Author’s note: More than 1,500 passengers died in the Titanic, a disaster that resonates nearly a hundred years later. The equivalent of about 50 Titanics capsize annually in U.S. hospitals, nearly one every week (based on the Institute of Medicine’s estimate of 44,000-98,000 deaths per year from hospital adverse events). As hospitalists, it is our obligation to ensure the hull is solid, the crow’s nest properly manned, and the ship is turning in the right direction.
I’m the Rev. John Harper, and it’s April 10, 1912.
As I grasp my boarding pass I can’t contain my awe and excitement. Imagine me aboard the world’s most luxurious cruise liner heading to America. Granted, I’m booked in second class. But as everyone knows, second class on the Titanic outstrips first class on most liners these days. It should—for $66 this is an expensive way to travel. Still, it’s less than the cheapest first-class ticket of $125 and much less than a $4,500 booking in the millionaire’s suite. I could buy several houses for $4,500.
Walking along the gangway I recall hearing that this ship—the largest ever built—weighs nearly 47,000 tons and cost $7.5 million. Outside my cabin door I encounter a fellow passenger who exults over the ship’s amenities. The liner has a heated indoor swimming pool, four electric elevators, two libraries, a Turkish bath, a squash court and gymnasium, and ample room to move about. The White Star Line has thoughtfully limited the amount of lifeboats to 20 to preserve precious deck space for passengers.
I’m Jeff Glasheen, and it’s Sept. 15, 2007.
As my wife prepares to deliver our first child in the coming weeks, we visit the labor and delivery deck of the hospital.
It will be our first major interaction with the healthcare system as patients. It’s the largest healthcare system ever and costs nearly $2 trillion a year to operate. We have chosen a new hospital that features an amazing array of amenities, including a birthing center with private suites, in-room baths with oversize soaking tubs, an in-room sleeping area for family and friends, and a DVD player and flat-screen television. There are even Internet connections.
Room service is available 24 hours a day, and the staff is top-notch. I’m told some choose to stay in the VIP suites for an extra $1,000 a night. This restricted-access area offers 600-square-foot rooms with original art on the walls, luxury mattresses and 350-thread count linens, complimentary robes and slippers, and an office area supplied with newspapers, a printer, fax, voicemail, and teleconferencing capabilities. There is a family room as well as a private refrigerator, an assortment of beverages and a dedicated chef. Unfortunately the cost is too steep, so we’ll spend this voyage in second class. However, as everyone knows, second class on this vessel outstrips first class in most hospitals these days.
Midnight, April 14, 1912
Something has gone wrong; the ship just hiccupped a bit. From my cabin I clearly hear a grinding that could happen only when two large objects come into contact. It’s strange, but I assure my bunkmates there is nothing to worry about. The Titanic is unsinkable, built with every feasible safety feature. The ship’s hull is made of inch-thick steel and held together with nearly 3 million steel rivets. In the unlikely event the hull is breached, the ship contains 15 watertight bulkheads to contain the leakage. Further, 3,560 life vests, 48 life buoys, and the aforementioned 20 lifeboats (four more than required by British law) allay my concerns.