I’m midway through my 40s, and I realize that I’m naturally a very cheerful person. I was cheerful when I arrived to Cambridge at 17 to start my studies at Harvard. I think I generally was still cheerful after graduating from medical school, but somewhere in between being hazed as a medical student and resident and just life as a mommy doctor – I became less cheerful. But now I’m cheerful again, and back to my natural happy self. It probably helps that I’m back in San Diego, the city that raised me to be generally cheerful. It must be our generally good weather.
So here I am at 5:42 AM and I’m still plugging away trying to help our author group reformat our paper “Child advocacy through fossil fuel divestment.” There are illustrious co-authors on the paper, and somehow through my being cheerful and dedicated to the cause of saving the literal earth for our children – I am also a co-author. I have contributed I believe a good amount to the paper, but it’s again my turn to step up as the other co-authors have grant and IRB deadlines to make. I have some time to sit and try to further the manuscript to the finish line.
But it’s like having an essay due for class. I have to do it! And the last two days I’ve been not actually procrastinating but having to sit and dwell and figure out how to do something that I’m not really well-versed at. I want to learn the skill set, which is why I volunteered to take a stab at it. But it’s taking me longer than likely my same age academic colleagues, because I’m a clinician and not an academic physician. But you know what! After this abstract, and the next paper – I am academic! I declare myself an academic! I have more publications now and I’m super proud of them!
So I’m going to cheerfully go back to the word document I’ve been staring at and dreaming about, and construct a 250 word informative abstract. I have to do it, as fossil fuel divestment is likely the most impactful thing I can contribute to in the fight to limit global warming to 1.5 degrees C.
I was feeling a bit off this morning, and I realized I needed to write. So I’m here now on the blog and with you. Realizing that I’m here really for myself, is important. Even introverted me, can get unnecessarily excited about certain blogposts or Instagram stories that go viral. But that elation and that notoriety is transient. What remains, is really family, the earth and the stories that we are creating.
Creating new stories, that is what I’m realizing is the power of the climate work and this blog. A new world order is being creating. My daughter calls it a renaissance after COVID and from the lost dreams of what the past world was. Even with all our efforts to mitigate the climate crisis, the natural world is changing and there are new stories that are being created.
We were at dinner with Dr. MC, whom we call at home my “baby doctor.” This is a special person that I have the honor of helping train to be a primary care pediatrician. I treat her like family and she is family, and we had dinner with her husband J – and we were telling stories. And I realize my husband Mr. Plastic Picker tells the same stories often. They are interesting but new stories are better.
So here we are on this blog through our different advocacy projects helping to create new stories. And these new narratives are what will draw more people to help with the climate crisis. I’ve thought about taking down the blog and kind of retreating. Even a joyful climate activists can get tired sometimes. But I realize that even if I’m the only one reading and writing, that it’s okay. This is my narrative, and a small window into what is happening throughout the world.
I’ve been thinking about what kind of funeral I want. Yes, I know I’m a bit weird. I’m not scared of that stage. But we often worry about whether our children will know that they were loved. And in the end for me, every blogpost here I wanted to impart that to the children I know and to my own children. That Dr. Plastic Picker loved you, and that is why we are trying to save the earth.
And that is a beautiful narrative for sure. Going to go pick up some trash and get my mind on right before I head to work the weird staggered shift today.
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.
How does one begin to write a book? WHY write a book? When you walk through the few remaining books stores in San Diego, case in point the Barnes and Nobles in Mission Valley right behind the megalith restaurant chain B.J.s, there is always the section of books that are at bargain prices. $5 for two, with large red stickers plastered on the covers. Even in Harvard Square’s COOP bookstore where tourists and students would mingle among erudite tomes and popular fiction, and crimson university branded spirit-wear just steps away, there were bargain books. At some point, even great works of literature are sold at rock-bottom prices.
My name is Vi Thuy Nguyen, and I am a Harvard-trained pediatrician. Having spent the better part of 15 years as an undergraduate, medical student, pediatric resident, chief resident and to cap it off a premedical tutor (fancy Harvard-speak for premedical advisor) in Cambridge and then having a spouse with the same credentials but in a fancy subspecialty – it’s hard not to want to write a book. There are a lot of books written by Harvard graduates, sometimes even before they’ve graduated from Harvard. I’m not sure if it’s because we’ve self-selected ourselves by being self-driven and narcissistic enough to believe our life stories are THAT INTERESTING and that’s how we convinced someone to let us into Harvard? Or that we are so insecure that we need that continual affirmation, which drives us to continually update our resumes? Maybe that is why almost always a quarter of all Harvard graduates go into medicine, as those same qualities are often the strengths and pitfalls of the best doctors.
Which leads me to why I am writing this book. I’m in the glorious middle, and indeed turning 44 soon – a wonderful palindrome and even number bespoking a life that starting from the first digit or the last digit, reads the same and makes sense to me. As my requisite long self-absorbed subtitle explains, I’ve gone “From Harvard, Burn Out, to the Beach and Back Again. I was trying to save San Diego’s environment, but I ended up saving myself.” If you are reading this book, likely you’ve found my blog, Instagram, Facebook page, or heard me speak at various events. My story is simple. Two years ago, I found myself completely burned out from my career as a general pediatrician and what I call “middle-management” at a large HMO. I was a hamster on one of these wheels, running to where I had no idea. Rewarded with emails and accolades and bonuses by an invisible “upper-management” hand, doling out pieces of cheese to the hamster on the wheel. And during that time of poor sleep, constant work-messaging, middle-aged back pain from being a runner for over 20 years, always feeling inadequate as a mother and physician but with “metrics” that looked like success, I had two toddlers in my practice almost simultaneously diagnosed with cancer. They were both the youngest in their families, and I had been the only pediatrician both families had known. This book is dedicated to those two little girls (Ashley and Audrey), whose cancer diagnoses were the catalyst for my burnout but more importantly for my climate work. Their diagnoses and the reverberating pain when they become sick, affected me. I thought I was made of Teflon. I wasn’t. I was human, and I settled into a deep sadness that manifested in irritability, tension headaches, and then an irrational plan to leave my middle-management career.
But I can’t give the entire story away in the first chapter?!!! I need you to keep reading. I’m in the glorious middle. I’m at bag 560 right now of ocean plastic pollution collected from mostly San Diego’s beaches. As my fully description subtitle explains, this is “My Journey Through 1000 bags of Ocean Plastic Pollution” and I’m literally at the middle.
What does the middle of 1000 bags of trash, bag 560 look like? What does the life of a middle-aged Harvard-trained pediatrician in middle-management who is also the infamous “Dr. Plastic Picker” look like? It’s 5:08 AM and it’s pitch dark outside. I’m sitting drinking my matcha green tea soy latte with a teaspoon of sugar, and I’m typing away on my computer. I was fueled on 2-6 cups of coffee a day for over 13 years, and now I don’t drink coffee anymore. I only drink what I call my “Green Awakening,” this beautiful cup of matcha green tea soy latte in the morning. I woke up this morning refreshed and slept well, partly because I know to slow down my body with some yoga at night. My husband is asleep upstairs curled next to our little black crazy poodle mix, and he’ll go to work also as a “middle-manager” at our HMO. I’ve labeled him Mr. Plastic Picker, and he is Assistant Chief of Radiology. He is generally on the road to healing and improved health after back surgery a few years ago, because I am better. I asked him to take me to dinner this Saturday, as it’s my birthday, and we never used to take time for ourselves to go out to dinner. My in-laws are up, and they’ll be wandering into the kitchen soon to begin their morning routine. Much of my story of my climate and health activism, has to do with the lessons learned from my Korean in-laws. My son is going to take his PSAT this morning, and our daughter just won her first school volleyball game yesterday. She was former preemie and her medical struggles and my guilt as a working mother in her early years, are intertwined with my burn out story. But the beautiful thing about yesterday, is that I missed her first step and her first words – but I was there at almost 44 for her first volleyball win.
And what does the middle of 1000 bags of trash, bag 560 look like? Bag 560 looks like I’m Co-founder of San Diego Pediatricians for Clean, and Co-Chair of the American Academy of Pediatrics Climate Change and Health Committee. It looks like October 14 being recognized as Children’s Environmental Health Day by multiple cities in San Diego County, and my pediatrician friends and students fanning all over the region at press events recognizing the importance of environmental health with the AAP banner behind them. It looks like an upcoming Clairemont town council meeting where I’m co-presenting with one of our advocacy interns and a developmental pediatrician friend on the health reasons why leaded aviation gasoline and it’s pollution is an environmental justice issue. It looks like I was invited back to the National Institutes of Health Undergraduate Scholarship Program to speak on my climate and health work. And it looks like I’m still in “middle-management” and happy and found my niche in pediatric quality work and head of the HMO “Green/Sustainability Team.” And it looks like my entire family laughing yesterday around dinner, happy and saying our gratitude and eating a plant-based meal.
The middle looks like happiness. It’s absolutely true what I say during my climate and health speeches. Feel free to page me, “I’m always on call for the earth.” These are the adventures of me as Dr. Plastic Picker, self-proclaimed local-litter picking pediatrician. And the WHY I am writing this book, is that I’m literally trying to save the planet as climate change is a pediatric public health crisis. My crazy adventures and social media presence and book tour are about raising the alarm. It’s all hands-on deck. But I think you’ll find that if you help me save the earth, you’ll end up saving yourself as well.
I went back to it yesterday. I have always wanted to write a book. I started a word document a few months ago, but the work with Rewild Mission Bay inspired me to go back to it. Andrew Meyer the conservation director for the San Diego Audubon Society had suggested we title our advocacy letter one of the local city councilpersons Paging Dr. XXX. For an advocacy letter, I thought it would not go over as well. Paging a physician who does not want to be paged about what they don’t see as an urgent matter, is not the best way to convince them. But it really did inspire me as I realized for non-medical people – it captures their imagination. Plus, at different presentations for the HMO Green Team, I’ve used the phrase “we are always on call for the earth.” And I do believe that.
But that’s pretty much what I’ve done. I’ve settled on a working title and acknowledgements, and thinking about it. I’m at bag #565 about, and it will probably take me two more years to get to #1000 personal bags. That works out perfectly because that is the summer I am planning on taking my well deserved sabbatical and go on my electric car tour around the country. In the craziness of medical training, I’ve never traveled cross country and that is one of the things I’ve always wanted to do. Since this blog has been about taking risks and trying new things, I figured I could do that while spreading my message about physician wellness and climate and health advocacy. Dr. Plastic Picker has always been the ultimate mulit-tasker. Getting exercise and cleaning the earth at the same time!
I have to have San Diego Pediatricians for Clean Air designated as an official non-profit with tax exempt status. I’m not even sure how much a book would make, but I just want to make enough to buy stethoscopes for all our premedical advocacy interns. We have nine interns now! They are really wonderful. I want to be able to buy them each a nice stethoscope when they matriculate to medical school from SDPCA and AAP-CA3. But it is getting expensive as I have more interns now! I figure the book sales can go to buying their stethoscopes and otherwise maybe fund a picnic for the children’s arts council, and maybe some Tshirts.
The book can’t be too long. People have very short attention spans. I think 150 pages is enough? What do you think? I’m going to stop by Barnes and Nobles and browse the Physician Wellness section and see about how long those books are. The blog has been a beautiful endeavor and I’ll try to repurpose some of my blog post, but it’s kind of all over the place. I think a book should have some kind of cohesion. I need to figure out my character arc. And I want to sprinkle in tons of local color. I’m pretty sure I can pull off a national book tour (at small independent book shops OF COURSE!) but I know for sure I can do a local tour of San Diego. The local tour would be the most important, because the entire point is to local climate and health advocacy.
That is it. I just wanted to let the blog readership know that I’m continuing to plug away at the climate work, but I’m not forgetting my dream about writing my book! Every Crimson University grad needs to write a book especially before the 25th class reunion. Especially since the idea for this all came during one of the sessions at our 20th class reunion!
The art of storytelling, the art of writing – is something that is so powerful. It’s how we teach. It’s how we experience life. For me life has always been a series of interwoven narratives, of your life and my life. The threads weave and then unwind, and come back. They get frayed and then when we reform community and connections, we reweave them together.
When a new family comes in, I have always thought of it as another storyline that arrives. Each new baby is a fresh book, and the chapters may follow a similar arc – birth, breastfeeding, first roll, first food, crawling, walking and than toddlerhood, but the details of the stories are different. And it is those details that make life and families and patients so interesting.
I think I had realized that I was burned out when I no longer was interested in the patient stories. Maybe it’s called compassion fatigue. But taking walks now and taking the time to self-care, has helped me relearn that. Catching those details in clinic are so key. How a teen reacts to announcing there are vaccines. What the parent is wearing. What room they are in today. What activities are they doing now. Did they seem happy or sad. I used to be a voracious reader. I still read, but I read less now. I consume less TV shows as well. Filling myself with imaginary stories that someone else created preventing me from appreciating the real stories happening around me. And that’s my job, to notice those patient stories and notice the stories of the young physicians that inhabit the real world with me. It’s my job to notice the arc of the teenage drama that is my daughter and the quieter story of our older son. Even Mr. Plastic Picker has the arc of his story, physician leader, proud father, exasperated husband of wife who disappears to pick up trash.
I wasn’t able to notice the stories when it was noisy. When I heard upper management’s endless stream of emails about metrics. This is why I detest shortcuts on the electronic medical record (I still use them), but I want to write the patient narrative myself and give them the instructions that I have created. I felt the endless workflows and smartphrases was erasing me.
But I realize now that I can use these shortcuts created at work to spend more time with patients, because I keep the stories in my heart. I remember them. I write about them (vaguely) on the blog. I echo my memory of the day in my silly art. I wish this for everyone. To live your life purposefully and slowly. Treasure the details, the moments. That was the true answer to burnout really. Reclaiming the narrative of my life and just slowing down time. It was rushing too fast before, and now it is gloriously slow.
COVID-19 is surging in the great United States of America. Between seeing patients and talking on the phone with families and catching up with them, I realized the common thread to all of yesterday’s conservations is that we are all living in this grim historic moment of COVID-19 infections and deaths. In pediatrics, we expect to see the wave of MIS-C (Mulitsystem Inflammatory System in Children) soon that occurs in about 1 out of 6,000 pediatric COVID infections and earily presents like Kawasaki’s disease. Our other Assistant Boss whose name rhymes with bong sent out a reminder to update our order panels with the labs that we have to order. I will do it today after the Pediatric Infectious Disease lecture at 8am. I didn’t give away some of my evening after hour clinic shifts for the next two months, because I know I need to be in the trenches with everyone else. So I’ll have my order panel ready as well.
Congratulations to me!!! Almost 8,000 people know the name Dr. Plastic Picker and spent about 2 minutes on this blog scrolling through on average 5 blog post. Most of those were here looking for Star Trek Fan Fiction! LOL. The top outsider referrering webstie was retireby40, probably because his website is the only one I consistently read. It’s Joe, and I like Joe. I get some traffic from other FIRE blogs when I comment and read them. Again with this blog is quality over quantity, since we are non-monetized. The traffic is mostly from facebook which I honestly know are mostly my friends, families and patients.
I posted this on my personal Facebook page, and it’s worth reposting on the blog. I have been interviewed by a few news outlets including KPBS and mentioned in Del Mar Times, and will be doing a podcast soon with KevinMD. But the one that has been the most meaningful was this recently completed interview with Voices of GenZ writer Arlene Nagtalon. Rereading our conversation in her article, I felt much the same way when my son talked about his Climate Strike Speech at school. To see our children especially these brave teenagers tackle issues that we as adults have failed at, is inspiriting.
“Its 11PM and trying to coordinate with some key people efforts to get a measure passed tomorrow at the San Diego County Board of Supervisors to limit flavored ecigs in order to protect our teens. And it’s frustrating because big tobacco and many forces are out there fighting against such a common sense measure. But when I get frustrated and want to give up fighting for pediatric health and our environment, I think about amazing teens like Arlene Nagtalon. This is a co-worker’s daughter. I was touched when she asked to interview me for the youth on-line magazine Voices of Gen Z. Below is the interview. I’m a bit tired of talking about myself, but I was so grateful to get to know Arlene during our virtual interview. She wrote all about me, but sprinkled during my replies was a true back and forth conversation that was very satisfying. I can tell you it was one of the best most intelligent and stimulating conversations I’ve had in a long time. Check out her article, but better yet check out this magazine. What these young minds are discussing, blogging about and writing – is simply amazing. They get it. They get the issues. It’s their world and they are fighting for a better future. I sound probably hypomanic in the interview because it was so fun to talk with Arlene. Kudos to her mother and father for raising an amazing daughter. Her pediatrician (a friend and colleague) for being her pediatrician. It really takes a community. Anyway just wanted to share why it’s worth fighting big tobacco at 11pm at night and why picking up plastic is worth it, because it’s for our children. It’s true we borrow the world from them.”
I am waiting for Mr. Plastic Picker to finish a call. He’s staffing for his department this morning, and will be done in about 15 minutes. He said he’d go to the beach with me to talk while I pick up trash. The beach has been a healing place for me the last year, and I am always grateful when he agrees to go with me. I think he is healed next to the ocean as well.