I Save a Life

After apologizing for waking me, the caller explained that his companion couldn’t sleep because she felt short of breath. Shortness of breath in an otherwise healthy person is either anxiety or a serious matter. The caller added that she was prone to respiratory infections. Maybe she has pneumonia, I thought. I can cure pneumonia.

She didn’t appear ill, but she was English, not a demonstrative people. She had no fever. Her heart was racing. Listening to her lungs, I heard the crackle of fluid which is audible in pneumonia but also in heart failure. I suspected heart failure. When the heart beats weakly, blood backs up into the lungs waiting to pass through, so victims have trouble breathing.

Calling paramedics was risky because they might decide she wasn’t sick enough to transport. Leaving after obtaining her promise to go to an ER was not an option because I would worry. Long experience has convinced me that if guests need to go to a hospital, I must make sure – with my own eyes – that they go. So I drove the couple in my car. Watching them disappear through the emergency entrance made it certain they were now another doctor’s responsibility. 

When I phoned later, the doctor explained that she was suffering rapid atrial fibrillation, an irregular, inefficient cardiac rhythm. He had performed cardioversion – delivering an electric shock to the heart – and she was now in a regular rhythm and feeling better. They were scheduled to fly to Las Vegas the day after my visit, and when I called they had checked out.

A Contagious Disease

I cared for a flight attendant in an airport hotel suffering a cough, high fever, runny nose, and sore throat. It seemed like the usual upper respiratory infection until I saw the spotty rash over her body. She had measles.

Does that ring a bell?... Measles may be the world’s most contagious disease. If you’re susceptible and enter a room someone with measles passed through hours earlier, you’ll probably catch it.

It’s also nasty. Even today, one or two per thousand victims die and a larger number are left deaf or brain damaged. I grew up before children were vaccinated against most childhood illnesses; we actually caught them. I had measles in 1946 and still remember how sick I felt; my chicken pox and mumps were trivial by comparison.

I informed the airline that a flight attendant fresh from a crowded plane had measles and also told the hotel management. You can imagine the reception.

Burned

A guest in a hotel restaurant asked a waiter to light her cigarette. When he complied, her forefinger burst into flame. She had recently put on acrylic nails, and the fresh cement is very flammable. Drunk and enraged, the guest refused to go to an emergency room. By the time I appeared, she had grown tired of hurling abuse. Head resting on the table, she was sobbing. Spilled drinks and broken glass littered the area.

Security officers had cleared the room. Near the entrance, a crowd of clerks, patrons, and the night manager parted to allow my passage and observe my performance. Although not a master at handling drunks, I understood the soothing effect of an old man with a grey beard and carrying a doctor’s bag.

Patting her shoulder until she looked up, I introduced myself and suggested we go to her room. After dressing the burn, I stayed long enough for her pain to give way to the effects of alcohol, and I could assure everyone she would cause no more trouble.

Paying My Fee

It’s less than the going rate, but no one considers it cheap.

When guests phone, I focus on their problems. Half the time, a housecall isn’t necessary. Once we’ve agreed that I should come, I mention the fee. About ten percent of callers reconsider, but almost no one does so directly. I hear….

“Let me talk to my husband and get back to you.”

“Our tour leaves in half an hour. I’ll call when we’re back and set up the appointment.”

“I’m going to try to ride this out, but I’ll let you know.”

“I need to check with my insurance.”

All doctors maintain that they never turn away a patient unable to pay. This is not an actual lie - provided we’re the ones who decide who’s unable.

I’m generous with guests from motels and youth hostels who are clearly not affluent, but plenty of callers are paying a daily hotel bill well in excess of mine. They object to my fee just as they hesitate at $5.00 coffee at Starbucks or $200 for an orchestra seat at a hit play. They know that $1.00 coffee at McDonalds or a $50 balcony seat provides a similar experience, more or less. I direct them to urgent-care clinics that accomplish this.

Hotel Doctor to the Stars

Now and then an agent expresses interest in my memoirs.

You don’t think I have memoirs?... I’ve been hotel doctoring since the 1980s, and I had literary ambitions long before. My proposal has been making the rounds for decades, and agents often respond. Our conversation always covers the same ground.

“‘Memoirs of a Los Angeles hotel doctor.’ That’s a great idea! It sounds like you’ve seen celebrities.”

“A few.”

“Did you see Michael Jackson?”

“Many hotel doctors saw Michael Jackson.”

“Tell me about him.”

“Doctors can’t do that.”

That ends the conversation. I suspect agents dislike hearing that my memoirs don’t discuss famous people, even those who’ve died. It’s correct that you can’t libel the dead, but you can anger surviving loved-ones; they’ve been known to sue. 

My book proposal continues to make the rounds, but it’s possible that you will be my only audience.

Cancelling a Housecall

A guest at the Doubletree wanted a doctor to examine his son’s ear. I was getting in my car five minutes later when the phone rang again.

“I’m really sorry,” said the guest. “The hotel called another doctor, and he’s on his way, so we have to cancel.” That was a shock. The Doubletree is a regular. Was another doctor poaching? This is not a rare occurrence.

I asked the doctor’s name. The guest wasn’t certain. What was his phone number? He didn’t know. I phoned the hotel. The operator assured me that she had given out my number and no one else’s.

To my relief, I realized that the guest had simply changed his mind and wanted to cancel. He assumed that a blunt cancellation would upset me, so he invented an excuse – not realizing that the excuse was more upsetting.

Why I Hate Appointments

“We have two guests with a cough and sore throat, but they’re at a conference. They’d like you to come at three.” This news arrived at nine a.m.

I love seeing two patients at the same time, but I prefer going immediately. Things happen if I wait….

 “No one asked for a doctor,” said the person who answered the door. Shown the names, he recognized them but added that they were at a meeting. He phoned and reported that they had lost track of time but would hurry back. Their conference was at a university five miles away. Their transportation was by city bus. 

I didn’t want to wait, but I have an exalted view of the medical profession. We are humanitarians, a superior breed.

All doctors agree but many feel that if they’re treated with disrespect (by the government, insurance companies, or a discourteous patient), their humanitarian obligations vanish, and they’re free to become jerks (google “concierge doctor”).

After weighing my options and taking no pleasure, I drove to the university, picked them up, drove back to the hotel, and performed my exam.

The Superiority of Alternative Medicine

At the Ramada, I cared for a lady whose eyes were red and itchy. She had no allergies, and I saw no evidence of an infection. I suspected something was irritating them, and she had been using several over-the-counter eye-drops. Drops themselves can irritate eyes, especially with persistent use, so I told her to stop.

No eye drops for an eye problem?.... She looked uneasy at this suggestion, so I left a bottle of antibiotic drops but told her to call in two days if she still felt bad and wanted to use them. This is another occasion why so many patients prefer alternative medical practitioners (herbalists, nutritionists, acupuncturists…). No alternative healer tells a patient: “Don’t do anything. This will go away.” There’s always a treatment.

Security Hell

I’ve been to Park La Brea Towers a dozen times. Navigating its maze of twisting private streets, tall apartments, and rows of bungalows is not exactly a nightmare but always difficult.

It was after midnight, so the drive passed quickly but a barrier blocked my entrance. For security purposes, Park La Brea restricts access during wee hours. I drove until I found a barrier with a kiosk and a security officer. 

Another car was ahead of me. Checking out visitors turned out to be no minor matter, so several minutes passed before the officer handed the driver a pass and waved him in. I pulled forward only to encounter a problem. My patient was visiting, so her name was not on the list of residents, and there was no answer when the officer phoned. Nervous about speaking English, foreign guests often don’t answer.

He explained that regulations did not permit my entry. The sight of my doctor bag, suit, tie, and elderly appearance did not change his mind, but he assured me that his supervisor had been summoned. I parked behind the kiosk and waited. The supervisor never appeared.

My patience exhausted, I phoned the travel insurance office in Miami to warn that I might have to return home. Urging me to wait, the dispatcher contacted the lady on her Brazilian cell phone. Eventually, she contacted the security officer and vouched for me.

Describing the pleasures of wee-hour visits, I always mention easy parking. This applies everywhere except large apartment complexes where everyone and their guests are at home, so all spaces are occupied. After a long search, I parked illegally.

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.

You Don't Need a Better Medicine

“My doctor gave me amoxicillin a week ago, and my sinuses are still blocked. I need a stronger antibiotic,” said a guest.

If a medicine isn’t working the next step is never to find a better medicine but to discover why it isn’t working. Sometimes there’s a problem that medicine won’t help.

Sometimes the patient needs a better exam. Pain on urination usually means a urine infection, and I’ve seen several patients whose urine infection didn’t go away after a course of treatment. They didn’t have a urine infection but herpes. It was obvious when you looked, but the doctor hadn’t looked.

Sometimes the patient needs to wait. After rubbing cream on an insect bite, patients worry when it grows to an itchy patch several inches around. I explain that insect bites generally worsen for two days and then resolve over the following days.

Sometimes the next step is to stop taking medicine. Treating pinkeye with drops usually helps, but patients occasionally return to complain that they’re worse. That’s because the drop has begun to irritate the eye. A few days after stopping, they feel better.

My malpractice lawyer warns me to warn you to read this purely for your own amusement. Only in mathematics can a statement be 100 percent true.

So if a medicine isn’t working, don’t stay away from the doctor on the grounds that I said it was OK.

Japanese Never Travel Alone

The room contained four young Asian men and extra beds, on one of which lay my patient looking miserable with a wet washrag on his forehead.

At my first question, several pulled out Japanese-American phrase books, a bad sign. It’s a fact that all Japanese study English in school, but all Americans study American history, and how much do they learn?...

Answers to my questions were on the order of “please perform a diagnostic evaluation” or “the reading of the thermometer seems excessive.” I had reluctantly decided to call their travel insurer’s 800 number (phone interpreting is tedious) when the tour leader entered. His English was rudimentary, and, being Asian, he was too polite to tell me when he didn’t understand, but I managed to confirm my suspicion that the young man had influenza, not life-threatening but a terrible illness for young people who take for granted they’ll never be ill.

A Dog-Eat-Dog Business, Part 7

When a travel insurer sent me to the Airport Marriott, I remembered that the hotel hadn’t called in a year, so I decided to reintroduce myself.

“We don’t have a doctor,” said the lady in the security office.

“I’ve made hundreds of visits.”

“I never called you,” she insisted. She summoned a nearby officer who agreed that no one knew about a hotel doctor. She accepted my card and put it in a drawer.

My next stop was the concierge desk, but it was vacant. When times are tough, concierges are the first employees to go.

The front desk clerks agreed that having a hotel doctor was a wonderful idea and thanked me for my cards.

“I guess no one’s been sick,” said the bellman cheerfully when I queried him. I had no doubt that whatever doctor he called tipped him $20 or $30 or $50 for the referral. This is illegal but a common practice. The bellman thanked me for my card and put it in a drawer.

If you assume that general managers hate choosing a doctor on the basis of his kickback, you’d be right. Sometimes. When I informed the GM of the Westin, he took action. When I informed the GM of the Beverly Hills Hotel he merely passed my letter on to the chief concierge who phoned to announce that I need expect no calls from the Beverly Hills hotel.

Sick guests often call the operator, so I dialed the Marriott’s number.

“Hi, Doctor Oppenheim. It’s been a long time.”

That was a pleasant surprise. The operator explained that she had worked there for twenty years and spoken to me many times. She admitted that the hotel had no policy on doctors nor was any name in their directory. She would be happy to take down my number and pass it around. 

I left feeling pleased with myself because I hardly ever market myself to employees. I continue to make the occasional visit to the Marriott but always at the request of a travel insurer. The hotel itself remains silent.

A Glamorous Job

A five-year-old was coughing and congested.

His parents were guests at Loews in Hollywood, nine miles away through city streets. Nineteen miles on the freeway would take less time provided traffic moved smoothly, but this was unlikely at 4 p.m. on a Friday. I told the mother that it sounded like a routine virus, but she insisted the child needed attention.

Sometimes being hotel doctor to the stars is not so glamorous. Then I recalled a pediatrician colleague who had expressed interest in helping out. I phoned his office. He was finishing his last patient and, to my delight, agreed to make the housecall. I was so relieved that I forgot to tell him a few things.

That evening he phoned to let me know the visit had gone well. 

“But it took over an hour to reach the hotel, and they charged me fifteen dollars to park.”

Helping a Lady

A guest at Checkers, an upscale downtown hotel, had the flu with a 103 fever. I washed my hands before examining her; afterwards I washed again and included my stethoscope. I’ve had the flu shot, but I still worry about catching it. I suffered the flu in 1977, and I remember it as the worst illness of my life until I became elderly.

I finished around midnight. Returning to my car, I passed two young women arguing bitterly on the sidewalk. One insisted on walking to their hotel, the other objected because she was wearing high heels. 

At my age, no one considers me threatening. As I started the engine, one of the women tapped on my window and asked for a lift. I drove her to the Bonaventure, six blocks away. She had been drinking but was coherent and grateful for the favor.

Why I Like Foreigners

“Do you take insurance?” asked a Biltmore guest after learning my fee. She was  an American.

Hearing that she would have to pay up front and submit my invoice, she decided to wait. She was suffering an upset stomach which would probably clear up in a day. I gave advice and told her to feel free to call.

“Could I have your name and room number?” I asked before hanging up.

“Is that so you can charge me?” she asked.

“Phone calls are free,” I said. “I just need to keep a record.”  

An hour later she called to say she had changed her mind. Could I come?

Her vomiting had stopped but not her nausea and headache. After an exam, I gave her two packets of pills: one for nausea, one for the headache.

“How much are these?” she asked.

“Nothing.” I assured her that she was over the worst of her stomach virus. 

“So it’s a minor problem that’s already going away. You came, but you didn’t do much for me.”

I agreed that I hadn’t cured her but perhaps I had helped in other ways. I could have mentioned the convenience of a housecall and the medicines I hand over, and my long drive to the hotel. None of this would have worked. I simply expressed satisfaction that she was improving and told her to phone if problems developed.

“And then you’ll come back and charge me again?” she asked.

I explained that I rarely make a second visit for the same problem, but I would try to help.

Tempting the God of Housecalls

I was mildly entertained during 45 minutes of the popular movie, Interstellar. The physics was wrong, and the politics of its dystopian future defied logic, but the production held my interest.

Then my phone buzzed for a housecall. Theaters will refund my money at any time, but I don’t ask unless the movie has just begun. Admission is cheap compared to my fee, and I can always return. Half the time, I’m happy to leave. When I go to a live performance, I ask a colleague to cover but never for a movie, although I sit on the aisle so I can leave without disturbing the audience.

Doctors agree that patients phone at the most inconvenient time, but I look forward to calls, so I try to persuade the fickle God of Housecalls that I don’t want to be interrupted. Going to a movie or restaurant or the dentist seems to accomplish this. If I have no plans for the afternoon, I may lay down for a nap in the hope, often fulfilled, that the fickle God will jump at the chance to wake me up.

I saw the final two hours of Interstellar a week later and remained mildly entertained. I won’t give anything away, but when a Hollywood movie features a conflict between science and love, only one outcome is possible.

I Was Once America's Leading Writer of Health Articles

I still hold the record for Woman’s Day – about 35 articles. I stopped as I reached middle-age in the 1990s in favor of a yearning to write literature. Don’t expect a plug for my fiction. It’s been published, but you have to look hard to find it. You can hear one of my plays (a reading, not a performance) on February 25. Google Cincinnati Playwrights Initiative for details.

Mass-market health articles deliver positive, uplifting information. Editors have no interest in controversy, muckraking, entertaining anecdotes, or the writer’s personal experience – the sort of material you find in my blog.

I knew this, but I sometimes couldn’t resist.

Media doctors love to warn of hidden dangers, ominous symptoms, and important information would make you healthier if you only knew about it.  

Readers learn that they can become superhealthy. In other words, if they are doing everything right, they can do even more – eat “superfoods,” “boost” their immune system, and fend off aging. It’s possible a super-healthy life-style can reduce a nine month pregnancy to seven months.

Media doctors insist that a positive attitude cures disease. To heal, you must fervently want to heal. I call that the “be happy or die” approach.

I wanted to do something different – tell readers of things they don’t need to worry about and things that are supposed to make them healthier but don’t. Green mucus, yellow diarrhea, smelly urine, sharp chest pains, and white spots on tonsils rarely require urgent action and often no action at all. Patients worry that a headache means their blood pressure is high, fatigue that their blood pressure is low, and that their third cold of the year means that their immune system is weak. All not true.

Editors hated this.

“Readers look up to us”, they said. “Why should we tell them that our other doctors are wrong?” they asked.

“We never tell a reader not to worry,” they added. “If she follows your advice, and something bad happens, she will blame you. And us.” 

Those articles remain unpublished. They never came close.

My Favorite Infections

Number one is urine infections in women, because I quickly make them go away. Handing over a packet of antibiotics, I assure someone who has been running to the bathroom every half hour that she’ll feel better by the next morning. In men, urine infections are usually prostate infections; these resolve slowly.

Eye infections (“pinkeye,” conjunctivitis) go away quickly after we prescribe antibiotic drops because most conjunctivitis goes away quickly whether or not antibiotics help (mostly they don’t). Everyone with a pink eye assumes they need eye drops, and doctors are happy to oblige, so we find these satisfying to treat.

Some intestinal infections respond to antibiotics but almost all occur in poor parts of the world. They’re rare in the US where vomiting and diarrhea is usually a “stomach virus” and short-lived.   

Amazingly, experts debate whether antibiotics help ear infections. Doctors in many nations don’t prescribe them, but Americans do. Patients give us credit when they get better. We like that.

47 No-Shows

When there was no response after my third knock, I experienced a familiar sinking feeling. Under the category “no show,” my database reveals 47 entries. 

I phoned the guest, but there was no answer. At the front desk, the clerk assured me that I had the correct room and that they had no idea where the guest might be. A security officer opened the room and confirmed that it was empty.

For mysterious reasons, guests occasionally wait downstairs. I wandered through the lobby and restaurants. With my beard, suit, and black bag, I look exactly like a doctor, and now and then my quarry jumps up and identifies him or herself. Not this time.

“When do you plan to arrive?” asked a desk clerk who phoned an hour later, adding that my guest had been waiting in the lobby. When I spoke to the guest, he insisted that he’d “told the hotel” where he could be found.

"This Has to Go Into My Blog!"`

A dispatcher from the agency that handles airline flight crew mentioned a sore throat, but the guest mentioned an “unprotected sexual contact” two nights earlier. The sore throat appeared soon after, and he was worried. Very worried.

No problem. Unprotected sex with a stranger is a bad idea, but the odds of disaster are low. I settled back to learn what happened.

He seemed distracted. Asked for details of the contact, he didn’t remember. The phone rang. During the conversation, he mentioned to the caller (apparently his supervisor) that someone was in the room who claimed to be a doctor. Could he explain?

That sounded odd. When he hung up, I suggested he call the agency to confirm my identity. He did so and then handed me the phone. The dispatcher apologized and admitted that the guest had been calling since the previous day and seemed disturbed. He hoped I could help.

Confirming my identity did not improve matters. When someone knocked at the door, he told them to go away. Ignoring me, he dialed the hotel phone. Reaching voicemail he explained that he needed a clinic appointment but someone had sent a doctor. He needed an explanation. Hanging up, he dialed his cell phone, reaching a friend for a short chat during which he mentioned that there was a stranger in the room.

I suggested that if he wanted to go to a clinic, I could arrange it. Waving this off, he dialed another number. It wasn’t clear who or why he was phoning. Someone knocked, and he told them to go away. When I expressed a wish to leave, he stood at the door. For the first time I felt nervous. I repeated my request several times in a soothing voice. He opened the door a crack. I squeezed out, and he slammed it behind me.

In the lobby, I phoned the agency to explain that the guest needed a psychiatric evaluation. Minutes later, as I sat filling out forms, a noisy flotilla of fire trucks, police cars, and paramedic van pulled up.

I followed half a dozen men up to the room. Several of the guest’s crewmates were on the scene, trying to persuade him to open the door. They would have succeeded if given time, but the officers wanted to wrap things up.

If I were paranoid, I would not want to hear strange men pounding on my door demanding that I open. They broke in and hauled him off. Acute psychotic breaks rarely last long, and he was back in a few days, much better according to the dispatcher. He needed another visit to clear him to fly.   

Does Everyone Live Like That?

The Beverly Garland is a sixteen mile freeway drive. The guest had phoned at 8 a.m. on Wednesday. I avoid distant housecalls during the rush hour; guests rarely object to waiting.

But I had finished breakfast. I had no plans for several hours. Why not get the visit out of the way? I checked my traffic app. North on the 405 was not bad; the second leg, east on the 101 was solid red. Maybe it would ease by the time I reached it.

Driving north on the 405, I shared my fellow drivers’ relief that we were not on the immobile southbound side. Half a mile before the connector to the 101, the right lane stopped cold. 

It took another 45 minutes to reach the hotel. I hate being late, but I had warned the guest, giving myself plenty of time. I listened to a tape. I paid close attention to driving, moving at a steady few miles per hour instead of braking and accelerating constantly. Doing that requires allowing the car in front to move ahead some distance. Cars from the adjacent lane occasionally pulled into that space, infuriating the driver behind me. I hoped he wasn’t armed.

Getting stuck in the rush hour was my decision, but millions of people have no choice. They do it ten times a week. How can they live like that?.....

Extremely Easy Housecalls

The desk clerk at an upscale hotel informed me that a guest wanted my services. The call arrived at 3 o’clock on a Sunday afternoon. I had no plans till dinner. Freeway traffic would be no problem. It was a perfect time for a housecall. What a great job….

The desk clerk added that the guest was not actually in the hotel. He would check in at midnight. Could I come then? So I set the alarm that evening and dozed until it went off.

                                                                                                                          

I regularly complain of how far I drive, but sometimes I hit the jackpot. I once saw a patient in my own neighborhood, a mile away. He suffered a minor illness, so I was there and back in half an hour. As I was faxing my bill, the phone rang.

“Did the patient pay the deductible?” asked the dispatcher for the insurance service.

“You didn’t mention a deductible.”

“I forgot. There’s a $75 deductible.”

That was annoying. Cheap travel insurance requires a deductible, and guests never remember to pay. When dispatchers forget to tell me to collect it, I insist the carrier pay the full amount. They always agree but, being cheap services, it requires several pestering phone calls until the check arrives. Since this patient wasn’t far, it was easier to get in my car and make a second trip.

"I Need Oxygen!"

Hearing this from a hotel guest, I know that (a) the guest is short of breath and (b) the guest probably doesn’t need oxygen – unless everyone in the room is short of breath in which case this is not a medical problem.

If you suffer an illness that produces shortness of breath such as asthma or heart failure breathing oxygen will not help much. Other treatments work much faster. If you have obstructive lung disease and become short of breath you certainly need oxygen, but you’re an emergency. Call the paramedics. All these problems require lengthy observation until symptoms improve, so making a housecall is a bad idea.

Anxiety is the leading cause of shortness of breath in a hotel guest. This is never fatal, and I have good success treating it, but making a housecall is risky. Between the time I hang up and arrive, many guests recover and cancel or leave the room and hide out until certain that I have come and gone.

Running Out of Medication

A guest at the Doubletree had run out of insulin. I could have made a housecall, written a prescription, and a pharmacist would have filled it. Instead I explained that insulin doesn’t require a prescription. She should go to the pharmacy and ask for it. The same is true for the morning-after pill, another request that arrives now and then.

An Italian guest at the Four Seasons brought a migraine prescription from her doctor. Pharmacies wouldn’t accept it. Could I come and write an American prescription? I told her to have the pharmacist phone, and I would approve it.

When national housecall services or competitors send me to guests who need a prescription, I write it, collect money, and leave. Those are easy visits, but guests are never grateful. Americans look sullen; foreigners understand that American doctors require immense fees for any service. When guests call me directly, I handle these requests over the phone, gratis. It’s no great sacrifice and good public relations.

It may even be good business. Long ago, when I returned from a day off, the doctor who covered told me a guest at the Casa Del Mar had phoned. That was exciting news; this was an upscale Santa Monica beach hotel which had never called. The guest obviously had a bladder infection, so the doctor had phoned a prescription to a pharmacy. I nodded. Treating an infection over the phone is not a good idea, but simple bladder infections are an exception. He added that he had charged $30 for the service. I mention this only because it happened during the 1990s, and I haven’t heard from the Casa del Mar since.

When Everything Works Out

A call arrived as I was eating dinner at the home of friends. A gentleman at the Biltmore needed a doctor. The meal was ending, so I took my leave.

Driving the twelve miles downtown, I parked and opened the trunk to retrieve my black bag. Dismayed, I realized I had left it at home.

I usually keep the bag in my car. My driveway is outside, and during hot weather I take the bag into the house to keep the heat from melting my pills. Getting a housecall jogs my memory, and I retrieve the bag, but I had driven to friends without giving it a thought.

I phoned the guest to explain that I’d have to return home. Before I could apologize, the guest apologized, explaining that he had run out of his blood pressure pills and only needed a refill. He knew his travel insurance would not pay for this, so he claimed to feel ill. He wasn’t ill. I phoned a prescription to a pharmacy and went home.

This blog is full of incidents whose entertainment value is based on things going wrong. But sometimes everything works out.

"Uno Momento..."

As I was brushing my teeth one night, the phone rang for a housecall in Torrance, twenty miles distant.

Traffic was no problem, and Google maps guided me to the correct address which turned out to be a massive apartment complex behind high walls. Now and then I drove past a locked gate with no guard and no evidence that it was the correct entrance. I phoned.

The patient’s husband answered. He was Italian and spoke rudimentary English, and his efforts to direct me were incomprehensible.

“Uno momento…” There followed several minutes of silence. Just before I decided he had hung up, he came on the line and resumed his unintelligible instructions. Then my headlights illuminated a distant figure in the middle of the deserted street waving a flashlight.

He guided me to a gate, punched the code to open it, and directed me to visitor’s parking. I followed him through a maze of sidewalks to the correct building. After I cared for his wife, he guided me back to my car.

Hotel Visits I Don't Make

I try not to make housecalls for shortness of breath, chest pain, loss of consciousness, or severe abdominal pain.

Treating asthma, the leading cause of breathlessness in the young, takes hours. Giving a shot and then leaving before the guest improves is risky.

Breathless in older people usually means heart or lung disease. No doctor in his right mind treats this with a prescription, although possessing a mind is not a legal requirement for practicing medicine.

No one ignores an elderly person who faints, but this doesn’t happen often. The young seem to faint regularly. They collapse, wake up, and call me, frightened. I’m happy to make a housecall, check blood pressure, do an exam, and ask questions. By this time he or she has recovered, and I’ve never discovered something alarming in otherwise healthy young people. “Everyone is entitled to one faint,” a wise old doctor told me. If it keeps happening, a doctor should investigate.

Chest pain is a serious sign, but serious chest pain is not subtle. Niggling discomfort does not qualify. Textbooks warn that heart attacks can occur with no symptoms although these are usually in people with other problems, especially diabetes. Since a doctor cannot diagnose a heart attack by listening with a stethoscope, a housecall isn’t helpful. If you phone because you’re worried, it’s unlikely the doctor will tell you not to worry because if he’s wrong, you might sue him.

As I’ve written before, when a guest suffers abdominal pain, I feel reassured when there’s diarrhea or vomiting. That usually indicates a stomach virus, miserable but short-lived, and I get the credit when the guest recovers. Pain alone can also be a stomach virus but plenty of serious conditions (gallstones, kidney stones, blood clots) come to mind. 

Medical science has no cure for drunkenness, but hope springs eternal, so my phone continues to ring.