Moving away.

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It's the most suddenly they have left a particular place since moving back to America, and it aggravates Carlisle to his core.

(His surgery patient survived. It relieves Carlisle somewhat to get this news as he is packing his stethoscope and labcoat away.)

A benefit of never sleeping: they manage to pack rather quickly. A benefit of never really having much to spend a doctor's wages on: they have the house for several months, to allow them to send for their belongings that are safe to be rifled through at their leisure.

They have to leave, so they are on a night train.