One of the first questions I was asked at my interview for ARV was “How do I think I would cope being part of the public face of Ambulance Victoria?” It was an easy question to answer as, before I came to Australia, I had spent every day of my life on board under scrutiny.
The senior ships doctor is a three-and-a-half stripe officer, just a little piece of gold brocade lower than the Captain. They are a member of the Executive Committee on board the ship and as such sit in meetings with chief engineers, hotel managers, and entertainment directors. These professionals have spent years getting where they are in the industry and often us doctors waltz in and get all the trappings of rank that they have struggled to get for themselves. We have the right to be out on deck, eat in restaurants and use passenger facilities. The kitchen stewards may spend months only going ‘above stairs’ to clean pots and help offload luggage on turnaround day. You may think the ability to go where you want sounds wonderful but it does have its disadvantages.
When out and about in public you have to be in uniform – almost all the time. Walking around in crisp white trousers and shirt (thank goodness I escaped the era of long shorts and knee socks) makes you a target for anyone with a question or a complaint. As the public face of the company you could never say ‘Sorry, I can’t help you’. You would be expected to greet every passenger with a smile, whether you were in a restaurant dining with your wife or lounging by the pool in your bathers. You were always on duty.
The cruise line industry is a service industry, but so is emergency medicine. I don’t mean in the McMedicine 4-hour drive-through target sort of way but in that we are supposed to help our patients. We are paid to do a job and we should not be resentful when someone turns up at our place of work expecting us to help them. The emergency department is the public face of the hospital and how we treat our patients is how the hospital as a whole is judged. Just as you would never want to go on a cruise that has no regard for its passengers nor would you want to go to a hospital that treats its patients badly. Whilst we can debate long waits and access block often what is needed is for the doctor to be human, apologise for the wait (without needing to accept responsibility) and ask “How can I make your day better?” rather than grumbling about the next patient to be seen.