Ricky's Riffs:

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

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 »

Mortality and Healing: A Meditation and Tribute to a Friend

June 14th, 2015

It seems to be a season of dying. It’s probably my age—almost 60—and the age of many of my friends. So it shouldn’t be a surprise that mortality is in the air.

It’s not that I haven’t experienced death before. My father at 69, my old friend Sigrid at 36, my sister-in-law at 40. Cancer got them all. Now cancer is getting my good friend Marilyn.

Marilyn has late stage ovarian cancer. She just turned 60. She had two rounds of chemotherapy, and the doctors thought they had things at bay. But the cancer came back fiercely. There is no more treatment for her; just digging in at home with the comfort of friends, the right pain meds and medical marijuana. Palliative care. Read the rest of this entry »

Pathologizing the Female Body: Pregnancy, Modern Medicine and Integrative Care

April 30th, 2015

Pregnancy can be one of a woman’s most beautiful life experiences; an event many have dreamed of since girlhood. Hormones surge, creating a sense of euphoria (as well as occasional nausea). The awareness slowly arises of a real human being, her child, growing inside of her.Read the rest of this entry »

From Stools to Thrones: The Chair and Its Discontents…or, How Chairs Tell Us Who We Are

March 6th, 2015

The objects with which we surround ourselves serve multiple functions. On the one hand they may be utilitarian: dressers, chairs, and desks that support our home and work lives. At the same time, they tell us and others who we are. Does our home or office convey sophistication (elegant furniture), intelligence (books) or artiness (paintings and sculpture)? Are we practical (sparely furnished rooms) or frivolous (surrounded by knick-knacks)?

These objects can also convey status and authority. A king’s throne, for example, sits squarely in the middle of the reception hall. It is likely the most ornately carved piece of furniture in the room and is placed on a platform, denoting power and proximity to God. Or take in contrast the simple stool, without frills, designating its user as a worker focused on completing a singular task.

Both “chairs” serve a function and tell a story. Like that king and those workers, we create our worlds with purpose.Read the rest of this entry »

“Sitting is the New Smoking”: “7 on Your Side” Featuring Dr. Ricky Fishman

January 29th, 2015

The utility of sit/stand desks is finally hitting the mainstream. Here is a Channel 7 segment that was on “Seven On Your Side” with Michael Finney. I am featured:)

Feel free to make comments or get in touch with me with any questions about the revolution taking place in the field of work site ergonomics.

Click below and enjoy!


“I Feel, Therefore It Is”: The End of Critical Thinking and the Rise of the Digital Mob

January 12th, 2015

I was never a Facebook “poster.” That is, until the latest Israel-Gaza War.

I watched as the tensions escalated on both sides of the conflict, sensing what was to come. First, there was the kidnapping of the three teenage settler boys in the West Bank. Immediately came the cries from the Israeli government spokespeople, echoed by the media and the American Jewish mainstream: “Hamas is responsible for this terrorist act. We must and will protect our children!”

Then the rampage began. The Israeli military proceeded to make mass arrests throughout the West Bank, taking back into custody prisoners who had been released in a recent hostage-for-prisoner deal. Houses were broken into without warrants, Palestinian youths protested with rock throwing, Israelis responded with tear gas and rubber bullets. Finally, a Palestinian teen, Mohammed Abu Khdeir was kidnapped and burned to death by extremist Jewish settlers.

The downhill momentum seemed unstoppable and the war began. Hamas fired rockets into Israel and Israel responded with aerial and naval bombardments of Gaza. An Israeli land invasion followed. These events predictably were accompanied by a worldwide surge of anti-semitism.

As world opinion mainly condemned and demonized Israel, Israel itself asked: “What are we supposed to do when rockets rain down on us? What would you do?” Read the rest of this entry »

Ebola, Chronic Disease and the Road to Wellness

November 23rd, 2014

The Ebola epidemic is still raging through West Africa. Thousands are dead, including many health care workers who bravely fought the disease on the front lines.

There is an urgent demand to develop the medicines needed to defeat Ebola. Experimental drugs are being rushed to field hospitals. While it is projected that large batches of drugs should arrive by January, many thousands will by then be dead–and tens of thousands will likely be infected.

Much has already been written about why the world was caught “off guard” when the Ebola epidemic struck despite warnings by infectious disease experts. We have a highly sophisticated pharmaceutical industry (Big Pharma) that produces a steady stream of “miracle” drugs. But what drives the research and development of these ubiquitous medicines is singular: profit.Read the rest of this entry »

A Meditation on the Middle East Conflict, Islamophobia and the Need for Global Healing

October 12th, 2014

The Middle East is imploding. Israel has “mowed the lawn” in Gaza, wreaking havoc on the Palestinian population. Hamas, aggressively or defensively, has launched hundreds of rockets, their goal to terrify the Israelis. Assad has slaughtered over 100,000 Syrians. ISIS pushes to establish a modern Caliphate, killing its way to the very gates of the ancient capital of Babylon. At the same time Afghanistan is collapsing, Libya has become a failed state, Egypt is under martial control once again, and the Arab Spring has given way to a cold, uncertain winter.

One major effect of these conflicts has been the worldwide rise of Islamophobia. Read the rest of this entry »

Prescription for Change: On the Construction of a True Integrative Health Model

August 22nd, 2014

In a health care environment marked by raging turf battles that pit one profession against another, positive change will require—as a start–introspection and self-criticism by providers from different disciplines.

I am trained as a chiropractor, and have practiced my craft for almost 30 years. But the dominance of the allopathic medical profession has forced me to work in isolation. Chiropractors have been excluded from hospitals, marginalized by insurance companies, and subjected to ridicule by the American Medical Associations PR wing.(1)

To survive, we have upheld a holistic philosophy and championed effective treatment. As a result, chiropractic has become the most powerful and popular of the “alternative” modalities. At the same time, the pressure to work on our own in solo practices has tended to separate us from practitioners in the other healing arts. Read the rest of this entry »