Month: August 2023

August 30, 2023

by Dr. Plastic Picker

Last night, our family (the Dr. Plastic Picker family) was a family. I turned it off after having jumbled thoughts the entire day about my friend Prof Adam Aron and his upcoming train tour of the the US speaking about his book “The Climate Crisis.” He’s speaking at Harvard Medical School, invited by our former student Co-Founder of San Diego Pediatricians for Clean Air who is currently a student at Harvard Medical School. The webs of connection in our climate activism is very much based on where we are all from, which is San Diego. I had a small part in making that connection, and now it will happen. My part now is to drum up interest and some noise.

But back to our family. I turned it off for the afternoon and evening. I turned the noise off and I just looked at my pretty daughter. I watched her play JV Volleyball at La Jolla High School, sitting up on the bleachers and watching her play part of the 2nd set. They lost the game, but she had some good plays in there. And then I encouraged her to go to the 10th grade social for our little private school, and even made sure her father Mr. Plastic Picker showed up. So we showed up at the very fancy house owned by her friend’s family, with fancy families and we were simply ourselves. I talked climate with a few physicians, one of whom I know his younger brother well because we went to the same high school and I was in the same AP Calculus class. San Diego is an inordinately small world. I talked mostly girls and boys, as I was the parent who was shamelessly spying on the the group of 15-year-old boys and girls and also other genders – as they navigating the new social dynamics that some have had mini-glow-ups and full glow-ups or had simply taken a shower or gone further into puberty. They are all still children, and making these hard decisions about which activities to do, what I want to be when I grow up, vaping/drinking/sex, and am I going to jump on the trampoline when there are the other kids jumping on the trampoline?

Our daughter? She had her new curtain bangs, and her earrings and she finally wore a cute outfit. She had not wanted to go to the 10th grade social, but I encouraged her to go. And she had fun. She looked very cute in her jean shorts and demure top, but she simply had fun looking pretty and knowing others thought she was pretty – but mostly it was her friends opinion that she cared about. She talked about boys with the girls, when the boys were out of earshot. And isn’t it weird what puberty does to people? Suddenly your friend you’ve known since 4 years old, you can’t talk to? But at least they were in the same space, and oddly it felt so fun and healing as the kids were all smiling and having fun. For some reason, the dynamics were different and the kids will be different.

I realized something a few years ago. That the introverted ones like our family, we have to get out there. We have to mingle and get to know people, and it’s good for us too. And sometimes having the smart girl who happens to be pretty and not allowed to date, throwing her in with the cool kids is okay. She restores some of the balance of the social milieau and reminds everyone, it’s okay just to be a kid and it doesn’t have to all be about which elite college you are going to and who is likely to date who? Because our family’s agenda last night, was simply to eat some good food and not have to cook dinner. And we got to see friends we hadn’t really talked to and seen in years in the setting of a beautiful home of a generous family We might not agree with all the decisions other parents make raising their kids, but spending an evening together in a school sanctioned event is not going to derail our children.

Am I going to let her date? Heck no! But she can hang out at the social and look cute. And the other families can hear me prattle on about wildfires and climate, and physician wellness – because I am just who I am and we are the family that has been part of this community for over a decade.

Okay, off to send off some epic climate emails. Have to try to fill the room at Harvard Medical School with my friends – and can you believe it? The Children’s Trust contacted me and wants me to help gathering experts and data on the federal case Juliana vs. the United States. I replied back

August 27, 2023

by Dr. Plastic Picker

This has been a topic I’ve been thinking of for the last year. It’s natural for me since we got our son off to college at UC Berkeley successfully and we are still navigating with our 15-year-old daughter the joys and pangs of being a teenage girl in our modern society. I’m also a pediatrician for now almost 20 years, and I’ve given “the talk” to more teens than I can imagine that come in and out of my clinic exam rooms. But when your own children are around the same age and going through the same, it hits differently. And honestly I counsel my children and my patients completely differently than when I was a younger pediatrician with just infants in my own house. Sex, consent, intimate partner violence, gender issues – all of it isn’t as pressing when you are changing diapers at your own home. But when you have two awesome teenagers yourself and a pretty 15-year-old girl at home – sex very much is in the back of our minds as parents.

For the first time ever, I had a teenager just having entered high school ask me after hemming and hawing for a bit “When do you think I should have sex? Beginning of high school? End of high school?” I was very proud of this said teenager for having asked me this question. We connected because this teenager had begun watching Kdramas and we just chatted about popular titles. Kdramas are so popular now beyond the Asian-American community, and I think a good thing mostly for representation of a more diverse cast of heroes and heroines. So with that connection, this teenager was brave to ask me this question and I am not the primary pediatrician. This was a chance visit with a doctor that said teenager will never see again.

I usually ask the teens what they know from school and reading themselves. I ask them if they know about birth control and different forms, so I don’t have to repeat myself. I ask them if they know how common chlamydia. I go over the numbers and how it’s easier to test now, just urine and blood for all the STDs. We used to do cervical swabs and urethral swabs, and I assure them it’s so much easier now whenever they need us to test them. I talk about planned parenthood, and confidentiality and that I’m here to not judge and be a resource for them. I give them all the information and I’m so comfortable doing it. I use funny stories from my own life, to make it more relatable to them. I’m honest with my own patients about my own life and decisions, to hope to be an example to keep them safe in loving relationships. I tell them I met my boyfriend when I was a freshman in college, and we were friends and dated after a year of being friends. So between 19 and 24 (when we were married during medical school), we had lived in the same dorm buildings and at some point “things happened.” I told them I got on birth control for acne initially and to regulate my period because I was so stressed as a Harvard freshman that I didn’t have my period, but at some point the birth control was there for birth control because I wanted to have children at the time I decided. I emphasize that as young teens for the girls that they are very fertile, and I joke around that “a boy will walk by you and you’ll become pregnant!” which is not true. But that I do have several cases where I’m not sure if there was actual vaginal penetration and I think I may have had 2 cases in my career, where the young boy ejaculated somewhere very close to the girl and the young teen girl got pregnant. In both cases, the two young teens actually did love each other and the families decided to keep the babies. Those children are healthy, but I tell them – gosh that was really hard for those kids and one was an AP Chemistry student too. So be careful, it can happen to you!

But what I told this patient and what I’ve told my own children and all the children that are thinking about sex or may have sex or are hanging out in the teenage social media mileau that have oversexualized everything is this:

You deserve to be loved. Whether that be after you are married or before, you 100% deserve to be loved. That you want to be close with someone you care for sexually is very natural. And whenever you make that decision, I am here for you as a pediatrician not to judge but to make sure you are safe. But sex is not just sex, it’s such a beautiful thing that should be shared with someone who cares for you. It’s like anything you do for the first time, if you kind of do it “right” initially – like brushing your teeth or flossing – you do it better forever after and there won’t be as many issues later on. It’s such a private thing, that try to have some privacy and comfort. My own children I hope they will wait, but I told my son who is in college, use a credit card and get a hotel room or call your uncle for advice if you are embarrassed to talk to us. And that’s it. You deserve to be loved in every way, and isn’t love such a beautiful thing?

For my own daughter, I’ve told her the same. Her own pediatrician actually gave her a very different talk in the privacy of a confidential visit. But my daughter is very open with me, and told me afterwards the broad strokes of that talk. I so appreciate the different pediatric perspective but that talk was very different.

But for my own daughter and the patients I’ve had since they were young, I add a wistful little ending. The beauty is in the waiting. The perfect boy, he becomes your husband (Mr. Plastic Picker) and a wonderful partner. But enjoy today however old you are. 14, 15, 16, 17, and maybe even 18. 19. The beauty is in the anticipation, the waiting, the yearning.

And again for my own daughter, I told her honestly you are so busy right now. You have to continue develop your sense of self – emotionally, professionally and physically. And having a boy (or girl or whatever gender of the person that you love) there with his opinions , no matter how wonderful he is, complicates things. It’s about you now. And girl, you got so much awesome stuff going on!

But the summer she goes off to college and I’m not there to keep an eagle eye on things? 100% she’s getting a nexplanon placed (long term implantable birth control). I’m a romantic, but I’m not stupid. LOL. And that’s my story and I’m sticking with it! Have a wonderful rest of your weekend from your local litter picking pediatrician. I’m going to the beach to pick up trash this morning, and I’ll be with my teenager this afternoon getting curtain bangs so she can look cute for herself. She’s super excited about the curtain bangs!

August 23, 2023

by Dr. Plastic Picker

One of my friends once told me, after I told him some of my grandiose plans, that he said “my grand plans are to clean the house and do something in the garden.” That really was cool. And because I respect this friend, I’ve been often thinking to myself “My grand plans are to . . . ” And today my grand plans are to do my taxes.

Our son has COVID for the first documented time ever. The entire pandemic none of us were known to have had it (excepting my mother-in-law) but I’m sure at some point we had it? We are fully vaccinated including the bivalent boosters. My son hopefully is having a mild case, but he is missing the first 5 days of college due to being quarantined. Orientation was mixing thousands of students, so it makes sense that he got COVID. I mean, he lives in a triple! We are monitoring the situation and I texted some of my doctor friends for advice. They were so great to reply.

And then my grand plans today are still to meet with all the different entities and loving souls that made H3SD possible. I sent emails off to friends at UC San Diego. Mr. Plastic Picker and I will meet with my friend Dr. Luis Castellanos. That is always a highlight to chat and have brunch. I have changed my schedule to be able to meet with County of San Diego, and I’ve invited the Kaiser entities that might be interested. I hopefully will meet with the ground level people that all made this happen, like the wonderful volunteer project manager Sed. There were so many personalities and loving people involved, but I was honest with my friends and home institution. We have to have a project manager for the next iteration and it has to be a team. It was half parts insanity and this unexplained joy and curiosity that enabled me to help make this major thing happen. I can’t be replicated, but the model is sound.

My activism has always been about what many of us in climate work talk about, the intersection of

And what brings me joy is a lot of fun and different new projects that are in the back of my mind. It’s usually working with people I find interesting. But I also need to do the work that needs doing, and the work that needs doing that also brings me joy is – doing my taxes. We’ve paid up our quarterly, but just need to gather everything together.

I’m also going on a kind of date with Mr. Plastic Picker tonight! We are going to walk around UTC Westfield as our daughter has a leadership meeting she has to be at. So when she’s at this meeting, I’ll get to walk with him around the mall. And honestly, for me? That’s super exciting just to get to hold his hand. I’m a romantic at heart. And that was ultimately what half enabled me to get the summit across the finish line, because I believe in happy endings in every aspect of our lives.

August 20, 2023

by Dr. Plastic Picker

We knew the hurricane was coming, so we made some memories. We had two cousins still here from New York helping with the summit, beautiful girls that I’m their aunt. They are at a beautiful age in life, young and their futures in front of them. They took some of their summer to visit their family which is their cousins and grandparents and uncle (and me), and to help with the summit. But because Hurricane Hilary was coming, we had to have their parents change their flights and we got them out before the Hurricane. They are from New York City, and they had many of their family memories destroyed during Hurricane Sandy. Climate fueled disasters are real, and they are aware of them as are we. Can we take a moment and acknowledge something? There is a Hurricane coming to Southern California! This is 100% climate change.

But my heart is at ease because I’ve known the disaster movie was starting. And at some point, you have to decide for yourself what character are you going to play in the movie. Are you on the side of chaos? Or are you on the side of justice? I picked my side four years ago. So we’ve filled our reusable water bottles and we have enough water. We didn’t really need to get more food, because honestly I think everyone has enough food in their house. Mr. Plastic Picker filled up the PRIUS with gas in case we need to evacuate. It will be horrendous trying to get out of Pacific Beach honestly but we have many places east we can drive to. We’ll weather the storm fine. But this scenario is going to be more common now. Hurricanes in Southern California. Extreme Heat Events. Climate migrations.

My heart is at ease because I’m continuing to organize. The H3SD Summit was 100% the right thing to do, because so many like-minded climate doctors met that day. Many new projects have emerged. Many new collaborations have started. We did something amazing last weekend, we really did. A group have started email discussion of a San Diego based on-line scientific journal based on racial and health inequities. I have mentoring meetings with several climate and health doctors who want advice about how to advance to the next stage of their careers. I’m surprised I’m at this stage, but I’m happy to give advice and to mentor those who want to be mentored. We have many papers we need to start getting out as a result of the summit. I gave an interview already to a youth journalist on the h3sd summit. I have made plans already to travel up to UC Berkeley to do a talk with some premedical students and my son on climate anxiety, and also have gathered a group of 5 climate and health physicians to network with the UC Berkeley students. This intergenerational collaboration is very powerful. Plus I can go spy on my son (with his full knowledge of course!) during this freshman year.

But as the winds are gathering strength and I’m looking out the window at the rain, I’m grateful we took some time to live life yesterday. Our tomorrows are never guaranteed. And yesterday I loved. I loved my daughter. I loved my nieces. I loved my mother and father in law by getting the girls all dressed up in the traditional Korean dresses we already had. Each hanbok my mother-in-law had special made for a particular wedding, and mine was sewn in Korea in celebration of Mr. Plastic Picker and my wedding over 21 years ago. My mother-in-law was recounting when each of the dresses were sewn, and she choked up a bit with some rare tears. Yesterday her pretty granddaughters aged 20, 17 and 15 dressed up. She got to dress up with them. She told them to take off their bras (you don’t wear bras underneath I guess), and tied the restrictive hanboks that flatten your breasts. She lovingly showed them how to tie the skirts and put on the multiple top layers. She put on her own hanbok and we took pictures in the garden and had the girls fan their skirts out while they sat on the grass. It was a beautiful and simple moment, and we have beautiful pictures.

I went for a walk with my one niece, who I did not know that well and now I know better. She’s a beautiful child and I got to tell her some stories that I’ve been wanting to tell her since she was little. We picked up trash on the beach, and heard the waves and had adventures yesterday morning.

You can never get these years back, and indeed we will never get yesterday back – so we lived yesterday to the fullest knowing the hurricane was coming today. They girls are tucked away safe back in New York now. We are safe in our house, and we are prepped as well as anyone can be for this hurricane. But my heart is at ease, because I’m living each day taking action regarding climate change and climate resiliency. I’m trying everything I can to influence the world toward the arc of sustainability and justice. But I’m also allowing myself to be a mother and be an aunt. I give my college boyfriend big hugs, and he’s so happy with how I love his family and his nieces.

I miss our son terribly, and he is worried about us. But I told him we’ll be fine. Someone in the family had a dream about my death. It was an anxiety dream. And I honestly told them, mommy has no regrets. I’ve lived such a wonderful life, especially the last four years. I haven’t held back the love I have for the world, but tried to pour it forth. I’ve sent innocent emails to my friends still dreaming of my daughter and her future. But I told my family honestly, I don’t think I’m going to die soon? I have too much work to do. The earth needs to me to do all the projects that I have planned. I’ll be here to see the ending of the disaster movie. And I hope that it will be beautiful filled with love and healing, and big smiles from all the climate families that I’ve gotten to know. Thank you for following along with me on my emotional journey in this emotional work.

August 18, 2023

by Dr. Plastic Picker

Has it been almost a week? I’m sitting at our kitchen table and it’s 8:40am. I slept so deeply last night. I could have put myself back in to work in clinic today but it’s been such an emotional roller coaster sending our oldest to college that I kept my vacation day to be a mom. Our baby (who is a moody but very pretty 15-year-old) has her first JV Volleyball game this season. So I’m going to watch her game and listen to her 15-yo ramblings. She’s a really accomplished and intelligent and creative 15 -year-old, but sometimes she says nonsense. And as we get deeper into 15 and I’m firmly at 45, the nonsense is more pronounced. Boyfriend? No! Instagram? No! Curtain bangs? Maybe. Earrings? We did that! Boyfriend? No! I’m joking of course, she’s not asking for a boyfriend. But for any normal pretty 15-year-old who is a she and likes hes, they are in the background always. Especially when your oldest brother goes off to UC Berkeley and 50% of the freshamn class are Asian, and you are put smack in the middle of a lot of good-looking tall Asian boys. There was a point in the hotel lobby we were in the elevator and there were two very tall good looking Korean freshman, who smiled at her. I swear the girl was going to have a seizure! LOL. They were too tall though at that height it gets ridiculous because the girl is only 5’4″. It was probably too much for her. But you should have seen her dancing around the hotel room afterwards posing in front of the mirror. When you get noticed by some tall boys, it really does something to you (or her). It was all fun to watch.

But we are back now in San Diego and in her safe little world, where the 15-year-old boys are a bit less overwhelming and distinctly annoying to her because she knows them. I like this world. I like being mother to a sassy 15-year-old girl, who think actual boys kind of smell at this point. I’ve done a 180 and trying to dissuade her from going to any dances. I can’t take the drama anymore, and the real heartache.

But what I really loved was knowing the H3SD San Diego’s Heat and Human Health inaugural summit was made into reality. It was a beautiful day. I hope to those that went or were involved, that you felt it too? It was such an overwhelming sense of love and caring. I know it fundamentally affected all of the members of our family who attended and helped, including our nieces from New York. We talked about important issues in a beautiful setting at UC San Diego Medical School with good food, and most importantly with the most beautiful hearts I can imagine. It had to be volunteer. It had to be through these personal connections and not one organization leading the way. It was a coalition, but really a coalition of families and friends and doctors and academics. The authenticity was palpable.

I’ve mostly been on Instagram making reels of our oldest son’s journey to UC Berkeley, which was an 8 hour drive. The move-in was relatively simple. Boys are easier that way. He had four big IKEA blue rectangular bags and that was it. We helped him make his bed with the ubiquitous mattress topper that everyone has, and tucked in the extra-long twin sheets that Mr. Plastic Picker ordered on amazon. He had his cat anime plushie and the green cylinder pillow he has flipped around since he was little, almost in a nervous habit. It’s amazing to watch him do it. You can tell his emotions depending on the complexity of the trajectory of this pillow. You can only find them at the Korean market. He has three and brought two up to Berkeley. The extra one is safely tucked at home in his bedroom.

But I think he is probably doing okay. I didn’t expect the emotional cycling during his leaving home and arriving at Berkeley. Sadness and parting. Tears and goodbyes. A little bit of anxiety and excitement. Amazement and joy. And now a sense of stability and settling into this new reality for our entire family. I’m sitting across from his seat at the kitchen table and it feels empty. I’m like every mother and I break out into tears once in a while. I don’t let him know, because he’s being a good boy and up at school and grateful for the opportunities he will have at Berkeley. My older brother said we raised a good boy, and I know he is. I had him talk to each of his uncles before he left, to get some words of advice. My younger brother will stop by to see him in a few weeks. I’ll be up at Berkeley too, to check in on him. We won’t hover, but we’ll be there to remind him that he is part of a loving and caring community.

And he was there too at H3SD Summit. I emailed my friends this paragraph which I believe in my heart.

“We were saying goodbye to our son, and realizing that the time he spent tabling at the summit and the interactions he had (especially getting to meet Adam Aron and now working with him a bit even though he’s up at berkeley) fundamentally affected him.  I have lots of funny stories about getting getting a freshman off to college from a parents standpoint. He’s in a triple. The three boys (thank goodness) all don’t smoke/drink nor vape. I’m relieved. But then made ground riules about how to signal each other if they bring girls over and they’ll vacate the premises quickly (LOL my son was intrigued but is just starting to think about dating now, it just never happpened in high school I think too small of a student body).  But as I have the normal worries of a mom (he forgot to brush his teeth the first night LOL), I know that the work we did envelopes all of our children in this blanket of security that loving and caring adults are doing the right thing. As I was cautioning him about Raves and drugs, I know he listens to me a bit more because of the wonderful adults that have surrounding him doing climate work.“

I usually end my emails with “Green hugs and thank you for being my friends!” And yes thank you for also being my virtual and real friends! Thank you for letting me share my journey. H3SD was filled with an overwhelming sense of love, and it was fun! It was exhausting but fun and most importantly impactful. We will definitely do it again next year. What will it look like? I don’t know. It’s really the collective we who will figure it out. I just know it will be likely mid to late August at UC San Diego School of Medicine, and I’ll get to hang out with all my San Diego climate friends especially Dr. Luis Castellanos again. And I hope all my other friends come back if they are free. And we bring along new friends who are good-looking and want to help save the earth. And the secret is when you are happy and you have a good heart and do good, the joy and beauty just shines through you. It’s true. When you see that beauty, you can’t unsee it. I see you. And gosh darn it, I’ll never forget all those real genuine smiles during the summit.

August 5, 2023

by Dr. Plastic Picker

To my daughter. I love you dearly. I made this reel of you and it’s mostly so I can watch it again and again. I love it because you are my daughter. I didn’t let you know but I know you have an Instagram account that you can look at other accounts, so if you see this and tell me to take it down than I will. I don’t think I’m that important that there are that many people reading. The most important thing is that I love you and I think you are smart and pretty and fundamentally good. The judgements of others, you know our family doesn’t really care. For some reason sharing our journey I know is helping the earth. Our family is lucky and showing others the beauty of family, and goodness and that a family like ours cares for others and for climate – I think is part of our responsibility. We have been so blessed and to those that much is given, much is expected.

With that, WOW! You are definitely 15 and not 14 anymore. I love that and expected that, but I’ll miss my sweet fourteen year old that agreed to go to homecoming with a boy from a nice family. I know the 15-year-old you now won’t take any of my mommy-nonsense. I’m looking forward to watching the 15-year-old you from the sidelines. Please be kind to me though, and remember sometimes I’m going to make missteps. But I love you and you have big emotions at this age, and sometimes you still need hugs from me. Keep on eye-rolling as much as you want, and I don’t mind you slamming things once in a while. But I am going to remind you once in a while to tone it down a bit.

You and your father are so similar. And I’m glad we all got over summer chem together. All that drama, and you ended up with still fantastic marks. Your father also had a mini-meltdown over summer chemistry. As did many other parents and students this summer. It was definitely not the summer that we expected, but I think neither was 14 the year we expected. But it was a beautiful year and the summer, although it seems like it was so “lame” now, we’ll remember with fondness years later.

I am so lucky to be here with you for this year of being 15-years-of-age. To live every day to the fullest and to be present, is the most we can ask. Keep on dreaming and keep on expecting more of the world and others. That you expect a lot of me is okay too. I expect a lot of myself as well. I love you so much, my #bossgirl and all the funny hashtags I use about you. It’s just my perception of how I understand your childhood. And really I hope you don’t see this because you are 100% not supposed to be on Instagram. And you are 100% not allowed to have a boyfriend. But we did let you get your ears pierced. You got to go rollerblading this summer. We went shopping a bunch of times. And last night you got to look cute at the movie theatre and I 100% saw you smile and happy when a group of cute boys noticed you. But yes, you are allowed to look and smile but no talking to them in real life or on social media. I got your number, and I’m keeping you on the straight and narrow! Your mommy is a pediatrician.