Standby MD asked me to see a guest at the Doubletree – in Santa Ana. That’s fifty miles away, but it was Sunday morning; freeway traffic was light, a perfect time to drive to Orange County. I quoted the fee which was larger because of the distance. The dispatcher promised to call back after consulting his supervisor.

Some travel insurers won’t pay extra. When the phone remained silent throughout breakfast, I suspected that was the case, but approval finally came through.

The guest was an elderly Canadian man suffering diarrhea and vomiting. He mentioned that a dozen members of his tour were affected; several had gone to the emergency room.

That brought back memories of a guest in 1991 with the same symptoms. Stomach viruses are among the most common ailments a hotel doctor encounters. They’re miserable but short-lived; I had delivered the usual advice and remedies. When I called to check the next day, I learned that he was in the hospital with cholera. That’s when I remembered he had flown in from Peru.

Cholera also causes diarrhea and vomiting. It’s extremely rare in the US. In fact, if an American patient turns up with any of the major historical diseases (cholera, malaria, rabies, leprosy, typhoid, typhus, plague, even tuberculosis) there’s a good chance the American doctor will get it wrong on the first visit.

The Canadian gentleman was already recovering, but my phone rang before I left with a request to see another tour member. She was sick enough to send to an ER where she stayed until the evening. There is little cholera in Canada, so this was a stomach virus or run-of-the-mill food poisoning.

Mike Oppenheim