Sunday, September 27, 2015

Another Spiked Drink

It was one a.m. as I drove Santa Monica Boulevard, but crowds packed the sidewalks in West Hollywood, lining up to hear the latest band. A few blocks beyond, I parked at the Ramada.

A guest led me to the bathroom where her companion lay in the empty tub, clutching a towel and moaning. This was not the first time I cared for a patient in a bathtub or even the tenth.

“We’ve been out drinking,” explained the guest. “But not more than usual, and she didn’t have more than me. Do you think they put something in her drink?”

This was not the first time I heard that – or the tenth. Guests often suspect foul play when someone becomes violently ill after drinking.

I examined the patient as best I could without moving her because she insisted she could not move. Afterward I explained that alcohol is a toxin that messes up the brain, usually in pleasant ways but occasionally not.

After delivering an injection for vomiting, I told her to suck on ice chips and phone if she wasn’t feeling better in a few hours. So far everyone has recovered.     

Wednesday, September 23, 2015

An Exotic Travel Destination

Tourists come to America expecting a strange foreign land. They usually leave satisfied, but encountering an American doctor is an unexpected bonus, so everyone on the tour gathers round, and I often go about my business in front of a large attentive audience.
My largest consisted of the entire company of the Chinese Peking Opera lined up along the wall of a ballroom in the Hollywood Roosevelt. One of its members had begun behaving bizarrely. I concluded he was suffering an anxiety attack which a tranquilizer might help. 

This took place well before Chairman Mao’s influence became passé, so it was likely the Opera’s resident physician had no Western training. Etiquette demanded I treat him as a colleague, so I presented my advice as a suggestion.

After consulting other senior figures, he gave his approval. No one except the interpreter spoke English, so many subtleties were lost, but everyone seemed satisfied, and the entire troupe lined up to shake my hand.

Saturday, September 19, 2015

Doctors Are Always Late

At 6 p.m. on the Friday before Labor Day, I learned that a flight attendant in Costa Mesa had a cold. I prefer not to drive 46 miles during the rush hour, so I promised to be there between 9 and 10. That was acceptable. Airline crew are not demanding.

Five minutes later a guest at the downtown Doubletree asked for a visit. This was a bad juxtaposition. Scheduling it for after Costa Mesa meant an arrival time near midnight.

Reluctantly I told her to expect me at around eight. Since it was the evening before a holiday, I gave myself over an hour for a 25 minute drive. To my surprise, the freeway flowed freely, so I was early. I worried the guest might not be in the room. When I say I’ll arrive “around eight” guests often hear “eight.” They leave, planning to return at eight or a little after. But the guest answered the door.

The freeway to Costa Mesa was also fast, and this time no one answered my knock at 8:30. The front desk was unhelpful.  

This was a situation I hate. Airlines have strict rules about sick crew, so this guest required a visit. If I waited until 9 and then left, I might get a call on the way home. If she was out partying, I might get it several hours later. I did not acquire my peerless reputation by refusing calls, so I’d make the return trip.

As I fumed and paced, the guest returned. I expressed relief, but she did not apologize. She was present at the appointed time, and no one expects a doctor to be early.

Tuesday, September 15, 2015

Medicine is Easy; Parking is Hard

A 23 year-old foreign student at the University of California had bronchitis. I live three miles from UCLA but this was the University of California at Irvine, 52 miles away. I quoted a fee that took this into account and was not overjoyed when it was accepted.

Navigating inside a huge campus is tricky, but Siri calmly directed me to the correct address. It was, as I suspected, the residence hall main office. No one lived there. I phoned the student to ask where to park because the streets were forbidden. He said he would come out and direct me.

When I phoned again in ten minutes, he assured me he was on his way. He arrived and guided me through winding streets to a parking lot with signs threatening serious consequences to anyone without a permit. He swore that it was OK. It was August; the campus was deserted, so I took the chance.

He wore shorts and t-shirt, appropriate for a hot summer day. Sweating in my suit, I trudged at his heels for several blocks, passing building after building until we reached his. It was a student dormitory, so there was no air conditioning. The visit went fine.    

Friday, September 11, 2015

Girls Are the Best

 “...allo!!” shouted a little girl from her bed as I walked in, but that was her only English. Her French parents had called because she was running a 101 fever.

She seemed delighted to see me and jumped to sit on the edge for her exam. Smiling happily she waited as I quizzed the parents, opened her mouth widely when asked and made no complaint when I poked my otoscope into her ears.

I found everything normal. She had a virus that might last a few days and required only Tylenol. Staying in bed was not necessary. Everyone seemed pleased, the child most of all; she waved goodbye as I left.

I loved that visit. Readers are familiar with my admirable qualities, but I admit that I am not the sort of jovial physician who enchants young children. Mostly I do fine, but I’ve endured plenty of encounters with apologetic parents and a screaming, struggling toddler.

These are almost all boys. Adult male pugnaciousness has not made the world a comfortable place, and it works equally badly in children. They get the exam regardless, but it’s drawn out and painful. The parents are embarrassed, the doctor relieved when it’s over.

Little girls rarely make a scene. If frightened, they keep quiet. If not, they realize, almost from birth, that charm works wonders. Everyone relaxes and takes care of business. Women should run the world.   

Monday, September 7, 2015

A Dog-Eat-Dog Business, Part 10

My last post reported a housecall service that charged an unbelievable fee. By an odd coincidence within a week I came across another new service with an even more unbelievable fee: $99.

A high-tech startup similar to Airbnb, Uber, and Lyft, Heal is clearly the wave of the future. You download its app. If illness strikes, you click on it, enter information, and (according to the web site) a doctor arrives within an hour. Business was brisk, its medical director assured me.

With a “medical assistant,” driving, Heal’s doctors care for acute illnesses, performing complex procedures that I don’t do such as suturing, injecting joints, and even complete physical exams.

Paying the doctor, driver, staff, and investors at $99 per housecall seems impossible, especially since the web site emphasizes that there are no extra charges. On the other hand, taxi companies complain bitterly about Uber, and hotels denounce Airbnb, yet both are prospering. Financial acumen is not my strong point, so it’s possible that Heal will drive me and my more expensive colleagues out of business.

If so, I might to work for them. Pay is low for a doctor but acceptable to me. Having a driver would relieve a major stress, and I might enjoy not being on-call 24 hours a day. This blog would vanish, but you could read Heal’s. It lacks my whimsy, being mostly earnest medical advice and public relatoins, but $99 will not include entertaining literary diversions.

Let me know if it works for you.

Thursday, September 3, 2015

A Dog-Eat-Dog Business, Part 9

I keep an eye on the competition, searching the internet for various combinations of “hotel doctor,” “house call doctor,” “housecall,” etc. My blog turns up but never a web site or one from other veteran hotel doctors. We don’t advertise, a sure sign that our days are numbered.

Last week, I came upon International Medical Services which promised to send a highly qualified doctor to a home, office, or hotel at a moment’s notice. When I phoned, its medical director knew my name, having dealt with me at previous jobs.

Like all new arrivals, he insisted that business was thriving. In fact, as we spoke, a hotel guest needed a visit, and I was welcome to go. I asked about the fee.

“We charge between $1600 and $2000. The doctor gets half.”

“Guests won’t pay that!”

“We don’t have trouble. These people have travel insurance.”

He suggested I quote $1200 and then add a few hundred dollars for medicines and supplies. That was their doctors’ routine.

I visited a young woman at the Hampton Inn with a simple urine infection. She handed over her credit card without complaint.

That felt creepy. I mailed $600 with a note asking him not to call again.

The Hampton Inn is not an upscale hotel. How did he persuade its staff to refer guests? My legal advisor warns me not to speculate.