Excellent post from Dr Bob. Without overdoing the issue related to guests traveling with you please let me include...on long passages I would be VERY hesitant to invite anyone on coumadin and to a lesser extent plavix. Knowing the reasons folks are on medications may be an infringement on their privacy... not knowing in an emergency could be a catastrophe! In our age group diverticulosos is quite prevalent, especially on our western diets. Diverticulitis is a surgical emergency in most cases! Medical evacuation would likely be the best course even if antibiotics are available. Oh darn, this list could go on and on... with each passing decade we are less agile and more reliant on medical care. Having trained personnel aboard to recognize and stabilize an emergency is most prudent but not practical on most vessels. Managing a medical emergency after the "golden hour" is much more problematic. Tom R PA-C 25 years experience Trauma and General Surgery in Level I Centers