“Field Notes from the Pipeline” by Dr.Terry Farrell

2014 World Champion Gabriel Medina! Photo Credit: The Guardian

2014 World Champion Gabriel Medina
Photo Credit: The Guardian

This year’s Billabong Pipe Masters was a very special event for many reasons. The event was held in honor of Andy Irons, who passed away in 2011. It  marked a changing of the guard, with Gabriel Medina ushered in as the new world champion and first from Brazil. Julian Wilson of Australia captured the Vans Triple Crown and the Billabong Pipemasters with one of the most exciting final heats in the history of the event.

The Crowning Glory. At 20, Medina was joint tie with Kelly for youngest World Champ every!

At 20, Medina was joint tie with Kelly for youngest World Champ every!

But for me, the main reason was that I was able to attend as the emergency physician for the event. The only tricky part was that I had only about a month to get the active Hawaii license and malpractice insurance required to work at the event.

The physicians on the team included Leland Dao, a local physician with 17 years of experience at the event, Spencer Chang (an orthopedist) and me. The staff also included a physical therapist, a massage therapist and a chiropractor.

Pipe Docs! Dr.Farrell (Left)

Pipe Docs! Dr.Farrell (Left)


We had front-row seats for the event and were stationed just up the beach from the water safety tent and clearing area for the jet skis. We were in an ideal position to respond to an emergency as it reached the shore.

Injuries …

The types of injuries we saw included minor lacerations to the face and feet, musculoskeletal strain and sprains, ear complaints such as ruptured TM and otitis externa, one dog bite and one large leg laceration from a fall. The most significant injury, a splenic laceration, happened to a non-competitor on one of the lay days. Three of the competitors had shoulder injuries: two AC joint separations and one dislocation.

Wounded Warrior: Jordy Smith's Shoulder Dislocation

Wounded Warrior: Shoulder Injury

Ready & Prepared!

Thankfully there were no cervical spine injuries and no resuscitation needed during the event. We did run a mock scenario on the second day of the competition to test the system and used all of our airway, splinting and immobilization equipment to practice our roles in the medical team and work with the water safety team.

The second day of the contest was amazing. The waves were 15 to 18 feet high and closing into three feet of water overlying an unforgiving jagged coral reef. That is when I realized how talented these surfers are – an impression cemented later that day when Jamie O’Brien and two friends free-surfed on pink foam boards into 15 foot pipeline barrels for fun. This was the day I realized the importance of my preparation for the event. The risks in surfing are real, and the medical preparation has to adjust to the location and intensity of each event. The lessons learned in the ASLS course have direct application whether you are surfing with friends or attending a professional surfing event.

Dr.Terry Farrell

Dr.Terry Farrell


Dr.Terry Farrell is a practicing Emergency Medicine physician and provides medical support for professional surfers at World Surf League (WSL), formerly the Association of Surfing Professionals (ASP), contest events. He is Board Certified in Emergency Medicine and Family Practice. Dr. Farrell lectured on the topic of head trauma and traumatic brain injury seen in surfing at the 3rd Annual Conference in Surfing Medicine. He will instruct at the upcoming ASLS Course 2015 later this year.


Professional Medical Support Teams for Athletes

Increasing professionalism in surfing has widespread implications, not only for surfers, but also for the health professionals who look after these athletes at contest events. Dr.Leland Dao discusses this issue and highlights the key role played by medical support teams in the above clip.

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