A New Cruise, A New Crowd!

After completing our four week cruise of Australia, we are now getting ready to set sail for the Fijian Islands and French Polynesia. 

As old passengers disembark the ship, the gears are set in motion to clean rooms, re-stock ship supplies, and arrange the new entertainment programme.  

The new passengers arrive. 

These ones don’t have walking sticks and hearing aids.  When they’re asked how they’d like their steak prepared, they don’t say “blended”. 

Oh yes, these passengers are much younger than I’ve been accustomed to. They’ve also brought their little joeys with them. 

A quick walk across the top deck witnesses lots of children running barefoot across wet floors and mile-long queues at the ice-cream parlour.

Sure enough, for the next two weeks my clinic sees pneumonia and angina exchanged for broken ankles and severe cases of brain freeze.

Alder hey prepared me well for this cruise. However, I challenge anyone to tell an 8 year old girl whose broken her ankle that she can’t go swimming with her plaster cast on... My ears bled with the screams!!!

One of our first stops on the cruise was to Dravuni Island. A small Fijian island with no medical facilities, and whose local population live primarily off coconuts and locally caught white fish.

I’m up at six o’clock in the morning throwing medical supplies and resuscitation equipment in the tender boat to be taken across to the island so that we can create a shoreside medical party and provide medical advice and treatment in case of beach emergencies... cuts, scrapes and jellyfish stings.

Nine hours and ten coconuts later we finally pack up camp and head back to the ship.

The stress of lemming-like children and acute coconut poisoning leave’s me in desperate need of spa treatment.

I speak to Ryan in the spa who sorts me out with my first ever acupuncture experience.

15 minutes later I’m sleeping in a darkened room with needles hanging out of my wrists, ankles and one between my eyes.  Incredible Experience!!!!

The rest of the cruise passes by pretty quickly with no major problems. 

However now on our way around New Zealand I can’t help but think I should have sacrificed a few more T-shirts for jumpers...

The Dark Side.

I’ve been on-call since early yesterday morning. The clinics have been long and cumbersome, patients have arrived after hours with a flurry of different medical complaints, and without fail the bleep goes off in the night with Breathless Patients who have less Lung Volume than a Chiwawa!!!

By the late evening I’m dead to the world, but coerced (as usual) to go to the Crew Disco where there’s Bingo, Horse Racing and Dancing running into the early hours...

By 1am I make a graceful departure. There’s absolutely nothing at this point that’s going to stop me going to bed!  As I walk back to my cabin I’m reminded by the fact that in 7 hours I finish my 48 hour on-call spell & I secretly hope for a peaceful resolution to tonight...

Sat on my bed, my trousers hit my ankles when the bleep goes off, “Hi Ryan, sorry mate but can you quickly come up to Dolphin Deck. Ooh and bring the Stryker Trolley and Oxygen with you...”

When I enter the room, with matchsticks keeping my eyes open and a Red Bull in my hand, nothing can wake me up more than the site witnessed before me...

A 70 year old woman tripods over the edge of the bed trying to sucking in as much air as she can muster & looking as White as my Uniform.  She's staring at me with a look of ‘Impending Doom’, and she's without a doubt one of the sickest patient I've seen!

The Stryker Trolley doesn’t fit into the awkwardly laid out cabin, and with time against us I tell Simon tell help me Bundle her into a Wheelchair and run her downstairs where we can actually do something!!! Meanwhile I tell her very anxious-looking husband to collect all of her medications and meet us down in the medical centre.

Straight into the ICU bed, Simon runs through 15 Litres of Oxygen, and sticks on the Cardiac Monitor while I get to work establishing an Intravenous Access to give her Drugs and Fluids... But I know deep down what she needs is Blood, and she needs it now!!!

I tell Simon to call out a Code Alpha and get the whole team here now. After speaking to the Captain up on the Bridge an Announcement goes up across the Ship, “Attention Passengers, this is an Urgent Announcement. We have a Medical Emergency onboard the Ship. Can Passengers who are Blood Group O Negative who are willing to donate blood please head down to the Medical Centre as soon as possible. Thank You.”

My Patient’s Heart Rate is 120 beats/minute & she’s breathing hard. I try my best to reassure her that she’ll feel better after a blood transfusion however all she keeps saying is, “Oh I’m not well, I’m Really Not Well!!!...”, and the look on her husbands face is of no comfort to me...

Five passengers come down and the team goes into autopilot mode with two nurses doing the initial screening questions, one nurse doing the HIV and Hep B testing and Me & Lennie taking pints of blood from the donors.

As my donor runs off her donation I walk across the Nurses station to see how everyone else is getting on...

I notice the cardiac monitor is reading a Heart Rate of 50 beats/minute. Shit! I run in and she Arrests in front of me. I shout for the team and we get to work with CPR for a couple of Cycles. We get her heart beating only for it to stop once again. I intubate her while the Senior Nurse hooks up an Adrenaline Infusion and Lennie runs through the Donated Blood ASAP. 

After a total of 3 Cardiac Arrests we finally have her stable.  I speak to her husband who say’s she’s been unwell for a while, but is still clearly upset when I explain her poor prognosis and tell him to hope for the best, but to prepare for the worst.

Me and Simon are up all night watching a Cardiac Monitor. The others go back to bed. We’ve still got Clinic in the morning. After 5 Pints of Blood, Simon runs a Haemoglobin Check through the machine... She comes back as 3.3g/dL (Normal Range for a woman 12-14)

At 11am the Ambulance finally turns up to take our intubated patient and her husband to the nearest hospital with an ICU bed. The team go up to Horizon Court for a well deserved Full English Breakfast and to reflect on our hard efforts.  

After being awake for 28 hours straight I finally head to bed to catch a few hours sleep before starting my afternoon clinic at 4:30pm.  Turns out this job has it’s Dark Side after all!!!