As in other aspects of health care, foreign nations had a better system. When American crew needed a doctor, they could go wherever they wanted and use their insurance. The combination of no transportation and American health insurance with its huge deductibles meant they usually went nowhere. Since many called the front desk to ask if there was a doctor, I dealt with their pitiful calls. American pilots occasionally bit the bullet, but flight attendants couldn’t afford me unless I cut my fees. I gave the usual free advice and, if necessary, directed them to the nearest 24-hour clinic.
Then I had to decide if they would go. Once anyone calls for help, I become his or her doctor. I’m responsible for their well-being. I think this is the law, but it’s certainly how some doctors feel, and it’s the reason lawyers (American lawyers) warn us never to give phone advice to a stranger. If a patient disobeys my instructions, I’m still responsible, and I hated hanging up the phone and worrying, so I occasionally made a housecall to an American flight attendant. My fee for a charity visit was $30 or $40. Afterward, I always felt virtuous, so there were compensations. Foreigners never required charity.
I became the doctor for a dozen foreign airlines including Alitalia, El-Al, Virgin-Atlantic, Aer Lingus, Japan Airlines, and Cathay Pacific. Two provided a fascinating contrast. Conveniently (for this discussion) they laid over a few hundred yards apart: Virgin-Atlantic at the Torrance Hilton, Cathay Pacific across the street at the Torrance Marriott. These were seventeen miles from my house, over a half-hour drive when traffic moved smoothly.
If a guest at the Park Hyatt, two miles away, wanted a housecall, I went, but I was liberal at giving free advice over the phone if that’s all an illness required. I don’t claim immunity from human nature, so my willingness to handle an illness over the phone grew with the driving time. A check of my computer reveals a visit on 56 percent of calls from the Park Hyatt. When the Warner Center Marriott in distant Woodland Hills phoned, I made the trip 29 percent of the time. I also leaned over backwards to avoid a visit if the guest might find the fee painful: 63 percent to the upscale Bel Air Summit versus 43 to the Airport Holiday Inn.
Foreign airline crew did not pay, but I had no objection to giving phone advice to guests in faraway Torrance. That’s when the English proved again why they’re the world’s best patients. If I explained their illness didn’t require a visit, they understood. If I didn’t give a prescription, they didn’t point out the oversight.
Matters were different with Cathay-Pacific. Based in Taiwan, its flight attendants came mostly from Southeast Asia: Thailand, Malaysia, Singapore, Indonesia, the Philippines as well as Taiwan. I quickly discovered these cultures have a different view of a doctor’s powers.
Although most Americans would deny it, they believe doctors – invariably doctors they like – possess healing powers that go beyond scientific medicine. It’s my impression southeast Asian cultures take this more literally, and they also believe employing such powers require a doctor’s presence. When Cathay-Pacific crew called they rarely welcomed advice.
Hotel guests generally loved to learn they suffered an ailment too minor to require a doctor, so I dispensed a great deal of instructions on self-care. The common cold makes up fifteen percent of all human illnesses including those of Cathay-Pacific flight attendants, but my expertise seemed lost on them. I deliver an excellent explanation of stuffy nose treatment. Since foreigners need names of American over-the-counter medicine, I always asked them to get a pencil. Time and again, the phone remained silent for several seconds before I heard: “When you come?...”
Everyone who flies worries about ear damage when they have a cold, so I discussed it. Everything you’ve heard is either worthless or positively harmful. Never pinch your nose and blow. Over-the-counter decongestants aren’t strong enough. Everyone who flies with a cold should buy a nasal spray such as Afrin or Neo-synephrine. While you’re sitting in the plane before it takes off, spray each nostril thoroughly. Wait ten minutes for the spray to work, then repeat. That carries the spray far back into your nasopharynx to the exit of the eustachian tube, the only connection between your middle ear and the outside world. Even if your nose is clear, swelling of mucus membranes can block this opening. If the flight lasts more than a few hours, repeat this as the plane begins its descent, an hour before landing.
Too polite to interrupt, Cathay-Pacific crew waited until I finished before speaking words that made my heart sink.
“You come?... When you come?”
My database confirms what I always believed: that I made visits on about half my callers. Cathay-Pacific held first place among my clients with 82 percent.
