what do you do after you escape the sinking ship and are safe?
1) Have an American Express Card. It's helpful to have the numbers on it memorized.
2) Once the immediate dangers are past, get access to a phone. Call them collect and ask for Global Assist.
3) Wait not very long at all while they bring you travelers' checks, a replacement American Express Card, a ride, and suggestions for a place to stay.
4) Get replacement passport or other travel documents from the US Consulate or Embassy.
While my experience with Global Assist overseas was far less harrowing than a cruise ship sinking, it was nice to see how quickly they had me taken care of.
Another option open to me is to call my mother, my sister, or my brother-in-law, and have my sister's lovely Italian in-laws come get me. I'd call them directly but I don't have their numbers.
Travel insurance is an excellent choice. Good travel insurance will indeed arrange for and pay for medical care or transport, in addition to providing emergency access to cash if things go badly awry.
I've no affiliation with American Express other than as a customer.