We recently caught up with Dr Lee Blackburn, who is currently at the end of his first tour of duty on board a cruise ship carrying around 1,900 passengers and 800 crew members.
Q. What made you decide to work on a cruise ship?
“Working on a cruise ship had never crossed my mind until I received a general email sent out by Medacs. I was not available at the time but enquired anyway as it seemed like an interesting opportunity.
Initially I had no intention of signing up to a long contract but was interested rather in a brief locum period at sea. However, after discussions and looking into the
terms and conditions, I came around to the idea of a longer contract!”
Q. What is a typical day like on board a cruise ship?
“Over the course of a three month tour there is no typical day on board a cruise ship, however there are certain routines that I can outline. The medical centre typically is staffed by two doctors and four nurses. There are two clinics to attend every day plus each doctor covers on average 12 hours per day on-call. Clinics usually run from 8.30-10.00 and 16.00-17.30 each day. These clinics can be busy and usually involve GP type presentations.
During on-call you may be called to deal with any type of emergency involving crew or passengers. Sometimes on-call is busy and at other times you may go a couple of days without being disturbed. Serious cases involve the mobilisation of the whole team via an emergency broadcast made by the Bridge. The medical centre is an impressive area of the ship and has in-patient beds, resuscitation room, treatment and x-ray room and consulting rooms. We are trained by the company to take our own radiographs and we utilise this skill often in patient care.
An average cruise will be two weeks in duration unless the ship is on a round the world cruise; during this period it is not unusual to send several passengers and crew off in foreign ports for specialist tests. It is also not unusual to disembark patients for care at a local hospital or for immediate repatriation for urgent care.”
Q. What do you get up to when you are not on-call?
“When not in clinic or seeing patients whilst on-call then your time is entirely your own and the medical team has full privileges on-board; which means that you can eat meals in any of the many restaurants, use all passenger facilities such as the gym and spa plus attend theatre shows or other events. Evening activities are excellent and there are always shows and bands to watch, plus no shortage of social events for crew and officers to enjoy.
Q. Do you get off the ship much?
“At all times one doctor and one nurse must remain on-board to cover on-call, which essentially means that each doctor usually manages to get off the ship at 50% of ports during a cruise.
Over the last two and a half months I have travelled to the Norwegian Fjords, the Canary Islands, France, Spain, Portugal, Morocco, Sweden, Denmark, Russia, Estonia, Germany to name a few, and I have absolutely loved the experience.”
Q. What is the most interesting/bizarre case you have had to deal with on board?
“In two and a half months at sea I have seen many patients with a wide variety of medical needs. Coming from A&E I have had to adapt to a general practice style for daily clinics, but there have been interesting emergency cases to deal with, such as myocardial infarctions, cardiac arrhythmias, severe pneumonias, TIA' s and strokes.
The ship can also be a dangerous place for crew, especially if they work in the engine room and machinery spaces, and lacerations, eye injuries and chemical contamination of the eyes is not uncommon. Some injuries which might ordinarily be referred to a specialist in the UK - such as complex hand wounds or significant facial lacerations - have to be dealt with on-board if the ship is at sea for an extended period. Dealing with these can be very satisfying however as you get to see the benefits of your interventions.
I had two cases of work related laceration of the hand within 24 hours of each other recently. One with a complete tendon rupture was eventually disembarked to a hand surgeon in Norway and then repatriated to India. The other was managed on board (which I would never be expected to do in a UK Emergency Department) and the Indian crew member made a very rapid and full recovery and was able to continue his contract at sea with only a short period of convalescence.”
Q. Do you have any recommendations for locums that are interested in becoming a cruise ship doctor?
“I would certainly recommend the position of ship's doctor, and the work has exceeded my hopes and expectations in terms of medical experience, quality of life and travel aspirations. Doctors with competence in dealing with GP type presentations, skills in dealing withmedical emergencies and trained in ALS/ACLS should contact Medacs directly for further information if the life of Ship's Doctor appeals to them.
It's also worth noting that as high-ranking officers on the ship, doctors are held in very high regard by both crew and passengers, which can seem a little strange to begin with! It is very humbling to witness the genuine respect that crew have for the medical team and especially the appreciation they show when you care for their medical needs, which makes the job very satisfying indeed.”
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