July 2021 – Dr. Plastic Picker

Month: July 2021

From noravargas.com

July 29, 2021

by drplasticpicker

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.


May be an image of nature, grass and tree
Sunset at a wild place I never knew. Near Salt-Creek Community Center.

July 28, 2021

by drplasticpicker

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. Best kind of bananas to made banana walbut bread.

July 26, 2021

by drplasticpicker

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.

All mixed up.

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.


She’s thinking about when Mr. Plastic Picker is going to take her on her next walk.

July 23, 2021

by drplasticpicker

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.


Seagull’s footprint pointing to my bag. Reused a tyson breaded frozen chicken bag from Costco. Lots of shoes that day.

July 22, 2021

by drplasticpicker

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?


Just the area I’m planning on having our high school reunion beach clean up. I talked to the lifeguards and they said OK. It’s shady.

July 21, 2021

by drplasticpicker

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

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.

Remnants of the toaster that caught on fire. I put it out!

July 20, 2021

by drplasticpicker

Yesterday was indeed a momentous day. Firstly (is that even a word), I finished binge-watching Dawson’s Creek. I’m glad I did not watch this during it’s original run 1998-2003 because I was premed and in medical school at that time. I was very busy with my studies and my own romance with Mr. Plastic Picker, who is now my lawfully wedded husband. There was also living your own adventures. But now that I’m in my 40s and trying not to spew carbon in the air by taking exotic vacations and it’s still a pandemic anyway, I appreciated the adventures of this group of friends in Capeside. I had to finish watching yesterday because I knew that Pacey Witter and Joey Potter end up together (Dr. Dear Friend was kind enough to Ecosia search it for me) but I needed to see it for myself. For me, Pacey Witter and Joey Potter will go down as one of the great romances right along with Dr. Plastic Picker and Mr. Plastic Picker. They stay together and live happily ever after. I may need to write a fan fiction piece about them afterwards! That will be epic! My star trek fan fiction piece of Trip and Tpol regarding the alternate ending of the Star Trek Enterprise is still my most popular blog post. Click here to check it out! https://drplasticpicker.com/the-star-trek-enterprise-romance-of-tpol-and-trip-im-going-to-give-them-the-ending-they-deserve/

Yesterday was also a momentous day because I went through the first full day of work without coffee. Today will be the fourth full day (the entire weekend and Monday and Tuesday). I didn’t intend to stop drinking coffee, but it’s something I don’t mind. The reason why I was able to stop drinking coffee is because a huge psychological stress was gone due to our restructuring some of my work Assistant Boss responsibilities https://drplasticpicker.com/500th-bag-came-and-went-just-like-my-building-up-the-per-diem-pool-a-lot-of-work-and-passing-it-on-with-little-fanfare/ It was interesting the reaction of various people when I told them about my coffee victory. Lets just say there is alot of subtext with different reactions. But it is done, and the thirteen year old coffee habit came and went without much fanfare. It’s better for me, and it’s something that happened because I’m more in balance in the truest sense of the word.

Oh, and then the picture above! I was making dinner last night and our daughter has decided to not eat any meat for a while. This is okay because she has a very positive body image and she is doing it for the earth. We had gone through a period of kinda vegan eating, so I’m comfortable with the different cooking methods and I’m almost pescatarian anyway. So I was making an Impossible Meat (which is vegan) sauteeds with garlic, onions, mushrooms, mixed vegetables from Costco, and we had it with the locally made Pita bread from Sprouts. Our daughter was toasting it in the toaster and it lit on fire. Mr. Plastic Picker was able to move the fire outside, but I was the one who grabbed the fire extinguisher and put out the fire. I bought it years ago and thought it was a good idea to have it. And then I had gone through the training at work twice. I felt very masterful putting out the fire. I knew to remove the pin. I knew how to aim the fire extinguinsher, and I knew about how much to press it. I felt really good.

And lastly, one of our premed interns who is the second class in our commitee and one of my former patients – got an amazing internship with one of my fellow climate activists who is a researcher at UCSD. I was able to make the connection and she is now going to work with this wonderful group. I am so proud of her.

And that it is is. That is why yesterday was an exciting day for me. Still not drinking coffee. Boo to the naysayers. I know they don’t read this blog. I am drinking a bit of green tea though. Much love to you all. Dr. Plastic Picker! Hopefully will make it to the beach this morning.

This also happened. Mulched around the planters, and it cooled the soil down. I’m going to get more mulch later. Step by step. For me it’s a learning process.
Wooga wooga man. I needed him, cookies and coffee to cope with life. And now I’m back to being me.

July 18, 2021

by drplasticpicker

Something absolutely wonderful and weird happenend. Between semi-binge watching Dawson’s Creek, giving up per diem physician management as per the request of the HMO machinery, and realizing how sweet the cherry tomatoes from our garden tasted, I stopped drinking coffee. Yes, just like that. I stopped. It’s been 36 hours, and I haven’t gone without coffee at least 2 to 6 cups a day for almost 13 years to this day. I also stopped for the most part cursing (I know, I know, it was a horrible habit and I only did it – in front of my husband or co-workers when the doors were all closed).

I went for a real jog and walked along the beach last night. And then came home and had a good nights sleep. I woke up at 5am or so. I had gone through all of my medical training including chief residency and the endocrine clinical year without coffee. PICU, NICU, pediatric surgery rotation – all of it without coffee. I remember now that after the birth of our daughter when she was a preemie baby and then brining her home from the NICU, it was a stressful time in life. In retrospect, I had postpartum depression. I didn’t recognize it. No one who cared for me recognized it. No one asked. I self medicated with coffee, lots of cream and lots of sugar. That is how I coped with life. And the coffee habit fluctuated from 2 cups to sometimes 6 cups a day with lots of cream and sugar.

But this weekend it happened, the coffee habit ended without much fanfare. My body feels right. I realize through the demands of work, emotional stress – it was my crux. I’m lactose intolerant anyway. It’s hard to get sustainable grown coffee anyway. And I put way too much sugar in it anyway. Oh, the cursing for the most part stopped about the time I started walking along the beach plogging.

Without the coffee, time has slowed down more. The tomatoes from the garden are so sweet this year. I think some of it is the compost, but some of it was that I didn’t drink coffee with sugar yesterday. I had the cherry tomatoes at breakfast with a sandwhich and then at dinner we used it on our homemade pizza. It was hard to get enough to put on the pizza, because I kept popping them into my mouth. And the sky looked beautiful yesterday above the Pacific, despite the air pollution. I noticed a monarch butterfly when I was sitting in the car at the park, waiting for our daughter to finish volleyball. And I gave more hugs to Mr. Plastic Picker yesterday.

When one is on the path of healing, it is slow but real. Healing the earth. Healing ourselves. Sometimes I doubt myself. But then I get these little flashes of fundmanetal change that just happened because I’m just better. I’ll still eat cookies here and there, but I much prefer vegan muffins homemade now with whatever leftover ingredients I have around the house. Life is so sweet now with the cherry tomatoes from our garden.

July 16, 2021

by drplasticpicker

There are 21 months and approximately 630 days left of my Assistant Boss term. Yes, I’ve decided in my melancholy and frustration regarding middle-managment to have a countdown. Yes I have. This is the beautiful United States of America and I have freedom of speech and freedom to count. If other MDs can have a retirement countdown and not suffer any professional repercussions, than I have an Assistant Boss countdown. I used to sometimes think about how many years to retirement, but I no longer even consider that thought – as the practice of actual patient care brings me so much fulfillment and joy again. Or maybe it never was as fulfilling and meaningful as it has been the last two years. But the Assistant Boss and middle-management time? I am doing a countdown. Yes I am. And no one can stop me.

I am also going to buy a rooster and I’m going to name him Louie. There is a special person named Louie and I talked to him recently. We caught up on life and I asked him how his retirement is going and he said with true happiness in his voice, “I’m good. I’m really content.” And rather than asking him to work shifts or talk about our middle-management needs, we just chatted about life. He really cared about the farm and wished me luck in Oregon. And I decided at that moment that when we start raising chickens (which the plan is relatively soon) that I will name one of the roosters after him. He laughed.

And that laugh, and that conversation made up for so much. His happiness and contentment gave me joy. During my time as Assistant Boss I was able to do certain projects that eased his transition. It eased the pain of what middle-management did to him at the end of his career. I remember the ignoble way the HMO machinery tossed aside one of it’s best leaders. As I think to my countdown the 21 months left, I don’t know where life will take me. But I always think to Louie when I have doubts. I call him sometimes when I have moral quandries. But it’s time to let him go too. He is living his life in retriement with joy, but I will have a chicken and name it after him so I can remember the Chief Boss and I’ll sing to that chicken/rooster that oh so fitting song.

“Louie Louie. oh no. said we gotta go. yeah yeah yeah.”

Another dream! A VW electric bus! Most of my highschool friends have the same dream! YEAH!!!

July 14, 2021

by drplasticpicker

I started this blog and the different “blog series” on Dr. Plastic Picker on a lark. I had always wanted to be a blogger, and this blog gave me an off-beat irreverent creative outlet. I wanted to document my eco-avatar environmental journey, and maybe inspire others to take that next step. I understand that we need systems change, but systems change can only happen if there is an upswelling in public support and sentiment. And that is where I come in. My half-arsed middle-management career was part of my journey to burn-out and back, and now integral to how I plan to help save the earth. Being in middle-management and I think an effective physician middle-manager made me realize that it’s literally easier to save the earth and change people’s hearts, than it is to “solve” certain middle-management issues.