"Here's a cheer for the
Doctor, so ready to please;
He will sew up your head, or
your arteries squeeze,
And through the long voyage
he'll treat, with skill,
The sick and the sad - will
that man of the pill."
From a poem, written by
Mr Ollivant, while on board the P&O ss Sutlej, in 1891
A Ship's Doctor, Ship's Surgeon
or Ship's Medical Officer, is the person responsible
for the health of the people aboard a ship whilst at sea. The term 'ship's
doctor' or 'ship's surgeon' appears often in reference to Royal Navy in the
age of sail. These men, like other physicians, often did
not have much in the way of formal medical training. They cared for the members of the ship's
crew,
dealing with wounds from battle, disease and the other medical problems
which plagued the Navy, wherever it served.
"I
was as busy as a journey man gravedigger; sometimes in the cabin, then in
the steerage, and as often in the forecastle. The sickness prevailed for the
space of twelve weeks and before we anchored we had no less than 24 deaths,
mostly of Cholera. The Captain took it himself the very night we anchored,
30 miles down the river where we had to ride quarantine for a fortnight, and
many was the prayer put up that he might meet the fate of the poor carpenter
- but he recovered. With regard to the Captain's conduct I have nothing to
say, as he was bound to provide for me, and I took care that he treated me
with civility, but it was well he was not tossed overboard by the
passengers, there was a general scarcity of sea store. I saw a shilling
offered for one pound of meal and a penny for a noggin of dirty water say,
ten weeks old. The women of course screamed (that's natural) the Captain's
countenance looked blue, the sailors behaved like jolly tars and most of the
passengers assisted. There was one however that I could not but remark when
the storm was at the worst. He was upon his knees, with his hands clasped
round the mast beating his breast and vociferating with religious fear,
'Hail Mary! Sweet Mary! Mother of God save us!' I gave him a kick in the
posterior and ordered him up to assist, told him there was no time to be
lost in praying upon such an occasion. He turned round with a face! - Shade
of Hogarth whether art thou fled! - a face that would have made a complete
frontispiece to the book of lamentation, and sung out 'Sweet Mary Save us!'
William Campbell, Ship's Surgeon
"The Surgeon must remember that he is
neither a Public Health Officer nor a private practitioner. He is an Officer of
the Company. His duty, in addition to safeguarding the health of passengers and
crew, is to add his contribution to the earnings of the ship by willingly making
available to all the Company's passengers at all times the services of his staff
and the facilities of his department. He can thus make of it the considerable
asset for goodwill which a human and punctilious medical service can be. He
must help passengers to travel—not to stay ashore. His relations with shore
authorities are equally important, and must be such as will contribute to the
fullest extent to the trouble-free performance of the ship's voyage.The Surgeon
is thus not only a professional man, but a link between the Company and its
supporters on the one hand and public authorities on the other, capable of
creating or losing a deal of goodwill.
A booklet is issued to the Surgeon on
joining, wherein he will find detailed instructions on his duties and
responsibilities, but the following must be rated as of first importance :—
Close
attention with the Chief Officer to the purification of water, in accordance
with the Company's instructions.
Close
attention to the vaccination state of all crew, which must at all times be
maintained at a two-yearly level.
Close
attention, in conjunction with the Purser, to general hygiene, more especially
directed towards food handlers and the spaces in which food is kept.
He will visit the Commander each day at noon so as
to keep him generally informed on matters of health. He will bear in mind that
if a patient travelling alone is seriously ill, the Commander must be informed
to enable him to send an appropriate message to the next of kin."
From: Regulations
Instructions and Advice for Officers in the service of the Peninsular & Oriental
Steam Navigation Company~1959
A good sense of humour was a
pre-requisite....
Imagine the comfort of a luxurious hotel, fresh
sea air, and waking up each morning to a different shoreline. Add
unpredictability, adventure, and scope to develop professionally—what do you
have? A career in maritime medicine and an esteemed position as a ship's Surgeon.
“It takes a definite personality to do the job. Someone who
likes challenges, has the ability to mix well with people from all backgrounds,
and is flexible. The job is likely to appeal to someone who really enjoys
medicine. When you are on board, you are on-call 24 hours a
day, seven days a week.You really need to be a Jack of all trades. In hospital medicine, you
more or less practice within a particular field, such as orthopaedics or
cardiology. On board ship, you diagnose and treat whatever comes your way. You don't
transfer anybody off to an inferior standard of care and therefore you often
treat someone from start to finish, which is incredibly rewarding. You're a
doctor in the true sense of the word. As the senior Surgeon, in addition to clinical duties, you are also concerned
with other aspects of ship life, such as management, health and safety, hygiene,
and public health. Ship's Surgeons are
required to work within a relatively small
medical team who provide general
and emergency care for several hundred people, of all
nationalities. The
ships’ medical staffmanage a wide variety of emergency medicine and general practice
cases within modern, well equipped sick bays. Clinical cases range from common
general practice ailments and occupational health issues to emergencies cases such as
acute coronary syndromes, anaphylaxis, trauma, orthopaedic injuries and surgical cases."
Dr. James Little
James Little enrolled as a student of
the Royal College of Surgeons in Ireland, becoming a Licentiate of the College
in 1856. On March 20th 1857, he left Southampton on the 'Vera', bound
for Calcutta where he had accepted a post as Surgeon to the Peninsular and
Oriental Steam Navigation Company, a post he would retain for 3 years. In his
diary Dr Little records his experience as a ship's surgeon and also the long
periods of unemployment when he lived at the Officers' Club in Calcutta.
On 16th February 1858, on one of his early voyages as
a P&O ship's surgeon, Dr Little's ship the 'Ava' was shipwrecked on rocks off
Pigeon Island
12 miles
from the cost of Ceylon. In his diary, written in retrospect some months later,
he describes in detail the experience.
Dr Little's diary is held at
the Royal College of Physicians of Ireland Heritage Centre,
Ref: TPCK/6/5/10
The ship having become stranded on the
rocks, the passengers were evacuated into lifeboats, in case the ship should
break up in the night. Dr Little and his charges spent a cold and
sleepless night. Before the evacuation, Dr Little had bravely risked venturing below
decks, to rescue his doctor's bag and diploma case, the essential tools of his
trade. In the morning, the boats were able to make the short journey to the
shore, and all the passengers were safely landed. After
spending the night in the open boats, the passengers were rescued and taken to
Trincomalee.
All the passengers and crew were saved although many lost all
their possessions. Dr Little and some of the ship's crew spent the next
few weeks living in a tent on the beach where they had landed, while the crew
attempted to rescue all they could from the wreck of their ship, which had split in
half and was slowly sinking.
Most of the cargo of specie and a replacement shaft for
the SS Alma, disabled at Aden, were recovered by divers from the Forte
Class Royal Navy screw frigate,
HMS Chesapeake.
At the
time of her sinking, the Ava, under the command of Captain Kirton, was sailing from
Calcutta to Suez with the mail, refugees from the Indian Mutiny including Julia Inglis, the wife of Colonel Inglis who commanded the British troops during the
Siege of Lucknow, and a large quantity of treasure. Although no lives were lost,
some of the treasure and the diaries of Colonel Inglis were never recovered.
Lady Inglis later published The Siege of Lucknow- A Diary (1892) which
ends with the story of the shipwreck of the Ava.
"We
made good progress all that day,Tuesday. It was eight o'clock, a beautiful
night, and we were running along at a great pace. Finding it very hot in the
saloon after tea, we had come on deck, and were sitting on the bulwarks behind
the wheel. Suddenly we were startled by a loud grating sound something like the
letting down of an anchor, and just then saw a large rock close to us. I said,
'We must have touched that.' Several men rushed to the wheel, and then again we
heard the same sound, only louder, and a quivering of the whole ship. She then
remained stationary, only heaving backwards and forwards. The steamer had struck
nearly in the centre; her fore part was sunk very deep, and we watched her with
the greatest anxiety to see if the water gained on her, fearing for the safety
of those still on board, and also dreading that if she sank our boats would all
be swamped. We rowed backwards and forwards between the rocks and the steamer
all night, and a weary time it was. Guns were fired, and rockets sent up; but
our signals of distress were not answered, though a light we saw at some
distance on the shore made us hopeful that assistance was at hand. The masts
were cut down to lighten the ship, and the crash as they fell into the water
sounded very fearful. "
The subsequent
Board of Trade enquiry
found that Captain Kirton had omitted to take proper precautions; instead of
continuing the ship's course at full speed for two hours after darkness fell, he
ought to have slackened speed, to have stopped the ship and hove to. Had he
adopted these proper and prudent measures, the calamity which followed would
have been averted. The
Board of Trade, in consequence, directed that his Masters certificate of
competency was to be suspended for six months.
Dr. Little was later to become the chief physician at the
Adelaide Hospital in
Dublin and
Regius Professor of Physic
at the
University of Dublin.
Dr. James Archibald McIlroy
Born in Ulster, Ireland, his parents moved to
England and settled at Kings Norton, Birmingham. His father was a shop keeper
and sent James to a nearby grammar
school, after which James took an office job, but soon decided this was not
what he wanted. He enrolled at Birmingham University for a
medical degree, and on graduation, took up position as House Surgeon at the Queen
Elizabeth Hospital, Birmingham. Again it seems that the settled life didn't suit
Doctor McIlroy, and so he decided to put his medical qualification to good use,
while seeing other parts of the world. He practised for many years in the Middle and
Far East, in Egypt and Japan and in and around the East Indies, as ship's Surgeon
with the P&O Company. In 1914, he was back in England and heard about Ernest Shackleton's expedition from a friend at his London club, Shackleton already had
one surgeon on board Endurance, and was looking for another.
Ando so it was that
Dr. James Archibald McIlroy,
joined Endurance, and took part in the ill-fated
Imperial Trans-Antarctica Expedition 1914-17.
McIlroy was suffering from malaria at the time of his interview, contracted in
the Far East, causing him to shake constantly while talking to Shackleton - but
was taken on - he had been the only applicant for the position of second
surgeon, and so was given the job. He also had the job of driving a team of sled
dogs and caring for the expedition's dogs. Lionel Greenstreet, the First Officer
on the Endurance , described McIlroy as being : “Of slight build, handsome in a
vaguely Mephistophelian way, and a sardonic, sarcastic blighter!”.
It was McIlroy who carried
out the amputation of ship's steward Percy Blackborrow's gangrenous toes, whilst
they were stranded on Elephant Island. With Leonard Hussey, McIlroy contributed
an appendix on meteorology to Frank Wild's account of the Quest expedition, 'Shackleton's
Last Voyage'.
During World War 1, McIlroy
saw action in France and was invalided out of the army after being badly wounded
at Ypres. When the war ended, he joined the P&O, eventually becoming the
Company's Chief Surgeon. In 1922 he was invited to join Shackleton's
'Quest Expedition', as Surgeon, and agreed. His original intention was to stay
with the expedition only as far as Madeira. However he must have once again
fallen under the spell of Shackleton, 'The Boss', as he changed his mind, and
continued South.
After returning home, he returned to the P&O again, as Ship's Surgeon, and when
they eventually retired him, he soon came out of retirement - and almost lost
his life at sea, on 9th October 1942 when the Oronsay , was torpedoed off the
coast of West Africa. Most of the ships 266 compliment were soon picked up by a
nearby British warship, but others, including McIlroy ,were adrift in an open
boat for five days before being rescued by the French ship Dumont d’Urville,
which landed them at Dakar in Senegal.
James McIlroy never married and for much of his life carried on his role of
ships surgeon. It is known that as late as 1957, when he was aged around 78,
he was still a ship's surgeon. He died at the age of 88, in Surrey. The
whereabouts of his Polar Medal and other awards are unknown.
Dr Peter Tate
"In 1971 I was
Surgeon on board the P&O liner Orcades. On Christmas morning early
the phone rang, could I come and look at someone with weird rash? The
patient was Goan, and was one of a batch of 20 or so that had been flown
in to Singapore some 5 days ago, to relieve others due leave. His problem was
spots and slight fever. They were on the young man's arms and chest, raised
from the surface of the skin, with a central dimple, and in medical jargon 'umbilicated'.
This was big jump from treating seasickness!
All the internal red lights
went on at once. The differential diagnosis was both mundane and terrifying.
Chickenpox was favourite, followed by insect bites, or a sort of skin
infection commonly called impetigo, but and it was a very big but, the spots
themselves matched the classical textbook description of Smallpox. Was there
Smallpox where he came from? It was still very early in the morning, about
7am, and the ship was just setting out on its to Hayman Island, a top tourist spot on the Great Barrier Reef, a good 2 days sailing away. Now smallpox anywhere is a terror,
but on a
passenger liner: it is a disaster of Hollywood proportions. Smallpox is one
of the most infectious diseases we know of, it also has a truly frightening
mortality rate, varying from nearly 100% to at best, 20-30%, depending on the
strain of the virus and the susceptibility of the community it struck. In
recent years we have become accustomed to think of it as a weapon of terrorism
- since
the disease itself was wiped out by the WHO's vaccination programme, the
last non laboratory case being in the early eighties. Even at the time of
which I write, it was rare, and confined to poor populations in hot
countries.
The
patient needed isolating. We were lucky in that respect, the ship's hospital
was situated over the propellers on C deck aft. There was a small self
contained room there designed for just this purpose, known as the Brig, as
it also doubled as a cell should the need for restraint arise in aggressive
crew or passenger.
The
ship radioed the Darwin Port Health, who said we could not go back,
and suggested talking to the Authorities in Brisbane. Eventually the Captain
spoke briefly and I was handed the radio to talk to the Australian Chief
Medical Officer. He was a cross sounding man with no discernable sense of
humour, not that the situation was funny. He insisted that all on board should be
inspected 24 hourly, but 12 hourly within 48 hours of landfall, and that all
on board, without a valid certificate, must be vaccinated - no excuses
tolerated. He did give the impression that he was as certain as he could be
that our diagnosis was wrong and this was probably a storm in a tea cup and
of course - it was only chickenpox in an Asian man! We were instructed to move out of
Australian Territorial Waters, and make our way to Brisbane for further
instructions.
The CMO
had insisted only the Ship's Doctors could do the inspections but the nurses
could help with the vaccinations. There were only 2 doctors, 2 nurses plus
an ex- naval dispenser, who counted as a nurse as far as I
was concerned. Fortunately, there already was an established inspection
routine, pre-docking in Australian Ports. The Port Health ruled that any ship
from Non Australian Ports must undergo a full smallpox inspection prior to
being allowed to dock, so that we were used to doing such inspections. There
was an established routine, and even an expectation of such from both the
passengers and the crew, - but doing it for four days, twice a day for the
last 2 days was going to severely test everyone's patience. Medically, we decided to combine the first inspection with the mass
vaccination; we did the crew first - to get our hand in as it were. We decided
to vaccinate all of the Goan crew, whatever their smallpox certificate
said. This was because to a man they were all notorious needle haters and it
was well known that most of the certificates were probably forged!. It was a cottage
industry in Goa. Vaccinating was done by placing a drop of serum on the
skin, and scratching two parallel lines at right angles and rubbing the
stuff into the scratches with a needle. It was not a painful procedure, but
the reaction of many would belie that fact, but we brooked no excuses, however
elaborate
We eventually got to Brisbane and were instructed to fly two yellow
quarantine 'Q' flags. Normally only one yellow flag was flown prior to being cleared by
Port Health, two yellow flags signifying we were a dangerous pariah. Our
patient was trussed like a cooked chicken, unceremoniously grabbed and
dumped on the trolley and whisked away, his breathing tube poking through
the wrapping. He looked like an insect chrysalis. We never saw him again.
Though we made several enquiries, Brisbane Port Health Authority never
confirmed it as smallpox, but they never said it wasn't either. I remain
convinced we saw the last case of smallpox on a passenger liner."
Peter Tate qualified as a doctor at Newcastle in 1968. After spells as a P&O
Surgeon and as a trainee in Kentish Town he was a family doctor for 30
years. He was an MRCGP examiner from 1981 and was responsible for the
introduction of the Video module in 1996; he retired as convenor of the
panel of examiners in March 2006. He is the sole author of The Doctor's
Communication Handbook, now in its 5th edition. He is also the author of The
Other Side of Medicine, a collection of essays and short stories. He has
also recently published 'Seasickness', a novel based on his experiences as a
young ship's surgeon. He was a co-author of The Consultation and The New
Consultation OUP. He has lectured widely on communication issues. He is now
semi retired and lives in Corfe Castle. His recent medical books are
available from Amazon and
www.radcliffe-oxford.com. Seasickness is also available from
www.lulu.com/petertate.
Article Source:
http://EzineArticles.com/357967
For
ships with smaller crews, and fewer passengers, there is The Department for
Transport's Ship Captain’s Medical Guide, intended primarily where it is
necessary for laymen to assess and treat injuries and to diagnose and treat
ill health. The Guide can also be recommended for use in other situations
where professional medical advice is not readily available, for example on
expeditions.
Rank Insignia
Ship's Medical
Department, off Acaplulco, Mexico
Ship's Medical
Department, Fort Lauderdale, USA
Dispenser,
Nursing Sister, Assistant Surgeon, Nursing Sister and Surgeon - The Ship's
Medical Department, off duty.
Prawns on the Post
Mortem Table
Penny Thomas, Nursing
Sister
Rob Coombes, Dispenser
The Serious Stuff
The Funny Stuff
"This
Medical Officer has used my ship to carry
his genitals from port to port, and my officers to carry him from bar to
bar!"
Commanding Officer's
Report on the conduct of a ship's surgeon.
Simon Sparrow, a
bachelor doctor, goes to sea to escape the boredom of shore practice, but
studies the nurses more than medicine, and Brigitte Bardot is around!
©Rank
Film Distributors
This is a
work in progress and more pictures and anecdotes will be much appreciated!
