"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!