Wow, I can't believe the luck some people have (or don't).
A lovely family was in the process of moving from New Jersey to South Carolina, but were on their way first to Tennessee for the Thanksgiving holiday. They happened to stop in Roanoke and got a room at the brand-new hotel across the street from our hospital. In the middle of the night, the youngest child became very ill with wheezing and respiratory distress. Although he had had problems with wheezing many times during his first year of life, he had not had any problems for nearly a year. His mom was trying to treat his symptoms with medication she brought with her, but it wasn't working, so they brought him to our pediatric emergency department, and he was admitted to our pediatric floor.
Luckily the child was not very ill, and if he lived locally, perhaps could have been able to go home directly from the ED with close follow up. But since they would be traveling for the next several weeks before they get settled, and since they have no primary doctor in their new location, who would follow him?
So, although a bit stressful for this family, we decided to keep him so we could watch his progress closely, and have our pediatric pulmonary (lung) doctor see him. It turned out that the pulmonologist has a very close colleague in the city to which these folks are moving, and was able to both make recommendations for ongoing acute care, start the process of more chronic treatment of what most certainly at this point is asthma, and get him set up for follow up in their new home town.
Because they needed to get on the road as early as possible today, the day before Thanksgiving, we also made arrangements to get them discharged BEFORE the official start of the day. Typically our team makes "rounds" starting at about 8 am, and it may take a few hours to see all the patients in the morning. So often, it is difficult to get patients discharged before about 10 am. However, I asked the first year resident who was on call over night to assess him several times, and to call me at 6:30 to let me know whether he thought the patient was stable for discharge, which he did. At that point I came in, spoke with the family, examined the child and sent them on their way.
This took a little bit of extra effort on my part, but I know it was the right thing to do. I know it is what I would want for my family if I were in their position, and I know we made a friend for life.
What could have been a distressing, miserable experience for this family has turned into a situation they are giving thanks for: that they chose Roanoke as a stopping point, that they stayed in the Cambria Suites, that they found the only pediatric Emergency Department in the region, that Dr. Muelenaer has the right connections in their new city in S.C., and that we were willing and able to make our system work for them.
I too, am thankful for this experience, and don't miss the extra hour of sleep at all.