Confessions of a maritime doctor: I have seen all manner of things from people who want to get off their ships

Two to three times each month, he gets an urgent call on his mobile phone.

Dr Ravin Nair hops on a taxi boat and 30 minutes later, he reaches a ship out at sea where he tends to a seaman's injury or affliction. In some cases, he faces a corpse.

When he is not working on maritime emergencies, the 43-year-old oversees Gleneagles Hospital as its assistant medical director. He's also the head honcho of Parkway Shenton's new Maritime Medical Services, which was started a month ago.

At sea, he works fast as the ships need to depart from Singapore waters on time.

This means he only has a couple of hours to save a life or treat a disease.

"I don't only treat the patient. I have to look at the environment these sailors are in too, to make sure that no one else falls ill. In a sense, I'm treating the ship," he says.

He gets calls for a variety of conditions common among sailors - trauma from falls, injuries sustained while working, or heart and lung problems.

In one incident east of the mainland four years ago, Dr Nair had to attend to a seaman who suffered a finger injury while operating a grinder.

Dr Nair tells The New Paper on Sunday: "His right ring finger broke off and his shipmates found it. He wanted me to reattach the finger."

It was a procedure that would cost between $20,000 to $30,000, so when the ship captain found out about the cost, he did something Dr Nair could not believe.

"He told me that it was too expensive. So, he took the finger from his crew and threw it into the sea," he says.

"Then, he turned to me and said, 'stitch it up.'"

Dr Nair did as instructed. The procedure cost $800.

Each time they are deployed, the rescue team - comprising Dr Nair and one or two paramedics - assesses if the patient is fit to continue the journey.

He says: "The next doctor that the ship crew sees could be weeks or months later, depending on the journey. If he can't continue, I will have to take him back to land."

This applies to terminally ill patients and those who are having a heart attack or suffering from brain death, the latter of which requires the patient be put on life support.

Occasionally, patients are airlifted back to the hospital by a privately chartered helicopter or taken back to land via boat to a waiting ambulance.

He's also been called upon to certify death when seafarers drown.

Sometimes, he encounters malingering sailors, who do all they come to get back to shore.

He says: "About two years ago, I was called on board a bunkering ship to treat a patient who had a common cough and cold. The ship moored beside a cargo ship which was around five metres taller than it."

On the deck of the cargo ship however, he noticed a commotion.

"It was a deck cadet (an intern on a ship) who had decided that he was tired of life at sea, and wanted to go home badly.

"But the captain had told him 'no'. When he saw me and my medics, he jumped from the cargo ship onto the ship I was on, even after his mates told him to stop," says Dr Nair.

The stunned doctor saw the man hit the deck of the ship, having fallen from a height of nearly two storeys. The man escaped unscathed.

"He landed right in front of me. I was stunned. I immediately carried out the spine injury protocol and took him back to the hospital." In the end, the cadet's cargo ship sailed away and he got what he wanted.

Another memorable case of malingering happened five years ago, involving a ship captain. He claimed he had suffered a heart attack, which required an evacuation by helicopter.

"When the pilot, who was also trained as a paramedic, reached the ship, he didn't see a heart attack patient. Instead, he saw the captain with two packed suitcases who said, 'I'm the patient, let's go.'

"The pilot told the captain to step back, and then flew off ," explains Dr Nair, who was then waiting in the hospital.

The shipping company was charged around $80,000 for the incident.

The job is not for the faint-hearted, he says.

There are many dangers associated with it.

To board a ship, he climbs from a boat taxi by using a rope ladder on the side of the ship's hull.

There are no harnesses.

Says the doctor: "It's definitely not a job anyone can do because of the dangers. It is why most doctors much prefer to stay on land.

"Me? Somebody's got to do it. I happen to love being outdoors too and I would hate being stuck in the hospital all day."

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SECRETS OF THE TRADE

1 Have a head for heights. The job requires you to climb ladders in order to board ships, which can be behemoths. The last thing you need is to freeze on the rope ladder.

2 Getting seasick is not a good thing as you must be prepared for rough seas.

3 Keep hydrated and fit. The work is physical and it requires getting out into the sun a lot. It wouldn't do at all for the medic to fall ill or faint on the job!