April 2023 – Dr. Plastic Picker

Month: April 2023

The big push on our side. Webinar.

April 26, 2023

by Dr. Plastic Picker

It happened. It was a big win last night, and I was home when I received the text. I can’t be everywhere but I have amazing premedical interns that need meaningful projects in the route to medical school admissions, and I deployed one to advocate on our behalf at the San Diego Unified School District and he helped get this done. I forgot to tell him to sign up to speak, and honestly there was no need. He was there in the rally crowd bringing his and our might. The news landed on Fox already https://fox5sandiego.com/sustainable-san-diego/san-diego-unified-school-district-approves-fossil-fuel-free-resolution/ and it is positive coverage. We had done our part, after I dropped the San Diego Union Tribune Op-ed and gas stoves, and also we deployed on Monday the webinar on the Public Health Benefits of Building Electrification. These two actions added to the cacophony we need to create to accomplish this for our region. AAP-CA3 San Diego and Imperial County (which we are proud members) have an email listserv and puts on Coastal Currents every month. And there were three huge climate mentions including my op-ed and a link to the webinar.

Last night when I heard, my heart was so happy. Even though I was not there, I knew I was part of it by organizing and cheering and writing and planning for the webinar over the course of several months. I am so grateful to these beautiful faces that helped get our webinar through.

Beautiful people

If you have a chance to watch the webinar, I highly suggest it. You will learn a lot. Save yourself some money. Improve your health. Help stop climate change. But more importantly you will see how happy and connected San Diego area climate activists are.

I sometimes get exhausted as I’m still trying to push the climate work forward as this remains an existential crisis. But the wins with the op-ed and the webinar and helping be part of this huge coalition to pass Building Electrification at San Diego Unified School District has been HUGE. I only learned about building electrification really about a year ago, but it’s the solution to so many things.

But I’m a person too and riding an emotional climate high, I know that I naturally crash kind of afterwards. I stopped myself from sending more climate emails this morning. I only sent one. I have to save energy for a climate meeting that I’m having with a student this afternoon. My son is also graduating from high school this early summer, and I want to enjoy him and plan his graduation dinner and a family party for him. I’m going to let myself be a mom today. I’m traveling to a conference soon too, and honestly need to do it for the earth but I’m going to really miss my kids and my family. I love them so much. I’m truly an introvert and if the world wasn’t warming, I would have never ventured into this world.

But it’s made me a better person and changed my personality. I will treasure them more when I come back. I will have fun of the trip, but today I will give to my family. I was going to write our newsletter but I really don’t need to. No one is asking me to write it. I’ve done enough today. I want to go look at my daughter more too. I just like to sit there and look at her at times.

Just sharing the real live musings of your local litter picking pediatrician (I picked up a big piece of plastic near the ocean yesterday and binned it) who is part of this amazing climate and health movement.

Rooms that we will use.

April 21, 2023

by Dr. Plastic Picker

It happened. It absolutely happened yesterday. A community inspired each other. It’s the morning after and I have just a few moments to type before rushing off to finishing packing for a flight, heading out to see a full day of patients, and then making it home before our family takes a short flight from San Diego to San Francisco tonight. Our son was admitted to some wonderful colleges, and he is choosing between UC Berkeley and USC. The four of us are flying to be at Cal admit day, and we have all our swag including a Berkeley baseball cap that our fourteen year old and I will share.

But yesterday, yesterday was truly special. I came and gave my talk, and told my friend Dr. Luis Castellanos’s first year medical students at UCSD School of Medicine PRIME HEq (Health Equity Cluster) my story. I know it well and I always include some new fun pictures, but I also talked about our heat and human health summit that we need to get done. Dr. Castellanos and his entire group are showing up for the earth. I have emails and notes jotted down, and ideas are flowing and this beautiful beautiful and hopeful thing will happen.

I will never forget yesterday. The bright faces and the glances at my friend, and the conversations. My friend Dr. Castellanos and I were texting last night, as we continued to exchange ideas and he told me “I think this is going to be an amazing event, bring awareness and energize the community!” and I replied “You put good people together and magic happens.” And that is what happened yesterday and that is what is going to happen on August 12, 2023 at UCSD School of Medicine. More to come!

Harvard Medical School Class of 2003 in the house!
Who she is still.

April 20, 2023

by Dr. Plastic Picker

I’m headed out to speak at UCSD School of Medicine PRIME HEq Health Equity Cluster this afternoon. My good friend from medical school, Dr. Luis Castellanos, is the director and we are working on the San Diego Heat and Human Health (H3 SD) Summit together. Indeed this year marks our 20th Harvard Medical School reunion and both of us are not going. We are busy this summer, trying to help our region deal with catastrophic heat waves.

But that power point presentation is almost done. [pause] Wow, it’s already done now. As I do more climate work (has it been four years now?), I find blogging is more of a place to reflect on my parenting. In the end, we all have our why for why we do things. And my why, has always been my children and yours.

I am so incredibly grateful to the earth for literally slowing time down. Especially about a year ago when I stepped away from middle management to focus on climate advocacy, something magical happened. Time literally slowed down. I became a Marvel-like hero, but the opposite of Flash – I began to slow down my internal clock. It may be eating all those real vegetables. We chomp on real carrots that I peel and slice. We dip them in ranch or hummus. It might be that my daughter and I are making much of our own breads. When we have breads, it’s usually my own pizza dough recipe or her homemade baguettes.

Like allowing the yeast to slowly ferment and things to rise, I’m slowing time down for her. We had a beautiful glimpse into what the future may hold during our family’s pseudo kdrama. But there is no rush. And for me having this idea, has allowed me to tell her to slow down. Let’s enjoy the journey. Her club meetings, changing activities, speech trophy, waiting for a reply from the New York Times regarding her op-ed, and simply wanting to get on social media. We’ve slowed time all the way down, and we have make-believe conversations with her stuffed Penguino. We talk about make-believe boys that may or may not do the same activities. We talk about friends at school, and she pouts and I look contrite. Every night she is yearning to grow up, and I pull her back and stop the teenage clock.

She’s almost 15, and that in-between age between childhood and the world of grown-ups? We are still there. It’s a beautiful space, the expectations but the innocence. Knowing there are challenges and excitement, but that it’s not quite time. She’ll get a further glimpse into what it means to grow up when we go this weekend with her brother to see UC Berkeley, but she said I’m the little sister. Yes you are the little sister, and the little girl and not quite 15. We will keep you this way for a few more years.

April 17, 2023

by Dr. Plastic Picker

Its 4:21am and I showed up. I showed up on this blog because I’m having a hard time doing my part as co-author for this very important paper. We’re on a tight deadline simply because the six authors are busy and normal people, that have multiple other projects and things to do. Advocating and writing about climate change, doesn’t pay the bills. We all have to work and do other things, and this is all extra. The extra love and extra attention to we pay to this work, is so important because no one is showing up. But that’s not true because the three reviewers showed up for us. They showed up and the Yale Journal of Biology and Medicine Editorial Board showed up to accept our paper. They made really good suggestions and to be honest, it’s suggestions that we need to take and to incorporate and it will make the paper better.

It’s really an act of love, isn’t it? All those long-winded reviewer comments. They actually read the paper and asked us to add more. So what they asked of me (or what I took on for my part) was.

I believe that it would benefit from incorporating more attention-grabbing elements to better engage readers. I encourage the authors to bolster their arguments and critiques, and to provide a more balanced approach by weighing both the benefits and challenges of divestment. For instance, while the manuscript includes a list of organizations committed to divestment, it would be beneficial to also address the challenges these organizations have faced, and to provide examples of successful case studies. Additionally, relevant evidence to support the arguments presented would be helpful. “

Okay. So let’s add more attention-grabbing elements to better engage readers. The introduction is kind of bland and I can add some pizazz! Just like I do when I go onto the news. Let me pretend I’m on the local news station in my addition to the introduction!

Climate change poses an existential threat to children’s health. The Lancet has described CC as “the greatest global health threat facing the world in the 21st century,” and also calls it “the greatest opportunity to redefine the social and environmental determinants of health.”  Increasingly, pediatricians are caring for patients with illnesses directly and indirectly related to climate and the environment, including allergies and asthma; heat-related illnesses; premature birth; injuries from severe storms and wildfires; water-, tick- and vector-borne diseases; and mental health problems. The threat to human lives is here and increasingly recognized by mainstream media. For example, the last two summers the Pacific Northwest was encased in a heat dome. What was supposed to be a 1 in 10,000 year event happened in two sequential summers. Summer of 2021, 800 died in the Pacific Northeast heat waves of 2021 [https://www.scientificamerican.com/article/deadly-heat-dome-was-a-1-in-10-000-year-event/]. The following summer of 2022, for a 5 day period a heat dome enveloped the Pacific Northwest and 11 million were placed under excessive heat warnings and 12 million under heat advisories. Ninety six people died in Oregon who were mostly home alone without air conditioning. [https://www.opb.org/article/2022/09/28/pacific-northwest-heat-wave-2021-oregon-summer-weather-heat-dome-climate-change/] . And then further south in California, what we now understand as climate whiplash where the wets are wetters and the dries or drier [Precipitation regime change in Western North America: the role of atmospheric rivers A Gershunov, T Shulgina, RES Clemesha, K Guirguis… – Scientific reports, 2019] – the west experienced extreme rain events with the landing of atmospheric rivers that caused historic flooding in California and Nevada.  200,000 were left without power, and 22 deaths including a 5 year old that was swept away in the floodwaters gaining national media coverage [https://www.npr.org/2023/01/10/1148094527/california-flood-boy-swept-away-montecito-evacuate].

Okay wow. That was super helpful. I’m going to put this in now into the track changes document. I added it to the track changes document. Can I tell you how I hate how ugly the track change document looks! It’s hard for me to follow what it actually reads like. But oh well, this is what I’m learning as I venture into more academic writing. I’ll be honest. Some of the stuff I got from Wikipedia which actually is legit, because I followed the citations back to the original reference articles. There are some smart people writing in Wikipedia! LOL.

Okay the next part is reviewer 2 wanted “I encourage the authors to bolster their arguments and critiques, and to provide a more balanced approach by weighing both the benefits and challenges of divestment. For instance, while the manuscript includes a list of organizations committed to divestment, it would be beneficial to also address the challenges these organizations have faced, and to provide examples of successful case studies.” So I need to incorporate two more paragraphs which I’ve been struggling with for the last two days because it’s hard to try to incorporate it into a very long document already. But if I can try to explain it to you dear readers, than it will make sense. Because the readers of these journals are just people as well, but they just need more “smart language” with some ivy league flourishes!

I had started this already so here I go.

The Challenges and Benefits of Divestment

We understand that in most institutions, fossil fuel divestment will be difficult and sometimes seem daunting. Within each healthcare sector organization, both professional organizations and health systems, there are complex systems in place that control finances. It’s often hard to figure out who has influence and responsibility for directing where money is invested. Organizations have complicated structures of who manages retirement plans, and who gets a say in how these plans are selected, and often it’s a handful of individuals on committees or those who hold financial positions who make the decisions despite overwhelming support for divestment/climate safe investments from the rank and file health care providers. The word divestment and ESG has now also become increasing partisan, and now included in the culture wars. When divestment or climate safe investments have been raised by physician climate and health advocates, the response from others has sometimes been founded in fear that climate safe decisions are in conflict with fiduciary responsibilities despite recent clarification by the Department of Labor that ESG investment guidelines are in line with fiduciary roles. There is the real threat that fund managers and retirement committee members can be sued for violating fiduciary roles, and organizations and individuals have had to purchase insurance to cover for this remote possibility. There is usually also not cross institutional lines of communication yet in terms of retirement fund managers and climate and health advocates in this space.

We understand that there are challenges to divestment, but there are precedents and success stories that can be examples. In May 2020, The University of California system became the largest public university in the country to divest from fossil fuels, and as the flagship system for California became a bright example of how divestment can occur. With it’s own complicated structure of governance, it was a combined effort from multiple groups within the university system that accomplished this. It was the UC Green New Deal, UC Academic Senate, and UC Board of Regents all involved in accomplishing this work. There were key professors and student leaders that represented a ground-swelling of support from faculty and students that were displayed in multiple protests throughout the different campuses. In the end the UC system was able to accomplish divestment, and gained moral authority and greater leadership and security in their academic reputation as a leader in climate science and advocacy.

Okay. That was really helpful actually! I think I’m done. I’ve added my part and just send a text to my friend about who to send the next document to. Sometimes writing a paper is like soup. We add bits and pieces and hoping it melds into something delicious. Everyone who is part of this paper poured their heart into it. It’s hard to work as a group and to coordinate, but there really is no other option. We have to work together. We have to try. This paper is really really important because the pediatric associations need to lead the way, and then family practice and emergency medicine and the rest will follow.

So it’s 551AM and it’s been a production 90 minutes. I had been thinking about this paper the entire weekend and just couldn’t get anything on the actual paper. But realizing that I’m imperfect but my part is important has helped. I’m not an academic. I do like writing. And I’ve added my part and my perspective, and I’ve reached out back to my academic friends because the track changes and citations scare the beejeebers out of me! But being able to type and realize if I can explain things to you, dear readers, and more importantly to myself – than maybe I can explain it to the academic pediatric world. I need this publication so that I can come back to the retirement committee head and my current nemesis, and just hand him a copy of this paper with a co-authorship. That way I can push our organization to divest a multiple billion dollar pension and funds. I may be cursing him and another person in my brain, but I’ll smile when I hand him this paper. Because I went to Crimson University.

Years ago on our first trip to Yosemite.

April 16, 2023

by Dr. Plastic Picker

The boys are coming home today. They got onto an earlier flight home from New York than planned. Our son went to see NYU during their admit weekend. We are so grateful , incredibly grateful and realize how fortunate we are, that he had a choice. It was a brutal admission season for many students, and somehow our very normal and very joyous son emerged okay. NYU’s admit rate this year was 8% but he was admitted. He flew with his father, and they did the admit day and at the same time he saw his aunts for the first time since the pandemic as his paternal side is all based in New York.

Our son had fun. They had a DJ, cotton candy machine and white wine for Mr. Plastic Picker to drink in a room that overlooked NYC. The view was incredible. But I talked to my son and he said honestly that it was all a bit too much. There was a little bit too much litter for his liking, and he’d rather be in California for school and catch a flight home earlier to spend the rest of the weekend with his friends and family.

And with that, my mommy heart was so relieved. His younger sister and I were in the car, living our lives here is our hometown of San Diego. We drove to the San Diego Central Library in downtown, and visited the art displays and dreamed of Gold Awards and artistic projects that she is pursuing. We picked up girlfriends and dropped them off, and she sat in the back with her friends and they talked about books and boys and boys in books, but definitely more about books in general than boys. We walked in nice Liberty Station where she felt safe in her jeans and cute top. We walked in East Village, where she got creepy looks and comments from strange men while she was wearing modest shorts and a sweatshirt. I clutched her tight and felt fearful that it was just me, and where was her tall brother and where was her father? Did they know? Did they know from across the country that I was scared without them in the state?

It’s hard to know why certain things happen. It’s hard to know why some children want to go away and some children want to stay. I realize that it’s their lives, and I absolutely gave him space to decide. But that the boys decided to come home earlier, and our son decided that he’d stay in California for college – made me so happy. The girls were home in San Diego and every 30 minutes or so, either I or his sister would exclaim – we are so glad. We are so glad he decided that home was better than away.

I really look happy.

April 11, 2023

by Dr. Plastic Picker

I’m happy. I can’t explain it better than that. I’m not chasing anything to validate myself. I’m not trying to have anyone recognize me or notice me. I’m not trying to change my body or my weight. I’m just happy in my own skin and most importantly within my family and in my own heart and mind. I like myself. I like that I have tangential thoughts, and that I am a smart and thoughtful pediatrician and parent. I like that I can string together a sentence.

And life has been beautiful and slow. The parrots are squawking and a friend told me that they often will eat citrus and fruit from home gardens, but they never eat ours? We have blackberries, kumquats, citrus and the parrots leave our garden blessedly alone. The butterflies and lots of bees visit my mother in law’s garden. I sat out in the back and front garden for long moments yesterday. I was sitting and just visiting with a friend, who is also a pediatrician and climate friend. We talked about our families and our children, in a way I could not have imagined 15 years ago when we first met. She’s a beautiful beautiful person inside and out, and it’s amazing that we are friends.

I told my other friend who is more of a pen-pal really about my mother-in-law’s blackberries. I told him that the children are lucky to be able to pick the blackberries and eat them directly. Maybe in 15 years we will be more than just pen-pals and the seeds that we have planted in both of our children’s hearts will blossom into something. The seeds are planted deep right now, and need time to grow. No matter what the families that each child is growing in, are both filled with love and caring and nurturing. That is why I’m confident that no matter what, when our families both met it was a beautiful moment. No matter what, when we met we created a ripple in the universe and that was a ripple of goodness and healing. The San Diego Heat and Human Health Summit will happen because we met, and thousands of lives will be saved because we are pushing our region to plan for extreme heat events.

Our son ate a blackberry and it was so sweet he said. His grandmother planted the blackberry and weaved the vine into a beautiful arc that is like a crown for a king. And he’s our king and the prince of this household. His father and his grandfather love him very much. We all love him. But the men in the family love him in a different way, with a father’s and grandfather’s pride that their name will be carried on – all the way to college and to hopefully to career success that has echoes of past Korean dynastic victories. It’s hard for me to fully realize their pride, since I’m neither Korean nor really have thought of my dynastic lineage.

In the end I’m a really simple person. I went to a fancy school with a fancy name, and I like being busy and decided to help save the earth. But the core of who I am is just a cheerful person. I am so glad I met me again.

When they were little.

April 5, 2023

by Dr. Plastic Picker

We had finished dinner last night. Mr. Plastic Picker and I had one of those fleeting middle-aged moments when the best thing, is having enough time between work and dinner to go to Costco together. It’s probably the most fun I ever have, going to Costco with my college-boyfriend now husband and deciding what to buy for our family with the money we have earned. This is why we had an easy dinner, because we bought the premade Costco fajita chicken corn taco set. Have you dear readers purchased that one too? It’s a fun dinner because who doesn’t love fajita chicken tacos. Certainly our family does.

After the said fajita chicken taco dinner was consumed, it was getting dark already but I wanted to go for a walk. My body needed to move because I had been with friends. When I am with friends, and I’m better at making friends and being a friend now, I try to listen more. But absorbing the stories of other families is hard for me. The stories are different from my own. The decisions are different than the ones I made. And I don’t have the clinical detachment as a clinician, because their decisions affect my own family. So I listened to my friends and their family stories, but I had this nervous energy after absorbing some of those stories and and I needed to walk.

Our daughter walked with me, and we walked and talked and rounded multiple quiet tree-lined blocks. We brought a flash-light and had fun chatting about our stories, other stories and just being together. We talked about family and she wants to be like me, have children at a reasonable age. She’s like me, a planner and has her years of college, post-graduate study, law school and life all planned out. Some of the plans are the innocent and entirely appropriate aspirations of a smart and articulate 14 year old, win international prizes and going to international type galas with Estee Lauder type endorsements. But some of the plans are those that I realize are important to her, because I am her mother. Her future children, and how she’ll mother and who will mother with her.

A lot of people worry about their legacy, and honestly I’ve never been one of those. For mothers who have daughters, our legacy to the world is our own daughters and the way they will mother. I realized I am incredibly lucky in that my mother is alive and healthy, and mothered me well past the time her own mother was taken from her due to war. I realized I am lucky that I have my mother-in-law, who has mothered me and loved me across our cultural barriers. Some of my love for Kdramas is honestly that I came to love them first (my husband’s family) and then the Kdramas came as a caricature of a real loving family and culture.

I do get to take some credit for this beautiful creature. She is my legacy because I poured all my love into this little person who was born too early and who was whisked away to the NICU before I could really get to know her. But I know her so well now because we walk and we talk. The boy who captures your heart will for sure be one lucky boy, who will get to bask in the love of you continuing your legacy little one. And I hope for you a daughter also, so you will realize how much love you gave me every time we walked and talked.