Ricky's Riffs:

Random Thoughts on Travel, Education, Health, and the World in General


Obamacare and the Shifting of the American Mind

March 20th, 2017

The first order of business for Donald Trump and the Republican party was to “repeal and replace” the Affordable Care Act (ACA), commonly known as Obamacare.

Obamacare was the signature piece of legislation of President Obama’s eight years in office.  In terms of historical significance, it has been compared to Social Security and Medicare. It was a big leap–and a messy one.Read the rest of this entry »


Trump Excitement Disorder (TED)…or Tribal Fever

March 7th, 2017

The shock of Donald Trump’s election has left many people disoriented.  Assumptions about the nature and order of the world have been upended.

Few, but not all, on the left side of the political spectrum believed Trump could be elected.  Yet here we are, six weeks into a Trump presidency.  He has moved with lightning speed, issuing executive orders at a dizzying pace, working diligently to undo the work of President Obama.

I described some of the effects of Trump’s election in my last piece “Trump Induced Stress Disorder: A New Diagnosis for a New Era”.  In that article, I described the physical and emotional effects on the millions of people who were aghast at his electoral victory.

But the Trump supporters are now displaying their own spectrum of signs and symptoms. I label their syndrome “Trump Excitement Disorder,” or TED.Read the rest of this entry »


Pain and Suffering of the Digital Natives

October 25th, 2016

“Digital natives” are those young women and men who have been raised from childhood on computers. We see them everywhere:  Toddlers in strollers playing with iPhones, pre-teens on iPads in restaurants, strategically distracted to allow their parents to eat in peace; Junior High and High School kids doing schoolwork on laptops in the classroom or at home, sitting or lying in bed.

For the digital native, the computer is an extension of his or her body.  By the time they enter pre-school, many can navigate apps.  Ten-year olds can program software. Adolescents live their social lives on tiny screens.  Most of the digital native’s life runs through this digital medium.

Read the rest of this entry »


Incrementalism vs. Revolution in Health Care, Part 2: Is Obamacare Crashing?

August 26th, 2016

The recent announcement that Aetna would be pulling out of a large number of the Affordable Care Act (ACA or Obamacare) exchanges, affirms a fundamental truth about health care and insurance in our country. Business and health care do not mix.

The ultimate goal of health care is to heal patients.  The goal of private industry, based upon shareholder mandate, is to generate profits.Read the rest of this entry »


Interview With Michael Finney–On the Direction of Health Care, 6/4/16

July 15th, 2016

Here is a radio interview I did with Michael Finney, KGO TV (Channel 7) consumer news reporter, on the direction I see health care moving in this country. We talked, among other things, about the differences, and similarities, between Bernie and Hillary on how we get to universal coverage. I explained to Michael how the changes in the health care system over the last several years have deeply impacted providers; about how most people have no idea about the reimbursement cuts most doctors have had to take; and more. So check it out and feel free to let me know your thoughts on this subject.

 


A World of Pain

June 30th, 2016

In our highly medicated society, Americans consume more mind and mood altering drugs—legal, illegal and prescribed–than any other people in the world.  Cocaine, heroin, marijuana, Xanax, Ambien, Atavan, alcohol and many more: a full spectrum of pain, anti-anxiety, anti-depressant and stimulating medications.

We all know people affected by the overuse of these substances. Some of us know people who have died from them.

But why are we in so much pain?  So depressed?  Why can’t we sleep? Or focus?Read the rest of this entry »


Revolution or Incrementalism: The Battle Over American Health Care

May 14th, 2016

As a health care provider, I have followed his year’s democratic presidential race with great interest. One major policy difference between Bernie Sanders and Hillary Clinton is that Bernie is pushing for a single payer model and Hillary wants to “build” on the Affordable Care Act that was passed under President Obama.

Here are a few of my thoughts on the subject.Read the rest of this entry »


A New Year, A New You: Some Perspectives on Integrative Health and Healing

December 7th, 2015

Co-written with Allie Stark, MA, RYT

In the world of wellness, the New Year is a business opportunity. The health industry can’t help but take advantage of the many people looking for salves, supplements, and “booty busting” exercises to make you, the best new you. And while eating nutritious foods, exercising regularly, and de-cluttering your house are certainly of value, they can also be distractions; one-off actions focused on symptoms rather than deeper forces at play.

Rather than seeing our health concerns accurately–as linked to our own mind/bodies and the world around us–we often tend to look beyond ourselves for explanations and solutions. It is important for us to understand why we see the world in the ways that we do. Otherwise we will seek answers that are of limited scope and value.Read the rest of this entry »


Empathy, Patient Centered Care and Healing

September 30th, 2015

Carlos presented in the clinic, walking stiffly.  He wore a green asbestos suit and steel toed boots.  The distinctive chemical smell of the steel mill where he worked clung to him like a second skin.  Carlos is a welder. He wields a blow torch for most of his day.  Large pieces of steel hanging from gigantic chains and pulleys circle above and around him.  One by one, he maneuvers them into a position where he can begin the fiery work of melting them down and reshaping them.

There are open fires in the big, hangar-like space where Carlos works.  A toxic cloud hangs over the building, penetrating the clothing and skin of all who are exposed.  The ground shakes every 15 minutes or so from a machine in the next building as it pounds tons of molten steel into new forms.  After awhile, one doesn’t notice these little earthquakes.  They just blend in with the sounds of saws, trucks and the loud whistles that signal break time.

The work is tough but lucrative, especially for a recent arrival from Mexico.  A union job.  Seventeen dollars per hour, English not required.  But it takes a toll on the body.  One day, after three years on the job, Carlos bent over to pick up his blow torch and felt a sharp lower back pain that radiated into his right buttock.  It was enough to stop him from going on.  He reported the injury to his supervisor, who filled out a work injury report and sent Carlos to the clinic where I work to be examined and treated.  While Carlos was glad to get the medical attention, he was also thinking about missed time from work, lost pay and his family.  As there were rumors that another round of layoffs was coming, he was feeling very anxious.Read the rest of this entry »


A Persian Wedding: Love and the Will to Freedom

August 19th, 2015

Mehraban and Sahar were married under redwood trees in the hills overlooking the San Francisco Bay.  It was a brisk evening warmed by the presence of their many friends and relatives who had gathered from near and far.

When I walked into the reception hall, the dance floor was already packed. Electronic music was blaring, drinks were flowing and the crowd was joyous, celebrating the union of these two beautiful people.

 Children of the Revolution

Although I had never been to an Iranian wedding, I have been to Iran. The first time was in 1975, during the Shah’s rule. I also visited more recently, in 2014, under the current regime: The Islamic Republic.

Many of the men and women dancing at the wedding were “children of the revolution,” born in Iran after the revolution of 1979.  Until they left for “The West,” they had only known an Iran of the mullahs, the religious rulers of that country.

And as the electronic dance beats stirred up the crowd, I thought about Iran and how distant that country was from this celebratory moment in space and time.  I considered how far we were from that world, where people lived under the ever present gaze of the mullah’s and the Basij (the religious police), where life is circumscribed by so many ancient rules, where women are compelled to wear the hijab (traditional head scarf), and the sexes cannot mix freely.  A world where alcohol and dancing are prohibited.Read the rest of this entry »