December 2022 – Dr. Plastic Picker

Month: December 2022

Plastic trashart from a food gift container that was delicious that I wanted to reuse.

December 31, 2022

by Dr. Plastic Picker

I want to ask forgiveness if you’ve been touched by my silliness or if you think I’ve taken up your time unnecessarily in 2022! I truly do. I think I had too much time on my hands after stepping down from Assistant Boss, or perhaps it was the euphoria of escaping those middle-management meetings. I tend to try to create my own reality and my own fun, and I may have taken up your time with half-baked dreams or unfinished projects. I am ever the imperfect Dr. Plastic Picker, your imperfect pediatrician. And that is all. For those that I need to ask for forgiveness, I am asking for it now.

And onward my friends! Onward to meeting new people, developing different kinds of relationships with those that we know. Onward to finishing those projects that we started, and realizing those that we started that aren’t progressing – probably can be abandoned. Onward to healing ourselves and the earth, and advocating for our planet. Onward to joy. Onward to the you and the me and the world that is meant to be.

The end and the most beautiful view on the way.

December 26, 2022

by Dr. Plastic Picker

The time was wrong on the microwave clock this morning. I had forgotten to reset the clock when the power went out on Christmas Eve. The children were fast asleep, and it was really just Mr. Plastic Picker and I that noticed since his HMO computer thingamajiggy was beeping. It was very brief just a minute or so, and things were reset and we went back to sleep.

We didn’t mention it to the children when we awoke on our slow and peaceful Christmas Day. There are so many of those moments in life that even when you are together in the same household, like the power going out on the in-between time of Christmas Eve finishing and Christmas Morning beginning, that you don’t share because the others did not notice. It happened, but really only two people experienced it.

This weekend was filled with those moments that we all shared. We all noticed. We were together. One set of grandparents are up in Utah, making memories with another set of grandchildren. And my two children, after a wonderful day filled with the smell of my daughter’s homemade cinnamon rolls filling the house and our bellies (in appropriate portion sizes of course), agreed to walk up with me on my most favorite walking path from our house to their maternal grandparents’ house.

Sometimes I wonder how that became the walk to the grandparents’ house, but it literally is the walk – that hugs along the Pacific Coast along one of the most scenic and biodiverse areas in the world. And we did that walk, and saw them before they head back to their new home away from us and their old lives.

It was such a beautiful and memorable walk. Just 45 minutes really. I showed them the sandstone cliffs that are often on my Instagram feed, and the rocks that I balance on as I’m cleaning the ocean. We went to deliver some medical things I had purchased for them at the HMO company store, and for our daughter to show them the actual print out of her report card which she can explain in pretty good Vietnamese that they are all As and A+s in honors classes. I’m most proud of her for knowing that phrase well. And we sat on the couch that is on the beautiful balcony overlooking the Pacific Ocean.

It’s real life but it’s also a metaphor. I saw with my father for a few long moments, and we talked about their 50th wedding anniversary next year and how they want to celebrate. We talked about Hawaii and San Diego, the weather and their happiness in their new home. We talked about memories and health, and we talked about death. At some point, we found my mother as she was furiously trying to clean the outside of a house that she is passing on to my brother. She doesn’t need to clean it anymore, but she can’t stop herself when she is in San Diego. At some point, we got her to sit down and enjoy the view and the quiet. We talked about the big 50th anniversary coming up again. Mr. Plastic Picker didn’t come on the walk with us, but he did arrive shortly afterwards to pick us up since we had made it to the grandparents’ house just before dark. He chatted with my brother and laughing with our son. Through the clear balcony doors that are so much cleaner than mine, my father commented at how handsome our son is. That he didn’t get into his early decision school doesn’t really bother us now, because he’s going to do well no matter where he ends up and we have a lot of resources and I admit privilege to be able to support him along his journey. We talked about the other equally wonderful schools that he is applying to. And I’m very much like my father, I’d rather our son be good-looking then anything. This is why my father and I are very much alike. Good-looking and a good person.

And then the princess walked in, our princess at least. Our daughter walked in and hugged her grandparents and she kissed them. She’s the embodiment (like all the other grandchildren) of the love of many generations. She’s the embodiment of the love of my parents who survived war and displacement, racism and macroagressions. She’s the embodiment of the hope of my family. I quietly told my father our plans, about college and law school and how she can be molded to be an activist as well.

But as she walked away to join the others in the kitchen, we commented and thinking the same thing. Gosh, she’s good looking and she’s ours.

Afterwards our daughter was laughing much of the night, about how funny her grandparents are. They are like most grandparents on this earth of ours. Marveling at the miracle of how love and beauty can be passed on to the next generation.

Mingei Museum

December 23, 2022

by Dr. Plastic Picker

I was feeling a bit off this morning, and I realized I needed to write. So I’m here now on the blog and with you. Realizing that I’m here really for myself, is important. Even introverted me, can get unnecessarily excited about certain blogposts or Instagram stories that go viral. But that elation and that notoriety is transient. What remains, is really family, the earth and the stories that we are creating.

Creating new stories, that is what I’m realizing is the power of the climate work and this blog. A new world order is being creating. My daughter calls it a renaissance after COVID and from the lost dreams of what the past world was. Even with all our efforts to mitigate the climate crisis, the natural world is changing and there are new stories that are being created.

We were at dinner with Dr. MC, whom we call at home my “baby doctor.” This is a special person that I have the honor of helping train to be a primary care pediatrician. I treat her like family and she is family, and we had dinner with her husband J – and we were telling stories. And I realize my husband Mr. Plastic Picker tells the same stories often. They are interesting but new stories are better.

So here we are on this blog through our different advocacy projects helping to create new stories. And these new narratives are what will draw more people to help with the climate crisis. I’ve thought about taking down the blog and kind of retreating. Even a joyful climate activists can get tired sometimes. But I realize that even if I’m the only one reading and writing, that it’s okay. This is my narrative, and a small window into what is happening throughout the world.

I’ve been thinking about what kind of funeral I want. Yes, I know I’m a bit weird. I’m not scared of that stage. But we often worry about whether our children will know that they were loved. And in the end for me, every blogpost here I wanted to impart that to the children I know and to my own children. That Dr. Plastic Picker loved you, and that is why we are trying to save the earth.

And that is a beautiful narrative for sure. Going to go pick up some trash and get my mind on right before I head to work the weird staggered shift today.

Sweet moment at Downtown Disney this weekend.

December 19, 2022

by Dr. Plastic Picker

I wanted so badly to talk to my friend who I’m not allowed to email. It’s a self-imposed “not allowed to email” situation because I don’t want to bother them, and my family does not want me to bother them. My friend is a father and I imagined him to be the perfect father-in-law to my daughter. But obviously that is not my decision to make right now. My friend was an educator for a long time before becoming an important player in the University of California system, so he knows children well. He is also a father to a boy and likely understands some of my confusion and parenting dilemmas (wow that’s a hard word to spell without spellcheck).

But I’m a pediatrician and I should be the perfect parent right? That’s what the world expects of me. Am I allowed to struggle? Am I allowed to make mistakes? If as a pediatrician your kids don’t “turn out well” isn’t there more judgement? I’m not worried about the judgement part, because I’ve moved beyond it. But I’ve always known that parents who work a lot and who are forced to place other’s needs in front of their own family’s needs and who have little control over their schedule, we’re supposed to be the perfect parents? In fact, good parenting is antithesis to the work-life of most doctors even pediatricians. It’s a fact.


Rally screenshots from EHC’s video

December 14, 2022

by Dr. Plastic Picker

It’s done. This is what I wrote on my personal facebook page which kind of blurs into my eco-avatar self. “We did it. Successful rally at the Port of San Diego representing health care voices as to why a cement plant with 10k diesel trucks trips per month in and out of barrio Logan is a bad idea for the children of Barrio Logan and neighboring National City. Spoke at the port commissioner meeting. It was an inspiring coalition of health care workers, environmental organizations, school board, faith groups especially the Catholic Church. It was honestly a few weeks of effort and winding down and exhausted emotionally. Made KUSI, ABC and Fox News. Our premed intern who is fluent in Spanish made Telemundo. Lots of new climate friends. Mitsubishi will be back and hopefully with a better plan than the polluting one they have now. Felt like I did my part today for the earth and for kids health.”

It was an invigorating day. It was a joyous day. It was a day filled with meeting new and old climate friends. It was kind of surreal because on one side of the Port of San Diego conference room were the black suits. They were the corporate Mitsubishi people. And I was on the other side with my white coat, on the side of the people and the rabble-rousers. Little did I know that – that is the side I prefer. I made my comments at the rally and at the Port of San Diego and they were reasonable health care voice comments. I made good eye contact with the commissioners and spoke my truth, to remind them that we are actually reasonable community members who are San Diegans. I also got to tell them I went to Harvard and grew up in Chula Vista, and said “Go Barrons!” I told them I spoke about this proposed plant at MGH/Harvard, and made a non sequitur about Dr. Ron Kleinman asking me to return to Harvard, and I replied “No, I’ll stay in San Diego.” It’s somewhat true (yes he did say that!) but somewhat contrived, because I wanted to balance out the anger. I wanted to make them understand that I am a different group and am supporting the mission of the Environmental Health Coalition and to underscore how big the community support and alliance is for Barrio Logan.

I’m still processing everything that happened, but I realize that I’m allowed to rest. We have only a few weeks until Christmas and two days until our kids finish school for break. So I finished having a nice breakfast with our daughter and I’ll sign off and send some Christmas cards. So many of the climate friends I know , I actually know just in the virtual space. Maybe that’s for the best. I don’t think I actually know 75 people’s addresses?

With @heylaisha our premed intern at the San Diego asthma meeting.

December 13, 2022

by Dr. Plastic Picker

Okay I’m up. I’m up!!! I’ve been dreaming about this presentation all night. I’ve given longer versions to two MD groups. But this afternoon is the actual rally at the Port of San Diego, and I have 3 minute. Just 3 minutes. But it has to be good so I can’t just do an impromptu version. I’m going to write out my comments.

I have many patients who live in Barrio Logan and Logan Heights. And this is really for all the children of San Diego because the Mitsubishi Cement Plant would increase in general green house gas emissions. Just reading about it I just learned ” About 60% of the cement industry’s total carbon dioxide emissions in California are from heating limestone in the kiln; the other 40% is from fuel combustion and electricity use, according to the Global Efficiency Intelligence report.

Most of the fuels used in the cement manufacturing process, such as natural gas, coal and petroleum coke, emit planet-warming gases. Unlike other industries, the cement industry cannot rely on most renewable energy sources to power its operations due to the extremely high temperatures that are needed for production. That’s part of the reason why the industry is making the switch to alternative fuels that consist of recycled waste products.”

The idea of growth and production is complicated. Cement is deemed necessary to grow, but I’ll leave the discussion about unmanaged growth for another day. I really need to just concentrate on the children of Barrio Logan and asthma. It’s not fair that this factory is slated for this Environmental Justice neighborhood. We don’t need to bear the environmental cost in this neighborhood that has suffered so much.

At some point, you have to take a stance. You have to say enough is enough. So today is the day our group San Diego Pediatricians for Clean Air speaks up and joins multiple groups lead by and Environmental Health Coalition to speak up for this neighborhood.

So I’m going to speak up today about the dangers of diesel trucks and what it would mean for this neighborhood as the pediatrician of Ollin, Metzli, Junior and Isabella. I’m going to speak for their respiratory health and the health of their community. And I’m going to do it with the spiritual backing of a few hundred doctors that I’ve told them I’m doing this, and they are supporting me spiritually. We spoke about this advocacy project yesterday at the San Diego monthly asthma meeting and I spoke about it at the regional asthma meeting. The allergist, the pediatricians, the internist, and the family medicine doctor friends all told me – go, go, GO!!! And here I go!

Trashart and being a speech tournament mom.

December 7, 2022

by Dr. Plastic Picker

My big task this morning is to figure out a title for the HMO Regional Asthma Symposium Presentation I’m giving on Friday morning. I think I’m going to name it “45 and my 2nd Act as a clean air advocate: @drplasticpicker a burnout story.” I’m opening up powerpoint right now and going to update slides I used for the MGHfC/Harvard Grand Rounds I gave in November.

Actually I renamed it. I think this works better “My Second Act as a Clean Air Advocate and SDPCA.” I’m going to talk about burn out, but focus on two recent projects we are working on which is rallying against the Mitsubishi Cement Plant and thousands of more diesel trucks in the Environmental Justice neighborhood of Barrio Logan. And also I’m going to touch on indoor air pollution and the push for building electrification.

I don’t really tell anyone other than the SDPCA/AAPCA3 email list and then my immediate clinic friends about the things we are doing. The clean air work and this beautiful alternate world as a climate and health doctor has been this beautiful thing that has happened. It’s connected to our department as all the players are also part of it, but it’s also outside of work as it’s all volunteer for us and for me. It’s a non-transactional relationship and completely a transformational journey for many of us, and has been for me

With that, it’s been hard. I left middle-management willingly and enthusiastically to pursue environmental health advocacy. The outside work needed to be done, and it was volunteer and honestly not enough people are showing up to do this work. With small efforts, I have a greater impact on child health than sitting at middle-management meetings. I had no grand plan for when I felt quietly exited middle management, but I knew it was the right thing to do. I’ve moved on to more regional and national work within our HMO. I’m making connections with climate and health advocates in Oregon, Northern California and other regions. We are all working toward the same goal and interestingly there are a lot of people like me, former chiefs and assistant chiefs, who realized we had to work outside to change the inside.

But I do get sad sometimes. I’ve chosen to be very quiet and let my former middle management colleagues figure out their second act. But as I see what I had worked on for five years be dismantled piece by piece, I get sad. But I know that everyone has to recreate their own reality. If you don’t make it yourself, you never feel that sense of ownership. I had thought I had been doing that work collaboratively, but as little things are changed that had remnants of my former administrative self – I naturally feel hurt. That had been years of effort. Years of worry. Years of how I felt things were efficiently organized to make life better for all of us. I had my colleagues wellness and my own wellness at the forefront always during those five years as Assistant Boss, and then the previous 5 years as lead of our clinic. It was a decade of my life, and a decade is a long time.

But one has to say goodbye and a department moves on. I’m a bit player sitting in my corner, and going to just wait it out. Wait until the new generation takes over at some point. It’s too painful for me emotionally to go to meetings and to participate. I listen in, or listen to the recordings. I find so much joy in my actual patients and clinical medicine, and I often wonder what insanity led me into management before. And I’m reminded that it was because the work was being dumped on me anyway as a young mommy doctor, and I had decided that if I’m going to be pressured to do the work than I might as well have the title and get the tiny little bonuses that are associated with it. I think that was the right thing to do as a woman doctor. And that led to the next which led to the next, which led to burnout.

But I’m happy and it’s best not to question our life’s journey. I have realized now that it’s in my own self-interest to acknowledge my emotions and that how I’m feeling is important too. So that’s how I’m feeling now. I’m also incredibly sad about our family’s pseudo kdrama. Nothing has happened otherwise, but it had been such a beautiful time of dreaming together about a shared future and family and friendship. We are doing very well and our daughter is flourishing in her speech team, and academically and in the midst of normal 14-year old worries about her sports teams. I learned so from that time. I learned that I need to place boundaries around how much I am involved in her life. I learned about para-social relationships (she taught me that), and to cherish the real relationships I have. I learned about my own intrinsic biases and we confronted at least a decade earlier than planned, how we at parents want to begin to navigate having young adults who will at some point date and hopefully create their own families. But the most important thing I learned is how incredibly wise my own daughter is, and how also incredibly young. I get flashes of the future woman she will do, and then stark reminders that she is firmly fourteen.

Rather than trying to meddle in her life or have para-social relationships with future in-laws and future son-in-laws, I’m allowed to lay in her bed and watch her study at her desk. She’s a beautiful child and of course I know I am biased because she is mine. But I lay there and I look at her, and I see her profile with her blue-blocking glasses perched on her beautiful nose. She’s always working on her schoolwork, and perfecting the presentations and making sure she presents her best work. I’m proud to say she’s one of the top students in her class, which I’m still puzzled about because not once have I asked her to do that. In fact during elementary school when the students were allowed to test into the higher spanish and math, I did not sign her up because I didn’t want my former preemie 28 weeker to be stressed. But she ended up in those classes anyway just through her performance. But I get to lay there and watch her study. She’ll ask me questions here and there, and smile at me. But I get to hear her quiet mutterings and comments to herself. She is one of those, very chatty to herself. She sings in the bathroom. She talks to herself at times. And two nights ago, the fourteen year old who now knows she can wear a shade of lipstick and pull an outfit together and wow some speech judges – had in her imagination already told her same-age law-school boyfriend that he’d have to wait for her at Yale Law because she had to go to fellowship and live in a flat in London. So she has been dreaming too along with me, about the future. But I’m glad now that it’s an amorphous person that does not have a name yet. Just a fuzzy thought it the back of her mind.

So we are firmly at fourteen and she turned to me yesterday and I told her I was done with my musings and imaginations about her future husband. And she looked at me with wise eyes and said, “That is good mommy. You told me I can’t date anyway until after my SATs.” She’s got better things to do. But I’m so happy we got to go shopping again for shoes and she looked beautiful at her speech tournament. I’ve realized that she’s very picky about friends and likely about future romantic interests. And I’m so proud of her for that. She won’t settle for just anyone and doesn’t encourage others to pay attention to her in that way. She just wants to preview what it would be like to be a “fancy lawyer lady.”

So I’m lucky, inordinately lucky. My department has moved on. Our family has moved on from our family’s pseudo Kdrama (although in the back of my mind it was just a weird coming of circumstance that I think they’ll meet again in a decade by accident). And I’m still here happy to be a general pediatrician and get to do clean air work. I get to be the mother of two great teenagers, and a 14-year-old who likes to go shopping with me. And I get to be with you dear reader on my blog. Oops, she’s coming down the stairs. Let me sign off!