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Tuesday, Aug 21, 2018
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Morgan: I had pneumonia, but I learned how virtual medical care can be a great idea

CASHIERS-HIGHLANDS, N.C. — As a rule I don’t like emergency rooms.

But late on a recent Friday afternoon I was having trouble breathing and felt like I could be in real trouble if I waited for Monday and office hours at the local clinic we use during summers in the mountains of North Carolina.

I am more accustomed to Florida emergency waiting rooms where you could die of old age waiting to see a doctor if you are not hauled in by ambulance. And I was a little worried about going into any heath care facility on a Friday, knowing that most people like to take the weekend off.

Before I could worry much, I was whisked from the Emergency Room doorway with no waiting period to an examination table in a cubicle at Highlands-Cashiers Hospital. The facility with a nice view of the surrounding mountains has 24 beds and is managed by the much larger Mission Heath Care system that is based about 70 miles away in Asheville.

We had been here before over the past 25 years, but more often my husband, the man with a heart condition, had been the patient.

I wondered if we were making a mistake to stop in this very small facility instead of going to a larger hospital in one of the Western Carolina towns around us.

That doubt vanished as nurses and doctors started drawing blood, inserting a link for an intravenous connection and wheeling in a portable X-ray machine to take pictures. It wasn’t long before they started injecting antibiotics and telling me that I was being admitted with pneumonia.

I have never had pneumonia before and it had not occurred to me that they might keep me. I guess I had expected, at most, a prescription for antibiotics and release to spend the weekend at home.


Interestingly enough, they did not ask any questions beyond my name and date of birth. I was already in their computer system. They didn’t check my insurance cards or ask me to make any kind of payment.

They just treated me, a novel idea unknown in the hospitals I have visited in the past.

I need not have worried about going into a small hospital on a weekend.

I was one of seven overnight patients housed in private rooms that surround a large nursing station in the center of the hospital.

Nurses quickly introduced themselves, writing their names and titles on a board in front of my bed. I was cold so they brought an extra warm blanket and put it next to me underneath the sheet and spread.

It was not a comfortable night. I was coughing. I had come in the door of the hospital wearing a nightgown and robe and carrying my purse. My cellphone had crashed, out of power. At the last minute I had put an iPad Mini in my purse, my only way to communicate with family.

I did what they have often done with us. I logged onto Facebook and sent a message saying I had suddenly been admitted to the hospital. I was too tired and sick to contact each one who should be told. I guess you could say I was reciprocating for all the news we get by Facebook from family members.

That’s the way we hear about new grandchildren on the way, engagements, new jobs, all the news we once got by telephone. It works. Everyone learns at once.

On Saturday morning, nurses came in to tell me that I would be talking to a doctor who would appear in my room on a television screen, a weekend way of dealing with patients in the hospital who don’t need emergency care.

Before long, Dr. Matthew Craig appeared on the screen of a rolling machine that allowed him to see me and listen to my heartbeat when a nurse held the stethoscope. He had copies of my records and advised me that I could expect to spend about six weeks recovering. He also answered all my other questions. His "virtual’’ visit lasted longer than most in-person visits you get with a real live doctor.

It was an efficient and fascinating way to provide a direct connection to a "hospitalist," a doctor with a practice in Charlotte, N.C. It’s a perfect way for a small rural hospital to provide good care for patients without forcing them to drive to distant facilities.

For my husband it was a godsend. Our house is about 17 miles from the hospital, a relatively short drive through the mountains. It takes far longer and is far more dangerous to set out for Asheville or some other city in the middle of the night.

While it’s quite common for large hospitals in Florida to offer this service, I wondered how many small ones with precarious financial lives might prosper with a similar system and how many aging patients might be able to remain close to home.

After five days of antibiotics delivered in megadoses and respiratory therapy provided four times each day, the nurses and physical therapists tested me to see if I could continue breathing and walk around the nurses’ station without falling down or running out of steam.

I passed.

My oxygen levels were holding up. Our daughter, Kathy Bauerlin, arrived from Florida to help us deal with cooking, grocery shopping and all the problems of living.

A few weeks later I am on the road to recovery, regaining strength each day. I never realized how much pneumonia could take from you. I hope we’ve seen the last of it.

But I have learned the best medical help may be much closer than you think. If only it lasts. HCA, the large Tennessee hospital chain, is negotiating to buy the non profit Mission Health System. We can only hope they continue the standard of care Mission is providing.

Lucy Morgan is a retired state capital bureau chief and senior correspondent for the Tampa Bay Times.

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