The perfect wave

We were standing casually at the front of the plane, talking, Barry, Jeff, Maria and me. The plane was halfway between St Louis and Phoenix. Jeff is the vice president of Nestle, and air-miles heavy weight champion, something like George Clooney’s movie “up in the air”. Barry is a retired entrepreneur, after selling his mortgage business, apparently one in every ten mortgages in America were sold through his company! Maria is a stewardess, pleasant, topping up wine for Jeff and Barry and white coffee for me. “I am telling you guys, I spent most of my life in planes, but never seen this before, to let us stand here and drink and talk’. He was very happy.

All started when I unplugged my laptop from the plane’s socket in my seat. I noticed that the USA-type prongs from the multi-piece adapter I bought earlier at Best Buy had disappeared, was not in the socket, not in the floor, not in my seat…Jeff who was sitting next to me, volunteered to have a look with the flashlight of his phone behind the seat, nothing…Another man, Barry, who was sitting next to us volunteered to help, he said my son will find it, he’s a champion. He was not kidding. We all stood up and the 11-year old boy tear the sit apart! Removed the cushions, the belt, the life jacket, left the metal frame only! It was a good thing we were on Amaerican Airlines plane, there is no way any BA stewardess would allow to touch the seat. But no adapter…! All other passengers who had no idea what was going on, and were looking very curiously. “Thank you so much for coming to our country to visit us” said Barry at the end, one of the extremely friendly Americans you find in many places. He then passed on his card and said my wife Dana and I would love to have you for dinner next time you are in St Louis…! Again, correct me if I am wrong but I think you see this only in America.

I was on a plane left St Louis, where I was invited to give a visiting Professor lecture at the Department of Neurosurgery. My trip started 24 hours earlier, from London with a three- hour stopover in Chicago (which became 6-hour stopover, due to plane being delayed in Minnesota from storm). Saleem Abdulrauf, Chairman of Neurosurgery in St Louis was a perfect host. He is building a young and dynamic department and the Walter Dandy Society he founded in 2012 is thriving. Was a pleasure to deliver a lecture on my awake craniotomy techniques and then have a ride with one of his two sports cars. From St Louis flawn to Phoenix and then off to San Diego.


OK, this is during landing in the first days of my trips but not sure which airport, am not kidding! I am fascinated looking from the air lit streets and buildings and light beams coming out of tiny homes’ windows.


Arrived in San Diego Thursday night invited by the Congress of Neurological Surgeons to their annual meeting. As you get off the plane, a wave of hot air is hitting your face. San Diego is spread out, wrapped around the see. Massive (I mean massive!) hotels overlooking the ocean, boats, bicycles. Despite seeing sea from everywhere there is no beach for swimming. You can take the boat and after a 20 mins ride you get off the Coronado island with a small sandy beach. We found a Greek gyros shop (these Greeks are everywhere!) and watched the first presidential debate on the big screen TV amongts (mostly indifferent) Americans.


One of the many San Diego marinas, under a hot, hot late September sun. You can rent a bike (like London’s bikes) and cycle across the “beach”, pass the airport (I never saw an airport so close to a city) and go to a little harbour with a pier.

I gave a talk on Saturday morning at 8 am on surgery of tumours on eloquent parts of the brain, along with Mitch Berger, Hughues Duffau, Lorenzo Bello and Richard Byrne. Alhtough my battery was full, minutes before I had to give my talk my macbook died! all battery juice drained! Never seen this before, I did not have an adapter, ok, what do you do? I asked Hughues Duffau and Mitch Berger to go before me and I run out to get an adapter. I had about an hour to go to Westfield San Diego to get another one and come back before the session ended. I got into a cab, gave the address and off we went. The driver, a nice Indian guy, started telling me his medical problems, and that his doctor does not believe him that he has serious brain probelms, while strolling leisurely on the roads despite telling him he had to run like the wind. After a while he started telling me that he had studied engeneeiring in India and could fix the problem by changing my mobile…! OK, not the best time to be driven by a crazy driver!

After several insane technical suggestions, including ordering parts from India! we finnaly arrived at the mall. I run to the electronic store when I realised that it opens at 10 am and it was just before 9…!  OK, back to the conference centre, with the same crazy driver who was waiting outside. I had at least loaded all my talks to Dropbox, not ideal as all conferences run on Windows and will completely distrort my slides, but now was no time for aesthetics. The IT guys were nowhere…! After running into different sessions we finally got hold of them. One guy had no idea, so we found the top nerd : -) who knew what to do and started to download my talk with several videos and photos. “OK, will download in 35 mins“said triumphantly. “you got to be kidding me!” said back.  “OK, I will use my own IP and will download faster, remotely to your session’s PC“, added with remorse. I walkded back to the conference room, an hour and 10 minutes had gone, seemed liked hald a day. Lorenzo Bello was finishing his talk. I waived to Mitch Berger, was ok for my talk.


My budge (of honour)!

I approach the lectern, I had no idea if my talk was there, and how it will look like. I moved the mouse, the screnn lit up, i saw a file with my name, clicked, it opened, and worled like a magic, not even change of slides from Mac to PC!  All videos played perfectly! “Great talk” Mitch said later, delegates asked questions, good discusiion follwoed, nobody in the room knew what happened for the previous two hours.

Like all American meetings, CNS was big! with more than 3000 attendees, and many speakers including non-surgeons, like Steve Wosniac, co-founder of Apple. Wosniac was happy, chatty, genuine and, of course, super nerdy :-) what did u expect?! Also Daniel James Brown, the author of “Boys in the boat” a hugely successful book, about the American rowing team who won the gold medal in 1936 Berlin Olympics under the eyes of Nazi Germany.


A jolly Steve Wozniac with his nerdy shoes (left) talking to the President of the CNS Russell Lonser (middle) in a massive conference venue (I am sitting in the first raw) with more than 3000 seats.

The scientific program was also productive with discussions on ARUBA trial on AVMs from Spetzler, where only 6 patients randomized for surgery! And a talk from my friend Mitch Berger on personalized and targeted treatment for glioblastomas. There was also live surgery daily, sponsored by medical companies, good effort but nothing like the surgery was have at the annual neuro-oncology course every summer in London, no I am not biased! :-) During reception I saw my friend Charlie Teo from Sydney, high energy and good spirit as always. Outside the scientific program I had the chance to run by the beach, cycle passed the airport and swim in pools and the ocean. It’s much easier to be active in hot weather, you are outside wearing shorts and tee, by the sea, where everyone is running, all you have to do is walk faster and faster, move your arms a bit more, and this is it! you are running!


During the evening reception, everybody did the same thing when getting out of the Marriot, stood at the top of the strairs, took a photo with their mobile and then walk down the stairs and get in line for food. I was no exception, so here’s my photo!

Between CNS in San Diego and my next talk in Boston had a full week, time to get a car and hang out in California. The car was a white, cabriolet Mustang, black soft top, bold red lights, still smelling new.


Driving somewhere in America in a cabriolet Mustang

San Diego to LA is just over a couple of hours, that is if there was no the legendary LA traffic. Around LA cars go fast, lanes are narrow, and there is no such thing as slow lane, everybody goes pretty much with the same speed. That’s good for me (I love speed) but you will never see some of the slow cars that you often see in the right lanes in UK’s motorways.


Can you believe I took this photo in Venice beach with a cheap Lumia phone I bought in San Francisco two years ago?

A couple of things are different in US, for example, when on crossroads, if you are on the right lane you can make a right turn, even with a red traffic light, this is legal. Also at a stop sign you have to stop completely! I know this is what the stop sign means, but in the UK drivers slow down a bit and carry on. In American roads you have to come to a complete halt! LA is a great city, has everything, great beaches in Malibu, amazing houses in beverly Hills, and trendy shops everywhere. You can go to Santa Monica Pier in an hour, with massess of tourists, or hang out in Venice beach, rent a board and surf in the not so massive (but coooold!) waves. Venice beach is so enormous, tons and tons of white sand, lifeguards are driving red pickups and run like crazy in the beach. Walking around in Venice beach with no surfboard or skateboard under your amr is like walking in Alps with slippers.


Venice beach at dusk. This is beggining of October…!

But if you are looking for the perfect beach… Driving from Santa Barbara to LA, long lines of RVs, traffic, had to make a stop. Could have been the time of the day, early evening but sun still strong…  or the sound of the waves drawning all sounds…or the straigh line of sign into the infinite…never seen or felt a better beach…the water was cold… but the waves perfect…you could feel a vast ocean, you could be part of it…looked at the sign, Faria beach, a perfect beach… or a perfect moment…!


You find the perfect beach when you are not looking for it! The feeling of looking at the line where the sky touches the sea was new

From LA took the plane to Boston for my next talk, at Mass General Hospital (Harvard Medical School!) for my next lecture on 6 October. I like Boston, the most european city in US, reminds me a big version of Oxford, intellectual, sophisticated, with rowers in the river, many foreigners looking for a better education, and the new high impact publication in research journals. What a difference from Venice beach, what drives people to do one or the other? Now hang on, am not taking sides, I don’t know what drives people riding waves or studying at a lab, and can’t be sure that pleasing our ego has nothing to do with either. But would like to take the  (naive) view that helping others makes life a bit more worthwhile…!

The nurses and doctors are walking around the Mass General in scrubs, I mean in shops, in the train, even the local bar, Harvard Arms…in the UK many NHS people would freak out. The symposium was great, and made new friends. Two days in Boston was added to two weeks in America, London, Chicago, St Louis, Phoenix, San Diego, LA, San Francisco, back to LA, Boston… time to jump back to BA’s plane to the familiar Heathrow terminal 5 and to my patients. Like a man with a brain tumour deemed “inoperable”. He finally came to my service and had an awake craniotomy and complete tumour removal. His two young children came to meet me with their parents with two handmade “thank you” cards. Adorable!


Thank you card 1 – Mr Samandouras vs the tumour


Thank you card 2 – Mr Samandouras, “the tumour destroyer” holding the knockout knife while the “angry tumour” cries Aggghhhh….how cute is that? Both cards posted with the permission of parents and the (young) artists.

So back to London…No surfboards here…no perfect waves…but same people in the core, looking for ways to feel happy and fulfilled (and try desperately to look cool!)…happiness is in the moments…you can capture these moments wherever you are…you just need to wait for a tall wave and jump on it…no, there is no perfect wave! don’t spend all our life at the beach waiting for it…stand tall…feel the sun on your face…the wind on your body…lock eyes with the next big wave…and go for it…!



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