# Cruise Ship Doctors **URL:** \ **Category:** Factual Questions\ **Created:** [September 18, 2014, 5:37pm UTC](https://boards.straightdope.com/t/cruise-ship-doctors/698846 "2014-09-18T17:37:04Z")\ **Posts on this page:** 13\ **Page:** 3
**Author:** ![Siam\_Sam](https://avatars.discourse-cdn.com/v4/letter/s/d78d45/32.png) [@Siam\_Sam](https://boards.straightdope.com/u/Siam_Sam)\ **Post date:** [September 21, 2014, 2:03am UTC](https://boards.straightdope.com/t/cruise-ship-doctors/698846/41 "2014-09-21T02:03:23Z")
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**Author:** ![Chief\_Pedant](https://avatars.discourse-cdn.com/v4/letter/c/a6a055/32.png) [@Chief\_Pedant](https://boards.straightdope.com/u/Chief_Pedant)\ **Post date:** [September 21, 2014, 11:01am UTC](https://boards.straightdope.com/t/cruise-ship-doctors/698846/42 "2014-09-21T11:01:47Z")
To cover the entire gamut of which surgery might be considered so emergent that it should be done with the typical cruise ship staff and facilities is not possible, so let me just tackle the “appendicitis” one. An operation for a presumptive appendicitis on a cruise ship would really be an exploratory operation looking for the cause of the patient’s presentation, with a presumptive diagnosis of appendicitis. While it is possible in theory to save a patient’s life if the diagnosis ends up being exactly what you thought it was, and if you just happened to be able to do the procedure, and if you just happened to have appropriate short term anesthetics, the risk/benefit is essentially undefinable. Under that circumstance, a cruise ship physician in the modern world is not going to open an abdomen hoping to find exactly what she thought she’d find. One can imagine a circumstance where an experienced surgeon (who just happened to be hobbying as a cruise ship physician, or who got wind of the case as a fellow cruiser and was OK with cowboying) would be willing to tackle it, but then again, one could imagine almost anything. Odds of the Cruise Line allowing it with the staff and facilities of the “average cruise ship” are trivial. In practice, the cruise ship physician would dial in to the home office, get some expert clinical (and legal) advice, and leave the abdomen unopened. ---
**Author:** ![Chief\_Pedant](https://avatars.discourse-cdn.com/v4/letter/c/a6a055/32.png) [@Chief\_Pedant](https://boards.straightdope.com/u/Chief_Pedant)\ **Post date:** [September 21, 2014, 11:11am UTC](https://boards.straightdope.com/t/cruise-ship-doctors/698846/43 "2014-09-21T11:11:00Z")
> [@Qadgop\_the\_Mercotan](#): > > I’d rather use a ton of local anesthetic, infiltrating as I go, than try to use ethanol as a general anesthetic. You know the drill, QtM: It’s guaranteed to be retrocecal, retroperitoneal, and anatomically anomalied as soon as you attempt an unpunished Good Deed. Let the retrospectoscoposcopists warm up now. ---
**Author:** ![rbroome](https://avatars.discourse-cdn.com/v4/letter/r/838e76/32.png) [@rbroome](https://boards.straightdope.com/u/rbroome)\ **Post date:** [September 23, 2014, 12:53am UTC](https://boards.straightdope.com/t/cruise-ship-doctors/698846/44 "2014-09-23T00:53:27Z")
> [@Chief\_Pedant](#): > > To cover the entire gamut of which surgery might be considered so emergent that it should be done with the typical cruise ship staff and facilities is not possible, so let me just tackle the “appendicitis” one. > > An operation for a presumptive appendicitis on a cruise ship would really be an exploratory operation looking for the cause of the patient’s presentation, with a presumptive diagnosis of appendicitis. > > While it is possible in theory to save a patient’s life if the diagnosis ends up being exactly what you thought it was, and if you just happened to be able to do the procedure, and if you just happened to have appropriate short term anesthetics, the risk/benefit is essentially undefinable. Under that circumstance, a cruise ship physician in the modern world is not going to open an abdomen hoping to find exactly what she thought she’d find. > > One can imagine a circumstance where an experienced surgeon (who just happened to be hobbying as a cruise ship physician, or who got wind of the case as a fellow cruiser and was OK with cowboying) would be willing to tackle it, but then again, one could imagine almost anything. Odds of the Cruise Line allowing it with the staff and facilities of the “average cruise ship” are trivial. > > In practice, the cruise ship physician would dial in to the home office, get some expert clinical (and legal) advice, and leave the abdomen unopened. I get that appendicitis isn’t going to rise to the point of requiring emergency surgery on a ship. But accidents happen-especially to staff. Someone falls down a ladder, gets a hand caught in the meat grinder, etc. Aren’t there at least a few plausible accidents that can happen on board that would require prompt surgery? Or is my television understanding of surgery so bad that only a specially trained doctor (a surgeon) would consider doing any surgery? I thought that all MDs are technically qualified to perform surgery-though in the real world only surgeons get sufficient experience to do so. So, aren’t there some injuries that would require surgery and can a staff doctor of the type that might serve on a cruise ship perform such surgeries? ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 23, 2014, 1:02am UTC](https://boards.straightdope.com/t/cruise-ship-doctors/698846/45 "2014-09-23T01:02:35Z")
> [@rbroome](#): > > aren’t there some injuries that would require surgery and can a staff doctor of the type that might serve on a cruise ship perform such surgeries? See post #14 where I discuss minor surgeries. In an emergency, sewing off a bleeding artery from trauma can be done also. ---
**Author:** ![Chief\_Pedant](https://avatars.discourse-cdn.com/v4/letter/c/a6a055/32.png) [@Chief\_Pedant](https://boards.straightdope.com/u/Chief_Pedant)\ **Post date:** [September 23, 2014, 2:40am UTC](https://boards.straightdope.com/t/cruise-ship-doctors/698846/46 "2014-09-23T02:40:41Z")
> [@rbroome](#): > > I get that appendicitis isn’t going to rise to the point of requiring emergency surgery on a ship. But accidents happen-especially to staff. Someone falls down a ladder, gets a hand caught in the meat grinder, etc. Aren’t there at least a few plausible accidents that can happen on board that would require prompt surgery? > Or is my television understanding of surgery so bad that only a specially trained doctor (a surgeon) would consider doing any surgery? I thought that all MDs are technically qualified to perform surgery-though in the real world only surgeons get sufficient experience to do so. So, aren’t there some injuries that would require surgery and can a staff doctor of the type that might serve on a cruise ship perform such surgeries? Trauma is probably the easiest and lowest risk\* emergency procedure if the patient is in trouble from an acute injury. I might not open a belly for a blunt injury unless the patient was almost completely dead, but I’d sure dig around in an open belly. Amputations and the like are pretty easy to do stabilizing “surgeries” for, yeah. \*Low risk meaning low risk of doing more harm than good, b/c the patient is already in bad shape. ---
**Author:** ![rbroome](https://avatars.discourse-cdn.com/v4/letter/r/838e76/32.png) [@rbroome](https://boards.straightdope.com/u/rbroome)\ **Post date:** [September 23, 2014, 12:53pm UTC](https://boards.straightdope.com/t/cruise-ship-doctors/698846/47 "2014-09-23T12:53:02Z")
> [@Chief\_Pedant](#): > > Trauma is probably the easiest and lowest risk\* emergency procedure if the patient is in trouble from an acute injury. I might not open a belly for a blunt injury unless the patient was almost completely dead, but I’d sure dig around in an open belly. Amputations and the like are pretty easy to do stabilizing “surgeries” for, yeah. > > \*Low risk meaning low risk of doing more harm than good, b/c the patient is already in bad shape. Thanks for both replies! The appropriate calculation is risk vs benefit. If the patient is already at high risk, then more immediate actions are justified. Making that risk/benefit decision is probably why the docs get the “big bucks” or at least the big responsibility. 🙂 ---
**Author:** ![Ann\_Hedonia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ann_hedonia/32/319_2.png) [@Ann\_Hedonia](https://boards.straightdope.com/u/Ann_Hedonia)\ **Post date:** [September 23, 2014, 1:28pm UTC](https://boards.straightdope.com/t/cruise-ship-doctors/698846/48 "2014-09-23T13:28:14Z")
On my last cruise a friend of mine broke a filling in one of her teeth and was very pleased to find out that the medical staff was trained to perform minor dental procedures. A little exploration of the cruise ship message boards seems to lead me to the conclusion that they generally don’t perform appendectomies on board. There were a couple of reports of airlifting passengers off the ship but for the most part the ships just hightailed it to the nearest port. Cruise ships spend a lot of time “cruising” and port time is expensive. While the schedule may allow, for example, 15 hours at sea between two ports…that can often be cut down to a couple of hours out of necessity. Not always, as others have mentioned there are some itineraries that go well out to sea but probably 90% of the cruise line routes stay pretty close to civilization ---
**Author:** ![Dahu](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dahu/32/3416_2.png) [@Dahu](https://boards.straightdope.com/u/Dahu)\ **Post date:** [September 23, 2014, 7:54pm UTC](https://boards.straightdope.com/t/cruise-ship-doctors/698846/49 "2014-09-23T19:54:26Z")
I worked on a cruise ship for a summer. I don’t know whether our ship’s doctor would have been able to take out an appendix, but given the amount of time she spent in the crew bar I’m glad I didn’t have to find out. ---
**Author:** ![Quartz](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/quartz/32/267_2.png) [@Quartz](https://boards.straightdope.com/u/Quartz)\ **Post date:** [September 23, 2014, 8:39pm UTC](https://boards.straightdope.com/t/cruise-ship-doctors/698846/50 "2014-09-23T20:39:56Z")
It’s a little old, but in Chris Parry’s Down South, which is about the Falklands War, he mentions a ship’s doctor (Royal Navy) who was reputed to be rather keen on appendectomies. ---
**Author:** ![purplehorseshoe](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/purplehorseshoe/32/2996_2.png) [@purplehorseshoe](https://boards.straightdope.com/u/purplehorseshoe)\ **Post date:** [September 23, 2014, 9:34pm UTC](https://boards.straightdope.com/t/cruise-ship-doctors/698846/51 "2014-09-23T21:34:29Z")
> [@Qadgop\_the\_Mercotan](#): > > Ethanol makes a piss-poor anesthetic. Too little and there’s screaming agony, too much and the patient expires, and the difference between too little and too much can be measured in milliliters sometimes. NOT an ideal way to do surgery at all. > > I’d rather use a ton of local anesthetic, infiltrating as I go, than try to use ethanol as a general anesthetic. You’re no fun. ☹ > [@drachillix](#): > > \ Me too! 😃 > [@Ranger\_Jeff](#): > > I don’t care to go into the details now, but from one of my experiences in the Coast Guard, I assert that women who are more than 7 months pregnant have no business going on cruises. Betcha I can figure out the details myself … ---
**Author:** ![Dr.Woo](https://avatars.discourse-cdn.com/v4/letter/d/7c8e57/32.png) [@Dr.Woo](https://boards.straightdope.com/u/Dr.Woo)\ **Post date:** [September 23, 2014, 11:21pm UTC](https://boards.straightdope.com/t/cruise-ship-doctors/698846/52 "2014-09-23T23:21:55Z")
> [@Qadgop\_the\_Mercotan](#): > > Ethanol makes a piss-poor anesthetic. Too little and there’s screaming agony, too much and the patient expires, and the difference between too little and too much can be measured in milliliters sometimes. NOT an ideal way to do surgery at all. > > I’d rather use a ton of local anesthetic, infiltrating as I go, than try to use ethanol as a general anesthetic. There’s a legend in my family that my great uncle Harvey insisted on a local anesthetic for his appendectomy so that he could direct the doctor during the incision so he didn’t sever any abdominal muscles. :eek: Like I said, legend. ---
**Author:** ![BrotherCadfael](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@BrotherCadfael](https://boards.straightdope.com/u/BrotherCadfael)\ **Post date:** [September 23, 2014, 11:44pm UTC](https://boards.straightdope.com/t/cruise-ship-doctors/698846/53 "2014-09-23T23:44:28Z")
Question: How experienced and competent would a typical cruise ship doctor be? [Previous page](https://boards.straightdope.com/t/cruise-ship-doctors/698846.md?page=2)