Wednesday, March 16, 2011

“There’s an emergency with my eye. Can you come right away?”

Hotel doctors don’t like to walk in on an emergency, so I asked him to elaborate.

“I’ve been to the Mayo Clinic where, it’s sad to say because they’re wonderful doctors, they performed the wrong MRI, so the eye is now looking to the right, but it’s not right because I’m a right-thinking citizen who looks both ways before crossing the street although a citizen who’s not a citizen who looks one way may be blindsided by the border patrol….

If a schizophrenic checks into a hotel, I hear about it.

In its dictionary derivation, schizophrenia comes from the Greek meaning “splitting of the mind.” Hollywood, as usual, gets it wrong in several movies featuring entertaining characters with multiple personalities. In fact, split personalities are so rare, some psychiatrists believe they don’t exist. The “split” in schizophrenia doesn’t involve personality but reality. Schizophrenics don’t know what’s real and what isn’t. They find this confusing, but it’s surprisingly uninteresting to observers. Holding a conversation is frustrating.

Like any disease, symptoms wax and wane. Victims with enough connection to reality to check into a hotel may deteriorate and become unable to check out, so employees ask my help. Everyone (the movies again…!) think an injection will fix things. Antipsychotics eliminate delusions, hallucinations, disordered thinking but do nothing to restore a sense of reality. In any case they may take weeks to work. Anxious to relieve themselves of a demented guest, hotels often offer to pay my fee. I once spent an hour in a room with a naked, incoherent man, and since then I try to solve these problems over the phone. Hotel employees may believe they can’t call the police unless there’s a danger, but I assure them that if someone is too helpless to care for himself, the police will take him to the appropriate social agency. It’s OK to call the police for crazy people.

Friday, March 11, 2011

A guest at a West Hollywood hotel called at 4:30 p.m. last Friday. Taking care of business at a nearby hairdresser, she had bent over and thrown out her back. Now she wanted “a shot” so she could stand and get back to the hotel.

I’ve cared for several hundred guests with severe back pain. These are fairly satisfying visits. I deliver an injection which makes the patient giddy, so time passes more quickly. By the following day, the pain is not so bad. Acute back pain slowly improves even if not treated.

Hotel guests are already in bed, and that’s where they stay. This lady would have to move, and over the phone I warned that the injection would not make that easier. Powerful narcotics work best against “deep” pain such as a kidney stone or heart attack, not so well when it’s sharp and acute. If I were to give you a huge dose of morphine and then touch a lit match to your fingertip, you’d feel the usual amount of pain. These warnings rarely work, and they didn’t work this time.

Beverly Hills treats people inside Beverly Hills kindly. For example, parking is much easier than in surrounding Los Angeles. If you’re just passing through, Beverly Hills shows no mercy. Traffic lights along Santa Monica Boulevard change simultaneously, so there’s no hope of getting through even when streets are empty. During the rush hour, traffic proceeds one street at a time. I cultivate tranquility, listen to my CD book, and never look at my watch.

Fortunately, the beauty shop closed at five, so I encountered only the patient, her companions, and a few employees. I examined her and then delivered the shot, gave pain pills for later, and assured her that she’d feel not-so-bad after a night in bed. Groaning and supported by friends, she hobbled off.

Thursday, March 3, 2011

A feverish Finn was staying in a Hollywood Hotel last Sunday. Treating flu symptoms is never satisfying, but I was pleased to learn that he was taking nothing for the fever. I handed over some Tylenol, and when I called back that evening he felt much better.

The following Monday was President’s day; hotel doctors look forward to holidays because freeway traffic is lighter. Sadly, no calls arrived. None arrived Tuesday or Wednesday or Thursday. Deep down, no one believes in the law of averages. If you flip a coin heads ten times in a row, that’s not a fluke but as likely as any other combination. And the odds that the next flip will be heads remain fifty/fifty. It’s guaranteed that someone will win the lottery, but the winner always credits God. After several days without calls, I conjure up images of a rival sweeping up my hotels with irresistible charm or twenty-dollar bills.

The phone sprang to life early Friday, a lady with a respiratory infection at the Georgian, a boutique beach hotel in Santa Monica. It rang again as I pulled up at the entrance. The caller was JI, a Japanese travel insurance agency with a patient in a downtown hotel. Ten o’clock is perfect for driving downtown, fifteen miles away. Rush hour traffic dips until noon when it begins a steady climb toward the evening rush.

“I can be there within the hour,” I said only to hear that the patient wanted someone between 2 and 6. I explained that people don’t realize how quickly I arrive. I could be there in 45 minutes. She checked but informed me that the guest wanted to go on a tour. Disappointed, I agreed to arrive at 2. The phone rang soon after I returned home, a lady at the airport Westin whose husband was coughing. Did I accept Medicare? I didn’t. American insurance pays little for a housecall, and billing requires skill and immense patience; foreign insurers do better. I gave directions to a walk-in clinic a mile away. The majority of elderly Americans decide that paying for a housecall is preferable; she assured me she’d call back if she wanted a visit, but she didn’t.