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RFK Jr. speaks candidly about his gravelly voice: ‘If I could sound better, I would’

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RFK Jr. speaks candidly about his gravelly voice: ‘If I could sound better, I would’

There was a time before the turn of the millennium when Robert F. Kennedy Jr. gave a full-throated accounting of himself and the things he cared about. He recalls his voice then as “unusually strong,” so much so that he could fill large auditoriums with his words. No amplification needed.

The independent presidential candidate recounts those times somewhat wistfully, telling interviewers that he “can’t stand” the sound of his voice today — sometimes choked, halting and slightly tremulous.

The cause of RFK Jr.’s vocal distress? Spasmodic dysphonia, a rare neurological condition, in which an abnormality in the brain’s neural network results in involuntary spasms of the muscles that open or close the vocal cords.

My voice doesn’t really get tired. It just sounds terrible.

— Robert F. Kennedy Jr.

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“I feel sorry for the people who have to listen to me,” Kennedy said in a phone interview with The Times, his voice as strained as it sounds in his public appearances. “My voice doesn’t really get tired. It just sounds terrible. But the injury is neurological, so actually the more I use the voice the stronger it tends to get.”

Since declaring his bid for the presidency a year ago, the 70-year-old environmental lawyer has discussed his frayed voice only on occasion, usually when asked by a reporter. He told The Times: “If I could sound better, I would.”

SD, as it’s known, affects about 50,000 people in North America, although that estimate may be off because of undiagnosed and misdiagnosed cases, according to Dysphonia International, a nonprofit that organizes support groups and funds research.

As with Kennedy, cases typically arise in midlife, though increased recognition of SD has led to more people being diagnosed at younger ages. The disorder, also known as laryngeal dystonia, hits women more often than men.

Internet searches for the condition have spiked, as Kennedy and his gravelly voice have become staples on the news. When Dysphonia International posted an article answering the query, “What is wrong with RFK Jr.’s voice?,” it got at least 10 times the traffic of other items.

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Those with SD usually have healthy vocal cords. Because of this, and the fact that it makes some people sound like they are on the verge of tears, some doctors once believed that the croaking or breathy vocalizations were tied to psychological trauma. They often prescribed treatment by a psychotherapist.

But in the early 1980s, researchers, including Dr. Herbert Dedo of UC San Francisco, recognized that SD was a condition rooted in the brain.

Researchers have not been able to find the cause or causes of the disorder. There is speculation that a genetic predisposition might be set off by some event — physical or emotional — that triggers a change in neural networks.

Some who live with SD say the spasms came out of the blue, seemingly unconnected to other events, while others report that it followed an emotionally devastating personal setback, an injury accident or a severe infection.

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Kennedy said he was teaching at Pace University School of Law in White Plains, N.Y., in 1996 when he noticed a problem with his voice. He was 42.

His campaigns for clean water and other causes in those days meant that he traveled the country, sometimes appearing in court or giving speeches. He lectured, of course, in his law school classes and co-hosted a radio show. Asked whether it was hard to hear his voice gradually devolve, Kennedy said: “I would say it was ironic, because I made my living on my voice.”

“For years people asked me if I had any trauma at that time,” he said. “My life was a series of traumas … so there was nothing in particular that stood out.”

Kennedy was just approaching his 10th birthday when his uncle, President John F. Kennedy, was assassinated. At 14, his father was fatally shot in Los Angeles, on the night he won California’s 1968 Democratic primary for president.

RFK Jr. also lost two younger brothers: David died at age 28 of a heroin overdose in 1984 and Michael died in 1997 in a skiing accident in Aspen, Colo., while on the slopes with family members, including then-43-year-old RFK Jr.

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It was much more recently, and two decades after the speech disorder cropped up, that Kennedy came up with a theory about a possible cause. Like many of his highly controversial and oft-debunked pronouncements in recent years, it involved a familiar culprit — a vaccine.

Kennedy said that while he was preparing litigation against the makers of flu vaccines in 2016, his research led him to the written inserts that manufacturers package along with the medications. He said he saw spasmodic dysphonia on a long list of possible side effects. “That was the first I ever realized that,” he said.

Although he acknowledged there is no proof of a connection between the flu vaccines he once received annually and SD, he told The Times he continues to view the flu vaccine as “at least a potential culprit.”

Kennedy said he no longer has the flu vaccine paperwork that triggered his suspicion, but his campaign forwarded a written disclosure for a later flu vaccine. The 24-page document lists commonly recognized adverse reactions, including pain, swelling, muscle aches and fever.

It also lists dozens of less common reactions that users said they experienced. “Dysphonia” is on the list, though the paperwork adds that “it is not always possible to reliably estimate their frequency or establish a causal relationship to the vaccine.”

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Public health experts have slammed Kennedy and his anti-vaccine group, Children’s Health Defense, for advancing unsubstantiated claims, including that vaccines cause autism and that COVID-19 vaccines caused a spike of sudden deaths among healthy young people.

Dr. Timothy Brewer, a professor of medicine and epidemiology at UCLA, said an additional study cited by the Kennedy campaign to The Times referred to reported adverse reactions that were unverified and extremely rare.

“We shouldn’t minimize risks or overstate them,” Brewer said. “With these influenza vaccines there are real benefits that so far outweigh the potential harm cited here that it’s not worth considering those types of reactions further.”

Anyone with concerns about influenza vaccine side effects should consult their physician, he said.

So what does research suggest about SD?

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“We just don’t know what brings it on,” said Dr. Michael Johns, director of the USC Voice Center and an authority on spasmodic dysphonia. “Intubation, emotional trauma, physical trauma, infections and vaccinations are all things that are incredibly common. And it’s very hard to pin causation on something that is so common when this is a condition that is so rare.”

No two SD sufferers sound the same. For some, spasms push the vocal cords too far apart, causing breathy and nearly inaudible speech. For others, such as Kennedy, the larynx muscles push the vocal cords closer together, creating a strained or strangled delivery.

“I would say it was a very, very slow progression,” Kennedy said last week. “I think my voice was getting worse and worse.”

There were times when mornings were especially difficult.

“When I opened my mouth, I would have no idea what would come out, if anything,” he said.

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One of the most common treatments for the disorder is injecting Botox into the muscles that bring the vocal cords together.

Kennedy said he received Botox injections every three or four months for about 10 years. But he called the treatment “not a good fit for me,” because he was “super sensitive to the Botox.” He recalled losing his voice entirely after the injections, before it would return days later, somewhat smoother.

Looking for a surgical solution, Kennedy traveled to Japan in May, 2022. Surgeons in Kyoto implanted a titanium bridge between his vocal cords (also known as vocal folds) to keep them from pressing together.

He told a YouTube interviewer last year that his voice was getting “better and better,” an improvement he credited to the surgery and to alternative therapies, including chiropractic care.

The procedure has not been approved by regulators in the U.S.

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Johns cautioned that titanium bridge surgeries haven’t been consistently effective or durable and said there have been reports of the devices fracturing, despite being implanted by reputable doctors. He suggested that the more promising avenue for breakthroughs will be in treating the “primary condition, which is in the brain.”

Researchers are now trying to find the locations in the brain that send faulty signals to the larynx. Once those neural centers are located, doctors might use deep stimulation — like a pacemaker for the brain — to block the abnormal signals that cause vocal spasms. (Deep brain stimulation is used to treat patients with Parkinson’s disease and other afflictions.)

Long and grueling presidential campaigns have stolen the voice of many candidates. But Kennedy said he is not concerned, since his condition is based on a neural disturbance, not one in his voice box.

“Actually, the more I use the voice, the stronger it tends to get,” he said. “It warms up when I speak.”

Kennedy was asked whether the loss of his full voice felt particularly frustrating, given his family’s legacy of ringing oratory. He replied, his voice still raspy, “Like I said, it’s ironic.”

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Can fire-resistant homes be sexy? ‘You be the judge,’ says this Palisades architect

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Can fire-resistant homes be sexy? ‘You be the judge,’ says this Palisades architect

At first glance, it looks like nothing more than a charming Spanish-revival, quintessentially Californian home — but this Pacific Palisades rebuild is constructed like a tank.

Every exterior wall of the steel-framed home is a foot-thick, fire-resistant barricade. The home is connected to a satellite fire monitoring service. Should a fire start in town, sturdy metal shutters descend to cover every window. An exterior sprinkler system can pump 40,000 gallons of water from giant tanks hidden behind the shrubs in the property’s yard. If the cameras and heat sensors around the house detect danger, the system can envelop the home in over 1,000 gallons of fire retardant and hundreds of gallons of fire-suppressing foam.

Palisades resident and architect Ardie Tavangarian is so confident in his design that he even asked the fire department if they could start a controlled fire on the property to test it all out. (They said no.)

Tavangarian built a career designing multimillion-dollar luxury homes in Los Angeles, but after the Palisades fire destroyed 13 of his works — including his family’s home — he found another calling: how to design a house that can handle what the Santa Monica Mountains throw at it. And how to do it quickly and affordably.

Water tanks form part of a backup water supply in a newly built fire-resistant home in Pacific Palisades.

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“Nature is so powerful,” he said, sitting on a couch in the new house, which he built for his adult twin daughters. “We are guests living in that environment and expecting, ‘Oh, nature is going to be really kind to me.’ No, it’s not. It does what it’s supposed to do.”

Tavangarian watched the Jan. 1 Lachman fire from his property not far from here; a week later that fire rekindled, grew into the Palisades fire, and burned through his house. But the painful details of the fire — the missteps of the fire department, the empty reservoir — didn’t matter when it came to deciding how to rebuild, he said. The reality is, many fires have burned in these mountains. Many more will.

A sprinkler on a roof.

A sprinkler on the roof is part of a house-wide sprinkler system.

For the architect, who has spent much of his 45-year career designing for luxury, hardening a home against wildfire has brought a new kind of luxury to his homes: peace of mind.

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It’s a sentiment that resonates with fire survivors: Tavangarian says he’s received considerable interest from other property owners in the Palisades looking to rebuild their houses.

The metal shutters and advanced outdoor sprinkler system are the flashiest parts of Tavangarian’s home hardening project, and the efficacy of these adaptations is still up for debate. Because the measures have not yet been widely adopted, there are few studies exploring how much or little they protect homes in real-world fires.

Ardie Tavangarian stands inside a house.

Architect Ardie Tavangarian inside the house he designed.

Anecdotal evidence has indicated the effectiveness of sprinklers can vary significantly based on the setup and the conditions during the fire. Extreme wind, for example, can make them less effective. Lab studies have generally found shutters can reduce the risk of windows shattering.

These measures aren’t cheap, either. Sprinkler systems can cost north of $100,000, for example. However, Tavangarian said when all was said and done, the home he built for his daughters cost around $700 per square foot — less than what Palisades residents said they expected to pay, but more than what Altadena residents expected for their rebuilds.

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Tavangarian also hopes to see insurers increasingly consider the home-hardening measures property owners take when writing policies, which he said could potentially offset the extra cost in a decade or less. As he explored getting insurance for the new home, one insurer quoted him $80,000 a year. After he convinced the company to visit the property, it lowered the quote to just $13,000, he said.

A living room inside a fire-resistant house, with metal heat shields drawn over the windows.

The house includes metal heat shields that can drop down if a fire approaches.

The home also has essentially all of the other less flashy — but much cheaper and well-proven — home hardening measures recommended by fire professionals: The underside of the roof’s overhang is closed off — a common place embers enter a home. The roof, where burning embers can accumulate, is made of fire-resistant material. The windows, vulnerable to shattering in extreme heat, are made of a toughened glass. There is virtually no vegetation within the first five feet of the home.

When asked if he felt he had compromised on design, comfort or aesthetics for the extra protection — one of the many concerns Californians have with the state’s draft “Zone Zero” requirements that may significantly limit vegetation within five feet of a home — Tavangarian simply said, “You be the judge.”

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Commentary: My toothache led to a painful discovery: The dental care system is full of cavities as you age

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Commentary: My toothache led to a painful discovery: The dental care system is full of cavities as you age

I had a nagging toothache recently, and it led to an even more painful revelation.

If you X-rayed the state of oral health care in the United States, particularly for people 65 and older, the picture would be full of cavities.

“It’s probably worse than you can even imagine,” said Elizabeth Mertz, a UC San Francisco professor and Healthforce Center researcher who studies barriers to dental care for seniors.

Mertz once referred to the snaggletoothed, gap-filled oral health care system — which isn’t really a system at all — as “a mess.”

But let me get back to my toothache, while I reach for some painkiller. It had been bothering me for a couple of weeks, so I went to see my dentist, hoping for the best and preparing for the worst, having had two extractions in less than two years.

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Let’s make it a trifecta.

My dentist said a molar needed to be yanked because of a cellular breakdown called resorption, and a periodontist in his office recommended a bone graft and probably an implant. The whole process would take several months and cost roughly the price of a swell vacation.

I’m lucky to have a great dentist and dental coverage through my employer, but as anyone with a private plan knows, dental insurance can barely be called insurance. It’s fine for cleanings and basic preventive routines. But for more complicated and expensive procedures — which multiply as you age — you can be on the hook for half the cost, if you’re covered at all, with annual payout caps in the $1,500 range.

“The No. 1 reason for delayed dental care,” said Mertz, “is out-of-pocket costs.”

So I wondered if cost-wise, it would be better to dump my medical and dental coverage and switch to a Medicare plan that costs extra — Medicare Advantage — but includes dental care options. Almost in unison, my two dentists advised against that because Medicare supplemental plans can be so limited.

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Sorting it all out can be confusing and time-consuming, and nobody warns you in advance that aging itself is a job, the benefits are lousy, and the specialty care you’ll need most — dental, vision, hearing and long-term care — are not covered in the basic package. It’s as if Medicare was designed by pranksters, and we’re paying the price now as the percentage of the 65-and-up population explodes.

So what are people supposed to do as they get older and their teeth get looser?

A retired friend told me that she and her husband don’t have dental insurance because it costs too much and covers too little, and it turns out they’re not alone. By some estimates, half of U.S. residents 65 and older have no dental insurance.

That’s actually not a bad option, said Mertz, given the cost of insurance premiums and co-pays, along with the caps. And even if you’ve got insurance, a lot of dentists don’t accept it because the reimbursements have stagnated as their costs have spiked.

But without insurance, a lot of people simply don’t go to the dentist until they have to, and that can be dangerous.

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“Dental problems are very clearly associated with diabetes,” as well as heart problems and other health issues, said Paul Glassman, associate dean of the California Northstate University dentistry school.

There is one other option, and Mertz referred to it as dental tourism, saying that Mexico and Costa Rica are popular destinations for U.S. residents.

“You can get a week’s vacation and dental work and still come out ahead of what you’d be paying in the U.S.,” she said.

Tijuana dentist Dr. Oscar Ceballos told me that roughly 80% of his patients are from north of the border, and come from as far away as Florida, Wisconsin and Alaska. He has patients in their 80s and 90s who have been returning for years because in the U.S. their insurance was expensive, the coverage was limited and out-of-pocket expenses were unaffordable.

“For example, a dental implant in California is around $3,000-$5,000,” Ceballos said. At his office, depending on the specifics, the same service “is like $1,500 to $2,500.” The cost is lower because personnel, office rent and other overhead costs are cheaper than in the U.S., Ceballos said.

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As we spoke by phone, Ceballos peeked into his waiting room and said three patients were from the U.S. He handed his cellphone to one of them, San Diegan John Lane, who said he’s been going south of the border for nine years.

“The primary reason is the quality of the care,” said Lane, who told me he refers to himself as 39, “with almost 40 years of additional” time on the clock.

Ceballos is “conscientious and he has facilities that are as clean and sterile and as medically up to date as anything you’d find in the U.S.,” said Lane, who had driven his wife down from San Diego for a new crown.

“The cost is 50% less than what it would be in the U.S.,” said Lane, and sometimes the savings is even greater than that.

Come this summer, Lane may be seeing even more Californians in Ceballos’ waiting room.

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“Proposed funding cuts to the Medi-Cal Dental program would have devastating impacts on our state’s most vulnerable residents,” said dentist Robert Hanlon, president of the California Dental Assn.

Dental student Somkene Okwuego smiles after completing her work on patient Jimmy Stewart, 83, who receives affordable dental work at the Ostrow School of Dentistry of USC on the USC campus in Los Angeles on February 26, 2026.

(Genaro Molina / Los Angeles Times)

Under Proposition 56’s tobacco tax in 2016, supplemental reimbursements to dentists have been in place, but those increases could be wiped out under a budget-cutting proposal. Only about 40% of the state’s dentists accept Medi-Cal payments as it is, and Hanlon told me a CDA survey indicates that half would stop accepting Medi-Cal patients and many others will accept fewer patients.

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“It’s appalling that when the cost of providing healthcare is at an all-time high, the state is considering cutting program funding back to 1990s levels,” Hanlon said. “These cuts … will force patients to forgo or delay basic dental care, driving completely preventable emergencies into already overcrowded emergency departments.”

Somkene Okwuego, who as a child in South L.A. was occasionally a patient at USC’s Herman Ostrow School of Dentistry clinic, will graduate from the school in just a few months.

I first wrote about Okwuego three years ago, after she got an undergrad degree in gerontology, and she told me a few days ago that many of her dental patients are elderly and have Medi-Cal or no insurance at all. She has also worked at a Skid Row dental clinic, and plans after graduation to work at a clinic where dental care is free or discounted.

Okwuego said “fixing the smiles” of her patients is a privilege and boosts their self-image, which can help “when they’re trying to get jobs.” When I dropped by to see her Thursday, she was with 83-year-old patient Jimmy Stewart.

Stewart, an Army veteran, told me he had trouble getting dental care at the VA and had gone years without seeing a dentist before a friend recommended the Ostrow clinic. He said he’s had extractions and top-quality restorative care at USC, with the work covered by his Medi-Cal insurance.

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I told Stewart there could be some Medi-Cal cuts in the works this summer.

“I’d be screwed,” he said.

Him and a lot of other people.

steve.lopez@latimes.com

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Diablo Canyon clears last California permit hurdle to keep running

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Diablo Canyon clears last California permit hurdle to keep running

Central Coast Water authorities approved waste discharge permits for Diablo Canyon nuclear plant Thursday, making it nearly certain it will remain running through 2030, and potentially through 2045.

The Pacific Gas & Electric-owned plant was originally supposed to shut down in 2025, but lawmakers extended that deadline by five years in 2022, fearing power shortages if a plant that provides about 9 percent the state’s electricity were to shut off.

In December, Diablo Canyon received a key permit from the California Coastal Commission through an agreement that involved PG&E giving up about 12,000 acres of nearby land for conservation in exchange for the loss of marine life caused by the plant’s operations.

Today’s 6-0 vote by the Central Coast Regional Water Board approved PG&E’s plans to limit discharges of pollutants into the water and continue to run its “once-through cooling system.” The cooling technology flushes ocean water through the plant to absorb heat and discharges it, killing what the Coastal Commission estimated to be two billion fish each year.

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The board also granted the plant a certification under the Clean Water Act, the last state regulatory hurdle the facility needed to clear before the federal Nuclear Regulatory Commission (NRC) is allowed to renew its permit through 2045.

The new regional water board permit made several changes since the last one was issued in 1990. One was a first-time limit on the chemical tributyltin-10, a toxic, internationally-banned compound added to paint to prevent organisms from growing on ship hulls.

Additional changes stemmed from a 2025 Supreme Court ruling that said if pollutant permits like this one impose specific water quality requirements, they must also specify how to meet them.

The plant’s biggest water quality impact is the heated water it discharges into the ocean, and that part of the permit remains unchanged. Radioactive waste from the plant is regulated not by the state but by the NRC.

California state law only allows the plant to remain open to 2030, but some lawmakers and regulators have already expressed interest in another extension given growing electricity demand and the plant’s role in providing carbon-free power to the grid.

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Some board members raised concerns about granting a certification that would allow the NRC to reauthorize the plant’s permits through 2045.

“There’s every reason to think the California entities responsible for making the decision about continuing operation, namely the California [Independent System Operator] and the Energy Commission, all of them are sort of leaning toward continuing to operate this facility,” said boardmember Dominic Roques. “I’d like us to be consistent with state law at least, and imply that we are consistent with ending operation at five years.”

Other board members noted that regulators could revisit the permits in five years or sooner if state and federal laws changes, and the board ultimately approved the permit.

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