The day I hated my job as a surfdoc

I had waited for that day. Everybody got barreled. Everybody. Stand-up pits in turquoise water, light offshore winds, and a good crew in the water. But I did not even get to paddle out that day. In fact, I did not even get wet that day. Well, apart from by my own sweat that is.
One by one, the surfers came in at the end of the day, stoked but humbled. I felt disappointed and scared at the same time. Disappointed I might have missed the best day of swell of the whole trip. Scared I could have the worst night of my life in front of me.

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A G-Land afternoon

The day had started with the typical morning sickness in G-Land. The swell was solid, the tide low and the winds bad. While waiting for the tide to rise and the wind to turn I removed some stitches (a guy had gotten bitten by a monkey) and looked at some X-rays. An Indonesian who had had an accident three weeks ago still could not walk. I put a bandage on his leg and sent a picture of the X-rays to a friend who knows more about bones than I do. Once the wind would swing offshore Speedies, the prime section of the G-Land reef, would be firing.

G-Land lies on the south eastern tip of Java, Indonesia. As a surfer you know of it. It has been in the spotlight since the 80s. Recently however, it has gotten fairly quiet. G-Land is hard to get to, the only reasonable option is a speed boat from Bali. It sits deep in the jungle in a national park. The landscape is stunning. As are the waves. But the focus of many surfers has shifted away from it, to cheaper and more reliable surf options in Indonesia. And more forgiving options.

There are three surf camps at the edge of the jungle. One is struggling, the other two are rarely booked out these days. It might be because the waves seem flawless from far away but get pretty nasty from up close. G-Land looks perfect but it is not. It constantly changes, no wave is the same. When you think you are in the perfect spot you are, most probably, not. The better a surfer you are the more you can enjoy it. After surfing G-Land you will know where you stand, it is not one of these waves that makes you feel good, make you look good. It’s a wave that makes you realize what a kook you are. So it is not the right wave for a German kook like me when you look at it that way. But I am a masochist too. I like difficult situations. And looking down the line after a take-off in G-Land having to decide what to do, pulling in or getting the hell out of there, is definitely one of those. After surfing conservatively for a week I felt like today was going to be the day. I am ready, I’ll pull in deep. I was pumped when I was heading, board under my arm, to the boat that would take me out to the waves just before high tide.

I never set foot on that boat. One of the photographers came running my way yelling they needed a doctor. I hurried to the launching pad and found a guy with blood all over, vomiting, looking severely injured. I gave my board to another surfer to bring it back to camp. I knew I would not need it that day. After a primary check I had a four wheel drive take the patient and me back to Joyo’s Surf Camp.

Dan* had hit his head on the reef at Speedies. Through the impact he lost consciousness. Other surfers saw his lone board floating on the surface, paddled to him, got him out of the water and on his surfboard, and pulled him to the photographers’ boat. He started breathing without CPR. Foam was all over his mouth.
Clinically, he had two tissue wounds on his head and a wound on his back that looked like Wolverine had gotten him. There was no sign of a spinal injury. His respiratory rate was just over 30 per minute. He had signs of hypoxia being confused, pale and generally very weak. He was coughing and vomiting non stop as I was taking care of him.

I knew he was not going to die just now. He was breathing spontaneously and his circulation was working – more or less. His head wounds looked gnarly, as if parts of his brain were coming out of his skull. But they were only coral heads that had gotten stuck in his bald head when he hit the reef. What worried me was his respiratory rate and the very basic medical equipment at my disposal. He could die here pretty soon. It was just after midday, the ventilator of the medical room was broken and I was still wearing my 1 millimeter wetsuit top. This is when I got wet that day. Sweat was running down my back in streams. I might not be pushing my surfing boundaries but I might have to push my medical boundaries today.

I took my rash vest off, asked for a fan and send somebody to find the wallet of the injured surfer from the other camp. I needed his details to organize the evacuation by helicopter. The day before I had gone through the equipment in the medical room and had made my German ancestors proud by putting everything in order. Being the only doctor in G-land at the moment I wanted to know what gear would be at my disposal in an emergency. So I knew there was plenty of stuff to look after Dan’s wounds but there was nothing for his lungs and airway. In case of a respiratory deterioration there was nothing I could do.

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The guy I had sent to Bobbies Camp to find the wallet returned empty-handed. When he came back I had already talked to the helicopter rescue team. They need the ok of Dan’s insurance otherwise they would not fly. I tried to talk to Dan. He knew where he was and he knew his name but that was it. He did not know the name of the insurance or where his wallet was hidden.

Luckily, my wife just had come back from surfing her favorite wave. She is a tough one. If she wants something she usually doesn’t stop until she gets it. She is a journalist, someone who knows where to dig. I told her to get the wallet and I knew she would find it. Meanwhile, I started cleaning Dan’s wounds and inserting  some local anesthesia. One of the head wounds was really hard to clean. Little pieces of coral everywhere among smashed skin. There was no way I could suture it without removing major parts of skin. In proper surgery surroundings I would have removed a pretty big flap and mobilized the skin around it to pull it back together. Luckily, us humans are pretty good in healing our heads. It might be an evolutionary advantage from back in the days when we used to hit each other over the head with sticks and rocks. So the head was not worrying me too much.

Just when I started to put in the first stitches my wife came back with Dan’s wallet and phone. They were hidden away in a board bag which was locked and the tiny key was hidden somewhere else in the room. I don’t know how she found it but if anyone could it was her. She called Dan’s insurance and passed the evacuation team on to me. They were great. They immediately understood the seriousness of the situation and said they would organize the evacuation while I should concentrate on preparing the patient for the transport via helicopter.

I went back to suturing Dan’s head wounds but the anesthesia had worn off. This is the first thing Dan remembers. About two hours after the accident he asked me what had happened to him. I upped the dose and continued with the stitches. When I asked Dan where all the other scars on his head are from he replied: surfing accidents. I wasn’t surprised.

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Of the 16 guys who were out surfing when Dan hit the reef and almost drowned one came in after the rescue. That’s it for the day, he said, I’m done. As I handed Dan the bucket to vomit once more the other surfer said: The tide is just not high enough for Speedies. Everybody else kept getting barreled over shallow reef. The photographers had gone back to capture every moment. If you traveled to the end of the world to do this you wouldn’t stop because of an accident. Would you?

Between the surfers who remained in the water a silent bond of brotherhood arose out of the accident. At night surfers told me that everyone was watching out for everyone. Dan’s rescue had been intense. It took six surfers to get the unconscious man out of the impact zone. The two surfers first at the scene were a Californian and a Brazilian. They had seen Dan take off on a wave – and never resurface. They reacted quickly, got Dan on his board, then four other surfers came to pull them out offering their leashes to hold on to. They got lucky that no wave washed them all on the reef. The impact zone at Speedies is serious, a big set could have ended the rescue quickly. Gabriel, the Californian first at the scene, was the best surfer out there. He was in a state of shock after pulling Dan out doubting if the surfer would survive. His emotions transformed into a mad kind of surfing, he told me, he felt invincible. Most other surfers surfed slightly more careful after the incident. Gabriel pulled in deeper. He felt so in tune with mother nature that he just could not stop. Even as the tide dropped he kept surfing the dangerous Speedies section. The last surfer tried to persuade him to come in with him. But Gabriel kept on surfing timing every move perfectly. One man’s desaster turned into another man’s glory. Even a thunderstorm couldn’t stop him from surfing until dark.

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Thumbs up for those two lifesavers Gabriel and Filipe. Their quick and brave reaction saved a man’s life.

But it could stop the helicopter from flying. When I finished stitching up Dan we got the bad news. There was a thunderstorm in Bali too, the rescue team would come first thing in the morning. I told them that we wouldn’t need a heli the next day. If Dan made it through the night he was out of mortal danger. The question was if he’d make it through the night.

I was afraid of an ARDS which means Acute Respiratory Distress Syndrome. Some people call it in a situation like this a secondary drowning. It would be on me to keep Dan alive. Mick, a guy of the  Joyo’s crew, took me to the other medical rooms. Each of the three surf camps has a medical room. This says a lot about the wave. I found the best equipment at Raymond’s Camp. In fact, there is a whole mini clinic. The Surfing Doctors, notably Phil Chapman, have brought a lot of medical supplies and established a well organized system. In the end, I had enough gear to intubate Dan and to secure his respiration through the night by hand. Well, I had found a bottle of oxygen but I wasn’t sure how long it was going to last. Also, I had gathered enough drugs to put him into a narcosis but after all I am an ENT resident no senior anesthesiologist. Thinking about maybe having to do all these things made me nervous.

That night, my wife and I spent at Bobby’s Camp together in a room with Dan. At first I had thought about taking turns with others in checking on him but in the end I knew I would feel better if the responsibility was only on me.

We talked all possible scenarios through with Dan. I put an i.v. line and got all the gear we could possibly need that night in order. Dan seemed good though. He could walk short distances and he was not confused anymore. I was still very far away from feeling relieved but I was relieved enough to go back to Joyo’s to get our stuff for the night.

When we came back to the room Dan was gone. I was worried. I went around the camp looking for him. Finally, I found him in the photographer’s room checking out the pictures of the day. I felt something in between anger and relief and looked at the footage of the accident myself. The wave Dan had taken off on wasn’t actually that big. But it was a nice shot of him deep in the green room, the place we all want to be. On the next picture of the sequence you can see a big ball of exploding white water with him somewhere inside, the place we all fear and yet spend a fair amount of time in.

The story is not over but the exciting part is. Dan recovered well. He was flown out the next morning but it took him weeks to fully recover. The x-ray in the hospital showed tissue damage in his lungs and he was put on antibiotics for a while. The head wound healed well, he sent me some pictures. The last thing I heard was that he went back to G-land charging like nothing had happened.

As for myself, I recovered well from missing out that day. No long term damage. I gave my wife a promotion, she is a surfing nurse now. Joyo’s granted her a discount as well on top of the discount I got for being the camp doctor. And after talking to Dan’s insurance company again they encouraged me to write them an invoice. I charged only a bit over 300 Australian Dollars for the  medical gear and 19 hours of work for me and my wife. Yes, I did not charge a lot. But since it is all the money I’ve made so far as a surfing doctor I am hell proud of it. The freshly promoted surf nurse is already asking for a raise though.

Most importantly: I got barreled somewhere else not too long after leaving G-land.

Next Trip to G-Land:

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Want to enjoy this? Be prepared.

G-land is a special place and I want to come back as soon as possible. Here are just two things to make your and my trip even better next time:

First, if you go to Gland get travel insurance! Yes, usually nothing happens but if something does happen you put yourself in a really bad position out there. And the people looking after you. Having capable staff organizing the evacuation allows you as a doctor to concentrate on the patient. And them appreciating the work done by a doctor in the jungle is great. Thumbs up for WE ASSIST, for Australians I can recommend them, it was great working with them.

Second, if you go to G-land support the Surfing Doctors! One thing is just to acknowledge their work. What Phil Chapman and his crew have established there is great. All the equipment does cost money and there is a lot of work involved. Let the camp owners know you appreciate having a doctor around. They want the doctors there but they are businessmen too. And for the doctors: Yes, it is only fair that we get a discount. You’re on vacation yet you carry a lot of responsibility – and might just end up not surfing a day or two and instead taking care of patients.

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Yes, there is a helicopter launching pad in G-land but do not get too comfortable. They never come in time.
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6 thoughts on “The day I hated my job as a surfdoc

  1. Youre a good man-and your wife too–and i wish the kinship you just descibed becomes more apparent in the ever more crowded spots…but yeh-G Land is hell serious-(i could never..)

    Like

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