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.