June 18, 2023

by Dr. Plastic Picker

I’m still in the whirlwind of climate work, and trying to still do this massive thing which is get H3SD San Diego’s Heat and Human Health Summit to happen. It’s definitely going to happen, and I’ve learned to listen to other climate advocates/activists, myself, and the earth to let this thing happen. I am more mindful of myself these days, as the last month was an absolute whirlwind of going to DC for the Kaiser Permanente and World Economic Forum Launch of “Connecting Climate Change and Health.” I still haven’t processed it all, and I’m not sure if I ever truly will. It was a moment that I realized I needed to be there. Traveling to DC for such a short trip and the massive emotional output and carbon output that trip entails was worth it, because it was part of the larger national conversation on climate change and health.

I was emailing someone at UCSD that I think of us as an ecosystem of climate activists, and each of us playing a different yet vital role. We are all interconnected to address this existential crisis. But as with all organisms, my own organism which is my body needs to rest. I’m not doing the furious emailing as much as many moving pieces are already in motion. We have about 2 months until the H3SD summit and an op-ed should drop soon this week regarding heat waves and human health. My name is not on the op-ed, but I had a big part in putting the writers together and they took it and ran with it. Another two op-eds are in the works that will hopefully drop in the LA Times, one on fossil fuel divestment and the other on lead pollution in k-12 drinking water. My name is on one, and the other is a team I helped put together. And then the breakout sessions for the H3SD San Diego Heat and Human Health Summit are mostly teams now linked together at least by email. They’ll figure it out, the hour they have to get things done. I’ve initiated the CME/CEU credit process already through our own HMO, and that has been a huge benefit and promise to those that are taking time out of their busy schedules to help make this happen. We should at least get some CME /CEU for it at the same time. If this summit doesn’t have educational content, than I don’t know what does?

I’ve been pushed to rethink about how we address fossil fuels, and Prof Adam Aron in an intense conversation advised that simply changing our personal banking over to Credit Unions has a huge impact https://aronclimatecrisis.net/. So I’ve started looking into switching some stock funds over and how to move things to ESG funds. I’m already trying to unravel our banking to move it away from the big funders of fossil fuels especially Bank of America and Wells Fargo. Step by step. We’ll get there. And at least my collective patients and children of the planet, and my own children know that I’ve been trying.

So I saw a big dead sealion on the beach and it was very shocking. I think I’m going to try to head over there to see if it’s still there. I need to pick up coffee grounds from my friend and drop off some lemons anyway. So I’m off my friends! Just wanted to let you know that I’m still fighting for us and our planet, but I need to be reminded of the why – which for me is when I go to the beach and get healed by the waves and the beautiful nature on this little stretch of the Pacific Ocean called Pacific Beach.

June 8 , 2021

by Dr. Plastic Picker

Good morning dear readers! I’m back from a epic less than 36 hour trip back and forth from San Diego to Washington DC. It was an epic and carbon spewing trip. Quebec/Canadian wildfires caused the Washington Monument to be clouded in smog. But I had to spew carbon to help address climate change. It’s the paradox of climate work. But I had to be there because of who I am and where I work, and the earth called me to be there.

I’m typing this and watching the recorded live-stream broadcast at the same time. It was epic. The room in DC was packed and it was live-streamed by over 115K viewers. Likely many of them were internal within my own health care system. I’m honored to have gone, but know I did something big yesterday by playing my role and talking about my climate work.

But honestly, what did I want to let you know? I literally sat next to the Vice President of Mars, and he isn’t a martian???????!!!!!!!! LOL. I thought I was more popular than the Vice President of Mars because I got to tell over a hundred thousand people that I was a plogger!!! That was so much fun! I also told them very briefly about my journey and about H3SD San Diego Heat and Human Health Summit.

I’m grateful to have been there and got to tell my friends via email all about my adventures. I have that on record in my emails. I also received my new favorite reusable water bottle. It’s really nice. You can see it on Instagram.

I think that might have been my peak. The Green Dragon has been awoken. I think I helped wake the Green Dragon that is our health care organization a bit earlier. I still have more projects to work on, but it was hard for me. It was absolutely hard for me to go there and be away from my family. It’s not easy for me to be vulnerable and put myself out there. It’s not easy to put oneself out to be judged. It’s not easy to try to balance telling everyone about my journey and never getting to say the word “fossil fuels.” It’s not easy to use precious vacation days to travel out there, literally probably over $5000 of my own time and funds to be there and pay my own way because my time is valuable when at times I feel nickle and dimed by some. But I have the big picture in mind, and I have so much love for the place I work in a global sense. It was not easy, but I know it was where I was meant to be. I absolutely was in the right place yesterday and helped set the tone of hope for the room.

I don’t think I’ll be back there. But I’ll continue to work on climate in a smaller way. I think Dr. Plastic Picker may have peaked and I’m glad. I really am tired and I need to take care of myself. It was absolutely fun but in a “I can do this” not “true joy” fun.

But what was really fun, was this interview I got to do about wellness and decompressing. I really like Joshua Fitch from Contemporary Pediatrics! He is so nice. The Vice President of Mars was nice. But Joshua, was awesome!

June 4, 2023

by Dr. Plastic Picker

It was a big day for our entire family yesterday. For my real-life friends you’ve seen it on Facebook, all those senior moments that led up to graduation. Knowing that I’m his only mother has given me permission to take a break from climate work to do all those things that only I can do. Mr. Plastic Picker and I rushed around in the morning to Costco (had to split a hot dog) and then to Vons (to try to find graduation flowers). I was looking for a graduation lei, but we ended up with a small cute graduation sloth (that is his spirit animal) and flowers. My brother’s family ended up making us this amazing folded money lei instead that was truly unique. And then making sure I dyed my hair. Making sure we saved seats ahead for the ceremony, the reservations for dinner at Liberty Station. And even for next week, we are having a party at our house and getting the cleaning company to do a deep clean and ordering the food and sending the evite to those we consider close family friends. All those moments, only I can do and he wants to be celebrated. And it’s made me take care of myself, because I’ve always been his (and his sister’s) mommy first.

I am usually snapping pictures but yesterday I was just experiencing, and letting others snap the photos. I was just experiencing it all. The breeze was gentle and cool. The sunshades were majestic and appreciated. The colors vibrant. The happiness of the day and sadness of the upcoming parting of ways palpable. I sat at later that night at dinner with our extended family and just looked and gazed. I looked at my parents face multiple times as my father was laughing and saving his grandson’s number of his phone. I gazed at my own son’s face, as he was enjoying both sides of the table that he sat at the center. I gazed at the face of my daughter too often, as she was glowing in the center of her male cousins and her brother. She’s pretty and her prettiest is more evident when she’s the only girl. I gazed at my mother-in-law and father-in-law, as they sat in their fancy clothes eating American food, which they haven’t in a long while. I gazed at my husband and I pinched his cheeks, and then my mother-in-law pinched my father-in-laws cheeks in jest at the same time.

Yesterday was mostly about family and they realized how important the oldest and only son of the only son of the only son is to our family. He’s been this beautiful group project that we’ve all contributed and he’s turned out to be such a wonderful human being. I’m not sure if I’m really going to cry. I’ve certainly been teary eyed. But for my oldest after he was born, I had this great sense of responsibility. The feeling is very different than for our daughter. For him, I felt a heavy weight knowing I needed to raise him well. And I did. We all did.

He will have a wonderful two months off, of hanging out with friends and camping with best friends. He will clean his room. And we will enjoy these two months together before we launch him off to college this fall. There is not much time because his school starts the earliest of the UC campuses. But I wanted to thank the blog’s readership. This has been my emotional journey on these pages, and I needed to tell you that today I just feel relief. I feel relief that he had the graduation that he had. He grew up within a caring school and family community, and he’s a great human being. And I’m 100% going to wear Cal Mom gear unapologetically for the rest of my life – because I deserve it and I’m proud of him and himself. No senioritis. Had the highest grades he’s gotten in high school the last trimester, and graduated with honor roll. And he took his AP tests seriously and prepared and we are pretty sure passed, hopefully with a decent score. The most important thing to his father and me, is that he respected his school and respected the sacrifices his grandparents and parents have made for him to attend and graduate from his particular school. And that gratitude to me, is worth more than any accolades or name brand university. He’s grateful. And I’m incredibly grateful for that. The Prom King? The Homecoming Court? Now that was just cool!

May 27, 2023

by Dr. Plastic Picker

A mother I know well came in this week and it has been a while since I had seen her. She’s really sick right now and has around a year left to live from a cancer diagnosis, and I have been the children’s pediatrician for well over a decade. It’s one of those relationships where I know them well, and my nurse knows them well – just because we’ve seen them since birth. The children are in with therapy and the supports and resources have all been deployed.

What does one say as a pediatrician to a parent? How should a pediatrician react?

There is no answer because each relationships is different, each family is different, each parent and each pediatrician is different. For me, it is about responsibility. I have been lucky to be there for all those moments in clinic. The first visit when the parents come in so nervous and exhausted, meeting their pediatrician for the first time. We teach them how to swaddle the baby, or reassure them about the pooping frequency. We ask them, are you doing okay? Being in the clinic rooms, I often feel like being on a sitcom (I often laugh in clinic with my patient’s families) or sometimes it’s more of a series of commercials. But those moments are so powerful, the first weight check, the bilirubin visits, the anxiety about the high fevers, the first viral rash, and first broken bone. The main characters are of course the little adorable toddlers, and it’s true for me – my little patients even when they are big and grown, are perpetually toddlers in my mind. They are the adorable 15 month olds that are so mischievous that you forgive them their tantrums and their scowls when you try to examine them. It’s hard to be mad at little beings that have such huge eyes. Toddlers are really the manifestations of anime proportions, round face and big eyes and perfect skin.

After being there for a lifetime of those sitcom episodes or the short commercial visits for very focused moments, you get to the point in your career after practicing for 20 years when one of the parents have died. And that for me, is something I’ve been mulling over the last year and had been thinking about and reflecting on. It’s hard for those families of course, and as a pediatrician – the more connected one is the harder it is for us. I’m a connected pediatrician to my families and my community, and I hope it’s true for most – I know my families and I care for them. And because of this, when Stephanie was diagnosed with cancer, when Nicole died in a tragic car accident on Christmas break, when Jonathan was murdered when he went back home to Detroit likely because he was a young black man – it forever affected the lives of their children and the pediatrician who remains.

I needed to write out their names to make sure I remember them, and to my families I do. I remember the arguments I had with Johnathan about Malcolm X and race issues, and found it amusing that he trusted a small Vietnamese-American pediatrician about vaccines – despite his mistrust of the world in general. I remember Nicole all the times you drove down from East County to see me, trusted your boys with me and we talked about just random things – but always really liking each other for some reason. And I remember Stephanie each visit you had with your two little ones, how blond they were and the interplay within your family and felt sad when your family separated and now after we talked – I know a bit better why since your life was more complicated as a child then I ever realized the first years I knew you. I needed to write this down because I remember. I was there with you, and you were there for me as well.

It’s powerful mindfulness and being present. Yesterday I had what was probably just a ho-hum clinic day, where I worked the late staggered shift. But there were the two cephalohematomas that I’m still worried about, attached to two set of parents. There was the stress of finishing three triplet wic forms and doing the third version of them because I dared to spell Similac incorrectly , and me wondering if the WIC office really had so little to do to perseverate over my spelling, but attached was a loving uncle that always wears a certain kind of shirt and sweater , and so lovingly holds one of the triplets when his younger sister who is the mother comes in.

I’m still here. And what I said to the mother that came in this week who is dying of cancer was simple. I’m so sorry that you and the kids and your family are going through this. Can I let my old nurse who knows your family too know? So that he can pray for you, because he goes to church? He transferred to Bonita about a year ago. Do you need more supports? I am so glad the kids are in therapy, and we have more social workers now. Do you feel comfortable reaching out to me if you need help? And of course I’ll fill out that camp form that you need and this is when I review things for the kids through puberty. Maybe we should talk about sex sooner than later, especially so you don’t worry about them not having had the talk before you go. And, I will be here for them Stephanie. I’ll be their pediatrician until they turn 18, and please let me know if you need anything. And what I didn’t say was “I really want to give you a hug but our relationship is different. So I didn’t hug you, but I hugged the kids after you left the room, because it really sucks when your mother has cancer.”

May 18, 2023

by Dr. Plastic Picker

We are getting there. We are getting there. It’s been an absolute whirlwind of meetings and support, and emails and coming of like-minded hearts. For those of us deep in the climate work, we know that there is a very narrow window of time. It’s a literal planetary code. And that’s why that even though I know this the San Diego Heat and Human Health Summit won’t solve everything, it will move the climate work faster. We will get to averting rising global temperatures and ecosystem disruption a bit faster. Every act counts. Every bag of trash counts. Every major summit that changes the national conversation counts.

But it’s been a marathon of meetings and marathon of emails. Convincing and cajoling. Talking and persuading. Pleading and asking. And I’m doing this all for our collective children, but honestly for my own as well.

To all my friends, let me have my innocent dreams of my daughter and innocent hopes for her future. I need it so badly because I know how truly dire the situation is. Rising temperatures, hurricanes, atmospheric rivers, asthma. I usually have hope. But this morning I have to put on my happy persona which is mostly true. I’m excited to go to DC. I really am. I’m excited to be invited to the World Economic Forum. I’m mostly excited to see all of my friends on August 12, 2023 at UCSD School of Medicine. But I’m so much of an introvert , that it’s hard for me. It’s hard for me to reach out again and again. Usually people say yes, but sometimes I get a no. And the no, they hurt so much. But I keep on re-engaging and re-connecting, because we have to do this together as a region and as a community and as a people.

I think the introverts, those like me. We are the beautiful ones that the world does not see, because we are afraid to get hurt. We hide. But after being hurt and being healed, it gives you this sort of super human strength and knowledge. Those that tried to hurt you. The naysayers, The negative people. They are gone now. And all is left is the stark reality of the climate crisis and the planetary code, and I’m there and you are there – and what does one do, but try to resuscitate the patient.

So it’s really happening, The summit is really happening and thank you to my real friends who have seen me run up and down the hallway. I’m exhausted because I was so happy. And being so happy, you crash. It’s not a natural state for me, this extremes of emotion. But I’ll take it, for the earth and realize that I am meant to be where I am and to be who I am. And that I’m allowed to look at a picture and smile, and dream for my daughter.

May 12, 2023

by Dr. Plastic Picker

That was honestly way too much fun! My good friend Dr. ABG and I stopped by UCSD AMSA Premedical Society and spoke. Dr. ABG is one of the doctors I admire the most, and also happens to be on the San Diego Air Pollution Control District Governing Board. I had a part in getting her elected and I did so because I believe so strongly in her heart, her clinical skills and her ability to enact change. But she’s also a good friend, and UCSD alumnus. So we headed over to UCSD AMSA and amused the premedical students with our anecdotes about climate and health, but mostly about our friendship, our families, our husbands and our kids.

We were REALLY FUNNY!!! Totally not planned but I kind of knew what the trajectory of our open flow dialogue would go. Our premedical students and high school students said we were hilarious and entertaining and inspiring. The room was filled with laughter, and filled with beautiful young faces looking for leadership and inspiration. I’m hoping that two middle-aged pediatricians in our 40s gave some of that to them.

We also invited them to the San Diego Heat and Human Health Summit! It’s at their college and university and 100% they should be involved. So we’ve invited the premedical students. I got ALOT of new really cute UCSD premedical instagram followers yesterday. And I think we picked up a few new premedical interns. We have two graduating so we actually do need a few more to fill out our ranks.

May 6, 2023

by Dr. Plastic Picker

It’s been on epic climate almost 2 weeks now. I haven’t been present as much on the blog to update the readership. I’ll update you now but mostly wanted to let you know that one of the main characters in my life turns 15 this month.

Our final version of the climate divestment paper was accepted to the Yale Journal of Biology and Medicine. I helped substantially with those edits and am in the middle of the authorship group, and incredibly grateful to have contributed to the writing of the paper. I was able to secure an interview session with Contemporary Pediatrics for our lead author to amplify the message of our paper. I initially thought we would have to write a commentary, so I’m relieved this will be an interview and I actually don’t need to do anything further. This paper helped me further understanding divestment work, and it will help with the overall movement to have this paper with important names on it to distribute to our friends on the front-lines advocating for divestment as child advocacy as climate change affects children’s health.

I also received a big award which I’m not allowed to share on social media but I don’t think this blog counts? I’m really honored to receive it. There is going to be a fancy reception and I’m getting a trophy! A real engraved trophy! Thank you to the American Academy of Pediatrics CA3 – San Diego and Imperial Counties for nominating me.

But it seems really simple and a bit selfish. One of the biggest reason I am working so hard to fight climate change, is that I want the above teenager to have a livable planet. I want her and her brother not to have to deal with as catastrophic heat waves that are predicted right now. I want to have grandchildren that can remain in San Diego, or at least not have to migrate too far. I want to hold my grandchildren and watch them, and it not to be that hot. I want this for them and myself, and for all our children and grandchildren.

And most of my time these days is organizing the epic San Diego Heat and Human Health Summit. I’m making lots of noise with my climate friends, to draw attention to the health effects of deadly heat waves. We need all hands on deck. And I think it’s working. Can you believe it? Its working. And honestly it began with a burned out pediatrician who almost left medicine because I was stressed and sad, and I found happiness on the beach picking up trash.

If you know me in real life and want to help with this summit, let me know! It’s going to be epic and filled with beautiful people who are so good and joyful, that it just shines when they walk in the room. Trust me. I see it! I see it in all of you. So to the being who has brought me 15 years of joy. I love you so very much. And this weekend, we will spend it together just our family.

April 26, 2023

by Dr. Plastic Picker

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

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

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

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

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

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

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

April 21, 2023

by Dr. Plastic Picker

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

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

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

April 20, 2023

by Dr. Plastic Picker

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

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

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

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

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