I’m pretty pleased with myself this morning. I made our local AAP newsletter, the local news outlets, and also likely it will be publicized on the HMO internal news. I played the generic pediatrician accepting the plaque for California HPV Vaccine Week. The entire process was serendipitous and fun. I stood really still in the background and smiled, and I pretended I was on a TV show. Which I kind of was. I knew my place and my role. Really it was for the politician to shine. I was happy and smiling, and shook hands. I said my piece, I think well, but in a generic way. I was the generic pediatrician and I had a great time playing that role!
When you love someone or some place, you take a risk. You take a risk that that person or place – can be hurt or can be lost. Oregon is burning, and there are wildfires near the farm. My family member is up there and so far things are contained, but they are ready to leave if need be. We have insurance. We have money. We can rebuild if need be. But the threat of the forest fires caused by lightening strikes, is a stark reminder that no where is safe. We’ve lived through many wildfires in Southern California. And the Oregon farm, seeing pictures of the forest fires in the distance is numbingly familiar.
I love this town so fiercely it hurts. It’s the city that accepted a family of Vietnamese political refugees, and allowed a little girl who did not speak any English until kindergarten to attend Crimson University. It’s a town that is tolerant, diverse and open. It’s a town that is my home. It’s a town that has values, deep down military and family values to our core. I had to leave San Diego for over 15 years to fully appreciate the warmth of our climate and our people. The innate goodness of us. Especially the south bay, there is something special about the south bay.
Life has been absolutely crazy with the delta variant. My meager career as a middle-manager keeps on keeping on. Likely more from inertia from the organization than anything. I’m still here, doing my job but doing it in a more sustainable way. I’m able to weed through the HMO nonsense still, and focus on the core issues that should be addressed. It’s another COVID surge due to the delta variant, and it’s really all hands on deck right now. I worked this morning in our weekend clinic, and it was not as bad as I expected. Mostly because phenomenol nurses and MDs the day before pulled together and leaned in and blasted through messages.
The culture of taking care of each other, and watching out for each other – has 100% to do with just the people who work. Those of us who see patients, put in IVs, triage messages. It has nothing to do with middle-management or upper-management. Those that grab the glory, they are very rarely the cause of said glory. Just talking-heads, many of them.
I haven’t been blogging as much as life has been full and beautiful, and also worrisome with the delta variant. But I did have dinner with a good high school friend who I hadn’t seen in over 27 years. It was a lovely dinner with her family, and well behaved children. We went to a old downtown place that I’ve wanted to return to for decades, but wasn’t able to. But we ate there together and we all caught up on life.
But the best part of the evening was walking through the seeing our town. I remember when downtown was run down and dangerous. I hardly ever dared to drive in downtown during highschool except once to attend an opera at the Civic Center, the one-way streets were so intimidating. But now, I pulled into East Village via the 94W and glided into a parking spot that I own. Yes I own a piece of downtown, as I invested in a condo over a decade ago when the real estate market had dropped. The condo has two parking spots. I marveled that parking as there was a Padres game was $33! I parked for free. And I walks from the parking spot across the revelers, pass the stadium and all the beautiful people having fun. We had a wonderful dinner, and then I walked back. And every step and every sight was lovely.
I had more middle-management nonsense yesterday to deal with. I usually don’t let minor personality issues bother me, as I can usually work with most people. But we heard a set of data yesterday and I tried to peel back the layers of things and figure out what went wrong and is going wrong. The set of data basically said that poor babies are not getting their vaccines. The issue is a set of people have not been hired, and another set of people who have been hired and recruited by me can’t work unless the first set are in the system. That is it. That’s the entire point. I know it’s a systemic issue and there are always excuses, but I needed to know the why. My questions may have bothered people, and sometimes it seems like we are asked to do impossible tasks in middle management. I was asked to do a seemingly impossible task almost five years ago, but I did it. This I felt was a safe meeting (at least I feel safe) but I guess I’m somehow intimidating. I had a long and exhausting conversation about middle-management nonsense afterwards and we moved forward somewhat. I’m still frustrated because in the end poor babies still aren’t getting their vaccines and my hands are tied in terms of pulling levers to fix that issue, and even if the team works well together and I somehow stop appearing intiminidating to folks – in the end we didn’t move forward.
I really really want a coffee right now. It’s been exactly 10 days since I stopped drinking coffee and I’ve finally weaned my body from the caffeine. But right now the COVID-19 delta variant really is making life difficult, and I want a coffee. I won’t drink a coffee but I really want it. What I really want is the sugar, cream and the caffeine to make me feel super-human and bring me joy. I want the aroma to mask the true stinkiness that is life right now.
But what one wants, one should not have. I really want to go to Montana to stay at a close friends lake cabin and go hiking at Glacier National Park. I really want to have the beach cleanup for my high school class. But I struggled last night and read up on the recommendations, and I have to make a decision. This decision does not come lightly. The delta variant is here. Kids are getting sick and in about 1-2 months, many are going to come in with Multisystem Inflammatory Syndrome in Children. We have to cancel. I need to tell people now. [PAUSE] It is done. That was very painful. So painful. But best to let people know asap, so that people can get flight refunds and change plans.
Now I have to talk to my sister about this amazing trip we had planned for Montana. I honestly think we have to cancel this as well. It’s just not worth the risk as we have two under 12 year old children who are unvaccinated. There is a risk to everything. But we can be together and not necessarily at a national park – albeit an amazing one. I need to talk to my sister today and talk to my good friend who has graciously offered us to stay at his place. We’ll probably just drive up to our farm in Oregon instead.
These decisions are hard. But just like giving up coffee and all that sugar, sometimes one is strong enought to make these decisions. Prevention is such a better strategy. I went in for hopefully was my last filling for a few decades. I’m determined to keep my teeth healthy and that is a large part of why I gave up coffee with all that cream and sugar I used to put. As my very young dentist was starting, I told her that I had given up coffee. It’s nothing she asked of me, but she said it was a good idea in general. Hey, the upside is that I can whiten my teeth with those rinses and they’ll stay pearly white since there is no more coffee to stain them!!! See, there is always an upside.
The upside of cancelling the flights to Montana, is that our son was resistent to doing a summer creative writing program Mr. Plastic Picker wanted him to do. But now since he’ll be home an extra week, I think we’ll be able to convince him to do it. It’s important for his career development and a great opportunity.
But it just really is painful today. Not drinking coffee this morning. Not be able to go on the vacations that we planned. But the reality of the delta variant is here, and I chose to reduce risks to loved ones rather than these other things that I really really really really really really want to do. So today for Dr. Plastic Picker, ten days ago was still the last coffee. And the reality is the delta variant is here – so please get vaccinated if you can and wear a mask.
LOL. That’s an awfully witty blog title Dr. Plastic Picker. How many clicks do you think it will garner? As this blog is non-monetized and completely for my own amusement and to keep me on track on my environmental advocacy, it does somewhat matter. The HMO Family Practice residents are descending upon pediatrics today and I am making vegan banana beer bread with coconut oil and extra dash of cinnamon and extra splash of vanilla extract. I even added in some coarsely chopped walnuts, I was feeling so fancy. I used one of Mr. Plastic Picker’s fancy IPA beers for the recipe. It essentially cost me nothing as I had all the ingredients already and a lot of overripe bananas.
I referred back to this recipe on this blog but used just bananas and not mangos. https://drplasticpicker.com/banana-mango-beer-bread-re-imagining-a-bad-costco-mango/ I also bought a bag of fancy granola from Costco. Otherwise these days instead of spending $150 on meat-filled breakfast sandwhich box from Einstein Bagels, I just made it simple. I just contribute when asked and do what brings me joy which was grabbing something simple at Costco and averting foodwaste and doubling a recipe. Half of this bananas beer bread will stay home, and half will come to clinic for the residents.
I really need to knock out the bags this weekend. I’m at 12 bags I think, so hopefully will do solo beach cleanups Saturday and Sunday. Today is a full week coffee-free mornings! My wake-time has shifted later so I’m up at 530 rather than 4am. I think this is healthier. My sleep is deeper and I’m going to bed earlier. My muscles are achy at night though which was an unexpected withdrawal symptom. This makes sense because when I was running half marathons, I fueled myself on coffee. I would drink one before the races and on long-run days would need more. This is not sustainable nor healthy. I’ve heard of older runners former pediatricians who needed knee replacements early on because they kept on running more than they should have. After my myalgias resolve, I’ll restart running again but maybe just 2-3 times a week 3 miles or so. Right now I’m working on getting through the days without coffee, and that is it. Things feel a peaceful sort of good. Yesterday I ate tomatoes, argula salad (thank you Dr. Dear Friend!), vegetarian burrito, lots of plums (thank you dear patient family), and a banana. I think it was a plant-forward type of day!!! I did eat other foods but those were the plants I ate.
A lot of people lose their shoes at the beach. Two days ago when I was able to get to the beach early in the morning, I found a lot of single shoes buried in the sand. I know these become bits and pieces of plastic because further north near Tourmaline, the plastic that washes back from the Pacific are often plastic bits of shoes. People really should remember their shoes at the beach. Is it really that hard?
OMG it’s Wednesday! I had a rough night last night. Today is the fifth day without coffee, and yesterday I had my first true noticeable side effect which was muscle aches. I had plogged to the beach which I think didn’t help. It was a gentle plog. My legs were so achy yesterday and I had to walk around the house. I google searched caffeine withdrawal (yes doctors google things too) and read up on the symptoms. For the most part, I’ve been well and even this morning am coffee free. But I wasn’t sure what was happened yesterday until I read an article last night. I drank plenty of water thinking some of my muscle cells might be breaking down and then I took ibuprofen 600mg. I sat on the yoga mat and did some stretches which made it worse. I think just sat and tried to meditate a bit, which helped. Eventually the aching subsided and I was able to go to sleep. But it was a restful and almost full eight hours of sleep which is amazing. This morning I’m feeling well. I’m drinking a cup of tea without any sugar or cream, as I realize my body probably needs to wean from the caffeine gradually. But I do think it’s a victory to have stopped the coffee habit. I was just drinking too many cups and adding too many cream and sugar.
But it’s Wednesday and I’m hopeful this Wednesday. I’m hopeful for new climate projects and just new projects in general. Usually I do little news bits and pieces, but I haven’t really read CNN or follow the news lately. I’m trying to live in the real world. I used to obsessively read the news but not anymore. It helps slow down time not being tethered to the endless news cycle of doom and gloom. They are trying to make money off the audience anyway. News is a business too.
Five Items That Give Me Hope, Are All Things That We’ve Accomplished
UCSD School of Medicine: There is some sort of planetary report card that ranks how medical schools fair on their climate change and health curriculum and general sustainability. It was developed my a UCSF medical student who is from San Diego, and the daughter of a Sharp Family Practice climate and health advocate. This physician is a leader in another medical group, and recently joined our advocacy team. Anyway, our local medical school UCSD doesn’t even make the list. All I did was link up three students together, and cc’ed my academic friend and former medical school classmate Dr. Luis Castellanos. https://drplasticpicker.com/dr-luis-castellanos-cardiologist-doing-his-part-for-the-environment-7/ That group is working on many other projects, but they are going to speak with their dean and raise this issue.
Pediatric Board Member for StayCool4Grandkids: This is a local San Diego based climate group who is part of the Rewild Mission Bay Coalition. They are looking for a public health voice on their board. We had a young pediatrician who wants to start doing climate work, and I thought this would be an amazing way for him to begin networking and become involved. I made the e-introductions this morning and likely the two physicians are on their way.
AAP-CA3 Climate Change and Health Committe and San Diego Pediatricians for Clean Air Apply to Join Rewild Mission Bay Coalition: This is a carbon sink project that just makes sense. We need the most natural bay to protect against storm surges, sequester carbon, provide more shorebird habitat, and provide active transport opportunities for children. This is something we’ve discussed at several of our meetings. I just emailed them and said “My name is XXX, and I am the co-chair of the American Academy of Pediatrics – CA3 (San Diego) Climate Change and Health Committee, and also Co-Founder of San Diego Pediatricians for Clean Air. https://sdpediatriciansforcleanair.com We had our monthly meeting. We are an overlapping group of 40 mostly pediatricians, premedical students and some allied health voices that advocate together on climate. Both groups after our monthly meeting yesterday, would like to formally apply to join the coalition. Many of us live near the bay as well, and we feel this is in the best interest for pediatric health. Please let me know if there is anything further I need to do. We have logos that we can send as well.” It’s amazing how much climate work one can do by sending just one email.
Air Pollution Control District: Hearing Committee – Pediatricians as the Public Health Member: One of our members won a seat on the hearing committee for the Air Pollution Control District Hearing Committee. There are three pediatricians on key positions for public health regarding air pollution. I’m patting myself on the back. I think I had an important role in all those political maneuverings. Yes I did. The candidate is great by the way. I’m just really good at letter writing and bringing together like-minded earth-loving pediatricians.
AirKeepers Program: This program I heard from Lori Byron, and they have been able to do it in Montana. I found out about the Prather lab at UCSD, and I guess the foremost expert on atmospheric aerosols something or another is local. And then I take care of a mother who is a middle school chemistry teacher and is connected with all the science education folks in the southbay. The key would be to get funding so that these middle schools have PM2.5 sensors and then run a flag up each day, with different colors depending on the air pollution. I think the San Diego APCD has a grant but I have to look at it. Anyway, been talking about it and I nees to call Dr. Sabrina Perrino to see how we can put this all together. Link a pediatrician from San Diego Pediatricians for Clean Air to each middle school. Draw the bonds between pediatricians and students closer. Educate and advocate together. Raise awareness. This would fit into middle school science’s integrative science model and the “citizen scientist” projects. This is our big next project.
So lots of things to be excited for. Our journal article will publish this week I think. I check the Children’s At Risk website and the Journal of Applied Research on Children. I submitted the final revisions last week. We also got a great offer on one of our rental properties. That way I can pay my family member for the rest of my portion for our Oregon farm. For the price of a studio in downtown San Diego near Petco Park, I bought half of a massive Oregon farm. Makes no sense, sometimes real estate prices. And then I’m going to invest some of that equity (if we close the deal) on an event center in the East County. I’m really excited. I’m going to start up a dance studio and event center. I figure anytime I want to go to classes there, if I partially own it – I can go for free. And then when our climate group needs to hold events, we’ll do it at that event center. I may even put a small office for San Diego Pediatricians for Clean Air there. Escaping the HMO Machinery (well not quite yet because I’m doing a countdown) has been a blessing. I have more freedom to be creative and think of new climate projects. As I was texting with a close friend yesterday that was asking me how I was doing. I replied, “I’m fine. It’s literally easier to save the earth than fix the department.” Yes it is. At least for me. I have to do things my way.