A national housecall service informed me that a caller in Huntington Beach was having a panic attack. He had had them before, and he needed a doctor to come and make sure he wasn't dying.

This was a bad call in many ways. Waking me at midnight was not one, because I don't consider that a big deal. Making a housecall for a panic attack is risky because victims often improve while I'm driving and cancel, and Huntington Beach is 45 miles away.

Finally, the caller didn't know the fee; I would have to tell him. It was likely that my fee to Huntington Beach at midnight adding a 40 percent cut for the service would never pass. Worse, once I mentioned it the horrified patient might quickly get off the phone.

My problem was that once someone asks a doctor for help, he or she is obligated to help (ethically obligated; in reality maybe not). So I held off delivering the bad news and kept the conversation going.

After half an hour of soothing and reassurance he began running out of gas and admitted that maybe this wasn't an emergency. He agreed to keep my number and call if he changed his mind.

Mike Oppenheim