Listomania

I once made sixty to eighty visits per year to the Crowne Plaza at the airport. Then they dropped to about five.

During a recent visit I noticed a printed handout on a bedside table, a long list of clinics and doctors which the reader was invited to peruse. Given a list, guests tend to call the first number first and then work down. My name was sixth.

When consulted, hotel lawyers always forbid staff from recommending a doctor. Should a guest ask for help, they insist, an employee should silently hand over a list, the longer the better. In this way, when the guest sues the doctor, he or she won’t sue the hotel. Lawyers admit that this doesn’t work, but they can’t help themselves. 

Told to make up a list, employees take the easy route by consulting the internet where they find clinics, local practices, and entrepreneurial physicians who charge spectacular fees. They won’t find me, so it’s a crapshoot where on the list I’ll end up.

Having produced the list, management forgets about it. Lists always contains doctors and clinics that don’t make housecalls. As time passes, some numbers no longer work; for the rest, guests who want to speak to a doctor end up speaking to an answering service or receptionist.

It might take years for calls to return to normal, but I am patient. 

Good News, Usually

A flight attendant with diarrhea is usually good news. Airline crew are young, so they suffer uncomplicated medical problems, and diarrhea qualifies. Her hotel in Costa Mesa was 46 miles away, but it was Saturday morning, so traffic was light, and I’m paid extra for the distance.

To my annoyance, this was one of those inexplicable weekend days when the freeway was jammed although it wasn’t a holiday, and I never saw an accident.

After caring for the guest, always the easiest part, I got back on the freeway and its creeping traffic. Five minutes later my phone rang. This was bad news because freeway driving is more tiring than practicing medicine, and I had had enough. The caller was a national housecall service, and, to my surprise, the patient was in Costa Mesa, a half mile from where I’d been.

Unaware that I was nearby, the service quoted its usual fee for a long drive, so I retraced my route, cared for the guest, and returned to the crowded freeway. I was weary when I finally arrived home, hours past lunch time, but it had been a lucrative day in the fascinating life of a Los Angeles hotel doctor.  

The Old Man's Friend

A guest was coughing and feverish, and I heard crackling noises when I listened to his lungs, a sign of fluid. I suspected pneumonia.

I prefer diagnosing pneumonia to an upper respiratory infection because I can prescribe an antibiotic and skip the stressful explanation of why I’m not prescribing an antibiotic.

Unfortunately, this guest was 85. Most victims of pneumonia don’t need hospitalization. Even without treatment, most recover. This is not the case with the elderly where, long ago, pneumonia was known as “the old man’s friend.” Dying of pneumonia when you’re already feeble is apparently not a bad way to go.

The son did not like hearing that his father must go to an emergency room, but they went. When I phoned the following morning, I learned that the diagnosis was pneumonia. The doctor had prescribed an antibiotic and sent them out.

I was shocked. Hospitals always admitted elderly patients with pneumonia. What incompetent was on duty?...  The son assured me that his father was resting comfortably and promised to return to the hospital if symptoms worsened. When I called that evening, they had checked out.

If something bad happens, they will sue the hospital, but they will also sue me. It takes a long time for a malpractice lawyer to organize a suit, so his letter wouldn’t arrive for about a year.

Another Glamorous Film Shoot

 “We’re at 501 West Olympic,” explained my caller. “Come up to the seventeenth floor.”

That’s downtown, my least favorite neighborhood for street parking. I might find a spot within three or four blocks, but it was summer, and I wear a suit. No problem, said the caller, and directed me to crew parking a mile away.

I pulled into a lot jammed with mobile dressing rooms, equipment, cars, and a line of vans. An attractive young woman directed me to the leading van which chauffeured me through downtown traffic and pulled into another line of vans to let me off. After phoning a contact number, I waited for another young attractive woman (all assistants at film shoots are attractive young women) to conduct me to an elevator which let me out into a crowded corridor.

It takes a small army to shoot a film. Dozens of people under thirty rushed about. They were probably crew. Lounging about and getting in the way, another dozen, mostly over thirty, were probably actors. A person in charge noticed that I looked like a doctor and summoned the patient.

It was fortunate he wasn’t suffering hemorrhoids or jock itch because there was no privacy. We huddled in a corner and discussed his eye irritation. Afterward, the person in charge asked if I’d see someone who’d injured his neck in a fight scene. Leaving the building, I boarded the first of the line of vans and returned to the parking lot. 

Whether You Want Me or Not

If you want a housecall in Los Angeles, you’re likely to get me even if you don’t ask for me.

I don’t have a web site, but searching the internet turns up several agencies and a few individuals that promise to send a doctor at a moment’s notice. Many rely on me.

They also solicit hotels. Recently a national housecall service informed me that a guest at the Marina International wanted a doctor. The Marina International is one of my regulars.

After I phoned the guest, he asked me to come. I made a mental calculation before quoting the fee. The housecall service took forty percent, so I added forty percent.

Since those who call directly pay less, you might wonder why hotels don’t make sure guests get the best price. The answer, of course, is that hotels don’t know what doctors charge, nor do they care. Guests regularly ask me, but hotels never do.

Eighty Gouty Patients

A man’s foot began hurting one evening. By the following morning pain was excruciating.

That sounded like gout, one of my favorite diseases. The diagnosis is easy, and I can quickly make it better. What’s not to like?

I carry a treatment for gout, but once I hand it over, I have to remember to restock my bag. So I went to my drug closet, made up another bottle of pills, and threw it in my pocket. 

Sometimes I’m surprised when I arrive at the hotel but not this time. He had gout. I produced the pills from my pocket, and everyone was satisfied.

It occurs to me that I’ve seen so many victims – this was my 80^th – that I can check the experts. They claim that it attacks men overwhelmingly. Sure enough, only seven of my patients were women. They say it’s a disease of older people. 67 cases were over 40, none under 30.

Until a few years ago, treatment was a powerful anti-inflammatory drug such as indomethacin which produced unpleasant side-effects. Then experts decided a large dose of cortisone for a short period worked as well with less unpleasantness. I already carry an identical course to treat severe poison ivy. Patients feel better within a day.

A Difficult Hotel

The J.W. Marriott is not a regular, but its doctor is not a friend, so I don’t turn down its calls which arrive now and then.

Driving downtown, I had no worries about the patient but recalled that visiting the J.W. Marriott was often an unpleasant experience. Sure enough, the valet ignored a request to hold my car, gave me a parking slip, and drove the car deep into the bowels of the hotel.

The elevator required a room key. I waited for a guest, but apparently new technology makes it impossible to piggy-back on another’s key. I walked to the front desk and asked to use the elevator. This struck the clerk as a suspicious request.

An elderly man in a suit, carrying a doctor’s bag, and claiming to be a doctor might or might not be telling the truth. She politely quizzed me on my motives, phoned the room to confirm, and then asked me to wait while she summoned a security officer.

The officer remained at my side until the guest opened the door. After the visit, I returned to the lobby and handed over the parking slip. The desk clerk stared at it as if she had never seen one and then excused herself to consult the manager.

I waited several minutes until she returned to hand back the slip and explain that the hotel “was unable” to validate parking.

Downtown hotel parking is brutally expensive, and I remembered the same difficulty during earlier visits. Everyone hates hotel parking, so its cashiers are immune to arguments. I scribbled “hotel doctor” on the slip, shoved it through the window, and hurried away to stand at the curb. No one ran after me, and after a few minutes my car appeared. I don’t do that often, but so far it’s always worked. 

Summer, and Life is Easy

A blast of hot air greeted me when the guest opened the door. As I complain regularly, foreigners believe air conditioning spreads disease, so when someone falls ill, they turn it off. They dress for the heat, but I wear a suit and tie. Asking them to turn on the air conditioner is like asking a Moslem to eat a hot dog, so I pretend nothing is amiss and go about my business ignoring the sweat soaking my shirt.

Most of the year, I have no objection to leaving my car a few blocks away to avoid the hassle of hotel parking. I don’t do this when it rains, but rain is rare in Los Angeles. Summer is guaranteed; I dislike making the walk in hot weather and regret it even more if the guest has turned off the air conditioning.

Beaches exist in Northern Europe, but they’re chilly with the sun not much in evidence. Southern California beaches seem more inviting, so Britons, Germans, et al relax, doze off, and acquire gruesome sunburns.

Summer is my busiest season. The phone wakes me three or four times per week, but I don’t mind wee-hour visits. Parking is easy, guests are grateful, and with no office waiting I can take a nap whenever I want.

A Bilingual Doctor at Midnight

A guest wanted a doctor who spoke French.

“I don’t speak French, and it’s midnight,” I pointed out. “You won’t find a bilingual doctor to make a housecall at this hour.”

The operator promised to inform the guest and call back. Waiting for people to call back is one of my least favorite activities especially if I have been aroused from sleep. Fifteen minutes passed before the phone rang. The operator apologized for the delay, explaining that the guest wasn’t answering, and she didn’t want to keep me up. When she reached him, she would suggest a housecall for the following morning.

I agreed, adding that I could arrive around ten. The hotel was in Norwalk, thirty miles away, and I prefer to avoid the rush hour.

I went back to bed. Half an hour later the phone rang. It was the operator announcing that the housecall was on for 10 a.m.

Freeway traffic was in the category of “could have been worse,” but I arrived on time. No one answered my knock. According to the desk clerk, the guest was part of a tour group that had checked out earlier.

There is no lesson here. It’s part of a hotel doctor’s life.

I Save a Life

The phone rang at 5 a.m. but I am an early riser. April Travel Insurance told me of a lady with a cough at the Residence Inn in Manhattan Beach. Vacationers hate to get sick, so even a bad cold produces wee-hour calls.

This sounded easy. It was a fifteen mile drive, but the freeways were clear, and I would return before the rush hour.

Guest often feel obligated to demonstrate how miserable they feel, and this lady coughed loudly from the time I walked in. Listening to her lungs was difficult because she wouldn’t stop, but what I heard was not reassuring. A bad cough doesn’t necessarily mean a bad disease, but this patient had one ominous sign: she was my age.

I phoned April Insurance to explain that the lady needed a chest x-ray and possible hospitalization. This is bad news for an insurer. An ordinary emergency room visit costs over a thousand dollars, a hospital admission for pneumonia twenty times that. Some insurance services work hard over their fine print to avoid paying for expensive incidents, and I occasionally urge guests to go to the hospital after they’ve learned that their insurance won’t cover it.

April doesn’t do that. The dispatcher explained that he would arrange matters. Later that day, the husband informed me that his wife had been admitted for pneumonia.

The No-Housecall Mode

Several times per year, a hotel guest suffers a bloody nose. I don’t make housecalls for nosebleeds because there’s nothing I can do. Treatment is to pinch the nose, releasing pressure every five minutes to check if bleeding has stopped. I tell guests to repeat until they get bored. If bleeding persists, the next step is cautery or nasal packing, both of which require expertise.

I regularly hear “I can move it, so I know it’s not broken…” but this is as true as most popular medical theories.  Examining a wrist, finger, ankle, foot, or ribs I can suspect a fracture, but I’m never certain. Most common fractures aren’t urgent, so I tell guests it’s OK to wait to see if there’s quick improvement. If not, they need an X-ray.

All insect bites look the same, bee stings included. Redness and itching spread, peaking at two days before slowly fading. I explain this over the phone, but guests often want me to take a look.

When a guest suggests he has bronchitis, I immediately go into no-housecall mode because this is a fake diagnosis doctors use when they prescribe an antibiotic as a placebo (other fake diagnoses are “sinus infection” and “bacterial infection” and sometimes “strep”). You may be surprised to read that bronchitis is not a disease but a medical term for coughing. 

Lost on Campus

It was after nine when I left for Long Beach, thirty miles away. Freeway traffic moved swiftly; the patient was a sixteen year-old with a sore throat, usually an easy visit.

Google maps guided me to 1250 Bellflower Boulevard which was the student union of California State University in Long Beach. That also turned out to be the address of the university. The student union was deserted. It was the summer break. I left messages at a phone number that may or may not have been the patient’s.

A couple walking nearby pointed me in the direction of distant residence halls which, when I arrived, seemed endless. I phoned the travel insurer who had sent me. The dispatcher managed to contact the patient in her room and then passed on her directions. She was not familiar with the campus, so these were unhelpful. It took persistence, but I convinced the dispatcher that, since the patient was an adolescent, she was undoubtedly part of a group with a group leader.

The patient agreed that such a person existed and went off to find him. After a considerable delay he came on the line, determined my location, and talked me through a complex warren of streets to the proper building. As usual, delivering medical care was the easiest part.

Don't Get On the Plane!

“My flight leaves tonight” is a phrase I like to hear because it means the guest will return to the care of the family doctor. Until then he or she is my responsibility. Now and then, I don’t like to hear it. 

A guest awoke feeling well but soon noticed some abdominal pain.

When I hear “abdominal pain” I ask about vomiting and/or diarrhea and hope it’s present. That points to a stomach virus, usually a short-lived and not very serious problem.

Abdominal pain alone can mean a stomach virus, but I also consider serious conditions (gallstones, diverticulitis) and potentially fatal ones (ectopic pregnancy, blood clots). I prefer to send these guests directly to an emergency room, but sometimes I end up at the hotel.

This guest considered my question before deciding that he had diarrhea. Maybe… My abdominal examination turned up nothing requiring urgent attention. He was young, so several life-threatening problems were unlikely. The pain itself was unpleasant but not quite excruciating.

It was a difficult decision, but doctors are paid generously to make difficult decisions.

I told him that he probably had a stomach virus, but I couldn’t rule out something serious. I would give him something for the diarrhea and check back. I added that he might need some tests and that he must not get on the plane if the pain persisted.

When I phoned after three hours, he had checked out.

I'm Not in It For the Money

The phone rang at 3:30 a.m. An airline pilot at the Costa Mesa Hilton needed a doctor, explained the caller. Could I go?

That Hilton is 46 miles away, but I drive there regularly for an agency that provides medical care to foreign airline crew when they lay over (American crew are on their own). It’s an easy drive at this hour. I accepted for several seconds until I woke up and remembered that the 405 freeway closes at the Orange County border during the wee hours for major construction. Despite the hour, closing the freeway produces an immense backup, and the detour through city streets is slow and tedious. Forced to go, I take a different freeway which is ten miles longer and only slightly less tedious.

I was in luck. Wee-hour patients usually suffer intense symptoms such as vomiting; they don’t like to wait. This guest had a cold and didn’t object to a visit later that morning.

I breathed a sigh of relief and went back to sleep. The delay would cost me $150 because the agency pays less for daytime housecalls, but it was worth it.

Is Murder Cost-Effective?

At a medical conference, a speaker came up with a radical proposal.

People regularly come to an emergency room complaining of chest pain, he said. Most are not having a heart attack, but doctors do a careful exam and many tests and often observe them for hours. Even if little turns up, doctors lean over backwards to admit someone with a possible heart attack. In the end, some are so obviously not having a heart attack that the doctor sends them home.

But medicine is not perfect, he added. Three percent of those sent home are having a heart attack. They sue the hospital and win.

Over the years, hospitals have become more liberal about admitting patients with chest pain. But, in the end, some are sent home.

No matter. Three percent are having a heart attack, and they sue. The average payout is over $400,000.

“It’s an impossible situation. What can a hospital do?” asked the speaker. He went on to suggest a tactic for a doctor who decides that a patient isn’t having a heart attack and can be sent home. Current hit-man rates are $10,000 per.

“Do the math,” he said.  

Going Back to College

Every summer, a hundred Brazilian adolescents descend on UCLA’s dormitories to study English. When one gets sick, a counselor phones April Travel Insurance which phones me.

I graduated UCLA fifty years ago, and returning is a strange experience. Crowds outside the dormitories shriek, laugh, and chatter. It sounds like a kindergarten. Were we that noisy? Women’s fashions don’t seem to have changed, but the males look dorky. My generation had long hair and tight clothes. Nowadays it’s short hair and baggy clothes. Men wear shorts. Don’t they realize how silly they look? We kept books in lockers. Now everyone has a backpack. Especially odd is the number of Asians who make up a third of the enrollment. Most speak perfect English, so they’re clearly American. Where were they when I was a student?

In my day, when you entered a university building, you found a door and entered. Today all except the main entrance are locked. Students manning the front desk consider names and room numbers privileged information. Using the elevator requires a key which all students carry. This is identical to hotel security and probably no more effective.

On arriving, I phone a counselor from the lobby who comes down to escort me. The dorm rooms are tinier than I remember, and I suspect little studying occurs because desks are piled with personal items. Delivering medical care is no problem, but it’s summer, and foreigners consider air conditioning unhealthy, so the rooms are hot.

Middle-class teenagers suffer respiratory infections, upset stomachs, and minor injuries almost exclusively, so, once I learned to deal with UCLA’s draconian parking policy, I found these easy visits.

Turning Bad News Into Good

A glum eleven year-old sat on the bed. His glum parents and two glum adolescents sat nearby. The eleven year-old had developed a sore throat, casting a pall over their vacation. They hoped I would make it go away.

Doctors love making things go away, and this would happen if the child had strep, the only throat infection (diphtheria aside) that medical science can cure.

Parents assume that a child with pus-covered tonsils has strep, but many viruses do this. Researchers have determined that a doctor can diagnose strep by observing four signs.  (1) pus-covered tonsils, (2) swollen neck glands, (3) fever, and (4) absence of cough. Since it’s strictly a throat infection, other respiratory symptoms such as cough or congestion make strep unlikely.

This patient had zero out of four. His throat and neck glands were normal; he had no fever; he was coughing.

Working hard to turn this into good news, I explained that the child had an ordinary virus. He would feel under the weather for a few days before getting better. I handed over some remedies, assuring them that these would help. Staying in bed wasn’t necessary. They should try to enjoy themselves.

When the father politely asked if something might speed things along, I explained why it wouldn’t. Never forgetting their manners, the parents expressed gratitude. I left them my cell phone number and urged them to phone if any problem developed. 

We parted on good terms, but I could sense their disappointment. No matter what the doctor said, everyone knows that sick children must rest. So they would wait.  

Bringing the Housecall into the Twenty-First Century

I keep track of competitors, so I saw Medicast’s web site when it came to life.

During an interview with two energetic founders, I learned that Medicast planned to bring the housecall into the 21st century, slashing the cost with volume, marketing, and digital technology. Doctors were rushing to sign up, they added.

I agreed to join them but declined the canvas carry-all they were offering, preferring to keep my traditional doctor’s bag. A handout listed required drugs and supplies which Medicast would sell to its physicians, but they agreed that I could use my current selection.

They gave me an Ipad Mini. All their doctors received one. Potential customers downloaded the Medicast app which gave them the choice of signing up for a paying program that provided free housecalls or paying nothing and summoning a doctor when they needed one. Clicking the app connected them to a dispatcher who recorded their credit card information and sent a text message to a doctor on-call. The program then automatically dialed the client from the doctor’s phone.

“Hotel guests phone me directly,” I said. “Wouldn’t that be quicker?”

“Doctors hate giving out their private numbers,” they explained. “This way you don’t appear on caller-ID, so patients can never bother you.”

A Los Angeles housecall cost $249 during business hours, $349 during nights and weekends. While this was in the ballpark of my fee, Medicast kept about one third. Medicines, supplies, and injections cost the patient extra, so a Medicast doctor had the opportunity to earn more – a lot more if he was creative. My hotel doctor competitors show positive genius in this area.

Carrying the Ipad everywhere was a minor annoyance, and software bugs made an appearance. If another doctor answered, the app didn't notice, so I phoned patients who had already set up a housecall.

Business was brisk. My Ipad chirped nine times during the first month to announce a call although some may have been software glitches. All were from local residents, so they didn’t overlap with my clients, but employees at two hotels reported visits from a Medicast representative, extolling their service.

I posted the above five years ago on this blog. Calls faded out over the next several months. Someone came by to collect my Ipad. Sometime in 2016 or 2017 Medicast went out of business.

It Never Hurts to Check

Universal Assistance asked me to visit a sick Costa Rican in Downy, a suburb of Los Angeles about thirty miles distant.

She gave the hotel address: 9640 Bell Avenue.

“Is that B – e – l – l?” I asked, spelling it out because English is never the native language of travel insurance dispatchers.

“Yes,” she said.

On Google maps (“29.4 miles; 39 minutes”), that address turned up in an adjacent city five miles away but not Downy itself. My first instinct was to accept it. As a visitor, the Costa Rican was unfamiliar with local geography. But several unhappy experiences persuaded me that it never hurts to check. 

“Not ‘Bell,’ said the desk clerk when I phoned. “It’s B – u – e – l – l.  Buell.”  Google found it in Downy.

"I Can't Afford That!

I hear this now and then when a guest learns my fee, more often in the form of a hint (“I’ll talk to my husband and call you back…”).

My routine when hotels call is to listen to a patient’s symptoms, deliver an opinion and advice, and discuss options (only half my callers require a housecall). Once a guest agrees to a visit, I reveal the cost.

Hearing a reluctance to pay, I mention local walk-in clinics. Their basic charge is less than mine, although that difference disappears if the doctor does anything (i.e. orders a test, gives a shot, writes a prescription, applies a dressing).

I feel uncomfortable suggesting leaving the hotel room if it’s a struggle – for example if someone is vomiting or dizzy. This guest had been dizzy all day. In these cases, I insist on coming, telling them they can pay whatever they feel is fair. Many guests end up paying the usual, but I’ve taken as little as $5.00.

Since she had already protested the fee, my expectations were low. They dropped to zero when I approached the hotel and saw paramedics loading her into an ambulance.

The guest’s symptoms were not life-threatening, but paramedics lean over backwards to take patients to the hospital, having been burned in the past when they didn’t. 

I wondered if she had called them because of worries about my fee. She may not have realized that paramedics will send a whopper of a bill.

Making the Doctor Feel Bad

If a prescription gave you diarrhea or made you vomit, you would complain. But until well into the twentieth century, people looked on a good “purge” as an excellent way to expel toxins. Physicians took pride in their cathartics, and when patients discussed a doctor’s skill, they gave high marks for the violence of his purges.

People who consult a doctor expect him to behave in certain ways. 21^st century Americans frown upon purges, but this is not a mark of superiority because we seem to expect medicine. It should be one only a doctor can prescribe; over-the-counter drugs don’t count. Pills are good; an injection works better.

Most of you will deny expecting medicine whenever you see a doctor. You want help. If you’ll get well without medicine, you won’t be upset… I often encounter such patients, but the other sort turns up regularly. I’m slower to prescribe than most, so I have many opportunities to see disappointment in patients’ eyes when they realize I don’t plan to “give them something.” This makes me feel bad.

Doctors genuinely want to help you, and it depresses us when we can’t. We also feel bad when we’ve done our best, and you don’t feel “helped.” So we often add a prescription or order a test to convince you that we’re doing what a proper doctor should do.

Following Instructions

I drove up into the hills late at night and parked on a narrow street. Following instructions from the caller, I walked up a driveway. It rose steeply and seemed to go on and on. There were no lights, but luckily I carry a flashlight for examining throats. After a hundred yards, I came to a small house with no lighted windows. No one answered my knock. There were two cars in the garage, so I assumed someone was home. I pounded on the door inside the garage. The lights came on, and a nervous woman’s face appeared at a window.

“I’m the doctor,” I said. “Is this 232 North Beverly Glen?”

It wasn’t. That was the house on the street. My instructions to “park on the street and walk up the driveway” weren’t wrong, but the caller failed to add that his front door was only a few yards up. 

How to Find a Good Doctor

Readers of these posts occasionally ask me to be their doctor. Since I’m long past retirement age and make housecalls exclusively, I can’t be anyone’s family doctor.

These requests bring up a serious problem:  how do you find a good doctor? Searching the internet turns up an avalanche of physicians yearning to care for you.

All seem humane, state of the art, eager to serve. Why isn’t the choice easy? The answer, of course, is that these are advertisements: fawning and phony.

It’s impossible for doctors to advertise without appearing shifty. They invariably point out their expertise, but you take that for granted. They extol their compassion. That sounds creepy, but they can’t resist. 

I’m not after your business. I give medical advice but only if it contradicts what you hear elsewhere or seems amusing.

I enjoy describing life as a hotel doctor and delivering opinions on the world, mostly as it relates to medicine. I write what I want although my wife exerts a modest influence (almost always by saying “you can’t post that...”).

I’m often the hero of my stories, but they’re mostly day-to-day events, some of which I wish hadn’t happened. The result is that I come across as a real human being. Why shouldn’t I? I’m a good writer. Most doctors can’t write; neither can their advertising agencies.

Terrific doctors aren’t rare. Their patients know who they are, so the best way to find one is to poll people you know. Asking doctors is OK, because they’re unlikely to name anyone bad, but they tend to prefer their friends. The only terrific doctors I know are those I’ve seen in action – most often caring for me. Ask around.

Amazing Facts on Nutrition, Part 2

Here are questions I often hear often.

“How can I make sure my diet is nourishing?”

Answer:  “Eat a variety of food. By consuming a good mixture of vegetables, fruits, grains, proteins, and dairy products, you’ll get everything you need.”

“How will I know if I’m missing something?  For example, how can I get enough riboflavin?  What foods have riboflavin?”

Answer:  “I don’t know.”

“You’re a doctor, and you don’t know the foods with riboflavin?”

Answer:  “I could look it up. It’s not important. Eating a variety is important.”

“I haven’t had much energy lately. Is it because I’m not eating right?”

Answer:  “Probably not.”

What should you do first if you're anemic?

Answer:  Find out where you’re bleeding. The most common anemia is the result of blood loss.

Amazing Facts on Nutrition

Although a third of the world would be better off on the typical American diet, it’s not ideal, but the defects are not what you believe.

What should you worry about?

Protein?  Not a problem.  Most adults consume more than they need. There’s no advantage to a high protein diet but not much harm either. Your body will use as much as it needs and turn the rest into fat.

Carbohydrates?  Americans should eat more. They’re high in roughage.  Americans need more roughage.

Fats?  Fat is OK. Vegetable fat is probably better than animal fat for lowering your cholesterol. Dieters should be careful about choosing low fat foods. They’re not necessarily low in calories; in fact, manufacturers add sugar to make them taste better.  

Sugar?  Americans consider sugar sinful. Like sin, it’s probably not good for you. Sugar certainly contributes to obesity and tooth decay but doesn’t cause serious diseases such as diabetes or heart attacks.

Preservatives?  They may do more good than harm. In poor countries a leading killer of children is diarrhea, often from spoiled food. This was also true in the U.S. during the nineteenth century. Refrigeration and canning makes this less of a problem today, but considering how careless we are storing and preparing food, preservatives still prevent disease.