Doing My Duty

“I can’t handle that in a hotel room,” I explained. “She probably needs an ultrasound.”

After consulting his superior, the dispatcher came back on the line to explain that he would like me to evaluate the guest, a flight attendant with abdominal pain and vaginal bleeding, and deliver a recommendation.

If the guest had called directly, I would have sent her to an emergency room or, during the day, to an obstetrician, but this request came from an agency that serves airline crew. It was paying the bill, and I had done my duty by warning that a housecall wasn’t appropriate. I was happy to make the visit. Once I confirmed her symptoms. I would simply call and report, and then send my bill.

A young man opened the door. I entered, expecting to see a girl friend or wife, but he was alone, and he identified himself as the patient. He had a sore throat.

I checked the name and date of birth on my invoice. It was identical. He spoke excellent English, so there was no chance of a misunderstanding.

After dealing with his problem, I phoned the agency. Was there another flight attendant with vaginal bleeding waiting for me? After a long consultation, he assured me that no one knew. It was probably a mistake.

How Much Does an Emergency Room Cost?

A lady had been vomiting for three days. She had felt better that morning but then relapsed. She sounded weary.

This was tricky. Stomach viruses are the second leading ailment a hotel doctor encounters. I consider them good visits because they rarely last more than a day. I deliver advice as well as an injection and pills. The guest recovers and gives me the credit.

When vomiting persists, doctors worry about more ominous digestive disorders. Worse, three days of vomiting produces some dehydration. This is not dangerous in a healthy person, but drugs don’t work well in its presence and recovery slows. Victims perk up when dehydration is relieved. 

I explained that it was probably too late for a house call. She needed intravenous fluids. After agreeing to go to the local emergency room, she mentioned that she was Canadian and had no travel insurance. I repeated that she should go.

I’ve found that it’s a bad idea to tell guests to go to an ER and then tell them how much it might cost.

My restraint was in vain because she googled the subject, perhaps turning up http://www.theatlantic.com/health/archive/2013/02/how-much-does-it-cost-to-go-to-the-er/273599/ to read that the average was over $2,000. Giving IVs would take hours and cost extra.

When I called the hotel that evening, I learned that she hadn’t gone, and she was still ill. She admitted that the cost had shocked her. I sympathized but told her she had no choice.

When I called later to reinforce this advice, there was no answer. When I called the following morning, she had checked out.