Little Moving Islands of People

Feb 26, 2013 | Dr. X | Dr. X
Little Moving Islands of People

image by: Sơn Bờm

Welcome to my world, the world of the cruise ship physician. If you’re sure you want to join Dr X, we’re embarking now

I suspect most readers will figure out my real name is not Dr. X. It’s something else and welcome to my Private Sea Journal.

In it I will recount the experiences I have had as a Ship Physician on world class cruise liners. I have practiced medicine on many cruise liners and worked for several companies and have found each has its own particular character and philosophy for providing pleasure cruises. I have made many good friends, some in position to know well-kept secrets of the industry.

I was almost a psychologist, at one time, but I regained my senses and went into medicine instead. I have always carried a healthy curiosity about the human mind; its motivators, what makes us good or bad, why we make the choices we do. No place I can think of would provide better fodder for my unofficial study of human behavior than the little moving islands of people we call cruise boats.

In this Journal I will show you how a ship works and how different companies approach guest service, all from the perspective of the Ship Physician. And I’ll show you the adaptations we must make in order to deliver medical care to guests and crew while at sea.

I have been an emergency physician on the east coast for 30 years and have seen the amazing advances in technology such as ultrasound, cat scans, blood tests, as well as the development of the therapeutic interventions in cardiac care.

The singular challenge for cruise doctors is to practice medicine without these advances being immediately available. Boats have no scanners, and usually no ultrasound. We have some of the newer blood tests and can use the medicines for breaking up blood clots in the brain or heart. We have limited x-ray ability, EKGs, and consultants available, sometimes, by sea phone. But basically, as the Ship’s Physician you are on your own. And if you are taking care of a senior officer in critical condition, as I have, the welfare of a boat and its 5000 souls can be in jeopardy.

That’s why the International Maritime Commission, to which almost all countries belong, requires an adequately trained physician to be in attendance for any vessel that has more than twelve paying passengers, crew doesn’t count. A boat may not leave the dock unless the doctor is on board. On the contrary, I have seen the ship’s captain put off the boat because it’s over-booked and it was decided a guest would get his cabin. There are many captains on any ship at any one time.

As the Ship’s doctor I have met many fellow crew members, from those with the lowliest job, which I always considered to be the galley’s plate wipers, an actual job title, to the captain with five bars on his sleeve. From talking with them and from my own observations I’ve gotten a privileged insight into the pleasure cruising business. I will give you a look at the industry from the inside; some of which is good, some bad. Each company is different and has its own philosophy and corporate personality.

And I will share with you some of the cases I have had. All names of the companies, their boats, their crew, and the identities of my patients have been fictionalized. Other than that, every word is absolutely true. The cruise assignment which is the subject of this Journal includes itineraries and specifics of different assignments I have had.

And my own identity has to remain secret. The cruise industry likes its privacy and doesn’t take kindly to anyone offering transparency. Doctors don’t have the same privileges and status in the world of cruising as they do on shore. Any crewmember to break the rules of secrecy is subject to immediate firing and can be put off the boat at its next port. That includes the doctor, it happens all the time.

A word about masks. We all have masks that we wear every day. Masks are a way of hiding our secrets and fears. They are how we fool ourselves and others into thinking we’re something that we’re really not. People are always trying to change who we appear to be. If we have a good enough mask no one can see what’s behind it.

But these masks come off under stress or change. Like during a visit to an emergency room or being a couple of thousand miles from the constancy of land. That’s when we can see what’s underneath, and get insights into what makes who they are; what makes us good, what makes us bad or what makes us funny and impressive and what makes us boring.

Welcome to my world, the world of the cruise ship’s physician. If you’re sure you want to join me, we’re embarking now.


About the Author:

Come aboard as Dr X's Private Sea Journal reveals with great story telling and wit the practice of medicine on the high seas including some of the deep dark secrets of maritime medicine, as well as Dr X.

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