The sky was still dark when Jim Gathmann pulled his car into the parking lot of the Tangier Shriners headquarters in Omaha on a warm July morning.
It was 5:30 a.m., and he faced an important job.
He and a fellow Shriner were driving Emily Koesters, a 10-year-old with a rare genetic disease, to Minneapolis for an appointment with specialists at the Shriners Hospitals for Children-Twin Cities.
Gathmann, a 79-year-old retired utility company manager, is a member of the Shriners Roadrunners, a local volunteer group that logs more than 150,000 miles a year driving young Omaha-area patients and their parents to Shriners specialty hospitals in the region.
The parents are seeking second opinions on such conditions as cerebral palsy and spina bifida, along with specialty care. Requests for transportation often spike in late summer as parents try to get their children in for appointments before school starts.
For parents, the transportation is a comfort, convenience and money-saver. The rides are free, and the Shriners also pay for the family's hotel stay, plus meals on the road.
With a Shriner behind the wheel, moms and dads can tend to their child, some of whom must receive medications on the road. Parents can also squeeze in a nap so they arrive at appointments with more energy.
Dr. David Finken, a pediatrician with Children's Physicians in Omaha, has referred Emily and other patients to Shriners hospitals and said they play an important role for local kids.
“It's isn't a guarantee they are going to get a life-changing procedure or cure,” said Finken, a member of the University of Nebraska Medical Center faculty. “(But) it gives them other options. It is hope.”
The Roadrunner program has more than 40 drivers, and many are retired. The drivers have children and grandchildren of their own, and are motivated by a chance to help sick kids and their parents.
Gathmann has logged more than 64,000 miles during his 15 years driving Shriner vans to hospitals in Minneapolis, St. Louis and Chicago.
An Army veteran, Gathmann has three daughters and knows firsthand the importance of specialty medical care. His oldest daughter, who's now 49, was diagnosed with multiple sclerosis more than two decades ago.
Bob Krause, 66, started driving after selling his Omaha jewelry store in January, and has logged 6,000 miles. He also drives his white Pontiac convertible in Shriner parades.
He's the son of a traveling jewelry salesman, and says road trips are in his blood. When he slides behind the wheel to drive a family to a hospital, he breaks the ice by saying, “Wake me when we're there.”
“Every trip has been rewarding,'' Krause said. “We're helping make children's lives better.”
The Shriners, an international philanthropic fraternity whose members are known for their red fez hats, opened its first children's hospital in the 1920s, primarily to care for kids with polio.
Now the Shriners run 20 children's hospitals in the United States specializing in orthopedics, burn care, spinal cord injuries and cleft lip and palate. The hospitals accept health insurance, but for uninsured families there is no charge.
Most trips are to Minneapolis, which has the closest hospital, said Bill Somerville, an Omaha Shriner and patient coordinator. In the past five years, more than 4,500 children from Nebraska and Iowa have received treatment there.
Gathmann said one of the best parts of his volunteer work is getting to know the children and families.
He and his driving partner, Krause, met Emily and her parents, Erin and Joe Koesters of Gretna, at the Shriners headquarters at 84th Street and West Center Road for the drive to Minneapolis.
By 6 a.m. they were on the highway in a white Ford van marked: Tangier Shriners Childrens Hospital Van.
They had to get an early start because Emily had a 1:30 p.m. appointment that day.
Drivers take their cues from each family on how much to talk during the trips. Some families prefer to stay mostly quiet, and will read or talk among themselves.
Other families open up to the drivers, even sharing their child's medical history.
That's how Emily's parents were, telling Gathmann and Krause how their daughter was diagnosed six years ago.
Until age 4 Emily had been a healthy girl, but one day her face began swelling.
At first her parents thought an allergic reaction caused the swelling. It turned out the swelling was from kidney disease, which is part of her condition.
The condition, a form of dwarfism, is called Schimke immuno-osseous dysplasia. It's characterized by short stature, kidney disease and weakened immune system. It has no cure.
Even though she is 10, Emily is less than 3½ feet tall.
She has had lymphoma twice, and has endured 44 surgeries, including a kidney transplant, all tied to her disease.
Her condition has weakened her bones, causing severe hip problems. This spring she started using a wheelchair full time because walking was too painful.
The purpose of the trip to the Shriners hospital, her mom said, was to seek a second opinion on whether Emily should undergo a hip replacement.
Not all of the conversation on the road was about serious topics.
Emily told the drivers about attending a recent Justin Bieber concert in Omaha to celebrate her 10th birthday.
She also told them about her love for animals.
Through selling homemade crafts she has raised hundreds of dollars for the Henry Doorly Zoo & Aquarium, and the Cheetah Conservation Fund in Africa. At home she has three cats, Bo, Princess and Bingo, and a yellow Lab-mix named Angel.
She also has a little sister, 2-year-old Taylor-Jo.
In Albert Lea, Minn., the travelers stopped for lunch at an Iron Skillet restaurant.
Gathmann and Krause asked Emily if she liked liver and onions, and she told them no. They said they love the dish, and playfully teased that she should order it.
When they arrived at the hospital, Gathmann pulled the van to the front entrance. He and Krause led Emily and her parents to the front desk so they could check in for their appointments.
Gathmann and Krause headed to a waiting room just for Shriner drivers. The room has a TV, cushy recliners and pop and coffee. The two men kicked back, and watched some TV.
During Emily's appointments, specialists recommended that the girl continue her physical therapy and other treatments, and return in six months for another evaluation to see if a hip replacement is the best option.
Emily finished her appointments at 5 p.m., and Gathmann and Krause drove the family to a nearby hotel and helped them unload their bags.
Gathmann and Krause stayed at the same hotel, and at 8 the next morning they were all back in the van and on the road home.
Emily's mom said the two drivers made the family feel safe, and wanted to make sure her daughter received the best care.
“They were,” she said, “like your grandpa.”