Len Kreisler MD at Taku Lodge in Alaska

Retired doctor Len Kreisler spent 4 years as a cruise ship doctor for Regent Lines in the 1990’s.  His book ROLL THE DICE PICK A DOC AND HOPE FOR THE BEST includes his shipboard experiences in a chapter called What Ship, What Cabin, and Doctor Who?

He had a pretty interesting time onboard, with more stories than fit in just one blog so this is the first excerpt from his book, with eight more blogs to come in the future chronicling the adventures of Len Kreisler MD, cruise ship doctor.

Dr. Len Kreisler’s book

Part 1 – Hiring On

Not enough attention is given to medical services when people decide to travel, especially on cruise ships.  I got first hand knowledge when I became a cruise ship physician (1990-1994).  Having gown up on the East Coast, I enjoyed the pleasures of beaches and salt water.  Living in Las Vegas for over 35 years has not diminished the call of the sea.

I had just left my 18-year position as Medical Director for the Nevada Atomic Test Site and was leafing through a family practice medical journal in the library of the teaching hospital.  An ad for a ship’s physician caught my attention.  An emergency group out of Baltimore, Maryland had contracted for the medical services of the Regent Lines, under the contract name of Maritime Medical Services.

The Regent Lines had five ships of 1960’s vintage.  A Greek man had bought the ships, refitted them and contracted out many of the ship’s services, like medical and food.  The cabins were spacious, the food and entertainment was good, itineraries were interesting and prices very competitive.  The owner was apparently well trained in deficit financing; he kept the subcontractors and investors dangling while he siphoned off a good part of the cash flow.  The operation went bankrupt in 1995.

I applied for the job…after getting an enthusiastic okay from my wife.  Our children had left the nest and she relished the idea of joining me for romantic adventure in domestic and foreign ports.  After waiting several weeks for a reply, I decided to call and see if I was still being considered for a job.

A gravelly-voiced female with a distinctive asthmatic wheeze answered the phone.  After saying Maritime Medical, she went into a series of wet coughs, and paused to catch her breath.  “Oh yes, I remember your application.  Glad you called.  We happen to be looking for someone just like you.  Can you be ready to travel next week?”

I welcomed the assignment and we became good telephone buddies.  I accepted the reality of dealing with a loosely run business model.  I also encouraged my newly found Maritime Medical friend to stop smoking.  I subsequently became an aficionado of cruising….as a ship’s physician, as a passenger, and as a guest lecturer.

My observation is that, in general, medical recruiters for cruise lines prefer foreign nationals.  They work cheaper and are less problematic in the litigious arena.  Who would you sue if a problem arose and the medical supplier was an independent contractor?  An event could most likely occur in international waters or in a foreign port, with a foreign-trained, foreign-national physician.

There are usually 35 – 50 nationalities represented in the crew on a medium-sized cruise ship (1500 passengers).  There are no mandatory standards for physicians or nurses.  Ships going in and out of United States ports have to comply with safety and health regulations, but there are no required educational or competency standards for medical personnel.  Some smaller lines stay out of American ports, thus avoiding U.S. Coast Guard Inspections.  I’d encourage you to check health and safety details before planning a dream vacation confined to distant parts of the world.

Most ships are registered in places other than the United States, for economic and political/legal reasons.  So you can roll the dice, pick a cruise and hope for the best….or….you can seek answers to pertinent questions….and then hope for the best.

Travel magazines recommend third party coverage for cruise insurance because if  you insure with the cruise line and it goes bankrupt the coverage could be as worthless as the line and leave you stranded.  This happened with the Regent Line and later with the Renaissance Line.  (Added note not in the book – it’s a good idea to pay for your travel with a credit card.  Then the credit card company may recover your money in the event of a bankruptcy.  This happened to me when the airline Canada 3000 went bankrupt and my credit card company recovered the cost of a useless airline ticket.)

Always read the fine print before buying travel insurance.  For example, will your insurance cover expensive air evacuation should the need arise?  Conde’ Nast and Travel+Leisure magazines have good recommendations for insurance coverage.

(Medical evacuations do happen.  A passenger was taken by helicopter from an Alaskan cruise I was on, and one from a transatlantic before it got too far from Europe.  Another passenger had medical issues when the ship had gone to far from land for a helicopter to reach it, so it sped across the ocean arriving on the other side several hours earlier than scheduled.  Must have been serious as cruise ships use much more fuel, therefore take many more dollars to run, if they exceed a certain speed.  At one port stop the ship next to us missed its scheduled departure, which was supposed to be before ours, and still sat at the dock with an ambulance at the gangway as we pulled away on time.  Not as expensive as a helicopter evacuation, but they would still have to get home on their own.)

More Stories from Dr. Len:

Crew Problems

The Seasick Passenger

Chasing Supplies

Dead End

Lights Out

Drunk and Disorderly

Cruise or Bust

Still Cruising