January 11, 2023

by Dr. Plastic Picker

Last weekend was the weekend of the Creme Puffs. Our baby (who is 14) decided to make 150 creme puffs. These were hand-made and hand-delivered by said 14-year-old. The creme puffs turned out wonderfully, but all the recipients were not exactly who were planned. We let our natural relationships and who actually likes creme puffs and who lives near us and who responded to emails timely, dictate to whom the creme puffs went to.

She thought the creme puff baking experience and delivery were disappointing, but now that we are a few days from the actual creme puff delivery – all I can say is that they were an absolute success! The actual creme puffs were light and airy and delicious. And unbeknownst (did I really use that cool word) to her, the intent of the creme puffs reached their destination and there is a lot of humor and good will between two families right now. The actual children are not really aware, but two families are aware. We are at a good place in our family pseudo-kdrama, waiting for two people to go through the pangs of adolescence.

But the entire creme puff episode reminded me that even creme puffs are a lot of work! I thought Mr. Plastic Picker and I were destined from the first meeting, but I had forgotten the years of friendship and all the encouragement and support our parents and friends gave us. We tend to recreate our own narrative, and I had written out in my mind all the others that supported and encouraged our relationship on the way. It’s funny the perspective the decades gives you.

Raising teenagers that will embrace adulthood and meaningful work and meaningful relationships is a lot of work as well! I think Mr. Plastic Picker and I are doing a decent job of things as we get our son through his senior year and our daughter through a more challenging freshman year than we expected (not academically but the entire social dynamics of being a teen girl). They are two funny and loving teenagers, and their lives are more nuanced and complex than I ever understood. But I love having the time to hear the changes day by day, and witness them and sometimes participate in their lives. These teenage years is absolutely absolutely beautiful. And one of the joys that climate work has given me, is being more present for them – more present to see the adults they are becoming. The particulars I’ll keep close to my heart. I have a rosy view of the world these days. Remember I’m the litter-picking pediatrician that believes I can save the earth (along with you), so of course I believe in the happy ending of the 100+ episode family pseudo-kdrama. Allow me my dreams dear reader, it keeps this climate activists going. And they are innocent and actually I think helping everyone.

But yesterday was an epic climate day. We had our first meeting of the 2023 Public Health Advisory Council for Climate Actions Campaign. I’m still trying to figure out my leadership style, or my co-leadership style with Dr. Katie Crist. And at the end of the day, the results are the truth and we had an engaged and dynamic PHAC meeting. So many beautiful faces and talking about advocacy. Our group feels closer together, and we have a lot of shared projects that we are doing. PHAC is going to gather at our home soon to talk climate and health, and eat vegan food!

Also yesterday I pushed forward the shared event with San Diego Audubon Society and our HMO. It had been in the back of my mind, but at yesterday’s meeting we hashed everything out and I think it will be easier than expected to bring our two organizations together to help with the upcoming Least Tern nesting season. More to come!

And the youth and climate art exhibition is going very well! The premed interns are really knocking it out of the park with their work. So proud of them. Hopefully today I can find a gallery space for us to show the children’s work.

Doing a lot of climate work here. I didn’t go to an HMO department gathering where it sounds like there was a lot of fun to be had. But honestly I have no regrets and don’t think about it much. It honestly did not sound that much fun to me, and I’d rather spend time with my own teenagers and I have more than enough friends in my life and don’t need anymore – especially if they aren’t climate friends. So I didn’t go. But I’m honestly glad everyone else had fun. Middle-management meetings seem so far away these days. I’m happy I’ve drifted off to climate work, which I’m much more suited.

Happy rainy day to California. I’m off to take care of some minor medical/dental things as I need to take care of myself so I’m taking a preplanned sick day!!! Yes I am. And you should too! We get dental coverage for a reason, to take care of your teeth! You don’t have to have a sob story to explain taking a sick day. Your health is your business so take care of yourself! In my world, no explanations needed. I trust you to love yourself.

January 8, 2023

by Dr. Plastic Picker

I remember when we adopted our two bunnies six years ago, they were a bonded pair. They were bonded at about 2 years of age, and stayed bonded until Bella just recently passed away a few weeks ago. We are worried about Peter, the boy bunny, as he is slower than before. Bella’s passing was unexpected as we thought she would be with us until our youngest graduated high school in about three years time.

I don’t have many regrets in life, as I think our paths are meant to be. I don’t ever think you meet the wrong person, and the universe has someone destined for you. And Peter and Bella were destined for each other.

One of my few regrets in life is that we never officially had the bunny wedding we were planning when we first adopted our bunnies. I was then, and am still now, a fairly traditional person. I believe you should love who you love, and I believe in marriage equality but I believe in marriage. And my one regret is that we never gave Bella and Peter, the spring bunny wedding – I always wanted to organize!

RIP beautiful spunky Bella. I didn’t have time to make sure you were a beautiful bunny bride. We are taking care of Peter though, and we did take him to the vet to make sure he was okay.

January 5, 2023

by Dr. Plastic Picker

The entire thing is beautiful. The UCSD premedical students involved. The collaboration with other states and climate and health advocates, now Oregon and Missouri and New York. Reaching out has been so powerful. Reaching out on a shared project that has been meaningful, has been an exercise in building community. Connecting premedical students and future physicians throughout the country, and re-energizing exhausted pediatricians deep in the weeds of climate work, has been partly my goal in this project. I always tell everyone, I 100% don’t know the answer to solving the climate crisis – but I know the answer includes you.

And that you – included the children that we are doing this for. In the end the title of child advocate is special. And as a pediatrician, we have the preservation of life as we know it on earth for our children and grandchildren as our goal.

Just typing away my thoughts here so I can sort through them, and move through the projects. Our leaded aviation paper was accepted through the Journal of Community Health. I am so proud of our team, but in particular Riley Gilbertson our premedical student. He’s been accepted to several very good medical schools, and I’m so proud of him. And the fossil fuel divestment paper is about to be submitted one last time to Pediatrics, and it is so good. So very well written. I am proud to have added a few key sentences and ideas to the writing of that paper.

I’m still having silly thoughts of our family’s pseudo kdrama. But I know they are silly, and I’m tucking them away. But when a climate advocate begins to dream of her future grandchildren in the many possibilities of what they will be, than you know there is hope. Hope through action. Hope through community. Hope through taking at least one action every day on behalf of the earth.

January 1, 2023

by Dr. Plastic Picker

Yesterday was an epic day. There are two doctors in our household, although I’m the only Dr. Plastic Picker, and one of those doctors had diarrhea and it wasn’t me. The reason it was an epic day, was because the diarrheal illness for that other doctor in our house, started off with excruciating generalized abdominal pain. This particular doctor has been through back surgery so I know this doctor has a high pain tolerance, but he called 911 without his Dr. Plastic Picker wife knowing during that early morning bout of abdominal pain.

What ensued was . . . memorable. One ambulance and one firetruck arrived to our house in the Pacific Beach area. The lights were flashing but thank goodness the sirens were silent. I had done a quick assessment of him when I saw him laying jesus-like in the foyer in his San Diego-style sleep-wear, moaning in his pain. It was generalized and a bit left sided, and his appendix was fine. Despite his prostrate position and my deep love for Mr. Plastic Picker, I told him “I can’t believe you called them! I can drive you to the ED. It’s 100% infectious and likely gastro.” He then at some point ran to the bathroom, and nature took it’s course. But by then the four tall good-looking EMT/fire-fighter people were nearly at our doorstep. Thank goodness I had the where-with-all to have put on foundation and drawn in my eyebrows (that had disappeared sometime in the 90s). My husband at some point returned to his prone position, but he confessed later that he was already feeling better. I helped him to the ambulance and the EMTs with training less than the 20 years we have been practicing medicine, reassured the still very handsome Assistant Boss of a specialty department that he had the best vitals that night. Outside the ambulance, the very imposing firetruck was also parked in front of our house with very good-looking young firefighters. I told them in my exasperated middle-aged Asian wife voice, “He’s fine. I checked his appendix. He has a very high pain tolerance and I think he was just scared of the pain. It’s probably gastro. He’s the chief of radiology!” Which is not true because he’s the Assistant Boss. But I was having fun playing my outraged role. Maybe in the back of my mind I knew I would be recounting this at some point.

In the end, the firetruck with the two handsome firefighters drove away. The ambulance with the equally handsome but slightly shorter EMTs let the doctor with diarrhea out of the ambulance, and his wife (Dr. Plastic Picker) walked him back into his house with the 15 year mortgage and low interest rate. His wife then ran back and gave the two young EMTs random unopened chocolate gifts and wished them a Merry Christmas and Happy New Year and sheepishly apologized to them. They were gracious and said, “it happens all the time ma’am.” And smiled very nicely and respectfully toward me.

The doctor that had diarrhea continued to have a few more bouts of diarrhea through the day. He still went to work to his solitary office, but likely spreading his diarrhea germs everywhere. At some point, he texted me and said he walked himself and his diarrhea germs to the emergency room to visit his ED friends and get himself an IV and some labwork. Said labwork made no difference in his clinical course, but it made him feel better.

And then at some point, he came home to greet his parents who had to take an Uber from the airport with his niece from New York. The niece is visiting from New York and that makes our children very happy to have some of that new york vibes soaking into our San Diego home. Plus she’s a cool college Sophomore. But as we were sitting and having dinner, the doctor with diarrhea was sitting in a slightly raised chair about 2 feet away from the main table and wearing a mask. Why he was wearing a mask, I’m actually not sure. He should be wearing a big diaper instead. LOL.

The doctor with diarrhea is my dear Mr. Plastic Picker and he was a big baby yesterday. But at some point after the ambulance left and before he went to work to spread his diarrhea germs, he recounted his lived experience as a doctor with diarrhea and his perspective as the patient who had panicked due to the pain – laying prostrate on the ground. And we laughed and we laughed. And in the back of my mind I thought, I hope this laughing doesn’t increase his intraabdominal pressure and a little bit of diarrhea comes out and makes me sick.

LOL. LOL. LOL.

December 31, 2022

by Dr. Plastic Picker

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

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

December 26, 2022

by Dr. Plastic Picker

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

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

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

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

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

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

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

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

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

December 23, 2022

by Dr. Plastic Picker

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

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

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

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

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

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

December 19, 2022

by Dr. Plastic Picker

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

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

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December 14, 2022

by Dr. Plastic Picker

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

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

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

December 13, 2022

by Dr. Plastic Picker

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

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

Most of the fuels used in the cement manufacturing process, such as natural gas, coal and petroleum coke, emit planet-warming gases. Unlike other industries, the cement industry cannot rely on most renewable energy sources to power its operations due to the extremely high temperatures that are needed for production. That’s part of the reason why the industry is making the switch to alternative fuels that consist of recycled waste products.” https://calmatters.org/environment/2022/06/california-cement-carbon-climate/

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

At some point, you have to take a stance. You have to say enough is enough. So today is the day our group San Diego Pediatricians for Clean Air speaks up and joins multiple groups lead by SanDiego350.org and Environmental Health Coalition to speak up for this neighborhood.

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