The Pleasures of the Beverly Hills Hotel

My September 3 post brings back memories of the Beverly Hills Hotel.

I love it. The hotel sits in a residential area of a city with benign parking laws, so I can leave my car on adjacent Crescent Drive. Because management ignores the tiresome obsession with security, even during the wee hours, I walk to the nearest door and never find it locked. I’ve made 135 visits.

I’m not the only doctor who loves the Beverly Hills Hotel. Although the oldest (built in 1912), later arrivals – Bel Air, Peninsula, Sofitel, and L’Hermitage share its reputation for opulence and expensiveness. However, something about it attracts the fawning attention of doctors, including those who don’t serve hotels.

I’ve never met the general manager. He has the authority to designate a hotel doctor, but GMs tend to leave that decision to guest service personnel. That works out fine for me – over the long term. Over the short term, aggressive doctors exert their charms. I’ve acquired and lost the Beverly Hills Hotel four times.

For an exciting year during the eighties, it called, and I visited Leonard Bernstein twice (I can mention his name because he’s dead). Then calls ceased. They resumed several years later before stopping again; this was probably the work of the unhappy celebrity whose visit I may have mentioned earlier. The hotel closed for renovations in 1994, reopening a year later with concierges who knew me from previous jobs -- always a good sign. Sure enough, calls began arriving. By this time, Doctor Lusman was on the scene (google “Jules Lusman”; you won’t regret it). He took over until he lost his license in 2002.

All luxury hotels call now and then, and a few call regularly, but I lack the key to winning their ongoing loyalty. This might involve something as straightforward as charming the general manager or as devious as money changing hands. I don’t know.

An Encounter at the Beverly Hills Hotel

In 1995, a man wearing only pajama bottoms dashed into the lobby of the Beverly Hills Hotel as I stood at the concierge’s desk.

“Don’t pay him!” he screamed.

Without lowering his voice, he denounced my competence and asserted that, once he informed the general manager, I would never again enter the Beverly Hills Hotel.

He had consulted me for a painful anal condition. I didn’t find anything wrong but gave some suppositories from my bag. He showed no interest in suggestions for sitz-baths and stool softeners, finally interrupting to declare that he needed substantial pain relief, preferably by injection. He heard my explanation for declining in sullen silence.

I left the room without the usual pleasantries and made a beeline for the concierge but not to get paid. I never ask for money after a visit turns out badly. If the guest isn’t planning to complain, the sight of my charge on the bill might change his mind. In these situations I try to neutralize damage by warning that I’d seen a guest who might cause difficulties. I had barely begun when the man’s entrance made this superfluous.

I kept quiet, and he eventually ran out of gas and stalked off. To my relief, several amused employees urged me not to worry. This guest was well known to them. 

Flying and Blood Clots

I hear from travelers who notice puffy legs after a long flight. Some worry about a blood clot, but this almost never causes both legs to swell.

Your heart has no trouble pushing blood to the far end of your body but plays no role afterwards. Blood returns to the heart slowly, squeezed along by surrounding muscles. If you don’t move, it returns even more slowly. In the absence of movement, gravity induces blood to settle in the legs where plasma leaks through the distended veins into surrounding tissue. You can make the diagnosis if pressing a finger makes a visible dent. Veins grow leakier with age, but I see plenty of guests in the prime of life. The swelling should diminish after you begin moving or eliminate the effect of gravity. A night in bed usually helps.

Textbooks list dozens of serious causes “peripheral edema.” I can’t recall a hotel guest who had one, but it’s possible that a traveler with swollen legs may learn that he has heart, kidney, or liver disease and remember that I downplayed its seriousness.

So, my legal advisor insists I warn you not to feel reassured by what I’ve written. It’s just my opinion; you might be dangerously ill. Consult your family physician. Go to an urgent care clinic. Call the hotel doctor.

The Celebrity B12 Franchise

Many singers and celebrities insist on a vitamin injection before a performance. That vitamin is almost always B12 because of (don’t jump to conclusions…) its color. Most drugs resemble water, but B12 is vivid red. Since everyone knows that injections trump pills, the same reasoning suggests that a brightly colored injection works even better.

My B12 experience impresses me with how closely celebrities resemble royalty. Arriving, I approach in stages – passing through rooms containing bodyguards, groupies, publicists, media, dressers. When I finally reach the room containing the celebrity and his intimates, he turns and drops his pants (women hold out an arm). I give the injection and depart. No one makes a move to pay, but I can expect a lesser person to come forward as I retrace my steps.

These requests don’t arrive often, so I wonder who owns the franchise on celebrity B12 shots in Los Angeles. It’s a gold mine. I also carry a vial of B complex – half a dozen B vitamins not including B12. It’s colorless, and I can’t remember anyone requesting it.

The Proper Role of Women Doctors

I was a medical student at NYU shortly after New York became the first state to legalize abortions in 1970. The big change, from a student’s point of view, was that deliveries at Bellevue plummeted. To ensure that we received training in obstetrics, NYU began sending us to Booth Memorial Hospital in Queens which served a middle-class population who wanted children. It was much nicer than Bellevue and the staff obstetricians were congenial.

During NYU’s obstetric rotation, students divided up into teams; mine consisted of me and two women.

One evening after midnight at Booth Memorial we were waiting for a delivery when the legendary Doctor Epstein arrived, an elderly obstetrician with an immense practice who had graduated medical school in 1928. With time on his hands, he gave my companions career advice.

They shouldn’t go into surgery, he warned. Surgeons must stand for hours. Being prone to varicose veins, women cannot tolerate that. He suggested anesthesiology because it’s so boring. Women are better at boring stuff. Since women have a natural love of children they couldn’t go wrong with pediatrics or child psychiatry.

This being a prefeminist era, the women were more amused than offended. But both went into pediatrics.       

A Few Celebrities

A famous actor at the Four Seasons showed me a pimple on his eyelid. This was a sty, I explained, a blocked gland. It wasn’t serious. There was no treatment except hot compresses. It would go away in a week or so.

He needed it to go quickly, he said. He had a television interview the following day. A previous doctor had stuck a needle into an earlier sty, and he’d be grateful if I did the same. He endured it stoically.

“You wouldn’t have any Oxycontin?” asked a guest. He was consulting me for a rash.

“I’m the doctor you call when you feel sick,” I said. “For Oxycontin you need a different sort of doctor.”

We parted on good terms. My refusal did not offend him; from his point of view there was no harm in making the request.

It’s wrong to divide celebrities into upstanding citizens and the drug-addled exceptions. They are a cross-section. Many work hard at their careers but enjoy the occasional drug if it’s available, and they move in circles where scoring requires only a modest effort. Wrecking your life with drugs, as with alcohol, takes persistence.  

Flying and Your Ears

Flying doesn’t cause ear infections, but getting on a plane if you’re stuffy can end painfully. My records show only a few dozen visits for ear pain because I handle most over the phone. If a guest felt fine before boarding, pain that begins afterward generally disappears after a few days, but it’s an unpleasant experience.

Before beginning this entry, I googled “ear pain on flying.” Internet medical advice is unreliable, and even reputable sites such as the Mayo Clinic and WebMD solemnly recommend feeble preventatives such as antihistamines and drinking fluids plus dangerous ones such pinching your nose and blowing (they warn you to do it “gently”). All deliver traditional advice: chew gum, suck on hard candy, yawn frequently, take oral decongestants. Traditional advice sometimes works but never dramatically.

The best preventative is a straightforward, chemical nasal spray (Afrin, Dristan, Sinex). When you’re sitting the plane before takeoff, spray, wait five minutes for it to work, and spray again. That sends the spray far up your nose to, hopefully, reach the eustachian tube opening, the only connection between your middle ear and the outside world. If the flight lasts more than a few hours, do the same before the plane begins its descent, an hour before landing. I give the same advice when guests call afterward. It’s not as effective then, but waiting works.