How to Find a Hotel Doctor

Getting sick in a hotel far from home is miserable enough; you shouldn’t have to scramble for help. Here’s the best strategy.

1. Ask a hotel employee.

This often succeeds, but you may see him scratch his head. ‘... St. Mary’s is the nearest emergency room. Take Seventh Avenue about a mile, then...’ 

Ask others. Relations with the ‘house doctor’ are informal. He or she is never a hotel employee, and many on the staff are unaware of such a person. ‘You’re our doctor?  I didn’t know we had a doctor...’ is a comment I hear at hotels I’ve visited for years.

2. Ask the manager.

Every manager knows hotel doctors although you’ll often hear: ‘I’m sorry but we can’t recommend anyone.’ You are encountering one consequence of today’s malpractice crisis. The hotel’s lawyer has assumed (correctly) that a guest who sues the doctor will also sue the hotel that recommended him, so the lawyer has forbidden the staff to name anyone. When a manager clams up, you have four choices.

A. Demand a doctor and keep demanding.

Occasionally I visit an assertive guest who has refused to take no for an answer. I introduce myself to the manager afterwards, but he or she invariably insists that this was an exception, and the hotel can never, never mention my name.

B. Phone another hotel and ask for its doctor.

All luxury hotels (Four Seasons, Ritz-Carlton, Peninsula) have doctors; popular chains (Hilton, Holiday Inn, Hyatt, Ramada) are unpredictable, but the larger the hotel, the more likely you’ll succeed.

C. Phone a national house call service.

All claim to operate nationwide, but they’re a crapshoot if no moonlighter happens to be available. Some names to Google are Expressdoc, Standby MD, Inn-House Doctors, Hoteldocs. Their fee not only pays the doctor but the organization, so it can take your breath away. Ask how much and then ask for the extras because the meter starts running as soon as he walks through the door. I’m pretty sure I’m the only hotel doctor who charges a flat fee.

D. Call your family doctor.

The law requires that a doctor be available to patients. You should reach the doctor or someone covering. If not, complain to your state medical board.

What about insurance? Specific travel insurance pays for almost everything, and it’s cheaper than you think. Traditional health insurance may pay a fraction or apply it to your deductible. HMO’s are variable. All claim to cover emergencies, but they look skeptically on house calls. I hate to give advice no one takes, but  here goes: read your policy.

Medical Myths That Doctor's Believe

Here are myths that most laymen take for granted. A more serious problem is that many doctors also believe them. 

1.  If it hurts, it needs an x-ray.

Excellent for detecting fractures, X-rays are surprisingly unhelpful in other painful conditions.  Almost everyone suffering an excruciating headache, backache, bellyache, or hacking cough wants to know what’s going on inside, and they assume that, like Superman’s X-ray vision, a film reveals this, but it doesn’t.

2.  If your sputum turns green you need an antibiotic.

Your respiratory tract produces a quart of mucus every day.  When irritated, it produces more and the sputum may turn yellow, green, or brown. In an otherwise healthy person, this has no significance.

3. If one medicine isn’t working, you need a better medicine.

Understandable in a layperson but doctors should know better. In medical school, students are drilled in the rule:  if a drug isn’t working, switching is almost never the solution. Find out why the patient isn’t improving. It’s more likely that the diagnosis is wrong.

4.  Spicy food irritates your stomach.  Fats are hard to digest.  Tasteless and colorless (i.e. bland) food is soothing.

All proven false by good studies. 

5. High blood pressure causes headaches or dizziness.

Ordinary high blood pressure causes no symptoms.

6. Bronchitis requires an antibiotic.

Almost anything that causes coughing can be called “bronchitis.”  The most common is a viral infection; antibiotics don’t work.

7. Injections work faster than pills,

Sometimes, sometimes, not.  Doctors can charge for an injection. If they write a prescription, the pharmacist gets the money.

Disappointment

“A guest needs a doctor. Are you available?”

“I am. If you connect me to his room, I’ll try to help.”

My tone was businesslike, but joy filled my heart. The caller was the Airport Renaissance which never called. Acquiring a competitor’s hotel is a rare and delightful event.

A male voice answered after two rings. “There’s something in my eye.”

“Tell me what happened.”

“It’s no big deal. If you give me tweezers, I’ll take it out myself.”

“You mean it’s visible?”

“There’s a sliver stuck in my eyeball… Don’t tell me to go to a hospital. I’ll sign anything. Come to the room. Or get me tweezers.”

He interrupted my response.

“No hospital! No emergency room! Bring legal documentation to protect your liability. I’ll sign. Come alone. Don’t bring any FBI or CIA.”

I called the concierge to report that this was a matter for the police or paramedics. She admitted that the guest was causing a disturbance.

Sadly, I realized that the Renaissance was not changing doctors. Hotels hate dealing with crazy, drunk, or disruptive guests. When the regular doctor refused to come, the staff, in desperation, began calling other doctors in hopes that one would make the problem go away. This happens once or twice a year.

Cash Flow Problems

“Pick up card! Pick up card!” intoned the computer. Unlike other messages, this never means a typing mistake, but I re-entered the numbers and heard the same announcement.

Wearily, I phoned International Assistance to explain that their credit card had been rejected. The dispatcher put me on hold for several minutes before returning with another card number. In the past, I’ve gone through several before hearing the computer’s approval, but this one worked, and I left for the hotel.

International Assistance insures travelers from Latin America. It’s sent me on nearly 900 housecalls since the 1980s. It was always a slow payer, but since the turn of the century it began requiring months of pestering before sending a check. Finally I lost patience and demanded that it pay by credit card. Although credit cards charge about six percent of my fee, they’re a big convenience. I punch in a series of numbers; two days later money appears in my bank account.

Slow payment usually means an organization is struggling. It’s maxing out its credit cards and getting them cancelled but keeping others in reserve. A few have gone out of business, owing money, but International Assistance has been irritating doctors for decades; many colleagues refuse its requests. It’s the oldest of half a dozen travel insurers that call me, so this may be a reliable tactic for minimizing cash flow.

A Dog-Eat-Dog Business...again

Waiting at the local carwash, my eye ran over a sheet of ads along one wall. Among notices for personal injury lawyers, pest control, acupuncturists, and pizzas was a photo of a smiling young man in a white coat carrying a doctor’s bag. According to the text, a phone call would bring him to your door at a fee less than an emergency room’s. All ads for housecalls deliver this cheerful boast, never mentioning that the average ER visit has passed $1500.    

My first instinct was to chuckle at the waste of money. Few customers at a carwash will pay the going rate for a housecall. My second instinct was to worry. This fellow was ambitious. His web site features the same photograph plus testimonials from rating sites such as Yelp describing him as a healer of Christ-like compassion.

My third instinct was to recall a visit to Le Petite Hermitage, a small boutique hotel off the Sunset Strip. The guest had spoken to this doctor the day before, decided against a visit, and expressed pleasure at finding me and my lower fee. Since Le Petite Hermitage was a regular, I assumed he’d gotten the name from the internet. Now I’m not so sure because this occurred early in the year, and hotel hasn’t called since.

In large hotels employees know me by sight and take for granted, even without an official announcement, that I’m the official doctor. Since it has only 80 rooms, I may not visit Le Petite Hermitage for months at a time, so I’m not a familiar face. As a result, when an entrepreneurial physician makes an appearance to extol the benefits of his service including, perhaps, an amenity for the employee who refers a guest, he makes an impression.

The Superiority of American Medicine

Patriots boast that American medicine is the best in the world. My view is more nuanced, but let me take their point of view. You’ll be amazed at the dumb things foreign doctors do!

They don’t give antibiotics for ear infections! 

If a child suffers a painful ear infection, the doctor prescribes an antibiotic. In many European countries, doctors give medicines for pain and fever but no antibiotic. If you’re wondering what happens to these poor European children, the answer is: they get better. Even in America, many experts believe that antibiotics don’t work for ear infections. It will take a lot more than expert opinion to persuade American doctors to avoid antibiotics in ear infections. American doctors love antibiotics as much as American patients.

They don’t care for hysterectomies!

Many women develop lumpy growths on the uterus called fibroids which may cause pain and irregular menstrual bleeding. A gynecologist can cure this by removing the uterus. It’s the second most common operation American women undergo (after caesarians; America leads the world in both).

The French have the odd idea the world would be a better place if there were more Frenchmen, so French doctors don’t sterilize women if they can avoid it. Mostly, they perform an operation that cuts off the fibroids but leaves the uterus intact. The surgery is more complicated and takes longer than a simple hysterectomy. American gynecologists could do the same, but they don’t, and they rarely discuss it with patients because they know American women aren’t interested.

They don’t try to cure every patient.

American doctors order more tests and prescribe more antibiotics, chemotherapy, and other powerful drugs than foreign doctors. They also perform far more surgery. These extras don’t necessarily cure. Sometimes they make patients sicker, but the important thing is that we’re doing something. American like aggressive doctors.

Foreign doctors spend a great deal of time making patients feel better – for example by ordering physical therapy (massage, exercise, heat, baths). American doctors prescribe physical therapy to speed recovery after surgery or injuries. European doctors prescribe it after childbirth and for migraines, irritable bowels, arthritis, fatigue, depression – dozens of problems.

European doctors actually send patients to health spas for baths, massage, etc., and health insurance pays for it! If you believe this is a waste of money, American doctors agree. Patients may feel better after a spa treatment, they explain, but it’s psychosomatic (in other words, if someone feels better -- but it’s only psychosomatic -- that’s not good).

I Love Medicare

I have collected Medicare since 2005. There’s a belief that this means I get free medical care, but that’s definitely not true. Both Medicare Part A and B have deductibles, and sensible retirees buy a policy that pays most of what Medicare doesn’t pay (and it doesn’t pay quite a lot). There is also Medicare Part D which requires a premium that pays for drugs. Believe it or not, Part D was passed by Republicans.

Being Republicans they made sure the plan met the approval of pharmaceutical companies, and it does. They love it. Part D specifically forbids Medicare from negotiating for lower prices. Other government departments such as the V.A. can negotiate. Hospitals and private health insurers can negotiate. Medicare can’t. As a result, Part D premiums, no less than drug prices, have been shooting up each year.

The result is that I pay about $550 a month for medical insurance. In exchange, I get almost no medical bills. I love it. Even though Medicare is a government program, I receive less paperwork than when I belonged to Blue Cross (even writing “Blue Cross” produces a surge of anger; I hated it). 

My brother, a physician, detests Obamacare. He is liberal and an activist, and he dislikes Obamacare because it delivers a bonanza to insurance companies with no controls on cost. His criticisms are correct, but I tell him that as premiums skyrocket the outcry will force Washington to take action.

Conservatives tell us that in European national health plans the downtrodden physician takes his orders and pitiful salary from the government. In fact, all these countries have some private insurance. In many, such as Switzerland and the Netherlands, everyone buys medical insurance from private carriers just as they do in the US. The difference is that laws closely regulate them. The carriers aren’t losing money.

Things will work out.

Historical Diseases

Standby MD asked me to see a guest at the Doubletree – in Santa Ana. That’s fifty miles away, but it was Sunday morning; freeway traffic was light, a perfect time to go to Orange County.

The guest was an elderly Canadian man suffering diarrhea and vomiting. He mentioned that half a dozen members of his tour were affected; several had gone to the emergency room.

That brought back memories of a guest in 1991 with the same symptoms. Stomach viruses are the second most common ailments a hotel doctor encounters. They’re miserable but short-lived; I had delivered the usual advice and remedies, but when I called to check the next day, I learned that he was in the hospital with cholera. I remembered that he had flown in from Peru.

Cholera also causes diarrhea and vomiting. It’s extremely rare in the US. In fact, if an American patient turns up with any of the major historical diseases (cholera, malaria, rabies, leprosy, typhoid, typhus, plague, even tuberculosis) it’s almost certain that the American doctor will get it wrong on the first visit.

The Canadian gentleman was already recovering, but my phone rang before I left with a request to see another tour member. She was sick enough to send to an ER where she stayed until the evening. There is little cholera in Canada, so this was a stomach virus.

A Death

A guest at the Park Sunset complained of the flu. His temperature was 101; my examination was normal, but patients with influenza have a normal exam.

He looked miserable, but he was forty-one and in good health, and everyone with the flu looks miserable. There was no reason not to give the usual remedies and check back later. This happened long ago, but I still remember the inexplicable feeling that something was not right. I couldn’t bring myself to leave him in the room.

Leaving after extracting a guest’s promise to go to an emergency room is a bad idea. If the guest decides not to go and something dreadful happens, I’m the last doctor he’s seen. Calling paramedics was another option, but they might not share my unease.  

Explaining that he required further attention, I drove him to the nearest hospital. The next day I phoned. He had been admitted and died a few hours later. The doctor who cared for him was as mystified as I. We theorized he was suffering an overwhelming infection from an unknown source. Perhaps he took drugs. This was early in the AIDS epidemic, and victims sometimes died abruptly when their immunity vanished. We never found out.

Not Hitting the Jackpot

“Our client had a heart attack,” explained the dispatcher from Universal Assistance. “He wants to go home, but the specialist says he needs a doctor. We have hired a medical flight, and we want to know if you can go to New York. You come back the same day.”

Experts advise waiting a week or two after a heart attack to fly, but no one knows the risks of flying earlier because no one does. An expert who suggests that a physician go along is covering his ass, not delivering advice based on evidence.

Still, the insurer had agreed, no minor matter when an air ambulance coast to coast costs about $40,000. I had no idea what I would earn; nor did the dispatcher, but it would be breathtaking. Hiring a doctor for a day to testify in a malpractice trial runs to $7000.

I still remember with pleasure the single occasion I flew first class. Flying in a private jet while earning the price of a European vacation might leave an even better memory.

But would the patient require a doctor’s skills? It was unlikely, but I could not dismiss the possibility. Like most doctors, I can perform basic CPR, but I and most doctors have long since forgotten advanced CPR: complex drugs and techniques required for various cardiac malfunctions. Emergency room doctors, paramedics, and ICU nurses deal with these.

Wistfully, I informed the dispatcher that those were the appropriate escorts. 

Impresssing the General Manager

Years ago Prentice-Hall published The Man’s Health Book, and UPS delivered my ten free copies. Usually I gave those to family and friends who didn’t read them, so I wondered if I could put them to better use. 

I decided to visit general managers of my biggest hotels, introduce myself, and impress them by handing over my new book.  

At each, I approached the secretary in the executive office, identified myself as the hotel doctor, and asked for a minute of her boss’s time. I delivered my spiel, surrendered the book, and accepted their thanks. Some GMs expressed pleasure at finally meeting me, adding flattering words about my service. Others listened politely and thanked me for the book, but it was obvious they had no idea who I was.

I encountered a third reaction at the Los Angeles Downtown Hilton. The secretary had barely replaced her phone when the GM shot out of his office. I began my spiel but he interrupted.

“What do you mean you’re our hotel doctor?” he exclaimed. “This hotel doesn’t have a doctor!”

“I’ve been coming for years….,” I said. My database showed 119 visits which implied over 200 phone calls. The staff knew me; the valets never refused to hold my car (essential downtown).

“This hotel doesn’t have a doctor!” he repeated. “What do you mean calling yourself our doctor?”

“When a hotel calls so often…”

“We don’t have a doctor. You’re not to call yourself our doctor!”

Flustered, I held out my book. He snatched it and disappeared back into his office. I could have made better use of that copy. A few days later the mail brought a certified letter from an attorney informing me that I was hereafter forbidden to refer to myself as the Los Angeles Hilton’s doctor.

I stopped handing out books. Seven years passed before the hotel, then the Wilshire-Grand, resumed calling.

Drugs are Cheap

A least they’re cheap for common problems your doctor encounters in the office which are the same as I see in hotels. Here are examples from my favorite internet supplier as of 2018.

Some drugs cost almost nothing, less than a penny a pill. A thousand hydrochlorothiazide (the most popular diuretic and blood pressure pill) costs $6.34. Valium 5mg is over a penny: $12.20 for a thousand. I can buy a thousand Benadryl, an antihistamine, for $11.28.

An excellent prescription pain remedy, Tramadol, costs $1.69 for a hundred; $15.11 for a thousand.

Long ago states began requiring doctors to file a report each time they hand out narcotic pain pills, so I gave it up. Despite the impressive street price of the most popular drug of abuse, Oxycontin, a bottle of a hundred costs $8.77.

Cortisone cream: $0.99 per tube.

Antibiotic eye drops for conjunctivitis: $2.25

Antibiotic ear drops for swimmer’s ear used to be about twice as expensive, but they’ve shot up to over $20. Luckily, it’s considered OK to use antibiotic eye drops for ear infections, so that’s what I do. 

The three day Bactrim antibiotic treatment for urinary infection (six tablets) is about 35 cents. A hundred costs $5.40.

Ten day treatment for strep throat, twenty amoxicillin 500mg: $1.30.

Ten day treatment for pneumonia, twenty doxycycline, is about $1.70.

A big attraction of injections is that a doctor can charge for them. If he writes a prescription, the pharmacy gets the money. Don’t assume common injectables are expensive. To begin, a disposable syringe costs twenty cents.

For allergies and itching, a vial containing thirty doses of injectable cortisone (Decadron 4mg) costs $11.06. That’s about 40 cents a shot.

For pain, a shot of morphine costs about $2.30 if the doctor buys single-dose vials, but that’s an expensive form. Multiple dose vials cost less than half as much per dose if he or she can find them.

Within the past five years, ondansetron has replaced Compazine and Phenergan as the leading treatment of vomiting. One shot costs 15 cents. A vial of ten doses is $1.54

Plain old Valium injectable has skyrocketed. This happens when some companies stop making a drug and the others realize they have little competition. Five years ago I paid $5.04 for a vial of ten shots; it’s now $51.00.

A Dirty Trick

In 1993 I opened a letter from the California Medical Board announcing a complaint against me.

The days when state boards went easy on doctors were past. In response to persistent criticism, California had joined others in raising license fees, hiring investigators, and issuing press releases boasting of doctors it has disciplined. Every month I receive a bulletin listing names of those punished with license revocation, suspension, or some humiliating probation. These doctors seemed sad cases: incompetent, alcoholic, dishonest without being clever. Was I about to join them?

Although Los Angeles is the largest city in California, my hearing took place in Diamond Bar, thirty miles east, and it was a gloomy drive. The investigator ushered me into a room where I sat at a long table, bare except for the evidence. He told me the name of my accuser who turned out to be a competing hotel doctor.

The investigator held up a tiny pill box labeled with my handwriting. The name on the box belonged to a guest I’d seen months earlier. My rival had visited her, noticed the box, and realized it offered an irresistible opportunity.

I carry dozens of medications in little boxes. Handing them out, I once wrote the name of the drug and the instructions. This violated California State Pharmacy laws, the investigator informed me. Whenever anyone (not only a pharmacist) gives out a prescription drug, its container must include the patient’s name, the date, the drug’s name, dose, quantity, expiration date, and instructions plus the doctor’s name and contact information. For violating these laws, he added, the board would levy a fine and issue a written reprimand. This was not, however, an offense that endangered my license.

The reprimand announcing my three hundred dollar fine duly arrived. For months I scanned the bulletin, dreading to read my name, but the offense apparently didn’t qualify. It also never appeared on the California Medical Board’s web site when I checked for transgressions (you can look up me or any California doctor at http://www.medbd.ca.gov/Lookup.htm. Other states have a similar arrangement.

Obeying the pharmacy law required a great deal of writing on that tiny box, but I went along. As for repaying that doctor for the dirty trick, my only recourse was to continue setting foot in his hotels. Hotel doctors hate that.

A Doctor for Cheap Lodging, Part 2

I had seen a guest at the Banana Bungalows, a budget motel near the Hollywood freeway converted into a hostel. It was my first visit, so I wanted to introduce myself. I caught the eye of the desk clerk, a youth with a shaved head, tank top, and jeans.

The quality of front desk personnel varies directly with the quality of the hotel. Since hostels are a nonprofit enterprise, their employees fall below the bottom of the scale. 

“Could I speak to the front desk manager?”

“I guess that’s me.”

“I’m Doctor Oppenheim. I took care of the man in bungalow ten. Did you call me?”

The clerk shook his head no.

“Maybe one of your colleagues?”

“I’m the only one on duty.” It’s a mystery how often I find no one willing to admit referring a guest. I began my sales pitch.

“Who do you call when a guest wants a doctor?”

“Nobody gets sick. We send them to an ER.”

“You must call someone. Someone called me…. I’m a fulltime hotel doctor. All the hotels use me.….”

At chain hotels, staff maintain eye contact and a smile as I speak. I often sense their lack of interest, but at least they remember their manners. The Banana Bungalow’s clerk kept nodding to encourage me to get to the point. He flicked an impatient glance at a guest standing nearby.

“I’m always available.”

“We don’t really need a doctor.”

“Here’s a number anyone can call 24 hours a day. Could you post it?”

“No problem.” The clerk snatched my card and then turned to the waiting guest.

A Doctor for Cheap Lodging, Part 1

The Banana Bungalows consists of cabins strung out along narrow alleys off the Hollywood Freeway. I parked near the largest.

A desk clerk directed me to a cabin a hundred yards up a hill. Its Spartan interior slept eight in four bunk beds, all unmade. Papers, food cartons, luggage, and clothes littered the floor, and there was no furniture, not even a table where I could write. The air smelled of French fries and unwashed bodies:  a typical youth hostel.

Sitting on a vacant bed, I introduced myself. One glance under the man’s shirt confirmed the diagnosis. Chicken pox can be serious in an adult, but this was a mild case. He wanted to go home. I told him not to get on the plane until all his pocks were scabbed over. That might take a week, and I suspected he wouldn’t wait.

Walking down the hill, I puzzled over the appeal of youth hostels. They charge thirty-five dollars a night, a bargain, but cheap motels begin at fifty dollars and offer privacy as well as an unshared bathroom. Perhaps young travelers like to clump together.

Something to Knock It Out, Part 3

Her vacation had been a disaster so far. Worse, when she tried to buy amoxicillin to knock out her bronchitis, the pharmacist told her she needed a prescription. This was obviously a scam to line the pockets of American doctors, the guest added. She didn’t need my services except to provide the amoxicillin, so I should not take up her time.

This monologue occurred in Spanish. I don’t speak Spanish, but I’ve seen thousands of Latin American travelers, so I got the drift.

This lady appeared upset as soon as she opened the door. Apparently accustomed to this behavior, her husband and a child sat in a corner, trying to look inconspicuous. Following my rule (see the post from March 16) I had no plans to refuse the amoxicillin, but first I had to deliver good medical care. I phoned the travel insurance office, and the dispatcher agreed to interpret.

I asked the usual questions; she answered at great length.

The dispatcher translated but summarized her interruptions with: “she’s mad about something.”

The guest rolled her eyes when I put a thermometer into her mouth and seemed impatient during my exam.

When I concluded that she would recover in a few days with or without an antibiotic but that I would give her amoxicillin, she slammed down the phone and waved off my prescription.

“If you don’t think I need an antibiotic then I don’t want an antibiotic. According to you I should continue to suffer. Thank you very much!….”  I’m not certain those were her exact words, but they were close.

I laid the prescription on the bed. The door closed behind me with a deafening slam.

Something to Knock It Out, Part 2

Influenza had afflicted a guest for five days with fever, body aches, and general misery. He had meetings, he said, and needed something to knock it out.

While antibiotics don’t affect influenza, antiviral drugs such as Tamiflu shorten the illness by a day or two. Sadly, they only work if taken within the first 48 hours; afterwards they are useless although doctors continue to prescribe them.  I gave him some useful medicine and told him that flu rarely lasts longer than five or six days, so he would feel better soon.

After I left, the patient went to a local clinic and received the traditional antibiotic which solidified his conviction that I did not know my business. A day after beginning the antibiotic he felt better which proved it. Confronting the hotel manager, he demanded his money back. Guests often believe that the hotel doctor works for the hotel.

The general manager phoned to pass on the request.

Something to Knock It Out, Part 1

An FBI agent was suffering a bad cough. He informed me that this happened every year, and his doctor knocked it out with an antibiotic.

My philosophy on prescribing a useless antibiotic is that I don’t unless the patient threatens to make a scene.

This FBI man seemed out of an old movie: dressed in suit and tie, composed and unemotional. He made eye contact, listened intently, answered succinctly, submitted to my exam, and did not interrupt as I spoke.

I explained that he had a virus that was incurable but would go away in a few days. As I delivered advice and handed over cough medicine and tablets for his fever, I could see him absorbing the news that I wasn’t prescribing the antibiotic.

He was not a person to quarrel with a figure of authority. He said nothing, but I could sense his inner turmoil….

Deciding the ice was getting very thin, I added: “You said your doctor gives you an antibiotic. This illness doesn’t require one, but I’ll write a prescription in case you want to call him and discuss it.”

He accepted it without comment. He also handed back the medical form that I had asked him to sign. In the hall, glancing at the paper, I saw that he had covered it with obscenities.

24 Hour Duty

As a hotel doctor, I’m on duty 24 hours a day. This sounds oppressive until you realize that even a busy week – say twenty visits – requires about thirty hours of actual work. A downside is that calls can arrive at precisely the wrong time.

This one came one hour and twenty minutes before a dinner reservation with friends.

I calculated furiously and decided I could make it. My destination, the Mondrian, was on the Sunset Strip, six miles away. It was Sunday, so traffic was tolerable, but street parking on the Strip is difficult. The Mondrian is not one of my regulars, so parking attendants would probably not accommodate me. The hotel possesses only a skimpy open space around the entrance, so the valet might drive my car deep into the garage where it might take ten minutes to retrieve. Worse, there was a chance they would charge.

Making a snap decision, I drove past, but no street parking materialized. I turned down a side street but no luck, so I returned to the hotel, handed over my keys, and announced (incorrectly) that I was the hotel’s doctor.

I arrived at the room and introduced myself only to hear the discouraging words: “Spik Spanish?”…

I shook my head regretfully and proceeded in English. This usually works because most Latin American males speak enough English to get along (women don’t do so well). Sadly, he proceeded to perform the Zero-English pantomime: pointing to his throat, pointing to his head, making coughing noises.

No problem. Peering outside the door, I appealed to a group of maids on their cleaning rounds, but they were recent arrivals and spoke no English. Luckily, a bellman pushing a food cart was bilingual.

Delivering medical care was, as always, the easiest part. To my delight, the valets had held my car, and I arrived at the restaurant not excessively late.

No Income Today

A lady at the Westin wanted a housecall for her cough and fever. This seemed reasonable until I learned that she was under treatment for multiple myeloma, a serious blood disease. It affects the immune system, so any sign of infection is a red flag.

I explained that she needed more than I could provide in a hotel room and gave directions to the nearest emergency room.

                                                 *          *          *

Two hours later I spoke to a guest at the Airport Holiday Inn who was experiencing stabbing chest pains. Chest pain is worrisome, but significant chest pain lingers. Fleeting pain in an otherwise healthy person is almost never a serious sign. I looked forward to the visit when, after my exam, I would deliver reassuring news. That anticipation disappeared when the guest mentioned that he had suffered several blood clots in his lung and was taking blood thinners. He added that these chest pains were different.

Different or not, it was a bad idea to assume that these were trivial. I sent him to a facility that could perform tests.

                                                *          *          *

A travel insurance agency asked me to see a hotel guest in Encinitas.

“That’s near San Diego,” I pointed out. “It’s a hundred miles.”

I’ve traveled that far in the past and charged accordingly, but I didn’t want to quote a fee and risk having it accepted because I wasn’t in a mood for the grueling drive. A local clinic would be cheaper, I informed the dispatcher. 

                                                *          *          *

“I’m a physician in the U.K., and my wife has conjunctivitis in both eyes. I went to the chemist for antibiotic drops, but apparently I have to see an American doctor.”

“It’s unusual to have bacterial conjunctivitis in both eyes,” I said. “If you’re certain, ask the pharmacist to phone, and I’ll approve the prescription.”

Later the pharmacist phoned. When it comes to their own illness or that of their family, doctors are no more accurate than laymen, but they have no interest in my opinion.