The call came without warning. A rolled up piece of paper came in through green dragon’s flame. Nurse Redheart opened the scroll, read the first line, and immediately summoned Red Cross to the front desk. Late at night, Cross (with the aid of his team) hitched the medical ambulance to himself and sprinted out of the garage. The stars shone brightly in the sky, and the moon illuminated the dirt road as the ambulance carriage thundered across the dirt, leaving a massive cloud in its wake. The ponies had little to no time to even read their dispatch orders, having been rushed out the door by the nurse. The pegasus member of the team, Lion, unfolded the printed sheet of orders and read them thoroughly. The unicorn doctor on call, Heart Beat, rode along with Cross’s carriage as it zoomed towards Ponyville. Knack the mule sat in the internal passenger seat, readying the various machines inside the rear compartment of the vehicle.

Lion directed the ambulance towards a tall golden tree at the very edge of town, surrounded by ponies and carriages alike. Dr. Beat pulled on a chain, and the magical siren of the ambulance roared, scattering the crowd and allowing the emergency vehicle to park close to the door.

While Dr. Beat and Lion jumped off the back, Cross quickly unhitched himself, leaving the harness on so he could get back in quicker. He ran into the tree with the other two, but not before opening the two rear doors of the ambulance and pulling out a folding stretcher. The earth pony slung it over his back and dashed inside with his companions.

Knack, jumped up from his seat in the corner of the carriage. He reached for power buttons, turning on all the EKGs and monitors. He opened a drawer and took out a syringe, then dipped it in a flask of anesthetic solution, for emergencies. Carefully he measures out seventeen milliliters of the clear yellow liquid, then wiped off the sharp end with a paper towel. Reaching for another cabinet, he opened a plastic bag filled with clear liquid, then hung the bag off a ceiling hook. Carefully, he screwed on a drop regulator to the open bottom of the bag, then held one of his hooves over the end of a plastic tube while the other wiped a transfer needle with an alcohol pad.

Inside, Lion watched as Dr. Beat took a purple pony’s temperature. He carefully slid the glass rod under her tongue, and watched as it steadily rose to one hundred and one degrees Fahrenheit. He pressed his stethoscope against her bloated belly, and heard the pulse of a second heart deep within her. The violent kick of a foal pounded against the stethoscope, and the doctor screamed and clutched his bleeding left ear. Likewise, the purple alicorn screamed as something deep inside began to stir. Lion knew what was going on. He shouted at Cross to hurry.

The purple mare was pregnant. The baby was coming out. Now.

Lion ordered Cross over, and together they lifted the purple mare onto the opened stretcher. He was heavier than she looked, and the added weight of a foal only made things worse. The other ponies in the room helped: an orange pegasus with blue hair seemed especially concerned. Dr. Beat tried to calm the others while Lion and Cross carried the screaming mare outside, Cross yelling at Knack to ready a painkiller. Her lavender wings dragged against the ground as the two ponies loaded her inside, lifting the heavy stretcher into the cramped ambulance.

“Will she be alright, mister?” said an orange mare with straw-blond hair.

“Yes, I’m sure.” said the doctor with his Hoofington accents. “She’s in good hands now.”

“I’m coming with you.” said the orange pegasus.

“No, you-”

“You don’t understand.” He pressed his hoof against his chest. “I’m the father. And I’m coming whether you like it or not.”

“Flash, are you sure?” said a white pony with purple hair. “Twilight’s-”

“Twilight needs me now more than ever.” said the pegasus.

“If you are coming,” said the doctor. “you have to come now, we can’t wait any longer.”

“Hurry up in there, doc!” shouted Lion. “Cross is already hitching up!”

Dr. Beat looked at the orange pegasus for a second before dashing out the door. The pegasus turned his head to look at the other ponies, and ran after the doctor.

Knack injected the mare with the needle before Lion and Cross had fully loaded her in. Immediately, the alicorn stopped her screaming, but a second later it came back. She writhed on the stretcher, so much that Knack had a hard time attaching all the wires to her body. her wings flailed with her legs, and the ponies tried with all their might to keep her down. She knocked over several vials of chemicals before Knack finally got her still. He carefully held her left foreleg down and injected an IV needle into her vein, letting the numbing chemicals in the drip flow into her bloodstream. Dr. Beat jumped into the open back, squeezing in the small gap to the mare’s right, followed quickly by a strange orange pegasus stallion Knack had never seen before. But the old mule was never one to question things. He simply motioned for the newcomer to close the doors and banged his hoof against the wooden wall.

The wagon lurched forward, sprinting back to the hospital. Cross ran as fast as his earth pony legs could take him, sweat beading on his forehead. He felt the lactic acid flow into his legs, the burning sensation beginning to slow his sprinting pace. The wooden wheels of the cart banged against the rocks and pebbles, shaking the ambulance with ever minor disturbance.

The orange pegasus held the mare’s hoof tightly while Dr. Beat and Knack monitored her vital signs. Knack set up another EKG machine and pressed the pads against the mare’s pregnant belly. Sure enough, the rhythmic ba-bump of a pony’s heartbeat registered on the device. Knack prayed that it would last. The cries of the mare echoed in the small rear compartment, and the old mule prepared another anesthetic shot.

“We need to perform an emergency removal.” said Dr. Beat. “Judging from the ultrasound, the little pony inside her won’t fit through the canyon.” He turned towards the small window that led out of the compartment and opened it.

“Lion!” he shouted. “Call ahead and see if they have  a surgical room open! The foal’s too big!”

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Something was wrong. Nurse Redheart ran out of the hospital towards Cross before he had even unlatched himself from the carriage.

“You need to go somewhere else!” she shouted. “The surgical rooms are full! There’s no way we can open up a space, even for a minute!”

“So where else do we go?” asked Cross. “The nearest hospital is in...”

“Canterlot.”

Cross sighed. “That’s twenty-five miles from here. I don’t think-”

“You’re gonna have to try” said Lion. “I don’t think the mare is going to hold on for much longer.”

Cross turned his head towards the golden city to the north.

He blew steam out of his nose, then reared. The momentum gathered from his powerful movement sent the cart thundering forward down the dirt road, passing the fountain in the courtyard within five seconds of initiation. He cared less that Nurse Redheart was now covered in dirt, or that the cart’s rear right wheel was cracked. He only cared about getting the mare to a surgical room in time.

The carriage thundered past Ponyville, sweat falling in a straight line behind it. Cross pushed himself to lengths even he had never seen before, blood rushing to his cheeks and lactic acid fill his legs. Pain shot up through his muscles and bones, and with every step the discomfort only increased. The carriage grew heavier and heavier as Ponyville slowly disappeared behind them, and Canterlot slowly became larger. The path wound around the foothills, and the carriage shook more and more as rocks and pebbles bounced underneath its wheels.

There were other carriages along the road. Dr. Beat pulled the siren chain fourteen times within the first minute of the inter-city highway, and Cross had to weave through heavy traffic, dodging recreational wagons and passenger taxis alike. The cracked wheel groaned under the strain, and the small gap slowly grew to a large one.

Inside the vehicle, Twilight screamed loudly for the thirtieth time in a row. Knack had already given her five injections, and refilled her IV bag once. The pain she felt was beyond belief, Knack knew that. All the pregnancies he had ever seen were filled with the dull pulsing of the world’s most devastating pain. But all the mares he had transported were brought to Ponyville Memorial, and none had a foal as big as hers. Knack estimated she had twelve or so minutes before the pain would simply become unbearable. He couldn’t risk giving her another injection- that would mean her probable death. All the old mule could do was watch the EKGs and wait.

The broken wheel finally gave in. Cross and the ponies felt the entire right side of the carriage lean over as it smashed itself into splinters. Lion quickly jumped off, the repair kit and spare wheel in his hooves, while Cross took a much-needed break. Lion worked as hard as he could, fitting the jack on the bottom of the wagon and unscrewing the six bolts that held the remains of the wheel in place. Carefully he grabbed the spare one, fitting the new wheel onto the slightly damaged axle. Quickly he screwed the wheel back on, his sweat mixing with the dirt, staining his cream-colored coat. From the front of the wagon, Cross yelled at Lion to hurry, and he did, slapping on the final screw and flying back up to the driver’s seat.

The repaired cart thundered down the road to Canterlot, Cross pushing himself as much as he could. The sprinting pace he had kept up was beginning to slow down, and even with every last bit of strength he could muster, the carriage could only go so fast. The earth pony was drenched in sweat, and his back hurt like the heavens were pressed against it. Only his eyes were free of any pain, but that soon would change, as the blood from the exertion rushed into his brain.

Blood vessels covered his eyes, his normal brown pupil becoming a dark black. His head ached with every step he took, and his powerful charge had been reduced to an average gallop. Even with Lion pulling the carriage with a rope, and Dr. Beat running alongside the aching earth pony, the ambulance would not go much faster.

The emergency vehicle was met outside Canterlot by a full medical team and several larger, motor-powered ambulances. It was at this moment that Twilight could not hold it in anymore. The foal needed out, NOW, and they could not get to the hospital fast enough. It was quickly decided that the surgery would be done inside the ambulance, and Knack prepared the proper monitoring devices for the surgical team.

A platoon of trained nurses rushed Cross to a waiting ambulance, the earth pony foaming at the mouth. One of the doctors said he had burst a brain aneurysm, a tiny bulge in a blood vessel that, when burst, unleashed a flood of blood over the fragile areas of the brain. The doc didn’t know if he’d make it. All he did know was that the ambulance rushed him off to Canterlot Central Hospital at lightning speeds.

Nearby, in the ambulance, the cries of a newborn foal mixed in with the screams of a mare. Then, three doctors lifted the purple alicorn’s stretcher, folding her wings in with her, and carried the limp body to another waiting ambulance, the doors open wide. Her belly was open, and blood poured out of her wound. The orange pegasus followed her, clutching something small in his hooves. He jumped in the back of the motor vehicle, and slammed the doors.

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The moon shone brightly in the sky as Twilight embraced her little foal for the first time, laying on a hospital bed at Canterlot Central, with Flash laying next to her. The tiny filly had Flash’s color scheme, but a tiny horn jutted from her forehead, and her amethyst eyes were as bright as her mother’s.

In the room next door, doctors could do nothing as Red Cross’s burst aneurysm pumped blood directly into his brain. There was nothing they could do. They could only watch as the earth pony died on the gurney, his eyes rolling back into his head, his mouth constantly foaming.

They shut off his life support as Flash kissed Twilight on the cheek and turned the lights out.

The little foal and her mother lapsed into cool slumber.

The earth pony rose into the warm embrace of heaven. A fitting rest for a stallion who would not. The doctors around his bed all lowered their heads.

In Twilight’s room, her little foal began to cry.