Wednesday, July 29, 2015

Another Wee-Hour Call


It was midnight when the phone woke me. An Emirate flight attendant at the Hilton in Costa Mesa needed a doctor.

That Hilton is in Orange County, a 46 mile drive. The agency that serves airline crew has an Orange County doctor but calls me when she doesn’t respond.

After I’d dressed and filled out the necessary forms, the phone rang again. The Orange County doctor had checked in and wanted to make the visit. Was that OK?... 
 
I’d received a similar call last month when I was already on the freeway. At that time, when the agency announced that my visit was cancelled, I made a fuss, so it promised not to do that again.

Did I want to spend two hours driving plus twenty minutes delivering medical care in the middle of the night? I boast that, not having an office, I can sleep late, but I enjoy getting up early to write. In any case, my body automatically wakes at the same time.

Returning to my cozy bed seemed extremely attractive; I gave my consent.

As soon as I hung up, I remembered that the agency pays generously for long drives in the wee hours. That thought gave me a touch of insomnia, so I still passed a sleepy morning.

Saturday, July 25, 2015

Trusting the Guest to Take Care of Things


A guest at the Crowne Plaza was feeling under the weather.

The guest spoke poor English but, through the bellman, asked if I took his insurance: April Assistance. I did, adding that, unless he wanted to pay me directly, he must call April and ask for a doctor. Then April calls me.

After giving April’s 800 number to the bellman who passed it on to the guest, I hung up and immediately regretted it. I should have asked for the guest’s insurance I.D. and then sent him to his room. Then I should have phoned April to tell them a client wanted a housecall. They would have phoned him and then approved. I’ve done this in the past; when I’m lazy and trust the guest to take care of things, I often never hear back.

I called an hour later, but the bellman didn’t remember the guest’s name.

Tuesday, July 21, 2015

Sickness Makes You Sick


“Normally I wouldn’t bother you with this cough, but when I started to bring up green mucus I knew I had to do something…..”

Hotel guests tell me this regularly, and it’s wrong. Everyone’s respiratory tract makes a quart of mucus a day. When the respiratory tract is irritated, it makes more, and the mucus may turn yellow or green. In an otherwise healthy person, this has no ominous significance.

No one stares at their throat when they feel fine, and a sore throat always looks suspicious. Everyone knows that white spots on your tonsils is a sign of Strep that requires urgent attention. In fact, plenty of ordinary viral infections make tonsils look bad.

“The fever came back,” guests tell me as if this were a serious development. But Tylenol or aspirin only work for a few hours, and then you must take more. When patients tell me that they worry about a fever, my advice is “then don’t take your temperature.” They treat this as a joke, but the truth is that fever is just another symptom.

All bets are off if you suffer a life-threatening illness or serious immune deficiency or are extremely old or extremely young, but this is not the case with almost everyone I see. When people in good health get sick, they feel sick.

You should certainly contact your doctor if something worries you, but make your decision on going to the office on the basis of how bad you feel.

Friday, July 17, 2015

Luckless Americans


Ailing US airline crew are out of luck. Without transportation, they must travel to a clinic, present their insurance card, and hope for the best.

Foreign airlines do better, sending a doctor to care for crew when they lay over. In Los Angeles that’s often me. Being young, crews suffer common ailments. Even better, company rules forbid work if they have a cold, a digestive upset, or a minor injury.

On my own, I handle these over the phone, but airlines demand a doctor on the spot to confirm the ailment and name a date when the employee may fly again. I enjoy those visits. These patients are never demanding; their priority is getting home. They hate being stuck in a hotel room. Airlines permit them to return as passengers, and I’m liberal about allowing them, so those visits usually end happily for both of us.    

Monday, July 13, 2015

The Decline of Civilization


The desk clerk tried to hand back my parking slip, but I made no move to accept it.

“We are unable to validate,” she said. “It’s fifteen dollars. You pay at the cashier’s window.”

“As I explained, I’m the hotel doctor. They let me park.”

“Unfortunately, the hotel doesn’t own our parking service, so we have no control over the charges.”

“That’s true for most hotels, but they let me park.”

“Let me speak to my manager.”

It was a stretch to call myself that hotel’s doctor. The Mondrian was not a regular although I’d been there a dozen times over the years with no problem. Several minutes passed before the clerk returned.

“Regretfully, my manager says we’re unable to validate. The hotel doesn’t own our parking service, so we have no control over the charges.”

Not willing to hassle hotel staff, I took the slip. I’m not poor, but paying fifteen dollars at a fraction of my hotel visits per year, say a hundred, is serious money. This is happening more often.

Thursday, July 9, 2015

A Doctor Gets Sick


Years ago I suffered a stomach virus, not a serious illness but unpleasant. I was resting after a night of vomiting when the Beverly Garland called. I could have stalled or asked a colleague to make the visit, but symptoms were improving.

I had not entirely recovered, so my wife agreed to drive. As we approached the hotel, my nausea returned. It grew intense by the time the guest opened his door.

I remain proud of delivering an Academy Award-worthy performance, sitting quietly, focusing entirely on the guest, not hurrying, providing sympathy, advice, and medication as well as collecting my fee.

As soon as the door closed behind me, I dived into the nearest rest room and resumed vomiting. Several guests entered, saw my distress, and fled. But I got better. Most sick people get better.

Sunday, July 5, 2015

Sometimes This is a Thankless Job


A one year-old at the Ramada was fussy and congested, but my exam was normal. She had a cold, I explained. It was not serious but might last a few days. Staying in bed wouldn’t make it go away quicker. The parents should encourage the child to drink, but it was OK if she didn’t eat. They were already giving Tylenol for the fever, and that was fine. They should try to enjoy themselves.

“So she doesn’t need anything,” said the father. I assured him she didn’t.

I gave them my phone number and promised to keep in touch. They thanked me effusively as I left, but I was not fooled.

Understand their point of view. They were in a strange city on an expensive vacation, and their child was sick. Naturally, all fun was cancelled and the doctor summoned fix things.

Had I written a prescription, I would be doing what a proper doctor does. They would have given the medicine and waited. Not giving “anything” meant that I considered the illness trivial. That was clearly wrong.

Mind you, obeying long and sad experience, I had carefully explained that the child might feel under the weather for several days. They had listened and nodded, but their yearning took priority.

I intended to call in 24 hours, but the following morning their travel insurer phoned to say the parents were requesting another visit. I explained that that wasn’t necessary. I would call.

“She’s the same. The fever hasn’t gone away,” said the mother.

I repeated that this was to be expected and that she should wait. She agreed and thanked me for calling.

No one answered when I phoned the next day. The insurance agency dispatcher explained that the mother had called earlier to demand another visit, so he had sent her to an urgent care clinic.

The child had barely swallowed the first spoonful of Amoxicillin when she began to improve. By evening she was fine, and the parents were congratulating themselves. Who knows what might have happened if they hadn’t found a competent doctor?