Sometimes people get sick on cruise ships. Each ship has a doctor on board to serve both passengers and crew. Dr. Len Kreisler spent four years working as a ship’s physician for Regent Lines who ran five 1960’s era ships until going bankrupt in 1995. Dr.Len included a chapter about his experiences as a cruise ship physician called What Ship, What Cabin, and Doctor Who? in his book ROLL THE DICE, PICK A DOC AND HOPE FOR THE BEST. This is an excerpt from his book.
I had office hours from 8:00 to 10:00 AM, after which I saw crew members. I also had scheduled office hours in the late afternoon from 4:00 to 6:00 PM. My nurse and I were available 24/7 and took turns on call nights and during port stops. We had approximately 900 passengers and an equal number of crew. Many passengers were upset to learn that medical care was not covered in the cost of the cruise. A visit or cabin call carried a base price, medications, tests, and extra time cost extra. I considered the fee schedule reasonable. Nevertheless some passengers would forego medical care to save money. It never made sense to me. They’re spending thousands of dollars on a vacation, why stint on medical care? Go figure human priorities. (Um, I did not see the cruise ship doctor when I had swine flu on a cruise.)
The demands for passenger medical services were usually minimal unless we hit stormy weather. Taking care of the crew could be demanding in time, communication, medical emergencies and social interactions. One had to be ready for all types of situations.
My wife and I boarded the Regent Sun in Ft. Lauderdale, Florida and settled in for a 10 day cruise. The first port was San Juan, Puerto Rico. The seas became a little rough as we started our two day run to San Juan. I got a request for a cabin visit. A wife suspected her husband was reacting poorly to the rolling and pitching of the ship. The nurse asked the wife if she would consider bringing the husband down to the medical clinic to avoid the extra charge of visiting their cabin. No, she wanted us to come up, and as soon as possible.
The poor man was sitting in bed, whiter than his sheets. He appeared confused about time and place, and was having trouble focusing as I introduced myself. It didn’t take long to determine he was experiencing double vision, difficulty in coordinating his arm movements and was not able to carry on a logical conversation. I took the wife aside and asked about his medical history since this was not a characteristic picture of motion sickness.
Turns out he was diagnosed with lung cancer a few months prior to this cruise. His doctor had made him “more comfortable” prior to their sailing by removing a few quarts of liquid from his chest…she matter-of-factly volunteered. GREAT! I would have liked having his doctor on board so he could take care of this man who, in my opinion, should have never been allowed to go on this cruise.
I informed the wife what she should have known (maybe she was told and chose to ignore it?) Her husband had lung cancer in various parts of his body (including metastases to brain) which caused his current problems; not motion sickness. I outlined a plan for trying to make her husband more comfortable during the next two days at sea. She would then have two options when we got to San Juan.
I told her we could move him to one of our two beds in the medical department, or we could start treatment in the cabin and see how he did with periodic visits. The nurse outlined the fees she could expect, and we got signed agreements for everything. She opted for the cabin trial.
We started intravenous fluids, patched one eye for visual comfort and gave him medication for nausea. I then took an educated guess: I figured his mental status was probably due in some degree to brain inflammation and swelling caused by the metastatic lung cancer. I added sizeable amounts of cortisone to his intravenous fluids with the hope of decreasing reactive brain inflammation. The nurse and I drew up a schedule for cabin visits and availability for possible emergencies. I informed the Captain and Hotel Manager. It was fine with them as long as it did not divert or disrupt the ship’s planned itinerary.
By the next morning I was ready to light a candle and make a donation. The man was remarkably better. I humbly accepted the praises and thanks of the wife, while I crossed my fingers and toes, with the hope he would remain improved long enough to get on a plane in San Juan and head home.
Her two options, once we got to San Juan, were to board a commercial flight and head home (if we could get seats), or check into a local hospital and make arrangements from there. God smiled. She was a travel agent and arranged for two first class seats. A private charter would have cost over $20,000. We assisted with the transfer to the airport, and arranged for medical care upon their New York arrival. I asked if she could drop me a note about their trip back. I never heard from her, but fellow passengers for the remainder of the cruise told me they got word they had made it back okay and appreciated the care given aboard ship.
More stories from Dr. Len: