INDIANAPOLIS — Many hospitals right now are overwhelmed due to COVID-19, a surge in other illnesses and a shortage of staff.
Some have been forced to go on "diversion," meaning they temporarily are not accepting patients from EMS. Others are sending patients elsewhere.
But the transfer request that IU Health Methodist Hospital received last week was extremely uncommon.
It came in the middle of the night, while Dr. Jennifer Hartwell, a trauma and acute care surgeon, was on call.
"I received a rather unusual call from our transfer center," Hartwell explained.
Unusual, not because a doctor wanted to transfer a patient here, but rather where that patient was located - 600 miles away from Indianapolis in Arkansas.
Every other hospital the doctor tried, he told Hartwell, was full and on diversion.
He'd made a lot of calls that night and knew getting the patient to Indiana would require a fixed-wing transport, or medical airplane flight, that would take time to coordinate.
"He was clearly desperate. It was very alarming to me that the situation was so desperate he would reach out to a hospital hundreds of miles away," Hartwell said. "I've been doing this work for about ten years and I can count on one hand two or three times I've had requests for a long-distance transfer and speaking to this physician on the other end of the line, I could just hear this desperation in his voice about, 'This patient can't stay here,' and I think there was just a sadness that we both felt that we just couldn't help this patient within a reasonable distance from her home and her family."
That patient needed surgery in a high-level ICU, but Arkansas is running out of ICU beds. The state's hospitals were down to just 12 Tuesday, according to Arkansas Governor Asa Hutchison.
"Everybody has to realize, this is not a good time to get sick," Hutchison said at a news conference Tuesday, "because the space is limited."
It's a problem hospitals are facing nationwide: beds maxing out, staff running short, more people sick from other illnesses because of delayed preventative care during the height of the pandemic.
A new surge in COVID cases, mostly in the unvaccinated, is making it all worse.
The CDC reports COVID cases are up 33% this week, compared to last week nationwide. Hospitalizations are up 40% since last week.
Dr. Brian Dixon, director of public health informatics with the Regenstrief Institute, said Indiana isn't at a critical stage yet, but the numbers show a troubling trend.
"Over the last month, our hospitalization rates in Indiana for COVID-19 have quadrupled," Dixon said, "and these patients stay on average in the hospital a week to ten days. We're also seeing about 400 people a day come into emergency departments for COVID-19. The combination of COVID patients with other patients is concerning."
"COVID is stressing our hospital systems, but also the toll that it takes on health care workers - we are exhausted! There are a number of physicians, nurses and other health care workers who have said, 'You know, I'm done being in health care'," Hartwell said. "And to be very busy and even to have to occasionally have to turn away an ambulance or a patient is very distressing. This is a national problem. This particular instance just really highlighted that to me, just how delicate our system is. I just want to tell people get vaccinated. Take care of yourself, don't neglect your preventative care: mammograms, colonoscopy, everything we should be doing. Also, I think, just being patient."
Hartwell shared her experience with that phone call from Arkansas on Twitter, adding "Be patient with us America. We are tired. We are crowded."
It got hundreds of responses.
She hopes it resonates beyond social media.
"I thought it was worthwhile to share the story of how I felt in that moment and just hearing that other physician being very distressed. You know, giving people who aren't in health care a little nugget of insight of what's it like to be on the inside of a hospital and what it's like at 3 o'clock in the morning, getting a phone call from a desperate physician hundreds of miles away. It's hard."
IU Health Methodist Hospital ended up not taking the Arkansas patient last week.
Hartwell said it's not because they were on diversion, but because she needed specific care that Methodist couldn't provide.