Recovering From Cocaine

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.

A Sad Story

A Chinese caller wanted a medicine to take back home. He gave the name which, through his thick accent, sounded like “desitin,” an over-the-counter treatment for diaper rash.

That didn’t seem right, so I coaxed him through the spelling (“S as in Shanghai….? “T as in Taiwan…?). The result was “dasatinib.” This turns out to be a treatment for leukemia, FDA approved a few years ago and superior to other treatments. A sick friend in China had asked the guest to obtain some.

I fulfill these requests if they sound legitimate, and this qualified. I made sure he understood that he must find a pharmacy and explain exactly what his friend needed including the dose and instructions. This sometimes involves phoning back to the home country. The pharmacist would then call me, and I would approve. A trip to the hotel wasn’t necessary.

The guest had phoned in the evening and mentioned that he was returning to China the following morning. When the day passed with no call, I had the sinking feeling that, by delaying till his departure day, the guest had waited too long. The average CVS or Walgreens might not stock these high-tech, chemotherapeutic drugs, so the pharmacist might have to order it or send him to another specialized pharmacy. This might take hours. With a plane to catch, the guest probably realized that there wasn’t time. 

Sticking With the Errant Doctor

A guest had a flight in a few hours, explained the front desk manager of the Marina Marriott. His wife was ill and needed a doctor’s note to reschedule. How fast could I get there?

“Very fast,” I said. It was Saturday evening, and I was reading a book.

The Marriott had called regularly for decades before falling silent a few years before. Hotels occasionally do that, and this call gave me hope.

My competitors enjoy an active social life. It was the weekend, and hotels often turn to me when the regular doctor is hard to reach. After caring for the guest, I returned to the lobby and tracked down the manager who shook my hand.

“Thank you so much for coming,” he said. “We have your card.”

I drove off in a happy mood. These urgent requests arrive several times a year, and my prompt response has won me new clients.

But not often. Few hotels give a high priority to providing medical services. The Marina Marriott reverted to silence.

Still, I have fond memories. Twenty years ago, Loews in Santa Monica phoned when its regular doctor hadn’t appeared after several hours. I hurried, but when I knocked on the guest’s door, it was the regular doctor who answered. The embarassed manager promised to make it up to me and kept his word.

Rashes Are Easy, Part 2

His client had developed redness over her eyelids. Could I come?

As I wrote last time, rashes are easy, and eyelid rashes mostly turn out to be one of two or three diagnoses. I asked for the room number.

The guest was in a meeting, the caller responded. When I arrived, I should ask the concierge to fetch her.

So I did. The concierge phoned and informed me that the meeting would end shortly. I waited half an hour.

As expected, the eyelid rash was no problem. After accepting a tube of cream, she mentioned that her knee had hurt since her run the previous day. I examined the knee and reassured her. Then we talked about her husband who had a sore shoulder but refused to see a doctor.

Rashes are Easy, Part 1

A woman at a Sunset Strip hotel had seen a doctor for an allergic rash, and now she wasn’t feeling right. Rashes are easy, and her symptoms were probably medication side-effects, so I expected no problem. That seemed to be the case,, and she agreed to stop the medicine.

She handed me her credit card. I took out my cell phone, dialed the credit card company’s computer, and entered a series of numbers at its request. It denied approval. This is often the result of a typing error, so I entered the numbers again. Another denial.

In the distant past, guests would apologize and promise to send a check once they returned home. Some kept the promise, but I soon decided it was better to collect on the spot.

The guest seemed genuinely puzzled. She wondered if the hotel was responsible. At check-in, a hotel often places a hold on a large sum from the guest’s credit card to ensure that it gets paid. She wondered if this exceeded her limit. She phoned the front desk, and this proved true. There followed a long series of calls, referrals, consultations, and arguments before hotel management agreed to remove the hold. It worked. The computer reversed itself and approved.

Googling a Hotel Doctor

If you get sick in a local hotel, you might google “Los Angeles hotel doctor.” My name turns up but only with links to this blog. I don’t have a web site. Nor do my long-established competitors.

However, several young doctors eagerly offer their services. All promise to arrive promptly and deliver superior care. Don’t take their word for it. Rating services such as Yelp are unanimously enthusiastic. Five out of five stars.

In fact, sick guests are more likely to appeal to the hotel than the internet, but these doctors have also been working their charms on bellmen, concierges, and desk clerks.

All this takes money and work, but it’s not going to waste. Veteran hotel doctors possess an exquisite ability to detect an interloper, and these whippersnappers are definitely setting foot in my territory. Listening to my colleagues grumble, I know they are not immune.

As I complain regularly, only a minority of general managers have the good sense to designate an individual, usually me, as the house doctor. I have never solicited hotel employees. It wasn’t necessary when I began because there was no competition. I’m too shy or perhaps too lazy to begin. It would probably be a good idea. 

More Competition

A caller from the Airport Hilton asked how much I charged.

This is often the first question I hear. If I answer immediately, the guest is likely to thank me and hang up. So my first response is that phone calls are free and might be all he or she needs. What’s the problem?....

He wasn’t a guest, the caller replied. Hilton management was checking on what hotel doctors charged. There had been an unpleasant incident…. Hearing that I charged $300 most of the time, $350 for a call that got me out of bed, he responded that this was a big improvement and that he would pass along this information.

When I asked about the other doctor, the caller gave me an 800 number. I called it and learned that I was speaking to Doctors Housecalls. When I asked for the medical director, the person who answered said he was the owner.

When the owner answers the phone, that doesn’t suggest a prosperous business. I introduced myself as a long-standing Los Angeles hotel doctor. He immediately went into PR mode and told me of his burgeoning nationwide service. When I pointed out that I’d only learned of his existence today, he admitted that he was just getting started in the city. He asked me to send my CV.