
On the (nearly lethal) comforts of a luxury cruise (1996) [pdf] - jonnathanson
http://harpers.org/wp-content/uploads/2008/09/HarpersMagazine-1996-01-0007859.pdf
======
pyalot2
Not mentioned in that story, but relevant.

Modern cruise ships for the most part are equipped with medical facilities and
staff of high standard, certainly higher than most destinations they set out
for. It's mainly because that's regulation.

If a passanger falls seriously ill however, those facilities are merely the
temporary means to keep you alive until the cruise ship arrives at the nearest
port where it leaves you in the capable hands of local healthcare.

As it turns out, most of the time it means they kick you out of the ship to
die. Because local healthcare of the garden variety is for the most part not
capable of keeping a patient alive, unlike the shipborne medical facilities.

If you have the particular misfortune to be befallen of some sickness that
looks anything like it could infect fellow passengers, no matter if serious or
not, you might also be entirely on your own. Because things like quarantine
facilities are not regulation. Because decontaminating a room is expensive,
you'll likely spend the duration to the next port in a bare cell that's easy
to disinfect afterwards. Should you die in there, they'll make it look like
they cared for you, and if not, well they acted by the book.

The reason this macabre theatre happens is because of this. Should a passanger
die on your ship, it's a huge headache for the cruise operator involving
inspections, tons of paperwork, possibly a being forced to stay in port,
missing a schedule and so forth. But if you can shuffle a passenger off to die
somewhere else, it's no longer your problem.

There is just one thing worse for the cruise operator than having somebody die
on his ship. It would be for multiple people to die, or many to fall sick, for
which the hassle would be exponentially worse than a single dead passanger.

~~~
pavlov
Perhaps not all that different from American health care in general?

While someone is footing the bill, they'll work hard to keep you alive -- and
also make sure it involves expensive work like tests and x-ray imaging for
maximum billing.

If you have the misfortune of suffering something that is not covered or is
not profitable for some reason, they'll figure out a way to kick you out to
die elsewhere.

The interests of the corporations that run cruise ships and American hospitals
are fundamentally the same.

~~~
telephonetemp
That sounds like an outline for a problem that should be happen across all
service industries that are run privately/paid by insurance companies, not
just healthcare. Do we hear more about it in (American) healthcare simply
because it's something the most people interact with or is it noticeably worse
there? For the record, I am not American and don't know what it is like to
interact personally with US healthcare.

~~~
lttlrck
The healthcare issue in the US crosses stark idealogical divisions.

------
DonGateley
He sure presages his fate in Infinite Jest. A tragic figure for sure and
without peer as a writer/philosopher. I'm 70 and widely read and over those
years no author has impacted me like he has (despite his propensity toward
shaggy dogs.)

He clearly told us in advance that depression such as his was not to be
suffered and when all was said and done he left me sympathetic with that point
of view.

------
jzwinck
On the lethal discomfort of being a junior crew member on a luxury cruise:
[http://www.telegraph.co.uk/travel/cruises/9860808/Five-
dead-...](http://www.telegraph.co.uk/travel/cruises/9860808/Five-dead-as-
lifeboat-plunges-into-sea-off-British-cruise-ship-in-Canary-Islands.html)

This happens again and again, year after year: lifeboat drills actually kill
people. Usually low-ranking, low-paid crew members, usually when the lifeboat
is being hoisted back up after the deployment drill. The systems are not
adequately designed to support this use case, best practices (few or no people
on board for drills) are not enforced, and people are dying--perhaps more
people than are actually saved by lifeboats.

Many more such incidents are catalogued here:
[http://maritimeaccident.org/categories/lifeboat-
accidents/](http://maritimeaccident.org/categories/lifeboat-accidents/)

------
increment_i
A classic essay. Consider The Lobster is another great one as well:
[http://www.gourmet.com/magazine/2000s/2004/08/consider_the_l...](http://www.gourmet.com/magazine/2000s/2004/08/consider_the_lobster?printable=true)

------
kclo4
My father almost died on a cruise. He has serious Diabetes/Heart issues, and
from eating too much, his heart went into Bradycardia (slow erratic rhythm).
They kept him alive on the ship quite well, left him in Cozumel in one of
Carnivals "recommended Hospitals". The nurses don't speak English, they did
not use gloves and did not have food during the weekend. You don't really want
to get sick on a cruise.

------
riffraff
why is this [scribd] ?

The url looks like

[http://harpers.org/wp-
content/uploads/2008/09/HarpersMagazin...](http://harpers.org/wp-
content/uploads/2008/09/HarpersMagazine-1996-01-0007859.pdf)

does it mean this was somehow produced by scribd ?

~~~
fuzzix
PDF links automatically get a scribd link generated - it is a separate link to
view the PDF using scribd.

Is there a browser remaining which does not competently handle PDFs without a
plugin?

~~~
pbhjpbhj
I've got FF25 on WinXP where I am now.

Couple of weeks ago I had a .pdf file that didn't open in pdf.js so I set FF
as the handler for .pdf files.

This link downloaded rather than opening pdf.js. Then it proceeded to open new
tabs at about one every 2s (it's a very slow laptop) ... not sure what was
going on there but I'd describe it as being "not competently handled" despite
it being probably specific to my [nearly?] unique settings.

------
rdl
I am currently re-reading (well, I skipped a lot of it she. I first read it)
Infinite Jest. It is even sadder and more screwed up now that dfw is gone.

