Category: Physician Wellness

August 23, 2023

by Dr. Plastic Picker

One of my friends once told me, after I told him some of my grandiose plans, that he said “my grand plans are to clean the house and do something in the garden.” That really was cool. And because I respect this friend, I’ve been often thinking to myself “My grand plans are to . . . ” And today my grand plans are to do my taxes.

Our son has COVID for the first documented time ever. The entire pandemic none of us were known to have had it (excepting my mother-in-law) but I’m sure at some point we had it? We are fully vaccinated including the bivalent boosters. My son hopefully is having a mild case, but he is missing the first 5 days of college due to being quarantined. Orientation was mixing thousands of students, so it makes sense that he got COVID. I mean, he lives in a triple! We are monitoring the situation and I texted some of my doctor friends for advice. They were so great to reply.

And then my grand plans today are still to meet with all the different entities and loving souls that made H3SD possible. I sent emails off to friends at UC San Diego. Mr. Plastic Picker and I will meet with my friend Dr. Luis Castellanos. That is always a highlight to chat and have brunch. I have changed my schedule to be able to meet with County of San Diego, and I’ve invited the Kaiser entities that might be interested. I hopefully will meet with the ground level people that all made this happen, like the wonderful volunteer project manager Sed. There were so many personalities and loving people involved, but I was honest with my friends and home institution. We have to have a project manager for the next iteration and it has to be a team. It was half parts insanity and this unexplained joy and curiosity that enabled me to help make this major thing happen. I can’t be replicated, but the model is sound.

My activism has always been about what many of us in climate work talk about, the intersection of

And what brings me joy is a lot of fun and different new projects that are in the back of my mind. It’s usually working with people I find interesting. But I also need to do the work that needs doing, and the work that needs doing that also brings me joy is – doing my taxes. We’ve paid up our quarterly, but just need to gather everything together.

I’m also going on a kind of date with Mr. Plastic Picker tonight! We are going to walk around UTC Westfield as our daughter has a leadership meeting she has to be at. So when she’s at this meeting, I’ll get to walk with him around the mall. And honestly, for me? That’s super exciting just to get to hold his hand. I’m a romantic at heart. And that was ultimately what half enabled me to get the summit across the finish line, because I believe in happy endings in every aspect of our lives.

February 22, 2023

by Dr. Plastic Picker

It’s 442am and I’m up more at my more natural awakening time. I’ve honestly watched most of the Kdrama netflix/Vikipass that I need to. So no more binge watching for me. I’ve caught up on most of them. And I stretched and did some light weight exercises to help me fall asleep last night. I asked my very tall and gentle son to hug me twice. I asked my husband to hug me last night, which he did before a little 12 pound poodle mix snuggled in between us and I had to scoot away. I could push her out of the way, since I am the alpha in the house (well maybe not the alpha, but the beta that pretends to be the alpha). I didn’t talk to our daughter too much about things, because I don’t need her at 14 to be exposed to the ugliness of the world too early. She will see it all soon enough, but while I have some semblance of control – I am raising her in a bubble of security and stability.

I was terrified yesterday. I had a parent patient interaction that I found absolutely terrifying. I find it helpful to process these emotions relatively quickly so things don’t fester. The details are not important here on this blog, and things need to be confidential – but it’s important to share my reaction. I think some of my reaction is because I’ve been mostly healed from many traumas, past emotional and professional abuses from blogging. It’s helped to write things and process, and for the most part I’m surrounding by positivity and joy. I also try to be positive and a force of good at the office and in the world, and certainly at home. But yesterday a person tried to emotionally pull me down into the darkness of chaos, and tried to provoke in me evil – and it terrified me. I was acutely aware of my racing heart beat, my hands began to shake, and I stood up even though that person was on the phone. I could feel my fight or flight response kick into gear. And I knew to politely set limits and hang up the phone. And then called the appropriate supervisor and threat management was alerted.

I felt threatened and I don’t have to take that cr@p anymore. I’ve certainly been in more dangerous situations. We all have. I’ve had scalpels thrown at me by angry surgeons. I’ve had other surgeons berate me as a student for no good reason. I’ve had parents threaten my own safety and the safety of my team, when they were often child abusers as we’ve tried to protect children from the same abusers. I’ve seen fellow physicians haze younger colleagues, and it ate me up inside to sit there and witness the hazing that is done really indirectly through decisions that are obscured. But I am 100% me now, and daughter of my father, the wife of my husband, the mother of my children, and the pediatrician for over 2000 children. And I called someone who called threat management, because I don’t have to deal with that cr@p anymore and neither should you!

Yesterday was an epic climate date. I spent two hours writing our newsletter updates for SDPCA and AAP.-CA3 Climate Change and Health Committee. I mentored and recruited another premedical student who will help with the heat and human health summit. I reached out to patients and extended extra care to those that are subject to poorer health due to environmental toxins and racial discrimination. I attended the above clinic meeting where we all whacked at the COVID pinata (brilliant idea by a colleague) and ate half of a cookie without guilt. I also took a good whack at the COVID pinata because it’s been a rough few years for sure. And then I went home and attended an epic meeting between the Office of Health Equity and Climate Change and the League of Women Voters and got to talk more about the idea for the heat and human health summit. I was late for that meeting because I took what I thought would be a quick 30 minute nap but ended up being a 45 minute nap, but the League of Women Voters Environmental Justice Subcommittee were very understanding of my working momma/climate warrior exhaustion! I even got invited to their gala!!! My premedical intern was there which is like I was there on time, so we were able to meaningfully contribute to the conversation.

And all this was important for the earth. What scares me the most about the worsening heat waves is that it will drive up rates of interpersonal and domestic violence. That is the scariest part. We have to try to mitigate the climate crisis by continuing to reduce green house gas emissions. We have to better prepare for the heat waves, because no matter what they will be getting more frequent in the summers. And when they do, tempers will fly and the situation I was in yesterday – will happen more often.

But I’m so lucky. I’m so incredibly lucky to be able to see the link between it all. I am no longer scared. My heart rate is normal. My vitals are stable, as is my mental health. I thought about calling in sick for a mental health day, because it was terrifying yesterday. I thought about punishing the system for putting me through this. But I realize that I’m better and I can whether this one incident that was terrifying because I have you. I have climate work. And I have my loving family. And I’m thinking of someone who is very brave and I’m sending you out a virtual hug. Signing off now, to do a few climate emails! Your local litter picking pediatrician!

September 8, 2022

by Dr. Plastic Picker

Now I’m realizing why in part the Iced Matcha Tea Soy Latte yesterday was so amazing, it has three scoops of matcha powder! That is a lot of matcha powder. Usually for my home hot version, I use one or 1/2 scoop and its mostly water and maybe 1 oz of soy milk. But oh wasn’t it wonderful yesterday. I’ll never forget that iced drink I had yesterday at the Starbucks at Vons located in PB. It was >90 degrees and my two tall teen children and I walked into the ultra-air conditioned grocery store. I left our oldest who at 17yo is well equipped with $20 in cash to buy three drinks for us. I wandered with our daughter 14yo to get more soy milk as I had run out of the organic soy milk I use for my morning drink. We stood there next to the freezer section and it was so blessedly COLD especially during the now almost week long heat wave in San Diego. I’ll never forget that contrast and that moment, the feeling of relief and cool air as we were looking for my soy milk amongst the other plant-based milks. And then after we paid for two items, meeting my son and he handed me unexpectedly iced matcha soy latte instead of my usual hot brew. He took it upon himself to get me the iced version, and it was the first time I had ever had the iced version and it was simply daebak!

And the whole day was daebak. I had not been on the computer system for four days, as it was the long holiday weekend and I took Tuesday off as the kids started school. I spent most of the long weekend working on our taxes and going through finances with a fine tooth comb. I’m the CFO of our family. It’s important for me to go through the details of all the charges and to stem any waste in our budget, so most of the weekend the children and Mr. Plastic Picker suffered from my constant, “what is this $14.99? $49.99!!! Another $1.99!!!” And even with all the nagging, we are amazingly consistent as a family and our savings rate is 52% year after year. And a large proportion of that is our 15 year refinanced mortgage at 2.75% and two private school tuitions for the children. Our high savings rate is mostly why when I say we are financially independent to save the earth, that I’m being honest. I could not work and we’d be fine. Mr. Plastic Picker was always the highest earner anyway, and we could easily within three years downsize our entire family to one of our smaller but very nice rental properties and drop our living cost to very little.

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July 20, 2022

by Dr. Plastic Picker

The best blog posts come when I’ve working through emotions and I’m working through a lot of emotions this early morning at 5am. My body is getting back to a regular schedule, as the toll of binge-watching Kdramas has taken. I’ve honestly watched most of the really good ones, and I’m going through Kdrama withdrawal. Even good things can be bad for you, when they are consumed in great quantities. But I’m sleeping more on schedule and the earth is pulling me back into my normal circadian rhythm. I haven’t done an early morning plog to the beach in months, and I think I may head out this morning to get some quiet time for myself.

But yes I’m working through a lot of emotions this morning. I’m royally peeved because I bought this Matcha Green Tea Mix at Trader Joe’s and I realize I bought some sort of latte mix that is mostly just sugar, and only some tea. I usually buy the matcha green tea at Costco, but we’ve been trying to vary our routine and buy a larger variety of food. I shouldn’t be surprised because honestly Trader Joe’s is a lot of packaging and plastic wrapping. My latte doesn’t have the quality of matcha that I’m used to, and when you mess with Dr. Plastic Picker’s matcha- you better matcha watcha out! It’s certainly could be blamed on me for buying the latte mix but I just had high expectations of actually more matcha in the matcha green tea mix. My morning cup doesn’t look the pretty green that I’m used to. It’s a poor imitation.

This goes for unknown groups/persons that I’ve tried to pull into climate work. I’m not going to go into more details because I don’t want to be hurtful, and the climate movement needs everyone whatever they can give. Let’s just say there are groups or persons that want the accolades and as I dive into climate work, don’t put in the work. They want the pats on the head, and what I can give them – but I’m unimpressed with the work. And then there are others that I’m in awe of the care and consideration that they place on their projects. I think this is a reminder to me that I need to focus on the local, and ones I can meet in person.

That’s it. I realize some of it is that I am in general feeling like many women leaders underappreciated. Subtle phrases and emails, folks don’t mean anything by it – but we’ve been preprogrammed as women to be people pleasers. We all are. I’ve talked to some friends who are the most green of the green heroes that I know, and they are also feeling underappreciated and feel the imposter syndrome. And if they feel that, what chance do the rest of us mere mortals have?

I honestly just need to take time for myself. I’m going to start building my endurance a bit more and exercise. I felt like I was being criticized for how I was cleaning the rug in the kitchen by my mother-in-law, and that was just a ridiculous thought. And this is a ridiculous post but it’s the honest ramblings of an pediatrician trying to save the earth. I’m working on big important projects and everyone of those projects is more than anything else anyone else has done, yet I feel underappreciated? Isn’t that ridiculous?!!! And I realize that all of us need to learn how to appreciate ourselves and it makes it less exhausting and more sustainable for everyone. In the end the earth appreciates me, and I am part of the earth and I need to appreciate myself.

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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May 3, 2022

by Dr. Plastic Picker

I’ve never understood regret. The Korean word for regret is 후회. Honestly, I don’t think I even know the word in Vietnamese despite being fluent. Just googled it. I do know the word. It’s tiếc. I guess I don’t hear my parents regretting that much growing up, unless it was a some food that was actually spilled. I remember once going to Costco (Price Club back in the day) and an entire large tray of eggs flipped and was summarily all broken and unedible. My father, young back then, had been joyriding on the shopping cart which caused the tray of eggs to be broken. My mother probably did regret it, and likely said ” tiếc” in Vietnamese. But I don’t think my father would have regretted that moment, because I remember him laughing and joyful and handsome in a young father way.

So here I am, older than my father when he was joy riding in the Costco (formerly Price Club) parking lot on the shopping cart. The tray of eggs, since they were mostly biodegradable, have been cycled back into the earth somehow (hopefully). And I’m thinking of regrets.

I’m thinking of regrets because I talk to more people now. No, that’s not true. I’m listening to more people now. I’m trying to share the burden of more of my friends, especially climate friends. And what I’m hearing is regrets. I’m hearing reflections. I’m hearing them processing professional and personal experiences and wondering, was it worth that time? Was it worth all those sessions preparing, when the session did not go as planned? After the comments, after the rejections, was it worth it?

I listenend and shared and tried to reflect some of their emotions back. Friends are dealing with it. Job rejections. Grant rejections. Feedback that may be intended to be constructive but feels like professional rejection or dismissal of your efforts.

I don’t have regrets. That’s all I can tell the readership. It’s your journey and it’s often circuitous, and that wandering in life is what makes it yours. Maybe that’s the commonality among those I love personally and professionally and their difficulty in processing things. They’ve never been rejected that much, and they live with too much regret when it rarely happens.

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April 21, 2022

by Dr. Plastic Picker

Wow. My body is tired. I now realize my binge-watching Kdramas (and I’ve been a bad middle-aged mommy and binge-watching a lot) has been kind of excessive. I now realize that some of this is not unlike people who drink alcohol (which I do not but I am not judging) to numb themselves. I now realize that ending my traditional middle management career at five years of Assistant Chief was an emotionally hard and wrenching decision. I was numbing myself from the emotional fallout. The fallout, ended up being the emails and calls from some upper management that never materialized. I know that they too are just cogs in the HMO machinery, but to say that I am slightly disappointed would be true. I think all of us deep down all want to be recognized. Since I’m a metric oriented person, I know objectively I did so much in the five years that I was Assistant Boss. But now that I’m at that age of being a middle aged palindrome, where my age is the same read forwards and backwards, I realize that it was meant to be. I’m meant to decide where my path goes. Read forward or backwards, I’m still me and actually more fundamentally me that I could ever be.

So with those convulated thoughts, something amazing happened yesterday at our HMO. I was one instructor at one of the breakout sessions, but my climate HMO Friend Dr. RA organized one of hte first of it’s kind San Diego wide climate symposiums with cross institutional participation on the instructor and resident side from all the major Family Practice and Emergency Medicine departments. It was very epic and she has her own narrative that she will share soon in an academic piece.

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March 28, 2022

by Dr. Plastic Picker

I thought this little friend I met this weekend was a Surfbird, but she’s actually a Black Turnstone. I’ll remember this past weekend for many reasons including a rare Black Turnstone that I don’t often see on the stretch of Marine Protected Area that I clean frequently. I’m at bag 655 abouts and I think I’ve made a dent. I think the world has made a dent. @drplasticpicker is above 1800 followers now and this blog continues to average between 400-1000 views a day. Who, I’m not really sure? But I have to believe that those that are following the adventures of Dr. Plastic Picker are also bending the arc of history toward a sustainable world.

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February 23, 2022

by Dr. Plastic Picker

Life is meandering. RG, our premed advocacy intern working on leaded aviation pollution, and I were supposed to make verbal comments at the EPA meeting last night. We both submitted written comments. It was nothing that was asked of us, just somewhere we thought we should be. But RG had to work last minute (all this environmental health work is volunteer) and I logged in once on my phone, and afterwards when I tried to log in again on my computer – the link did not work. Mr. Plastic Picker is a witness that I tried to log into the EPA “EPA’s Draft Strategy to Reduce Lead Exposure and Disparities in US Communities” and the it was unsuccessful. I really really tried. But since RG wasn’t there and part of advocacy is fun for me, if I get to do it with the premed interns, I didn’t really mind that much. Instead of being attached to the EPA meeting until 9pm, I ceased by Zoom logging in efforts at 710PM. And then I watched Kdramas! Well, the current show I just finished is more artsy so not really a drama. But I learned something that was very profound from the close-captioning translations. I love the Kdramas because I actually do have a decent grasp of Korean, and it’s this weird world where I’m learning all this Korean but I get to read too. Anyway, the translation was the best part of this show about a family of three women and the percussions of domestic violence.

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February 19, 2022

by Dr. Plastic Picker

It’s 442AM and I am back to a semi-normal rhythm. I did watch Hulu “Descendents of the Son” K-drama, but I did not binge-watch it last night. It’s really good and I’m trying to savor it. Yesterday was a very full Friday at work, and I have almost 30 charts to finish this morning. It used to make me upset to work on my “inbox” on my “off time” but its a wonderful thing perspective. I’ll blog this morning, do climate work, drink my matcha green tea and finish my charts in the next 2-3 hours. I sit at the kitchen table and doing work that is meaningful and I am happy in my quiet world.

I received the above card with a beautiful tulip and package of tea from a family I’ve been taking care of for years. I had done a small thing for them, lend them a book I have to help them on the path to healing, and they returned the book so happy and on the path to being better with a gift for our family.

The gift itself is meaningful but the sentiment is something I’ll never forget. And indeed yesterday with all the busyness of an overbooked Friday and the leftover charts, was filled with real interactions for me and true joy. I’ve had friends and foes ask me what my next career step is. World domination? Further in leadership? Office politics never ends. But the odd thing that for me it has. Office politics is over. I don’t know what the next step in my career path is. I know I will go where the earth needs me, and that I fundamentally love being a pediatrician more than I have ever have in the past. So no matter where my leadership journey takes me, I want to see my patients and take care of those families entrusted to me. And that includes a super adorable 4 month old that I added on yesterday that looked at me with the bluest eyes. She had rolled off the sofa onto the ground, and scared the beejeebers out of her parents. She was okay, and I didn’t mind adding her to my already overful panel of 2500+ weighted families – because she is adorable and her parents are kind.

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