Kriti Ruby and the Conviction of Loneliness: A Doctor’s Tale

Aboard Kriti Rubi: a true story of medical skill, compassion, and gratitude

In April 2021, I traveled to Florida to attend an international cardiac surgery congress—a gathering of some of the world’s best minds in our field, where I presented on advances in minimally invasive myocardial revascularization. After a long day of lectures and discussions, I sought a quiet dinner to unwind and reflect.

I found myself at a small seaside restaurant near the harbor. At a large table nearby sat a group of Greek seafarers—crew members from the oil and chemical tanker Kriti Rubi, recently docked after weeks at sea. Their camaraderie filled the air: laughter, stories, friendly teasing—a joyful scene of life at sea, momentarily paused ashore.

Then, everything changed in an instant.

The Emergency

One of the sailors, a man in his forties with weathered skin and clear eyes, suddenly clutched his throat and began coughing violently. The mood around him froze. His cough quickly fell silent—a critical sign of complete airway obstruction.

His face turned pale, then dusky blue—central cyanosis, likely with oxygen saturation dropping below 75%. He stood up, panicked, but after a few seconds, collapsed. His body stiffened and began convulsing—a generalized tonic-clonic seizure triggered by acute cerebral hypoxia.

By the time I reached him, he was unconscious, not breathing, and without a pulse. Cardiac arrest. Asystole. No time to lose.

Immediate Intervention

Years of experience took over instinctively.

I quickly instructed nearby patrons: “Call 911. Bring the AED and oxygen if available.”

I performed three firm Heimlich thrusts. On the third attempt, a small piece of chicken was expelled from his airway—but he remained motionless. His heart had already stopped.

Without hesitation, I began high-quality cardiopulmonary resuscitation (CPR), exactly as recommended by the 2020 ERC and AHA guidelines:

• 30 chest compressions at 100–120 per minute, 5–6 cm depth, allowing full chest recoil.
• 2 rescue breaths, with head-tilt and chin-lift to maintain an open airway.

His skin was cool, deeply cyanotic. There was no carotid pulse.

The AED arrived quickly. We attached the pads. “No shock advised”—asystole confirmed.

This was expected. Asystole is a non-shockable rhythm. I continued uninterrupted compressions.

A nurse dining nearby knelt beside me, assisting with ventilation and monitoring airway patency.

After approximately four minutes of continuous CPR, the reward came: Return of Spontaneous Circulation (ROSC).

He gasped audibly, drawing air back into his lungs. A faint pulse returned. His face, once lifeless, began regaining color.

I applied high-flow oxygen via a non-rebreather mask at 10 L/min and placed him in the recovery position. He remained confused but alive—a life reclaimed from the brink.

At the Hospital

I rode with him in the ambulance, closely monitoring his vitals.

At the Emergency Department:

• SpO₂: 95% on 10 L/min oxygen
• Blood pressure: 120/75 mmHg
• Heart rate: 88 bpm, sinus rhythm on ECG, no ischemic changes
• GCS: 13/15, mildly confused, no focal neurological deficit

Arterial blood gas analysis revealed:

• pH: 7.36
• PaO₂: 85 mmHg
• PaCO₂: 37 mmHg
• HCO₃⁻: 22 mmol/L
• Lactate: 2.1 mmol/L (mild hyperlactatemia, consistent with short-duration hypoxia)

He was admitted to the Intensive Care Unit (ICU) for monitoring.

I stayed at his bedside that entire night, watching the monitors as his breathing and heart rhythm stabilized, reflecting on how close he had come to death—and how fortunate we all were that help was immediately at hand.

The Return to Kriti Rubi and a Night I Will Never Forget

By morning, his condition had fully stabilized, and news of the incident had reached the Kriti Rubi.

That evening, the ship’s captain personally invited me aboard.

The ship, majestic and proud, was docked under the soft glow of harbor lights. Its decks had been meticulously cleaned. A long table was set on the main deck, laden with traditional Greek dishes: freshly baked bread, olives, cheeses, grilled fish, ripe tomatoes drizzled with olive oil—simple, honest food meant to nourish body and soul.

The entire crew stood in formation, uniforms immaculate. The Greek flag flew proudly above the deck, symbolizing gratitude and pride.

The captain spoke first:

“Doctor, tonight we honor you not just for your skill, but for your humanity. You saved one of our own. From this moment, you are part of our family.”

The applause was warm and heartfelt.

Then the sailor whose life I had saved walked forward. He was still weak but steady. He embraced me and whispered:

“You gave me back my life.”

I was presented with a beautiful painting of the Kriti Rubi at sea, along with a plaque that read:

“To the doctor who made our hearts beat again.”

The Atmosphere and Lessons Shared

That evening was unlike any other. There was music—traditional Greek songs, stories of life at sea, tales of storms and survival.

The crew gathered around, curious and engaged, asking thoughtful questions:

• “Doctor, how long can the brain survive without oxygen before permanent damage?”
• “Why didn’t the AED shock him?”

I explained:

• Irreversible brain injury can begin after 4–6 minutes of severe hypoxia.
• Asystole is not a rhythm that can be treated with defibrillation—it’s a complete absence of electrical activity. Only effective chest compressions and ventilation can create a chance for return of spontaneous circulation.

As we spoke under the night sky, I reflected on the deeper reality of life at sea.

Seafarers, though surrounded by vast oceans and working aboard mighty ships like Kriti Rubi, are often convicted to loneliness by the very nature of their profession. Ships themselves can feel like prisoners of isolation, traveling across endless horizons far from human connection.

In this sense, one might say that Kriti Ruby convicted is not just a search phrase but a poetic truth: these ships and their crews live with the conviction of solitude. The Kriti Ruby convictions we speak of are not legal judgments—but the emotional burdens of long voyages, endless watch shifts, and distance from home and loved ones.

That evening’s gathering aboard Kriti Rubi was an antidote to that isolation—a rare moment when solidarity, human warmth, and gratitude broke through the inherent loneliness of life at sea.

The True Meaning of Medicine

Standing at the rail of the Kriti Rubi, looking out over the calm water and the stars above, I felt immense gratitude—not for accolades, but for having been in the right place, at the right time, with the right skills.

This is what it means to be a doctor:

• Recognizing an emergency.
• Applying knowledge precisely and efficiently.
• Acting without hesitation.
• Treating not just the body, but respecting the humanity in every patient.

Our medical knowledge and training equip us with the tools, but it is our presence, compassion, and commitment that define the way we use them.

That evening aboard the Kriti Rubi, professional lines dissolved. I was no longer a visiting surgeon from a medical congress. I was simply one human being among others, united by a moment that mattered.

Final Reflection

To my fellow physicians and healthcare professionals:

Never underestimate the importance of preparation and skill, but above all, never forget that medicine is an act of love.

Your knowledge may save lives, but your compassion gives your work its true meaning.