Category Archives: Creating Human Culture

Words Create Worlds.11: What Are We Going to Do Now?

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Images: Renee Nicole Good and Alex Pretti were shot and killed by ICE in January, 2026. ICE photo by David Guttenfelder/The New York Times/Redux. The cover of The Clash’s 1979 album London Calling.

The Clash song, “Clampdown,” from the 1979 double album Londong Calling, starts with the question: “What are we going to do now?”

I have had this song by The Clash going through my head this past week. Now after the second killing of American Citizens by ICE in the past month, I keep asking myself, asking us, “What are we going to do now?”

The shooting death by masked government agents of Alex Pretti strikes close to home as he was a VA ICU nurse. Having trained and worked in the VA system for close to 20 years, I know the kind of professional dedication and commitment that VA employees bring to caring for Veterans who have served their country.

Renee Nicole Good had just dropped off her 6-year old at school before she was shot by armed masked government agents. Her last words were reportedly, “That’s fine, dude. I’m not mad at you.”

“What are we going to do now?”

I always wondered what “the clampdown” was when I listened to this Clash song as a kid. I wasn’t sure what it was, but I knew I didn’t want to work for it – and I know I don’t want to work for it now.

Taking off his turban, they said, is this man a Jew?
‘Cause they’re working for the clampdown
They put up a poster saying we earn more than you!
When we’re working for the clampdown

I pictured something like Hitler’s paramilitary Brownshirts, or some other loosely organized group that came together to inflict violence on it’s own people. I suppose this queston of those working for the clampdown about “is this man a Jew” made me think of the Nazis.

We will teach our twisted speech
To the young believers
We will train our blue-eyed men
To be young believers

The Clampdown seems to require teaching “twisted,” violent speech to the young of the nation, and invoking “our blue-eyed men” again recalls the Nazis. It continues to confound me how many MAGA and now ICE believers there are, who don’t see how words create worlds. The deaths of Renee Nicole Good and Alex Pretti are the worlds that have been created by the words of name calling and bullying and “othering” of Americans.

The judge said five to ten, but I say double that again
I’m not working for the clampdown
No man born with a living soul
Can be working for the clampdown

At least some judges are finding for the rule of law, but what happens when the judges are working for the Clampdown? I hesitate to dehumanize others and say they don’t have a “living soul,” but dehumanization, scapegoating, projection, and “othering” are key psychosocial operations that pave the way for violence. I can see questioning the humanity of those working for the Clampdown when the Clampdown dehumanizes others.

Kick over the wall ’cause government’s to fall
How can you refuse it?
Let fury have the hour, anger can be power
D’you know that you can use it?

It does seem like government is falling. We have a crisis between the federal government’s masked paramilitary organization. The Feds are blocking city and state government from investigating these shooting deaths of American citizens. Who holds the power here? Why are there armed masked men kicking down doors and kicking over walls? The seem to encapsulate the fury of the hour, which is how I always heard that line. The current President seems to have a fury of the hour, but The Clash seem to say that those with the fury are carrying the hour. Anger can be power. That is true. Anger can be power. “Do you know that you can use it?” This could be giving permission for paramilitary organizations to channel their fury and anger into anti-democratic activities and violence. But we can also hear this line from the perspective of those asking “What are we going to do now?” We can channel our anger into peaceful protest, into not looking away from abuses of power and tyranny. But again, this line could also be from the hooligans who have risen to power, looking toward their leader, ready to carry out the fury of the hour.

The voices in your head are calling
Stop wasting your time, there’s nothing coming
Only a fool would think someone could save you

Here The Clash tell us that it would be foolish to think that someone is coming to save us, we each have to refuse to work for the Clampdown.

The men at the factory are old and cunning
You don’t owe nothing, so boy get running
It’s the best years of your life they want to steal

Now the Clampdown also takes the form of the “old and cunning” men who want to steal the “best years of your life.” The Clampdown takes away your rights, it takes away your soul, it can steal away the best years of your life, and, apparently, it can even take your life with impunity.

You grow up and you calm down
You’re working for the clampdown
You start wearing the blue and brown
You’re working for the clampdown

I heard this as a warning. It is one thing to be full of a piss and vinegar as a young punk, but there is a risk that you “grow up” and you “calm down” and end up working for the Clampdown, even though you resisted it in your youth. I knew about the Brownshirts, but I didn’t know about the Blueshirts – are The Clash singing about the Irish party of that name? I’m not sure. It is clear though, The Clash are warning you not to work for the Clampdown, no matter whether you are wearing a brown shirt, a blue shirt, or a red white and blue shirt.

So you got someone to boss around
It makes you feel big now
You drift until you brutalize
You made your first kill now

This is always a chilling stanza. I always think of the kids who I had been friends with in elementary school who became thugs and bullies in high school. People who feel small and have listened to the “twisted speech” and become “young believers” that the way to feel big and powerful is to find someone to “boss around.” Once you have given over your power to the fury of the hour, you cease to direct your own actions, you become a puppet who drifts “until you brutalize,” and from there the next step is making “your first kill now.” Words lead to action which leads to creating worlds of violence and when you are working for the Clampdown, you can easily end up killing.

I had to look this line up on The Clash website because Google Lyrics listed it as “Doesn’t make you first kill now,” which really doesn’t make any sense.

In these days of evil presidentes
Working for the clampdown
But lately one or two has fully paid their due
For working for the clampdown

Doesn’t that just capture it! It sure seems like we are living in the “days of evil presidentes/working for the clampdown.” We can only hope that one or two will fully pay their due. Right now it seems like the Clampdown is in charge and unrestrained.

Ha! Gitalong! Gitalong!
Working for the clampdown
Ha! Gitalong! Gitalong!
Working for the clampdown

Not much more to say here – sounds like a cattle drive with masked armed men who have immunity under the Federal government, trying to heard along protesters and killing the occasional one or two.

Yeah I’m working hard in Harrisburg
Working hard in Petersburg
Working for the clampdown
Working for the clampdown

Everyone, no matter they are, they’re working – and either your working hard for the Clampdown, or your working hard against it.

Ha! Gitalong! Gitalong
Begging to be melted down
Gitalong, gitalong
(Work)
(Work)
(Work) And I’ve given away no secrets – ha!
(Work)
(Work)
(More work)
(More work)
(Work)
(Work)
(Work)
(Work)
Who’s barmy now?

The song just tails off with “work” and “more work,” finally asking “who’s barmy now?” Meaning who’s crazy, I suppose. “Clampdown” gives us much to think about in the United States at this moment. It gives us pause and reminds us that the Clampdown could be almost anything and could be almost anywhere, but right now it is here…now.

“What are we going to do now?”

Maybe the answer to that question is: you are either working for the Clampdown – or you are not.

Are you working for the Clampdown?

Clampdown, Live – Fridays 1980: shorturl.at/TdE5A

London Calling album, studio version: rb.gy/kdhzxe

Announcing the Becoming A True Human podcast!

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I’ve been thinking about how we need to build a community of practitioners discussing the problems of burnout, compassion fatigue, and soul loss. Isolation and loneliness contribute to burnout, and social connection is an antidote to burnout. To this end, we are creating the Becoming A True Human podcast. Who is “we”? Well, for now, it is me and my good friend Chris Smith – therapist, meditation teacher, Whole Health educator, storyteller, author (Be a Good Story), founder of the Academy for Mindfulness consulting, and all-around wise guy (and I mean that in multiple senses of the phrase).

The audio of the episode 1, Lost, is at the bottom of this post.

Chris Smith
Dave Kopacz

What is burnout? Just what exactly is it that burns out? How can whatever is burned out be re-ignited?

What is compassion fatigue? How does compassion wear out? Should it really be called empathy fatigue? Is the problem that there is too much compassion going out? Or not enough coming in? Or could it be that institutional structures and protocols make us busy with so many things that there is little time left in the clinical encounter for caring?

What is soul loss? Could we think of the soul being the “thing” that burns out? Not necessarily in a religious or metaphysical sense – although it could be if that fits your belief system – but in a metaphorical and psychological sense. If in burnout we lose connection with our souls, how can we reconnect and either go on a quest to find our lost souls, or create a welcoming environment in our bodies and lives so that our souls can return and flourish?

I address these questions in my book, Caring for Self & Others: Transforming Burnout, Compassion Fatigue, and Soul Loss, but we need to have further discussions around these topics as I feel strongly that we need a kind of ongoing practice, a yoga of burnout, in which we continually work in our own practices as well as in building communities of caring to support each other with this human, all too human dilemma.

Based on the topics we discussed in the first episode we titled this episode “Lost,” even before we realized that we somehow lost video of me and only recorded video for Chris! In this episode we explore topics of burnout as an initiation into becoming a wounded healer, soul loss, yoga for the health of healers, and we end with a meditation exercise and a poem, “Lost” by David Wagoner.

We don’t really know what we are doing with the technology aspect.

Let me tell you a story that illustrates the problem.

My high school friend Jack and I drove across the country after college. We were into the beat poets and writers, reading Kerouac’s On the Road, and envisoned a trip full of excitement and philosophical observations. We had a microcassette recorder and would talk into as we were driving, having many deep discussions and creating a record of what we saw.

Somewhere around South Dakota (having left from Chicago area) I noticed that the wheels of the recorder weren’t moving when we were recording. It was then that I noticed that there was a pause switch that was clicked on and prevented any recordings from being made! All of our bits, routines, observations, and experiences were lost! We were a bit crestfallen and we made half-hearted attempt to resume recording, but something had been lost – the energy, the enthusiasm. I think we eventually gave up on it. Maybe you could say we burned out on the idea after investing so much energy and enthusiasm and not having anything to show for it.

From a mindfulness perspective, there is surely some kind of lesson here – about not being attached to goals or outcomes, about being in the present moment versus memorializing experience, and maybe even that the organizing ego is an illusionary construct for creating a reduced and more manageable limited reality (if you want to take it that far!).

Well…I remembered this story after Chris Smith and I had just had our wide-ranging and enthusiastic discussion as we recoreded it on Zoom, only to realize that I had messed up the settings and we only had Chris’ video and both our audio. Well, crestfallen again! Urgh, technology failure again!

So, I think I have figured out how to share the audio of our video podcast, rather than have video of just Chris and my disembodied voice. Titling this episode, “Lost,” was prescient as we lost the video. Chris also spoke of his caring for self routine and how he purposefully skips some days so as not to get caught up in perfectionism, performance, and productivity. We’ll consider the lost video as a sacrifice to the Divine or the Cosmos, a giveaway, in addition to it being a bumbling failure of technology.

So, welcome to the first episode of the Becoming A True Human podcast – Lost – it highlights the vulnerability and imperfection of being human, that we are all a work in progress and that our work is a yoga practice – yoking mind, emotions, body, soul. The practice of Becoming A True Human is an ongoing practice, we can only do it in the present moment and the next moment we are again lost, at sea, trying to figure it out and Keep It All Together (KIAT). We will attempt to have the next episode as video and hope to post it on the Becoming a True Human YouTube site.

Nature & Medicine: Restoring the Balance Between Earth & Health – Nov 12 & 13

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I am on the Doctor as Humanist’s conference planning committee for our free, virtual, international symposium – Nature & Medicine: Restoring the Balance Between Earth & Health on November 12 & 13, 2021. Register here.

We’ve got a great line up of speakers and round table panelists, including Bob Lawrence, one of the founders of Physicians for Human Rights and Center for a Livable Future Professor Emeritus in the Department of Environmental Health and Engineering at the Johns Hopkins Bloomberg School of Public Health and the founding director of the Center for a Livable Future; Rachel Corby, author of ReWild Yourself: Becoming Nature; Julia Corbett, author of Out of the Woods: Seeing the Nature in the Everyday; Lewis Mehl-Madrona, author of Coyote Medicine and Narrative Medicine; Qing Li, author of Forest Bathing: How Trees can Help You Find Health & Happiness, amongst many others. Link to the program.

One of the projects we are doing as part of the symposium is the Tree of Medicine – a photomosaic on the Mosaically site. You can post on Instagram or Twitter with the hash tags: #NatureMed2021 and #DoctorHumanist and we’ll upload your photos into the Tree of Medicine. You can write a few words of why this photo is important to you and how it relates to Nature & Medicine. Here are a few of the photos I’ve posted.

An unexpected beautiful scene on a walk through Seattle – reminding me that Nature is here, now.
The face on this tree on San Juan Island’s Lime Kiln State Park reminds me of the sentience of nature.
Cannon Beach, Oregon, a breath-taking & invigorating view.

The idea behind this conference is to highlight the many benefits of nature & health while also expanding our idea of being a medical professional to including the health of the Earth. We are in a symbiotic relationship with Nature and cannot exist apart from Nature. In fact, we ourselves are nature, we are made up of nature, our backyards are nature. I’ll be giving a workshop on Saturday 11/13/21 with a focus on Nature is Here, Now. The care of Nature begins with the care of ourselves, the nature of our homes, the nature of our backyard, and breaks down the artificial separations of humans/nature and city/nature. I’ll be joined by a couple of great psychiatry residents I’ve been working with, Eunice Stallman, MD (who has been doing an elective on Narrative Medicine) and Lewis Kerwin, MD (who has been doing an elective on Nature, Health, and Design). We’ll be joined by my friend, photographer and author, John Riggs, author of Clear Cut – The Wages of Dominion. I wrote a review of his book on 5/8/20.

Each of us on the planning committee recorded a short video on the Tree of Medicine project and the Nature & Medicine: Restoring the Balance Between Earth & Health, here’s the link to my video.

We hope you join us!

Nature & Medicine: Restoring the Balance Between Earth & Health on November 12 & 13, 2021. Register here.

How are you doing…really?

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How are you doing…really? New post on CLOSLER: Bringing Us Closer to Osler

This is a reflection piece on the challenge of answering this simple question, asked so many times a day, “How are you doing?” While this is usually asked in passing, the true answer to this question is increasingly complex for health care workers as the pandemic wears on.

You can read the essay, here, and some past essays published on CLOSLER, here. The piece features a detail of my painting, “Planting the Seed of the Heart,” which was published in Walking the Medicine Wheel: Healing Trauma & PTSD.

Thanks again, CLOSLER, for all that you do for person-centered care & provider well-being!

Planting the Seed of the Heart, D. Kopacz (2016)

What Does it Mean to Be Human? The Role of Psychiatrists in Philip K. Dick’s Life & Writing

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This is the title of my presentation from May, 2012, at the Royal Australian New Zealand College of Psychiatrists annual meeting, held in Hobart, Tasmania, Australia. This is a timeless topic and applies as much as ever to us as we work to come out of this pandemic which has changed how we relate to others and how we relate to ourselves. The struggle to “stay human” in medicine is an ongoing practice and we can learn from the life & works of PKD.

Every Thought Leads to Infinity:

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Perspectives on Personal Growth, Psychosis & Spirituality:

Carl G. Jung’s Red Book & Philip K. Dick’s Exegesis

I presented this paper at the International Society for Psychological and Social Approaches to Psychosis, New Zealand/Australia annual conference, August 2012 in Auckland, New Zealand. I thought I would share the slides from the talk.

Video available from Toward a New Way of Being with Plants conference!

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My sister, Karen, and I presented at last month’s Toward a New Way of Being with Plants conference.

The video of our presentation is available here.

Our overall presentation was called, “Remembering Our Living Relationship with Plants,” my talk was entitled “Toward an Ancient Way of Being with Plants,” and we also featured video that Karen created with Joseph Rael, “Becoming Medicine Initiation Ceremony,” and Karen’s talk was “Shifting Into a Relational Mindset With Nature.”

The conference was great! Very interesting, bringing together scientists, artists, poets, writers, and naturalists from around the world. There is a YouTube channel for the conference where you can watch the presentations.

Thanks to all the organizers and people who brought this great event together! It was very enjoyable, inspirational, and educational.

Making America Healthy Again: Indigenous Perspectives on Land & Health – new article About Place Journal

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Making America Healthy Again: Indigenous Perspectives on Land & Health

By David R. Kopacz, MD & Joseph Rael (Beautiful Painted Arrow)

About Place Journal from the Black Earth Institute

We have a new article published at About Place Journal for their Geographies of Justice Issue – Volume VI, Issue III, May 2021! We are very excited to be published in this excellent and important journal.

We look at the relationships between land and health, private land/private health, and public land/public health.

When I spoke with Joseph about the topic of Geographies of Justice he immediately resonated with it. “All humans are looking for that – some justice, a just place where we can feel adjusted and feel safe. A just place is where you are adjusted to justice,” he said. Here are a few excerpts of Joseph’s thoughts on Geographies of Justice:

“There are a lot of resources on the land that we take care of and they take care of us.

We need to start with the origin of the land, the place before everything broke apart – Pangea. We start at 1 – that’s Pangea. Then the scientists say the continents broke apart, and then people came out of Africa, then the Indians walked across the Bering Strait into the Americas – that’s how the scientists tell it.…

We can learn from our environment, from our geographies. We cannot have justice unless we learn from our geographies. Pangea was created and all around it was Panthalassa, the great ocean. Then Pangea spilt and you had the Pacific and the Atlantic Oceans eventually, and the Americas, North, South, Central, and then you had all these tribes in North America, and you had tribes in South America. For all these tribes, their religion was based on geography. The Eskimos had igloos and they would have ceremonies that reflect where they live, all the tribes would have ceremonies that reflect where they live.

There are different areas of land. You become your place before you live in your Mom and Dad’s house because they come from the land and you come from them. They teach you about the weather. The ceremonies are related to the climate of their place. First there was Pangea, and then it split and you had Europeans and Americans, but we are all from Pangea, we are all related...”

“Justice is right here in the room with me and it is right there in the room with you and it is right there in the room for all the people on the planet – it is here.“

To read the whole article, follow this link to “Making America Healthy Again: Indigenous Perspectives on Land & Health” in About Place Journal.

The Social Determinants of Clinician Health – new post @ CLOSLER!

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I have a new article posted, “The Social Determinants of Clinician Health,”

at CLOSLER: MOVING US CLOSER TO OSLER A MILLER COULSON ACADEMY OF CLINICAL EXCELLENCE INITIATIVE, Johns Hopkins.

Here are some opening quotes and the first paragraph…

“Every system is perfectly designed to get the results it gets,”—W. Edwards Deming

“An abnormal reaction to an abnormal situation is normal behavior.”—Victor Frankl

“Many believe burnout to be the result of individual weakness when, in fact, burnout is primarily the result of health care systems that take emotionally healthy, altruistic people and methodically squeeze the vitality and passion out of them.”— Swenson and Shanafelt, Mayo Clinic Strategies to Reduce Burnout: 12 Actions to Create the Ideal Workplace

If every system is perfectly designed to get the results it gets, then many healthcare systems around the world are designed to create high levels of burnout and compassion fatigue in the people who work within them. Maybe burnout isn’t a lack of resilience or coping skills in clinicians, but an iatrogenic effect of modern healthcare.

Read the rest of the article at CLOSLER

Toward a New Way of Being with Plants Conference – June 17-18, 2021

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I am very excited to announce that I will be speaking at the Toward a New Way of Being with Plants conference on June 18th! This is an online conference and registration is free.

I will be presenting along with my sister, Karen Kopacz. Our talk is called “Remembering Our Living Relationship with Plants“ and is from 1:20 pm-2:05 pm US Central Time.

My part of the talk is called “Toward an Ancient Way of Being with Plants“ and will review some of my work with Joseph Rael (Beautiful Painted Arrow).

The center of our talk will feature a video of Joseph Rael Becoming Medicine Initiation Ceremony video (5:16) that we filmed and Karen produced.

Karen’s talk is called “Shifting Into a Relational Mindset With Nature.”

You can check out the speakers, here, and the agenda, here. The conference is put on my a number of international partners, including the University of Minnesota.

Maybe we will see you there!

Also, I just had a post up on CLOSLER, “Making the Most of Your Daily Nervous Breakdown,” where I write about taking a mini-rest cure connecting back to nature.