Industry Update
Opinion Article24 September 2020

Recovering From Cocaine - The Life of a Hotel Doctor

By Mike Oppenheim, MD

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Oppenheim

He had turned bright red, a frightened guest informed me. Searching the internet revealed that this indicated dangerously high blood pressure. Could I come…?

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This was as accurate as most internet medical advice, so I was not alarmed. In response to my questions, he admitted using cocaine earlier but emphasized that he had never turned red before. His heart was pounding, his skin tingling, and his head pulsating but he denied having a headache or chest pain. Could I come?

What to do…. Allergic reactions turn patients red, but this is accompanied by itching which he didn't have. Otherwise, his symptoms were typical of cocaine. They didn't sound life-threatening, but it's a bad idea for a doctor to dismiss the possibility.

I do not like to make housecalls to frightened hotel guests. Waiting often becomes intolerable, so they dash off to an emergency room or call the paramedics before I arrive. I asked him to count his pulse. It was 100: not terribly fast. I kept him talking, and he grew calmer.

A hotel doctor's nightmare is a guest dying after he leaves the room, but dying before he arrives is also bad. It was a stressful drive.

When he opened the door, he wasn't bright red, perhaps very faintly pink. When I took him to a mirror, he agreed that he had improved. His blood pressure was high, but not too high. His heart sounded normal. He was recovering from the cocaine.

Mike Oppenheim

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