8:08 PM EDT, April 30, 2013
After dinner and a walk around their Viking River Cruises ship on Russia's Volga River last May, Charles and Cecilia Ford went back to their cabin. Charles, 82, was in a good mood, his wife said, cracking jokes and singing during their walk.
But he also was battling a cough, which grew worse in the night, and his breathing became increasingly labored. By morning, he had died.
A year later, Cecilia Ford, of suburban Chicago, remains upset not just at losing her husband of 36 years but by what she considers to have been incompetent care from the ship doctor. She said the struggles included a language barrier, incorrect diagnoses, marginal equipment and an inability to administer basic medical care.
She said the doctor spent 10 minutes struggling to attach an oxygen machine to her husband's nose. After 30 minutes, she added, the machine stopped working. With the doctor out of their cabin, Ford said, she summoned the help of two American doctors from among the passengers. They said Charles needed oxygen immediately, but by then it was too late.
In addition to her heartbreak, she is angry. She said she researched which cruise companies would offer the best medical care and felt let down. After sending a letter to Viking, she said, she got back a two-sentence response offering sympathies.
"I was writing a really sincere letter that you can improve your medical facilities so there won't be more victims in the future," she said. "And that's the only letter they sent to me. It made me very upset."
Viking declined to discuss the case but sent a statement that said its "onboard staff members are trained to handle many medical situations."
"Viking maintains contacts with local emergency medical services in every country where we sail, and there is a doctor onboard each of our cruises in Russia," the company said. It declined further comment because "it is still an open issue."
Though the two American doctors told Ford her husband's heart condition was to blame for his death, not inadequate care on the ship, the death presents a stark truth of cruising: In cases of medical emergency, you're beholden to your surroundings. In some cases, that can mean a wait until reaching a port with a hospital. It also means a patient also often must rely on the care of one doctor.
Quality of care can vary widely, said Steven Stern, who has been writing "Stern's Guide to the Cruise Vacation" since 1974. Much depends on the size of the ship and where you are traveling, he explained. Plus, he said, river cruises have become more popular with older travelers, who may have pre-existing conditions.
"My caveat in (the Fords') case is that you're in Russia," Stern said, "which is not being in America or Germany or France."
Though an avid cruiser, Stern said he often is wary of the quality of medical care on a cruise ship. He once contracted pneumonia on a cruise in Asia, he said, and thought inadequate treatment led to two years of lung problems.
"When you get into these Third World countries and places without Western medicine, you have to think twice," Stern said. "I highly recommend you call the cruise line if you go and find out what (medical) facilities they have."
Richard Stennes, who became a cruise-ship doctor primarily for Holland America after retiring from 40 years of emergency medicine practice in San Diego, said cruise ship health care can be top notch. But he also said it's incumbent on passengers with iffy health to think hard about the travel they attempt.
"I'm somewhat surprised sometimes at the passengers who have significant illness, and know they are at risk, who don't ask the question, 'What is this ship's medical capacity and who are the doctors?'" Stennes said. "I think most people don't think about the fact that they might get sick."
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