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##Standing by, 51. Give me a new set of vitals and send me a strip as soon as you can. I want to rule out cardiac involvement due to an electrolyte imbalance. Specifically, I want to look for hyper or hypokalemia. I've found that people who're top gymnasts, sometimes get sensitive to those two conditions while they're touring hard professionally.## Roy agreed. "He is a member of a circus troupe, doc." ##Add 100 mgs Thiamine I.V. That'll lend you some momentum. Run that through a saline lock, just in case we have to adjust his blood glucose more aggressively.## "100 mgs Thiamine, piggyback, with a saline lock." Roy confirmed. Roy and Johnny soon had a flowing I.V. of sugar solution entering Yuri's veins. The young man did not awaken. "He's gotta be real low, Roy." Johnny puzzled. Roy nodded to his partner. "Let's administer the glucagon. If he's gonna snap out of it, it'll be then." DeSoto said, picking out an orange case that contained a single vial of powder and a sheathed syringe. "What's that?" asked the bearded lady, finally returning with a blanketed Sonya and Cap. Gage smiled without looking up. "Glucagon is a hormone that the pancreas makes. It raises blood sugar by turning sugar stored in the liver, glycogen, into glucose, the kind of sugar anybody needs for a little brain fuel. Hopefully, this shot'll make him come to." Both ladies nodded and Cap finally left them alone to watch silently. Hank watched as Johnny inserted the needle through the rubber seal disk on the glucagon bottle. Then Gage injected all of the liquid in the syringe into the bottle. Then he left the syringe in place and gently shook the bottle until the white powder inside of it had completely dissolved. Then he handed the whole set up over to Roy. DeSoto made sure the plunger was completely down to the zero mark as he, too, shook the vial and needle, leaving his finger on the plunger to stop it from coming back up due to its vacuum pressure. Then he gently pulled the shot's grip out until all of the mixed hormone solution was drawn up into the syringe fully. Then he eyed it under a tent ceiling spotlight to be sure that all of the solid medication was truly dissolved. |
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Stoker carefully rolled Yuri over and pulled up one of his short's tights, exposing skin. Roy swabbed the area down with an alcohol pad and then gave the shot into upper, outer part of the man's buttock. "Shall we draw a red top for the glucose level check the hospital's gonna want?" Gage asked his partner. "Yeah, let's do that next. Mike, you can let him back down now. Easy.." said DeSoto, disposing of the spent glucagon needle into the sharps bin of the drug box. Roy was just about to stick an empty blood drawing vacuum syringe into the saline lock when Yuri came to. Violently. One second he was out and the next, he was talking and trying quickly to get onto his feet. "Watch it! Watch it here! You've got a couple of I.V.s in!" Gage said, as he, Cap and Roy all tried to hold the man's wrists. "Don't try to fight us or you'll hurt yourself.." Johnny yelled. "Let go! I'm Yuri Komenche', it's Monday, and I'm in the food tent. Let me go! I'm fine.. Get off me!" said the trapeze artist. Hank, frowning, gave the order. "Boys, let him go. We can't restrain him if he's fully oriented to self, place and time. And that he is, by self declaration." Reluctantly, the two paramedics followed Cap's lead and let him loose. "Good riddance. What IS all this?" said Yuri angrily. "Why am I stuck with needles?" DeSoto took his helmet off into one of his hands so he could wipe perspiration off of his face with a napkin."You were passed out, Yuri. And you're even possibly coming out of a serious diabetic crisis." Roy told him, still holding out a couple of hands in the air, still worried about the I.V. lock hub and line hanging off the man's skin, where he stood. "Me? Having the blood sugar disease?!" Yuri demanded. "I am not sick!" And with that, Yuri swiped a few fingers and pulled out the saline lock and the other dextrose catheter from both his arms. "I don't need these. And I don't need you to tell me what might be wrong with me. You are not doctors! That much I know!" said the thickly accented man. Gage immediately changed his expression from tense to neutral. "Yes, that's true, a paramedic is no doctor. But we do work through one. And we've been doing just that from minute one, through this phone line." Johnny said, holding up the waiting biophone receiver. "Makes no difference! Don't touch me." Yuri fumed. "Yuri.. let's get out of here..." said Sonya, suddenly hurrying over to her lover's side. Yuri blinked a few times, ridding himself of the sweat running down into his eyes and he nodded firmly in agreement. They turned to go. "Yuri, wait a minute. You're going to have to release us from our legal responsibility." Roy began. "I just did!" shouted Yuri indignantly, grabbing up a cup of juice to wet his mouth. He drained the whole thing and accepted another that someone else handed to him. "On paper.." Cap told him firmly. "It's called an Against Medical Advice form. It'll only take a second..." said Hank, who towered over the diminuitive Yuri by at least a foot. "Then you can go about your business as usual." "Fine. I will sign them." said Yuri. |
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Gage stepped forward. "Will you at least let us put on a couple of bandaids? You're bleeding all over the place." he said, pointing to where Yuri's I.V. sites used to be. Yuri looked down at his streaming arms. Finally he held them up with a shrug. But Sonya shoved Johnny away. "No. I will take care of him myself!" she said fiercely. A part of what she said was addressed to the silent, listening circus crowd around them. Grudgingly, one by one, those other watchers nodded respectfully and left them both in peace. As Sonya twitched out of her blanket to give to Yuri, Johnny had one more parting comment to make as he accepted his green pen back and the signed AMA papers. "You do realize, the fact that he responded to glucagon means that Yuri might be a new diabetic. Now that's a dangerous state to be in without a doctor overseeing developments. Especially for someone coming out of their first hypoglycemic crisis." "He is not one. Do not tell us what we know not to be true." said Sonya. She ended the conversation by leading Yuri off to their box car on the train. "Come on, Yuri.. We have only three hours before we go on. Come, you must rest. And eat." she glared at the two paramedics. Once they were gone, the bearded lady leaned into Cap. "I thought he was real sick or something. Can they just leave like that?" "They just did." Johnny replied flatly. "And we have no power to stop them as long as he's still awake. Because this paper says so." "What a stupid document." she grumbled, drawing her furs more closely around her sequined dress. "Tell me about it." Roy stated wholeheartedly. |
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*************************************************** From: "patti keiper" <pattik1@hotmail.com> Subject: Coda Date: Sun Oct 29, 2006 9:17 pm It was evening and the storm had long passed over the circus grounds. The gang from Station 51 were still enjoying themselves off duty. Roy's wife, Joanne had even shown up with their children and the delight was glowing in their eyes while they laughed at the sights and smells happily unfolding around them. Their laughter made a joyful noise that infected all the firemen, causing them all to completely escape any thoughts of menial work. Johnny offered Chris DeSoto another clump of cotton candy. "So.. Did your dad and I get stuck with a good enough work assignment detail or what..." he said, nudging Roy's young son in the shoulder. "You sure did, Uncle Gage. This isn't working, this is playing." he beamed. "The rescue squad sure looks neat under all these lights." "It does feel a little like the fourth of July, doesn't it?" Chet chuckled, munching on warmed up caramel corn. Johnny shifted on the star bangled bleacher seat as he stuffed more pink sugar fluff into his mouth. "Hand the rest of this to your sister, Chris. She can't reach hers from over there." "Ok." he said, tapping the much younger girl until he had her attention free from colorful distractions. "Eat up." he encouraged her. "You're falling way behind the rest of us. Here. I'll hold your lemonade." he offered. |
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Joanne and Roy were knotted around one another as they leaned up against a supporting tent pole in a blissfully companionable hug. Mrs. DeSoto leaned into him. "This is real nice. For once, your uniform doesn't smell like fire smoke." Roy chuckled. "You should have been here earlier. Johnny and I were up to our necks in some of the stuff. We found ourselves right in the middle of flames, too." "You were? Where?" Joanne grinned, peering at her husband suspiciously. "I don't see anything that's burned down." "Oh. It wasn't a what. It was who. And he's not here right now." Johnny quipped, looking at her with a smirk. Joanne made a face, still seated in between the two paramedics. "I'll ask more about that, later. Glad the kids missed that kind of spectacle." "Oh, they did it ok." Roy remarked, kissing Joanne on the cheek affectionately. "You see, they didn't toast just any guy. They smoked a clown." "They what?!" Joanne laughed uproariously. "Through his sportspages. And it was hilarious." Johnny said to her, finally over all misgivings about the stunt. "I sure hope it was, for all the children in the audience's sake." "Don't worry. They buffered our pretend rescue with generous doses of slapstick." DeSoto giggled. "While we were slapping." added Gage. Cap, seated and flanked by two miniscule DeSotos, opened his mouth and out came a burst of rich toothy laughter. "Never thought I'd ever see the day a fire horror was joshingly fun poked. Wish I could've been there." "You just might get your chance, Cap." Johnny told him. "Mac the clown told us we were such a hit doing that, that the ring master ordered the fire scenario to be used every night for the rest of our circus's run." |
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"I just hope nobody gets hurt. You know I'd hate that." Joanne said. "It'll never happen." Roy told his wife. "Not here. This is the circus." Chet piped up. "Yeah, I passed a sign on the way in that said it all, Joanne." "What did it say?" she asked Kelly. "The Samson Brothers' Circus Extravaganza..Defying death every day." Mike Stoker spoke up eagerly. "Shush.. SHhhhh." he hissed. "It's starting." he stage whispered. "I've been waiting for this act all night." "Oh, yeah.. This is gonna be Sonya Skye's act next, isn't it?" Marco asked. "Yeahhh.." said Chet breathily. "The... Birds of ...Paradox.. no." he corrected. "..of..Paradise." he said, reading off his program myopically in the glowing darkness. "There are gonna be two of them?" Hank wondered. "We didn't see a second girl in the mess tent." "We'll find out that answer soon enough." Lopez grinned. "Two pretty girls for the price of one? I can hardly wait. Sonya's costume was positively beautiful when I saw her dash by a couple of minutes ago backstage. All diamonds and red velvet." A burst of ethereal music and the soft gushing of fog machines sighed as they began to fill the circus canopy above them full of mist. Two long bolts of red chiffon floated down from invisible heights in slow delicate tumbles. The hushed, warm misty darkness was stabbed with dazzling sparkles as a spotlight lanced down and transfixed an athletically ballet posed Skye as she began her dance in the air, suspended from the red cloth lengths. The audience quieted, getting spellbound by the sheer grace of her movements and soft demonstrations of strength timed with the music. Everyone was captived in a moment, caught in timelessness. The music thunderclapped and harsh lighting stabbed the ceiling, illuminating a platform far above the crowds that was lowering itself above Skye's red tethers. A trapeze artist in peach leaped for a suspended swing tied above him and flipped to perch himself onto it. |
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The two paramedics immediately got to their feet in shock. "That's Yuri! Oh my G*d. He's trying to perform tonight?" Roy asked incredulously. "Let's get down there. Maybe we can convince somebody that this is sheer craziness." Cap agreed. "He was in no shape to do anything tonight." "Joanne. Watch the kids, we'll be right back." Roy told her. The six firemen excused themselves and made their way quickly off the grandstand benches as they headed for the green room space behind the main performance ring. They confronted the ring master as soon as they spotted him. The older man held up his hands. "I know what you're thinking. But it wasn't me who authorized the go ahead. Yuri's stubborn beyond belief when it comes to performing. He must have used his emotional sway over Sonya and then tricked the stage manager. I told him no." "What do we do now? His part of the act's already started." Gage fumed. "There's not much we can do." said the ring master. "There are no radios or speakers up there." "Put up the safety net." Cap told him. "What?" sputtered the ringmaster. "You heard me. I saw the crew rigging it to fire up from under the sand before the show." Stanley said. "I can't do that. It's a matter of professional courtesy to respect any performer's wishes about how they want their acts run. Sonya and Yuri haven't flown above a net for years." the circus boss insisted. "Everyone else will flay me alive if I betray their confidence. If I deploy it now while their act's still going on, I - " "Mr. Masters, he's a very sick man." Roy glared. "Yuri only looked like he was recovering. That's how glucagon works. It's only a temporary fix." "Where's your triggering crew?" Cap roared. "His life is in danger!" "I, uh, ..ok. Ok. I think Ike and Ben are over here. I'll - I'll go get them right now." said the ring master nervously. "You'd better find them. You'd better hurry." Hank yelled after him. Then he turned to his men. "Are all circus folks this stupid?" he asked Stoker angrily. "They do seem like any grunt that's ever come out of the fire academy." Mike grumbled. |
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Roy and Johnny began to fret after they began hugging the curtains just shy of the lighted entrance that led to the circus ring waiting for a miracle to happen. A scream rippled out just then. A single, high strangled yelp from a frightened little girl seated just beyond the curtain and it instantly froze the hearts of all the firemen. Far above, Yuri's had slipped off his trapeze swing's bar after he missed catching Sonya's supporting hand grip and his peach clad sparkling form was beginning to plummet like a limp rag doll to the ground. Roy and Johnny burst into a frantic run for the ring just as two circus workers in black leaped for a red and white hand painted wooden lever located alongside the main tent pole. It looked for all the world like a railroad track control arm lever. It was the net's trigger mechanism. But they didn't reach it in time. Yuri struck the deep sand sickeningly from his original height of forty feet, and then he bounced up horribly into the air, suddenly a broken sodden mass. Only then did the net finally pop up in a cloud of dust to form a protective mesh cocooning around him as it elastically rebounded from the ground on safety cables. Yuri was curled up into a ball inside of a second smaller suspended net as the main one finished deploying like a trampoline beneath him. "Get him down! Get him down now!" Gage shouted to the circus men. Sonya was the next to fall. She let go of her red cloth scarves and landed on her back into the large net. Sobbing, she scrambled to the edge and was helped off by stagehands and lowered to the ground. She ran for Yuri as the firemen grabbed him as his net was lowered to the earth. |
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The ringmaster made an immediate appearance in the center ring, gesturing animatedly. He was calling for a clown troupe. "A var! A var! Send them in!" Loud carnival music began and on his order, stunned clown performers obeyed and began their act , ignoring the ring that was quickly darkened next to them where the firemen and Sonya were kneeling over a gravely wounded Yuri. The rescue squad was pulled up, lights and siren silent by hidden assistants under the black cover of a blue filtered spotlight. Roy looked up, and he minisculely shook his head at Cap while he and Johnny began an effort of futile resuscitation while the others swiftly got a firm backboard and cervical collar into place. The endotracheal airway did not thread down, failing in the presence of damage from two collapsed lungs and multiple rib breaks. A doctor ordered percutaneous needle cricothyrotomy was begun carefully in a pause between CPR sets. |
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Tears streaming down her face, Sonya took Yuri's blood stained fingers into her own and she began to speak to him softly with gentle words that desperately sought a warm tenderness. Sighing in pain and grief, Sonya's saddened heart quietly spilled out only pure love as the others listened while they frantically worked. |
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"Isn't it rich? Are we a pair? Me here at last on the ground, You in mid-air. Where are the clowns? Send in the clowns. "Isn't it bliss? Don't you approve? One who keeps tearing around, One who can't move. Where are the clowns? Send in the clowns. "Just when I'd stopped opening doors, Finally knowing the one that I wanted was yours, Making my entrance again with my usual flair, Sure of my lines, No one is there. "Don't you love farce? My fault I fear. I thought that you'd want what I want. Sorry, my dear. But where are the clowns? Quick, send in the clowns. Don't bother, they're here. "Isn't it rich? Isn't it queer, Losing my timing this late In my career? But where are the clowns? There ought to be clowns. Well, maybe next year." |
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*************************************************** From: "patti keiper" <pattik1@hotmail.com> Date: Tue Oct 31, 2006 9:25 pm Subject: Freedom Of Choice.. Johnny Gage got on the biophone as soon as the tenuous emergency airway was in and the EKG turned on. He found that he had to shout over the circus music cranked over the tent's sound system. Deep inside, he knew that distracting the kids in the audience was necessary, but another part of him was mad that the show was still going on as if the accident had never happened. "Rampart, the needle crich was partially successful. We've no chest rise visually discernable with ventilations by bag valve due to bilateral flail segments, but he is not suffering any gross cyanosis. More information, Rampart, Uh,...this is a traumatic cardiac arrest due to a fall taken from a distance in excess of thirty feet onto sandy ground. He's been fully C-spine immobilized in the position found. He struck dirt completely supine. Note, he did not land on his head." Nearby, Marco was talking into the squad's HT. "L.A., Squad 51. We're requesting Life Flight to our twenty for a victim of a fall with extensive trauma. We've a male in his twenties currently in cardiac arrest...." ##10-4, Squad 51. 'Copter Two reports an arrival of three minutes.## said L.A. Captain Stanley nodded at Lopez. "Marco, go outside and pace them out a safe landing zone. Make it a hundred feet by a hundred. Use five cherry flares in a square with the fifth showing our location's upwind direction. Get the area clear of any debris that might possibly become airborne. Then notify the pilot of any powerlines or nearby radio towers and give him our wind speed along with a visibility report." "Right, Cap." said Marco, running for a side exit from the tent. ##51, are you detecting a carotid pulse with compressions?## came the bio-comm's reply following Johnny's report. "That's affirmative, Rampart." Johnny told Dr. Brackett, gripping the receiver in worried anticipation. He was very glad that his stationmates had chosen this night to come to their circus gig. Their aid was proving invaluable in more ways than one. He could feel their emotional professionalism buffering and calming him down despite the presence of Sonya's painful, knifing grief as she started crying out loud, in shock, next to them. ##Ok, then it may be that his aortic and pericardial integrity is still intact without any significant ruptures. What's the scope showing?## |
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Roy took the phone from Johnny while Chet, Stoker and Cap continued Yuri's cardiopulmonary support. It took two of them to make sure the thin, needle threaded cricoid cartilage pierced airway stayed open and in place in Yuri's windpipe while CPR continued. "Doc, we've still got coarse v-fib. He's shockable." ##Place him into antishock trousers first before defibrillating one time only. Ignore all limb and pelvic fractures when you use the suit and don't worry about movement in his back below the waist. His circulatory priority is first. Inflate both the M.A.S.T.'s legs and abdominal compartments as far as they go. His chances of making it back will be better if the worst of his soft tissue and internal bleeding is under control. Start two large bore I.V.s of Ringer's Lactate of 1000 cc's each into both carotid arteries and hand pump them in wide open. Turn them down only if infiltration PE develops and you start to get more solution than blood on suctioning. If he doesn't convert electrically, 51, provide continuous CPR and crico ventilations during transit. Get him in here by the fastest means possible. I'll have a full surgical trauma team ready to meet you. Deliver 1 mg 1/10,000 epinephrine IC and follow up with two amps sodium bicarb I.V.## said Kel. "10-4, two Ringer's large bore, M.A.S.T suit priority, 1 mg of 1/10,000 epinephrine intracardially, two amps bicarb, and defibrillate once. Stand by." said DeSoto. Inwardly, he agreed with the minimal shocking order. ::That would only further exacerbate any damage he's already taken. Our CPR's already doing enough of that on its own.:: he thought grimly. He tossed down the phone and accepted the long needled syringe Johnny handed to him. "Cap, can you get her clear?" DeSoto asked Stanley, tossing a sympathetic head at Sonya as he uncapped the epi's six inch needle. |
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"Yep.... Stoker, stop CPR. They have it ready." said Hank as he knelt by Miss Skye and gently took her shoulders. "Sonya. Come on, hon. You have to let go of him for a minute." "I can't leave him.." she sobbed. "He'll know that I let him go." "Just for a minute. I don't want you to get hurt when we try to cardioshock Yuri." Cap told her gently. He finally had to pry her fingers away from Yuri's hand. Then he used his greater strength to lift her to her feet by her elbows. "No! Please.. Don't take me away...." she yelled. "It's not right!" "It's for your own safety, Sonya. Now let's look away from him. I want to turn your back for a moment." Cap told her. "Why?!" she screamed angrily. "We have to give Yuri a heart injection. It's some medication that's very like adrenalin. It might be something you won't want to see." Cap gently explained. Sonya immediately accepted Hank's shoulder into a hug, her mouth gaping open as he turned her away. "Yuri's truly gone?" "Now we don't know that. Only a doctor can say what his condition is for sure. And that's only after every other possible option and medical treatment has been tried." Stanley explained. ::This whole code's being worked for her sake now. So she'll have some comfort about Yuri's passing later, knowing that we at least tried everything to help him.:: Hank thought. Sonya's face twisted in stifled grief and she fell silent in his arms as she buried her cheek into his jacket with her eyes closed. "I should have said something to the ring master. And to you. Yuri does take insulin. He injected himself just before we went on..." she squeaked. |
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Roy looked up in horrified discovery at that. He knew that Yuri's glucagon probably had had some side effects that caused a falsely high blood sugar reading following its use. ::That was only temporary, too. For a couple of hours at the most. Yuri must have injected too much to counteract what he thought was a normal food high and that must have crashed him into a rapid low while he was still up on the trapeze. Oh,..of all the-- this whole tragedy could have been completely avoided. If only he had listened to us...:: DeSoto thought sadly. Gage stabbed the epinephrine home and pushed the plunger. "It's in, Roy." he said, pulling out the needle and checking its end to be sure all of it was still there and unbroken. DeSoto nodded. Yuri's blood flecked body lifted under the paddles when Roy delivered his wattage in a shock at the lowest setting any adult needed. ::120. That's the least harmful.:: Intently, he eyed the monitor. "Nothing... Guys, start up on him again." he told the others. He picked up the phone. "Rampart, no conversion. His rhythm's degraded into fine ventricular fibrillation." ##Bring him in, 51. I'm afraid that's all you can do for him out there. Maybe we'll be able to do a little more for him once he's reached the hospital.## Kel encouraged. |
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"10-4, doc. Our ETA's eight minutes. The chopper's here." Roy said. ##See you soon, 51.## Brackett said, signing off. Soon, Yuri was packaged onto a gurney and wheeled out of the circus tent. Roy's family came running up to the squad once they saw that DeSoto had begun packing the medical gear Johnny didn't need on the chopper, away. Chris couldn't contain himself and he ran into his father's arms. "Daddy, is that man dead?" "Yeah, I'm afraid he is, Chris. I won't lie to you about that. How's your sister doing?" "She didn't understand. She thought it was part of the act as another one of your mock medicals." the boy sighed. "Mom wants us to go before she figures out what really happened." "That's a good idea. Are you doing ok? Seeing someone die unexpectedly's gonna be hard for while. You shouldn't've seen that kind of thing at your age, son. I'm sorry it had to happen. I was..... hoping you'd be spared being exposed to something like that, until you were.... old enough to join the fire department." Roy told him, releasing their hug. Gently, he wiped Chris's tears away. Chris's face screwed up in grief. "Why couldn't you save him, dad?" he sobbed. Roy's expression grew quietly sad. "Sometimes, you can't save somebody who doesn't want to be saved. And that's all there is to it." he said, gripping Chris's shoulders to show that he was completely there for him. "I'll tell you about the dark side of AMA forms someday. It's something I see a lot of working as a paramedic. But we won't talk about that today. I think we've seen enough unhappiness already." The younger DeSoto nodded bravely as he finally gave into his shocked emotions completely. Roy just took his son deeply into both arms and let him cry. |
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Twenty minutes later, Chet showed up to let Roy know that everything was back in order as far as the squad and its equipment was concerned. He noticed that Chris was a little numb and instantly, he understood why. He spoke up loudly, with a grin. "Hey, fellas." he said to them. "Did you hear about the fire at the circus?" he asked Chris, kneeling down next to him to offer the boy an affectionate head rub along with a steaming hot chocolate cup. "No." said Chris softly. Roy started smiling. "Yeah, man.. It was really "in tents." Kelly quipped. Chris DeSoto's face split into a tearful laugh and soon, he found that his heart's pain had become.. just a little bit less.. than it was before. FIN Episode Thirty Eight A.M.A. Emergency Theater Live ----------------------------------------------------------- |
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