A Death

A guest at the Park Sunset complained of the flu. His temperature was 101; my examination was normal, but patients with influenza have a normal exam.

He looked miserable, but he was forty-one and in good health, and everyone with the flu looks miserable. There was no reason not to give the usual remedies and check back later. This happened long ago, but I still remember the inexplicable feeling that something was not right. I couldn’t bring myself to leave him in the room.

Leaving after extracting a guest’s promise to go to an emergency room is a bad idea. If the guest decides not to go and something dreadful happens, I’m the last doctor he’s seen. Calling paramedics was another option, but they might not share my unease.  

Explaining that he required further attention, I drove him to the nearest hospital. The next day I phoned. He had been admitted and died a few hours later. The doctor who cared for him was as mystified as I. We theorized he was suffering an overwhelming infection from an unknown source. Perhaps he took drugs. This was early in the AIDS epidemic, and victims sometimes died abruptly when their immunity vanished. We never found out.

Not Hitting the Jackpot

“Our client had a heart attack,” explained the dispatcher from Universal Assistance. “He wants to go home, but the specialist says he needs a doctor. We have hired a medical flight, and we want to know if you can go to New York. You come back the same day.”

Experts advise waiting a week or two after a heart attack to fly, but no one knows the risks of flying earlier because no one does. An expert who suggests that a physician go along is covering his ass, not delivering advice based on evidence.

Still, the insurer had agreed, no minor matter when an air ambulance coast to coast costs about $40,000. I had no idea what I would earn; nor did the dispatcher, but it would be breathtaking. Hiring a doctor for a day to testify in a malpractice trial runs to $7000.

I still remember with pleasure the single occasion I flew first class. Flying in a private jet while earning the price of a European vacation might leave an even better memory.

But would the patient require a doctor’s skills? It was unlikely, but I could not dismiss the possibility. Like most doctors, I can perform basic CPR, but I and most doctors have long since forgotten advanced CPR: complex drugs and techniques required for various cardiac malfunctions. Emergency room doctors, paramedics, and ICU nurses deal with these.

Wistfully, I informed the dispatcher that those were the appropriate escorts. 

The Perks of Age

Getting old is a nuisance although there are benefits. Police in passing patrol cars no longer eye me suspiciously late at night. Lone women in elevators have stopped looking uneasy when I join them. 

As a college student in 1965, I wrote a play that won a national award. It was never produced, but in 2006 a theater group in New York chose it for a staged reading. This was not a big deal, but I wanted to attend.

As soon as I entered the small theater, everyone perked up. I became the center of attention; people introduced themselves; they sat me in the place of honor. For reasons I still puzzle over, the group boasted that its public readings were cold (i.e. unrehearsed). The performance made this only too clear.

Later I realized why everyone treated me so well. No one in that theater appeared older than forty. Since I was past middle-age they assumed I was an agent or producer – an important person. They did not forget their manners on learning I was merely the writer.

A Dog-Eat-Dog Business, Part 2

“Doctor Lusman is out of town. Could you speak to a guest at the Fairmont?”

That was a jolt. Lusman was an ambitious young doctor who had phoned months earlier to introduce himself and offer to cover my hotels when I wanted to get away. I declined but suspected he was poaching. For Lusman to instruct his answering service to send me to one of my regulars showed immense gall or perhaps immense confidence.

In private practice it’s unethical to solicit another physician’s patients, but hotels are a grey area. Established hotel doctors who want to remain on friendly terms do not step on each other’s toes. I had made hundreds of visits to the Fairmont.

After the visit, I stopped by the concierge desk to mention that a guest had called another doctor.

Her eyes widened. “Gosh, I don’t know what happened, Doctor Oppenheim. The guest never talked to me.”

I felt better. Maybe it was an innocent mistake. This feeling lasted until I passed the front desk, and a bellman called out.

“Doctor! My name is Andre. I’m glad to meet you.” He hurried over, holding out his hand; we shook. “It was me that called you for the guest. Is he doing OK?”  I knew what this meant.

“Who do you think I am?”

The bellman cocked his head. “Aren’t you Doctor Lusman? People say I should call Doctor Lusman.”

“I’m Doctor Oppenheim, the hotel’s doctor.”

He looked confused. “Where’s Doctor Lusman?”

“He’s not available. You should call me in the future.” I walked away, pleased at frustrating the bellman who clearly expected a payoff. Bellmen were hopeless, I told myself. Concierges were the key to a hotel’s loyalty, and it looked liked they were still in my corner.

But this happened some time ago, and I haven’t heard from the Fairmont since. 

Things Guests Say Again and Again

“Can you come up right away?”

It’s surprising how many guests believe I am sitting in an office downstairs. In fact, I’m at home or going about my daily business when the phone rings. I keep a suit jacket, tie, black bag, and paperwork in the car, a mild inconvenience because I must park in shade on sunny days to prevent the heat from melting my pills.

“I’ll call you back.”

Middle-class Americans are mostly insured. Talking to a doctor willing to make a housecall is already disorienting; hearing that they’ll have to hand over money comes as an additional jolt, so they often reconsider (“I’ll talk to my husband and call you back…..”). No one who says this ever calls.

“Sorry about the mess”

Entering a room, I look for a place to set down my clipboard and bag, so I hear this as someone hastily removes the pile of articles covering the desk. After putting a thermometer in the guest’s mouth, I announce that I will wash my hands, so I hear it again as someone rushes ahead to clear a space around the sink. 

“Do you accept insurance?”

My answer is yes – if the guest is foreign. Billing US carriers is so complicated that offices employ trained billing clerks. I work alone.

Impresssing the General Manager

Years ago Prentice-Hall published The Man’s Health Book, and UPS delivered my ten free copies. Usually I gave those to family and friends who didn’t read them, so I wondered if I could put them to better use. 

I decided to visit general managers of my biggest hotels, introduce myself, and impress them by handing over my new book.  

At each, I approached the secretary in the executive office, identified myself as the hotel doctor, and asked for a minute of her boss’s time. I delivered my spiel, surrendered the book, and accepted their thanks. Some GMs expressed pleasure at finally meeting me, adding flattering words about my service. Others listened politely and thanked me for the book, but it was obvious they had no idea who I was.

I encountered a third reaction at the Los Angeles Downtown Hilton. The secretary had barely replaced her phone when the GM shot out of his office. I began my spiel but he interrupted.

“What do you mean you’re our hotel doctor?” he exclaimed. “This hotel doesn’t have a doctor!”

“I’ve been coming for years….,” I said. My database showed 119 visits which implied over 200 phone calls. The staff knew me; the valets never refused to hold my car (essential downtown).

“This hotel doesn’t have a doctor!” he repeated. “What do you mean calling yourself our doctor?”

“When a hotel calls so often…”

“We don’t have a doctor. You’re not to call yourself our doctor!”

Flustered, I held out my book. He snatched it and disappeared back into his office. I could have made better use of that copy. A few days later the mail brought a certified letter from an attorney informing me that I was hereafter forbidden to refer to myself as the Los Angeles Hilton’s doctor.

I stopped handing out books. Seven years passed before the hotel, then the Wilshire-Grand, resumed calling.

Why Don't They Call?

In my experience, a hotel generates approximately one request for a doctor per month for every hundred rooms. My record, in case you’re wondering, is 208 calls in 1995 from the old Century Plaza which had 1076 rooms.

The Airport Hilton has over 1,200 rooms, but I average a dozen calls a year. When I asked the security officer why the hotel called so infrequently he gave the usual wrong answer (“no one’s been sick”). When I asked who they called besides me, he peered down at his desk where, under a sheet of glass lay business cards advertising taxis, masseurs, florists, limousine services, clinics, pharmacies, et al. I saw my card and none from three rival hotel doctors who prefer the area in and around Beverly Hills where luxury hotels concentrate. They occasionally drive the extra ten miles to the airport, but I doubted they were responsible for my shortfall.

My eyes fell on a card from a national housecall service. Several exist, and I made half a dozen visits for this agency but stopped because guests blamed me for the bill.

“Do you know how much these people charge?” I asked. “Eight hundred dollars!” The security officer expressed polite dismay. Guests rarely complain about a doctor’s fee, so he didn’t care.

That’s the problem. Luxury hotels make sure a doctor is available, but many managers at the mid-level give it a low priority, so employees make their own choices when a guest asks for help.

Now and then, mysteriously, the light dawns, and a hotel begins to call regularly. Decades may pass before this happens, and I’m still waiting for the Airport Hilton.