My competitors pay close attention to local luxury hotels (Beverly Hills Hotel, Four Seasons, Sofitel, etc), so none call me exclusively. But they don’t care to travel, so I’m the doctor for the most opulent hotel in Los Angeles County: the Langham (formerly Ritz-Carlton) in Pasadena twenty-five miles away. It sits on twenty acres that includes a beautiful Italianate-style main building, luxurious Spanish Revival-style cottages, and a historic garden.

Last week the Langham concierge asked me to speak to a guest. As soon as she came on the line, I knew she felt terrible. She sounded weary and hoarse after vomiting for several hours. She was in good health, so odds favored the usual stomach virus, miserable but rarely life-threatening. Most vomiters want quick relief, and I offered to come, but she preferred to wait it out. I gave the usual advice (don’t eat, don’t drink, suck on a piece of ice) and left my number. Fifteen minutes later the same concierge connected me to another vomiting guest who also declined a visit.

Caring for two patients at the same hotel would have been a rare treat. Sadly, both were American. Since Pasadena lacks the international tourist caché of Los Angeles, Langham guests include more Americans who are less inclined to pay for a housecall than foreigners who accept their helplessness in the hands of a rapacious medical system.

When I phoned later that day, both had recovered. They were grateful for my concern, but they would have been more grateful if I’d cared for them. Although you might not think so, I consider vomiting a good visit. It usually doesn’t last long, and the doctor gets the credit when it stops