Confessions of a cruise ship doctor

Pre job- Getting there

I don’t remember why I wanted to become a cruise ship Doctor or even when the thought entered my head. When I tell people, they recall their obsession with Wendy or Golfer from the Love boat, but never Doc. They only recall his weasel like glasses or that he was a nerd.  When asked why I am doing it? I have a standard spiel, but “why not?” is as good as any. Then comes the ‘dancing with old ladies’ line, which I would have no problems with, and I counter with that the company targets young people, and recall my last days at work, on land, and wished I was dancing with purple rinsed beauties. The parry goes on. The truth is I have little idea what leaving my land lubber ways and entering a floating city will be like.

Once I’d hatched the idea and incubated it for a while I began research. I talked to one person and read a few infomercials on the net. Sold. When you apply for a job on a cruise ship, don’t ram your stethoscope straight away up hospital management’s cubicle, wait about a year. After the process of application, medicals, police checks, and sneaky references as you don’t want your boss to know, I feel I am cancer free, squeaky clean, amazingly slightly above average at my job (probably not) and able to pee in a test tube.

A year later, strenuous negotiations with my girlfriend, and a freshly washed stethoscope, I packed my bags ready for a new me. I feel I have to reinvent myself. The mongrel surfer image was burned ceremoniously and Andrew became Andreas, cruise ship Doc, tango expert and shuffleboard king. But first, a month in Mexico, reliving my mongrel days

Mexico breathes colour, flavours so rich even the most steeled stomach has an off day. The sky was always blue, beers chilled, people friendly and architecture and history so humbling my local church looks like a bus stop.  That said; let me tell you about the waves. Puerto Escondido, for its clichéd gringo pothead reputation is great. One heaving gut wrenching, throaty sand dredging barrel on its beach of doom, and that’s your trip. Of course, that’s all I got, one.

Ready to go in due to the hoards of marauding Mexican and iced up gringos, I saw it. Not a monster like the movies, but a slinky minx of a wave reared. I swung, paddled, stood grabbing the rail of my board. The wave heaved encasing me in liquid glass, entombed in a swirling vortex, a crystal womb. Four, five, six I counted, she held me tight. I held there suspended in time. Seven, eight… I reached Nirvana. Then my palace came down like Sampson. Not even the concrete like sand bottom could wipe the grin off my face, just a bit of skin.

So now I sit on an airplane headed to the 1990’s TV capital, Miami. My life as cruise ship doctor is unknown. I am soon about to find out 

Week one- Welcome Aboard

It was 30 degrees in the shade as I walked up the gangway into my new steel hotel. The bad connections, heartless customs agents and endless unpadded seats faded. A ship is literally a well organized floating city. There are human motorways, restaurants, shops, casinos and swimming pools. Most of the crew lives in a sterile ghetto, bunked down with others of your station on board. However, the Ship Physician is royalty. Contrary to the outside world, the doctor is respected, treated well and privileged. Our uniforms are regal, with elaborate social uniforms like admirals. It’s like joining the Navy as a big cheese.

Nothing is thought of a five course Dinners, room Stewarts, personal waitresses, some rather pretty and distinctly eastern European. The hours are gentile, about 4 a day. Uniforms are starched white and epaulettes golden and stiff. The crew is a family and most nights there are parties and activities. Greenbacks flow like waves off a bow. Sound too good to be true? Here are the snags…

When you were young, can you remember being trapped inside because it was raining? Staring out, nose pressed against the glass wishing you could run around. That’s the feeling. The movie “The Shining” captured it perfectly; I am waiting to take an axe to my cabin door.

Routine is something I have always avoided; here I am devising my own, just to stay sane. Suddenly the bar calls me at 10am; I even look forward to clinics. Clinics are something else. I thought people knew if you have food poisoning, not to eat Coke and ice cream, together. Food is king on the boats. You could do laps of the buffets or wallow in the desserts until you exploded, and some people look well stretched. I used to be call “the Buffet Dragon” but I formally hang up my gloves.

Underlying the decadence is a constant nagging voice saying; “If it hits the fan, I am responsible” Put this in context, 5000 people, 2 doctors, literally the middle of the Atlantic Ocean. No help. Gastro is a weapon of mass destruction and simple illness, limpet mines of litigation. There is something momentous about being in the middle of the ocean, riding shotgun. Where is the adventure in cruise ship medicine? Here it is.  

Week three- The headache

It’s been three weeks and I feel rather numb. Ancient civilizations have graced me with their ruins; Latin cultures lured me with tastes and numbed me with wines. Life in the ship has a strange routine that is both addictive and repelling. At times, I feel like a king, other times, a convict. When in port I wonder through the Italian cities looking for glimpses of nature. It’s hard to look at another church when all I want to see is a beach with a tree. I live within the large steel hull, emerging to watch sunsets and ports disappear. However today was miraculous. A sea volcano spurted hot lava and steam as we slowly circled the cone shaped island with the sun turning orange. More magnificent than any of our brick and mortar creations.

The medicine onboard is quite amazing. It is really a science experiment in human excess in confined spaces. The cases I see amaze me, as do the people. As always, there is a mixture of stoicism and hysteria, self diagnosis and ignorance. Severe illness mingles with times spent scratching to find something wrong. All this occurs in an environment where hospitals can be portside or five days away. Although only occasionally strenuous, the on call consumes time, but you will hear no complaints from me. So far, so good.

Week 5- Stayin’ Alive

As Ship Doctor you have certain privileges. Being a senior officer, this means you have the run of all the Guest areas. This however is a double edged sword as no matter how nice the area is, there is always a past patient hustling for more medical advice. American guests are brilliant at vocalizing their medical problems, often in front of teams of people. So solitude is hard to find. Especially when strapped to your waist is; a pager, a radio and a phone. The pimpin’ white uniform and gold name tag adds to your disguise.

There are simple pleasures in life that keep me sane. One such pleasure is getting off the ship (I typed boat) and heading to the beaches of Europe. What a pleasure it is to submerge myself in the surprising clear waters of the Mediterranean. Even more pleasurable is to ease back in the sand and enjoy the beauties of the beach. I don’t know if they sell bikini tops in Europe. For an antipodean, this cultural exchange is welcomed.

After cooling off with a gelato, another swim and a cold shower, I wander back to the ship trying to fathom how I get paid to do this.

Dinner is a convivial affair, three courses, eight if you wanted it, white linen and silver. Then its entertain yourself time until the crew party. You become a master of self improvement projects, as the other areas of your life deteriorate. The crew parties are like the full moon parties in Thailand- minus the drugs, go for about two hours, and everyone has to work the next day. There is still time for gossip generating behaviour and indiscretions. Gossip is amplified as teams of Chinese whisperers create myths out of molehills. In general, people are cool. All trying to get along in a very close situation, and they do. Ninety different nationalities, living in relative harmony- a model for the wider community.

Then amongst the mingling crowd your cacophony of communication goes off. Someone is acutely unwell, and they do get very ill, or someone has swallowed their own fist trying to get that last cream cake at the midnight buffet.

 Week 7- Some insights into ship life

Each department onboard tends to have a predominant nationality to their crew. The officers tend to be Italian; great for the ladies, except if you were ‘last week’s’. The dancers and social hosts are mostly American and British. Who else can talk all day without offending someone's sensibilities. The security is Indian, housekeeping Indonesian, maintenance Latinos, and the list goes on. The most important guys are the chefs, mostly Indian, but I guess they know how to cook pasta like ‘mama’ does as there aren’t many complaints. The medical staff tend to be a mixture, being small we form conglomerates with other small departments such as Information Systems and Corporate trainers- us misfits.

Everyone is one happy family; Ninety different nationalities, eleven hundred crew, and now, football madness. The World Cup has really opened my eyes to what a melting pot cruise ships are. Although a rugby supporter, my eyes have been open to the theatre of football Only surpassed by the fever of the supporters. The crew bar swells to capacity each game. As it should considering most drinks are a greenback. Usually quiet wall flowers shake their hip to the calypso drums of the green and gold. Mild mannered Englishmen swear, ruddy faced, at the screen. Outspoken Italians are silent, assessing every pass. And how silent were they when Italy played America in the first round. The crew is divided between Italian officers and those who had no stripes upon their shoulders but on their flag.  Torn between supporting Uncle Sam’s Army and the ‘Greatest Civilization in the World’, I ended up bedding down with George’s underdogs.

The Americans, barely comprehending the rules, cheered and paraded in the Stars and Stripes, as the Italians gestured vigorously, willing divine intervention to get the ball in the back of the net. The final whistle blew and it ended in tears and cheers, but no hostility. Everyone, finishes up and slinked away to their respective duties, or to their cabins, to contemplate the begining of another day at sea.

Week 9- Life of a groundhog sea hog

The clang of a gangway or thrust of engines usually wakes me up. The cabin is efficiently spacious; a double bed, computer, TV, desk, enough floor space to do some yoga (which I conveniently postpone). Best of all, is the two portholes that look out onto the ocean, and the lack of cabin mates that most crew are afflicted with. Three S’s later, epaulettes strapped to shoulders, it’s a gentle stroll to the breakfast buffet. Breakfast is rather continental, nothing to rave about.

8am is the first clinic- a combination of general practice with the odd curve ball. The wonderful nurses do a great job of filtering the trivial from that which is worth consultation, so in a way, the clinics can be quite interesting. There is also the continuity of crew care. Its great working with different ethnic groups, each seem to have a particular fascination (gross generalization to follow); For the Indian continent it is “lack of power”, Eastern Europeans have “terrible pain”, Asians cough with sore throats. Probably more to do with their jobs on the ship than anything else.

11am and it’s self improvement time until lunch. This involves an interactive computer programme where I learn how to say “the ball is on top of my aunty” in Spanish, or how to type without looking at the keyboard… I wasted years. It’s back to the buffet for lunch. The salad bar is great, the main area has about five hot dishes, usually tasty but again not overly, and slightly unhealthy. I take a leisurely three course meal culminating in dessert- cake and fruit. Conversation is fun; there are enough social extraverts to keep it at gutter level, an area I know a fair amount about.

While others head back to work, the casual Doctor gets to go to the guest gym- A buffet of machines that flex and extend every part of the physique. Believe it or not, in three months I have lost weight, grown four more abdominal muscles (a four pack with two to go) and developed an addiction to the elliptical machines. I now walk by pulling myself around with my arms. There is the option of basketball, a swim, a sunbathe, more food, however finding an opponent can be hard as everyone else has to work.

The sand man usual takes hold of me for a mid afternoon snooze. The afternoon clinic passes and evening draws near. Dinner is similar to lunch. Afterwards it more self improvement or its self degradation at the crew bar- Always good for a laugh and a few tales of ship life.

Certain days have different tasks. For instance, weekly there is a penguin parade, where the senior officers dress in formal “waiter like” outfits and march on stage to the applauding, usually hungry, masses. Perhaps a trip to the nightclub, jazz bar or a crew party.

Of course there is the weight of the communication station you carry as you are on call. However they get put in their little electric beds every second day when you are off and can do what you like in an European city. Due to sea days, this seems to come up about every three days, and can be complicated by problem patients.

Internet access is 24/7, phoning home is easy, and people are friendly, but life in a metal box is not all desserts and running machines, well, actually it is.

Week 12- Barcelona

What a fantastic day. This morning as I strolled back from a walk around the cool city of Barcelona, This little ditty came into my head. It is supposed to be a ska song but I haven’t got a tune for it yet.

MR PHYSICIAN

Mr Physician

Can’t you see what you’re missing?

I’ve got a reason, to be sneezin’,

I got the flu.

What do I do?

What do you mean,

I can’t be seen.

Don’t want a magazine,

I’m turning blue.

What do I do?

Mr Physician,

Not that position!

Is this how you greet, a guy off the street?

What’s that? Glue?

I’m gonna spew.

Ok you’re right,

Work is shite

But I got tickets, to the cricket,

How about you?

Want to come too?

Bring your secretary

She’d be a bit scary,

With a drink or two.

Alright we’re through.

Mr Physician

You got to be kiddin’

Money for that, a little chat?

Screw you.

And your secretary too.

We Sit in the back of a bus, as a bottle of Montserrat brandy is passed around. We have descended from a mountain and I think everyone is on a spiritual high. Montserrat is an extraordinary mountain, like a giant rock jelly, with a monastery cradled in the heart of it. The air is thick with that mystically ether you get in similar spots around the world- the Mexican pyramids, Indonesian Temples. The Monk brew a brandy made from 40 different mountain flowers. As we pass it around the different nationalities, an Indian guy comments “Made from 40 flowers and 40 different mouths”. Grown men giggle, and people sing “Like a virgin” as Montserrat is the home of a black virgin visitation.

The camaraderie on the ships is fantastic- a surrogate family. I get back to the ship just in time for a 3 on 3 football match with the Jazz musicians. A great bunch of very talented artists, who have as much free time as the Doctor. They get paid to be as creative as possible for three hours a night, again, like the Doctor. Then it’s talking T and A, with the Latino guys that, like the squares in their own countries, hang around in the corridors, all night chatting. They have the patients to have me bumble along in my toddler Spanish. Of all the things I like about this job, it’s the people that make it great.

Week 14- Mornings

Light from the porthole flickers across my cabin roof like an early motion picture. Though the haze of sleep confusion, I know its morning and we are still moving. I lie in bed suppressing an urge to scream. Not a scream of anger or fear, more a slow burning rawness that comes from being away from ones home and family. The feeling of how am I going to entertain myself today? The ships thrusters groan and we push closer to the dock, signifying the temporary freedom of land. Yet this freedom is conditional, like a man on parole, you must be back to by curfew. It’s a self inflicted sentence, everyone here has a choice, I have a choice, yet I also have a commitment. In a way that self denial gives a feeling of pleasant purity.

Prisoners’ feet stomp to the driving rhythm of Johnny Cash. Folsom prison plays and I think of my family and friends. My girlfriend sounds happy back home, but I can hear the strain in her voice questioning why I did it, and will it change. The burning quickens as I think how long it will be to I see her, see my niece, see my parents. Next to me lies last night’s book, Sea of Glory, the great American Expedition 1838- 1842. Fleeting thoughts of adventure, danger and hardship. No, my empathy with these sailors is feeble; my housing luxurious, days idle and dangers nonexistent. But an inch of my being has some understanding.

I think of the unfolding day. What will I enjoy? A game of football, a dance lesson, a conversation with friends. The fire eases. I hope they have my favourite dessert. The absurdity of my comparison dawns like the light flickering on my roof. “You lucky bastard” get up and have some fun.   

Week 17- The Cruise Medicine Conference

The ocean crashes against my cabin porthole like the door of front end loading washing machine. We are in Tropical storm Ernesto and the ship takes on a more mobile state. Try doing a consultation when your pen roles off the desk and the patient’s ear canals become docking stations. I have ventured to the Caribbean in search of waves, beaches, tropical rhythms and soul. Prior to joining my new ship I had the pleasure of attending the 6^th Annual Institute of Cruise Ship Medicine Conference. Having arrived from Europe dressed only in a clear plastic bag I was glad to see the luxury of the conference centre, surrounded by the shaven PGA golf courses. Not being a golfer, and specifically not wanting to afford the green fees, I could only admire the manpower it took to convert “worthless swamp and wildlife reserve” into the five 18 hole courses that stretched out before me. Of course, if it was a surfing resort I would have rolled around like a pig in muck.

 The conference was hard work. I know you pasty prematurely wrinkled registrars have just spat that luke warm coffee across the screen, but I kid you not.  Preconceptions of conference life sliced straight into the pond as I sat through 10 hours a day of intensive and very relevant lectures. For the attendees, an eclectic bunch of buccaneers, the content helped justify our individually reached conclusion that cruise ship medicine is not easy. It is often remote, clinically based and challenging, like trying to find healthy food in Miami; land of wide cars and wide arses.

One week later, wiser, fatter, I emerged, part of a kinship of Doctors, more fearful than ever to sail the litigious seas of cruise ship medicine. The warm waters of the Caribbean are now breaking over my window and the rhythmic melodies, a chaotic thump. I think the Caribbean will suit me fine.  

The Caribbean – Week 19ish

Having never been to the Caribbean, I didn’t know what to expect.  I had visions of; palm trees, Rastas, cricket and ganja. Either I am a prophet or TV does teach you something. Why the colonials left these isles for the hail and smoke of Europe, I’ll never know. Whatever they took with them, they forgot one thing- style. From the cheerfully colourful houses with their two tone patios, to the tight braids the school kids have, these people have style. Travel on the bus in Barbados and you will see three piece suits, felt hats and canes, and that’s the Grandpas. The ‘Grannies’ have the finest collection of retro shoes, hats and handbags I’ve ever seen. If you are from the Caribbean you seem to be born with a Don Johnson six pack and a smile to match. Our colonial gene pool seems to have got pissed in along the way.

So how does the Doctor fit into the Caribbean? I try my best. My days off involves the soul struggle of looking for waves. I battle my way through daily customs searches as every inch of myself and my board are roasted with x-rays hoping to catch the next Bin Laden. Then it’s barter with the taxis until I find a price that even the ship doctor can afford. Whoever thought the Caribbean is cheap, hasn’t been here. So I ride through the narrow streets, the cane fields and down to the areas which I think should have waves. If I’m lucky, there’s swell and the conditions are right. Then what do I do with my bag?

Usually there’s a shop, or something like it. Last time I walked in on what looked like a Rastafarian drug den; one man was the first yellow black man I have seen, I think it was jaundice. The other had been cut at some stage and had a head seamed like a baseball. After a morning ‘friendship beer’, these guys looked after me and my stuff like I was a good mate.

When surfing is not an option, there are the lures of; golf, diving, sailing, windsurfing and bikini watching. Life off board is as fun as you want it. Onboard is a different ball game…  

Ship life- sex, lies and videos

A 4500 person vessel is a floating multicultural town. With so many people in such confined space and unusual living conditions, means interesting things go on. While not condoned by the company, the industries on the ships are great. Amongst the sweaty hallways of the lower deck where the crew live amongst the laundry and the pipes is a fully stocked black market DVD rental shop. There are all the movies, games and music you could want. When a colleague was four days overdue with a rental and worried about late fees, it was commented “They’re not f@#ken Blockbusters!” I am unsure about this, as there are rumours of the ship mafia- maybe nutbusters.

Like symbiotic organisms, we survive of one another. After a 16 hour work day, some crew take to the laundry to do other peoples washing. Often the laundry resembles a Bruce Lee movie with standoff’s over irons and washing machine priority. There is no violence and all competition is in good jest.

Friendly competition is the name of the game when it comes to crew bingo. If you can imagine the seen for a basement dogfight, you have the atmosphere. Daily wages are spent on bingo cards and you’d swear some players had more than two arms as they hunch over five cards; arms’ moving like Popeye’s punching arms. The booty’s not bad either, in the thousands.

If sex is not an industry on the ships, someone is losing out. Maybe it’s because there is no value in such an available resource. Infidelity is common practice; sometimes the more stripes on the shoulders the more notches on the bed posts. Before all you partners of ‘seamen’ go running to the divorce court, not everyone is like this. In some ways it’s quite understandable with such close living spaces, long periods away, time to kill and sexy uniforms around. I’m kind of glad the 60’s still live on in certain areas. There also exists the mythical practice of ‘coneing’ (I guess that’s how you spell it). Some individuals have obtained legendary status in this art form. It involves fulfilling the love boat fantasy of certain guests. This is definitely not the norm, as ship policy strongly forbids it. Evading security guards is part of this art form, if you are caught; you receive ‘the six o’clock knock’. Not five swift kicks to the head once the bar is closed, but your rapid eviction and loss of job without notice in the early hours of the morning.

Ship life, like any cities has its industries. The smoothness of how this runs and how well everyone gets along is a credit to individual entrepreneurship. The friendly camaraderie amongst the 60 different nationalities gives me hope that the world can get along, as we all can live in a big boat together.