Office Politics/Leadership Development – Dr. Plastic Picker

Category: Office Politics/Leadership Development

You can’t make this stuff up. I saw this yesterday on my beach plog on the way to Tourmaline.
Left the motorcycle but recycled the cans.

May 17, 2021

by drplasticpicker

Sometimes life is stranger than fiction, or even my trashart. I gathered bag #455 yestserday and it was a reused pita bread bag that was filled with wet plastic bags mostly washed up on Tourmaline Beach. I hadn’t really meant to head to the beach but I’m glad I did. It’s always an adventure. I wanted to start jogging more, so naturally ended up in my spot and did a beach cleaning amongst the rocky shore. I saw a beautiful snowy egret. They are a rare sight and only come feed where the kelp is left in it’s natural state. Where there is kelp, there are insect and remnants of crabs and other crustaceans. The “beach” of the white sand is really not natural. There is supposed to be kelp. The surf-rake removes it for us humans so we can recreate (and I mean to use that word in a new way). If it was up to me, we’d leave the kelp and the beach would be for the beautiful birds like the snowy egret.

I’ve collected/salvaged 34 items this month from the ocean that have mostly been recycled. In total I’ve salvaged #1609 things from ending up in the the landfill/ocean and it’s fitting and not suprising that the most recent 5 items were crushed beer cans next to a burnt out motorcycle.

I got a comment from someone yesterday. A criticism really about something at work. Maybe two years ago, that comment would have generated a lot of sadness or anger. Even three years ago, a comment like that would have made me put that person into a mental box – written them off in my mind. I used to do that, literally just delete people from my mind. But since I’ve been picking up trash, I notice things and the world and nature – and I certainly notice people. No one deserves to be deleted.

But when I received that comment, I took it at face value and did not read anything more into it. It’s funny when someone is deep into their own anguish, their own issues – it’s hard to notice what other people are going through. This is why burn out in physicians is so dangerous. Clinical medicine , the true practice of healing and not the endless “smartphrases” and algorithms, is about noticing the details. If you miss those nuances during the history and the physical, you can make an error. This is why burn out is so dangerous in middle-managers as well. Our colleagues that we “manage” especially the young ones, are like our patients. There are subtle signs in their own pscyhological health that we can miss if we are in the midst of our own burn-out. Yet middle-management is exactly the types of position that drives one to burn out. It’s a catch-22. I had a good interaction with said colleague but I was frank with that colleague and texted back “The last four years almost broke me. If you are interested in admin, let me know.” My text was met with silence.

I used that opportunity to move forth another quality project, but how the exchange ended is my being honest and frank. I want people to know, especially now that I am stronger and feel free – it is a choice. You have a choice in the words you use. You have a choice in the comments you send. We are all human. And we can be hurt. Be careful what you say with your colleague as much as with your a patient. I try to be more careful with my words now. Words matter. Words matter so much , and that has been the biggest lesson of the last two years. And I hoped that my interaction yesterday made that person think a little bit and helped them on their journey. I know their journey has not been an easy one. I thanked them for their contributions to the department and to patient care, and I thanked them for their criticism – and took the value in their comments and brushed off the sting of the delivery.

And I looked at Mr. Plastic Picker yesterday and said, “is this the year? One more? I’ve done enough I think.” We have six year terms in the particular middle management position we are in. He is also at the beginning of the 5th year of his term, but for him it hasn’t been quite such a difficult set of obstacles as I have had. For him, he has always been my cheerleader and the best source of advice. “Just take it day by day, year by year.” And with that, I am still here. No longer burned out. Stronger for each bag of trash I’ve picked up. Stronger for each snowy egret I’ve seen at the beach. And as I’ve gotten stronger, I try to make everyone around me stronger. I try to build people up. I try to build the department up. But I know how fragile things are. I know how fragile people are. Just one comment from one colleage, and it makes me question myself. But I am here, still standing. Better than the motorcycle.

We are all fragile creatures. I thought I was like teflon when I was younger. Knowing good people, strong people helps. Surrounding myself with positively helps. My friend Dr. Jill Gustafson once told me that I was senstiive, and I never realized that about myself. I am sensitive and it’s okay. It’s okay to feel hurt, and I hope that it helps me not make hurtful comments to others. I’m sorry if I ever said hurtful things to anyone who is reading this blog. I’m sure I have. We all have. Your forgiveness is something that I am grateful for.

And with that, at some point this journey will end. Dr. Plastic Picker will get to at least 1000 bags, but I think my fighting for planetary health and pediatric health that will never end. That I feel so much joy and freedom, because each bag I pick is completely voluntary. I chose to pick those bags. No one made me. It was my free will. But management, sometimes it feels forced. It really does. It’s not for the faint of heart.

Faceless colleague. Also trying to balance life.
Mantilija Poppy

May 4, 2021

It’s someone’s birthday this week. Mr. Plastic Picker and I have two teenagers now in the house. One about to drive and another living in a world of dreaming about volleyball spikes and playing varsity. They both have such conventional lives with conventional concerns. For someone who grew up in a refugee household, I realize how unusual that is. Mr. Plastic Picker and I are who we are because of the way we were raised, within loving households that faced more struggles but anchored in a country that had opportunities for us. We are not trying to recreate ourselves in our children or recreate the circumstances that molded us. We are happy that the children have volleyball, and some of the biggest concerns is who is going to be taller than whom. Which SAT prep course to take? Summer house vacation with friend or go with your parents camping? I concentrate on them and also concentrate on the society surrounding them.

Did you hear about Bill and Melinda Gates divorce? Do you think money had anything to do with it? No money in the world is worth the dissolution of a marriage. I remember when Al and Tipper Gore annoucned their divorce. Because I had rewatched the Inconvenient Truth so many times, I was shocked. My own parents are still married. Mr. Plastic Picker’s parents are still married. And indeed when I was a young doctor mulling over the divorce of Al and Tipper Gore, a Dr. KJ who was older worked beside me and she came out and said “I’m still married.” That reminded me not to borrow the concerns of others.

Bill and Melinda Gates mentioned in their press release about their three children, and successfully raising them. Mr. Plastic Picker and I are in the midst of raising our two tweens. For me, our marriage and the family we’ve created which is an extension of our two families merged into these two teens – is the most important thing in my life. Maybe this is something a liberal feminist would disagree, but its more important than my career and more important than money. I don’t talk about my marriage and my family as much about plastic, but I wonder if my friends truly understand.

But that’s the wonderful thing about the new world. I can do it all. I can be married, have two teens, and be Assistant Boss and be an Eco-Avatar Dr. Plastic Picker. I can do it all and also be head of vaccine quality measures. It’s funny one truly understands who is supportive of your career, or those who gently push you along and help you along the way. Beware of those who subtly leave professional land-mines. Dr. Plastic Picker is all my years of being a mentor and Assistant Boss, I never told anyone to quit. I never told anyone that you could not do anything. I hope that I encouraged people along their career path and their family. There is no race. You can have children, a successful marriage, and be in leadership. I’ll clear the professional land-mines for you. Other people don’t see them, but as a litter-picker now I notice them all.

Funny upcycled planter, will go on the other lunch table at the employee patio area at wr work. See his nose ring?

February 21, 2021

by drplasticpicker

I’m kind of all over the place this morning, and this weekend. We had a phenomenal pediatric drive through vaccine event yesterday. That’s already posted and publicized over several facebook pages and Instagram accounts. Then we did some parenting yesterday, and finally bought some underclothes for our daughter and much needed running shoes. Between Dicks Sporting Goods and RoadRunners Store (which I actually don’t recommend), we spent $350. So much for being frugal! We haven’t really purchased any sustaintial clothing for her in months. I don’t remember the last new piece of clothing? She is such a good daughter and okay wearing hand-me-downs and on this sustainability journey with me, but when you need sports-underthings you need sports-underthings. Mr. Plastic Picker and I are both real middle-managers and it doesn’t make sense during the COVID-19 pandemic to spend time exposing our daughter to possible infection and time is money, so we spent 3 hours shopping for things and spent $350 on things she really needed which are quality products that should last her a very long time. I told her honestly yesterday, “Mommy always likes to reuse and/or find a deal. But honestly dear daughter, we have plenty of money and daddy needs to work so let’s just get what you need and get home. It’s okay to get good quality clothes and spend money sometimes.”

I was pleased that we didn’t fall into the Road Runner’s trap of getting the custom orthotics for our daughter who has no foot issues. Sheesh. It was like going to buy a new car, and them trying to sell us all the bells and whistles when you just want to go home with the basic model. Definitely a hard sell. But we walked away and even had a good dinner, and avoided take-out yesterday. We almost ordered pizza and almost got burgers. But knowing that I could whip up dinner really fast, we saved ourselves the unhealthy fats and saved the earth a bit of emissions yesterday.

But I feel so connected with everyone today, even though I am just sitting at home typing away at the computer. I have been on and off typing, but in between communicated with the amazing students at the Sustainable Pharmacy Project who are applying for a grant, posted on my Crimson University Alumni Page about the same grant that all aims to increase the discussion on climate change and health. I made the Bobby Flay’s pizza dough again, as I looked through our fridge and homemade pizza is a great food waste recipe! So lunch will be pizza after about a 6 hour rise. I made one further step in solidfying the judging panel for the Green Ribbon that one of my amazing colleagues is organizing for the Greater San Diego Science Fair. And then I made a trash art piece that is very profound.

Do you see yourself?
6 months that thing was sitting there. 6 months.

February 20, 2021

by drplasticpicker

I usually want to present pretty pictures of nature and trash art for the readership. But yesterday I dragged this plastic large thing (I think it’s the underside of a car) from the corner of the HMO parking lot to the trash can near this hidden back patio where employees eat. I dragged it there and gave myself 3 bag credit. I’m at 13 bags of trash now, and I committ to 20 bags for the month. Honestly, around my neighborhood is pretty clean and I get to the beach about twice a week at most. I have a lot of environmental projects to do, and since I really am trying to save the earth – I’m taking the easy way out and picking up trash around the canyons and the HMO parking lot. And there is a lot of trash.

I had time at lunch yesterday to go on a walk with Dr. Dear Friend and we visited the baby succulents. She was tired and feeling sad, because a dear family member is very sick and in hospice. We are all going through life struggles and it’s important to hear our friends. So we walked up the HMO parking structure and I leant her my water bottle and she squirted some water on our succulent babies. We chatted and we were just together as colleagues and friends. The succulent babies are doing well, and you can check out Instagram to see how they are doing. I usually post at least once a week photos. They are succulents so they don’t really need to be watered. We are planning on planting trees up there and some succulent fairy gardens.


I put it on the lunch table outside! Yes I did!

February 19, 2021

by drplasticpicker

It’s totally out. It’s totally out in my HMO and physician group. I gave a podcast interview on physician wellness and I talked about Dr. Plastic Picker. I know it sounds odd since I’ve been out there already all over the blogsphere and Instagram for almost two years, but it was an oddly anticlimatic moment. I guess I’ve gone up the middle-management ladder so far already, that I realize that pretensions are silly and it’s the subtance of the person and their work that is the most important. I have no fear anymore of being ridiculed or looking silly. I’m totally out there now. And the reason I am out there is I need to make real changes from within and green our healthcare sector.

Everything is decomposing in my former “guerilla gardening” project up on the HMO parking lot. It’s not really guerilla gardening anymore since everything has decomposed, and I’m going to actually put real compost into those planters. There is an aloe tree and a bunch of succulents, but I’m just going to plant some bluberry pushes and a lemon tree soon. Why not. I even told the head of engineering (I think he is the head of engineering? It might be an imaginary person). And he was okay with it.


I don’t think this one is a puffy/airy as the last one?

February 6, 2020

by drplasticpicker

I have nothing TO DO this weekend. I will probably DO a lot, but I have nothing TO DO. I even put my work text messages on BUSY. Not DO NOT DISTURB just BUSY. I will finish Fridays charts this weekend, and probably do a couple of patient follow up calls. But even with the climate work, I don’t have anything TO DO. Last week we gave UCSD Family Practice Grand Rounds and submitted an abstract to the Journal of Applied Research in Children. So a lot happened.

And it is Saturday morning and even the kids don’t have anywhere to be because it is quarantine still. Last night I came home late from clinic on the later side, but not as late as the Friday night before. Our daughter had a Girl Scout meeting at 630pm and their father picked up sushi with lots of plastic packaging, as the kids requested sushi. I guess the carbon footprint from sushi isn’t that much because at most it’s little bits of fish. So we had sushi while our daughter was listening to her Girl Scout meeting and I went to bed early. Even with a normal full clinic day, work is tiring. Dr. Dear Friend had a very irate parent and multiple child protection issue cases, and she had a harder clinic day than I did. But it’s hard these days at work because of all the saddness when our families come in. COVID-19 has particularly hit the hispanic and southbay communities more, and this is where I practice. This is where I grew up.


Don’t food food in the vaccine fridge!

January 29, 2021

by drplasticpicker

I’m really proud of myself. I think it’s a function of having very encouraging parents who always taught me to be proud of myself when I deserved the praise. But I’m really proud of myself. I spent my time last evening being certified by the California Department of Public Health as a California Vaccines for Children Provider (VFC). It’s simply a series of 5 modules one has to go through, and are very specific for vaccine storage, distribution and how to account for these vaccines. Because it tests on a specific set of tasks that is required to order, distribute, store and ensure the safety of vaccines – you really can’t guess. I had done a similar training at the CDC website when I thought about leaving my current job during the height of my physician burnout and opening my own office. Good thing I started walking along the beach, and stopped feeling so bad. But this training was specific to california. For each module I was able to answer most of the questions as the material was similar to the federal one, but it was not exactly the same. Therefore missing one question, I had to go through the entirety of all four modules and test out. I passed them all.

Here is proof.

I proud of myself just like I’m proud of myself when I pick up a bag of litter. I have 2 more bags to reach my 20 bag a month goal I set for myself. It’s raining today and I have to orient a young pediatrician regarding the minutiae of quality metrics and then also have patients. But definitely this weekend I eyed a new spot I want to hike at, and maybe will pick up a bag of trash there.

Well. That is it. Nothing earth-shattering (which is good!) this morning. I spent last night on my OFF time training to be a California Department of Public Health as a California Vaccines for Children Provider (VFC). I’m one of two pediatricians in my organization, and it helps save our organization millions of dollars. Certainly that 4 hours is worth it. I also updated my resume on doximity! LOL.


Sometimes the best solutions are cheap.

January 28, 2021

by drplasticpicker

Thank you to everyone for the virtual and real sympathy yesterday after my adventures with Moderna #2. Now almost 48 hours post vaccination, I am better after 3 doses of tylenol 1000 mg. My body feels like it ran a marathon, just exhausted but refreshed after actually sleeping and Mr. Plastic Picker brought home Rubio’s fish tacos and the fish taco was very healing. Someone in high school once told me fish was brain food, and since then I always think that when I eat fish – even if it’s from a fast-casual place.

The sympathic messages were very appreciated and healing. Please text me if you need similar sympathy, as I’m happy to text back some encouraging messages now that I’m done with Moderna #2 post-vaccine experience. Many of my real MD friends are about to embark on their experiences. This is a common shared experience for us, which is relatively uncommon in general but so much more frequent since the COVID-19 pandemic started.

I have been thinking about frugality and the importance of being truly fiscally responsible. Yesterday as I was trying to make it through the day, I was alternatively moaning in bed without anyone to attend to me (Mr. Plastic Picker was at work, my usually attentive tween daughter was at blended school, my teen son doesn’t hear anything and he’s a teenage boy and I’m his middle aged mother, and my in-laws are hard of hearing) except our crazy poodle-mix puppy. I did rest in bed, which was good to catch a few extra hours of sleep. I did take some tylenol 1000 mg doses, because after the first time it brought relief – I said why not??!! and took two more doses as I’m confidant that my body is teeming with spike protein antibodies. Just half kidding. I did take a total of 3 doses in the 48 hours. But in between my delirious social media posts about generating your will as I was thinking about my own eventual demise, texting my friend Usa who is the troop cookie mom this year for more cookies, and passing out again on the bed – I did do several things that I know were very healing and they were very cheap. The most relaxing things yesterday that helped me feel fundamentally better were sitting outside in the sunshine for a bit, and watching the birds at our two bird feeders. I looked at my small little container garden to see where the onions, sweet pea plant and succulents were at in their journeys. And then twice yesterday I did a few yoga stretches, once in the afternoon on the artifical grass in the warm sun and last night before going to bed. I turned on ocean waves as well before I went to bed and I had a good nights sleep. And now I feel better.


Our Girl Scout Troop’s Plant-based recipe. The interpretation of what plant-based means depends on the person.

January 26, 2021

by drplasticpicker

I was completely overwhelmed last night. There is a bit of political tussel at work about committee responsibilities. It’s easy being Assistant Boss because that’s the title I have, and I’ve reached a point in my career where I realize the titles are not that important. The important part is that I have specific responsibities in areas of our organization that actually mean money. I have to make sure we meet certain metrics, state required projects need to be completed, clinical quality measures reached. And if we don’t meet these metrics or get these state required quality projects completed, it means millions of dollars in fines. We are also a bonus driven organization, so when the physician group meets certain metrics than there are certain calculations to our compensation that happens. Sometimes I look out at departmental meetings and a fellow physician will be spouting nonsense about appointment times slots and 15 minute this and 30 minute that or why they aren’t included in certain meetings, and I’ll go into a trance and stand there and nod but I retreat into my own inner universe. I’ll think to myself “penny wise, pound foolish” and think about my networth or about the plastic pollution crisis or about my EMR inbox and the patient results I need to respond to. So much of the world is penny wise and pound foolish. I need to retreat into my inner universe at a lot of meetings, so I can just stand there, keep my mouth shut and move our department painfully forward.


Kumquats. Rediscovered and reimagined.

January 15, 2021

by drplasticpicker

I am really happy this morning. I am really happy because I have always had so many kumquats in my life. Kumquats are a citrus and the kumquat tree is relatively easy to grow. It bears these small little fruits that you can eat the entire thing including peel. My mom has given me kumquats. Friends have given me kumquats. We have a kumquat tree and my mother-in-law always has them in a square plastic container of food from the garden that we need to eat. She puts it in the center of our large kitchen island to prompt the family cooks to use that ingredient. There are always kumquats.

But we should appreciate our kumquats because through the power of Ecosia, I now know that organic kumquats are $10 a pound. Isn’t that crazy? $10 a pound when I’ve neglected previously gifted kumquats. I know kumquat trees are relatively cheap as I see them at the local home improvement stores a lot yet the organic fruit is $10 a pound. We have two kumquat trees in our front yard. We also have a lemon and lime tree. We always have fresh lemon and lime, and now kumquats.