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1-9-13 2156


Wow,busy day. Didn't start off that way, but it sure got that way. It was my first day being 1st call. I got to the clinic, opened it up and started things just like I was supposed to. A few minor problems cropped up, a passenger with a sunburn, seasickness, etc. We got an email saying a passenger had chipped a tooth on a piece of bacon the previous night and declined to see medical. The passenger showed up right before lunch time and wanted to talk about his tooth problem, which quickly ate into lunchtime. But, it is a customer service job, so I answered everything I could and tried my best to be helpful.

I skipped lunch up on the Lido deck because we were pulling into San Juan at 1300 and I, along with all newly embarked crew, were supposed to meet up with Puerto Rico customs agents on the 2nd deck. So, I had to change out of scrubs and into the monkey suit and hang out so that a guy could look at my passport, look at me and say have a nice day. Only took about 40 minutes. I got to talk to some of the musicians I met at the hotel and around the ship. Nice folks.

So, I ended up snatching a bite to eat down in the PO mess, which is not of the same quality as they feed the passengers. More like Phillipino and Indonesian comfort foods. Still pretty tasty, just not as healthy for you. We pulled in to port and I took the stairs up to the 11th deck to check out the city. San Juan is pretty from here. We moor right across from an old stone fort. Pretty neat really. The Nieuw Amsterdam is here along with a Norwegian Cruise line and a Carnival cruise line. I snapped some pictures and headed back down. Getting tired of those stairs, but I made a commitment. I am averaging 40 flights of stairs a day.

Then it was back down stairs so I could open the clinic by 1400. I am supposed to run the clinic until 1600 and then be off for two hours to rest because I will be on call all night. It stayed pretty slow until the ship's captain walked in. He just needed some OTC medication, no biggie. Then the phone rang. It was the front desk telling me there was a 911 call up on the 4th deck. I called my backup to come take over the clinic, grabbed teh cabin bag and closed the doors on my way out. I checked the elevators as I passed, but they were all up on 8 or above, so it was the stairs. 5 flights at a sprint and then a run all the way to the back of the ship.

Chest pain.

We took him back to the clinic and started the workup. Potential heart attack. The guest physician was on shore, enjoying the day. Luckily the crew physician was there and we got busy. All of the normal ER protocols were done, although some of our testing on board is limited. I think back to the door to balloon time goal of 90 minutes in some of the heart care ERs and laugh. It took all day figuring out what to do with this guy and where he was going to go. Everything from med evac jets, to several local hospitals, to 24 hour ICU care on the ship all the way home was considered. Eventually, after around 5 hours, he was sent ashore to a local hospital in San Juan.

All of this, on my first day as 1st call. Now I get to try to get some sleep while waiting for the phone to ring.

All of this leads me to the suggestion that, should you go on a trip like this, get the travel insurance. I heard a story about a ship getting turned around to medically evacuate a patient back to the port they just left. IT was $70k for the fuel alone, which was charged to the patient. Above all the other medical cost onboard. Get the insurance. Some air services won't take an uninsured passenger without cash up front. Unless you can produce $10,000 or more for a medical charter flight, get the insurance.

That's all for now. Time to try for some sleep.


2311

Just as I was about to turn out the lights, the phone rings. It was the ships doctor asking if I wanted to go to the bow to watch the sail away. We ran up in time to watch the pastel colored lights of the city shrouded in fog as we passed by in the night. The old Fort on the hill, the doctor called it Moro, was beautiful. But, the fog turned to rain and we went back inside. There are parts of this which are awesome.