SAN FRANCISCO — Every doctor has some galvanizing memory of medical school. Most involve some dynamic moment of enlightenment, like finally grasping the elusively subtle audible differences between heart rhythms.
For Dr. Mark Renneker, an assistant clinical professor at UC San Francisco Medical School, a staff physician at a local poverty clinic and a cancer prevention and education specialist at Samuel Merritt Hospital in Oakland, the memory is of a different kind.
Renneker recalls clearly the day he and a fellow medical student were at the beach, sitting in a Volkswagen Beetle with surfboards strapped to the roof as they crammed for a cardiology class.
With textbooks spread out in their laps and a tape cassette of heart sounds playing on the car stereo, the pair strained to hear the difference between various heartbeats, all of which, Renneker recalls now, seemed to sound like "La-ta-ta-Dump." All the while, the waves kept crashing in on Ocean Beach, a stretch of sand here that is normally close to deserted but regularly produces better waves than Malibu.
Stashed in the car alongside the cardiology texts were books that chart tidal patterns, and the two young men knew they were only moments away from perfect surf. At the instant the tide books specified, they shut down the cassette player, threw cardiology aside, jumped out of the Beetle, pulled on their wet suits and disappeared into the waves.
Renneker's recollection illustrates the apparent cultural conflict that he and an unknown but clearly not large number of other doctors allow to rule their lives. All are physicians whose lives are driven--sometimes even consumed--by the passion of surfing.
Twenty-seven-year-old fourth-year medical student Kevin Starr, originally from San Diego, ponders a question designed to force him to list his priorities. His answer says a lot about his perspective.
Starr wears his blond hair long and would never be mistaken on the basis of appearance for someone remotely connected to medicine if it weren't for the stethoscope that occasionally falls unexpectedly out of his shoulder bag. His academic record is impeccable, but surfing is what drives his life.
He remembers that his girlfriend once asked which was more important to him, surfing or sex.
"I said, 'Well, sex is,' " he recalls. "But . . . you can always have sex later. That's the bottom line. Surfing is urgent. Sex can be urgent but you know it's going to be there, with a reasonable certainty."
For doctor-surfers like these, the psyche apparently permits coexistence of the two disparate life styles. Renneker, 35, likes to use his medical school recollection to illustrate his argument that the obsessive pursuit of the surfing life style requires organizational skills not unlike those a doctor must develop.
"The surf," he says, "is never good everywhere. It will be best at one spot and that might be two or three hours away.
"To get up there at the right tide and the right wind, you've really got to be on it. It's a very similar process to taking care of a really complicated case where there are so many variables.
"If you're just sort of floundering through it, you'll blow it with the patient, and so, correspondingly, you would miss a swell. Most surfers, they're just not on top of it. They're just happy surfing what comes to their beach. But if you really have the hunger, you'd have to say it's an intellectual curiosity about what the ocean is going to dish up."
Renneker still has the tide book somewhere nearby at all times. While other physicians consult their appointment calendars or personal organizers to check their availability for meetings, Renneker habitually checks the tide book to be certain he does not schedule anything when there is likely to be good surf.
"I started doing that in medical school," he says. "I found that you should never make an appointment with a professor on an outgoing tide. You'd set it up a week in advance and miss the waves. Then you'd show up at the beach and everyone would say, 'Where were you?' "
During his residency in family medicine, Renneker managed to con the UC San Francisco Medical Center into a schedule in which the length of his training was adjusted to provide sufficient surfing time. He treasures a memo from his supervisor noting that "Mark is a devoted surfer" who needs to "be completely off in October and in Hawaii."
Renneker, a psychiatrist's son who was raised on the Westside of Los Angeles and started surfing when he was 11, chuckles when he recalls the strange reactions from some of his fellow doctors in training.
"Usually, if you would say at lunchtime, 'Look, cover for me for the next couple of hours,' residents would do that for one another," he recalls. "But if you said, 'I'm going surfing,' they'd say, 'Forget it. I'm not covering for you.'
"So what I learned to say was, 'I gotta go work out. I gotta go swimming.' It sounds like something that involves pain and suffering."
A Bit Extreme