A lady had been vomiting for three days. She had felt better that morning but then relapsed. She sounded weary.

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This was tricky. Stomach viruses are the second leading ailment a hotel doctor encounters. I consider them good visits because they rarely last more than a day. I deliver advice as well as an injection and pills. The guest recovers and gives me the credit.

When vomiting persists, doctors worry about more ominous digestive disorders. Worse, three days of vomiting produces some dehydration. This is not dangerous in a healthy person, but drugs don’t work well in its presence and recovery slows. Victims perk up when dehydration is relieved.

I explained that it was probably too late for a house call. She needed intravenous fluids. After agreeing to go to the local emergency room, she mentioned that she was Canadian and had no travel insurance. I admitted that American ERs are pricey but urged her to go.

I’ve found that it’s a bad idea to tell guests to go to an ER and then tell them how much it might cost.

My restraint was in vain because she googled the subject, discovering that it’s between one and two thousand dollars. Giving IVs would take hours, making the cost much higher.

When I called the hotel that evening, I learned that she hadn’t gone, and she was still vomiting. She admitted that the cost had shocked her. I sympathized but told her she had no choice.

When I called later to reinforce this advice, she had checked out.

Mike Oppenheim

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