I was Cruising Alaska’s beautiful but desolate Inside Passage aboard Holland America Line’s MS Zuiderdam (“Zuider” rhymes with cider) and perusing several thousand passengers whose cumulative life spans must run in the hundreds of thousands. I couldn’t help but wonder how medical emergencies would be handled (being personally responsible for a hunk of those total years) and found myself on “A” Deck as a guest of Dr. Florentino Subion, or Dr. “Tino” as he is known to the crew.
View of Holland America cruise ship (MS Zuiderdam)
Dr. Tino is a Filipino medical grad, an amiable and well-spoken gentleman who has been practicing medicine for a dozen years. Along with a current staff of two other doctors and two nurses he looks after the passengers and crew of this huge cruise liner. Usually there is also a physician assigned to the passengers who is a Canadian or American graduate. This makes sense given the passenger demographic, while the crew are made up of Indonesians, Filipinos and to a lesser extent East Indians meaning an Asian graduate would likely be familiar with the sociocultural norms of the crew, especially important when dealing with the stressors often found from being away from home, family and friends for months at a time.
Dr. Tino in his infirmary
One of the challenges Dr. Tino faces is encouraging the 30 to 35% of the crew who smoke to “butt out”. Other issues can include minor and major trauma from handling and working around heavy equipment. Interestingly, all crew members are blood typed before signing on so that there is a living breathing blood bank to suit almost anyone’s type. The ship has the lab equipment available to screen for HIV, hepatitis etc. to ensure reasonably safe transfusions should they be necessary. EKG and x-ray equipment is also available but the bottom line is that once stabilized, seriously ill passengers must be evacuated to land-based facilities. All physicians working on board should have ER experience and these in the past have included emergentologists, family practitioners and surgeons.
Hospital unit aboard ship
Greg, a former ER nurse, tells me that emergencies can range from cardiovascular, to strokes to respiratory ailments, but lately they have been faced with a spate of gastrointestinal bleeds. Maybe a little more alcohol intake on holiday coupled with the use of stomach-eating medications like ibuprofen and aspirin for the subsequent hangover?
ER nurse Greg
Crew doctors sign on for longer periods of time, generally four-month contracts while passenger docs can sign on for as little as two weeks. A nice perk is being able to take your family along. I get the impression that while the family may have a nice relaxing time, their MD spouse/parent may find themselves involved in a host of mundane and not so mundane medical duties, much as they would back home.
If you are a health professional and this sounds like it might appeal to you, check out:
Holland America Line – Careers
Photo Credits
All Photos by George Burden – All Rights Reserved
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