It’s Christmas Eve Day and I’m working just the morning shift, and then I have our Educational Time. I think this is the first holiday season I haven’t felt resentful because we all have to cover, mostly because our two kids are almost grown and life is more peaceful now. I’m grateful for every day in clinic, and to get to be kids’ pediatrician hopefully for a lot of them their entire childhood. It’s a powerful statement, that I don’t think I fully realized when I joined our HMO. Now that I’m toward the latter half of my career, I realize how rare that experience is. My patients are lucky, but honestly I’m the luckiest. I get to be part of their lives in very specific ways and to help guide them to a healthier future.
I mentor a lot of young adults, as they are trying to find out what their profession is. And I think as one is choosing your life’s work, it’s important to remember that what you choose to do and who you choose to do it with – will fundamentally change you. Getting into medical school is certainly hard, but the practice of medicine itself can be transformative. It can make you a better person and a better listener. It demands so much and certainly can burn you out (cue the increased rates of physician suicide and burn out), but at it’s core devoting your life to healing and protecting children makes pediatricians better human beings.
I’m not sure why I’m thinking these thoughts this morning? It feels really good to be back on the blog! Oh, mostly I wanted to let the internet know and some of my extended family know that I’m sorry if there are people in your life, or at your school or at your work that ever bullied you or made you feel yucky. As someone who has gone through bullying in multiple places, it doesn’t feel good and it stays with you. But please tell your pediatricians, your parents and other people you trust. It’s important to share the burden and bullies isolate their victims. But staying connected and speaking up, will defuse and 100% help the situation. There is no reason any child should be bullied in this age.
And Dr. Plastic Picker made some Styrofoam people to fight off the bullies!!!
OMG! The BLOG is BACK!!! For certain weird reasons the blog has been down for 6 months. When the blog disappeared, I was really sad. I had six years worth of thoughts and ramblings and climate work in over a thousand of blogposts just suddenly gone.
But this entire endeavor has really been about climate work and having fun, so I figured I would not stress about it too much and know that somewhere out there my internet ramblings were still out there – somewhere. I continued to do climate work, and shared on Instagram and Facebook. But in my heart, I missed this place on the virtual ethernetwork the most. Where was my blog? Where were my ramblings? Where were my thoughts?
And suddenly like that, because one of my family members who helps me manage things updated his credit card information and for $10 – by BLOG is BACK!!!
I’m so happy! But honestly I’m generally happy these days but definitely HAPPIER that I have this forum again to share my rambling thoughts on climate, children and raising kids and being a pediatrician.
Wishing our blog readership a Merry Christmas, Happy Holidays, Happy Hannukah, Happy Kwanza, Happy New Year, and Happy Winter Soltice (however you choose to celebrate this winter). An atmospheric river is coming so I’m going to go clean the street gutters around my neighborhood today. I hope you get out and do something great for yourself and the earth!
It’s 657AM and I’m going soon to jog to my parents’ house to visit my dad. He had cataracts surgery. I’m getting older too and I didn’t fully realize what happens to a woman’s body as she ages. It’s been much harder on me than I realized, knowing that I have to wear this patch and take supplements that my doctor recommended to feel okay. It’s hard to know that you are relying on something to feel like you – does that make sense?
Just here typing on the blog, and returning to where I can be me. I think there are still folks reading? But I’m not really sure and honestly this was always just me living in my own head.
Our own son wants to be a doctor now, and a pediatrician in fact. It feels so right. His father and I have told him his entire life not to be a doctor. We are both physicians. And even with that and being born during our residency and how chaotic our parenting and our lives were during the years we were raising him, he still wants to be a doctor.
I’ll be honest. I’m still a practicing pediatrician despite my forays into legislative advocacy, buying a tree farm and all the “side quests” I’ve been on. I still see patients and have to decide diagnosis and imaging, and talk to so many children and families through the day. I’m absolutely happy being a pediatrician. Every day I walk into clinic and I am so happy to be where I am. I don’t think too much about the next clinical day. I absolutely don’t dread it anymore. I just do what I’m meant to do, which is doctoring. I’m happy.
But the realization that our son wants to be a doctor too, makes me worried. It is bringing back all the good and the terrifying moments that my husband and I lived together. The journey has not been easy, and in fact it’s been incredibly hard. I am not dissuading him. I am supportive. But as a mother who is a doctor, it’s the next stage in my life that I did not expect.
I just wanted to let the readership know. It’s terrifying to me. I wish he’d pick something easier.
But he’s the kindest boy. He was the easiest baby. And he’ll make a wonderful pediatrician. He has the absolute biggest heart. But it’s understandable that as his mother and knowing exactly the path he is entering, I am knowingly . . . reflective about it all.
I can’t believe it was only 5 days ago. It was one of those days that will be seared in all our memories, when our resolve and our activism was leveled up. I remember those moments so vividly. When I first started picking up trash and realized I could make a difference. The first time I was able to identify certain shore bird species, and began considering myself a birder. The first time I testified at city council, or reached a certain advocacy milestone. The first academic paper. The first blogpost. The first grand rounds. And first premedical student admitted to medical school with climate and health on their resume.
This one was a first, and again like anything – it was organic and through natural connections and it just happened. At least from our standpoint.
My mentor Bruce Bekkar actually told me about it. He texted me and asked me if I was going, and I’m always doing so much advocacy that I was overtired and irritated. There are so many protests and things to do for environmental health that sometimes it seems endless. But Bruce reminded me pointedly that this one was important. I had honestly blocked a few of the organizers on Instagram because I just know too many people and was being asked to speak at so many gatherings that it was overwhelming, so this one was not on my radar screen. I was irritated and not sure, and our family mulled over it for a few days. The kids were concerned about climate, but honestly other political issues too. Mr. Plastic Picker had been texting with a like-minded radiologist friends about the state of the world. We were all, the four of us, despondent. Climate laws were being overturned. Public lands being sold. Neighbors being snatched from their homes. News of chaos from Los Angeles, but from San Diego – LA always seems chaotic.
And in the midst of this milieu and I was working on Sunday, I was being reminded by a wonderful friend to come – to show up at #NOKINGS. And then our family slowly together decided over several dinners and quiet conversations that we were going to show up. I sent one email to the larger advocacy group and here is the text of that email. It’s a group of almost 100 members of the climate and health community (but I made sure to delete the email addresses of those from my actual work place to keep things clean). I actually do want to keep my job, and you never know how these things are going to go.
Here are some phrases that I sent to that large listserve.
“I wanted to let you know our family friends know that we have been struggling with what is happening in the world. Everything we care for is being threatened, our community, our climate and the health of our children. I had a long conversation with Dr. Bruce Bekkar who I consider a close friend and mentor, and our entire family. These are difficult times and I realize if I’m tired and afraid (and we are established physicians and community leaders) than there are others who are afraid as well. And how in the world did we get here, and how do we move forward as a community? . . . Everyone has to make the decision that is right for their path. I have never pretended to know the path of others. I wanted to let our network know that we will be attending the “No Kings” March at the Waterfront in San Diego and Mr. Plastic Picker (who is a doctor too) and I will be wearing non-branded white coats. This is likely the single largest mobilization of the climate movement along with the broader community, but the Climate folks will be out in force and I feel the need to be there as a Climate and Health Leader. Our children will be there as they are worried and anxious about the world as well. We also donated to the march organizers (that is another way to take action). We will be cautious with safety in mind. Sierra Club and San Diego 350.org is part of the very large coalitionAgain, I am not encouraging anyone to go. I just wanted to let you know that on a very busy weekend with so many other things to do – our entire family will be attending together. If you should want to meet up and feel safer together, please reach out so we are connected.
Much love from our entire family.”
And after this message, we made it there. We weren’t sure what would happen, whether it would be safe. We hoped it would be. We are protective of our two children, and had plans to leave it case things were not peaceful. But it was peaceful and 13.1 million people showed up for our country, our community and our climate. 80K in San Diego waterfront showed up. Thinking back to that day is still overwhelming. The entire day is seared into our memories and it will be something that we shared together as a family, and together with other 13.1 million concerned Americans.
I’ve woken up in abject terror. My friend Prof Adam Aron texted me some stories and updates about the speed that we are expected to be at 2 degrees warming and what is going to happen to certain ocean currents. Some areas of the world will have catastrophic sea rise and others will be plummeted in even more frigid winters some 50 degrees F colder than now. I keep connected with him because as a pediatrician and a mother, I want to know the truth. I want to know how bad it will be. What the world will be like in 20 years (I will be about 70), if we do not act now.
But the reality of today is that it is – we are not there yet. It is not 20 years from now. And the only answer I have after asking myself so many existential questions is this – I exist. I exist. I exist.
And my children exist at this moment, and they are allowed their mother. They are allowed their mother to be present and not dwell in terror. I can’t mother if I’m terrified. I can’t climate organize if I can’t even imagine the future. And I realized this while I was texting my friend the professor. I’ve already lived through terror. I know there are forces out there that are evil. There are forces of chaos. There is no greater evil than fossil fuel companies and the rapid militarization of our world, at the cost of children and the climate.
So I realize I can disagree with my friend the professor. I vehemently disagree with him. The answer to this climate crisis is our human relationships, and that we exist together. And the webs of connection and social cohesion that make us people, that literally allow us to exist. Those were the bonds that will solve the climate crisis. We must be bond more tightly together to literally survive what is to come.
So build your networks and build those bonds. Of friendship. Of marriage. Of family. Of common vocations. Of alumni networks. Of whatever titles and branding that gives you joy.
And you are allowed to exist. And we will continue to exist if we live lightly upon this earth. I did an incredible amount of climate organizing yesterday on AMICUS briefs for Our Children’s Trust, on H3SD , on combating fast fashion, on interesting projects for students and physicians. And in those moments, I know I am doing what I’m meant to do.
I still haven’t finished a post about the #NOKINGS march. It’s half way done reliving that momentous day. And I would like to remind my friend the professor, 13 million people marched. And neither you my friend nor myself are that unique. The both of us have done an incredible amount of climate work, and can you imagine another 13 million of us now more tightly bonded and connected? You can’t predict what will happen when people meet. What thoughts are exchanged. What growth people will have, and what actions they are inspired to do next. We were both at the same march, but saw such starkly different realities. And I think between the both of us, and 13 million other people, there will be a future that will be livable. I have to project my dreams into the future. Manifesting that desired destiny is very powerful. And I have to do that for my children. Every day they give me strength to move forward.
I exist. And this morning I have to exist in the office, and see a full day of patients.
It’s 5:51am and I’m still alive and kicking! The world is kind of messed up right now. Greta Thunberg is on a boat that has been intercepted by Israel, as they’ve tried to reach Gaza/Palestine. The National Guard has been deployed to LA. I try not to watch the news too much and concentrate on doing what I’m supposed to do, but even after working the late shift – it was disheartening. All of it.
I’m not going anywhere. I’m not sure why folks are asking if we are moving to Oregon, but that is our climate bunker. We are here and advocating and part of this community. Oregon was a good investment and at some point it might make sense to migrate there, but for now – the problems in LA and the problems with our climate are our problems. I briefly mentioned to Mr. Plastic Picker around South Korea, and whether that is an option if things become unsafe. But I rethought, and honestly – I am not one of those. I’m not abandoning the only area that we know and call home. There is no where to run from climate change nor civil unrest. If we don’t stay strong, than who will? It’s crazy talk and it shows how confused the bad actors are trying to make us.
But do not be confused!!! I am not confused. I saw my patients yesterday and for the most part closed most of my charts. I have stuff to do and children still to parent. I am not being incapacitated by the chaos. If I’ve irritated by it, than there are others. I hope everyone votes at midterm elections, and that is what our family is concentrating on.
But there are more mundane things to worry about. I need to write two letters of recommendations. I need to respond to a very important email. Actually I need to respond to several emails. And I need to write an article about the Tijuana Sewage Crisis and give several talks at Harvard Medical School regarding the crisis. So this is what I will do.
Plus it’s our daughter’s last day of junior year and I want to pick her up at 3pm and have a fun SIDE QUEST! I am excited about the side quest! Just some thoughts as the national guard and marines are being deployed to LA. It’s really messed up all of it. We should have more native flowers around, and are we really deporting Mexicans and our citizens. Wasn’t all this part of the world formerly Mexico and before that it really belongs to the Kumeyaay. Maybe we should just give it all back to them. I think they’d do a better job than the current national government.
It’s June! I can’t believe it’s June! I’m sure if you see me in clinic today that is what we are all going to be saying. “Dr. Plastic Picker! It’s June! I can’t believe it’s June!” I’ll be seeing Dr. Melissa Campbell in clinic today for the entire glorious day, and I’m really happy about that. It’s June, and I can’t believe it is the last June of her three years with me in clinic. She’s graduating and going on to be chief resident beginning in July. She’s my first continuity clinic resident after having been a pediatrician for almost 20 years. I decided late that mentoring suited me, even though I had been mentoring for most of my career – because that is naturally what doctors do.
But it’s June, and everything is in full bloom.
But I’m holding it all back. Purposefully slowing down time. Mindfulness, prayer, bird-watching, plastic-picking – are all very powerful. Because they all literally slow down time. And with time, we have joy and can be effective in doing the things that we need to do.
Everything is in full bloom, but I need time. I need the year until Mr. Plastic Picker agrees to be chief of his department. A position that I am absolutely dreading. The job is literally killing him. It’s too stressful and he needs to take care of his health. I need the entire 365 days until our little one graduates, because her life has taught me so much about my own life and the world. I have no desire to see her leave me one minute sooner than she will, as she likely will go off to college away from us and away from my mothering. I need the entire 365 days to organize and to work on climate projects, interwoven somehow into my clinical work. I need the entire 365 days to be a daughter-in-law to my in-laws who are getting older, and these 20 years with them have been wonderful. We’ve raised the four of us two wonderful human beings. I need the entire 365 days to be a daughter to my own parents, to spend more time with them. We are always working our family, and isn’t it time we were just together?
I need the entire 365 days. So it’s June, and everything is in full bloom. What do I do now? I live. I live every second and every moment of this beautiful chaotic life. I get to live today. And not worry about tomorrow.
It was exactly three years ago that I decided to leave middle management and return to full time clinical work, ostensible to take over the Public Health Advisory Council Chair of Climate Actions Campaign. But it was also to choose to do things that brought me joy.
I don’t think I could have predicted how life would end up. I’m home upstairs and it’s 7:41am. Mr. Plastic Picker is at work, still on the path to chief of his department despite my best efforts to stop him from going that route. I’d rather he be chief of his own health, and just do clinical work. But he is who he is, and he still reaching for the titles. My parents-in-law are still in relatively good health, despite some minor recent setbacks. They are in their 80s, and not as vigorous as they used to be. But we life each day together. And my sisters-in-law, two of them, are here from New York and the house is full with their back and forth with their parents. At these times, I’m more of an observer than a main character – and I’m okay with that. They are here to see their parents.
But what I wanted to share today is how incredibly grateful I have been for these three years. For odd circumstances, I have been jotting down my climate thoughts and thoughts on my own daughter regularly for three years. And I have so many memories of her that are precious. Things she said. Little dramas about friends and schools. Snapshots of her creative process with her ceramics. I’m so incredibly grateful for those three years of observing her and noticing her, and being truly present for that time.
It was scary to leave. It’s always scary to take a path that is uncommon. But I never realized I would in return get to live this incredible three years.
Our daughter is finishing junior year, and she tells me she’s technically a senior now. She has a fancy digital camera and already I can see her capturing snippets of her life and her narrative voice is more powerful than mine. I think this next year I’m just going to live it with her and not document daily anymore. The reason for documenting is gone now, but the emails remain as this beautiful window into how I raised her.
She went to junior prom with her friends, and the three girls were very beautiful. They got to join their larger friend group later. And even during the climate and political chaos of the present, they get to still be teenagers in high school.
It’s 6:12am and I’m getting back to my happy place. I’m actually seeing my own doctor today, and I will ask for advice about how to manage perimenopause / menopause symptoms. It’s a common topic of conversation in the clinic these days, as I’m chatting with my patients and their parents that I’ve known for over a decade. Many of us are going through it, and it’s good to ask my actual doctor advice about what to do. I’m taking a much needed planned sick day, and I need to get my COVID booster as well. I will try to do that in clinic. I’m hoping I can get labs done as well. It’s a very busy weekend and the next few days. But it’s good to take some time to reflect and remember all that is happening.
I’m trying to run a mile a morning when I can find the time. I think to myself, “I can give myself a mile.” I’m thinking about my heart and my health. I’m taking fish oil here and there. There is a bottle in the middle of our kitchen table, and when we sit down to eat – Mr. Plastic Picker and I at times will take a gel capsule. There are 145 capsules in that bottle, but there are still many capsules left. It shows you how often we don’t eat together and that we aren’t mindful to think about our own health. But we are trying as we are also working toward a sustainable future for our children. And want to actually be alive for our grandchildren.
Part of that work in making sure we have grandchildren, is helping an amazing friend and climate advocate and pediatrician organize the District 8 heat summit. I’ve been calling it the heat summit, because the one in San Diego is named H3SD San Diego’s Heat and Human Health Summit. But my friend QT Nguyen, who is also a Harvard grad and a friend through the Harvard Vietnamese Association (although we are friends through many more things than that), has named it “From Extreme Heat to Fire: Disparate Effects Through the Arc of Human Health.” I’m fully appreciating the name, as it’s so – her. Bigger, more dramatic, and more eloquent than our straight-forward name. And honestly the name is apt. It’s scope is broader. It’s ask is bigger. The audience is grander.
QT. Honestly when I suggested you do this, I had no idea it would become such a massive thing that is so hopeful and wonderful for the earth. I don’t think I quite understood how your brain works, and how organized and energized it is. I had no idea that you would be putting me to work! Which I’m excited about, especially learning the new skill in successfully moderating a summit session. I brought along these wonderful premedical students from the UCSD Academic Internship Program and an amazing student from UC Berkeley, and that was what you needed to help you get this massive thing done. Where there is a will, there is a way. And your will and want of a livable future for your two beautiful daughters is so very evident in what this event is turning out to be.
I had the program printed out and was reviewing the times I needed to be present, and thinking out loud about what I needed to do and say. I brought out a highlighter and a pencil, and started making notes and writing down thoughts. I thought this would be an easy thing to do, but it was incredibly difficult for you and me. Thinking back to the number of virtual meetings we did, and trying to catch up with what was happening – I’m amazed that it all came together. I don’t think the students fully understood as well. But it’s all been so incredibly invigorating and fun, and hopeful.
I haven’t been blogging as much but today was an important day to document that this amazing thing is happening. It’s connecting the entire District 8 of the AAP, and myself and you, and you to your UCSD roots. It’s connecting a lot of like-minded folks that will synergize and further the work that they are doing.
I had no idea that this event would be this awesome. And honestly I always knew you were amazing, but now I know the full extent. I’m glad the admissions committee back decades ago accepted this petite Vietnamese girl from Orange County into the Harvard Class of 2001. I’m so glad I met you and became your big sib through Harvard Vietnamese Association. That we ended up doing BRYE tutoring together, PBHA and lived in the same house. Who knew that almost 3 decades later, we’d need each other to save the actual earth. When there is a planetary code, you call on the best and your friends. And I called on you, and you came. It’s amazing but brings me to tears at times. Who knew it would get this bad? We were so young back then, and now we are older and need each other to help save the climate for our daughters.
That is the only way I can describe it. For the last 3 years, I’ve been involved in so much pollution work and on social media sharing this journey. I think part of the reason for my overall state of health may have been poor sleep, too much netflix and a large part the normal body changes of peri-menopause and menopause. I’m still working pretty much full time and no longer giving away those extra shifts that we are asked to work (although it’s manageable now – or at least a bit more). Patients are more sick due to air pollution (wildfires and Tijuana Sewage hydrogen sulfide gas). So the only way I can describe my mental state when I seemed happy (and I was) but a bit scatter brained is that my mind was fracturing. I did an epic trash art piece and it’s private and I won’t share it here, but it shows you how fractured my mind is right now.
So like any good physician, I heal myself. So how am I healing myself. I am learning to say no. I am saying no to additional speaking engagements that do not bring me joy. I am saying no to additional students since the ones we have are more than enough. I am saying no to some on social media that have formed an attachment to me that is not healthy for me, because I have never sought to be their physician or mentor.
I am saying yes to the UCSD Academic Internship Program, which formalizes some of this work that I’ve been doing. This also enables me to say no to students from other universities. I really am not responsible for the entire state of California. I am saying yes to running 1 -1 .5 miles in the morning. I took a break this morning, but the last two morning I have run 4-6 times around the block. I can run a mile. All of us can run a mile. It has been really good, and I’ve incorporated some stretching as well. I am saying yes to having coffee/matcha with students here and there. I am saying yes to holding my daughter’s hand. I am saying yes to cooking again, and thinking about muffins and berry breads that bring me joy in the morning and feed those I love. I am saying yes refocusing on my finances, because my time is my money and it seems like there are constant asks for money. I am here to help the earth and not the finances of students or other physicians. I don’t understand why folks don’t understand that. If you tell me your parents have worked as many hours as I have and Mr. Plastic Picker and his parents combined, than I may consider. I highly doubt it though. Your parents can work to pay for your school since you are clearly an upper middle class student. There are many more students worse off than you.
I am saying no to those who want too much from me, and need to contribute more to the earth. I am saying yes to new experiences.
And I needed to tell those who read this blog. I am amazed that there are more and more, despite my not blogging much these days! Thank you for following along this journey. I forgot that the most important thing I can do is to inspire. And it’s not the quantity of those that I can inspire. It’s those key folks out there who see what I am doing, and believe they can incorporate some of my workflows into their lives. Mostly other physicians and pediatricians.
And for those fellow physicians, you understand that again I can get burned out. That this work can take it’s toll, especially when you are in the middle of so much pollution and so many who are looking for leadership.
But having our daughter keeps me grounded. She (and her brother) are my climate why. And it’s always been about having some sort of livable future for them. But I need to spend time with her now, and it’s my turn to hold her hand and celebrate her wins. There are other pediatric climate and health advocates out there, but I am her only mommy. When my mind was fractured, I would zero in on her. On her life. her journey. Her art. Her beauty. Her innocence and every day left of being sixteen. She’ll be seventeen soon. And honestly that is the most important thing in the world to be now. I remember when she was just born and there was the real fear that she would not come out of the NICU a healthy baby. And now she is 17 and wants a cake that has a dancing queen on it.
Saying no to some things. Saying yes to others. Means I remember she asked for a special cake for her birthday this weekend. 17 and a dancing queen. And haven’t you been an absolute miracle child and you won another national award. Mommy loves you so much. Thank you for being my baby.
