A lady at the Westin wanted a housecall for her cough and fever. This seemed reasonable until I learned that she was under treatment for multiple myeloma, a serious blood disease. It affects the immune system, so any sign of infection is a red flag.
I explained that she needed more than I could provide
in a hotel room and gave directions to the nearest emergency room.
*
* *
Two hours later I spoke to a guest at the Airport
Holiday Inn who was experiencing stabbing chest pains. Chest pain is worrisome,
but significant chest pain lingers. Fleeting pain in an otherwise healthy
person is almost never a serious sign. I looked forward to the visit when,
after my exam, I would deliver reassuring news. That anticipation disappeared
when the guest mentioned that he had suffered several blood clots in his lung
and was taking blood thinners. He added that these chest pains were different.
Different or not, it was a bad idea to assume that
these were trivial. I sent him to a facility that could perform tests.
* * *
A travel insurance agency asked me to see a hotel
guest in Encinitas.
“That’s near San Diego,” I pointed out. “It’s a
hundred miles.”
I’ve traveled that far in the past and charged
accordingly, but I didn’t want to quote a fee and risk having it accepted
because I wasn’t in a mood for the grueling drive. A local clinic would be
cheaper, I informed the dispatcher.
* * *
“I’m a physician in the U.K., and my wife has
conjunctivitis in both eyes. I went to the chemist for antibiotic drops, but
apparently I have to see an American doctor.”
“It’s unusual to have bacterial conjunctivitis in both
eyes,” I said. “If you’re certain, ask the pharmacist to phone, and I’ll
approve the prescription.”
Later the pharmacist phoned. When it comes to their
own illness or that of their family, doctors are no more accurate than laymen,
but they have no interest in my opinion.
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