The Ship Captain’s Medical Guide is designed to assist ship captains and other trained personnel to deal with illness and accident on ships not enjoying the benefit of a doctor. It’s a weighty volume and on first reading, it can have the same effect as a Stephen King book. It can keep you awake at night imagining the horrors that await you.
Your first step into the mysteries of the medical profession is usually by way of a short course in First Aid, plus instructions on how to give injections for various tropical diseases without doing too much damage to the patient. After that you are on your own except for The Book.
So You have completed the Ship Captain’s Medical Course, passed the examination and now possess a certificate. You are now allegedly qualified to care for the sick, lame, weary, and those merely seeking free transport at the next port of call.
Your pass marks in the exam? Eighty per cent? Not too bad. The odds in favour of success stand at four to one. With luck the unfortunate fifth man will at least survive to the next port where the professionals can take over and get him back on his feet. Or kindly arrange for the flowers of his choice.
In these extreme cases it is important to put the patient’s mind at rest. Tell him not to worry. At this point you will be doing enough worrying to satisfy both of you.
Of course, you can add to your knowledge by serious study of the Ship Captain’s Medical Guide. The downside of this is you may convince yourself you have serious medical conditions yourself. You could then become more worried about your own health than that of your shipmates.
There will inevitably come a time when you are called upon to apply bandages and dressings to cuts, grazes and assorted wounds. For the peace of mind of the patient do not overdo the dressings. He will not be impressed if he comes in with a minor cut and leaves looking like the sole survivor of a motorway pile-up.
While a simple plaster may do the trick you will discover that iodine on an open cut is a great deterrent to both germs and patients. One liberal application can reduce your workload at a stroke. Your patient will discover a latent streak of self-reliance, and will in future be inclined to treat his own cuts.
No language problems will be experienced with foreign crew. “Aaaagh” seems to be a universally accepted expression signifying the onslaught of sudden pain. Your diagnosis will be swift and certain. Your patient is conscious, alert and heading for the dispensary door - presumably to resume normal duties. You are entitled to feel a glow of satisfaction.
We will now consider some of the symptoms and problems you may come across in your new career:
LOSS OF APPETITE
If you are a Chief Steward this is one symptom you will obviously not want to discourage. The most common cause of loss of appetite is chronic indigestion. Your SCMG will advise you to rest the patient and keep him on a light diet.
But a word of warning. Captains are inclined to be unsympathetic if they find half their crew tucked up in bed on light diets. Some have been known to get downright nasty and may question your medical expertise. Not to mention your motives. Their version of the Hippocratic oath at such times is inclined to be far more pungent. Nor are they likely to be impressed with the argument that feeding costs will be more than favourable.
DEAFNESS
This is a common complaint among seafarers. The onset may be sudden and often occurs as the patient is being detailed off to perform a task he finds distasteful, leading one to suspect a possible psychological connection. This point is perhaps worth an article in The Lancet.
As a clout round the ear to dislodge any obstruction is not encouraged under maritime law, the Higgison ear syringe is the next best thing. In extreme cases it may suffice to shout louder.
An alternative treatment not mentioned in the SCMG is to whisper “I’m stopping your shore leave for three months. You will immediately note a frown of deep concentration appear on the patient’s face as he strains to hear what you are saying. It has been known for the patient to cry out “But you can’t do that”.
In that case you can put away your Higgison syringe and chalk up a miracle cure.
EYES-BLOODSHOT
Another common complaint among seafarers. Saline solution is recommended. If this fails, try closing the Bar for a week.
HYPOTHERMIA
Not widely experienced in tropical waters unless you have upset the cook and he has shut you in the deep-freeze room while on inspection. Prevention being preferable to the cure, do not upset the cook.
HYPODERMIC SYRINGES
You will without doubt at some time encounter certain infections where you will be required to administer injections. You were probably shown how to do this on your medical course, with an orange being used for demonstration purposes. Yet another word of warning. The skin texture of some posteriors is noticeably tougher than orange peel. This could be a result of sitting down too much. Do not be timid. Imagine you are aiming for ‘double tops’ and strike with confidence. On no account aim for a ‘bulls eye’.
HYSTERIA
Often afflicting yourself and brought on by being called out in the middle of the night to deal with a situation the Glasgow Outpatients department consider as routine on Hogmanay, Burns night and most Saturday nights. Medicinal brandy has been known to help but don’t overdo the dosage.
MENTAL CONFUSION
Frequently a direct result of not heeding the warning regarding medicinal brandy.
PARALYSIS
Often follows mental confusion if the warning regarding the medicinal brandy is totally ignored.
VOILENT BEHAVIOUR
Your SCMG advises that this state is most likely to occur in delirium, drunkenness, insanity and insulin overdose. It does not mention that it can also occur under the following conditions;
(a) Using too strong a purgative
(b) Using a blunt hypodermic syringe
(c) Applying a very hot poultice
(d) Pouring boiling hot water down an enema tube.
So be warned. Treat your patients with compassion and mild laxative tablets. The directive ‘physician heal thyself ‘has no practical application when swimming freestyle in the wake of a fast receding ship.
