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My voyage as a ship's doctor

In this new series, GPs share experiences of taking time out from general practice to use their skills in different contexts. This week, Dr Mandy Fry tells of her amazing voyage on a tall ship with a disabled crew

In this new series, GPs share experiences of taking time out from general practice to use their skills in different contexts. This week, Dr Mandy Fry tells of her amazing voyage on a tall ship with a disabled crew

Sailing has been a lifetime passion for me. As an undergraduate I took time out to take up a post teaching sailing on the Mediterranean. So most of my friends and family were not surprised when I decided to take a short sabbatical to indulge my interest.

Just as the weather was deteriorating last autumn I took six weeks' leave from my post as a GP retainer. I asked the partners if I could take three weeks of unpaid leave, which I tagged onto the end of three weeks' annual leave. This enabled me to participate in TransAt – a voyage from the Canary Islands to Antigua on SV Tenacious, which then spends the winter doing shorter voyages around the Caribbean.

SV Tenacious is one of two purpose-built ships owned by the Jubilee Sailing Trust and designed to give able-bodied and disabled individuals the opportunity to share the challenge and adventure of sailing and living together aboard a three-masted square rigged ship.

I flew to Gran Canaria to join the ship along with a crew of 40 volunteers, about half of whom had a physical disability. For instance, Anne had a T10 spinal injury, Sam a left-sided hemiplegia caused by a CVA and Peter was registered blind. The office had previously matched each individual with an able-bodied crew member, and they were then allocated to one of four watches. There was also a permanent crew of eight individuals including the medical purser and an RGN.

Dealing with problems
As voyage doctor I participated fully in watches and setting sail and steering the ship. So my sailing gloves were as important as my stethoscope. In fact there was no need to take any specialised medical equipment as the ship had a fully stocked medical bay, although I did take my amplified stethoscope so that I could hear chest sounds above the noise of the generator!

Sue, the RGN, acted as first port of call for all medical problems, so she dealt with the inevitable seasickness in the early part of the voyage.I was, however, called upon on a few occasions – unfortunately the ship was hit with diarrhoea and vomiting, which affected 75% of the crew and saw the mate swap his sunset watches for galley duty when even the cook was afflicted.

Old fashioned epidemiology identified the probable cause as eggs infected with salmonella (not uncommon in the Canaries) so the stock was dispatched overboard (ruining the Cook's recipe plans) and isolation procedures introduced. We were also involved in the rescue of some French sailors who had lost their steering gear.

They became known as the 'hitchhikers'. We tried towing their yacht for 24 hours but even weighted rope kept snapping, so the following day the decision was made to scupper the yacht after rescuing the crew and salvaging most of their gear. The hitchhikers were generally in good health, although glad to be rescued and the most I had to do was provide some antibiotics.

Mayday call
Before I went, several of my colleagues had admired my bravery (or foolhardiness) in being prepared for any eventuality. I think the real truth is that I hadn't really considered the possibilities fully.

But on the night we were towing the French yacht there was another mayday call from another boat about a man overboard. The yacht in question was 50 miles behind us so the captain concluded that we could not turn back, despite being one of the nearest boats, because we were already engaged in another rescue.

The man was, however, rescued, but not in good health – and for a short period he was en route to me as the nearest source of medical help. Frantic reading of the BMJ's ABC of Near Drowning did not inspire me with confidence, as it talked of the importance of ventilator settings and assessment of potassium levels – neither readily available mid-Atlantic.

All I could offer was my GP skills, which meant that I wasn't even confident I could intubate successfully in a 7m swell! So I have never been quite as relieved as when the Navy came on the radio offering their help – and I never even got to see the unfortunate man.

Reflections
In between the excitement, however, a month at sea gave me time to reflect on my career and think creatively about the future when I complete my time as a retainer. It rekindled my enthusiasm towards general practice – maybe not as my sole career but as a springboard to other opportunities.

Sharing the experience with disabled individuals also made me even more determined to make the most of the life I have as they were incredibly inspiring. Anne even managed to haul herself up the backstay to the top of the foremast!

All in all I can wholeheartedly endorse it – and if the TransAt is too long or too intimating to begin with, the JST also needs voyage doctors for much shorter trips around the UK, Canaries and the Caribbean. That is how I started and it quickly becomes addictive.

Dr Mandy Fry works part time as a GP retainer in Cirencester, Gloucestershire, part time as a GP VTS course organiser in Oxford and as a senior lecturer in primary care at Oxford Brookes University

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