June 28, 2022

by Dr. Plastic Picker

It’s been a minute, hasn’t it? When I began blogging I found so much freedom in being able to write into the internet ether. I remember the first November, I was blogging up to sometimes twice a day. It was cathartic and it meant freedom for me. Freedom to vent. Freedom to create. Freedom to be silly. Blogging is also written in the first person narrative. I am a blogger. I am Dr. Plastic Picker. It’s mostly all about me, even this eco-avatar is still me.

And having that “me” time, oddly allowed me to be the third person narrative at work. I stopped talking about myself as much, because I was finally listening to myself when I was blogging and creating. And now during clinic, I listen more attentively. Being the third person narrative at work, has been life-changing.

I was with a mother yesterday in clinic, who I have cared for through three different partners. I have been the stable part of that mother’s life, the person who cares for all of the children’s medical needs in this complex blended family. Sometimes when families are torn apart and then blended and torn apart again, the medical problems get more complex. Referring to specialists, getting more labs, recommending new wellness classes, talking about recipes and vegetables and screen time – we together are only scratching the surface. But over almost a decade, I’ve been there for them. Even when I myself was going through burn-out and just making it as a young mother doctor, I was there for my patients. My patients never suffered. Adding them on when the schedule was already full. Pausing and taking that extra moment to suggest something new on their road to health. And now that I’m better and able to really listen and be the third person narrative, I realize that part of what families really needed was me. They need me to listen and to witness.

So that is what I did yesterday for this mother. I just listened and I finally understood better what was going on in her life and her narrative. The core of what was the cause of the different partners and the severed families. She was understanding herself. The patient in front of me, the toddler, is just beginning to learn her words. And what she says is filled with emotion and tangents and loose associations. It’s coming out garbled. She needs therapy. And it’s a metaphor for how the mother’s narrative came out garbled and in phrases and sentences and actions over the decade that confused me, and didn’t make sense. But the mother is learning the vocabulary and the words. And then she can teach her daughter along with the speech pathologists and the therapist, so that that child can also clearly express herself.

I listened and took the time yesterday. I didn’t think about the green dots that are annoying sometimes, and remind me other patients are waiting. It turned out no one was waiting and I was on time at that part of the day. I can read body language well being a pediatrician for almost 20 years now. She didn’t need a hug. I put my hand lightly on her right shoulder in comfort. I kneeled in front of my little patient and at eye level, thanked her for coming it and waved good-bye with two hands. And during the visit as we went back to forth in a somewhat garbled patient visit, we figured out the next steps. I said sandwiched in between us trying to figure things out together, “I’m proud of you. My general impression is that you are starting to reach out. You are reaching out and forming your support network. You came today and I’m lucky to be part of that network. I’m proud of you for breaking this cycle of abuse. You will end it in this generation.” What a remarkable narrative I witnessed yesterday.

June 16, 2022

by Dr. Plastic Picker

Hey Rachel. We miss you a lot. All of us miss you. A bunch of emails are going around the department listserv and people are saying memories and their goodbyes. Not much grand-standing or politiking, I think because most of us know you could not stand that crap. I haven’t replied to the email chain because it seemed so inadequate. I posted a cryptic message on Instagram that was heartfelt and Saadia saw it, and replied. Gosh, you’ve left such a big hole in our department. For those that don’t know me in real life, one of our colleages a well respected pediatrician died after a year and a half battle with cancer. She was young.

Thanks for letting me interview you for my blog a long time ago. https://drplasticpicker.com/dr-rachel-guest-pediatrician-and-nature-defender-5/ You were nature defender, pediatrician #5. I hadn’t interviewed many people after you. I think because you were a hard act to follow.

I was in the nurses triage room at Otay, and there is just a bit of quietness. They all worried about you, asked how you were doing. I never really knew all the details of your illness, and I know that you know – it’s because I didn’t want to overstep the work/friend boundaries. I don’t make friends easily. You knew I was there when you needed me. Jong and I emailed a final message to all the nuclear medicine doctors that helped you get those PET scans scheduled asap. I knew you knew I was there when you needed me. I thanked them for you, and included a short few senteces about how much you meant to all of us and the kids you took care of.

It really sucks. #cancersucks I can think of many other people I’d rather died of cancer than you. I’m being morbid and dark now, but you understand I know. We vented a lot together. You called it how it was. But I have to say that at those migraine-inducing early morninng leadership meetings with all the clinic leads, you always seemed a glass half-empty kind of person. Don’t get me wrong. I’ve always been your biggest fan, but you were kind of intimidating. Remember when I sent you a sketch of how I thought we could fix afterhours with mock schedules for the 3 urgentologist. OMG, your response was fierce. You essentially ripped me to pieces. I almost peed in my pants! That is true. I mean you trained at Wash U one of the best pediatric training programs in the country and one of the few people at our HMO who knew who Will Keenan was. That man was scary and you survivied a training program that had that brilliant pediatrician questioning your every GI decision. I bow down to you Rachel. You are a better pediatrician than me, which given how fundamentally arrogant I am – is saying a lot.

But your battle with cancer showed me that you aren’t a glass half-empty kind of person. You were tenanciously holding onto life and hope and fighting this cancer injustice every step of the way. It was really passion you had. I was telling Melissa in the lunchroom yesterday, she’s not doing too well by the way. But I was telling her that you were fierce.

What I will remember mostly about you is how fiercely you fought for the young doctors. You advocated for them. You cared so much about them, that you made the rest of us with any sort of decision making responsibility – care as well. I think that is why there is a quietness when we are all thinking of you right now. We are reflecting on how you fundamentally made us all better. This is not a platitude when written about you. It is absolutely true.

This is my blog goodbye, my friend. I’ve cried so much for you. I don’t know what it is. Maybe it’s all those beach walks. We never got to pick trash together as we talked about. Thanks for being there for all of us doing this climate work. Co-signing all those letters. Being there for moral support for us. I’ll be seeing your family still, and I’m so lucky to know that I’ll get to watch your nieces grow up. Your family are environmentalists, and intertwined with mine as we try to save the earth. Your niece is beautiful by the way. I always thought you were beautiful and thought it was a shame you didn’t have daughters yourself, as they would have been beautiful. But you did have children, your nieces, your patients, and all the young doctors that you helped mentor. I’ve written this last blog post but I will repeat it again. There is no way that souls aren’t recycled. Everything is reused in nature. I think you will be reborn as this graceful egret, it reminds me of you. Lets meet in the next life and work together again. #cancersucks and you are a work friend that changed me and made me better. I can’t imagine the pain your parents are going through now. You were their baby girl who has died before them. But I hope in the next life, you will be again their daughter and the brilliant beautiful fierce person you were in this life. Good-bye my friend.

by Dr. Plastic Picker

I’m almost at bag #700 to my #1000 goal! This month I gathered 13 bags for a grand total of 694. I gathered #11 items for a grand total of #1920 items. I’m going to dispense with the table format today. Next month I’ll be more motivated to do that.

Mostly this blog has been to keep myself accountable to the ether of the internet and blogsphere, as a fun way to keep myself motivated. I never dreamed that I would have sometimes up to 1000 unique visitors a day to this “Personal Environmental Action Blog.” But this morning was proof that this blog has meant something to me and meant something to the world, as frugal pediatrician me paid $110 a year to protect the blog against Brute Force attacks. I guess I’m a moderate sized website that deserves this protection. The blog pieces are my thoughts and my environmental journey, and a real facebook friend said that as a cherished hobby – I should spend the money. So I did.

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June 8, 2022

by Dr. Plastic Picker

Savings the earth and picking up plastic is my hobby. I don’t get paid to plog (picking up plastic and jogging), and I don’t get paid to be a climate and health advocate. I get paid to take care of patients in clinic, and that is it. This blog is non-monetized and purposefully so. I remember back when this all started and Mr. Money Mustache’s blog people approached me about monetizing things, and I stuck with my origianl purpose. I’m an environmental hobbyist and I’m totally into it.

But like most hobbies, it cost money but I want to make sure it doesn’t break the bank. I try to mostly donate money to other environmental organizations like Rainforest Trust, Eden Projects, EDF and want to make it cost effective. The blog cost $25 a year for the domain name. Blogging is fun for me. It’s my environmental journal. But now my silliness is under brute force attack. Not sure what they are looking for on the blog? But it is, and I hadn’t realized it’s sometimes 800K attacks a day. There is an option for $110 a year to install a plug-in to protect this site. I’m not sure how much protection it will provide. I’m going to ask around, but it just brought up the issue of finances.

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June 7, 2022

by Dr. Plastic Picker

I’m watching this current K-drama that I told my friend Dr. Sandra Gee about. She’s my green pediatric climate friend up in University of Rochester. It’s about an alien that arrived to Earth specifically Korean 400 years ago during the Joseon era. He stays for 400 years because he was stranded due to his fated love, who dies with arrows in her back as she sacrifices herself for him. Of course he is a very handsome alien of the Korean-persuasian. And now he is in our modern time, ready to leave earth 400 years later but waylaid by the reincarnation of his fated love who is now an A-list Korean actress.

The current K-drama is kind of silly, but I like it and I get to learn new korean words and rewatch scenes as I practice the conversations. This sillier K-drama works for me, because it’s not as addictive as the really excellent ones like “Descendents of the Sun” or “Reply 1988.” Those were really really good, just good story telling and better than anything I’ve seen in English. The non-addictive nature of the current K-drama is really good for me, because I went to bed on time and now I’m up blogging. The blog traffic is really going up. I’m not sure who is reading but it’s just me – Dr. Plastic Picker, former Assistant Boss and now just almost full time (technically 80% time) pediatrician doing volunteer climate work outside and showing up where I should.

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June 2, 2022

by Dr. Plastic Picker

It’s 540AM and it’s been a few moments since I got up at what is my natural wakening time to blog. I’ve been binge-watching Kdramas for the last few months, in between my climate work and work work. I have enjoyed it immensely and my Korean is a lot better now. The longest Kdrama with “The Young Lady and Gentlemen” which was over 50 episodes. It was kind of getting ridiculous when the main male lead gets amneia for the 2nd time though! Let’s just say my family and Mr. Plastic Picker have been staging an intervention(s)! If anyone from work is reading, certain nursing friends of an Asian-persuasian are not helping the matter by encouraging my addiction LOL. It’s fun to talk about our latest show and current Kdrama boyfriends at work. This is the life of a middle-aged happily married litter-picking pediatrician.

But one of the things that awoke me this morning from my slumber having slept deeply and restfully, was the morning birdsong. The backyard birds were signing this morning. “Arise Dr. Plastic Picker. Arise!!! You have earth work to do!” And with that, this is absolutely true. I have earth work to do. Besides a half day clinic or work work, where I was happily chatting with patients and teaching my little patients how to be little doctors – I also had three phone conversations that were climate related. Those were important conversations with two of our premed interns, setting them on the right path on their various projects. And one with an MD/PhD student who works with us on one of our climate groups, and manages our new twitter account. I’m not on twitter, but I guess I need to be.

So the birds woke me up this morning, and I need to send a good number of climate emails this morning. Single-use plastic reduction project. AAP resolution on single-use plastics. Several emails to the San Diego Audubon Society. I’m also going to make Red Lobster biscuits for the kids’ breakfast. I need some cooking inspiration and I just grabbed one of their biscuit mix boxes at VONS. Red Lobster used to be the fancy fancy place to eat when we were young. I still think Red Lobster is really fancy.

Awoken by the morning birdsong this morning, and will spend another hour doing climate work before work work. I hope the birds were singing to you also this morning. If not, likely we need to add some green space and native shrubs to the built environment around your house.

May 30, 2022

by Dr. Plastic Picker

Good morning dear readers! I’m back from an epic few days up in Oregon. I don’t fly lightly but it was a combined brief vacation and working trip to try to figure out our Oregon farm. Stay tuned as try to figure out what I’m labeling CPR Cow’s Creek Professional Rescue. I’m forming a board of directors, and working with a friend on curriculum right now. It’s a fun dream and we are making this dream a reality. Mowed a few acres of pastureland. Roamed around the forested lots on the Polaris, and saw how much nature is in these timber forests. Family of deer, temporary wetlands with water fowl. We know there are bears and cougars and foxes. That large predators are on this land is to me heart-warming. So I’m trying to preserve this land but make it cashflow in our capitalistic society. I believe in responsible capitalism and democracy, and I think I can make this work.

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May 22, 2022

by Dr. Plastic Picker

It’s 820AM and Sunday morning. The two teenagers are fast asleep. Mr. Plastic Picker had worked 3 extra overtime shifts Saturday, and then within the last 20 minutes of his shift (which he did telemedicine from home) was called into the hospital to do an urgent procedure. This kind of put a wrench into our plans as a family to have dinner. He was slightly annoyed and had to throw on scrubs and leave the house. We were planning on going to UTC in La Jolla for some window-shopping and dinner. The teenagers watched another English period drama episode they are watching together, and I waved him off standing in the front yard as he drove off in his old trusty Prius. When you are a young doctor newly getting paid to save people’s lives, the paging and the immediacy and the hero-worship can be thrilling and addictive. But for us well into middle-age and having been doing this competently for over 15 some would say 20 years, it gets old. It gets old – really fast.

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May 19, 2022

by Dr. Plastic Picker

It’s 454 AM and my body is coming along. I was in this daze of binge-watching some really good Kdramas and not getting enough sleep. The broca wernike area of my brain is so enjoying the Korean-language dump, and also the heart-wrenching story lines – that it was getting kind of ridiculous. If you know me in real life, any of my clinic friends will tell you – it was kind of getting obsessive. But I’m an adult and generally healed, so I turned it off to get some good sleep yesterday.

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by Dr. Plastic Picker

I just have a few minutes before we start off for the Rewild Mission Bay site. It’s been months in organizing, but we are bringing together an interesting group to the Kendall Frost Reserve for a nature-based session on education, land-restoration and wellness. I’m hoping that moves the needle locally to help build organic support to Rewild Mission Bay. I just submitted an article to Sketches, the San Diego Audubon quarterly journal, and my perspective as a pediatrician on the Rewild efforts. I spent a good amount of time on the article, and the response for the editors was gratifying. They have accepted it and will need just minor revisions.

But here at Dr. Plastic Picker, I understand the math. I understand the climate change math, and it doesn’t add up unless we divest from fossil fuels. Yes I pick up plastic but I know that divestment, even if it’s a pie in the sky effort, is something we need to do. SB 1173 is coming up and the environmental forces are mobilizing. The AAP California State Government Affairs Committe on Environmental Health and Climate Change has already signed on. But the vote will come up soon, and I’m trying to do my part in the state to activate lobbying on the grassroots level.

I’ve already forwarded the toolkit to folks, and organizing health care voices. After we return from the wetlands today, I’m going to leverage all the environmental connections I’ve made to try to make this happen. I never thought I’d be one of those that knew about bills and committees and an expert in lobbying. But I’m at that point now. I’ve done it enough, and I’m proud to lead the effort.

If not me? Who? If not now? When? Adults and pediatricians, we need to take a stance. It’s now or never. Here we go. SB 1173. Time to go for the most impactful actions. Divest from fossil fuels. Our HMO pension and also the CalPERS and CALSTERS.