Johnny Fain was Malibu's golden boy of surfing in the late 1960s. Known for an aggressive surfing style of quick, slashing turns and "hang-ten" riding (10 toes over the nose of the board), Fain became one of the world's top surfers, and was rewarded with endorsements and years on the professional surfing tour.
The only child of "Lassie" screenwriter Jeanne Bartlett, Fain grew up in Malibu Colony and parlayed his blond good looks and surfing prowess into small movie and stunt parts in such cult classics as "Muscle Beach Party," "How to Stuff a Wild Bikini" and "Beach Blanket Bingo."
But during years of rough-and-tumble surfing and prolonged exposure to the elements, Fain also racked up a litany of ailments.
More than a dozen cancerous and precancerous skin lesions and moles have been removed from his face and body. He has endured three ear operations and four surgeries to remove growths from his eyes, and hundreds of stitches from surfboard collisions. And now a recent operation to repair a hip eroded from years of battering has left Fain on crutches.
"You have to believe you're invincible to reach a high level of surf expertise," said Fain, 50. "You have to go beyond what a normal person thinks of as a human limit. I am paying a price for that attitude."
So, too, are many other surfers, enthusiasts and their doctors say.
Surfing, with an estimated 500,000 Southern California devotees, has always radiated images of fun and health, of bronzed bodies, youthful good looks and pristine beaches. But as the baby-boomer innovators of the sport grow older, some of them say a troublesome array of maladies has emerged.
"As opposed to the blunt trauma of a football injury, many surfers suffer from a series of cumulative ailments," said Steve Hawk, editor of Surfer Magazine. Hawk, 38, who has been surfing for more than 20 years, has suffered from chronic back, ear and nasal problems. "It's almost death from a thousand cuts."
County officials say it is difficult to determine the extent of surfer illnesses and ailments.
"We don't have such a file," said Dr. Laurene Mascola, chief of the acute communicable disease control unit of the Los Angeles County Department of Health Services. "Some surfers don't go to a doctor and if they did, doctors have an abysmal rate of reporting routine diseases and illnesses."
In general, surfers tend to be a fit bunch with strong muscles and lungs derived from hours of grueling paddling against the tides.
Still, many surfers and their doctors say plenty of anecdotal evidence attests to the sport's health consequences.
Middle-aged surfers in particular say they must cope with a growing history of skin ulcers, reef cuts, lacerations from surfboard fins and surfer knots and craters--bumps and cuts slow to heal from constant paddling and water exposure.
In December, San Francisco physician Mark Renneker co-authored "Sick Surfers," a book that outlines a comprehensive list of surfer maladies. Renneker founded the Surfer's Medical Assn. in 1986, a Northern California-based international organization of roughly 700 members, including 400 medical professionals, who are dedicated to improving the health of surfers.
Renneker has chronicled such surfer ailments as chronic neck and back problems, fungal infections from wet suits, fatty growths on the rib cage from paddling and so-called "ice-cream headaches"--migraines brought on by dunking under huge waves in frigid water.
The book also attempts to answer surfer queries about angioedema--the swelling of the extremities in cold water--and even the consequences of ingesting surf wax, which is used to improve the grip on the boards.
One of the most common maladies, however, is "surfers' ear," or exostosis.
It is caused when excess water in the ear canal evaporates in windy conditions and chills the ear. The body responds by growing extra bone in the ear canal, obstructing hearing. The affliction is treated by drilling away the excess bone.
"I must get two to three surfers a month who have to have their ears drilled out with a high-speed diamond burr--it's very painful," said Dr. Justin MacCarthy, a partner in a Pacific Palisades practice. "I try to tell them to wear ear plugs, but they won't do it. They say it affects their sense of balance."
Surfers have their own descriptions of the pain of the operation and its aftermath. "It's like a cherry bomb going off inside your head, but you're still living," said Fain.
Exposure to the sun also has taken a toll. Many dermatologists are reporting increased cases of basal cell and squamous cell carcinoma, as well as malignant melanoma.
Veteran surfers also suffer from pterygiums, a tissue growth over the cornea of the eye caused by exposure to wind and ultraviolet light.
John Hearne, 45, regional director of the Surfer Foundation, a nonprofit environmental organization, has cataracts on both eyes from sun exposure.
"I've tried to wear ski-glasses with a leash, but it's a hassle in big surf when you're duck-diving under waves," he said.
Aside from infirmities caused by the natural elements, many veteran Los Angeles-area surfers believe water pollution is eclipsing the sunny elements of the sport.
Amid uncertainty in the scientific world over whether toxins in Santa Monica Bay are making people sick, surfers believe they are unwittingly helping to establish a link between the water and certain illnesses.
"I feel like we're the canaries in the coal mine--we've got this young healthy group of people that keeps getting sick," said David Saltman, former executive director of the Surfrider Foundation.
Rainwater washes untreated sewage, trash, debris, animal waste, pesticides and motor oil into concrete rivers and storm drains that empty into Santa Monica Bay. In August, the American Oceans Campaign, a nonprofit environmental group, completed a two-year study that identified 160 toxic chemicals flowing into the bay from Los Angeles streets.
Santa Monica Bay surfers say they suffer from a range of illnesses that could be related to pollution, such as stomach flu, skin rashes and sinus and ear infections.
The level of pollution increases dramatically after storms--bad news for surfers, as that is when the waves are best.
And the prime surfing spots are near storm drains, which dump sediment onto a series of points, reefs and beach breaks. Better-shaped waves are produced as swells peel over the buildup.
To many medical experts, storm surfing is a horrific combination.
"When diving under a big wave you're getting worked over pretty good," said Dr. Gordon LaBedz, a member of the Surfer's Medical Assn. and a Seal Beach resident. "Bacteria-laden water is being forced into your sinuses. (It) sits in little hollow areas of your skull, which if it runs down, can cause an upper-respiratory infection."
An extreme and controversial medical case involves surfer Eric Villanueva, 22. In May, 1992, Villanueva came down with flu-like symptoms after surfing near Malibu Lagoon in the wake of a storm. Within a month he had congestive heart failure, and two months later he received a heart transplant.
Doctors found high levels of antibodies in Villanueva's blood caused by the coxsackie B virus, a strain found in human feces that can attack and weaken the heart. Public studies have located coxsackie B in Malibu Lagoon.
"If you go out there after the rains, or after the berm is breached, you're gambling with your life," said Villanueva, who had to have a second transplant 11 months after the first one because of complications.
But experts cannot say for sure where he contracted the illness.
"It's possible that someone could get the virus while surfing in the bay," said Dr. Michele Hamilton, co-director of the UCLA cardiomyopathy program, which is treating Villanueva. "However . . . it could have been poor hygiene, family contact or a restaurant."
Many surfers are aware of the problems associated with the sport, but addiction to the waves overrides their concerns.
Even after surfer Jeff Estep came down with hepatitis A shortly after surfing at Malibu, he remembers going surfing with his sons and walking past a sign on a Malibu beach warning of possible unsafe water. "I told my boys to check for any open wounds, and to just spit a lot, keep spitting. Then out we went." County officials recommend staying out of the water when such signs are displayed.
But most surfers don't stay out of the water for long. Johnny Fain regularly and painfully swims a mile in the Pepperdine University swimming pool to rehabilitate his hip--and to get ready for his inevitable return to the surf: "I'm a gladiator. "I'll be back out there within eight months."