capable of earning shoreside from that which he would have earned at sea, reducing future losses to present worth at 6%. These losses total $17,500. Third, from June 1, 1975, until October 13, 1987, at which time plaintiff will have reached age 65 and the end of his work life expectancy, we find that he will be able to engage in full time shoreside work earning $8,200 per year (he is capable of earning $150 per week or $7800 per year now, and we posit some increment, though smaller than the seafaring increment), but because he will earn less than as a seaman (he would average $12,217 per year), we find plaintiff's earnings loss will be $4,000 per year or a total of $49,300, which, reduced to present worth at 6% simple interest, amounts to $37,283.
4. Medical Expenses
As a merchant seaman, plaintiff is entitled to receive free medical care from the USPHS, and, except with respect to his mental illness, he has received it. The question of an award for medical expenses (past and future) arises only because plaintiff was not offered psychiatric care at USPHS and thereupon incurred expenses for private psychiatric care, and because he will need intensive psychotherapy for at least two years in the future.
It is clear that a merchant seaman is obliged to accept and undergo treatment at the USPHS. However, this rule is subject to certain exceptions. For example, if private medical treatment gives a seaman benefits he could not obtain by recourse to a public health facility, then the cost of private medical treatment is recoverable by him. McManus v. Marine Transport, Lines, Inc., 149 F.2d 969 (2d Cir. 1949). And the fact that a facility of the USPHS certifies that a seaman is "fit for duty" does not preclude that seaman from proving that he was in fact disabled and in need of treatment. Labenz v. National Shipping and Trading Corp., 153 F. Supp. 785 (E.D. Pa. 1957). In such circumstances he would be entitled to recover the money spent by him for private medical treatment, even though the USPHS had previously certified him as "fit for duty." See Scott v. Lykes Bros. S.S. Co., 152 F. Supp. 104 (E.D. La. 1957).
We first address the question of plaintiff's entitlement to recover the sum of $700 representing the bill of Dr. Dillon for psychiatric services.
Psychiatric care and treatment was not offered to plaintiff by the USPHS either before or after his suicide attempt for which he was hospitalized in the USPHS facility in Baltimore, even though, at least during his second inpatient stay, the USPHS officials were aware of his psychiatric problem. In Nunes v. Farrell Lines, Inc., 129 F. Supp. 147 (D. Mass. 1955), the plaintiff sought to recover for bills of his private physician and hospital in connection with the insertion of a plate to cover a hole in his skull. In awarding the merchant seaman the amount of his private medical expenses, the Court found that "[there] is no evidence that the Marine Hospital had either suggested or offered to place the plate in the plaintiff's skull." 129 F. Supp. at 147. We elect to follow Nunes, and find that plaintiff is entitled to recover the amount of Dr. Dillon's bill in these circumstances, i.e., where the plaintiff desired the treatment and the treatment in question was reasonably necessary.
We turn then to the question whether plaintiff can recover the value of the future psychiatric care which he requires. No record was developed at trial as to whether the future psychiatric care needed by plaintiff is available at USPHS. We asked the parties, following post-trial argument, to determine from USPHS whether outpatient psychiatric care is available at USPHS facilities geographically accessible to plaintiff. The parties have agreed that such care is available at Baltimore, as well as at Staten Island and Norfolk, Virginia, but not at Cleveland, which is the only USPHS facility geographically accessible to plaintiff's present home. However, an even greater obstacle than geographic distance confronts any efforts by plaintiff to obtain psychiatric treatment at a USPHS facility. That obstacle stems from 42 C.F.R. § 32.17, which provides:
Where more than 90 days have elapsed since an applicant's last service as a seaman and he can show that he has not definitely changed his occupation, such period of time shall not exclude him from receiving care and treatment (a) if due to closure of navigation or economic conditions resulting in decreased shipping with consequent lack of opportunity to ship or (b) in the event the applicant has been receiving treatment at other than Service expense.
It is far more than 90 days since plaintiff's last service as a merchant seaman and he cannot show that he has not changed his occupation, for he has. Since plaintiff is therefore not eligible for USPHS outpatient psychiatric treatment and is also not geographically accessible thereto, we find that he is entitled to recover the sum of $2,160, representing the cost of future medical expenses necessary to improve his condition.
5. Pain and Suffering
We have described the nature of plaintiff's injuries in some detail. We find that these injuries were the efficient and producing cause of physical pain and mental anguish. The initial phase of plaintiff's injury was particularly painful, as is demonstrated by the comments in the Port Arthur clinic record, the heavy medication administered to him while the ship was en route to New England and later at the USPHS Hospital in Baltimore, and his own testimony. Indeed, the 25-foot fall through the jagged hole to the steel plates below was a horrendous experience in and of itself. We find that plaintiff is entitled to receive the sum of $7,500 for his pain and suffering during the initial phases -- until he was orthopedically fit for duty. During the latter phase of plaintiff's injuries, as manifested by his psychiatric problems, he suffered more than a modicum of mental anguish in the form of depression, fear, anxiety and tension. At times the mental suffering was intense. At most times, however, it was only moderate, alleviated by medication. Or, it was accommodated by plaintiff's regressive life style which mollified his distress. While the anxiety and depression will continue to some degree in the future, we believe that it will be greatly minimized by the aid and insight obtained from psychotherapy. We find that plaintiff is entitled to the sum of $6,500 to compensate him for pain and suffering, past and future, in the latter phase of his injuries, or a total of $14,000 for pain and suffering.
C. Conclusions of Law
In addition to the conclusions of law set forth in the liability section of this Opinion, we find that the accident which plaintiff suffered on March 29, 1970, was a proximate cause of the personal injuries and damages that we have set forth in our findings of fact on damages. In summary, we conclude that plaintiff is entitled to recover: (1) the sum of $67,583 for past loss of earnings and future loss of earning capacity; (2) the sum of $700 for past medical expense and the sum of $2,160 for future medical expense; and (3) the sum of $14,000 for past and future pain and suffering, or a total of $84,443.