May 17, 2021

by drplasticpicker

Sometimes life is stranger than fiction, or even my trashart. I gathered bag #455 yestserday and it was a reused pita bread bag that was filled with wet plastic bags mostly washed up on Tourmaline Beach. I hadn’t really meant to head to the beach but I’m glad I did. It’s always an adventure. I wanted to start jogging more, so naturally ended up in my spot and did a beach cleaning amongst the rocky shore. I saw a beautiful snowy egret. They are a rare sight and only come feed where the kelp is left in it’s natural state. Where there is kelp, there are insect and remnants of crabs and other crustaceans. The “beach” of the white sand is really not natural. There is supposed to be kelp. The surf-rake removes it for us humans so we can recreate (and I mean to use that word in a new way). If it was up to me, we’d leave the kelp and the beach would be for the beautiful birds like the snowy egret.

I’ve collected/salvaged 34 items this month from the ocean that have mostly been recycled. In total I’ve salvaged #1609 things from ending up in the the landfill/ocean and it’s fitting and not suprising that the most recent 5 items were crushed beer cans next to a burnt out motorcycle.

I got a comment from someone yesterday. A criticism really about something at work. Maybe two years ago, that comment would have generated a lot of sadness or anger. Even three years ago, a comment like that would have made me put that person into a mental box – written them off in my mind. I used to do that, literally just delete people from my mind. But since I’ve been picking up trash, I notice things and the world and nature – and I certainly notice people. No one deserves to be deleted.

But when I received that comment, I took it at face value and did not read anything more into it. It’s funny when someone is deep into their own anguish, their own issues – it’s hard to notice what other people are going through. This is why burn out in physicians is so dangerous. Clinical medicine , the true practice of healing and not the endless “smartphrases” and algorithms, is about noticing the details. If you miss those nuances during the history and the physical, you can make an error. This is why burn out is so dangerous in middle-managers as well. Our colleagues that we “manage” especially the young ones, are like our patients. There are subtle signs in their own pscyhological health that we can miss if we are in the midst of our own burn-out. Yet middle-management is exactly the types of position that drives one to burn out. It’s a catch-22. I had a good interaction with said colleague but I was frank with that colleague and texted back “The last four years almost broke me. If you are interested in admin, let me know.” My text was met with silence.

I used that opportunity to move forth another quality project, but how the exchange ended is my being honest and frank. I want people to know, especially now that I am stronger and feel free – it is a choice. You have a choice in the words you use. You have a choice in the comments you send. We are all human. And we can be hurt. Be careful what you say with your colleague as much as with your a patient. I try to be more careful with my words now. Words matter. Words matter so much , and that has been the biggest lesson of the last two years. And I hoped that my interaction yesterday made that person think a little bit and helped them on their journey. I know their journey has not been an easy one. I thanked them for their contributions to the department and to patient care, and I thanked them for their criticism – and took the value in their comments and brushed off the sting of the delivery.

And I looked at Mr. Plastic Picker yesterday and said, “is this the year? One more? I’ve done enough I think.” We have six year terms in the particular middle management position we are in. He is also at the beginning of the 5th year of his term, but for him it hasn’t been quite such a difficult set of obstacles as I have had. For him, he has always been my cheerleader and the best source of advice. “Just take it day by day, year by year.” And with that, I am still here. No longer burned out. Stronger for each bag of trash I’ve picked up. Stronger for each snowy egret I’ve seen at the beach. And as I’ve gotten stronger, I try to make everyone around me stronger. I try to build people up. I try to build the department up. But I know how fragile things are. I know how fragile people are. Just one comment from one colleage, and it makes me question myself. But I am here, still standing. Better than the motorcycle.

We are all fragile creatures. I thought I was like teflon when I was younger. Knowing good people, strong people helps. Surrounding myself with positively helps. My friend Dr. Jill Gustafson once told me that I was senstiive, and I never realized that about myself. I am sensitive and it’s okay. It’s okay to feel hurt, and I hope that it helps me not make hurtful comments to others. I’m sorry if I ever said hurtful things to anyone who is reading this blog. I’m sure I have. We all have. Your forgiveness is something that I am grateful for.

And with that, at some point this journey will end. Dr. Plastic Picker will get to at least 1000 bags, but I think my fighting for planetary health and pediatric health that will never end. That I feel so much joy and freedom, because each bag I pick is completely voluntary. I chose to pick those bags. No one made me. It was my free will. But management, sometimes it feels forced. It really does. It’s not for the faint of heart.

May 16, 2021

by drplasticpicker

My family member and I (our two families) put in an offer for a 25-acre ranch on the Big Island of Hawaii. It’s surprising that even with the hot real estate market, there are only two financial entities in the world looking for a 25 acre ranch on the Big Island in that particular lava zone. Yes we have to know about lava zones if you are buying on the Big Island. As always we are trying to get a reasonable deal, so offered lower than the asking price. We will be the back-up offer as they accepted an offer already. But it is contingent on financing and selling another property. With real estate, many many things can happen to derail a transaction. We are experienced buyers in a strong position who can get the deal done. This is reflected in our lower offer though. So we will wait and see, and if it happens – it happens. If it doesn’t, than that’s the market and we move on.

It’s been so much fun thinking about the two properties. I’ve purchased a lot of real estate before, but it’s the first time I’ve looked at a property so large and during a pandemic. We got to do two facetime tours of each property. The views from the 6-acre one was phenomenal, but we passed as the living space was actually kind of small. The property itself was also on a weird elevation and the land was actually quite sloping. I guess we won’t own those lychee orchards. The promised “lychee” orchard wasn’t that many trees anyway.

I’m curious to see if we end up going through the the Big Land deal. It has 15 cows, did I tell you that? They are foster cows so we will not eat them. There are two separate houses on the 25 acre Big Island property, so we could easily rent out one of the houses for $1500 a month. If we do that, and try to generate no other income from this property – then the other house and grounds is available to use and will cost us our half just under $7000 a year. But of that $4200 will be equity. So it will actually “cost” us about $2800 a year for 25 acres on the Big Island. That is super crazy. There are a lot of ifs. I don’t at all recommend this for the faint of heart. You need to have a HUGE emergency fund to able to weather vacancies, repairs. But more importantly, we are not buying this as an investment. We are buying it as a second home with our eyes wide open that if it costs up $20K a year to maintain, than that is fine. But as with everything with Dr. Plastic Picker, I’m pretty sure if we get it – I’ll find a way to make it pay for itself and help the earth as well.

But here are just some fun things I’m learning about the Big Island of Hawaii in case we end up owning a 25-acre ranch there.

Five Interesting Facts about the Big Land of Hawaii – Since We are Looking At A Ranch

1. There are lava zones. Lava Zone 1 is the MOST HAZARDOUS and Lava Zone 9 is the least hazardous. There are 5 active volcanoes on the island of Hawaii. This property is on Lava Zone 3 “Zone 3 – Areas less hazardous than zone 2 because of greater distance from recently active vents and (or) because of topography. 1-5% of zone 3 has been covered since 1800, and 15-75% has been covered within the past 750 years.” https://en.wikipedia.org/wiki/Lava-flow_hazard_zones That is not bad odds. This is just for insurance and mortgage financing reasons.
2. Island Vegetarian : Vegetarian Society of Hawaii. There are vegetarians on the Big Island, actually a lot of them. This property has 15 foster cows and we are not going to eat the foster cows. An Ecosia search for foster cows led me the Island Vegetarian. There are chapters on each island, but not the Big Island. Mr. Plastic Picker and I could become the chapter presidents for the Big Island. The only program is that we are just plant-based and not really vegetarian? But we’d love to get to know them more and are supportive of their efforts. There are discounts!
3. Hawaii Cow Rescue. There is a “Hawai‘i Cow Rescue began its first rescue round in early January 2019” after the last volcano erupted and a bunch of homes were destroyed. I’m wondering if we have foster cows if we can become part of the rescue? I think that would be really fun to add to my environmentalist resume! My friend Dr. DK would really like that !
4. Kona Coffee Farm! I guess the Big Island is the perfect environment to grow coffee! We may seriously start doing that. That would be great fun. But it looks like only the climate on the western part of the Island Kona is ideal for coffee growing, and we would be on the eastern side You can get to Kona Coffee Farms from our (hopefully) ranch in 1 hour 50 minutes. We plan to leave our 2012 Prius there. It would be a daytrip but with beautiful oceans views the entire trip.
5. Koa Trees: Koa trees are one of the most valuable trees on the planet! Since our ranch is generally deforested land, I wonder if we could grow Koa Trees? “Koa is the largest native tree in the Hawaiian Islands reaching heights of about 115 feet (33 m)! Commercially, koa is one of the most expensive woods in the world. It is used to make furniture, veneer, and crafts. Most koa is harvested from remnant individuals or stands in pasture lands.” http://nativeplants.hawaii.edu/plant/view/Acacia_koa After reading more about the Koa Tree and since we are at the appropriate elevation, higher, if we get this property – we will definitely be planting some Koa Trees!!!

And that is it. The truth is that we put in an offer into a ranch on the Big Island, and don’t know if we will be accepted. We do know we can close the deal. I know that it is not a stretch financially for us, as we are FISE (Financially Independent and want to Save the Earth). And otherwise I had a great time getting to tour via FaceTime two properties and got to learn five interesting things about the Big Island as I’m trying to envision life there. We are definitelty going to compost as well especially since there are going to be 25 acres! Eventually we hope to split the lot into two equal parcels for each family.

Aloha from us!

May 15, 2021

by drplasticpickernJust thinking outloud of the blog. If we can write an article Durrwachter-Erno et al and have it based on an avatar theme, why can’t I frame the new Climate Change and Health HMO Residency Clerkship around a similar framework. It makes sense to me.

Clean Air Week – Rotate with pediatric allergist Dr. Michael Land or UCSD allergist Dr. Christine James in clinic two sessions, linking rise of pediatric allergic diseases like asthma and allergies with climate change. Attend Air Pollution Control Board Meeting either with Dr. Birkbeck Garcia or Dr. Dan Spencer or Portside AirQuality Meeting. Definitly a cool session with Dr. Dave Neison on wildfire mitigation and thinking about active transport and how can physicians aid in these efforts, or advocate for this.

Clean Water Week Either pick plastics or pharmaceutical waste? This week we could also focus on storytelling and narrative medicine. What is your climate story? Shadow policy folks at Climate Actions Campaign or site visit with the Environmental Health Coalition. Environmental Justice focus on water issues. Access to beaches. River health. Wetlands.

Earth Regeneration Week Plant Based eating rotation with Dr. Dana Patton Ku (Pediatric GI) or Dr. Angie Neison (Sharp Culinary Medicine). Thinking about built environments and shade trees (hang out with the city arborist or community garden). Link between regenerating the earth and natural spaces as an partial answer to pediatric obesity and mental health issues.

Workplace Sustainability Week – Reflection piece due about what changes could be done in the workplace to reduce healthcare industry’s greenhouse impact but dovetail with improving patient care experience and containing cost. Attend Kaiser Green Team/Sustainability monthly meeting. Networking with HMO workplace green people. Option to work with physician wellness team.

Just thinking outloud. Would love any thoughts.

May 14, 2021

by drplasticpicker

Yep. It’s going to happen. I’m going to buy half of that Big Island Property. The math works out. It’s crazy when the math works out. I have our portion of the downpayment easy, and we are still investing in the other commercial project but this will be for fun and for creativity. The mortgage payment and taxes we split with my family member, and the monthly cost is actually not that much. Even if we just keep the land and let family and friends use for free (or you just pay to make sure it gets cleaned), it will be worth it. And when organizations like the posh private school we send our kids to ask us for donations, I can just donate a week at our vacation home and deduct it. I can do the same for Girl Scouts. But more importantly, we will get the land that I’ve been dreaming of.

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May 13. 2021

by drplasticpicker

The birds’ collective singing this morning is particularly trilling and lilting and beautiful. Its 547AM and I haven’t been able to truly be here on the blog to write in a few days. I posted things related to my climate work, but I haven’t been able to process and reflect. The writing has become much needed as I try to figure out this wonderful thing called life.

I went to bed crying last night. I was cleaning up my photos and I delete all the litter-picking photos and nature scenes, because I’ve taken then and chosen which ones to post and use on the blog versus Instagram versus facebook. It takes some sort of carbon to keep them, and those images I let go. But I must have accidently pressed a screen function that I didn’t know exist, because suddenly a lifetime of selfies on my daughter and myself popped up. I scrolled through those photo of a younger me and my little girl , and I did what any mother would do. I looked at her face, the tilt of her head and the roundness of her cheeks and the gap-tooth smiles – and I cried. A decade of regrets came pouring down my face. Where had the years gone? Where had I been? Where had that little chubby cheeked grade-schooler gone to?

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May 10, 2021

by drplasticpicker

I’m done with being afraid. It makes sense for some to be afraid, if you’ve lived through abuse, been hungry, worried about being able to survive the next day. I get it. I am lucky. I have had difficult moments to overcome in life that made me fearful. We all have especially women. It makes sense to be cautious when you are worried about survival. But now that I’m on the other side of what is the “Fear Zone” and into the “Learning and Growth Zone” I don’t want to go back.

If not me, than who? I declared that I was going to help save the earth by gathering one pieace of plastic at a time and I’m almost to 500 bags! I’ve encouraged a movement of climate activism in my small corner of the world and we’ve made real changes. Some of this is about plastic, but it’s also a metaphor about life. Not to waste life. Not to waste resources. To be creative. To free ourselves from the conventional life and conventional thinking, it order to tap into that authenic self in order to find true contentment and also to help save the earth. It’s all related.

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May 9, 2021

by drplasticpicker

21 engagements yesterday from facebook to the blog regarding the Big Island Pipe Dream of buying 25 acres. 21 engagements! https://drplasticpicker.com/physician-wellness-institute-im-pretty-sure-i-could-do-it-better-and-cheaper-than-1300-if-i-own-the-land/I hope some people come back to the blog this morning and read about what this blog is REALLY ABOUT. Picking up ocean plastic pollution! I am DR PLASTIC PICKER not DR REAL ESTATE INVESTOR, although I do invest in real estate. But on this blog we glorify the eco-avatar half of ourselves. Am I speaking of myself in the third person? My sister thinks that is really funny and telling for various reasons.

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May 8, 2021

by drplasticpicker

I’m just having random fun. I told Dr. MM in clinic yesterday, that sometimes that dream you had of something you always wanted to do – it can be easy to get. The trip to Paris was just sitting there and staring her in the face. I said, “GO!!!” Just buy the flight and go with Dr. AF. He’s going anyway. $450 round trip for a flight and you guys split a hotel room, and go to Europe. Sometimes attaining your dreams doesn’t have to be hard, it can be easy. I told them I’d cover both their inboxes.

A similar dream, a dream that I never thought I had, was staring me in the face. It was looking at me and kind of danced around and said, “why don’t you grab this opportunity?” As the blog readership well knows, Dr. Plastic Picker is always financially savvy so if the numbers don’t add up – I’ll take a pass. But the dream was looking at me in the face and said, “HELLLLOOOOO, it makes sense financially.” I’m literally looking at the dream and flabergasted that it could happen? If the numbers work out, than it makes sense.

So I’m having just random big dreams and taking steps that financially make sense. I’m selling a rental property that I was meaning to sell for a while. That particular rental property was never a really great buy, but it wasn’t a bad buy. I was going to sell it last year, but it was a blessing in disguise that I didn’t sell it last year. Right now the market is HOT HOT in our area, So I’m pretty sure it will sell for 50K more than the one offer we got last year. And then Mr. Plastic Picker and I since we have a 50% savings rate, have our cash cushion war chest ready. Between the equity on that rental property that I’m going to sell and our war chest, I’m going to buy some land somewhere on some big Island somewhere in the United States of America. This big land somewhere has foster cows, a lava rock bar, sauna, and two all done houses. Its just 25 minutes straight shot from an airport. It has avocado trees and citrus trees and solar panels. And I can buy it outright without a mortgage with a family member. Even if I keep just said land for fun, and just vacation on it – it will make financial sense.

But you know Dr. Plastic Picker! When there is land, there is opportunity. Thinking of earth and planetary and physician wellness. I’m pretty sure I can organize a physician wellness retreat on that land, and charge less and provide a better program than other people. I’m pretty sure I can use the profits to put back into my climate work. I’m pretty sure we can heal physicians and heal the earth at the same time. Because Dr. Plastic Picker just wants everyone to be happy. And my physician wellness institute will be better because I actually really care about my colleagues and I won’t be making money off them. I’ll charge a reasonable rate to cover the cost, and proceeds will go to paying the instructors who will be physicians themselves and everything going back to climate advocacy. But I’ll get to have the physician wellness proceeds pay for the land and I get to keep the land. But I will love the land and not hurt the land, and be a good steward of the land. That’s it. And below is more pictures of the virtual property viewing I had with a family member. It was so much fun and one of the most joyous moments I have had with this family member. Of course I blocked out his face because he is truly anonymous.

OMG I may by partial owner to 8 foster cows. If you come to this physician wellness institute, you will get to adopt a cow for your stay. LOL. Just thinking about crazy dreams and crazy things on the blog. Who knows, right? Shoot for the stars and you’ll hit the moon. I may just land on this Big Island. If I don’t show up at work one day (because I’ve shown up to work every day for over 12 years without fail), you’ll know where I am. I’ll send a postcard and maybe some avocados.

May 6, 2021

by drplasticpicker

The art of storytelling, the art of writing – is something that is so powerful. It’s how we teach. It’s how we experience life. For me life has always been a series of interwoven narratives, of your life and my life. The threads weave and then unwind, and come back. They get frayed and then when we reform community and connections, we reweave them together.

When a new family comes in, I have always thought of it as another storyline that arrives. Each new baby is a fresh book, and the chapters may follow a similar arc – birth, breastfeeding, first roll, first food, crawling, walking and than toddlerhood, but the details of the stories are different. And it is those details that make life and families and patients so interesting.

I think I had realized that I was burned out when I no longer was interested in the patient stories. Maybe it’s called compassion fatigue. But taking walks now and taking the time to self-care, has helped me relearn that. Catching those details in clinic are so key. How a teen reacts to announcing there are vaccines. What the parent is wearing. What room they are in today. What activities are they doing now. Did they seem happy or sad. I used to be a voracious reader. I still read, but I read less now. I consume less TV shows as well. Filling myself with imaginary stories that someone else created preventing me from appreciating the real stories happening around me. And that’s my job, to notice those patient stories and notice the stories of the young physicians that inhabit the real world with me. It’s my job to notice the arc of the teenage drama that is my daughter and the quieter story of our older son. Even Mr. Plastic Picker has the arc of his story, physician leader, proud father, exasperated husband of wife who disappears to pick up trash.

I wasn’t able to notice the stories when it was noisy. When I heard upper management’s endless stream of emails about metrics. This is why I detest shortcuts on the electronic medical record (I still use them), but I want to write the patient narrative myself and give them the instructions that I have created. I felt the endless workflows and smartphrases was erasing me.

But I realize now that I can use these shortcuts created at work to spend more time with patients, because I keep the stories in my heart. I remember them. I write about them (vaguely) on the blog. I echo my memory of the day in my silly art. I wish this for everyone. To live your life purposefully and slowly. Treasure the details, the moments. That was the true answer to burnout really. Reclaiming the narrative of my life and just slowing down time. It was rushing too fast before, and now it is gloriously slow.

May 5, 2021

by drplasticpicker

It’s 141AM and I needed to brush my teeth. I usually would just go back to sleep, but I’ve learned to sometimes take these opportunities to do what every parent of a teenager should do – go check up on them. Our daughter’s room was dark and she was asleep. I crept downstairs and the grandparents room was dark and quiet. But from our son’s room it was quiet and there was light coming from the closed door. I’ve learned to knock, because one does not burst into a teenage boys room. It’s impolite. So I gently knock knock knocked. No answer. I knock knock knocked – no answer. I gently opened the door and my teenage son was sitting in front of his computer with his headphones on – which is why he didn’t hear me. There was a youtube video of a Obama political speach. But the boy was fast asleep while sitting in his chair. I gently woke him up and told him to go to bed.

And I got to send a very fun email to Dr. Perry Sheffield, who is a very accomplished environmentalist friend and follows Dr. Plastic Picker, asking her to speak about clean air in San Diego. And I got to tell her that I was able to lead our wonderful author group Durrwachter-Erno et al and how much fun we had. And I got to articulate for the first time my real dream of writing my book about this journey and the drive cross country that I want to do picking up trash with all my environmental friends. Because this blog has always been about the dreams of a liveable planet during the real work of cleaning up the earth, and activating environmentalism here in my little corner of the world.

But this book and book tour and dream of meeting all these wonderful people, is intertwined with making sure said teenage boy actually gets through highschool and goes to college. I’m really lucky because Mr. Plastic Picker is so good with the kids , and on top of them and their schooling. He made me review next year’s junior year schedule and it seemed really heavy. AP US History, AP Chemistry, AP Precalculus, AP English, AP Spanish and Creative Writing. He could take another class which is advanced programming, as he is really good at it and it’s an easy A for him – but I did weigh in that I thought it would be better to take 6 classes and have a study period.

So my job is to keep on picking up trash, making organic homemade food which hopefully will keep him well nourished, and pop in here and there to make sure he is in bed. He usually is in bed on time, but he is still my son and that is what moms are supposed to do. During the dark of night, one should sleep. And I will go to sleep. But at least I got to make sure he slept in his proper bed and did not get neck strain. I got to send an inspired email to the famous Dr. Perry Sheffield. She is really famous and has done so much to try to save the earth for our children. And I got to dream about the book I want to write and 2 summers from now when I can finally go drive cross country. And I will go to bed. I did a lot of work work today on vaccines, and reorganizing redundant committees, and doing the final submission on our article. I posted a bunch of times on facebook about the article and then took down the post. I realize the more I accomplish in our environmental work, the more quiet I need to be. I can be on this blog and write my truth, but to more the world forward in climate activism – I need to let people have space to grow in their work. And that is what I noticed about Dr. Perry Sheffield at meetings. She has this quiet confience and builds people up. That is true leadership.

The picture above is because we are presenting at that conference as Durrwachter-Erno et al !!!! We are seriously going to get Tshirts which I’m going to deliver on my book tour!