Another Free Service

A caller in Huntington Beach was having a panic attack. He had had them before, and he needed a doctor to come and make sure he wasn’t dying.

This was a bad call in many ways. Waking me at midnight was not one, because I don’t consider that a big deal. Making a housecall for a panic attack is risky because victims often improve while I’m driving and cancel, and Huntington Beach is 45 miles away. There’s not much a doctor on the spot can do with medicine for a panic attack  (“a shot” doesn’t exist).

Finally, the caller didn’t know the fee; I would have to tell him.

In his distress, he had searched the internet and found a national housecall agency. Most such agencies tell callers the fee, so by the time I hear from them, they’ve agreed to pay. But this particular agency specializes in foreign airline crew and tourists with travel insurance where the fee is already arranged. On the rare occasion when an American contacts the agency’s answering service directly, it simply passes the call onto me.

I knew that my fee to Huntington Beach at midnight including a 40 percent cut for the service would never pass. Worse, once I mentioned it the horrified patient would quickly get off the phone.  

That wouldn’t bother an operator, but once someone asks a doctor for help, he or she is obligated to help (ethically obligated; in reality maybe not). So I held off delivering the bad news and kept the conversation going. 

After forty minutes of soothing and reassurance he began running out of gas and admitted that maybe this wasn’t an emergency. He agreed to keep my number and call if he changed his mind.

Taking No Chances

A guest at the Westin wanted a doctor to look at a rash. I quoted the fee, always a tense moment.

“Do you take insurance?”

If the caller is American, the visit is doomed, but this one wasn’t. I asked the name.

“Assistcard.”

I know Assistcard, but it doesn’t allow clients to call the doctor on their own. They must phone Assistcard which confirms their eligibility and then phones me.

Most travelers know this. In the past, when I told the rare exception what to do and then waited for the call from Assistcard, it never came. So I told him I would arrange matters.

Foreign insurers have offices in the US, so their customer service is painfully familiar. I listened to a recorded welcome in Spanish, Portuguese, and English. I punched “3” to choose English. A recorded voice told me to listen carefully to choices on the menu because they had recently changed. I chose and then listened to muzak. 

After several minutes a dispatcher greeted me in Spanish. I proceeded in English which I suspected he spoke and this proved correct. He assured me that he would phone the guest, and arrange approval. He kept his word although an hour passed before he called.

During the wait, the guest’s wife decided that it wouldn’t hurt to have the doctor check her cold. The approval, when it arrived, added a consult with the wife, so it turned out to be a lucrative visit.   

Who's Taking Care of Avianca

Coris, a travel insurer, sent me to the Crowne Plaza to care for a Spanish lady with stuffy ears. She turned out to be a flight attendant for Avianca airlines. Airline crew can’t fly if they suffer a host of minor ailments, so they provide plenty of easy visits.

That evening a call arrived from Traveler’s Aid, a national housecall service, and I returned to the Crowne Plaza. The guest, a Columbian man with a cold, was also an Avianca flight attendant.

That was puzzling. Foreign airlines once called me directly to see their crew. They don’t do that today. They call a more traditional provider organization who then calls me.

But what was Avianca doing? I theorized that it calls Coris, and the Coris dispatcher consults her list for Los Angeles. If she decides to call me, Avianca will pay Coris perhaps double my charge. If she calls Traveler’s Aid, the additional middleman will increase it still more.  

I’ve long since stopped trying to see the logic.

An Easy Visit

A young woman suffered an episode of dizziness earlier that day. By the time I arrived, she had recovered. The examination was normal, and I reassured her. 

Any sudden episode in a young, healthy person (dizziness, chest pain, shortness of breath, even fainting) is probably benign and not worth intensive investigation unless it keeps happening. We take these more seriously in the elderly.

Some guests are sicker than others, but I have a soft spot for guests who are not sick at all. 

Bedbug Calls

“All insect bites look the same,” I explained.

Bedbug calls are tricky. Victims are often unwilling to pay. When, confronted by an angry guest, hotels ask my help and offer to pay the fee, I come but refuse to take their money. The hotel will probably comp the guest’s room, and I don’t want to add to their expense and hassle. Also, since a bedbug call involves management, it’s excellent P.R.

Naturally, I hope that a grateful hotel will remember. This doesn’t always work, but I drove off in a good mood. I love nearby hotels, and the Westwood Comstock, which rarely calls, is three miles away. It’s also very exclusive, and my left-wing politics does not diminish the pleasure of caring for hotel guests with plenty of money.

The patient turned out to be more distressed than angry. Sometime guests show me a rash that is obviously not insect bites. Sometimes I see bites confined to the legs, meaning the guest acquired them while erect, perhaps at the beach. There were many bites on her upper body, so I couldn’t deny the possibility of bedbugs.

I delivered my opinion and handed over a free tube of cortisone cream and my business card. Everyone seemed pleased including the general manager who thanked me for my quick response. Now I must wait.

Departing From Your Routine

Twenty years ago I drove thirty-five miles to Pasadena to see a patient. When I opened the trunk to get my bag, it wasn’t there. I had left it at home. I drove back to retrieve it.

I mention this because last week I made a visit to the Hyatt Regency in Long Beach, thirty-five miles away. I had my bag, but when I consulted my invoice while waiting for the elevator, there was no room number. 

I recalled how it happened. I had never been to that Hyatt Regency, so I had stopped filling out the invoice at home to look up its address on the internet. I found it, copied it down, and forgot to add the room number from my telephone notepad. Departing from your routine is always perilous.

Worse, the patient was a woman. In our sexist society, when a couple checks in, it’s the man whose name goes in the register – and couples sometimes don’t share a last name. That was the case this time as I listened with a sinking heart as the desk clerk assured me that the guest list contained no such person.

The Wrong Way To Do It

“My son has a boil on his leg. Our doctor says he needs an antibiotic.  Could you come to the hotel and give the prescription?”

A boil is collection dead tissue, full of pus and germs. It has no blood supply, so an antibiotic can’t reach it. Antibiotics alone don’t cure boils.

Left alone, boils eventually go away, so victims who use one of the innumerable silly home remedies from the internet will give it credit. Allowing nature to heal is commendable but may require few weeks of misery.

Unnatural healing works instantly. The doctor cuts into the boil, squeezes out the pus, washes the cavity with saline, and then stuffs a strip of sterile cloth into the hole. A few days later, he or she pulls out the strip.

I don’t drain boils in a hotel room, so I had to decide where to send the guest. At an emergency room, the doctor would certainly do the surgery, but an emergency room is a tiresome experience.

A local walk-in clinic would be more civilized. The downside is that the doctor in a walk-in clinic would have a background similar to mine but probably without my vast experience and wisdom.

I sent the boy to a walk-in clinic where the doctor punctured the boil and sent them away with an antibiotic. The puncture might seal and the boil recur (that’s the purpose of packing it with the cloth). Or it might ooze for weeks before resolving. I wish the doctor had done it the right way, but the boil would eventually heal.