Ricky’s Riffs: A blog about health and healing and a world that needs care.

On Impermanence and Illusion

On Impermanence and Illusion

We spend so much of our lives constructing stories; narratives to make sense of our worlds. And we usually cast ourselves as the heroes, the center pieces of what are, all too often, tall tales. As I watch my boarded-up city of San Francisco slowly re-open, I know that it will not be what it was before. Like a tidal wave washing over the city, sweeping away lives and livelihoods, COVID-19 has destroyed so much. I, like millions of others, was comfortable with my illusions of stability and permanence. I have had a practice for more than 30 years on quaint, tourist friendly, Union Street. I was part of an integrative, holistic health center with chiropractors, acupuncturists, massage therapists and many other types of practitioners who have come and gone over the years. But now, just a few years from retirement, I am caught in the wake of a flood…

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On Practice in the World of COVID-19

On Practice in the World of COVID-19

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. On March 16, complying with the orders of Mayor London Breed, I shut down my San Francisco chiropractic practice. As an essential service, I could have stayed open. But my partner and I (along with the other practitioners in my office) chose to “shelter in pace” in order to help “flatten the curve” of the coronavirus spread. I plan to re-open for business this coming Monday, May 4. We will take all of the necessary and recommended precautions: wearing masks, physically distancing our clients in the waiting room, reducing patient appointment numbers, scrubbing down…

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Some Early Thoughts on a Global Pandemic

Some Early Thoughts on a Global Pandemic

We have suddenly been thrust into a global pandemic. Seemingly overnight, our lives have changed. Many of us are on lockdown, prohibited from leaving our homes except to go to the grocery store, the pharmacy, or the doctor. We must now maintain “social distance” to prevent infection, staying at least six feet from others. There were already signs, back in December 2019, of a strange viral disease originating in the filthy live animal markets of China’s Wuhan province. Then it was seen in South Korea, and Japan. Somehow it jumped to Italy, and spread throughout Europe. All the while, from our “distant” perch–despite alarms being sounded by infectious disease and public health experts–our leaders looked on, and did nothing…

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The Democratization of Health and Healing

The Democratization of Health and Healing

I’d like to start a movement called “Humans for the Democratization of Health and Healing.” The movement will include many stakeholders: patient/consumers, healthcare practitioners, industry, and government. It will question the traditional relationships among all of these entities. And it will demand change from them all–including myself!…

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Cannabis: Medicine of the Future?

Cannabis: Medicine of the Future?

The cultivation of cannabis is a science and an art. As medicine, it can be used for relief of pain and the enhancing of pleasure; to relax and to sleep. It can stimulate the creative mind, and the spiritual one as well. The Emerald Cup, an annual event held at the Sonoma County Fairgrounds, is the “Academy Awards” of cannabis.  Named for Northern California’s “Emerald Triangle”–the center of the state’s cannabis cultivation industry—it is now in its sixteenth year. Awards are given…

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The Sound of Healing

The Sound of Healing

I relaxed at Philz, my local cafe, sinking into a soft leather couch, taking in a fine selection of indie rock, and enjoying some very strong coffee. As I sipped on a tall Tesora, I daydreamed about the trip I’d soon be taking to Peru. I was excited, but at the same time troubled by a pain I was feeling. I knew its source. A deep wound inflicted by someone whom I thought was a friend. He had stolen something from me, something real and material, but also something more…vital. It felt as if this “friend” had made off with a piece of my heart. But knowing this…

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The War on Health Care

The War on Health Care

Our health care system is in crisis. Everyone feels it. Premiums and deductibles keep rising, provider networks are narrowing, and the bite out of the average American paycheck gets bigger and bigger. Health care has taken center stage in the run-up to the 2020 election.

The Democrat arguments swing from elimination of the private health insurance industry and Medicare-For-All to a public option to buy into the Medicare system.  The Republicans have no plan, beyond destroying the ACA (Obamacare) and crying “socialism!”

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In Guatemala with the Integrative Health Project

In Guatemala with the Integrative Health Project

I just returned from a week in Guatemala, where I worked with the Integrative Health Project.  The project was started by a few acupuncturists about six years ago.  They wanted to work with the underserved, indigenous population living around Lake Atitlan, a beautiful, fertile and impoverished region in the Guatemalan highlands.

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Pain, the Opioid Crisis, and Alternative Care

Pain, the Opioid Crisis, and Alternative Care

Drug overdoses killed approximately 72,000 people in in the United States in 2017. This was an increase of 10% from 2016. The two reasons cited are (1) Americans continue to use opioids in increasing numbers, and (2) there are more powerful, deadlier, synthetic opioids available in the underground marketplace—mainly fentanyl, which is 100 times stronger than morphine.  While the latter is the primary cause of fatalities, there is a connection between the two explanations…

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On the Opioid and Gun Violence Epidemics: Rationales in Common

On the Opioid and Gun Violence Epidemics: Rationales in Common

We are currently in the midst of the most lethal drug epidemic in our country’s history. One of the shocking things about this crisis is that it has been going on for the past 20 years without showing any signs of letting up. In 2016, overdoses involving opioids killed more than 42,000 people. Of those deaths, 40% were from prescription opioids. (Statistics are still being finalized for 2017.) Several recent books describe the evolution of this…

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A Rationale For A Single Payer Health Care System

A Rationale For A Single Payer Health Care System

Real change is coming to our health insurance system. This is inevitable for the simple reason that the system, as it stands, is not sustainable. Premiums and deductibles keep rising, way beyond the rate of inflation. Drug prices also rise, as do hospital and medical device costs.

In 2010 President Obama pushed through his landmark legislation, the Affordable Care Act (ACA), which enabled millions of previously uninsured people…

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Welcome to “Condition: Health News That Matters”

Welcome to “Condition: Health News That Matters”

For quite some time, I have been thinking about writing a book.  I believe I have a unique perspective on health and healing and that this perspective might be interesting and useful to others.  After all, I’ve been in practice for more than 30 years.  I’ve taught...

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A World of Pain

A World of Pain

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,...

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Empathy, Patient Centered Care and Healing

Empathy, Patient Centered Care and Healing

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. ...

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Obamacare and the Shifting of the American Mind

Obamacare and the Shifting of the American Mind

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...

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Public Option: Next Step Toward Universal Health Care

Public Option: Next Step Toward Universal Health Care

The Republicans have failed to “repeal and replace” the Affordable Care Act (ACA).  They stated this would be their first order of business upon coming into power.  Although they will surely continue their efforts, it is unlikely that they will succeed. It is now time...

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Trump Excitement Disorder (TED)…or Tribal Fever

Trump Excitement Disorder (TED)…or Tribal Fever

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...

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Pain and Suffering of the Digital Natives

Pain and Suffering of the Digital Natives

“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;...

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Music, Art and Revolution: Cuba, 2016

Music, Art and Revolution: Cuba, 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...

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A Persian Wedding: Love and the Will to Freedom

A Persian Wedding: Love and the Will to Freedom

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...

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Mortality and Healing: A Meditation and Tribute to a Friend

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...

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Ebola, Chronic Disease and the Road to Wellness

Ebola, Chronic Disease and the Road to Wellness

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...

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Health Care Reform: A New Way of Thinking

Health Care Reform: A New Way of Thinking

Discussions about health care reform tend to focus on payment methods. Critics assert that insurance companies (in concert with pharmaceutical companies and hospitals) are the primary causes of runaway costs. While there is a relationship between payment methods and...

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Israel/Palestine: A Land of Hope and Pain

Israel/Palestine: A Land of Hope and Pain

On the beaches and in the hip cafes of Tel Aviv, it is easy to escape the feeling of life at the edge of a precipice. Israelis refer to this modern Mediterranean city as “the bubble”: a place where one can imagine an Israel of secularism and safety. That feeling,...

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New Models for Health and Healing

New Models for Health and Healing

We are currently in a full-blown health care crisis. The Affordable Care Act (ACA, or Obamacare) roll-out was a disaster. People in some states are still struggling to register through exchange websites to buy insurance. Others resist being forced to get insurance at...

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Magic and Healing: An Interlude

Magic and Healing: An Interlude

My good friend and colleague, Paul, strongly disagreed with my last blog. In that article I described what I believed to be a paradigm shift taking place in health care: a cultural movement away from allopathic medicine, now our dominant mode of healing, to a medicine...

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Paradigms, Power, and Healing

Paradigms, Power, and Healing

I recently read through some materials given to me by a colleague. She is a broker for a company that creates health care programs for large corporations and had just returned from a “Wellness” conference sponsored by a major health insurance provider. The emphasis of...

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The Insurance Game

The Insurance Game

A few weeks ago, a patient gleefully told me that he had gotten excellent new health insurance through his employer. The coverage included more chiropractic visits than his previous insurance plan, yet his co-pay was still minimal. It was difficult for me to share his...

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NAMM, MusiCares, and Tribal Healing

NAMM, MusiCares, and Tribal Healing

I recently returned from attending my second NAMM (National Association of Music Merchants) show.  This year, as in the past, I was working with MusiCares, the charitable health and human services arm of the Recording Academy (GRAMMYs). MusiCares offers support for...

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ricky@rickyfishman.com www.rickyfishman.com
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