"RRAAAAAUUGGGHH!"
The agony-filled scream rang out through the small, closed-off chamber, echoing slightly from the primal intensity. It wasn't the first those empty walls had heard, and it certainly wouldn't be the last, borne of tortured beings who often wished they could simply die rather than endure the shattering feeling of being ripped apart from the inside. Another voice, slightly frantic and distinctly male, spoke over the panting and ragged breaths of the unicorn lying on the table.
"Come on, Mrs. Blue, just a little more! You're doing fine and almost there. Just a little more, you can do this!"
Doctor Pulse had been working at Manehatten General Hospital for seventeen years as of last month and in that time had come to develop a long list of sayings and encouragement that were most effective on a mare in labour. Unfortunately, it seemed that just the setting of the delivery room was enough to make his subconscious realize that there really was nothing particularly good to say and that just about anything would get him screamed at. They were screaming already, of course, but being the only stallion in the room often served to make him a target for the entire male gender.
Less than a minute later, however, one final cry faded into a wheezing breath that was second in volume only to the crying of a newborn foal. It was a feeling only mothers could understand; hearing those first cries of a new voice in the world, and right now it was soaring through the mare's entire being. Her face was streaked with tears, her throat was raw, she was out of breath, her hooves felt like they were crushing the table's steel railings, and she was starting to lose feeling of everything below her waist. Diamond Blue couldn't be happier.
After a few seconds the crying receded to a more bearable level, and Pulse carefully walked around the raised platform with a small pink bundle cradled in his arm. He placed it delicately into the tired arms that eagerly awaited it and smiled at the face that hovered above it before his ears twitched and he turned slightly towards the commotion that had broken out behind the door.
"She's not saying anything, why isn't she saying anything?" asked the muffled but still entirely understandable voice.
"Sir, I'm sure everything is fine."
"What if it's not? Is something wrong? What if something went wrong?!"
"Sir, you have to stay here, you can't g-"
"Like Tartarus I can't!" The doors flew open, following the red lines painted on the floor that marked the area that Pulse kept clear for this exact reason, and the stallion was instantly at his wife's side, cradling one of Diamond's midnight blue hooves with both of his own white ones. An angry-looking nurse was next through the door, her hoofsteps making the unmistakable sound of a very ticked off mare as she marched toward Pearly White to take him back outside. Pulse, however, only smiled and held up a hoof towards her, halting her path. It was a breach in standard protocol, but it happened so often that it might as well be part of the game plan by now. She huffed and returned to her station outside.
"Oh, Diamond," he whispered, "she's beautiful." His wife weakly squeezed his hooves with her own, unable to do much more in her current state.
"You helped," she chuckled in reply, looking down at the foal. After all the chaos and noise had calmed down, the baby had gone to sleep. Pearly reached up and pulled the blanket back a little to show the bright yellow coat, topped with a deep red mane that split around the horn.
Wait...her horn...something wasn't right. He called upon his long years of school and career of professionalism as he looked at the doctor, intent on forming an eloquent way of phrasing the question.
"What's wrong with her horn?"
Close enough.
Pulse walked over as Diamond looked down, not having noticed anything out of the ordinary in the surge of emotions as she first held her newborn child. He kept his face neutral and chose his words very carefully.
"Mister and missus White, please remain calm." Because politely asking them was going to work. "That's what we've come to simply call 'Fallen Horn Syndrome,' and before I explain any details, I need you both to understand that ponies with FHS are in no danger and grow up to lead perfectly normal lives. In fact, several of the staff here at the hospital had it, myself included." Indeed, the baby unicorn's horn looked as if it had been pushed from the tip towards the back of her head at a somewhat steep angle. "It's a rather less-known condition, but not as uncommon as you might think; about six percent of unicorn newborns have it, and of those about sixty-five percent are recoverable, leaving one point three percent of our total population affected."
"What do you mean, 'recoverable' and 'affected'?" Pearly blurted, both parent's eyes suddenly fixed on Pulse's. The doctor sighed to himself. This was never easy, but he had long since found that the most direct path was usually the best.
"She...may not have the use of magic," he said quietly, holding up a hoof to forestall the barrage of questions that he knew were coming. "Let me finish. It starts just past the months of early development, wherein unicorns begin to grow horns, pegasi wings, and earth ponies a more robust skeleton. In the majority of Fallen Horn cases, the developing cranial section does not recognize the new material that the horn is made of as its own; it continues to treat and build with it like normal bone. As I'm sure you're both aware, being unicorns yourselves, horns are made largely of the same material as hooves." Pulse tapped his own horn with the rigid edge of his hoof, the result a dry ticking sound. "It's not exactly the same, but it's an apt comparison for most medicinal purposes.
"In essence, the two development processes clash, resulting in either a thicker and sturdier horn due to the rush of chitin that the system uses to overpower that developing the actual bone, or the second case as you can see before you wherein the horn is overtaken and attempted to be made as part of the skull. The degree of severity varies from case to case, but most often it is shown by the horn being bent towards the cranium at a noticeable angle. Contrary to common belief, a unicorn's horn is not built at a perfect right angle to the skull; it usually varies by a few degrees on average, so when after the surgical processes that have been developed are used and the horn is brought back to a more or less 'normal' position they appear no different than any other."
"What's this about no magic, then?" Pearly had stayed quiet as long as he could manage, but his newfound protective fatherly instincts had finally taken over. Diamond, for her part, was handling herself quite well.
"That's what the final point of the developmental clash determines. If there is a high enough concentration of the specific type of chitin that channels magic, then the horn is readjusted and the foal grows and learns just as any other unicorn, though sometimes they do so at a slightly slower rate, something quite expected." His face fell slightly as he continued. "However, if the concentration is enough less than that of the bone, then the innate magic gifted to unicorns cannot be channeled and used."
"How can you tell?"Diamond spoke up for the first time since he had started into his explanation, and Pulse was grateful for a question that finally left an opportunity for a good outcome.
"We have a sensor, a very simple device that the nurse should be back any minute with. It is charged with raw magic from any unicorn, and then it attempts to feed that through the horn. If it conducts the magic, then it's a simple step to right the position and be limited only to minor checkups for a few years. If the magic doesn't pass through, though..." he trailed off, shaking his head slightly as his gaze fell. Pearly spoke up again.
"What? What happens if the horn doesn't work?" There it was. He'd had to tell this to only a hooffull of families throughout his entire career, and it never got easier. He steeled himself with a deep breath and looked them both directly in the eyes before answering.
"Standard procedure details that we remove it completely."
