"Not only is the universe stranger than what we imagine,
it is stranger than what we can imagine."
Sir Arthur Eddington

Docteur


The Pharmcaie in The Saints, Guadeloupe, F.W.I.
The Pharmcaie in The Saints, Guadeloupe, F.W.I.

"Aller chez le docteur or le medecin (I need to see a doctor)." A concern of many of our non-cruising friends, or those sailors considering a "cruising life style", is the question of what to do when you need a doctor. Back home, it was simple, go see your GP. Living on a boat, in a foreign country, or out at sea, it is not so simple. In a foreign country you may even have a language problem.

In the eight years of cruising and living aboard we have been fortunate not to have any serious emergencies needing immediate medical attention. Both Maureen and I have issues (who doesn't after 70 years here on earth) but we can schedule routine doctor's visits and procedures months in advance and fly to the States. The issue is emergency situations.

The most serious ones we faced, were on our first sail down to the BVI's, two days out from Norfolk VA, crossing the Gulf Stream, with high winds and very rough seas. A gash on my face and a notch in Maureen's ear left small scars but both could be handled easily. Maureen, as a retired RN, made a difference! I was laid out on my back for a week once with what we believe was chikungunya, a mosquito born fever while in the BVI's. Nothing much could be done, much like a bad flu, and no doctor was called.

Others that we knew or know were not so fortunate. Yes, we know cruisers that are no longer with us, having passed on their boat or ashore. Would prompter medical attention helped? Its impossible to say although similar cases ashore often had the same outcome.

Yesterday, we heard on our VHF radio a cruiser whose husband appeared to suffer a mild TIA (mini stroke) while
moored here in the Saints. Maureen got on the VHF and gave her the telephone number and office hours of the local doctor. Oddly enough, a few years ago we remembered hearing the same wife's VHF call for help, for the same condition, while they were sailing off St. Lucia. We were in Rodney Bay Marina there at the time. Some cruisers went out in their dinghy to help her sail back to the dock. An ambulance was waiting on the dock and her husband was whisked to the hospital and apparently recovered. We assume all turned out well then, and today, as they were now making plans for sundowners with another couple. Well, the question you are probably thinking is, why did Maureen have the local doctors telephone number and office hours?

Well not to go into too much detail, but for the last few weeks or so Maureen was dealing with a cyst on her shoulder. It was not getting any better with self-treatment and we went to a French "parmacie" for advice in Marie Galante. They were very helpful and recommended some ointments. After a few days, more help was needed and so she went to the local "docteur". No appointment was needed, and he gave her a prescription for some additional medication. He advised her that in a week or so, if it didn't improve, she should see a dermatologist. He did not charge for the visit. A week later we are in the Saints and it was no better. Off to the "parmacie", again very helpful, and directed her to the local doctor. Again, no appointment, just wait your turn, about 20 minutes, and he wrote a prescription for antibiotics. He did charge (about $30) but with that and with what the "parmacie" recommended (tea-tree oil) seems to be doing the trick. That is how Maureen knew the telephone number and office hours of Dr. Miguel Cassin.

Office hours and fees for Dr. Cassin
The point is that there is medical assistance most everywhere although if you are out to sea, emergencies are problematic. If you are ashore or in a marina or anchored, help, even delayed, is available. Certainly, in larger communities other than Marie Galante and the Saints, there are larger clinics and hospitals. The doctors, Maureen saw, worked out of store front offices and didn't even have receptionists. It was a little disconcerting seeing the doctor donning shorts and t-shirt while practicing his craft.

Dr. Cassin's office
Dr. Cassin's office

We know cruisers that have had hip replacements in Trinidad or flew to Thailand for hernia operations. Good dental services are common in most areas. Serious non-immediate-emergencies that can be addressed within a day or so are usually dealt with by flying home or to a large medical facility. It is also possible to get airlifted from the sea if you are not too far offshore.

The last concern is cost. Regular medicare (or private insurance) normally does not cover overseas expenses. There are policies to cover these, including evacuation expenses, that can be purchased. But most non-lethal injuries or conditions can usually be address locally at far lower cost (with equivalent care). In those cases, out of pocket costs could very well be below any "co-pays" from American insurance companies.

As we get older (and who doesn't), health issues become more of a concern. Everyone has different risk tolerances' but living the way you like is itself a risk.

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