Starcode - Emergency on board of "Mein Schiff 2"

“These things have really grown over the last 40 years...”. Just as Margaret Brown spots the top of the 16 decks of “Mein Schiff 2 ”, it comes back. That damn cough. All the muscles in Margaret’s body contract and the 78 year old feels the ache down to her bones. The cough exploding from her lungs, over and over. If she wasn’t in a wheelchair, she would be writhing on the floor.

“Mum! Are you okay?” Molly leaves everything at check-in and runs to her mother.
“I’m alright, darling. Let’s get on Board, shall we?”
“Where’s your inhaler?”
“Pardon?“
“Your inhaler, where is it?“

One last cruise. Just like way back, with her beloved William. “I want to feel the wind in my hair and the salty water on my skin again,” she said to her daughter during her last visit. Molly had travelled all the way from Germany to see her. That touched her. Molly had so much on her plate. The two boys, her grandsons, had grown into young men, but still behaved a bit irresponsibly. Achim, Molly’s husband, had a good job in the  pharmaceutical industry. She was doing fine on her own after William passed on. “Has it really been eight years, darling?” Margaret asked her daughter over a cup of tea in their little house in Reading. “Yes Mum. But we’re going on a cruise, I promise.”

“There are guests like that. Guests who want to experience their last trip on a cruise ship. These are of course a special challenge for us, but also an opportunity,” says Prof. Dr. Berthold Petutschnigg, “Doc on Board” for over ten years and Chief Senior Doctor of the “Mein Schiff ” fleet of TUI Cruises since 2015.

“I can remember we had a guest who came on board lying down. His plan was to start his very last journey here on board. We in the medical team were with the gentleman in his cabin every day. Checking on his state of health of course, but that is only part of our job. We had a lot of good conversations, not just about his health, but also about life. After 14 days the guest left us. At port - on his own two feet. Those are moments you don’t forget.”

The medical crew on board the newest ship in the “Mein Schiff ” fleet is prepared for all scenarios. Whether a crewmember has to recover from the flu or there is a serious cardiac emergency. Especially with the latter, seconds count: We can reach any emergency site here on the ship in less than ten minutes and initiate the appropriate therapy - no rescue service on land can guarantee that”. Three words over the ship’s intercom are all it takes to set a well-oiled machine in motion:

STARCODE! STARCODE! STARCODE!

“When we hear that, we drop everything and start running,” says the second doctor on board “Mein Schiff 2,” Markus Lanzerath. At the same time, ten specially trained crew members from all areas of the ship head for the medical centre. “While we are on the way to the emergency scene with the corpuls3 and the emergency kit, the Stretcher Team arrives at the medical centre, gets equipped and also heads to the scene.” This means, the TUI Cruises medical team ensures that every emergency can be treated optimally - even if the initial report to the bridge was not complete or correct. But that hardly ever happens.

“Emergency messages come through to us on the bridge on a red phone. One of my officers takes the call and works through a brief but specific list of questions. Basically, the procedure is comparable to what many rescue organizations do on land - we triage, so to speak, at the time of the first report. If we are sure that the situation is serious, I give the order “Go for Starcode,” says Captain Tom Roth. The thoroughbred seafarer does not come from one of the European coastal regions, as one would expect, but came into the world in 1970 in the Swiss metropolis of Zurich.

This backs up an interesting pattern that has come to our attention since we boarded “Mein Schiff 2”: The number of crew from the alpine areas of Austria, Switzerland and Bavaria on board. This infiltration goes so far that we three guys from Bavaria had the best Kaiserschmarrn of our lives on board “Mein Schiff 2”. But this was no wonder when we heard that the executive chef of the “Esszimmer” restaurant is... Austrian! You meet mountain people everywhere, even at the reception desk in the medical centre. That’s where Madeleine Gallowski from Bavaria sits: “Of course I miss the mountains from time
to time, but I always felt a bit claustrophobic at home.
My Dad used to tell me stories about deep sea fishing. Something must have resonated with me. And today, if I’m on land too long, I get restless.” A sentiment that seems to be shared by many here on board.

For me, vacation means being on board,” says Captain Roth. “We are pretty spoiled here, too. A few days at home and you wonder: How is my dirty laundry getting more and more dirty? Why is the fridge always empty? And vacuuming? I don’t even know if I even own a vacuum cleaner. We’re very well looked after here on board. And we see the most beautiful corners of the world every day - it really doesn’t get any better than that.” But with the luxury comes responsibility.

“We have around 3,000 passengers on board. And a crew of around 1,000 people. Illnesses can happen here too. Imagine that someone from our kitchen crew catches a stomach bug and doesn’t realise in time. There’s one thing I’d definitely rather not experience on board,” says the captain with a wink. To avoid this from happening, the medical crew is prepared for any nasty thing under the sun. The ship’s pharmacy would also fit in in a medium-sized hospital. “In the worst case, we can even perform surgical procedures - we are equipped for that,” says Chief Senior Doctor Petutschnigg.

Two hospital beds with complete intensive care equipment are available just in case.“ And if our options are no longer sufficient, we still have the option of flying patients out. However, that decision is up to the captain.”

And he listens to his medical crew: “When the doctor says “It has to be done”, then we no longer discuss “If”, but “How.” I am not a doctor, others have the authority. And if it means we have to change course and turn the schedule upside down, then so be it.”

Margaret feels the sun on her skin. A light breeze makes her shiver briefly.  “Here you go, Madame...” Kevin, the lovely waiter, brings her a cup of Earl Gray tea with a dash of milk. Just how she likes it. Kevin’s name isn’t actually Kevin at all, as Margaret found out. But he calls himself that for the passengers. His homeland is actually the Philippines, where he has a wife and child. There are many crew like Kevin on board. They keep the operation
running smoothly, cooking, cleaning, doing laundry, mixing cocktails, serving tea to an old lady - and they are always smiling. Maragaret smiles too, thinking about her William.

“Someone’s in a good mood today!” The voice of the ship’s doctor pulls Maraget from her thoughts. “Who wouldn’t be in such a charming company?, Margaret replies. If she were just a few years younger, the tall officer would have to be careful... 

“Do you mind...?”,asks the doctor and points to the empty chair next to her.
“Absolutely not!”,she says.
“What do you think, would William have liked it here?”,the doctor asks as he takes a seat. “No”, says Maragaret as she enjoys the puzzled look on his face, “He would have loved it.”

I sit a few seats away from the pair and watch them.
Margaret beams and they both laugh. Sometimes it really is the best medicine.

From a medical point of view, a cruise ship the size of “Mein Schiff 2” is probably the most unfavourable place to work. A lot of people in a small space, and the nearest medical support is often hundreds of kilometres away. But for many, that is the appeal of working on a cruise ship. Optimal training and the best equipment is essential for medical professionals. Therefore, the Chief Senior Doctor of TUI Cruises, Prof. Dr. Berthold Petutschnigg has developed a targeted training program for those interested.

IMPULSE:
Professor Doctor Petutschnigg, what are the basic requirements if I want to work as a nurse or doctor on board a TUI Cruises ship?

Prof. Dr. Petutschnigg:
Let’s start with the easier of the two: The nurse. Training as a paramedic or something comparable is certainly a big advantage here. If you also have experience as an intensive care nurse, that’s half the battle. The other half also applies to doctors: You have to be passionate about what you do. Good knowledge of English is essential, even though most
of our guests speak German. The crew language is English. Documents such as reports or our doctor’s letters, must be completed in English.

IMPULSE:
... which brings us to the doctors?

Prof. Dr. Petutschnigg:
Exactly. Specialist training in general medicine, surgery/trauma surgery, internal medicine or anaesthesia is sometimes a prerequisite, because a good ship’s doctor needs a certain amount of basic experience in each of these disciplines for their work. It is also advisable to brush up on the basics of other disciplines in practice. For example, by sitting in on an intensive care unit, the trauma room or an initial surgical admission. A competent ship’s doctor is also always an emergency physician. The specialist qualification in rescue services or the emergency physician diploma for Austrian doctors are therefore mandatory. An emergency can occur at any time, anywhere, with any conceivable degree of severity. A doctor must be specially trained and experienced for the special
situations on a cruise ship. And the best way to acquire this competence on land is through the emergency medical services.

In addition, there are international certificates such as ALS (Advanced Cardiac Life Support Course) and PALS (Pediatric Advanced Life Support Course) with the corresponding refresher courses in accordance with specified time limits. As a ship’s doctor, you always need to be up to date in recognizing a critically ill patient and the appropriate therapy. You must not forget: We don’t just have old people on board here, we primarily have young families with children.

IMPULSE:
So all areas in which the corpuls devices can show their strengths.

Prof. Dr. Petutschnigg:
Absolutely! We have two corpuls3 on board here and I couldn’t wish for a better tool. The fact that the corpuls3 can be divided into three parts is simply the best, especially in narrow corridors or elevators. Unfortunately we don’t have the corpuls cpr on board, but I know the device very well. The build, the technology and the certification for the treatment of children from the age of 8 - that’s something. In my opinion it is the most practical chest compression device currently available.

IMPULSE:
But on board, you would be more likely to deal with bone injuries in children than with cardiac problems.

Prof. Dr. Petutschnigg:
That is correct, and why sonography knowledge for extended diagnostics on board as well as repositioning and immobilization therapy, i.e. a “cast course” for extremity trauma are further admission criteria. And of course you should know how to operate a corpuls3 and the ventilator. So: Knowledge of all the devices used on board according to the Medical Devices Act is a requirement.

IMPULSE:
That’s a pretty long list of requirements...

Prof. Dr. Petutschnigg:
It sure is! And I forgot the radiation protection qualification – you see, the work on a ship is special, not only because of the spatial conditions. And we are responsible for around 4,000 people on board (passengers + crew). It is absolutely necessary that the medical staff is optimally trained.

IMPULSE:
Is that why you came up with the idea of the Intensive Course in Cruise Ship Medicine?

Prof. Dr. Petutschnigg:
Yes, on the one hand, but also to give those interested a single point of contact where they can obtain their qualifications. As the title suggests, it is an intensive course in which some of the certificates required to work as a medical doctor on ships can be acquired. In addition, the ‘normal’ medical training also takes place on land! We are however, on a ship and we also train on a ship – exactly where you as a doctor will have to save lives. Compare it to training in an ambulance simulator. It’s a good thing. But outside, on the street, in action - the situation is different there. You could say: Every day on board brings new surprises, new challenges - but that’s what makes it so exciting and varied.

INTERESTED? Then take a look at www.tuicruises.com/karriere/karriere-an-bord/medical  You can find all the information about the Intensive Course in Cruise Ship Medicine at www.dgkmed.de.