It is very difficult to treat. Unfortunately there is no Magic Bullet like in the treatment of opioid use disorder. The medicine for heroin users almost instantly cures their cravings. Sadly, there is no perfect pill for alcoholism.

The opioid problem is an epidemic. An epidemic is when many people are dying in a short period of time. Yet alcohol seems to cause way more suffering overall.

From my experience in Addiction Medicine, it seems as though alcohol use disorder is one of the hardest problems to treat. Very few are successful. Studies show that 70% of people relapse within a year after getting sober. There is hope, I have met a few that achieved sobriety. I always ask them how. Most of the recovering alcoholics will give two explanations for their success.

The medicines actually work and they attend multiple AA groups every week. That’s it, meds and friends. MEDS and FRIENDS.

I’ll explain the meds next but remember, addiction usually leads to isolation and the absence of friendship. Many times it is rooted in past trauma that a patient, a human being simply tries to escape.

The most successful patients are those who have a solid sponsor who they talk with a few times per week, attend AA meetings several times per week and have accepted that they have ZERO control over alcohol.

Relapse happens.

I’ve seen it a few times now that someone gets sober for a few days, weeks or even months and suddenly disappear from my clinic for a while. Eventually the cat drags them back. Usually they achieved a period of sobriety but then mistakenly thought they could control the urge to drink. It never works. Unfortunately the frontal lobe that normally exercise self control loses the battle with the primal urge to drink more and more.

Why does alcohol have such a strong grip on the brain?

Alcohol is one of the oldest psychoactive substances known to man. They found evidence in China that people used alcohol as early as 7000 BC. Alcohol is also one of the simplest molecules. The complexity of chemicals is based on how many carbon atoms they contain. Heroin and THC (cannabis) contains 21 carbon atoms, Cocaine and Xanax has 17, Ecstasy has 11. Alcohol only has 2, that’s it! Most substances of abuse act on one neurotransmitter system, alcohol acts on most of them. Maybe that hasto do with its addictive potential. The more obvious reason is that it is readily available. If cocaine and meth were sold at every gas station we would have just as large a problem on our hands.

How does this tiny molecule cause so much havoc in the brain?

Once alcohol enters the brain it acts on multiple receptors but its main effect is on the Gaba System. Gaba is a tiny neurotransmitter that acts like the break in your car. It is the main inhibitory chemical in the brain. It tells the brain to slow down. This explains why alcohol has a calming effect and in high doses can be sedating and even cause black outs or a coma.

The brain also has the opposite neurotransmitter, called Glutamate. This one acts like the gas pedal your car. It is the main excitatory chemical in the brain. It tells the brain to go go go. Normally the Gaba and Glutamate systems are in perfect balance.

When a person drinks alcohol regularly, the alcohol will act on the Gaba receptors, therefore telling the brain to slow down. The brain then tries to reach a balance by producing more Glutamate to balance out this external source of inhibition. Since there is alcohol to tell the brain to slow down there is no more need for Gaba, so the brain decreases the amount of Gaba.

The trouble happens when the alcoholic suddenly stops drinking. In the absense of Gaba, the Glutamate system is so active and upregulated that without the alcohol telling the brain to slow down, the brain becomes hyperactive. The glutamate system is unapposed. This is why chronic alcoholics develop the shakes when they don’t drink for a day. In the worst case they can experience life threatening seizures and delerium tremens.

So what is the solution?

Meds;

The medications we use target the Gaba, Glutamate and opioid systems. To detox an alcoholic in the hospital we can give them benzodiazepines to target the Gaba system. We will then slowly decrease them to allow the gaba and glutamate system to normalize. Another drug is called Acamprosate, it suppresses the Glutamate system, therefore decreases the tremors and other effects of alcohol withdrawal. Naltrexone is another great medicine that targets the opioid system, therefore decreases the reward and euphoria associated with alcohol use. Gabapentin among several others are also used to target the Gaba system.

Disclaimer: please consult your doctor before taking any of these medicines, I take no responsibility for your use of these medicines.

Friends;

Alcoholics Anonymous. I was skeptical at first as well. From the patients I’ve met in recovery, going through the twelve steps seems to be crucial to healing. People develop friendships with others going through the same struggle. The human mind is normally very apprehensive to share it’s faults and failures. A strange thing occurs when one does share these past mistakes or problems. It opens up conversation with other people. It leads to acceptance and eventual healing. I think it’s a form of altruistic help or maybe a future rm of solidarity. By sharing one’s faults, mistakes and struggles, one will receive help to overcome them. By humbling the spirit one finds the way to manage these problems. AA seems to empower people to constantly fight the good fight, together. It lends help and understanding where these people have largely been outcast from society.

AA, Alcoholics Accountable

From moment to moment one is faced with a choice. A choice to choose the better path or the other. The other leads to destruction and shame. Regret sinks in when choosing the wrong path. The easy path leads to pain. AA seems to offer a constant reminder and immediate help from a sponsor to choose the better choice. The daily or weekly meetings help to keep accountable to these choices. It’s a precious thing to find a good sponsor. It’s life changing to find a good mentor.

Good luck, fight the good fight…

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Boredom, a trigger for drug and alcohol use

Why do we get bored? What is boredom really? Why does it lead to drug or alcohol use? Can it be a good thing for us? Did Einstein really suffer from boredom

Continue reading “Boredom, a trigger for drug and alcohol use”

Surfing

War. Since the dawn of time. For centuries the forces of nature have collided in an epic battle. For ages the armies of the North and South have clashed in the Pacific Ocean. A shoving match in perfect balance. Sword and shield in hand. Battleground ripples reaching distant lands. Some as far as the most remote archipelago on earth. Hawaii.

Millions of years ago these lands broke through the crust of the earth miles beneath the sea. Conceived in the bowels of earth and birthed by Mother Nature herself, growing from infancy to grandeur. Eventually rising to the heavens to stand as giant underwater mountains. Legend tells that through persistent pressure Pele pushed these peaks higher than any on earth. Never resting to surpass Everest. High enough to breach the ocean surface. Growing over millennia, welcoming a new colonizer every few thousand years. Patiently awaiting the arrival of man. Until a day came. A day of discovery, a beautiful secret uncovered. A treasure discovered. Years later, at the very end of this massive struggle, at these mountain tops lived a people in perfect harmony, little concerned with the ages of effort beneath their feet.

No Kahiki mai ka wahine `o Pele,

Mai ka `aina mai o Polapola,

Mai ka punohu a Kane,

Mai ke ao lapa i ka lani.

Translated:

The woman Pele comes from Kahiki,

From the land of Polapola,

From the rising mist of Kane,

From the clouds that move in the sky.

A people in harmony with their world, content in time see the passing storms as mood swings of the gods. Storms so great as to baffle the mind. To the Universe simply strings in vibration. Mother Nature and Father Time’s offspring at play. The oceanic ripples resemble a rope spanning between the far North and South gently being tugged up and down. The waves reaching the Hawaiian islands inspire awe. A moment in time lends a glimpse of these forces at play. Enough to inspire a desire to enter the game.

A million year old battle. Time and again teeth of the tides try to tear away at the fresh infantile land emerging from its earthen womb. Waves of the big blue pacific crash on the reef night and day. In the midst of this timeless torment floats a searching soul. Sullenly swaying in the soothing swells. Just a few thousand years ago there was a one brave enough to conquer his forefathers’ fear. The first to try and ride these forces of nature.

A fight against fear.

The dapper will surf at dawn which is the best time of day. The best way to enter the water on a cold morning is to simply run at it. The best way to catch a big wave is to paddle all out for it. Success at surfing follows persistent effort, crashing time and again, near drowning, swallowing sea water and sore muscles. Effort, rinse and repeat.

While sitting on the water facing away from the safety of shore, the surfer watches the open prairie of the pacific for a chance. A chance to catch a wave. Constantly gazing, analyzing, waiting to strike at his prey. The anticipation of the hunt and the reward of the catch triggers a primal instinct. It engages the senses completely, senses evolved for survival. In tune with the forces of nature, waiting to strike for a kill.

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Suddenly distracted, the sun glistens up the face of a curling wave, the lip becomes see-through with swirling colors of dancing light. The wave starts to break. It curls over extending in a protruding tongue. The contrast of a glistening colored tongue against the dark belly of the wave inspires awe. Magnificent art displayed against a back drop of endless open blue sky. Clouds of white paint scattered across the canvas. The sensory overload weaved through the thrill of the catch keeps the surfer hanging between the forces of nature until pure exhaustion. At that point, an internal negotiation, an eternal struggle… return home, or try… to catch… one more…

Never enough.

To strive, to seek, to find the freedom of flight. Icarus felt the sensation of flying. His father taught hubris but his desire to get higher was cut short by a heavenly fire. For centuries man has envied the elegant gift bestowed upon the bird.

The brave die young. The cautious hardly live. Those who find the line and push the boundary will push the human race.

The feeling of flight has stirred many an imagination, the attempt has filled many a grave. For some a platform to fight. Hard earned success propelled men and women into the ages.

Despite man’s ingenuity to reach for the stars he still failed to see the light. Despite all the trials and tribulations there was always a shortcut to the sensation. One which may have allowed Icarus to live. A way that delivers the pure joy of flight with nothing more than a piece of drift wood. Flight without the need of a Twin Turbo Rolls Royce engine but instead a simple piece of foam. Discovered off the shores of these ancient islands.

As a bird takes to the sky with its porous bones filled with air, the surfer takes to the seas with a body, mostly of water. Floating in the air the bird sways back and forth. On the water the surfer sways in wait for the perfect wave. When duck diving under a wave, the force of the water in the belly of the wave shears past the surfer’s face, the sensation resembles that of an Eagle in free fall off the edge of a cliff. Come up behind a wave like this and feel the rush explode. The bird hears a hissing sound when cutting through the air. The same produced by a board slicing through the water. When the sea bird soars past the surfer in search of a kill, their eyes meet for a brief moment in mutual respect.

It is a strange feeling being so far out at sea but here lies the surfer in wait. Hopefully just far enough to catch the perfect wave. Sitting, waiting, staring into the curvature of the earth. Wishing. Trying his best to predict the next wave. In the distance, he looks for that small sign of a wave. A little bump of hope on the horizon. A white dove. A sine wave signaling a sign from above. Every wave he allows to pass grows his anxiety. A thrilling game, weighing the odds in order to react. Don’t want to hesitate and paddle too late, then risk wasting energy on lost fate. Never paddle too soon, then get chased by the fury of a crashing monsoon. Better to dive under such a colossal stampede.

The best approach? A Stoic philosophy hails heroic harmony.

Patience.

The distance from shore makes a betting man excited. Sit in the right spot and catch twice as many or more. Misjudge your distance and watch every wave go by. The anticipation becomes overwhelming. Often ends in despair. Often raises one’s hairs.

It’s a game. The decision to go for the wave or let it go. It rests in a mental battle with the Big Blue Sea. A consistent sine wave with unpredictable frequency and amplitude. One fact stands in the heart of the surfer. A wave will always come. A double stacked amplitude will make the adrenaline run.

It’s one thing to get up on a wave and ride, it’s another to harness the tide, take control and glide, seek flow as a guide. Flow, a state of perfect focus, it occurs when skill matches difficulty. Here lies the birth place of creativity. It’s during the time in which your mind is perfectly engaged in an activity. At the height of focus all brain power devoted to a single activity, nothing spared for extraneous concerns. Nothing else matters. According to Mihaly Csikszentmihalyi it is required that from moment to moment the brain is analyzing via feedback of the activity is done correctly. A musician can instantly identify a false note, a surgeon can instantly see blood leaking, a rock climber is aware at all times if they are safe. The surfer riding a wave is perfectly in tune with the shape of the wave.

Mind over water. If only your mind was ready, ready to believe. At the very moment of being tested. The moment of truth. A Truth known only to you. The potential to result in dire consequences. When you spot a big one, the wave of the day, no, the wave of the week, a question, it safe, wise? Time ticks away. Still trying to decide, what may be your crowning chance may soon fade. The pain from previous opportunity passed, pushes the will. At the last tick of a clock, give in to temptation, fight off fear to commit. Enormous, momentum building. You paddle with all your might. What might be a legendary wave. The water’s energy starts to take over. Heart racing. Then, the moment of despair. Destiny turns to doubt. Suddenly you realize you may have misjudged. Belief crumbles fast as the wave picks you upward, no longer sliding down the face. Instead, it is retracting away. Suspended on the soon-to-break lip of the wave. Looking down as the wave picks you higher, fear starts to sink in deeper. Usually the impulse that follows the energy of the wave taking over is to jump up on your board. A good idea if the wave starts pushing your board forward. Bad idea when being picked up skyward. The choice to try and bail or to drop in over the lip to a void of thin air hangs in a split second. The scale of experience tips away from safety, away from the comfort of the known, of stability guaranteed. Toward the unknown. The drop, the raging water inaudible, a body suspended in time above victory versus defeat. Everything quiet. Faith cracks, give in, regret. Silence. Mind over water falters in disaster. Storms from the North Atlantic collide with the tides of the South Pacific. This eternal war now at the center of the heart. Leading the onslaught, a surfer in doubt. His reward? Getting crushed by the forces of nature unrealized till this very moment. Raging remorse. Rolling like a rag doll.

A gasp of air, may be the last. Held under, loose oxygen fast. Down under up over, this way and that. Consciousness slips, now turning black. Save a breath. To the very last. Confusion crash. Roll like a dice. A virtuous vice. A gamble for life. Last breath of air a floating device. Proximity to death keeps the anxiety alive, fuels an addictive drive.

If only the mind was ready, ready to believe at the very moment of being tested. Ready to commit whole heartedly.

The other side. Cross over to the unknown. Breach the gap of resistance. Allow the road blocking boulder to become a stepping stone, a corner stone. The key, forget regret. Let the past sleep where it lies. Allow fear to propel to potential. A leap of faith is what advances the human race.

Taking a risk. Making the big drop. Terrifying. Rewarding. Classical conditioning casts doubt. Too late, convinced in a split second to continue. The lack of experience beaten by bravery. The drop down looks fierce, but surviving this slide down a 10 foot face and shooting out in front of the wave is what sets off fireworks in the pleasure center of the brain. The unexpected result is what drives the addiction. Better than any vice. The reward for conquering doubt. The reward for belief in the moment of being tested. The reward for taking a leap.

Is it luck? When two sine waves travel in the same plain and meet, two things may happen. If their amplitude differ by a negative they will cancel. If their amplitude differ by a positive they will increase in strength. When one takes note of the frequency of ripples through the ocean and by chance the length of time between each peak decreases there should come a point when two ripples overlap and cause a much bigger wave. An outlier occurs. A randomized event in favor of excitement. The likes of hitting a triple 7 at the slots. A once in a life time event. When these wave peaks collide and add to massive glory, the surfer finds the reason he goes through so much trouble.

The friends you make, the seals you see, the sunrise and clouds, remind us we are free.

The surf spot I visit has a substitute teacher with a streak of 1 month. Always the first one in the water, right as darkness starts to shrink. Known as Mark in the Dark. His daily visits to this spot has taught him the ways of this break. Teaching his trade, he taught me about a light colored bush on shore. Perpendicular to the shore line marked by this bush is where the reef splits the wave. Sit right there and catch waves each way. This doubles the number of waves you get. It’s an insiders secret.

Dawn of man, the spread of knowledge. A collection of advice. A military contractor, a botanical gardener, a substitute teacher, an eye doctor and a construction worker, all share a love of surfing. We talk story at the break of dawn. Breakfast club on a calm day. Thrill seekers otherwise.

The gardener grew an idea in my mind. The construction worker built on the idea. The ophthalmologist gave me a new perspective. “An optimist sees opportunity in failure. A pessimist sees only failure.”

The contractor told me to inch up on the board ever so slightly. Find the center of balance. The nose of the board suddenly sunk just barely below the surface and the board came to a level halt under my chest. This is known as the sweet spot. With the board at a level angle you can gain much more ground with less energy. The board gets taken by the force of the wave and with a few strokes you are in sync with the speed of the wave.

Advise is a gift but knowledge has to be sought.

Knowing when to go for it? It comes down to that moment when you have to pull the trigger. That split second to decide. To exert maximum effort or to quit and let the wave pass. With the correct guess you can successfully catch the wave and enjoy the ride. Or the opposite, you could decide at the right moment to let it pass and save energy for the next wave. This is the surfer’s gamble. A human gamble. Like betting on the stock market, waiting to ride the waves of commerce into profits.

Catching a wave is just a prelude to much more demand. Once up and standing the immediate goal is to turn either left or right. Go straight and simply end up in the white wash. It can swallow you whole. Get stuck in the mouth of the bowl or fight to get back behind the break. Once up on the board, look left, then right and decide. Lead with the chest and pivot at the waist. Lean into the turn. Once you turn, the goal is to get up the face of the wave, to gain the higher ground. From this vantage point you can fly back down the the wave or enjoy the view from the upper edge. Up there is where potential fuels possibility.

Fighting the forces of nature can result in disaster. The shoulder inflammation gets worse the more I fight. An intense shoulder pain right over the acromium. Worse when I lift my arm. Brought on by repetitive overhand activity like tennis or surfing. In my case, fighting. Fighting to catch a wave, fighting to get out of the bowl. Fighting a losing battle. Impingement Syndrome. Surfer Shoulder. The fix, physical therapy or surgery. Got me a bungee cord, pulling this way and that, surgery is one thing I can’t afford. Temporary relief from therapy. Temporary release back in the water. Permanent relief came when I stopped fighting. I became one with the ocean. My timing improved. No longer having to paddle all out for 10 yards. Instead I only need to paddle a few times to catch the wave. My duck diving improved. No longer getting stuck in the lions den of crashing waves. When pinned down underwater I no longer struggle to surface for a gulp of air, instead I just relax and swim deeper. No longer shoulder pain and gnashing of teeth. The more in sync with the ocean the less of a fight.

The Chase. Hawaii gets a big northern swell during the Northern hemisphere winter and a southern swell during the summer. It results in a year long migration in search of the perfect wave. Water flows to the path of least resistance. Surfers flow to the opposite. Bigger swells mean bigger crowds. They tend to clump in areas of easy access and perfect waves.

How to escape the crowd? The only rule of Mahalapu, don’t tell anyone you surf Mahalapu.

The hand of God. When you truly catch your first wave it is exhilarating. First you paddle until you feel the force in the wave starting to take over, then you jump up and lean just a little to turn the board and stay on the upper part of the face of the wave (the top of the slope) then turn just slightly the other way to suddenly shoot down the slope of the wave. Whenever this happens it feels like an invisible force wraps around your backside and heaves you forward. The first time I felt this I simply collapsed in the water and floated on my back looking up at the blue sky. If anyone saw me they would have seen the exhilarating yet confused look of disbelief mixed with utter enjoyment expressed on my face.

On the shoulders of giants. With persistence the other surfers start to observe your technique, you get to a point where you start hearing comments on not just the surf as a whole but the very tiny intricacies of each turn or bump or slide you do. I was asked how I get up on my board. My foolish reply, “I just pop up.” The equivalent of asking a construction worker how he built a high rise and he replies “oh I just built it up.” The correct answer, one brick at a time. One limb at a time. There is a system to getting up. A step by step. First place your thumbs by your nipples on the board. Then bring your rear foot to the back of the board. Then raise your chest. Then swing your front foot forward and place it between your hands. Then get up to a semi squat. Then stand. Not just popping up. Less falls, a ratio improves. How did Edmund Hillary climb to the top? One step at a time. How did Edmund Halley discover his comet? One calculation at a time. Hail History.

Hail Mary. The waves also get broken down to add to the discussion. The last blip where the right hits the reef and it creates this little bump on the wave that sometimes spill over into a tiny barrel. This is labeled as the Little Blessing. If you time it just right it will give you that last little push into the end zone.

There comes a time when you figure out how to catch enough waves to get a decent record. When you catch just one you become a statistic. One out of ten is better than none out of ten, then the ratio improves. Soon you catch about 5 out of ten. That’s a 50% success rate. It also happens to be just enough to match that of the veterans. You see, the guys that have been surfing your spot for ages rely on their average and when a new young buck comes in to disrupt it can get ugly. Risk a post surf beach brawl. One guy broke the other guys fins off his board. In Hawaii usually just a welcoming warning, a lesson on surfing and a Shakabrah from Uncle.

It so happened that one day I was catching about the same amount of waves as the veteran. At first, the problem with reaching the 50% average is that you may very well catch the waves but don’t quite know what to do with them after that. It takes a while to figure out how to pop up, turn, carve, ride the lip and stay on the smooth surface ahead of the curl. So when you catch as many as the veteran but don’t make each wave count, it can invoke anger. Think about it. The veteran sees the young buck catching waves that he could have gotten, but watching the buck waste a good wave can be infuriating. A small part in the veterans heart is satisfied when the buck crashes and burns.

So the day comes when the old lion snaps at the young cub. The warning to back off. It happened when I went for a wave, the veteran pulled out to avoid a collision, I crashed and ended up in the white wash. On my way back to where the waves break I saw the veteran paddling into a perfect wave. Right inline with me. I didn’t know if I should veer left or right or duck down below, he didn’t show me which way he was going to go. Imagine two cars heading straight for each other on the road, one waiting for the other to choose a side to veer off to in order to respond and go the other way. The veteran came rushing towards my head and at the last moment years of experience kicked in and he simply cut away and splashed a ray of water in my face. The way a hockey player can shoot the ice at an opponent’s head. I only laughed. The next round the veteran said hi, he acknowledged the young buck. A mutual respect. He gave me advice on popping up on my board better. Thanks Uncle.

The best thing to do is to paddle toward the side of the wave that already closed out. A surfer tends to try and stay where the wave is open. Just duck dive under the raging water.

The meeting place. There are few sports that bring the same characters to the same spot day after day. Surfing in the morning is like a daily reunion of the same characters. A few dare the cold dive before the sun is up. A sacred time with no wind. The morning sun has not had the chance to wake the onshore winds. The ocean wakes from a calm glass dormancy to greet the morning crew in succession. The birds have not had the chance to wake the tourists.

Bill reads the surf report. Today the disappointment is evident. He says the guy that wrote the report today most likely got up and did the Mexican Hat Dance on his D***. I’m still confused, but I guess that’s the point he’s trying to make.

Roger. He is 85 years strong. He has surfed for 65 of those. I was astonished. He said he is more amazed that he is still alive. I asked him if all those years have taught him to predict when a wave comes. He said at this point he can’t see very well, he only sees lines on the ocean surface. When the lines get higher he starts paddling then holds on for dear life. He doesn’t stand on his board, he stays on his knees. That way he is closer to see the shape of the wave better. He also has limited mobility in getting up. He can’t drive so he gets a ride to his surf spot. He still goes almost every day. He says he will do so until the day he dies.

A moment of silence for when the wind withers away.

The sun the surf the forces at play. The wind and the waves, a surfer sways. Rays from the sun travel a long way, for millions of miles to warm the earth every day.

The sun. Creator of the currency of life. A burning bank of potential composed of hydrogen gas. Emitting life giving energy via nuclear fusion. Four fundamental forces in perfect balance to keep its fire burning for another billion years. Our universe is governed by the strong, weak and electromagnetic forces. The fourth, gravity is the weakest of the four. So weak that we can easily escape it here on earth by leaping in the air. An impossible feat when compared to the shear size of the sun. A size that results in enough gravity to accelerate hydrogen atoms toward one another destined for a head-on collision. The result, nuclear fusion to create helium. The energetic byproduct keeps the core in constant commotion, the equivalent of a billion hydrogen bombs exploding per second. The energy released embarks on a 30 thousand year journey to escape the gravitational pull of the sun. It’s path destined for earth. It’s purpose, to provide for a perfect host. A host of life. Flora create order via photosynthesis. Green plants use this energy to assemble the elements created by the death of the very same stars. The ordered energy locked up in the plants is donated to the animal. The four fundamental forces in perfect balance to allow for the enjoyment of life.

One force remains a mystery, a force with a gravitational pull that draws the surfer to return to the waves day after day. Perhaps a fifth force?

The energy that provides for life also creates for the excitement there within. As the sun bakes the surface, the solid earth quickly warms up. Heating air rises rapidly and the vacuum left behind draws in cool air from the ocean. The liquid oceans absorbs the heat slowly through the day and releases it back late evening. The opposite occurs where air rushes in from the land to fill the void. This movement of air can cause onshore winds (towards the land) or offshore winds (from land to ocean). Onshore winds are the least tolerated. They tend to blow over the waves thereby preventing them from breaking. Enough to cause a mass frustration among the brooding surfers. Offshore winds are welcomed, they fluff up the waves which creates a loftier feel to the surf.

A surfers delight. There occurs this blissful time when the winds suddenly die down. The constant bickering ceases. The ripples previously created by the wind disappears. The ocean surface becomes glass. Oncoming waves become more predictable. Combined with a good swell all the elements seem to combine for the best surfing one can wish for.

A surfers debacle. A human fallacy maybe. Success breeds ambition. On to a bigger wave, faster ride, foreign wave.

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