I try not to make housecalls for shortness of breath,
chest pain, loss of consciousness, or severe abdominal pain.
Treating asthma, the leading cause of breathlessness in
the young, takes hours. Giving a shot and then leaving before the guest
improves is risky.
Breathless in older people usually means heart or lung
disease. No doctor in his right mind treats this with a prescription, although
possessing a mind is not a legal requirement for practicing medicine.
No one ignores an elderly person who faints, but this
doesn’t happen often. The young seem to faint regularly. They collapse, wake
up, and call me, frightened. I’m happy to make a housecall, check blood
pressure, do an exam, and ask questions. By this time he or she has recovered,
and I’ve never discovered something alarming in otherwise healthy young people.
“Everyone is entitled to one faint,” a wise old doctor told me. If it keeps
happening, a doctor should investigate.
Chest pain is a serious sign, but serious chest pain is
not subtle. Niggling discomfort does not qualify. Textbooks warn that heart
attacks can occur with no symptoms although these are usually in people with
other problems, especially diabetes. Since a doctor cannot diagnose a heart
attack by listening with a stethoscope, a housecall isn’t helpful. If you phone
because you’re worried, it’s unlikely the doctor will tell you not to worry
because if he’s wrong, you might sue him.
As I’ve written before, when a guest suffers abdominal
pain, I feel reassured when there’s diarrhea or vomiting. That usually
indicates a stomach virus, miserable but short-lived, and I get the credit when
the guest recovers. Pain alone can also be a stomach virus but plenty of
serious conditions (gallstones, kidney stones, blood clots) come to mind.
Medical science has no cure for drunkenness, but hope
springs eternal, so my phone continues to ring.
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