Another Guest From Hell - The Life of a Hotel Doctor | By Mike Oppenheim, M.D.

The manager on duty appeared even before the elevator arrived, but I had expected this, because he had called earlier to ask for the visit. Since the hotel was paying my fee this was what I call a “medicolegal visit.” I make half a dozen every year to see guests injured on hotel property or who otherwise worry management. This guest was mentally ill but not in a frightening way.

He was middle-aged, American, and well-dressed. As I introduced myself, he suggested we not shake hands because he didn’t want to give me his lice. He had lice.

I settled myself comfortably and listened to his story. He explained that whenever he stayed in a hotel he asked the housekeeping department for the temperature at which they laundered bedding. Nowadays, to save money, they often kept it under 150 degrees, too low to kill the eggs. He was particularly susceptible to lice. His case mystified doctors, and treatments only worked for a short time, but this was a cross he had to bear. At home he laundered his bedding and clothes daily and professionally fumigated the apartment once a month, but this barely kept the infestation at bay. He concluded by handing me a sheaf of printouts from internet medical sites on the subject of lice and its treatment.

This was delusions of parasitosis: rare but not terribly rare. I’ve encountered half a dozen cases over thirty years. They drive hotel management crazy. Everyone, doctors included, cannot resist the urge to cure these people using the feeblest weapon: facts. As anyone familiar with the debate over health care reform knows, faced with a firmly held belief, facts are worthless.

“Can you show me a louse?” I asked.

“I pick them off so fast they’re hard to find. But let’s look.”

I pulled out my flashlight, and together we peered at his pubic area.”

“There’s a nit (egg),” he said after a long search.

“That’s a flake of skin.”

We looked elsewhere but turned up only bits of debris. Finally, I straightened up. “A louse infestation isn’t subtle, and I don’t find one.”

Having heard this from most doctors, he was not offended. “I need a prescription for the treatment; over-the-counter remedies don’t work.”

I wrote the prescription and held it out.

“Give it to the hotel,” he said. “They’ll pick it up and pay for it.”

“I’m not sure they will,” I said. “I have to tell them there’s no lice.”

“They usually pay. I’ve already told them I plan to sue.”

Doctors hate hearing that word. “That costs a lot of money,” I said. “And I doubt you’ll win.”

“Right on both counts,” he responded pleasantly. “It costs between five and ten thousand dollars to hire the lawyer and file the suit, and I hardly ever collect anything. But I can’t let these irresponsible hotels get away with filthy bedding.”