Another Celebrity Injection

A VIP was flying in from San Francisco. He was under the weather and needed a shot before the night’s performance. 

Someone else has the Los Angeles franchise on celebrity injections, but I handle the occasional request.

There were the usual inconveniences. I was told to be at the hotel at 2 p.m. but his flight was delayed. The new time was 3 p.m. I waited at home. It was 3:20 when a phone call announced that he was on his way, so I drove off.

He was a singer but not an A-list. I’ve long since forgotten his name. I met him in a suite at an upscale (but not luxury) hotel on the Sunset Strip accompanied by only three assistants. Unlike international stars, he shook my hand, thanked me for coming, and allowed me to ask about his illness and examine him. Major celebrities nod a greeting and then resume communing with their entourage, pausing momentarily for the injection. 

He had a cough, and his doctor had recommended cortisone. Unlike B12, the traditional celebrity injection, cortisone works but probably not by the time of his performance in a few hours.

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 Miracle Drug

Handing me a vial of an injectable medication, a guest explained that he needed a refill. Its label was in Spanish, but technical terms are recognizable in any language, so I had no trouble deciphering its mixture of vitamins and minerals. And cortisone.

That was disturbing. The guest’s wife’s rheumatoid arthritis occasionally flared up, and her doctor in Argentina wanted to make sure this didn’t spoil their vacation.

Discovered in the 1940s, cortisone seemed miraculous. Patients crippled with arthritis saw their pain melt away. Ugly psoriatic plaques disappeared. Hay fever vanished. Eczema victims who had been scratching for years stopped after a few doses of cortisone.

A cure for cancer could not have produced more excitement. The Nobel committee, which prefers to wait decades, rewarded cortisone in 1950 - just as doctors were realizing that symptoms return with a vengeance when the effect wears off, and repeated use produced disastrous side-effects.

Creams are fairly safe, and cortisone taken internally remains a life-saver for many serious diseases but a bad idea for ongoing symptoms (generalized pain, itching, inflammation). Large amounts for a short period are safe provided the problem is also short-lived. I give a huge dose for poison ivy but stop after two weeks. By that time the poison ivy has run its course.

A rare shot is probably OK for arthritis, but this family’s G.P. used it generously, a common tactic because the short-term effect is so good. There are no benign treatments for rheumatoid arthritis, but many are safer than cortisone. I prescribed enough for one shot.  

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.

A Good Call

A singer felt a sore throat coming on, his manager explained. He needed a shot of cortisone. I’ve given many; singers seem to think they work, and they’re harmless.

These are good calls. I drive to a hotel, give an injection, collect money, and return home. What’s not to like?

The manager added that the singer would need his shot the day of his performance the following Saturday. Early Saturday he phoned to inform me that the singer was free at midday. He would call to give an hour’s notice. Midday passed without a call.

As I prepared for dinner at six p.m. the manager phoned to announce that his client was ready. But there was a hitch. The singer was not in Los Angeles but at a resort hotel in La Puente thirty-five miles away. Although weekend freeways are usually fast, this trip took an hour. The resort was hosting an event called The Urban Music Festival; it was packed with black people, the women in dazzling gowns, the men dressed as gangsters.

No one answered when I knocked on the singer’s door. I phoned the singer’s manager and heard voicemail. I paced the hall for fifteen minutes, knocking and phoning now and then. I checked with the concierge who obligingly offered to call the room.

My phone rang as I was driving off. I retraced my steps to the room, now packed with the singer’s colorful entourage. I gave the shot, collected my money, and returned home to supper.