These comments will be lengthy, but because (fortunately) most Celebrity passengers will not have the medical emergency experience we did, I thought some detail about it might be helpful to others. If you don't like medical details or are a major worrier, you might want to skip this one!
My husband and I were passengers on the April 8, 2012 sailing of the Solstice from FLL to the Eastern Caribbean. This was our first experience with Celebrity, one we had been greatly looking forward to. Unfortunately for us, what was to have been a happy and relaxing 30th anniversary celebration turned into a disaster due to a medical emergency and what we believe was Celebrity's poor decision to mandate that we leave the ship at the first port of call, San Juan.
We have both enthusiastic praise and very serious issues with the way Celebrity handled our situation.
First, some medical background on me. I am a retired college professor in my 60's who in February underwent open heart surgery for a mitral valve repair. This unexpected surgery forced us to cancel our first scheduled anniversary cruise with Celebrity, which was to have been on the Summit to the Southern Caribbean January 28. The heart surgery went well and by the time we booked the Solstice sailing for April 8 I had my doctors' unreserved endorsement that I was fully fit to travel and that the rest and relaxation of the cruise were "just what the doctor ordered" for the lingering post-op fatigue all open-heart surgery patients experience. We chose an itinerary that was less port-intensive than our original one on the Summit because my primary focus was to rest and regain my stamina and spend quiet quality time with my husband, not sightsee. However, please do not get the idea that I am frail or fearful. I have been quite active since my surgery, and we are an adventurous and well-traveled professional couple, former leaders of a number of overseas study tours for a fairly sophisticated clientele, not too-often-stereotyped "geriatric basket cases" (no offense intended).
In addition to being cardiac post-op, I have had Crohn's disease and other autoimmune disorders for decades. The Crohn's was in remission and causing no problems when we boarded the Solstice April 8, and had been for some time, though the medication I take to control it (azathioprene/Imuran, prednisone) leaves me immunosuppressed.
The first full day of the Solstice cruise, April 9, an at-sea day, I awoke feeling fine and we were greatly enjoying our first Celebrity experience. Other than my personal feeling that the food did not live up to its PR (more on that in a separate post), we were thoroughly delighted with every aspect of our accommodations and shipboard facilities and service. However, about noon I began to develop increasingly sharp abdominal pains and severe vomiting which over the next four hours reached 10 out of 10 on the pain scale. 24 hours into the cruise I was taken by wheelchair, in tears, to the ship's medical facility where I immediately began to receive excellent and concerned care from all present.
I would particularly like to single out for praise Dr. Sara del Ormo and nurse Sheila Javelosa, who not only were consummate professionals but who showed me a great deal of warmth and human concern in what was a very distressing situation for my husband and me. The level of care I received from them was fully on a par with the best doctors and nurses who have treated me in the hospital here at home in Seattle. I also received good and concerned care from nurses Laurel Bill and Joel Adison. Well done. I am sorry that I was too upset at the time of admission to get the name of the Ecuadorean (?) doctor who I gather was the ship's chief medical officer. I had only a few brief interactions with him in which he seemed rushed and somewhat preoccupied, though certainly highly professional and polite, and I frankly would have to give a more mixed review to them. The shipboard medical facility itself was clean, well-run and as well-equipped as one could reasonably expect given its size and venue.
On my arrival in the ship's hospital it was immediately determined that this was not Norovirus but something more serious. After morphine brought my pain under control and I was able to relate my medical history more coherently to the medical staff, an X-ray and stethoscope exam of my lower GI tract confirmed that my Crohn's had caused a very sudden but complete intestinal blockage. I was given blood and urine tests, put on IV's, antibiotics and prednisone (the usual treatment I receive during a Crohn's flareup -- very thorough and well-done) and a gastro-nasal tube was inserted to begin draining the contents of my upper GI tract in order to relieve the pressure and hopefully reopen the obstruction. I had never required such a tube, but the nurses inserted it skillfully. I appreciated their frankness that it was an unpleasant procedure, but one which was necessary to help me. They were as gentle and reassuring as they could be in such an uncomfortable process.
After the doctor whose name I didn't get reviewed all the diagnostic results and consulted with Celebrity HQ at Miami, I was told that we would need to leave the ship the following day in San Juan, PR where I would be transferred to the best local hospital for further medical care. It was repeatedly emphasized to me how lucky I was that this misfortune had happened to me near San Juan, or else they would have had to medevac me off the ship by helicopter in the middle of the night, which they indicated is quite dangerous. Needless to say, even so this was a heartbreaking ending to our second attempt at a Celebrity anniversary cruise, but it was a decision I understood in light of the pain and X-ray results I was having at the time. I have no doubt that this decision, initially, was made with my best interests at heart.
I spent the night in the ship's hospital wide awake under very harsh overhead fluorescent lights because the sick bay has no softer, indirect alternative to that or complete darkness -- a pretty minor complaint, but one I suggest Celebrity review for the comfort and rest of future patients. A bedside lamp or dimmable overhead lights would have been very welcome! At one point Solstice's very kind hotel director, whose name I didn't write down, paid me a visit and attempted to create some indirect light for me by propping the bathroom door open with a plastic back board (?), but it didn't stay. I appreciated her visit and her concern. All in all, all Celebrity's shipboard staff lived up to the line's reputation for excellent, courteous service.
By the morning of April 10, 12 hours after my admission to the ship's hospital, I was completely pain free and had required no morphine for some time. The third set of X-rays showed that the intestinal constriction was now only partial, and stethoscope exams showed that, to the doctors' surprise, my lower GI tract was now fully active again. In short, the situation was rapidly resolving itself thanks to the good care I had received. I felt well enough that the only thing I urgently needed was sleep, and I began to question the staff about the necessity of removing us from the ship later that day. I explained that after decades of Crohn's, the partial constriction the X-rays were showing is a CHRONIC CONDITION that I have lived with for a long time. Every X-ray and CT scan I have had for the past many, many years shows it. I provided the ship's staff with contact information for my gastroenterologist in Seattle to confirm what I was telling them, but I do not believe they or anyone at Miami HQ made any attempt to contact him.
The doctor whose name I did not get visited me briefly again that morning, April 10, and told me that, in light of my current improvement, I would be transferred to a hospital in San Juan for a CT scan, and that if it showed I was continuing to do OK we could re-board the ship before its 11 pm departure. This sounded very reasonable to me, a compromise between Celebrity's understandable need for caution and my need to minimize my fatigue, distress, and susceptibility to infection in an unknown foreign medical facility. However, a couple hours later, even though I continued to feel fine other than my exhaustion and my lower GI tract had obviously resumed busily working away again, the same doctor returned and told me that my husband and I would be off the ship permanently no matter what the tests at the San Juan hospital showed. He was very firm about this, offering no explanation other than that it was for my own good. To be truthful, at this point I began to feel that the decision was made more because Celebrity didn't want to be bothered with me further rather than because it was medically necessary. I felt, and still feel strongly, that the decision to boot us off the cruise no matter what was contrary to my medical best interests, especially under my particular circumstances.
Dr. ? did attempt to make me feel better about the situation by assuring me that arrangements had been made for my care at Ashford Presbyterian Hospital, San Juan's best, by a Dr. Goss, who spoke English, and that she had been fully informed about my condition. I would be in excellent hands, etc. etc. Nevertheless, my concern was rapidly increasing that this medical expulsion from the ship was not only unwarranted, but was dangerous for me. I'm a very cooperative person so I tried not to raise a ruckus about the decision, but I was quite unhappy and apprehensive about it and expressed this fact politely but repeatedly. I was also feeling mounting concern about my husband, who has well-controlled bipolar disorder but who was feeling increasingly agitated about the unfolding events. I conveyed to the medical staff my concern about this, and about how he would fare if I were stuck in a hospital in San Juan for a while and he was on his own in a strange city where he does not speak the language and had no knowledge of the place, nada. (I make all the travel arrangements and was the only one who had researched San Juan, a city we had never been to before.) The Solstice staff were sympathetic, but at no time did anyone relent on, or apparently even reconsider, the decision to remove us from the ship no matter what. I was never given a rationale for it, only a reiteration that it was an unchangeable decision.
The ship's concierge, Jennifer, did kindly assist my husband in making a hotel reservation at the Marriott Courtyard Miramar in San Juan and booking a flight for us SJU-MIA for Friday, April 13 by which time I would presumably be fit to travel. She was very nice and Jim appreciated her help. However, she made a couple errors that added significantly to our misfortunes. First, for reasons unknown to me she incorrectly informed American Airlines that I would require oxygen during transport when I have never required it in my life other than during surgery and it was in no way connected to an intestinal obstruction, and due to this misinformation AA refused to let us board our flight when the time came. Secondly, the hotel reservation Jennifer made was mistakenly made under the surname "Eod" rather than my husband's actual surname McLeod. When I was finally released from the hospital and made my way to the hotel, they had no record of my husband's registration and spent almost an hour contacting every Marriott property in San Juan trying to find him for me before eventually discovering the garbled name under which he had been mistakenly booked. These are just human errors which I don't really wish to complain about as Jennifer was sincerely trying to help us, but they inadvertently made an already-traumatic situation even worse for Jim and me.
Because of my concern about getting my husband settled in San Juan with as little confusion and distress as possible, and because I felt fine by now other than my extreme need for sleep, I asked that we at least be allowed to leave the ship by taxi to the hotel to check Jim in and drop our luggage, then on directly to the hospital for the CT scan. I was told no, ambulance was mandatory. When the ship docked in San Juan at 3:45 pm the personable port agent, Jennifer Robles, conferred with us very pleasantly but briefly, merely repeating the reassurances that all had been arranged and I would receive the best of care from Dr. Goss. An ambulance crew who spoke no English then came aboard to take me off and informed us that we needed to pay $150 cash on the spot. No one had advised us of this, and Jim and I did not have that much cash between us, having used our Seapasses for everything. It was another frantic hassle for Jim to find a working ATM onboard (the first one wasn't working and no one was helping him, being too busy preparing for the other passengers' debarkation for the port of call) to obtain the money for the ambulance.
At Ashford Presbyterian Hospital's emergency room shortly after 4 pm, no one knew a thing about me and they were not expecting or prepared for my arrival in any way, shape or form. Dr. Goss, if in fact she had been advised about me, had gone home for the day and evidently no one called her. I speak passable schoolgirl/ traveler's Spanish, but it is totally inadequate to convey complex medical information. The two young nurses, male and female, who eventually began dealing with me as best they could in the ER cubicle were very nice but spoke no English, were quite obviously perplexed, and were apparently receiving very minimal direction from anyone. To make a long story short, 5 hours later I finally saw one doctor (don't know his name) for less than five minutes and his primary concern was obtaining my name, address and insurance information and list of medications. I told him that I felt fine other than extreme exhaustion, that I was cardiac post-op and in desperate need of rest as well as immunosuppressed, and that I had a long history of the narrowed ileum the X-rays had shown and just wished to be released to go to the hotel and sleep. He would not look at any of the medical info or X-rays on the CD the ship's staff had sent with me. I tried to fill him in on how my doctors at home treat my Crohn's flareups but he cut me off. He was brusque and unsympathetic and very rushed. I frankly think I understood my own medical condition far more than he ever did. In my opinion this was very poor medical care, not what the ship's medical officer had assured me I would receive. I felt trapped and so exhausted that by now I could not stop crying.
For 10 hours from my admission I never saw this doctor or any other doctor again, but he apparently ordered an IV and a reinsertion of the gastro-nasal tube which had come out during the long walk to the hospital's X-rays. The young nurses did not insert it in the manner the ship's nurses had, failing to make the turn at the back of my nose to aim the tube down my throat. Instead they kept pushing straight back until I was in great pain and fear and bleeding profusely, crying out in Spanish "Please stop! You are hurting me very badly! I cannot stand this!" They then tried the same technique in the other nostril with the same results. Clots poured out of both nostrils for the next 10 minutes. Everyone was very upset, including the nice, well-intentioned but inept nurses. By now I was borderline hysterical. My husband was extremely unnerved by now from witnessing all this and worrying about me -- the most destabilizing possible situation for a bipolar person -- and I insisted that he leave and go to the hotel for fear he would have an acute psychiatric episode and our disaster would be exponentially increased. He very reluctantly agreed, realizing what thin ice we were both on by now. I was now totally on my own, beyond exhaustion, worried sick about my husband, and receiving no help, only inadvertent injury.
Eventually an older nurse came and inserted a new gastro-nasal tube properly. However, rather than draining the contents of my upper GI tract into a bag as the ship had done very efficiently, the staff with no explanation hooked me up to an electric pump which merely sent the contents of the tube back and forth, back and forth endlessly from my stomach to the pump receptacle. In 10 hours less than 75 cc of fluid was drained from me, whereas on the ship it had been coming off at the rate of 100-200 cc or more per hour. Moreover, the ship's medical folks had told me that since my stomach was constantly replenishing the fluid that was being drained, I knew that what the San Juan ER was now insisting on "draining," even though it was going nowhere, was normal digestive fluid, not a reason to keep me indefinitely.
Other than that very brief, very unsatisfying discussion with the doctor, the only English-speaking person I saw occasionally for many, many hours was Anthony, the hospital's personable patient assistance coordinator. An hour after our arrival he did kindly help us make a phone call to my family to inform them we had been removed from the cruise when my Verizon cell phone would not work in the hospital and they had no internet connection available, but other than that I saw him very briefly only every hour or two and he either would not or could not convey my rising concern to the medical staff. He merely reassured me repeatedly in a well-practiced, soothing speech that all this was for my own good. I know his intentions were good, but other than the phone call he did not really assist us, but rather made me feel like I was talking with a very polite brick wall. After he went home somewhere around 11 pm or so, no one came to see me, though passing nurses observed me crying exhaustedly and looked sympathetic but uncertain what to do.
7 hours after my admission, I asked how much longer I had to wait for the CT scan. I was told that it would not happen at all that night and perhaps not for several days. I was also told I could not be admitted to a regular room where I could rest while waiting for the CT scan, but had to stay in the brightly lit, chaotic ER where the bed had no blanket or pillow (the nurses laughed, though not unkindly, when I asked if such were available -- apparently the hospital does not provide them to anyone). My cubicle was directly across from the bathroom, and throughout my stay I watched a steady parade of men and women patients and family members use it and not once was it cleaned. It sounded like many who used it were not even washing their hands. I myself could not use it till 2 AM, 10 hours after my admission, because my IV was not on a movable pole and my GI pump was stationery, and I couldn't get anyone to come help me get to the bathroom. Misery. In fact, for 95% or more of the first 10 hours in the hospital, I was left entirely to myself with no information and almost no active care. When I finally was helped to the bathroom many hours later, it desperately needed cleaning. Please remember that I am immunocompromised. I hope you can understand why by now my only thought was to get out of this miserable facility as quickly as possible for my own safety.
After midnight I composed a long note to Anthony explaining why I could not remain in the ER any longer, why it was medically dangerous for me. I told him I desperately needed sleep and would return to the hospital the next day if a CT scan could be done at that time. I did not know that Anthony had gone home by now without handing me over to anyone else, and for a long time there was no response to my note. But thankfully about 2 AM a very kind and efficient new doctor, Dr. Hernandez Chuan (?), only the second I had seen, appeared and spoke English and began to take matters in hand. This was a TREMENDOUS relief and I am very grateful to the good doctor. He could see how distraught I was, especially at the idea that I might be held a virtual prisoner here for days. He arranged to have my IV and the nasal tube and pump removed and I was at last able to use the dirty bathroom. About 5 am I finally received the CT scan, which showed what I had been saying all along and confirmed that I was OK, and at 7 am I was released, 15 hours after my arrival. I was so profoundly grateful to be on my way to the hotel that I didn't even notice or question the fact that the only paperwork I received at discharge was four prescriptions and a totally unfilled out checklist of symptoms and instructions, in Spanish, that the doctor and I both signed.
When I reached the Courtyard Miramar which, BTW, treated us wonderfully with lots of extra TLC) and was finally reunited with my husband after the very upsetting inability to locate him due to the error in surname booking, I slept for two days. By Friday the 13th we were eager for our flight back to the mainland. We arrived at the airport 2ï¿½Â½ hours before our flight only to be denied boarding by AA because of the Solstice concierge's unnecessary request for oxygen. The airline said they could not fly us that day or ever without official certification from a doctor that I did not in fact require oxygen and was medically fit to travel. All that I possessed was the unfilled out discharge form from the hospital, which was totally inadequate. AA initially said that they could do nothing for us until we had gone back to the hospital or seen a private doctor and obtained a proper medical release, which might take another 1-3 days. Our flight left without us. Finally the airline relented and, after much confusion taking several hours, succeeded in reaching Dr. Hernandez Chuan by phone and obtaining his verbal release. By the time we finally reached Miami on a later flight, all our arrangements for travel onward were kaput and we were both at the breaking point. This particular Friday the 13th earned its reputation. This latter set of dismaying reversals could have been totally avoided if the well-intentioned but misinformed request for oxygen had not been made by the Solstice and/or if someone on the ship had informed us ahead of time that a much more complete hospital discharge form would be necessary in order to leave the country. If (God forbid) anyone reading this should experience a medical emergency requiring debarkation in a foreign country, please keep in mind this very crucial fact!
This account is far too long already, and there are many unpleasant details I have omitted. Let me just summarize by saying that, although I sincerely appreciate the good medical care I got on the Solstice and have no complaints about the initial decision to remove us from the ship, I believe very strongly that the decision to persist with the emergency disembarkation despite the fact that my symptoms had resolved themselves was a very poor one which actually put me in further medical jeopardy as well as emotional and financial distress. I don't know who was ultimately responsible for it, but it was a very bad call which I do not feel was in any way justified by diagnostic results from the morning of April 10 onward.
As to the quality of care in the emergency room at Ashford Presbyterian, I would have to give it a D, though others' experiences there obviously differ. I was told that the hospital is the facility of choice for all Caribbean cruise ships, and they have won many commendations. I apparently just fell through the cracks and had no one, from Celebrity or the port authority or anywhere else, advocating for me or following up on what was happening to me. It was a profoundly traumatic experience, and this is not just an emotional overreaction. It is a medical fact, given my immunosuppressed and post-op condition and need above all for rest, not further unnecessary medical intervention. The care Celebrity assured me I would receive was simply not forthcoming, and I believe that the decision to forbid our re-embarkation under any circumstances was not only unreasonable but negligent, although I do not doubt it was initially well-intentioned. If Celebrity is truly concerned about passenger welfare, I strongly suggest they re-evaluate their policy regarding emergency disembarkations mandated by them. Even if I had continued to be unwell, which I was not, I would have been far better off remaining on the ship in my cabin or even the shipboard medical facility than being held a virtual prisoner in a chaotic, unsanitary, uncomfortable and unresponsive ER in San Juan.
At this point I do not know how our trip insurance will handle our claim. 11 days after my discharge, Ashford Presbyterian Hospital has yet to submit to me or to my health and trip insurers, whose information I gave the hospital, ANY record whatsoever of my admission, treatment and discharge. Other than the one unfilled-out discharge form in Spanish, it's as if the whole experience never happened. Understandably, neither of my insurers can even begin to address our claims, which amount to many thousand dollars, without hospital records. I have spent the last two days trying to contact the proper people at Ashford, by phone and e-mail, and have so far gotten nothing but voice mails which hang up before my message is completed. The e-mail addresses at their website keep getting bounced back to me as undeliverable -- no such address.
We had prepaid non-alcoholic drink packages for our cruise. I used mine zero, unless you count IV fluid, and even if I had, was off the ship 5 days before schedule. Jim did use his for 2 days out of 7. We were given no pro-rated refund on disembarkation, only the shipboard medical bill of $2059.60 which we had to pay before leaving the ship. To add insult to injury, we were told that although we had paid fully for the cruise and did everything within our power to persuade Celebrity to let us continue it, and Celebrity will incur no financial losses because of its curtailment by them, we will not even receive Captain's Club credit "because we did not complete the cruise." I find this absolutely astonishing.
Would we try another Celebrity cruise? Boy, at this point I just don't know. Before my illness and even immediately after it began there was much to like about this experience, short as it was, and my husband bought Open Passage certif's in case we do make a third attempt at celebrating our anniversary this way. But I'm bothered not only by X's ultimate handling of my medical situation but by the fact that they have not in any way contacted me since our return home to ascertain my well-being, comment on their decision, refund any portion of our prepaid shipboard charges, or anything else. They have, however, totally bombarded me with advertising material about future cruises with them and dumb mass e-mails saying they hope we found our cruise delightful. So far the lengthy e-mail I sent to Celebrity HQ two days ago has received only an automatic e-mail acknowledgement of receipt, though the fact that it is a weekend undoubtedly accounts for some or all of that. So the jury's still out...
That's my story. Hope it helps someone and doesn't scare the bejeezus out of anyone. There is a lot of reassuring stuff to commend Celebrity on, though obviously a lot that disturbs us a great deal.
P.S. I'll post my opinionated comments on the Solstice's food separately!