He
had turned bright red, a frightened guest informed me. His search of the
internet revealed that this indicated dangerously high blood pressure. Could I
come…?
This
was as accurate as most internet medical advice, so I was not alarmed. In
response to my questions, he admitted using cocaine earlier but emphasized that
he had never turned red before. His heart was pounding, his skin tingling, and
his head pulsating but he denied having a headache or chest pain. Could I come?
What
to do…. Allergic reactions turn patients red, but this is accompanied by
itching which he didn’t have. Otherwise, his symptoms were typical of cocaine
use. They didn’t sound life-threatening, but it’s a bad idea for a doctor to
dismiss the possibility.
I
do not like to make housecalls to frightened hotel guests. Waiting often
becomes intolerable, so they dash off to an emergency room or call the
paramedics before I arrive. When I suggested these possibilities, he refused,
urging me to come quickly. I asked him to count his pulse. It was 100: not terribly fast. I kept him talking, and he
grew more calm.
A
hotel doctor’s nightmare is a guest dying after he leaves the room, but dying
before he arrives may be worse. It was a stressful drive.
When
he opened the door, he didn’t appear bright red, perhaps faintly pink. When I
took him to a mirror, he agreed that he had improved. His blood pressure was
high, but not too high. His heart sounded normal. He was recovering from the
cocaine.
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