Monday, August 14, 2017

Flying and Your Ears

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 because I handle most over the phone. If a 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 even reputable sites such as the Mayo Clinic and WebMD solemnly recommend feeble preventatives such as antihistamines and drinking fluids plus dangerous ones such pinching your nose and blowing (they warn you to do it “gently”). All deliver traditional advice: chew gum, suck on hard candy, yawn frequently, take oral decongestants. Traditional advice sometimes works 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.

Thursday, August 10, 2017

Doctor Oppenheim's Screenplay

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

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

“Well…. As a matter of fact…”

At his urging, I mailed him a screenplay.

Does this surprise you? I work in Los Angeles. Why shouldn’t I write screenplays? Everyone else does.

I was reminded of 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 produced a surge 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. They pass a minuscule handful 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. Nevertheless, that rejection marks the highlight of my literary career since 2010. The highlight that year was an actual publication, 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 amusing quirks, he cannot resist extolling his screenplays to sick celebrities. I never do that. The writer mentioned above took the lead.

You may be curious for the upshot. He never replied.  

Sunday, August 6, 2017

The Law

A Finnish man with a fever was staying in a Hollywood Hotel. Treating flu symptoms is rarely 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 better. 

The following day was July 4. Hotel doctors look forward to holidays because freeway traffic is lighter. Sadly, no calls arrived. None arrived the day following or the day after that.

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 remains fifty/fifty. It’s guaranteed that someone will win the lottery, but the winner always credits God. After several days with a silent phone, I conjure up images of a rival sweeping up my hotels with irresistible charm or fifty-dollar bills. But calls resumed

Wednesday, August 2, 2017

Against Medical Advice

A friend has had his gall bladder removed. He’s recovered, and you’ve agreed to drive him home. He is dressed and ready when you arrive. Hospital rules require the surgeon to examine him and approve the discharge, but after two hours the surgeon has not appeared. When asked, the nurse says he has been delayed. Asked an hour later, the nurse admits that no one knows where he is. They must wait.

An hour later, the exasperated friend announces that he will leave. You can’t do that says the nurse. If you do, you must sign this. She produces an impressive document that relieves the hospital of responsibility and lists terrible things that might happen when the signer leaves Against Medical Advice.

“Another thing,” adds the nurse. “If the doctor doesn’t sign the discharge, your insurance won’t pay.” Naturally, your friend decides to stay.

This happens all the time, but it’s nonsense.

First, you don’t have to sign an Against Medical Advice form. You can just leave.

Second, according to surveys, almost all doctors and nurses believe that medical insurance doesn’t pay if a patient leaves AMA, but it’s not true. Insurance pays.

Surveys also show that patients who leave AMA have a much higher rate of complication and readmission. Generally, it’s not a good idea. But, except for certain psychiatric cases, hospitals have no legal right to keep you.