The perfect wave

Surfing and cataract surgery have more in common than 
you might think, says Leigh Spielberg MD

Leigh Spielberg

Posted: Sunday, April 1, 2018


Illustration by Eoin Coveney

If you’ve never gone wave surfing on Costa Rica’s Pacific coast, I highly recommend you do so. Even if, like me, you don’t know how to surf. But it doesn’t matter. All you need is a surfboard. And also airplane tickets to San José, a 4-wheel-drive vehicle and some off-road driving confidence. Because to reach this ocean paradise, you’ll have to traverse steep, rocky, dirt roads and cross jungle streams. But once you arrive, surfboard in hand, you’re ready to go. Good luck!
The setting was perfect on this particular evening. It was Christmas Eve, 2017. As the sun set over the ocean, it lit up the sky in a riot of orange and pink, against which the other surfers were silhouetted. Spectators on the beach were illuminated like actors on a stage, their shadows growing longer by the minute. Picturesque.
However, I wasn’t there to enjoy the scenery. Although I had never surfed, I was determined to catch a wave and ride it in its entirety. But I did a lot of waiting, which allowed me to do some thinking. As I lay on my board, bobbing over the waves, which seemed to keep breaking elsewhere, my mind started to do what it often does during new experiences: it started comparing the current activity to ophthalmology. It wasn’t easy. Wave surfing and ophthalmology do not, at first sight, have much in common. Surfing, I assumed, demands scant preparation, simple equipment and no education. Just the opposite of ophthalmology, right?
And then a wave came, and I found myself at the right place at the right time. Or so I thought. I cruised down the front of the wave and suddenly I found myself underwater, upside down and tumbling violently. Time seemed to slow down. My surfboard was gone, and I hoped it wouldn’t crash into my skull. I also hoped I wouldn’t crash myself onto the hard ocean floor. Damn!
I surfaced with my body intact. Lucky. But then a second wave crashed overhead and I was back inside the sea, rolling as if in a washing machine.
And then it hit me. No, not my surfboard. Insight!
As I finally resurfaced, I realised that learning to surf is like being an early-career ophthalmologist. More specifically, an early-career cataract surgeon. Very early. Like, first-month-of-work early. Full of confidence, you wait until it’s your time to act, to operate. But you often have to wait a while. You wait for the “perfect cataract” to select as your first case in the OR while referring the difficult eyes to your colleagues. Pass. No need to get sucked into a big wave that’s too dangerous to handle. Complications, like wipe-outs, are always stalking the unprepared.
Both surfing and ophthalmology have a steep learning curve, requiring a lot of practice and get much more fun once you get better at them. And, as I discovered, you can get yourself into trouble if you’re not ready.
I’ve since done some research and realised that surfing is a serious pursuit in which only the most dedicated excel. Despite its apparent “laid-back” lifestyle and mellow image, professional surfers are devoted, driven athletes, true perfectionists.
“I’m definitely not lackadaisical. Otherwise I wouldn’t be here,” said pro surfer Dane Reynolds in an interview after winning a big surfing tournament. “I put a lot of pressure on myself to do it well.”
That wasn’t the answer the reporter was expecting, but it sounds exactly how most of us would describe ourselves as eye doctors and surgeons. Study, preparation and diligence are what leads to success. That is how we do it.
I know I’ll never become a good surfer, but I’ll stay enthusiastic. I was back out on the water on New Year’s Eve, having messed around in smaller waves every day since Christmas eve. The water was empty. The only sign of life was the pelicans, who were dive-bombing into the water, hunting for sushi. They eyed me suspiciously, as though I might steal their dinner. But I was there to catch waves, not fish.
This time, luck was on my side. As a big swell surged beneath me, I manoeuvred my 10-foot (3.3m) board downhill and stood up! It was a bumpy ride, but I remained standing as the wave crashed above and behind me. Its momentum brought me all the way back to shore. I stepped off the board, picked it up and walked out of the water, smiling.
The sun set behind me as I strapped the board to the roof of my car. I had had a good time, but I looked forward to getting back in the OR, where I have everything more under control than I do in the water.

Dr Leigh Spielberg is a vitreoretinal and cataract surgeon at Ghent University Hospital in Belgium

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