Monday, August 25, 2014

Whether You Want Me or Not


If you want a housecall in Los Angeles, you’re likely to get me even if you don’t ask for me. 


I don’t have a web site, but searching the internet turns up several agencies and a few individuals that promise to send you a doctor at a moment’s notice. Many rely on me.


They also solicit hotels. Last week, the answering service for a national housecall agency informed me that a guest at the Marina International wanted a doctor. The Marina International is one of my regulars.


After I spoke to the guest, he asked me to come. I made a mental calculation before quoting the fee. The housecall agency keeps forty percent, so it was larger than usual. 


Since guests who call directly pay less, you might wonder why hotels don’t make sure they get the best price. The answer, of course, is that hotel management doesn’t know what doctors charge, nor do they care. Guests occasionally ask, but hotels never do.

Thursday, August 21, 2014

Eighty Gouty Patients


A man’s foot began hurting one evening. By the following morning pain was excruciating. That sounded like gout, one of my favorite diseases. The diagnosis is easy, and I can quickly make it better. What’s not to like?

I carry a treatment for gout, but once I hand it over, I have to remember to restock my bag. So I went to my drug closet, made up another bottle of pills, and threw it in my pocket. 

Sometimes I’m surprised when I arrive at the hotel but not this time. He had gout. I gave him the pills, and everyone was satisfied.

It occurs to me that I’ve seen so many victims – this was my 80th – that I can check the experts. They claim that it attacks men overwhelmingly. Sure enough, only seven of my patients were women. They say it’s a disease of older people. 67 cases were over 40, none under 30.

Until a few years ago, treatment was a powerful anti-inflammatory drug such as indomethacin which produced unpleasant side-effects. Then experts decided a large dose of cortisone for a short period worked as well with less unpleasantness. I already carry an identical course to treat severe poison ivy. Patients feel better within a day.

Sunday, August 17, 2014

A Tropical Disease


They had just flown in explained a father at 1 a.m. While in Hawaii, their two year-old had suffered mosquito bites followed after a few days by fever, restlessness, and refusal to eat. Checking the internet (my heart sank….) he learned about dengue fever.

I explained that dengue is a viral infection that produces the usual symptoms of a viral infection (fever, body aches, general misery) and has no cure. He agreed but pointed out that deadly complications, although uncommon, did occur, and he wanted the child examined.

Before leaving, I consulted a medical book to refresh my knowledge of dengue fever. I’ve never seen a case. The child did not seem terribly ill. Certainly there was no sign of shock or internal bleeding, the typical complication.

I reassured the parents.

Wednesday, August 13, 2014

A Difficult Hotel


The J.W. Marriott is not a regular, but its doctor is not a friend, so I don’t turn down its calls which arrive now and then.

Driving downtown, I had no worries about the patient, a toddler with a cough, but recalled that visiting the J.W. Marriott could be a frustrating experience.

Sure enough, the parking valet ignored a request to hold my car, gave me a parking slip, and drove the car deep into the bowels of the hotel.

The elevator required a room key. I waited for a guest, but apparently new technology makes it impossible to piggy-back on another’s key. I walked to the front desk and asked to use the elevator. This struck the clerk as an odd request.

An elderly man in a suit, carrying a doctor’s bag, and claiming to be a doctor might or might not be telling the truth. She politely quizzed me on my motives, phoned the room to confirm, and then asked me to wait while she summoned a security officer.

The officer remained at my side until the guest opened the door. After the visit, I returned to the lobby and handed over the parking slip to be validated. The desk clerk stared at it as if she had never seen one and then excused herself to consult the manager.

I waited several minutes until she returned to hand back the slip and explain that the hotel “was unable” to validate parking.

Downtown hotel parking is brutally expensive, and I remembered the same difficulty during earlier visits. Everyone hates hotel parking; cashiers are immune to arguments, so I simply scribbled “hotel doctor” on the slip, shoved it through the window, and hurried away to stand at the curb. No one ran after me, and after five minutes my car appeared. 

Saturday, August 9, 2014

It's Summer


A blast of hot air greeted me when the guest opened the door. As I complain regularly, foreigners believe air conditioning spreads disease, so when someone falls ill, they turn it off. They dress for the heat, but I wear a suit and tie. Asking them to turn on the air conditioner is like asking a Moslem to eat a hot dog, so I pretend nothing is amiss and go about my business ignoring the sweat soaking my shirt. It’s summer.

Most of the year, I have no objection to leaving my car a few blocks away to avoid the hassle of hotel parking. I don’t do this when it rains, but rain is rare in Los Angeles. Summer is guaranteed; I dislike making the walk in warm weather and regret it even more if the guest has turned off the air conditioning.

Beaches exist in Northern Europe, but they’re chilly with the sun not much in evidence. Southern California beaches seem more inviting, so Britons, Germans, et al relax, doze off, and acquire gruesome sunburns.

Summer is my busiest season. The phone wakes me three or four times per week, but I don’t mind wee-hour visits. Parking is easy, guests are grateful, and with no office waiting I can take a nap whenever I want.

Tuesday, August 5, 2014

A Bilingual Doctor at Midnight


A guest wanted a doctor who spoke French.

“I don’t speak French, and it’s midnight,” I pointed out. “You won’t find a bilingual doctor to make a housecall at this hour.”

The operator promised to inform the guest and call back. Waiting for people to call back is one of my least favorite activities especially if I have been aroused from sleep. Fifteen minutes passed before the phone rang. The operator apologized for the delay, explaining that the guest wasn’t answering, and she didn’t want to keep me up. When she reached him, she would suggest a housecall for the following morning.

I agreed, adding that I could arrive around ten. The hotel was in Norwalk, thirty miles away, and I prefer to avoid the rush hour.

I went back to bed. Half an hour later the phone rang. It was the operator announcing that the housecall was on for 10 a.m.

Freeway traffic was in the category of “could have been worse,” but I arrived on time. No one answered my knock. According to the desk clerk, the guest was part of a tour group that had checked out earlier.

There is no lesson here. It’s part of a hotel doctor’s life.

Friday, August 1, 2014

I Save a Life


The phone rang at 5 a.m. but I am an early riser. April Travel Insurance told me of a lady with a cough at the Residence Inn in Manhattan Beach. Vacationers hate to get sick, so even a bad cold produces wee-hour calls.

This sounded easy. It was a fifteen mile drive, but the freeways were clear, and I would return before the rush hour.

Guest often feel obligated to demonstrate how miserable they feel, and this lady coughed loudly from the time I walked in. Listening to her lungs was difficult because she wouldn’t stop, but what I heard was not reassuring. A bad cough doesn’t necessarily mean a bad disease, but this patient had one ominous sign: she was my age.

Long ago, pneumonia was called, perhaps sarcastically, the old man’s friend. Nowadays, we usually treat it as an outpatient but not in the elderly who are, I say with reluctance, too fragile.

I phoned April's office to explain that the lady needed a chest x-ray and possible hospitalization. This is bad news for an insurer. An ordinary emergency room visit costs over a thousand dollars, an admission for pneumonia twenty times that. Some travel services work hard over their fine print to avoid responsibility for expensive incidents, and I occasionally urge guests to go to the hospital after they’ve learned that insurance won’t pay.

April doesn’t do that. The dispatcher quickly agreed to arrange matters. Later that day, the husband informed me that his wife had been admitted for pneumonia. That meant I had saved her life. I don’t save a life often, and it makes me feel good.