I Get Letters

In my dreams, agents write, suggesting a book, perhaps entitled “Hotel Doctor to the Stars.” So far these haven’t arrived, but physicians occasionally E-mail me. They want to know how to become a hotel doctor.

I advise them to (1) let local hotels know they’re available and (2) wait. It helps if (3) there’s no competition. That worked for me although I began in 1983 and it wasn’t until 1992 when my yearly visits passed 1,000, and I quit other jobs to become a fulltime hotel doctor. By then others were entering the field, so newer doctors will wait longer.

My only advertising is a dignified letter to general managers three or four times a year. Aggressive competitors who extol their services to desk clerks and concierges often take over my regular hotels, at least temporarily, but it didn’t work when I tried it. At better hotels, employees are nice to everyone, so they listened intently, eagerly accepted my business card, and promised to keep me in mind. The first few times, I left feeling pleased with myself, but calls never followed. At cheap hotels and motels, staff seemed mystified at the concept of calling a hotel doctor. No one ever got sick, they insisted.

It’s possible I was missing the key inducement: money. Paying a bellman, desk clerk, or concierge “referral fee” has a long tradition in hotel doctoring. It’s illegal, and all my competitors condemn the practice, but I suspect it happens.

Three Discouraging Words

In rudimentary English, a Hilton guest explained that his rash needed attention.

“I’ll be there within the hour,” I said and quoted the fee. He replied with a phrase that makes a hotel doctor’s heart sink.

“I have insurance.”

From an American, this usually means no visit. Collecting from American carriers requires either a trained billing clerk or far more patience than I possess. I refer these guests to a local clinic.

Foreign travel insurers are better. I send a bill, and (unlike American insurers) they send a check for the identical amount. I asked the name of his insurer. It was Assistcard, an agency that’s called since the 90s.

The proper step was to ask the guest to phone Assistcard who would confirm his eligibility, and phone me. This never happens quickly, but it’s rarely a problem because 95 percent of travelers call their insurance first, so I don’t hear about the visit until it’s approved. This guest had mistakenly called me. I told him I would arrange matters.  

After listening to my explanation, the Assistcard dispatcher said she would call the guest, confirm his coverage, and call back. To pass time, I booted up my copy of Sim City. This worked too well; after 45 minutes of wrestling with urban problems I realized the phone had remained silent. Calling, I discovered that my dispatcher had vanished, perhaps to lunch. After putting me on hold, another dispatcher assured me that the wheels were turning. I phoned the guest to make sure he hadn’t wandered off only to learn that no one at Assistcard had called and that his tour was leaving in two hours. I called the dispatcher who explained that the guest was Indonesian. Assistcard was in Argentina, so getting approval from Indonesia might take a while.

Once the guest left for his tour, the visit would evaporate, so I decided to drive down and take my chances. My phone rang while I was on the freeway. The dispatcher informed me that no one could find the guest’s proof of insurance, but it might eventually turn up. Learning I was on the road, he offered to call the guest and suggest he pay me directly and try to claim reimbursement. That rarely works, but it worked this time.

My Distance Record

My distance record is a 94 mile drive to care for a man with a sore throat.

I’ve found it good business not to refuse inconvenient visits. It’s hard arrange a housecall on short notice, so agencies and travel insurers keep a list of doctors for every area. But humans are creatures of habit, and once a dispatcher learns that calling me always gets the housecall, they continue to call. Ignored, other doctors drift away, and I become the only one available. As long as I don’t refuse too often, they don’t bestir themselves to refresh the list.

I quoted a fee that took into account the long drive, pointing out that it would be cheaper to send the patient to a local clinic. This sometimes gets me off the hook, but it didn’t in this case, so I drove to Santa Barbara. That’s where I served my internship long ago in 1972-73, and the hotel turned out to be three blocks from my former apartment. The hotel was not there forty years ago, and the area had become unrecognizable, so I felt no nostalgia. I saw the patient, stretched my legs, and drove home.

Passing the Word

The Kyoto Grand is a large hotel in downtown Los Angeles that hosts many Japanese. Insurers send me every few months, but the hotel never calls.

One of the staff accompanied me to the room to interpret. After the visit, I described my services. He responded that the hotel had a doctor who practiced in nearby Little Tokyo. I pointed out that this doctor was undoubtedly reluctant to make a housecall during office hours and not eager to come at inconvenient times. The employee shrugged, accepted my business card, and promised to keep me in mind.

That same day my phone rang. It was the employee informing me that another guest needed my services. Naturally, I was delighted, and I drove back downtown to care for a guest with an upset stomach.

You might think I am now the doctor for the Kyoto Grand, but this happened long ago, and no calls have arrived since. While the employee may have lost the card, it’s also likely he neglected to tell anyone else about me. A dozen Los Angeles hotels call rarely because only a single employee knows me. Now and then the news gets around, and the hotel becomes a regular, but I have never figured out how to persuade someone to pass the word.

My Norwegians, Part II

At midnight the Norwegian lady from the previous post phoned, begging for a housecall. Something terrible was happening. This was a full-blown panic attack, she informed me. She knew for certain that she was dying. When I assured her that she would not die, she did not deny it but pleaded tearfully for me to come. Victims of panic attacks are not psychotic. They know they’re behaving irrationally, but they can’t resist.

These calls are not rare, and I usually handle them without a visit. Ten minutes of soothing reassurance and the knowledge that I’m immediately available over the phone generally works. Reassurance also works when I visit a guest whose complaint unexpectedly turns out to be a panic attack. Unfortunately, these successes are guests who don’t know they’re having an attack or suffer them rarely. This lady was a hard-core, locked-in panic attack veteran. Her attacks followed a strict pattern, and no reassurance would change matters.

If I came, examined, and found everything normal, she would express gratitude, but even before I finished counting my money, she would be pleading for another exam. Yes (I know you’re asking) there are shots, and I give them, but they don’t work. I hate walking out on a guest who’s begging me to stay, and these attacks may last hours.

This guest’s conviction that she was dying was clearly wrong. Yet every doctor has heard of patients who announce that they’re dying and then proceed to die. No doctor wants to be the source of such an anecdote, so this lady needed at least one exam. As I was agonizing, she broke in to say she would ask the hotel to call an ambulance. Then she hung up. I phoned the front desk to make sure they had done so. Like me the paramedics have encountered plenty of panic attacks; in the unlikely event something bad happened, they were the last medical professionals the guest had seen.     

My Norwegians

Oil gives Norway the world’s highest standard of living because, unlike oil-rich countries in Africa and the middle-east, Norway has an honest government. Besides putting away money for the future, it invests heavily in infrastructure and services such as universal free medical care and college education. Many Americans consider such government programs soul-destroying, but Norwegians tolerate them pretty well.

A  Norwegian tour arrived in the city last year, and I cared for four members. Thanks to a good education, all spoke English.

They were guests at the Hollywood Heights hotel in my least favorite part of Los Angeles. Despite our legendary freeways, none reach from my neighborhood to Hollywood, so I drove nine miles through the city. Planned in the 1960s, the Beverly Hills freeway would have solved my problem, but it vanished from maps when the city insisted it be built underground, an excellent idea.

The first Norwegian suffered a urine infection, common and easy to treat. The second had a hacking cough, present several days, which tormented three roommates almost as much as the patient. I handed over cough medicine. The third had been vomiting. Everyone with an upset stomach blames their last meal, so I listened to a recital of everything he’d eaten. I gave medicine and told him he’d be better in a few hours.

The last had been to Universal Studios and thought she had sunstroke. Sunstroke is life-threatening, but there are lesser sun-related conditions, none of which she had. She did not even have the painful sunburn that northern Europeans acquire almost as soon as they get off the plane. Universal City is in an area hotter than Los Angeles proper, but weather hadn’t been abnormally hot.

Hearing my reassurance, she admitted that her nausea and anxiety may have represented a mild panic attack. She suffered them regularly. This one seemed to be receding…. The story continues in my next post.

Oppenheim's Rule

Less in high school, more in college, and even more in medical school, students agonized before a test, suffering during, and grumbled afterward about how badly they did.

At some point in life, I had an epiphany. It occurred to me that I was smarter than most people. If a test seemed hard to me, it was certainly harder for everyone else. So I would do fine. When I decided to think this way, a great weight lifted from my shoulders, and I stopped worrying about exams.

As a certified family practitioner, I must take a test every six years to keep my certification. With no office practice, I can’t take the shorter test given to colleagues. It takes three hours; later someone visits the office to evaluate their charts. I must take the same day-long written exam given residents fresh out of training.  It includes subjects I’ve long forgotten such as obstetrics and surgery, so I spend a lot of time guessing. But I did fine in exams I took at the age of 39, 45, 51, and 57. By the time I was 63, the questions seemed harder, and I was guessing more often. For weeks afterward I broke my rule and worried. Failure would be humiliating. Also, I’d have to pay $800 to take the test again. But the rule held. I passed.

Wee Hour Gridlock

The phone woke me at 11:30. A lady at a downtown hotel was suffering an allergic reaction. This was not bad news; downtown is not too far, I charge extra for calls that get me out of bed, freeway traffic is light, and I can sleep late. I wrote down the information and dressed.

Traffic was minimal, but as I approached the freeway interchange leading to downtown, a line of traffic cones forced me to the outside lane. The ramp heading north was closed. The highway department schedules inconvenient maintenance for the wee hours, and I occasionally encounter these obstructions. No problem, I thought. I continued on to the next exit and re-entered the freeway to retrace my route. Cones appeared, so the other north ramp was also blocked. By the time I learned this, I was forced onto the freeway heading south. Again I left at the first exit only to discover no on-ramp in the opposite direction.

Fortunately, there was Figueroa, the main street through downtown, so I decided to follow it. That turned out to be everyone’s idea, so I joined a gridlock that crept north.

I apologized for arriving an hour late, and the patient was too polite to express skepticism that heavy traffic at 1 a.m. was responsible.

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.

Doctor Oppenheim's Screenplay

During the 1990s, I was called to the Bel Air hotel to care for a screenwriter working for Francis Ford Coppola. Chatting before I left, I revealed that I was a full-time hotel doctor.

“I bet you have great stories,” he said.

“Well…. As a matter of fact…”

At his urging, I mailed him a screenplay.

Does this surprise you? I work in Los Angeles. Why shouldn’t I write screenplays? Everyone else does.

I was reminded of this incident because my mail recently included a short story I’d submitted to the New Yorker. Across the inevitable rejection slip was a handwritten scrawl “great read but not quite...” That produced a surge of pleasure, but there is less there than meets the eye. Although the preprinted rejection is signed “the editors,” no New Yorker editor reads stories as they pour in, thousands per month. All are screened by low paid young English majors, happy to be on the first rung of the journalism ladder. They pass a minuscule handful on to editors who choose one or two for each issue.

I’m proud to have caught the eye of an overworked reader at America’s premier market for short stories, but there is no telling who will read my next submission. Even if it were the same person, she would not remember me, having read hundreds in the interval. Nevertheless, that rejection marks the highlight of my literary career since 2010. The highlight that year was an actual publication, but it was in the Wisconsin Literary Review. You won’t find it on the newsstand.

Everyone who learns I’m a hotel doctor urges me to write my memoirs, so I wrote them. I wrote a novel about a hotel doctor. I even wrote a proposal for a TV pilot featuring a Los Angeles hotel doctor. All those are, as we say in the business, making the rounds. The TV hotel doctor is not entirely based on me because, among his amusing quirks, he cannot resist extolling his screenplays to sick celebrities. I never do that. The writer mentioned above took the lead.

You may be curious for the upshot. He never replied.