February 2023 – Dr. Plastic Picker

Month: February 2023

The site the houses my resume.

February 25, 2023

by Dr. Plastic Picker

I’m not sure what drives me? I find these really cool opportunities that will help the earth, and help a student or colleague – and I jump on in. Why not? I think. I don’t try to take over the project, but usually I find it’s helpful to mentor someone or to collaborate on these shared climate projects. And then when one project is brought across the finish line, I update my resume on Doximity. It’s a legitimate site that folks look toward. I even got a grant from doximity to travel to Peru years ago with our HMO Global Scholars Program. It was $1000 or so!

It’s all good for the earth and climate, which is the most important. I figure I might as well update my internet resume. Just checking now I have the “Most Press Mentions 2021 and 2022” and the “Most Published in 2021.” I’m not trying to get the most press mentions or most published. What I’m trying to do is get the most impact on green house gas emissions. But it’s fun to update things on the site.

What’s wrong with me? Nothing. I just wanted to type something today. And I wanted to thank everyone who reached out to me in person and virtually to encase me in that big cozy hug. Thank you. I feel better. I feel safe today. And it’s raining like crazy, and it’s a beautiful world.

Processing a different kind of terror.

February 22, 2023

by Dr. Plastic Picker

It’s 442am and I’m up more at my more natural awakening time. I’ve honestly watched most of the Kdrama netflix/Vikipass that I need to. So no more binge watching for me. I’ve caught up on most of them. And I stretched and did some light weight exercises to help me fall asleep last night. I asked my very tall and gentle son to hug me twice. I asked my husband to hug me last night, which he did before a little 12 pound poodle mix snuggled in between us and I had to scoot away. I could push her out of the way, since I am the alpha in the house (well maybe not the alpha, but the beta that pretends to be the alpha). I didn’t talk to our daughter too much about things, because I don’t need her at 14 to be exposed to the ugliness of the world too early. She will see it all soon enough, but while I have some semblance of control – I am raising her in a bubble of security and stability.

I was terrified yesterday. I had a parent patient interaction that I found absolutely terrifying. I find it helpful to process these emotions relatively quickly so things don’t fester. The details are not important here on this blog, and things need to be confidential – but it’s important to share my reaction. I think some of my reaction is because I’ve been mostly healed from many traumas, past emotional and professional abuses from blogging. It’s helped to write things and process, and for the most part I’m surrounding by positivity and joy. I also try to be positive and a force of good at the office and in the world, and certainly at home. But yesterday a person tried to emotionally pull me down into the darkness of chaos, and tried to provoke in me evil – and it terrified me. I was acutely aware of my racing heart beat, my hands began to shake, and I stood up even though that person was on the phone. I could feel my fight or flight response kick into gear. And I knew to politely set limits and hang up the phone. And then called the appropriate supervisor and threat management was alerted.

I felt threatened and I don’t have to take that cr@p anymore. I’ve certainly been in more dangerous situations. We all have. I’ve had scalpels thrown at me by angry surgeons. I’ve had other surgeons berate me as a student for no good reason. I’ve had parents threaten my own safety and the safety of my team, when they were often child abusers as we’ve tried to protect children from the same abusers. I’ve seen fellow physicians haze younger colleagues, and it ate me up inside to sit there and witness the hazing that is done really indirectly through decisions that are obscured. But I am 100% me now, and daughter of my father, the wife of my husband, the mother of my children, and the pediatrician for over 2000 children. And I called someone who called threat management, because I don’t have to deal with that cr@p anymore and neither should you!

Yesterday was an epic climate date. I spent two hours writing our newsletter updates for SDPCA and AAP.-CA3 Climate Change and Health Committee. I mentored and recruited another premedical student who will help with the heat and human health summit. I reached out to patients and extended extra care to those that are subject to poorer health due to environmental toxins and racial discrimination. I attended the above clinic meeting where we all whacked at the COVID pinata (brilliant idea by a colleague) and ate half of a cookie without guilt. I also took a good whack at the COVID pinata because it’s been a rough few years for sure. And then I went home and attended an epic meeting between the Office of Health Equity and Climate Change and the League of Women Voters and got to talk more about the idea for the heat and human health summit. I was late for that meeting because I took what I thought would be a quick 30 minute nap but ended up being a 45 minute nap, but the League of Women Voters Environmental Justice Subcommittee were very understanding of my working momma/climate warrior exhaustion! I even got invited to their gala!!! My premedical intern was there which is like I was there on time, so we were able to meaningfully contribute to the conversation.

And all this was important for the earth. What scares me the most about the worsening heat waves is that it will drive up rates of interpersonal and domestic violence. That is the scariest part. We have to try to mitigate the climate crisis by continuing to reduce green house gas emissions. We have to better prepare for the heat waves, because no matter what they will be getting more frequent in the summers. And when they do, tempers will fly and the situation I was in yesterday – will happen more often.

But I’m so lucky. I’m so incredibly lucky to be able to see the link between it all. I am no longer scared. My heart rate is normal. My vitals are stable, as is my mental health. I thought about calling in sick for a mental health day, because it was terrifying yesterday. I thought about punishing the system for putting me through this. But I realize that I’m better and I can whether this one incident that was terrifying because I have you. I have climate work. And I have my loving family. And I’m thinking of someone who is very brave and I’m sending you out a virtual hug. Signing off now, to do a few climate emails! Your local litter picking pediatrician!

She was incredibly beautiful child.

February 19. 2023

by Dr. Plastic Picker

I’m working the Sunday shift from 830-5pm and I’m at peace. I did a three way trade so that I could make an HMO Wellness and San Diego Audubon event in two weekends. That is for the earth and work, but I do that on my own time. Of course even though I am increasing our visibility in the community, and indirect advertising and membership growth and general goodwill – I am not paid for it. I created this opportunity for the earth, our HMO and myself through my own networking and creativity. It’s difficult because I don’t think the HMO upper leadership really gets me. Most people who work within the system – actually don’t. They are creatures of being told what to do, what do think, and have their times micromanaged down to the millisecond. After breaking away from true middle management, there is so much room for creativity. But I still work in the system I work in, and I do believe for now it’s the best system out there – so I will show up to work happy today. But I did a triple way shift trade in order for a friend to make a skiing trip, and myself to make the HMO Physician Wellness and San Diego Audubon event – and it all seemed to work out. This event is really the first of it’s kind. So I’m able to make that event and fulfill my obligations at work, which I used to find annoying because who likes to work on the weekend?

But I’m not annoyed this morning having to go to work even though my children have the day off. There is someone special there working also. This someone is someone who I haven’t seen in a long time. I want to give her a hug because we have a close friend in common that died. We all miss her acutely in different ways. I talked to another friend about her, and we used to talk and meet constantly during the years I was Assistant Boss. It’s hard. The sadness comes back once in a while when issues come up, where she would have had a fierce and just and insightful opinion. That passionate voice and that beautiful person is gone now. But those of us who knew her, were made better by her.

I’m not as annoyed to go into work because my children are doing well in life. That’s the honest fact. Physicians are stressed due to extra work duties, not because they want to go party. Come on! We were all studious premedical students. Most of us are annoyed to go into work on the weekends because we are worried about our families and want to spend time with our children. My own children are doing well for various reasons, but some of the reason is that after I decided to do climate work – I became happier. And a happier and more present parent, is a more effective parent.

And the beautiful toddler in the picture is now 14 going on 15, and I am so incredibly lucky. I am incredibly luck to be so loved by my daughter. She tells me often, and I tell her often the same. I still don’t know what I did to deserve such a living being in my life. She has so much love in her to give. Mr. Plastic Picker and I are not parents to overestimate our child’s abilities, but she is also incredibly intelligent. That is saying a lot when both parents are Crimson trained to the 8th power! Her spanish is progressing very well, and she is the honors track. She will get to the AP Spanish Literature level and will always have that skillset. Spanish is relatively easy to maintain since it’s so incredibly useful and an important international language. She also speaks Korean very well. She’s been in Korean language studies since she was four, at a Korean language school and now with a language professor who teaches her weekly. She does duolingo every day for both Spanish and Korean, and speaks with her grandparents every day. Most importantly, every day she takes linguistic risks and moves her language skills further and she enjoys languages. She’s been asking me to start Vietnamese language studies for the last few years. We’ve had fitful starts and she has learned some from me. Her intonation is perfect in Vietnamese and I’ve never been concerned since she’s heard the language her whole life. Now we have met with an excellent college Vietnamese language professor who is local, and speaks the more proper and easier to learn Northern dialect. So we start tomorrow with her official studies, and I’m confident that she will at least be conversational. Four languages isn’t bad! It’s the same four languages I speak, but other than the Vietnamese – I an honestly say her English, Spanish and Korean are better than mine!

That our children are better than us, and we try to leave the world better for them – is a central tenet in my life. But today I’m amazed that my daughter wants to learn my mother tongue, Vietnamese, mostly because she loves me and she hears me speak it often. After I had a prolonged conversation with our new Vietnamese language professor and she overhear, she turned to me and said “Mommy you are really awesome.” So that’s the happy mommy that doesn’t mind working the Sunday extra two shifts today.

My trash art last night.

February 17, 2023

by Dr. Plastic Picker

I’m really excited. I had this idea for a “Heat and Human Health” Summit at UCSD and it’s taking shape. I have some wise people guiding me. They believe in the earth but can taper my enthusiasm and guide it in the right direction. So it sounds like to make it doable, it should be a smallish gathering of 50 or so people for half the day. This advice helps me quite a bit, because it puts limits on my enthusiasm and grandiose plans. The most important thing is that it gets done, and we start it. The heat waves will be coming for the next 30 years or so. Having the first of it’s kind conference in San Diego will bring much needed attention to this issue. It also just gives us a goal to continue to address the real threat of heat waves and what we as health care organizations can start doing to plan as a region.

So I’m excited and reaching out to people. I thought I needed more students, but honestly I have enough right now. I have two premedical students who can help with this, and one high school student. That is all I really need. And then we have our Public Health Advisory Council, Climate Actions Campaign folks that are already bonded and can work together. Even the food won’t be that much. If it’s just a half day, then we just need coffee and drinks and snacks.

It’s really just a big meeting, but it’s an important meeting. It’s a kind of meeting with topics that are not being discussed right now. And we can do it for the first time in San Diego. It will create opportunity for three premedical students. And it’s really interesting to me. Probably initial address by Dr. Wilma Wooten or someone like that. I can make brief comments. Then breakout session at least 3. Heat waves and ED access. Heat waves and youth sports workflows. Heat waves and effect of NICU admissions and Ob-Gyn admissions. Heat waves and leveraging technology to help. Heat waves and psychiatric admissions. Increasing access to cooling centers to those that are most at risk.

Okay. That was a super productive blogpost. Do you like my trashart man? I call him “I am a fiduciary. I am an earthing.” That is a whole other project that I am working on. LOL. So grateful for green friends.

Me being loved by my sister-in-law. Our wedding over 20 years ago.

February 15, 2023

by Dr. Plastic Picker

The climate work has been remarkable the last few days. I’m in the midst of San Diegans who truly care for the earth and a livable future for our children. I’ve been on the phone and in conversations with such influential people in San Diego, and our ultimate goal is to build some climate resiliency for our region. The one thing I contributed is my creativity and thinking of the name and idea of a “Heat and Human Health” Summit to be held at UCSD, and bringing all the healthcare groups in San Diego together to tackle this issue. This will be the first of it’s kind in the country and hopefully a model for other regions.

But in the process of truly reviewing the data from Scripps Oceangraphic Institute and the power point presentations on heat from the County of Public Health, one again realizes how absolutely dire the climate crisis is. The heat waves are here already, and they are only going to get worse. We have to continue to try to address the climate crisis by plummeting our green house gas emissions, but we have to also plan for the more likely future of worsening heat waves. Heat waves drive premature birth, smaller babies, cardiac deaths, mental health flares and violence of all kinds. In looking at the data objectively, I again was met with a wall of climate grief.

Climate grief is real. It is so very real. And when you are a deep in the weeds climate and health advocate, you know what it means. It weighs on your heart, as you look at your children and realize the world that we’ve handed them. It weighs on me, and I’m holding back tears this morning. Last night, a few slipped out as I was laying next to my peacefully blissfully asleep husband. I still have dreams for my children, dreams for my son and my daughter and for their families and future grandchildren. But when you dream, one has to acknowledge that when we make the predictions for a 7x fold increase in heatwaves in 30 years in San Diego – that those that will be bearing the brunt of this are the current children we have when they are adults raising their own children.

Realizing the existential crisis of climate change, opens ones heart. My heart is so open these days. I was chatting with a work friend who is also a climate friend, and we talked about how we are different. Exploring passions and talking about our work and climate with others.

This morning I’m realizing I need to give myself some time. I’ve been on a whirlwind of planning and brainstorming for this conference. “Heat and Human Health” Summit! I think that is a great idea! I just need to bring everyone together, and other’s will be standing on the podium when we do the opening sessions. But you heard it here first dear readers!!!

Love this morning as I think about those that are on this journey with me. Love for our premedical students who have been spreading ideas and inspirations. Love for those at UCSD who have opened their hearts and their physical facilities to this prospective conference. Love for my future family, those that will join us when my daughter and son decide whom they will love. Love for my future grandchildren, in whatever form they will take.

And love for myself today. I still need to remind myself to take care of myself. I went for a short jog yesterday. This afternoon I think I’m going to take a break from the frantic emailing, and buy myself some vegetables and try a new recipe. And despite my teen daughter reprimanding me for mentioning a certain boy’s name yesterday, I will refrain from mentioning that boy’s name but I can still dream for her. I can still plan and think of a fuzzy future. But I realize that I don’t want to be thought too weird so I’ll keep those thoughts to myself! So if you see me humming and thinking, just remember I’m imagining my daughter in a hanbok like myself on her wedding day.

Evidence of manuscript submission.

February 12, 2023

by Dr. Plastic Picker

I’m exerting so much self control dear reader by not posting semi-anonymous pictures of the volleyball-cute in her winter formal dress. Also our senior son looked dapper yesterday wearing a boutonniere for the first time. He also had a very beautiful “friend-date” and we did the proper thing and had a matching white rose corsage for her with a black ribbon. She was wearing a black dress and it matched. I haven’t seen his pictures from his phone yet, but the blurry and out of focus photo-booth pictures has the pretty “friend-date” wearing the corsage.

The freshman volley-ball cutie had her own corsage as well that her parents bought for her. It was not the dance experience she expected, indeed all of freshman year has been one surprise after the other. But she was absolutely beautiful and elegant last night, and she was able to curl her hair for the first time and wear a fancy clasp purse for the first time. Other girl-friends who are gorgeous themselves said she looked beautiful and they took mirror selfies together, so she got the pretty girl validation from other pretty girls – which is saying a lot. It was also one of those nights that she realized she’s absolutely an introvert but a beautiful and elegant one. The thumping music and night-club ambience made the complications of her home-coming seem benign. I absolutely don’t know what I did to deserve a teenager that while going into the night-club (where the high-school dance was at), and at the last minute whisper to me “I wish you could come and be my date.” And then later that night after she was home and make-up off, want me to hold her and her confess to me how head-ache and migraine-inducing the strobe lights are. She told me that she’d like to find a boy (after SATs are gone with a high score) who is a handsome introvert who likes books, and doesn’t like the clubbing scene. Can you imagine how happy I was to hear that? Yeah. I’m incredibly lucky. That boy sounds very much like her father. He’s out there little one, just growing up like you are. Hopefully reading a book last night.

And as my two teenagers are growing up, I’m continuing to work on saving the earth and moving the climate work forward. It’s still going to be absolutely close dear readers to mitigate the worse of climate change. Dr. Plastic Picker and extended family haven’t bought our climate bunker for no good reason, we have very good reasons to worry about water scarcity, and air quality and migrate northwards eventually if we aren’t able to avert the worse of things. But we still have a decade to advocate and to act, and at the same time our teen children are living their lives and growing up.

So it’s 638am and it’s Sunday. I’m imagining the week and it’s mostly climate work and writing. I just wrote an email to all my climate friends about maybe having a “Heat and Human Health” Summit this summer. I emailed my Target contact that had offered to collaborate and will hopefully get to do a corporate type meeting on Wednesday! So excited about that one! Then I just shared on my Instagram @drplasticpicker an important article regarding environmental exposures and human health. They are helping us with publishing a commentary on our fossil fuel divestment work as well. We are all like-minded environmental health advocates.


I think I’m going to actually go pick up trash and just count it on my own plastic picking totals. I’ll post those updates later. I have to finish charts this morning, and then get some headway on one writing project, help my niece organize a Barnard/Columbia webinar on Environmental Justice, and then find a site for the Youth and Climate Arts Exhibition. I also need to clean our house a bit. It’s all really manageable because being Assistant Boss was such an abyss of responsibilities without any power not enough time. Saving the earth is easier than changing work-flows for sure, or scheduling doctors to work! LOL. Happy in my green corner. Sending you green hugs! Also I need to do our SDPCA newsletter too.

Recent pieces.

February 11, 2023

by Dr. Plastic Picker

It’s 533am and I’m up early with my matcha green tea soy latte! Our 공주 (Korean for princess) was selected for the Stanford Invitational Speech Tournament (which is virtual) and is competing today in Impromptu and Declamation. She’s also been selected for the California State Qualifiers which are next month. It’s been a remarkable time of growth and scholarship for her, and we are proud. Reflecting back, this all really happened after we met a certain boy and family and had our family kdrama. I realized she needed an outlet to dress up and get attention, and speech competitions fit the bill perfectly! We are on to a local academic beauty pageant as well!!! Or at least dreaming of one. I have a close patient family friend who had done those pagents as well, and may get back into it and do it with our daughter. The two girls would be beautiful together and get to know each other. I have been a pediatrician for so long especially to some families, and those families know my heart. To be honest, sending her to private school with the social set she is in – sometimes it is exhausting. I’d rather my daughter be friends with my patients with their values. In the end, your friends should care about you and spending time with them should be something that is fun and joyful. If that is not the case, then perhaps they are not your friends. The teenage years are complicated for her, and my mantra – is less friendship drama the better.

But back to my title, “Trash-Talking Pediatrician” – I think it’s really clever! I might use it in my next talk. The truth is I started using minor profanity (only amongst adults) when I started my pediatric rotations as a third year medical student. I was I think 23 at that point. And then I stopped profaning about 20 years later, around the time I became Dr. Plastic Picker. Those that know me in real life in a professional setting, will know this to be the truth behind closed doors when I would get frustrated with others that I felt were missing diagnosis or providing poor care or when I was just upset about this workflow or that workflow. I tried many times to stop the profanity. Dr. Dear Friend know I had a profanity jar where I dropped $1 each time. And it did not work, even with my uber-frugal self!!! But then it magically stopped around the time I became Dr. Plastic Picker! Poor Mr. Plastic Picker started dating a sweet Vietnamese girl and then she became an F-bomb dropper and now he has a sweet environmentalist pediatrician wife now. But it was an unexpected time for him for sure. I think he still has PTSD from those years. It was stressful to say the least. The reason for the profanity was stress, but also someone named Babak Kalantari who I believe is a radiologist now in LA. He went by Bob. He and I rotated together in pediatrics and he LOVED to profane. I mean he LOVED it. And he was so funny. I picked up the habit from him! I’ll need to have lunch with him soon in LA so that I can tell him I finally stopped. I likely needed the release because those 20 years were stressful.

But I was literally a trash talking doctor because the first patient yesterday was a 3 year old well known to me who hugged me. The mother I’m sure is okay with my telling this story. She hugged me and she was cute, and then showed me her hands! She had the tell-tale lesions of hand, foot and mouth and I said “F*&&^” and that is it. The mother looked at me and laughed, and I looked at the child in horror and then laughed. The mother laughed so hard!!! And then the 3 year old was semi-chasing me around the exam room, and I was trying to stay away from her. I semi-changed my clothes and disinfected religiously the rest of the clinic day. We shut down the exam room as well. I think I’ll be okay and otherwise had a long clinic day and added on patients because it was the right thing to do, and closed most of my charts and answered all my messages and did not leave the office until 630pm. I said goodbye to Dr. M who is near retirement and doesn’t leave until the wee hours of the night for various reasons. He has really great music playing though.

So I was literally a “trash-talking” pediatrician because the above is my trash art with upcycled clean medical waste from work, and also I dropped a profanity at a toddler yesterday.

But let’s acknowledge a truth that all pediatricians want toddlers to know! #donthugmewithcoxsackie LOL LOL LOL

February 9, 2023

by Dr. Plastic Picker

Good morning green friends!!! It’s your local litter picking pediatrician who is still picking up litter and still making trash-art. I realize when my mind is racing with the wonderful projects that I get to be involved in, but wandering too many different places – that I need to come back here to refocus. It helps me sort out my thoughts and what I need to do for myself and the earth.

I haven’t been posting as much because I realize I need to give my teenage children their privacy. I could have an entire blog just dedicated to raising them. But they are living their super interesting lives and I’m joyfully their mother, but trying not to overshare their images. But honestly it’s so very interesting and so much fun!!! Let’s just say our kdrama continues and there is a lot of joy and laughter and strutting up and down our hallway as we dream about fancy evening gowns and interviews. If it comes to pass, I’ll let folks know. But now it’s just a lot of silliness at our house as we break out the high-heels and talk about dreams, in between activities and applications and real aspirations that the children have for themselves. I hope you as well are enjoying your teenage children. It’s a beautiful age-range and I never realized it would be this fun.

But back to saving the earth. I’m going to have a meeting at Target! An actual corporate meeting!! I tell my friends I just go where the earth leads me and I am good about talking about my passions. I think having the super beautiful UCSD students also inspired those that visited us. Someone from Target offered to fund some of our work and I’ve invited myself to the corporate office to check it out! I’m really really excited!

And then yesterday I went to my first meeting as a member of the Retirement Committee. They said a lot of big words and tried to instill the gravity of the position I now hold. I’m a FIDUCIARY and that carries a lot of responsibility. I guess we are collectively responsible for a few billions in pensions. I told them I’m a climate advocate as well, and head of the green team at the Federation level. I really did enjoy the meeting and learning all the new terms. But I kept on hearing the new financial terms FICUCIARY and some other term. But I wanted to tell them, I am also an EARTHLING and would like a livable planet. I’ll be there in person during the first quarterly Retirement Committee meeting! Mr. Plastic Picker took the day off and is going to drive me!

And then I am in the process of co-authoring two papers. One paper on Fossil Fuel Divestment is being submitted shortly one last time to Yale Journal of Biology and Medicine. I’m proud to have contributed a good amount to the last rewrite. And then we are starting a new journal writing project with a new author group. Let me check back on that project right now!

OMG it’s 7:01 AM and I have to get started with the real day. Caught up on all my charts yesterday after being put on the naughty chart list. I’m going to try to keep up everyday and not fall behind. Sometimes climate work and real life is too fun, but I need to remember that I’m actually a real pediatrician trying to heal my patients as well. Much love from your local litter picking pediatrician!