Two women at the Holiday Inn were ill. The mother suffered low abdominal pain with vomiting and diarrhea. It seemed like the usual stomach flu. I assured her that it wouldn't last long and gave medication.

Her adult daughter also complained of low abdominal pain but without other symptoms. It's a good rule that when two members of a family are ill at the same time, it's the same illness, but no rule is absolute. Stomach flu can occur without vomiting or diarrhea, but I feel reassured when they're present.

The problem is that isolated low abdominal pain in a young woman can indicate an urgent problem such as ectopic pregnancy or twisted ovary. This seemed unlikely, but I couldn't rule it out. If she weren't better in a few hours, I explained, she must go to the local emergency room. She did not object.

When I phoned a few hours later, the mother's symptoms had vanished, and the daughter told me she felt a little better. Patient tend to tell doctors what they believe we want to hear, so "…a little better," does not reassure me. Pressed, she admitted that she wasn't feeling better. When urged to go to the emergency room, she worried about her lack of insurance and the late hour but promised to give it serious consideration.

I passed a restless night. When I phoned the next morning, she had recovered.

Mike Oppenheim