A Rash During the Rush Hour

 A guest in Long Beach had broken out in red spots.

This looked like a terrific visit; skin problems are easy. A sudden rash is frightening but hardly ever indicates something serious. I have no objection to making a diagnosis over the phone, but guests are terrible at describing a rash’s appearance. In any case, most want the doctor to look at it.

My only problem was that the call arrived at 5 p.m. on a Friday, and Long Beach is thirty miles away. I avoid long drives during the rush hour, so I told him I could come around 9.

That wouldn’t work, he replied. He had a long business engagement that evening. But he’d be happy to see me the following morning.

Saturday morning drives are easy, but a rash that arrives quickly often departs quickly. I wanted this visit, so I told him I would be there in an hour. Or two. 

 

Why I Hate Appointments, Part 2

“I need you to look at a rash,” said a Loews guest. “But I have meetings all day and dinner tonight. Could you be at my room at 9?”

He meant 9 p.m. His call arrived at 9 a.m. Appointments more than a few hours ahead end badly more often than not, so I avoid them.

“I’m always available,” I said. “But we’re both busy people. Phone just before you get to your room, and I’ll come over.”

He phoned at 7 p.m. to say he’d be delayed till 10. I waited at home. He phoned at 9:30 to say he was on his way. I arrived at 10. No one answered when I knocked. He appeared at 10:20 with apologies.

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.

Rashes are Easy, Part 1

A woman at a Sunset Strip hotel had seen a doctor for an allergic rash, and now she wasn’t feeling right. Rashes are easy, and her symptoms were probably medication side-effects, so I expected no problem. That seemed to be the case,, and she agreed to stop the medicine.

She handed me her credit card. I took out my cell phone, dialed the credit card company’s computer, and entered a series of numbers at its request. It denied approval. This is often the result of a typing error, so I entered the numbers again. Another denial.

In the distant past, guests would apologize and promise to send a check once they returned home. Some kept the promise, but I soon decided it was better to collect on the spot.

The guest seemed genuinely puzzled. She wondered if the hotel was responsible. At check-in, a hotel often places a hold on a large sum from the guest’s credit card to ensure that it gets paid. She wondered if this exceeded her limit. She phoned the front desk, and this proved true. There followed a long series of calls, referrals, consultations, and arguments before hotel management agreed to remove the hold. It worked. The computer reversed itself and approved.

Little Red Bumps

 “They’re little bumps all over… Sort of red.”

“Could you be more specific?”

“Little red bumps over my body… spots. Some are raised. They sort of itch…”

Americans, even with a college degree, are painfully inarticulate. Can you describe the face of someone familiar? Novelists do it all the time, but I bet you’d have trouble. Words like nodule, pustule, blister, wheal, plaque, ulcer, scale, and fissure are not obscure medical terms. Educated people know what they mean but can’t seem to use them.

If a caller said “I have dozens of one to three millimeter pustules surrounded by a red base, mostly on my back and chest, not so many on my arms and legs,” my diagnosis is “chicken pox.” But “red bumps” is the best many can do.

I’m happy to make diagnoses over the phone, and guests are eager not to pay for a visit. I have little trouble with respiratory infections and upset stomachs, but skin problems frustrate me.

“I worry about bedbugs. Do you think it’s bedbugs?”

“What do they look like?”

“Little red bumps….. Do you think it might be an allergy?”

“Could you be more specific?”

“Bumps…They’re raised, some of them, and they're red….”