Monday, April 25, 2011

A famous actor staying at the Four Seasons showed me a pimple on his upper eyelid. This was a sty, I explained, a small blocked gland. It wasn’t serious. There was no treatment except hot compresses, but even if he did nothing it would go away in a week or so.

He needed it to go quickly, he said. He had an interview the following day. A previous doctor had stuck a needle into an earlier sty, and he’d be grateful if I did the same. So I stuck a needle into it. He endured it stoically.

* * *

“You wouldn’t have any Oxycontin?” asked a guest. He was consulting me for a rash.

“I’m the doctor you call when you feel bad,” I said. “Providing Oxycontin… That’s a different sort of doctor. It’s a bad idea to mix them up.”

We parted on good terms. My refusal did not offend him; from his point of view there was no harm in making the request.

It’s wrong to divide celebrities into upstanding citizens with a few drug-addled exceptions. They are a cross-section. Many work hard at their careers but enjoy the occasional drug if it’s available, and they move in circles where this requires only a modest effort. Wrecking your life with drugs, as with alcohol, requires proclivity as well as availability.

* * *

Many actors and singers insist on a vitamin injection before a performance. That vitamin is almost always B12 because of (don’t jump to conclusions…) its color. Most drugs resemble water, but B12 is blood red. Since it’s commonly believed that injections trump pills, the same reasoning suggests that a brightly colored injection works even better.

My B12 experience impresses me with how closely celebrities resemble royalty. Arriving, I approach in stages – passing through rooms containing bodyguards, groupies, publicists, media, dressers. When I finally reach the room containing the celebrity and his intimates, he turns and drops his pants (women hold out an arm). I give the injection and depart. No one makes a move to pay, but I can expect a lesser person to come forward as I retrace my steps.

These requests don’t arrive often, so I wonder who owns the franchise on celebrity B12 shots in Los Angeles. It’s a gold mine. I also carry a vial of B complex – half a dozen B vitamins not including B12. It’s colorless, and I can’t remember my last request.

Monday, April 18, 2011

During the 1990s, I went to the Bel Air hotel to care for a screenwriter working for Francis Ford Coppola. Chatting before I left, I revealed that I had been a full-time hotel doctor for over a decade.

“I bet you have great stories,” he said.

“Well…. As a matter of fact…”

At his urging, I sent him a screenplay.

Does this surprise you? I work in Los Angeles, and I love movies. Why shouldn’t I write screenplays? Everyone else does. I mentioned earlier that I’m a writer. Although successful by the standards of freelance writing, I don’t plan to quit my day job.

I mention this incident because my mail recently included a short story I’d submitted to the New Yorker. Across the inevitable rejection slip was a handwritten scrawl “great read but not quite...” That gave me a glow of pleasure, but there is less there than meets the eye. Although the preprinted rejection is signed “the editors,” no New Yorker editor reads stories as they pour in, thousands per month. All are screened by low paid young English majors, happy to be on the first rung of the journalism ladder. A minuscule handful move on to editors who choose one or two for each issue.

I’m proud to have caught the eye of an overworked reader at America’s premier market for short stories, but there is no telling who will read my next submission. Even if it were the same person, she would not remember me, having read hundreds in the interval, including a few good ones. Nevertheless, that rejection slip marks the highlight of my literary career so far in 2011. The highlight of 2010 was the actual publication of a story, but it was in the Wisconsin Literary Review. You won’t find it on the newsstand.

Everyone who learns I’m a hotel doctor urges me to write my memoirs, so I wrote them. I wrote a novel about a hotel doctor. I even wrote a proposal for a TV pilot featuring a Los Angeles hotel doctor. All those are, as we say in the business, making the rounds. The TV hotel doctor is not entirely based on me because, among his entertaining quirks, he cannot resist extolling his screenplays to sick guests who work in films. I never do that. The writer mentioned above took the lead in quizzing me and asking for my writing. You may be curious for the upshot. He never replied.

Sunday, April 10, 2011

The room stood at the end of the hall, the largest suite on the floor. Through the half-open door I smelled alcohol and cigarette smoke, never a good sign. At my knock a voice urged me to enter. The room was empty, but this was the sitting room. A doorway led to the bedroom containing a small figure in a huge bed, covers drawn up to his chin. Balding and past forty, his disheveled hair was the single unkempt feature, and a goatee the only evidence of his foreignness. He was Prince Abdul-Aziz from Saudi Arabia. Arabian princes are more common than you’d think.

“I have pain,” he announced.

“Where is the pain, Mr. Aziz?”

“Kidney. I have kidney stones in my kidney.” He threw the covers to one side and pointed to his right flank. “My doctor prescribes Dihydrolex.”

“That’s not a drug I’m familiar with.”

“It is from London. I live in London.”

“Do you need a prescription?”

“Yes, but also a shot.”

I examined the prince’s abdomen and tested his urine for blood. Both exams were normal but this can happen with a stone. I thumped his back in the kidney area, and he groaned.

“I’ll give you a Toradol injection, but if the pain comes back, you’ll have to go where they can do some tests.”

“Many thanks.”

Any doubt about the prince’s drug consumption vanished when my needle jerked to a halt half an inch beneath the skin. Fibrosis from hundreds of injections had given his gluteus the consistency of a block of wood. I forced the syringe down a further inch and delivered the injection. Anticipating the pleasures ahead, the prince whirled to thank me, clasping my hand in gratitude.

“Remember what I said if the pain returns…” I repeated. “Should I ask the hotel to pay and put it on your bill?”

“No, no no. I pay!” Keeping a grip on my hand, he yanked open the drawer of the bedside table which turned out to be stuffed with hundred dollar bills. He snatched a handful and held them out.

Grateful the prince had forgotten his request for a prescription, I thanked him and hurried off. Later I counted fourteen bills. I gave them to my wife who bought a small Chinese rug for our living room.

The following day a rival hotel doctor phoned. “The Nikko wants me to see a guest,” he said. “Apparently you saw him yesterday, but you don’t want to see him again. Naturally I’m curious to know why.”

“I’m pretty sure he’s a drug abuser.”

“They said he was difficult. Is there any reason for me to see him?”

“He’s a big tipper.”

Sunday, April 3, 2011

Almost everyone I see has been on a plane, so I deal with two problems that result: ear pain and swollen legs. Neither is serious.

Flying doesn’t cause ear infections, but getting on a plane if you’re stuffy can end painfully. My records show only a few dozen visits for ear pain after a flight because I handle most over the phone. If the guest felt fine before boarding, pain that begins afterward generally disappears after a few days, but it’s an unpleasant experience.

Before beginning this entry, I googled “ear pain on flying.” Internet medical advice is unreliable, and the results did not rock the boat. Reputable sites such as the NIH and WebMD solemnly recommend useless preventatives such as antibiotics and steroids plus dangerous ones such pinching your nose and blowing (they warn you to do it “gently”). They suggest antihistamines, helpful if you’re allergic, worthless for a cold. All deliver traditional advice: chew gum, suck on hard candy, yawn frequently, take oral decongestants. Like all medical advice accompanied by weasel words (“traditional” “natural” “sensible”), these may work but never dramatically.

The best preventative is a straightforward, chemical nasal spray (Afrin, Dristan, Sinex). When you’re sitting the plane before takeoff, spray, wait five minutes for it to work, and spray again. That sends the spray far up your nose to, hopefully, reach the eustachian tube opening, the only connection between your middle ear and the outside world. If the flight lasts more than a few hours, do the same before the plane begins its descent, an hour before landing. I give the same advice when guests call afterward. It’s not as effective then, but waiting works.

I hear from travelers who notice puffy legs after a long flight. Some worry about a blood clot, but this doesn’t cause both legs to swell (I mention clots on January 30).

Your heart has no trouble pushing blood to the far end of your body but plays no role once it forces its way through tissues into veins. Blood returns to the heart more slowly, squeezed along by surrounding muscles. If you don’t move, it returns even more slowly. In the absence of movement, gravity induces blood to settle in the legs where plasma may leak through the distended veins into surrounding tissue. You can make the diagnosis if pressing a finger makes a visible dent. Veins grow leakier with age, but I see plenty of guests in the prime of life. The swelling should diminish after you begin moving or eliminate the effect of gravity. A night in bed usually helps.

Textbooks list dozens of serious causes “peripheral edema.” I can’t recall a guest who had one, but it’s possible that a reader with swollen legs may eventually learn he has heart, kidney, or liver disease, remember that I downplayed its seriousness, and sue me.

So, my legal adviser insists I warn you not to feel reassured by what I’ve written. It’s just my opinion; you might be dangerously ill. Consult your family physician. Go to an urgent care clinic. Call the hotel doctor.