In the room, I was prepared to diagnose a routine stomach virus until I pulled back the covers and saw her swollen abdomen.

“Is this how your stomach usually looks?” I asked.

She denied it. She also had more pain than I expected, and I heard silence through my stethoscope. It seemed like a bowel obstruction, I explained. She needed to go to the hospital. Immediately she remembered that she was constipated, a condition that made her abdomen swell.

Hearing they must go to the hospital, guests often work hard to change my mind, but it’s a bad idea to reconsider. She went off in an ambulance, and I left hoping I’d made the right decision (doctors worry about these things). I phoned the next day to learn she had been admitted to Cedars-Sinai.

Mike Oppenheim