I'm Under a Doctor's Care

“I parked illegally, and they towed my car. It’s in an impound lot, and, wouldn’t you know.….”

Tales of misfortune (as opposed to complaints of illness) at one a.m. are a routine tactic of drug abusers.

“…My prescriptions were in the glove compartment. I don’t know when I can get them. I’m under a doctor’s care for….”

I declined his request for Oxycontin. The call had come from the desk clerk who had immediately handed the phone to the guest. As a result, when I hung up, I knew the guest might inform clerk of his disappointment with the hotel doctor. 

Under those circumstances, I phone the clerk and explain that the guest has made a request that I cannot, in good conscience, grant. Remembering his manners, the clerk expressed sympathy, but you never know…. 

A Big Tipper

Le Meredien in Beverly Hills has a firm policy against recommending a doctor. This does not mean that it never calls, only that a call from Le Meredien means a guest making trouble, and the harassed employee has chosen Doctor Oppenheim as the lesser of two evils, the greater being burdening his boss with the problem.

 “I’m here to see the gentleman in 499,” I informed the concierge. “Is there anything I should know?” 

She made a show of checking her computer. “That would be Prince Mahmel. He’s been asking for a doctor. Repeatedly. The Saudi consulate had your number.” 

Concealing my pleasure at that news, I thanked her and headed for the elevator. 499 stood at the end of the hall, the largest suite on the floor. Its door stood open. Knocking and then pushing it further, I encountered the smell of alcohol, never a good sign when the patient is Moslem. No one was in sight, but a doorway led to the bedroom and the prince, a small figure in a huge bed, covers drawn up to his chin. Balding and past forty, his disheveled hair was the single unkempt feature, and a goatee the only evidence of his foreignness

“Pain. Terrible pain,” he announced loudly.

“Where is the pain, Mr. Mahmel?”

“Kidney. I have kidney stones in my kidney.” He threw the covers to one side and pointed to his right flank. “My doctor prescribes Dihydroco, but I have no more.”

“That’s not a drug I’m familiar with.”

“It is from London. I live in London.”

“Do you just need a prescription?”

“Also a shot. The pain is unbearable.”

I examined the prince and tested his urine for blood. Everything was normal but this can happen with a kidney stone. I thumped his back over his kidneys, and he groaned. I was not convinced. Le Meredien wasn’t a potential client, so I could expect no advantage from pacifying the prince, and no damage from a complaint.

“I’ll give you a Toradol injection.” An excellent pain remedy, Toradol is similar to ibuprofen but probably not what he expected.

“Many thanks.”

Any doubt about the prince’s drug consumption vanished when my needle jerked to a halt half an inch beneath the skin. Fibrosis from hundreds of injections had given the prince’s buttock muscle the consistency of wood. I forced the syringe down and delivered the injection. Anticipating the pleasures ahead, the prince clutched my hand in gratitude.

Yanking open the drawer of the bedside table which turned out to be stuffed with hundred dollar bills, he snatched a handful and pushed them into my grasp.

Grateful the prince had forgotten his request for a prescription, I thanked him and hurried out. Later I counted fourteen bills. I gave them to my wife who bought a Chinese rug for our living room.

A Message From a Stranger

“A guest would like to meet you at 4:15 in the lobby.”

The caller was a concierge at the L.A. Hotel.

“Is that all?”

“I’m sorry, Doctor Oppenheim. The guest just made the request and walked off.”

This really happened a few years ago. Doesn’t it sound like a bad novel? Retired CIA agent, Skip Oppenheim gets a message from a mysterious stranger as he unwinds at a luxurious hotel. The adventure begins.

As a hotel doctor, I am allergic to adventures. Sick guests rarely schedule a consultation in a public place. Most likely he had a request. I prefer to handle these over the phone at no charge. This is good P.R. but it’s also self-defense. If I travel to the hotel, and the guest makes a request I have to refuse, the consequences may not be life-threatening but they are not pleasant. Also, it’s hard to collect my fee.

“I don’t make appointments without talking to the guest first. Do you have his number?”

“I’m afraid not.”

“Have him call when he gets back. I’m sure we can work out something.”

The concierge agreed. Sadly for this post, there is no punch line. I never heard from him.

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.

An Encounter at the Beverly Hills Hotel

In 1995, a man wearing only pajama bottoms dashed into the lobby of the Beverly Hills Hotel as I stood at the concierge’s desk.

“Don’t pay him!” he screamed.

Without lowering his voice, he denounced my competence and asserted that, once he informed the general manager, I would never again enter the Beverly Hills Hotel.

He had consulted me for a painful anal condition. I didn’t find anything wrong but gave some suppositories from my bag. He showed no interest in suggestions for sitz-baths and stool softeners, finally interrupting to declare that he needed substantial pain relief, preferably by injection. He heard my explanation for declining in sullen silence.

I left the room without the usual pleasantries and made a beeline for the concierge but not to get paid. I never ask for money after a visit turns out badly. If the guest isn’t planning to complain, the sight of my charge on the bill might change his mind. In these situations I try to neutralize damage by warning that I’d seen a guest who might cause difficulties. I had barely begun when the man’s entrance made this superfluous.

I kept quiet, and he eventually ran out of gas and stalked off. To my relief, several amused employees urged me not to worry. This guest was well known to them. 

I Don't Do Adderall

“A guest at the Century Plaza wants his Adderall refilled. Can you go?” asked someone from the office of a local concierge doctor.

“I can go, but I don’t do Adderall,” I said.

“No problem.” She would find another doctor. Prescription refills are easy house calls.

You’ve heard of childhood attention-deficit disorder. Recently psychiatrists have discovered that it also affects adults. Treatment is the same. That includes drugs related to amphetamines; the most popular for adults is Adderall. As a hotel doctor my only experience with attention-deficit disorder comes from guests who need more Adderall.

None sounded like drug-seekers. All were happy to pay my fee for a visit during which I would check them out. Since there is no way that I can examine a guest and determine if he or she suffers adult attention-deficit disorder, I told them I’d have to speak to his or her doctor. None ever called.

It’s been decades since I made a similar decision on narcotics. Guests occasionally forget their heart pills, but soon after becoming a hotel doctor, I grew puzzled at how many needed more Vicodin or Oxycontin. Some sounded suspicious from the start, but many were clearly in great pain. Their distress tore at my heart, and they often produced a sheaf of X-rays and letters from a doctor. With no reliable way to tell the fakes from the genuine, I gave up on narcotics.