his friend's hands.

"Greg, don't try to move your head. Just stay as still as you can."

"Cyrus?"

"We're almost there."

Greg swallowed. "Am I going to be paralyzed?"

Cyrus didn't answer immediately. He checked his friend's grip one more time, hoping he'd been mistaken.

He hadn't.

And this time, Greg could barely squeeze his fingers.

Chapter 3

The truck pulled up to the emergency department entrance, its headlights sweeping across a crowded parking lot. Two police cruisers were parked near the ambulance bay, and several people were standing outside the sliding glass doors, some with makeshift bandages wrapped around their heads or arms. Cyrus could hear raised voices coming from inside the hospital.

He jumped down from the truck bed and hurried through the entrance.

"I need a stretcher out here!" he called to the first nurse he recognized.

Nancy Watkins, a veteran emergency department nurse who had worked at Corlen Community Hospital for nearly thirty years, looked up from the registration desk.

"Dr. Darian? What happened?"

"It's Dr. Hale. He was thrown off one of the floats. Possible cervical spine injury with progressive neurological deficits. He's on a backboard in the pickup."

Nancy's expression changed immediately. She turned toward a hospital orderly standing nearby.

"Get a stretcher. Now."

Cyrus followed them outside, and together, they transferred the spine board onto the hospital stretcher, maintaining his cervical alignment as they moved him.

"How are your hands, Greg?" Cyrus asked.

"Still tingling. Maybe worse."

"Can you move your legs?"

Greg tried, producing only a slight movement beneath the blanket Linda had placed over him.

Cyrus felt his stomach tighten. At the parade, Greg had been able to move all four extremities. Now, less than half an hour later, he was developing weakness in both his arms and legs.

They wheeled him through the sliding doors.

Corlen Community Hospital was a small, twenty-five-bed facility serving the town and surrounding rural communities. Its emergency department had just four treatment bays, and its resources were limited. Aside from the emergency physician on duty, there were no specialists on staff. Serious injuries requiring surgery or specialized care generally meant transferring patients to a larger hospital, nearly an hour away.

Cyrus had worked in the emergency department countless times, but he'd never seen it like this. Every treatment bay was occupied, and patients lined the hallway on stretchers brought down from the inpatient floor. Nurses moved between them carrying medications and supplies, while a hospital administrator stood near the nurses' station trying to coordinate additional staff.

A man sat against the wall with his arm in a makeshift sling, his shirt soaked with blood. Across from him, a young girl was crying while her mother held a towel against a cut on her forehead. Somewhere farther down the hallway, a patient was shouting for pain medication.

The smell of blood and antiseptic filled the air.

"Where do you want him?" Nancy asked.

"Let's get him into a treatment bay," Cyrus said.

Nancy directed them toward the last available bay, where they carefully transferred Greg from the backboard onto the examination stretcher.

Cyrus listed out new orders. "Nancy, I need two large-bore IVs, a cardiac monitor, trauma labs, and a type and crossmatch."

As the nurses began working, Cyrus glanced into the adjoining bay. Dr. Robert Mitchell, the emergency physician on duty, was preparing to reduce a badly dislocated ankle. The patient's foot was visibly deformed, and Mitchell was examining the circulation in his toes.

"Bob, I've got Greg Hale over here," Cyrus called.

Mitchell looked up. "Greg? What happened?"

"Thrown from one of the floats. I've finished the primary trauma survey and I'm working on the secondary. He's got a deep wound to his right buttock with significant blood loss. I'm also worried about a cervical spine injury. He was moving all four extremities at the scene, but he's developed progressive weakness in his arms and legs."

Mitchell glanced toward Greg. "How bad is the weakness?"

"He can barely move his legs now. I'm concerned about spinal cord compression."

Mitchell frowned. "That's not good." He looked back at his own patient. "I'm sorry, Cyrus, but I can't leave this guy right now. He's got a dislocated ankle with compromised circulation, and I need to get it reduced. Can you take the lead with Greg?"

"No problem, Bob. I've got him."

"Let me know what you find. I'll come over as soon as I can."

Cyrus nodded and turned his attention back to Greg.

A nurse had already cleared the examination table, and within moments Greg was connected to a cardiac monitor.

His blood pressure was 104/68, with a heart rate of 118.

Stable for now.

Cyrus glanced at the monitor as Nancy inserted an IV.

"Let's get a liter of saline started while we're waiting on the blood work. And I want a CT of his cervical spine right now."

"Radiology's backed up. They've already got two trauma patients waiting," Nancy said.

Cyrus wasn't about to wait. Greg's neurological function was deteriorating, and he needed to know what was happening inside his neck.

"I don’t care if they’re backed up. We’re taking him down there now."

He grabbed the stretcher and hurried toward radiology, with Nancy helping guide it through the crowded hallway. When they reached the CT suite, Cyrus explained the urgency to the technician, who immediately cleared the scanner.

Within minutes, Greg had undergone a CT of his neck, and Cyrus studied the images as they appeared on the monitor. His chest tightened as he saw it: a unilateral C4–C5 facet dislocation, commonly called a jumped facet. One of the small joints connecting the vertebrae had dislocated, allowing one bone to slip forward over the other and compress the spinal cord. That explained Greg's rapidly worsening weakness. Unless the pressure was relieved quickly, the damage could become permanent, leaving his friend paralyzed from the neck down. Worse still, if the injury affected the nerves controlling his breathing, Greg could die.

As Cyrus pushed the stretcher down the hallway, he passed Dr. Susan Whitcomb, another of the county's family physicians, who was treating a man whose lower leg had been crushed beneath a parade float. His pants had been cut away, exposing a gruesome open fracture of the tibia. Susan was checking the circulation in his foot while a nurse prepared IV antibiotics.

A few doors down, Juliette was bent over a middle-aged woman, running an ultrasound probe across her abdomen. Cyrus recognized the FAST examination immediately. Juliette paused to study the image on the screen, then looked toward a nurse.

"She's got free fluid in her abdomen. I think she's bleeding from her spleen. We need blood started, and someone needs to arrange a surgical transfer."

Cyrus continued further down, passing patients on stretchers, and others who sat in chairs along the walls, waiting for someone to examine them. The girl was still crying. Her mother hadn’t moved. Nearby, an elderly man sat with his arm in a sling, staring blankly at the activity around him.

Corlen Community Hospital had never been equipped to handle anything approaching this many injured patients.

Cyrus glanced down at Greg, who lay unusually quiet on the stretcher.

"How are you doing, buddy?"

"My hands are getting worse," Greg replied. "I can barely feel my fingers."

Cyrus quickened his pace.

As they pushed through the curtain into Greg's bay, a terrible scream erupted from the adjoining room. Dr. Mitchell had begun reducing the dislocated ankle, and the patient was crying out in pain as the joint was manipulated back into position.

Cyrus barely registered the noise.

He positioned the stretcher beside the cardiac monitor. He glanced at his friend, who lay pale and frightened, struggling to move his hands.

He turned toward the nurses' station.

"Nancy! Greg needs an immediate transfer to a trauma center with neurosurgical capabilities. We can't manage this here."

Nancy looked up from her computer. "I'll activate helicopter transport right now."

Chapter 4

Cyrus looked down at his friend and immediately noticed that his breathing had changed. Greg was taking rapid, shallow breaths, and the muscles in his neck were straining with each inhalation.

"Greg, how are you doing?"

"Can't..." Greg struggled to take another breath. "Breathe... right."

Cyrus felt a surge of alarm. The injury was now affecting the muscles Greg needed to breathe. He knew that mortality rates could exceed 60 percent when a jumped facet caused severe respiratory compromise, even with mechanical ventilation. Greg was dying before his eyes.

He looked at Nancy. "Any word on the helicopter?"

"Dispatch is working on it. They haven't confirmed a flight crew yet."

Cyrus glanced toward the adjoining bay, where Mitchell was still occupied with his patient. Even if the helicopter arrived in the next few minutes, Greg would still have to survive the flight and the delay before a specialist could relieve the pressure on his spinal cord.

Cyrus was convinced his friend wouldn't survive that long.

If Greg was going to have any chance, Cyrus would have to intervene himself.

He had seen this injury before.

It had been during his fourth year of medical school, when he'd spent a month on the neurosurgery service. He remembered a young construction worker who had fallen from a scaffold and arrived with a cervical dislocation. Like Greg, the man had initially been able to move his extremities, only to develop worsening weakness as the displaced vertebra continued to threaten his spinal cord.

The attending neurosurgeon, Dr. Andrew Kessler, had gathered the medical students around the patient's bed. Kessler was an imposing man with graying hair who had a reputation for demanding that his students understand not only what they were doing, but why.

Cyrus remembered asking whether the patient needed immediate surgery.

"Eventually, yes," Kessler had replied. "But first we need to restore the alignment. Sometimes we can accomplish that without an incision. It's called a closed reduction."

He had explained that the usual approach involved carefully controlled traction, until the displacement is reduced.

"The objective is to unlock the displaced joint and allow the vertebrae to return to their normal relationship," Kessler had told them. "But remember something. You're working around the spinal cord. If you make the displacement worse, you can turn an incomplete injury into a complete one."

Cyrus had watched as the neurosurgeon carried out the reduction. The procedure had been controlled and deliberate. Afterward, the construction worker had begun moving his fingers again.

The memory had stayed with Cyrus long after his rotation ended.

Now, standing beside Greg's stretcher, he found himself recalling that afternoon in extraordinary detail.

The difference was that Dr. Kessler had been an experienced neurosurgeon working in a major academic medical center. He'd had specialized equipment and a team trained to manage spinal injuries.

Cyrus had none of those advantages.

Cyrus turned back toward Greg. "How's your breathing?"

"Not good." Greg struggled to draw a deeper breath. "Cyrus, am I going to die?"

The question hit him harder than he'd expected.

Greg had helped him through his first years in Corlen. Cyrus had always thought of Greg as the steady, unflappable physician who knew what to do when everyone else was uncertain.

Now Greg was looking at him with unmistakable fear.

"I don't know," Cyrus answered. "But I'm going to do everything I can to prevent that."

Greg closed his eyes.

Cyrus had spent years practicing in a small rural community, where physicians regularly faced situations that would have been handled by specialists in a larger hospital. In Corlen, he often had to act before specialist help arrived. This decision was beyond anything he had faced.

He looked down at his friend. "Greg, I need to talk to you."

Greg opened his eyes.

"Your spinal cord is being compressed by the dislocated vertebra. The usual treatment would be to have a neurosurgeon reduce the dislocation using specialized equipment. But we don't have that equipment here, and I'm worried about how quickly you're losing function."

"You're thinking..." Greg paused, struggling to draw another breath. "About reducing it... yourself."

Cyrus nodded. "It's dangerous, Greg. But I’m not sure we have another choice."

Greg was silent for several seconds. "Then do it."

Cyrus took a deep breath.

He called Nancy over.

"I'm going to attempt a closed reduction. I need you here with me. Keep him on the cardiac monitor, watch his oxygen saturation, and reassess his neurological function with me throughout. If anything worsens, we stop immediately."

Nancy moved to the monitor while another nurse stood ready with airway equipment.

"Greg, I need you to stay awake and talk to me. If you feel anything change, tell me immediately."

“Understood,” Greg whispered.

Cyrus closed his eyes for a moment and tried to remember Kessler’s hands.

Then he began.

Cyrus positioned himself at the head of the stretcher and carefully cradled Greg's head with both hands. He began applying gentle, steady traction along the axis of Greg's spine, hoping to relieve the pressure between the displaced vertebrae. His goal was to separate the locked joint surfaces just enough to allow them to slip back into their normal alignment.

But nothing happened.

He maintained the traction, wondering if he was doing something wrong.

Was he applying enough force? Too much?

He fought the urge to pull harder, terrified that one wrong movement could cause irreversible damage.

Then he felt a subtle shift.

He stopped immediately.

For a terrifying moment, nobody spoke.

"Greg?"

No answer.

"Greg, can you hear me?"

"Yeah."

"Can you feel your hands?"

Greg hesitated. "I think so."

"Try moving your fingers."

Cyrus watched his right hand.

At first, nothing happened.

Then Greg's index finger moved.

Cyrus stared at it.

"Do that again."

The finger moved a second time, followed by a slight movement of his thumb.

"Nancy, did you see that?"

"I saw it."

Cyrus moved to the foot of the stretcher.

"Greg, try moving your toes."

A moment passed.

Then the toes on Greg's right foot flexed.

Cyrus felt an enormous surge of relief, though he knew better than to assume the danger had passed. A successful reduction would still need imaging confirmation, and Greg would require urgent surgical stabilization. His spinal injury remained unstable.

But for the first time since the parade, his neurological function appeared to be improving.

"Can you take a deeper breath?" Cyrus asked.

Greg inhaled.

It was still shallow, but noticeably stronger than before.

"Better," he whispered.

Cyrus looked at Nancy.

"Get radiology ready. We need to confirm the alignment before he goes anywhere."

Nancy nodded, but before she could leave, the cardiac monitor began alarming.

Cyrus looked up.

Greg's heart rate had climbed to 142.

Then the blood pressure cuff cycled.

76/42.

Cyrus stared at the numbers.

"That can't be right."

Nancy repeated the measurement.

72/38.

Greg's face had gone deathly pale.

"Cyrus," Nancy said, looking at the monitor. "His pressure's crashing."

Chapter 5

Cyrus stared at the blood pressure reading. 72/38. Greg was in shock, and given the severity of his injuries, hemorrhage was the most likely explanation.

He immediately thought of the deep wound in Greg's right buttock. It had been bleeding heavily at the parade, and he'd managed to control it with an improvised pressure dressing.

"Nancy, help me roll him just enough to check the wound. Keep his spine aligned."

With Nancy's assistance, Cyrus carefully inspected the dressing. The tampon and gauze were still in place, and there was no evidence of active bleeding.

That concerned him even more. If Greg was losing blood, it wasn't coming out through the wound.

Cyrus looked toward the doorway and spotted the portable ultrasound machine Juliette had been using earlier.

"Nancy, bolus fluids and get the blood transfusion STAT. Start him on pressors now. I'm getting that ultrasound."

"Somebody get me a bag of Levophed!" Nancy called out as Cyrus hurried across the hall.

He grabbed the portable ultrasound machine and wheeled it to Greg's bedside. After applying gel to the probe, he began scanning Greg's abdomen, looking for signs of internal bleeding.

He moved the probe to Greg's right upper abdomen, examining the space between the liver and kidney. Nothing obvious. But when he moved to the lower abdomen, he saw a dark collection of fluid where it shouldn't have been.

Blood.

Cyrus suspected that the penetrating wound in Greg's buttock had torn a major blood vessel deep inside his pelvis. Although he'd managed to control the external bleeding, blood could still be pouring into the surrounding tissues, causing a massive internal hemorrhage.

If that was what was happening, Greg could bleed to death before the helicopter arrived.

Cyrus needed to do two things immediately. First, he had to apply pressure to Greg's pelvis to try to control the internal bleeding. Second, he needed to get his blood pressure up before his organs began shutting down.

While Cyrus had been performing the ultrasound, Nancy had started the Levophed through an IV in Greg's right arm. The medication constricted blood vessels, artificially raising his blood pressure to help maintain circulation to his vital organs. She had also started a blood transfusion through another IV in his left arm, replacing some of the blood he'd lost. But these were only temporary measures. Unless Cyrus could slow the bleeding, Greg would continue to deteriorate.

He glanced across the room and spotted Crystal, another nurse who had just finished helping with a patient.

"Crystal, get me a pelvic binder. Now."

She hesitated.

"Your wife.” Nancy paused. “I mean Dr. Stone, she used the only one we had for her patient."

Cyrus took a deep breath and looked around the room. His eyes settled on Don, a respiratory therapist he'd worked with for years. Don had apparently come in to help with the emergency and was still wearing his street clothes.

"Don, I need your belt."

Don looked puzzled but immediately unbuckled his leather belt and handed it over.

"Crystal, get me a couple of towels."

Crystal returned with the towels and handed them to Cyrus.

"What are you doing?" she asked.

"Making a pelvic binder. By compressing the pelvic bones together, we may be able to reduce the bleeding until we can get him to surgery."

He folded the towels and positioned them on either side of Greg's hips, then wrapped Don's belt around them. He made sure the belt sat low, across the tops of Greg's thighbones, rather than around his waist.

He tightened the belt, drawing the two sides of the pelvis together. Once it was secured, he checked that the improvised binder hadn't shifted and that Greg's spine remained immobilized.

As Cyrus finished securing the binder, he heard a faint rumbling overhead. The sound grew steadily louder until he recognized the unmistakable thumping of helicopter rotors. Moments later, the noise intensified as the aircraft descended toward the hospital's landing pad.

Cyrus felt an overwhelming sense of relief. Help had finally arrived.

"Dr. Darian," Nancy called from beside the monitor. "His pressure's holding at 101 over 47. Levophed's running at twelve mics per minute. MAP is 65."

Cyrus checked his friend's hands and feet once more. Greg could now move his fingers and toes, and his breathing appeared stronger.

For the first time since the accident, Cyrus allowed himself to feel hopeful. Greg was still critically injured, but his circulation had improved, and he was regaining neurological function. Now they just needed to get him to the trauma center.

Within minutes, the flight crew entered the emergency department, pushing a transport stretcher loaded with equipment. Cyrus introduced himself to the flight nurse and gave a detailed handoff, explaining Greg's injuries, the treatments he'd performed, and his concerns about the ongoing internal bleeding.

The flight crew moved quickly, checking Greg's vital signs and preparing him for transport. Cyrus stepped aside as they transferred his friend onto their stretcher.

Cyrus walked alongside the flight crew as they wheeled Greg out of the emergency department toward the waiting helicopter. He held his friend's hand as they walked, relieved to feel Greg's fingers squeezing his own. The roar of the rotors grew louder as they approached.

Just before they loaded Greg into the aircraft, Cyrus stepped beside the stretcher.

"Hang in there, buddy. You're going to be okay."

Greg looked up at him. "Thanks, Cyrus. For everything."

Cyrus gave his friend a reassuring squeeze on the shoulder, then stepped back as the crew loaded him into the helicopter.

A few moments later, the doors closed, and the helicopter lifted off, rising above the hospital before turning toward the distant lights of the Shenandoah Valley.

Cyrus watched until it disappeared into the night sky.

Epilogue

Several months later, the local newspaper carried two stories.

LOCAL PHYSICIAN RETURNS HOME AFTER PARADE TRAGEDY

CORLEN, VA — Dr. Greg Hale, one of the most seriously injured victims of the Halloween parade accident, returned home this week following an extended hospitalization and rehabilitation at a Roanoke medical center.

Hale, 53, was thrown from a parade float when a pickup truck collided with the procession on Main Street. He suffered a severe cervical spine injury and extensive internal bleeding, requiring emergency surgery and several months of intensive treatment.

Doctors initially feared Hale might never walk again. However, following surgery and rehabilitation, he has regained movement in all four extremities and is expected to make a full recovery.

Speaking briefly with reporters, Hale credited fellow physician Dr. Cyrus Darian with saving his life.

"Cyrus is the reason I'm here today," Hale said. "I wouldn't have survived without him."

Hale said he hopes to return to his medical practice after completing rehabilitation.

SEARCH CONTINUES FOR MISSING CORLEN PHYSICIAN

CORLEN, VA — Authorities are continuing their search for Dr. Cyrus Darian, a local family physician who disappeared under mysterious circumstances more than two weeks ago.

Darian, a longtime resident of Corlen, was last seen with his family in Colorado. Investigators have released few details about the circumstances surrounding his disappearance.

Friends and colleagues have expressed concern, describing Darian as a devoted father and respected physician who was deeply involved in the community.

His wife, Dr. Juliette Stone, has declined to comment publicly.

Anyone with information regarding Darian's whereabouts is encouraged to contact local authorities.