A dispatcher from the agency that handles airline flight crew had mentioned a sore throat, but the guest admitted an "unprotected sexual contact" two nights earlier. The sore throat appeared soon after, and he was worried.

Unprotected sex with a stranger is a bad idea, but the odds of disaster are low. I settled back to learn what happened, planning to deliver advice which would be mostly reassuring.

He seemed distracted. Asked for details of the contact, he didn't remember. The phone rang. During the conversation, he mentioned to the caller (apparently his supervisor) that someone was in the room who claimed to be a doctor. Could he explain?

That sounded odd. When he hung up, I suggested he call the agency to confirm my identity. He did so and then handed me the phone. The dispatcher apologized and admitted that the guest had been calling since the previous day and seemed disturbed. He hoped I could help.

Confirming my identity did not improve matters. When someone knocked at the door, he told them to go away. Ignoring me, he dialed the hotel phone. Reaching voicemail he said that he needed a clinic appointment but someone had sent a doctor. He wanted an explanation. Hanging up, he dialed his cell phone, reaching a friend for a short chat during which he mentioned that there was a stranger in the room.

I suggested that if he wanted to go to a clinic, I could arrange it. Waving this off, he dialed another number. It wasn't clear who or why he was phoning. Someone knocked, and he told them to go away. When I expressed a wish to leave, he stood at the door. For the first time I felt nervous. I repeated my request several times in a soothing voice. He opened the door a crack. I squeezed out, and he slammed it behind me.

In the lobby, I phoned the agency to explain that the guest needed a psychiatric evaluation. Minutes later, as I sat filling out forms, a noisy flotilla of fire trucks, police cars, and paramedic van pulled up.

I followed half a dozen men up to the room. Several crewmates were on the scene, trying to persuade the guest to open the door. They would have succeeded if given time, but the officers wanted to wrap things up.

If I were paranoid, I would not want to hear strange men pounding on my door demanding that I open. They broke in and hauled him off. Acute psychotic breaks rarely last long, and he was back in the room the next day, much better according to the dispatcher. He needed another visit to clear him to fly.

Mike Oppenheim