Monday, May 30, 2011

Tokio Marine, a Japanese insurance service, phoned about a patient at the Kyoto Grand. Insurance services make up a quarter of my business, and I love them. All serve foreign travelers who often speak no English and stay in distant locations, but they also stay in every local hotel including those of my competitors. I enjoy good relations with one competitor, so I wouldn’t step on his toes. Others regularly poach, and while I don’t visit their hotels to solicit, if I happen to be there on other business…

The Kyoto Grand is a large hotel in downtown Los Angeles. Insurers send me every few months, but the hotel never calls. I was pleased when the Tokio Marine dispatcher told me to stop at the front desk where an employee would accompany me to interpret. Of all foreign patients, Japanese have the largest percentage of zero-English speakers, and interpreting over the phone with the insurance company is tedious.

Leaving after caring for the patient, I told the employee of my services. She responded that the hotel had a doctor who practiced in nearby Little Tokyo, but she accepted my business card, promising to keep me in mind.

Minutes after returning home, my phone rang. It was the employee informing me that another guest needed my services. Naturally, I was delighted, and I drove back downtown to care for an Australian with an upset stomach.

You might think I am now the doctor for the Kyoto Grand, but this incident happened months ago, and no calls have arrived since. While the lady may have lost my card, it’s more likely she simply neglected to tell anyone else about me. A dozen Los Angeles hotels call rarely because only a single employee knows me. Now and then the news gets around, and the hotel becomes a regular, but I have never figured out how to persuade someone to pass the word.

Sunday, May 22, 2011

Several hundred Norwegians arrived in the city last week, and I cared for four who fell ill. Not all Norwegians are good-looking or blonde, but I didn’t see any who were overweight, and they spoke English.

They were guests at the Hollywood Heights hotel in my least favorite part of Los Angeles. Hollywood's tourist glitz is a minor matter; I dislike the drive. Despite our legendary freeways, none reach from my part of Los Angeles to Hollywood, so I travel nine miles through the city. Planned in the 1960s, the Beverly Hills freeway would have solved my problem, but it vanished from maps when the city insisted it be built underground, a good idea.

The first Norwegian suffered a urine infection, common and easy to treat. The second had a hacking cough, present several days, which tormented three roommates almost as much as the patient. I handed over a bottle of cough medicine. The third had been vomiting. Everyone with an upset stomach blames their last meal, so I listened to a recital of everything he’d eaten.

The last had been to Universal Studios and thought she had sunstroke. Sunstroke is life-threatening, but there are lesser sun-related conditions, none of which she had. She did not even have the painful sunburn that northern Europeans acquire almost as soon as they get off the plane. Universal City is beyond the Hollywood Hills, an area hotter than Los Angeles proper, but it hadn’t been abnormally hot.

Hearing my reassurance, she admitted that her nausea and anxiety may have represented a mild panic attack. She suffered them regularly. This one was receding.

At midnight two days later she phoned, begging me to come immediately. Something terrible was happening, and she needed me to take her blood pressure and examine her and tell her she was OK. This was a full-blown panic attack, she informed me. She believed she was dying. When I assured her that she would not die, she did not deny it but pleaded tearfully for me to come. Victims of panic attacks are not psychotic. They know their fears are irrational, but they can’t resist them.

These calls are not rare, and I try to handle them without a visit. Ten minutes of soothing reassurance and the knowledge that I’m immediately available over the phone usually works. It also works when I visit a guest whose complaint unexpectedly turns out to be a panic attack. Unfortunately, these successes are guests who don’t know they’re having an attack or suffer them only rarely. This lady was a hard-core, locked-in panic attack regular. Her attacks followed a strict pattern, and no reassurance would change matters.

If I came, examined, and found everything normal, she would express gratitude, but even before I finished counting my money, she would be pleading for another exam. Yes (I know you’re asking) there are shots, and I give them, but they never work. I hate walking out on a guest who’s begging me to stay, and these attacks may last hours.

This guest was young and healthy. Her conviction that she was dying was clearly wrong. Yet… Every doctor has heard stories of patients who announce that they’re dying and then proceed to die. No doctor wants to be the source of such an anecdote, so this lady needed at least one exam. As I was agonizing, she broke in to say she would ask the hotel to call an ambulance. Then she hung up. I phoned the front desk ten minutes later to make sure they had done so. The paramedics would examine her and, if the results were normal, leave despite any pleas.

Thursday, May 5, 2011

In 1995, a man wearing only pajama bottoms dashed into the lobby of the Beverly Hills Hotel as I stood at the concierge desk.

“Don’t pay him!” he screamed.

Without lowering his voice, he denounced my competence, railed at my refusal to relieve his suffering, and asserted that, once the general manager learned of this, I would never again enter the Beverly Hills Hotel.

He had consulted me for a painful anal condition. I didn’t find anything wrong but gave some suppositories from my bag. He showed no interest in suggestions for sitz-baths and stool softeners, finally interrupting to declare that he needed substantial pain relief, preferably by injection. He heard my explanation for declining in sullen silence.

I left the room without the usual pleasantries and made a beeline for the concierge but not to get paid. I never ask for money after a visit turns out badly. If the guest isn’t planning to complain, the sight of my charge on the bill might change his mind. In these situations I try to neutralize damage by warning that I’d seen a guest who might cause difficulties. I had barely begun when the man’s entrance made this superfluous.

I kept quiet, and he eventually ran out of gas and stalked off. To my relief, several amused employees urged me not to worry. This guest was well known to them. They were right. Calls continued for another year before stopping. They often stopped. I’ve gained and lost the Beverly Hills Hotel four times.

I love that hotel. The buildings sit in a residential area of a city with benign parking laws, so I can leave my car on adjacent Crescent Drive. Because it ignores the tiresome obsession with security, even during the wee hours, I walk to the nearest door and never find it locked. I’ve made 135 visits.

I’m not the only doctor who loves the Beverly Hills Hotel. Although the oldest (built in 1912), later arrivals – Bel Air, Peninsula, Sofitel, and L’Hermitage share its reputation for opulence and expensiveness. However, something about the Beverly Hills attracts the fawning attention of doctors, including those who don’t serve hotels.

I’ve never met the general manager although he’s been there since 1997. He has the authority to designate a hotel doctor, but GMs tend to leave that decision to guest service personnel. That works out fine for me – over the long term. Over the short term, aggressive competitors exert their charms.

For an exciting year during the eighties, the Beverly Hills called, and I visited Leonard Bernstein twice (I can mention his name because he’s dead). Then calls ceased. They resumed several years later for several years before stopping again; this was probably the work of the celebrity whose visit I may have mentioned earlier. The hotel closed for renovations in 1994, reopening two years later with concierges who knew me from previous jobs -- always a good sign. Sure enough, calls began arriving. By this time, Doctor Lusman was on the scene (google “Jules Lusman”; you won’t regret it). I once walked into the lobby as he was leaving. A few months later he took over until he lost his license in 2002.

All luxury hotels call me now and then, and a few call regularly, but I lack the key to winning their ongoing loyalty. This might involve something as straightforward as moving in the same social circle as the general manager or as devious as money changing hands.

Decades ago, in a letter to the Beverly Hills general manager, I foolishly wrote that I don’t “provide amenities” to hotel staff in exchange for referrals. He apparently showed the letter to the concierges. One phoned to inform me that I should not expect calls from the Beverly Hills Hotel. Ever!… He was wrong, but several years passed before I realized this.