If you are really sick in the middle of the Pacific Ocean on a cruise ship the treatment options are limited. The mid-Pacific is international water — there is no Coast Guard and there is no hospital helicopter to pick you up. The ship can only go 20 – 30 mph so going somewhere in a hurry is just not possible.
The doctors on the ship do what they can and over the past 10 years shipboard medical capability has improved. But, there is no CAT scanner, there is no cardiac catheterization laboratory and if you hit your head and get a hematoma on your brain you will probably die. Remember, you are on a vacation ship, not a hospital ship!
When a person is seriously ill and near a port (75 miles) a helicopter pick-up is possible. Or, when the ship is in port an ambulance pick-up is possible. Then what? If you are in a third-world country the hospital you go to might not be much better than the ship. If you are stable enough you might be able to take an airline flight home. Otherwise, you might hire a med-evacuation flight — but plan to spend $50,000 unless you have insurance to cover it.
If you are seriously ill you can not stay on a ship — once the ship docks you will be taken to the closest hospital — even in Guatemala.
The number of elderly people on cruise ships is huge. The big cruise ships carry between 2,000 to 8,000 passengers. During almost every week-long cruise on one of those ships someone gets sick and is taken off the ship, usually at port. And, every year several people die on cruise ships.
Medical care on a cruise ship is very expensive. Medications are very expensive. A cast placed on a broken arm is very expensive. If you are quite elderly or have significant health problems you need travel insurance and med-evac insurance. Or perhaps, just skip the cruise instead. Remember, regular health insurance or Medicare will not pay for cruise ship medical care.
Cruise ship doctors usually have experience with diarrhea, dehydration, colds, pneumonia, urinary tract infections, sea-sickness, cuts, bruises and broken or dislocated extremities. The ships all have communication equipment and doctors can contact specialists anywhere in the world.
Despite access to a world of medical information the ship has limited medications and no major surgical capability. In some respects, there is no need to do complicated tests because there is not much that can be done! Why do a brain scan if you can’t do brain surgery!
So, caveat emptor — buyer beware.