I love cruise ship vacationing and generally take at least one cruise per year. Having traveled with virtually every major cruise line I have had several discussions with heart disease prevention professionals and patient groups about vacationing or attending conferences on cruise ships and thought I would use the opportunity created by my latest cruise to investigate the subject in a more in-depth manner. The attitudes held about cruising with serious health conditions ranged from incapacitating fear to blissful, and potentially hazardous, ignorance. What I discovered about safe and healthy cruising was equal parts fascination and common sense.
I had the opportunity to discuss these matters at length onboard the Celebrity Cruise Lines ship "Century" with Senior Medical Officer Dr. Charles Laubscher who was extremely generous with his time. Additional thanks go to Hotel Director Niyazi Korkmaz for providing information on "healthy cruising" (I'll have more in an upcoming article) and to Guest Relations Manager Bryan Cooper for the copious amounts of time he spent arranging interviews, clearing corporate hurdles, and compiling information for me - all based on my impromptu request to learn more about safe and healthy cruising.
Dr. Laubscher immediately caught my attention with his personal focus on prevention and the concept of "remote" medicine. Clearly, the best way to resolve onboard medical problems is to keep them from happening in the first place. More importantly, it is essential to keep in mind that a cruise ship is literally a floating city that is isolated in what are often extremely "remote" areas without access to the same medical resources as modern, land-based hospitals. It was not surprising to learn that many of the doctors who gravitate to shipboard medicine have experience practicing in "remote" areas such as the northern reaches of Canada or the rural regions of South Africa and that the nurses typically have ICU and trauma-team skills.
A second concept that Dr. Laubscher spoke of is "planning for the worst case scenario." With the resources available in a modern, land-based hospital, care can be more conservative. For example, if you feel chest pains you may go to the emergency room for evaluation, stabilization, and observation and be sent home with instructions to return if the pain re-occurs. On a ship at sea one does not have the luxury of convenient trips to the emergency room and chest pain may well need to be approached as a frank heart attack and treated with a "worst case" plan to arrange for immediate evacuation to a shore-based hospital. The ship's doctor has the final say on who stays onboard regardless of what any shore-based medical team may advise.
The remainder of the interview and tour of the medical facilities centered on what level of care can be expected onboard. The doctors tend to be general practitioners but, as you can imagine, may have significantly more experience with emergency situations under less than ideal circumstances. While these doctors certainly have many "MacGyver-like" stories of lives saved through medical skill and innovative use of tools at hand, passengers should expect a small clinic experience with a focus on stabilizing serious conditions for further treatment ashore.