I Don't Do Adderall

“A guest at the Century Plaza wants his Adderall refilled. Can you go?” asked someone from the office of a local concierge doctor.

“I can go, but I don’t do Adderall,” I said.

“No problem.” She would find another doctor. Prescription refills are easy house calls.

You’ve heard of childhood attention-deficit disorder. Recently psychiatrists have discovered that it also affects adults. Treatment is the same. That includes drugs related to amphetamines; the most popular for adults is Adderall. As a hotel doctor my only experience with attention-deficit disorder comes from guests who need more Adderall.

None sounded like drug-seekers. All were happy to pay my fee for a visit during which I would check them out. Since there is no way that I can examine a guest and determine if he or she suffers adult attention-deficit disorder, I told them I’d have to speak to his or her doctor. None ever called.

It’s been decades since I made a similar decision on narcotics. Guests occasionally forget their heart pills, but soon after becoming a hotel doctor, I grew puzzled at how many needed more Vicodin or Oxycontin. Some sounded suspicious from the start, but many were clearly in great pain. Their distress tore at my heart, and they often produced a sheaf of X-rays and letters from a doctor. With no reliable way to tell the fakes from the genuine, I gave up on narcotics.

No Housecalls Today

A guest dropped an ice bucket on her toe. Pain was excruciating, and blood poured out. Holding the toe under the tap didn’t help.

Over the phone, I explained that running water won’t stop bleeding. She should apply pressure over the wound and add ice to dull the pain. When I called an hour later, she was having dinner in the hotel restaurant.

A man had developed a slight cough, in his opinion a prelude to full-blown bronchitis. He wanted something to knock it out. I explained that, in a healthy person, viruses cause almost all coughs. I could come, but I couldn’t promise an antibiotic. The man said he would get a second opinion.

A teenager bumped his head on a bedpost and developed a lump the size of an egg. The parents asked that I check him for brain injury. That requires a CT scan, I explained. He would certainly get one if he went to an emergency room, but the injury didn’t seem serious enough for that. It was OK to wait. He did fine.

A guest had missed his flight because of an upset stomach. He was well now but needed a doctor’s note to avoid an expensive ticket-exchange fee. These requests arrive now and then, and they put me in a difficult position. I can’t write “The guest was unable to travel because of an upset stomach” because I don’t know if that’s true (sometimes the patient admits that it isn’t). So I offer to write the truth: “The guest states that he suffered an upset stomach and could not travel.” I sweeten the pot by offering to fax it to the hotel at no charge.

Guests usually accept. To date, no one has complained, so the note may work.

Paramedics

My personal encounter with paramedics occurred the day I fell (ironically during my morning exercise walk) and broke my hip. I might have lain there for some time because pedestrians in my middle-class neighborhood ignore the occasional bearded old man lounging on the sidewalk. Luckily, I had taken a detour through an alley behind a restaurant where two Hispanic workers noticed, came to my aid, and called 911.

I was not in great pain as long as the leg remained immobile. Any movement hurt terribly. When the paramedics approached with their gurney, I was frightened, but they scooped me up, drove to a hospital, and shifted me to another gurney with hardly a twinge. Never mind their medical skills; that showed talent.

While I admire paramedics, they have little use for me in my capacity as a hotel doctor. Paramedics almost never encounter a physician on their calls, and they don’t like finding one. Most likely, they worry he might pull rank. As a result, when paramedics arrive at my hotels, I sit quietly, never speaking unless spoken to. In turn, the paramedics go about their business, pretending I’m not there.

Siri Would Catch That

Could I visit a Quantas crew member at the Marriott in Costa Mesa, asked the answering service at one a.m. Costa Mesa is fifty miles away, but the local doctor had just been there and didn’t want to go back.

I don’t work for nothing or keep office hours, so I have no objection to long drives during the wee hours. Unfortunately, the San Diego freeway, the major route to Orange County, closes at 11 p.m. for major construction at the San Gabriel interchange. You might think that this requires a modest detour, but closing the San Diego freeway, even at 2 a.m., produces an immense backup as it contracts to one lane leading to the exit. That’s followed by a long, slow drive through city streets.

Several aggravating experiences have persuaded me to take an alternate route through downtown and the Santa Ana freeway, a bumpy truck route and ten miles longer. After driving fifteen miles, I was dismayed to discover that the Santa Ana Freeway was also temporarily closed, a fact not revealed on my computer's Google Maps.

I followed the orange cones onto Washington Boulevard, a major street that intercepts the freeway further on. It was a deserted industrial area with little traffic, but I grew increasingly uneasy as the miles flew by with no freeway in sight. Pulling over, I consulted my ancient Thomas guide which revealed that I had turned the wrong way on Washington Boulevard and driven five miles back toward downtown.

“Siri would have caught that,” my wife pointed out later. Siri, of course, is Apple’s computer voice that recites your route on the I-phone GPS. She has proved valuable on vacations despite the occasional glitch. If you wander off course, Siri immediately recalculates it and tells you how to get back.

Thirty years of making housecalls has convinced me that I know everything about driving Los Angeles streets, a confidence not shaken by the rare occasion when I get lost. There’s an I-phone in my future.

Lost In Translation

“Bom dia” said the woman who opened the door.

“Bom dia,” I responded. That’s the limit of my conversational Portuguese. My heart sank as I looked around the room which contained a toddler but no adult male. Among foreign couples, the husband is much more likely to speak English.

The mother pointed at her child, made coughing noises, tapped his chest, and produced a thermometer which she waved significantly. Once she understood that I needed more information, she took up her cell phone. 

After some effort because her husband was apparently in a meeting she delivered a long recitation before handing me the phone.

“He have cough. He have the flu. He need something. She wants you to examine him.”

In response to my question, the father insisted that this was everything she had said, but I knew he was summarizing. This is a chronic problem with amateur interpreters. I asked more questions and received short versions of her long answers. The child looked happy and not at all sick, and my examination was normal. He had a cold. He’d coughed for four days and might cough for a few more, I explained. She was already giving him Tylenol, and no other medicine is safe for a two year-old. Luckily, he didn’t need medicine or bed rest or a special diet. It wasn’t even necessary to stay in the room.

If I had handed over medicine, every mother from Fiji to Mongolia to Nigeria would understand that I was behaving like a doctor. But I wasn’t. What was going on?

I’ve encountered this hundreds of times, so I work very, very hard to communicate that the child has a minor illness (husband’s translation: “Doctor says child is OK…”), that no treatment will help (husband’s translation: “Doctor does not want to give medicine…”) and that being stuck in a hotel room is boring, so she should try to enjoy herself (husband’s translation: “Doctor says go out; child is OK…”).

Tap, tap, tap…. The mother beat a tattoo on he child’s chest in a wordless appeal. Everyone knows that a sick child must be confined and given medicine. Why was I implying that he wasn’t sick?

I knew what she was thinking. I repeated my reassurance, and the husband translated. When, at the end, I asked if she understood she knew the correct answer: yes. She remembered her manners as I left and thanked me effusively.

I left feeling as discouraged as the woman. She was in a strange country, trapped in a hotel room with a sick child. Despite her best efforts, the foreign doctor didn’t understand that her son was sick.

A Brush With Disaster

A Beverly Garland guest phoned as I worked out at my gym one morning. I’m happy to cut this short to make a housecall, but the guest wanted me to come at one o’clock. I don’t like appointments, but this seemed an easy visit, and it was convenient because I could go after lunch.

After showering, I was walking to my car when a disturbing thought occurred. Exercise is boring, so I read the New Yorker while on the treadmill. When I finish an issue, I leave it in the locker room for anyone else. With a shock, I realized that I had scribbled the guest’s name and room number on that New Yorker which I later finished and absent-mindedly left behind. I rushed back, but the magazine had vanished. I prowled the gym, searching for anyone reading a New Yorker. No luck. I phoned the Beverly Garland to ask if anyone remembered referring a guest. No one remembered.

Now and then a competitor’s hotel calls when its doctor fails to show up, but I boast that this never happens at my hotels. I always tell a guest when I’ll arrive and make sure that I arrive on time. Now I had visions of the guest fuming as hours passed and eventually denouncing me to the staff.   

I racked my brain. The guest sounded Australian and had a Slavic-sounding name. Dutifully, the desk clerk checked her computer and found nothing. I asked if I could come and examine it myself; she agreed.

Guests who make appointments occasionally change their minds, so I always phone to make sure they’re in the room. With great good sense, I had told the guest I would check at noon. To my immense relief, when 12:30 passed with no call, he phoned.

Curing Hiccups

Every few years a hiccuping hotel guest appeals to me.

Hiccups rarely lasts more than a few hours, so a victim gives credit to his last effort and immediately rushes to his computer to proclaim its benefit. Literally hundreds of treatments exist: proof that all are worthless. Google “hiccups cure” to confirm that you must never look for health advice on the internet.

Long ago when an old doctor described a good treatment, I was skeptical. Even today, hotel visits for hiccups make me nervous, so I give a money-back guarantee. Once in the room, I take a tongue depressor and rub the soft palate at the back of the hiccuper’s throat. Sometimes he or she gags, sometimes not, but so far everyone has been happy to pay my fee.