Queen Mary 2 has been called a “city at sea.” Just as in any city, people get sick. In charge of taking care of both the medical needs of both passengers and crew is Dr. Albert “Bertie” Van der Merwe. QM2's Medical Centre is located midships on the port side of Deck 1. “This is the biggest medical facility of the Cunard ships. We have 10 beds aboard. Each one is an ICU [Intensive Care Unit] bed. We also have two isolation beds.”
“The staff consists of two doctors, four nurses and one medical tech. Mostly, they pick [the doctors] from either an emergency background or anesthetics, You have to have a bit of ITU experience. The nursing staff mostly come from either an ER, ITU or antithesis background as well. We are responsible for all the medical care and the in-patient care that you would require onboard here.”
“We can treat most of the conditions that you will find on land [like at] a primary level hospital. Obviously, we don't have big technical equipment like CT scanners, MRIs and things like that. But we do have ventilators, defibrillators, ECGs, infusion pumps and things like that, which you will find in a critical care setting.”
Of course, equipment is only one aspect of medical care. Medicines are also crucial. “We try and have one or two drugs from a particular drug group or drug family. So win e will have one or two from one group of blood pressure medications and one or two from another group of blood pressure medications. One or two drugs for treating urinary tract infections. Various kinds of antibiotics because infections are a common thing. We try and cover all our bases. But specialized drugs, you won't find here. We won't carry things like chemotherapy drugs.”
Queen Mary 2's immediate predecessor, Queen Elizabeth 2, was equipped with an operating room. However advances in medical science have made such a permanent facility unnecessary on QM2. “There is a room that can be converted into one. But we don't do say an appendectomy, we don't go in and take out the appendix anymore. We stabilize - - high doses of antibiotics, pain killers - - we treat the symptoms and then we get you to a shoreside facility.”
“It is very difficult to operate on someone while at sea. You might be in rough weather and your patient may be moving away from you while you are trying to cut into them. And we don't carry a stockpile of emergency blood. So even though I am qualified to do an appendectomy, we can't do that because if they start bleeding there is no emergency blood supply easily accessible that we can give to someone.”
“Because QM2 does transatlantic [crossings] we can't always get someone to a shoreside facility there and then. We sometimes have to wait a couple of days until we reach the point where helicopters or Coast Guard vessels can come out and transport them to a shoreside facility. That does play on your mind a little bit that you know that you have an extended responsibility.”
Sometimes circumstances prohibit waiting until the ship comes within helicopter range during the normal course of a voyage and the ship has to change course and/or increase speed in order to do a medical evacuation sooner. “It is usually a life or limb time [sensitive] situation where the person in question's life is in danger or [he or she] will lose a body part or will suffer serious harm. Then we go in and divert the ship and get them into a shore side facility.” (See separate article on medical evacuations on QM2)
The ship can also divert from its course to help people in need on other vessels. “If there is a humanitarian mission that is on our course, then we can divert a little bit and provide them with [such things as] food, tea, a satellite phone, medical supplies. If there is need, we will try and lend a hand."
Above: The Medical Centre reception area.
Below: An examination room
One ailment that is not usually encountered on land is seasickness. “It is less common on here than on other ships because we are so stable. We still do get them - - people who come in different shades of green, feeling rotten. We treat them.”
Another ailment that is quite prevalent on land but which gets more notoriety when there is an outbreak on a passenger ship is the norovirus. “We are very geared towards sanitation and we are very strict when it comes to sanitation. Organizations like the CDC [U.S. Center for Disease Control] and the World Health Organization monitor us very closely to see that we actually adhere to these standards.”
“If we think there is an outbreak, if our numbers increase, we step up our sanitation level.” This decreases the chances of the disease spreading. “It is a lot of work and a lot of people to take care of for a small staff. Then we can call in - - I almost want to say reinforcements from ashore - - extra people to help us from other ships, do all of the paperwork, take care of the people and treat them, get things under control.”
Guests who come down with the ailment are treated. “If we can go to you, we will go to you in your cabin to prevent cross-contamination with other areas. You are isolated to your cabin for a certain amount of time depending upon where in the voyage we are and what sanitation level we are on. We have various medications to stop the diarrhea, the cramping, nausea, vomiting [and for] electrolyte replacement. We treat you and we follow up with you twice a day to see how you are doing and whether your symptoms are improving.”
The work does not end when the infected passenger leaves the ship. “The cabin is disinfected. We have a special team of deck stewards that is trained in that duty and they go around and they do, I almost want to call it, a deep clean. They sanitize the cabin. We keep it closed off for a certain amount of time before we let people go in there again.”
The cost of medical care on QM2 is not included in the fare for the voyage. “If you receive treatment, consultation, medication while onboard, everything gets added onto your shipboard account. You settle that at the end and we give you an itemized statement with the date, the stamp, the diagnosis, the time on it and you submit that to your insurance company and they should settle it for you. You submit it to the carrier and they take it from there.”
Practice on QM2 also has a unique social side. The doctors and nurses - - identifiable by the bright red between the gold stripes on their uniforms - - attend passenger receptions in the ship's ballroom and occasionally host a table in the main dining room.
“It is the hotel table basically. Every formal night it gets hosted by a different member of the hotel team or by us. So it might be the hotel manager, executive housekeeper, purser, me or whoever is available. We try and host it at least once every voyage. It is part of what makes Cunard, Cunard – - that interaction.”
Cruise ship interview - - Cunard Line - - Queen Mary 2 - - Dr. Albert Van der Merwe