Mr. Plastic Picker’s mother turned 80 this weekend and we had a small family party. Our small family party included buying a pumpkin pie from Sprouts (we had all been wanting to eat one for a while and there was very little plastic), singing Happy Birthday while our tween daughter played on the piano, and shooting the requisite pictures to send to family members. We then ended by eating said pumpkin pie before dinner which is pure luxuriousness. It was a standard 9 inch pumpkin pie so just enough for everyone in our 6 person family (excluding pets who can’t eat pie) to have one piece and an extra bite.
I was a bit despondent about the state of the COVID-19 vaccine roll out in our particular institution and in the country, probably felt like the trash art piece I made from bottle caps yesterday. Looking. Looking. Where is my vaccine? But then I read an article in the New York Times about how the wealthy countries including ours have ensured that rich countries will be vaccinated first and the poor will be last. It was all kind of depressing.
But if there is anything that Dr. Plastic Picker is good at, it’s compartmentalizing things. What happens in our institution will happen. We will get ours in due time, and both Mr. Plastic Picker and I don’t want to tempt fate. We actually would rather get the Moderna vaccine simply because it sounds better, Moderna sounds more modern. And regarding the inequity of poor versus rich countries and echoes of colonialism, wow – I can’t do anything about that right now.
I Ecosia (not googled) searched “Stretching Calming Youtube Video Hawaii” last night. I had the video on and the calming beach sounds while I did some simple stretching for 10 minutes. I had just a normal busy day in clinic. I had extended myself to doing bi-monthly VIDEO sessions with a family that is at a crisis point due to a common pediatric psychiatric diagnosis. The patient is in with the therapist but the appointment is not for another month, and it’s frustrating for both the family and myself. I happened to have a psychiatry book on this topic in my house. It has vetted therapy techniques to “Improve Your Daily Life and Take Back Your Peace of Mind, Calm Anxiety, Diasable Panic Triggers, Prevent Relapses and Setbacks, Manage Responses.” The author I just checked is the director for mental health training at our sister HMO up north. Now I definitely know I am in good hands!
I am sending to the family short lessons from the workbook for their child, and just checking up with them and seeing how they are doing. It is through the secure portal. I’m doing it for them, but I’m also doing it for myself. I’m getting to learn something so valuable that no one has ever taught me. I desperately need to learn for myself and for my patients. How do we heal ourselves?
Did you know that Salvia rosmarinus or Rosmarinus officinalis commonly known as rosemary, is a woody, perennial herb with fragrant, evergreen, needle-like leaves and white, pink, purple, or blue flowers, native to the Mediterranean region.”https://en.wikipedia.org/wiki/Rosemary I had known these shrubs on my walks around the parking lot, and I had seen bees around them. But for some reason yesterday I really noticed the plant, and broke off a few branches to smell the leaves. Indeed, it smelled like Rosemary. I thought they were native, but they are a transplant from the Mediterranean that has a very similar climate to our little corner in Southern California. This is a wild growing cultivated plant. Just reading the Wikipedia page there is a long history of it’s journey during Greek and Roman times, through Europe, and finally “Rosemary finally arrived in the Americas with early European settlers in the beginning of the 17th century.” Then at some point it arrived in a little hidden corner of our HMO Parking lot.
I know that the particular non-descript HMO complex I work at was built about 30 years ago. Rosemary plants can live about 30 years. I wonder how old this plant is? I wonder who planted it? I love Wikipedia. It details the history of Rosemary and “In Don Quixote (Part One, Chapter XVII), the fictional hero uses rosemary in his recipe for balm of fierbras.” What is the balm of fierbras? “According to a chanson from 1170, Fierabras and Balan conquered Rome and stole two barrels containing the balm used for the corpse of Jesus. This miraculous balm would heal whoever drank it . . . Don Quixote mentions to Sancho Panza that he knows the recipe of the balm. In Chapter XVII, Don Quixote instructs Sancho that the ingredients are oil, wine, salt and rosemary.” When Don Quixote drinks the balm of fierbras, he vomits and sweats and is healed from it. Sancho gets diarrhea and is nearly killed from it.
It’s 530am after the 2020 Pandemic Era US Elections. There was the Executive Branch on the ballot, but so was the Senate, House and many local races. There is palpable sense of disappointment on my personal Facebook feed as there is in our home. Yet I have always known we live in a skewed bubble echoing chamber. Of course California went blue, as did the entire west coast. 65% of Californians voted for Biden. Yet I also know the history of the anti-socialist Cuban community, and I could have told you that they 100% they aren’t “Latino Voters” that would suddenly vote for a ticket with a black woman as VP candidate? They are Cuban-Americans and they hate Communist, just like the community I grew up in. Case in point their favorite son is Mark Rubio. He is not a caricature. He is elected by a population and represents that view. Do you think Cubans and Southeast Asians in the majority care about Black Lives Matter? There is still centuries of internalized racism and colonialism. But we can’t save the earth with just half of the population, and no matter what happens with the election – we know that at least half voted for Trump.
Did anyone ever think it was going to be easy? There are still many ballots to be counted. If this pandemic has taught me anything, it’s that no one can predict anything. Demoacracy will play out in it’s messy and beautiful way. Dr. Plastic Picker believes in democracy – this is the only way things will work. The only way we can save this earth, is changing hearts person by person. We also need to speak the language they understand, which can include finances or faith. It’s hard and messy, and takes engagement and building community. Mr. Plastic Picker looked at me yesterday with a clearer gaze and he said, “You are right. You keep on doing what you are doing no matter what the election results. You’ll still be Dr. Plastic Picker.”
Does the world seem out of whack? I had the third HR/middle-management issue come up this weekend. This one came from far left field. I was texting with Chief Boss and I told her if I wasn’t a happy litter-picker these days, I would seriously quit. I realized all these issues likely have to do with the chaos in the world right now. There is a pandemic going on, with greater than 200,000 COVID-19 deaths and we are entering the third wave and bracing for the headlong collusion of flu and COVID which is fluVID. She has had to deal with 10x greater HR issues. I get it. We are all stressed, and therefore everyone is going a little bit crazy. The three issue are now solved (at least in my mind) but geeze-louise people.
Seriously, trying to help run a department if you want to do it right and just and actually improve healthcare within a large bureacracy is hard. It’s so easy to just sit there, draw your compensation, have your pension grow, complain about late patients, point out that they didn’t come on time and just avoid larger structural issues. But that is the problem right? Large systems breed complacency. And MDs have a higher calling to actually improve health outcomes and to agitate. Unfortunately anytime you agitate or make changes, people get all bothered. And then there are the micro-aggressions that women leaders have to go through. It is so real and painful and unfair, that I can’t even begin to explain.
Did I really get into a vaccine debate on Facebook with the COVID-19 Pediatric Group? Yes I did. I couldn’t keep my big mouth shut. I left my comments there because they are actually really important. Someone was complaining about pharmacies giving out flu shots to kids, and I disagreed. I think kids should get their flu shot wherever they are available, and I think they should get other vaccines as well. Sometimes when I shoot my mouth off, I’ll go back and delete comments. But I left these up despite the controversy. And those that feel the same way as I do and are looking at the “big picture” in terms of vaccine rates need to see the comment. But I MUTED a bunch of the repliers. Wow, gotta love Facebook that you can MUTE people. The crux of the issue is that some pediatricians want vaccines only given in their office. I get it. They are actually reimbursed quite a bit for vaccines and well child visits and vaccines are 60% of pediatric outpatient volume. I work in an integrated healthcare system and I don’t need to think about my reimbursements and patient volume. I’m always busy. I do procedures. If pharmacies and dental offices and others give out vaccines, what are pediatricians going to do? It threatens their livelihood and is an existential threat to some of their identity. They believe they are dispensing wonderful advice and care during well child visits. Kids should 100% come in for well child visits. But the truth is they are not coming in for vaccines right now, and they need their vaccines. My take on things is that it’s about the patient. We need to admit when we are supposedly painting things as “for the patient” when it’s really “for us.” I don’t believe it. Then see sick kids! You can start siphoning off work from the urgent cars and EDs. We can start seeing up to 21 years of age. Or stop referring to dermatology or all the specialist, and learn to work up patients more thoroughly for bread and butter stuff. Oh, open up a Headache Clinic! Start training to do bread and butter mental health issues, as we don’t have enough pediatric psychiatrist. Put in implantable birth control. Or go pick up some trash. Trust me, there is enough work for everyone. Their business and livelihood is not my problem. I’m looking at the big picture which is increasing plummeting vaccine rates in the country. It felt so good to MUTE the said person. Flu Vaccines absolutely should be given at pharmacies and I believe HPV should as well, and maybe even dental offices. Why not? If pediatrics can’t survive without vaccines, than what are we? I’m pretty sure we are smart enough and versatile enough to pivot.
The Aerobin 400 composter is still out of stock at Costco! It retails on other sites for $370, but at Costco it is $299. There is currently a coupon for $75 but it is out of stock. I’m checking every day and I’d rather get it for $225. But I think after the rebate expires, I’ll be able to get it for $299. If I have patience, I’ll save $75 at least. I almost bought it for $325 on amazon yesterday, but Dr. Young-Ho Yoon told me to check the costco site again. The aerobin 400 was available for a hot second, and then the “OUT OF STOCK” image came back on. Anyway, I’ll keep on checking back. It’s providing me some amusement as I want to snag it for a good price. I want to compost but I also know that it’s not good to waste $75 just being impatient. Amazon is a really tricky platform. It made me think I needed $15 compost starter and also a $20 snazy kitchen compost container that looked so eco-cool and stores about 1L of food scraps. So it would have been almost $400. But Young-Ho told me he didn’t get the compost starter and we have plenty of plastic tubs that can hold a days worth of food scraps, so I don’t need that kitchen scrap compost container. This is why I don’t like shopping on amazon. They always make me think I need things that I don’t!
One of my favorite bloggers is LenPenzo. He’s one of the original personal finance bloggers and sometimes writes nonsense and talks a lot about the gold standard. He’s from Southern California as well, and represents a conservative financial and political outlook that I’m very comfortable. I grew up in that kind of culture, although I am more politically left now. It’s hard not to be when you take care of children as a pediatrician in an underserved area. But LenPenzo has been blogging forever and he’s still my internet hero. I stop by his blog now and again, and leave comments. Len’s dad passed away recently and he left a short post on his blog https://lenpenzo.com/blog/id63332-black-coffee-10-oct-2020.html.
Our tween daughter and I finished watching the documentary “RBG” yestserday in preparation for our Cadette Girl Scout Meeting. It was a special night to have the time to watch it with her and answer her questions, and watch her expressions. It was meaningful for so many reasons. As someone who considers myself of a historical bent, I did earn my undergraduate degree in History of Science, I am always curious as the origins of quotes. The original quote that RBG credited but is often forgotten by our modern society comes from Sarah Grimke https://en.wikipedia.org/wiki/Sarah_Moore_Grimk%C3%A9.