A Stoic Patient

This patient lived on the edge of Beverly Hills, far up Topanga Canyon Road. Turning into a side street, I stopped at a guard house. It was not impressive – a tiny shack next to a commercial port-a-potty, but a genuine uniformed guard asked my business. According to Google, the street beyond held only a dozen houses, but they were big. Really big.

Following the lady who greeted me at the door, I walked and walked, passing through room after room with polished wooden floors, high ceilings, exquisite furnishings, bookshelves and paintings lining the walls. Movie stars and Arab princes live in such places. Visit Hearst’s Castle to share the experience.

But sick people are just sick. A lady was suffering excruciating right eye pain. She hadn’t injured it. My diagnosis was acute glaucoma, an emergency.

You may know about glaucoma, a disease where fluid drainage from the eye is blocked, increasing pressure, eventually causing blindness. Experts advise you to have a yearly check, but this is for common, chronic glaucoma where pressure rises slowly, so doctors can make an early diagnosis and treat it with eye drops. It’s painless. Acute glaucoma, where drainage stops abruptly, is rare and very painful.

This was not news to the patient who explained that many family members were blind from the disease. She agreed to go to UCLA’s emergency room but asked for something to help her vomiting; severe pain often causes vomiting. I gave an injection and took my leave.

Phoning the next day, I was flabbergasted to learn she had stayed home. She didn’t want to travel because of the vomiting, she explained. By evening it had diminished, but so had the pain. She decided to wait. She had an appointment at the ophthalmologist for the afternoon.

A Mysterious Seizure

Airport security confiscated a tourist’s glaucoma eye drops, so he called his insurance who called me. 

The drops come in a tiny 2½ cc bottle, so the seizure seemed puzzling. On the other hand, ten years ago the examiner took my tweezers, a beautiful needle-nosed instrument perfect for removing slivers. It cost $20. Later, I checked the Transportation Security Authority web site and learned that tweezers are permitted. I’m still fuming.

Usually, I offer to phone a refill to a pharmacy when a traveler needs a legitimate prescription, but business has been slow, and the insurance had already told the guest I would come. Ironically, medical experts unanimously frown on giving prescriptions to an unfamiliar patient without an examination. They never explain how an examination in a hotel room can prove that a patient has, for example, glaucoma, osteoporosis, emphysema, acid reflux, or epilepsy. If he takes high blood pressure medication, and I find a normal pressure, must I refuse the refill?

Another Easy Visit

Airport security confiscated a tourist’s glaucoma eye drops, so he called his insurance who called me. The drops come in a tiny 2½ cc bottle, so the seizure seemed puzzling. On the other hand, nearly ten years ago they took my tweezers, a beautiful needle-nosed instrument perfect for removing slivers. It cost $20. Later, I checked the Transportation Security Authority web site and learned that tweezers are specifically permitted. Naturally, I’m still fuming.

The visit was easy. Usually, I phone a refill to a pharmacy when a traveler needs a legitimate prescription, but December has been slow; no calls have arrived in a few days, so I’ve felt uneasy. Ironically, medical experts unanimously frown on giving prescriptions without an examination. They never explain how an examination in a hotel room can prove that a patient has, for example, glaucoma, osteoporosis, emphysema, acid reflux, or epilepsy. If he takes high blood pressure medication, and I find a normal pressure, must I refuse the refill?