As the sun begins to set behind the quiet hills of Virginia's Shenandoah Valley, chaos breaks out on the grounds of Camp Fantastic. Lured by the smell of barbecued chicken, a hundred boys and girls descend from their dormitories to the Front Royal 4-H lodge, where dinner is being served and the evening's much-anticipated special event -- the annual talent show -- awaits.
But before the campers can eat, sing and dance, there is one thing they all have to do.
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The word cuts through the din of kid-conversation, a hodgepodge of the 7- to 17-year-olds' gossip of the day.
At Camp Fantastic, a weeklong summer camp for kids with cancer, the medline is as much a ritual as the swimming classes and campfire singalongs. Four times each day, the children line up, arriving on foot and on crutches, by wheelchair and golf cart, to meet with medical professionals.
It's a mini-checkup for kids battling such conditions as leukemia, bone cancer and brain tumors. At Camp Fantastic, the checkups just happen to be book ended by canoe rides, archery lessons, dance classes and a carnival.
"This is a place where kids can just forget about their cancer and have a good time," says Erica Campbell, a Camp Fantastic counselor and board member. "It's amazing -- they're able to forget about their cancer at a place where they're surrounded by it more than ever."
Camp Fantastic was founded in 1983 as the cornerstone program of Special Love, a nonprofit dedicated to kids with cancer. In the decades since that first session, more than 1,800 children have attended the camp, funded primarily by private donations.
The National Institutes of Health provides 24-7 medical care, including chemotherapy and other intensive treatments, and a fully equipped emergency room. With the help of 60 volunteers and nearly 70 medical staffers, campers are able to safely participate in a variety of activities.
Quadriplegic children take rides in the hot-air balloon, Campbell says. Campers who can barely sit in wheelchairs go horseback riding. Some kids have their first dances and first kisses at Camp Fantastic. Girls take off their wigs in public for the first time.
"We will do anything to make sure a kid who wants to take a risk, whatever that risk may be, gets that chance," Campbell says.
For 13-year-old Avery LaChapelle, whose diagnosis of leukemia came at 14 months, the highlight of his first summer at camp is simply being away from home, away from the hospital and surrounded by other kids just like him.
"I always wanted to do sleep-away camp, but I never could before. I think my parents miss me, but that's OK," he says with a shy grin. "I've made a lot of new friends."
Organizers like to say that Camp Fantastic isn't a sad place. But it has more than its share of sad moments. During the week, the youngsters learned that one of last year's campers, a 12-year-old boy whom friends described as a "big hugger" and who sang in all the camp musicals, had died. The news hit hard.
One girl dedicated her performance in the talent show to him. She softly sang along to a recording of "I'm Gonna Love You Through It," about a woman with breast cancer who is supported by her husband.
Even those who didn't know the boy well were moved.
"We're all family here," says Ryan Tomoff, an 11-year camp veteran who celebrated his 18th birthday during the week. "Something happens to one of us, it happens to all of us."
According to 14-year-old Courtney Ott, having something in common with fellow campers is the best part of coming to camp.
"It's helped me to know other people are going through the same thing," says Courtney, who nearly lost her left leg to bone cancer when she was 10. Instead of amputating, doctors removed the five-pound tumor from her shin and replaced the bone with donor tissue. There is noticeable scarring and a depression around Courtney's lower leg.
"When somebody here sees my leg, they know it's from the cancer," she says. "They don't say 'Eww! What happened?'"
As the talent show winds down, a dance party begins. Courtney's friends call out to her to join a conga line, marching toward her to the beat of Katy Perry's "Firework."
"When the doctors told me I had cancer, the first thing I thought was, 'I'm gonna die,'" she says, stepping toward the dancers. "Then I thought I was gonna lose my leg. But they saved it. No matter how bad I have it, there's someone who has it worse."