Ricky's Riffs:

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


On Heroes and History: Normandy, 2023

July 11th, 2023

Growing up in the 1960’s, one generation removed, World War II deeply informed my sense of both past and present. My father and almost all the men of his generation had signed up or were drafted. It was just the thing to do, whether it was to go and fight Nazis or because they realized the neighborhood corner was empty so they might as well go off to where their buddies were. They were spread out from England to France to Burma to New Guinea. Some guarded prisoners, some worked on intelligence, some were on aircraft carriers, and some stormed the beaches of northern France on D-Day.Read the rest of this entry »


COVID Diaries, Part One: On Practice in the World of COVID-19

May 2nd, 2020

One of the biggest challenges for me during this pandemic has been the very real possibility that work, as I have known it, may never be the same.Read the rest of this entry »


Music, Art and Revolution: Cuba, 2016

March 22nd, 2016

Havana’s Jose Marti International Airport is typical of many airports in the “developing” world—one terminal and one carousel for our bags (AND the bags of another two flights coming in right after us).  After an hour of chaos, we found our last piece of luggage and boarded our bus into Havana.

The first thing I noticed were the old American cars.  I recalled these from my previous trip to Cuba, in 1989.  Surely, I thought, they could not still be on the road–at least not in the same numbers.

Photo by Cheryl Lucanegro

Photo by Cheryl Lucanegro

But there they were, by the dozens, clogging the traffic flow, held together with spare parts and Cuban ingenuity: Chevys, Cadillacs and Buicks, spewing diesel smoke in all of their boxy, 1950’s glory.

And there was something else striking about the cityscape: it was completely devoid of billboards.  No public promotion of soft drinks, beauty products and/or the services of personal injury lawyers.

images-4Instead, I saw large political signs proclaiming “Socialism O Muerte” (Socialism or Death) or “Con Cuba Siempre” (With Cuba Always); most with images of Fidel Castro and/or Che Guevara, along with an assortment of other revolutionary “heroes.”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 »


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 »