March 15, 2020

by drplasticpicker

Did the picture above catch your attention? It’s a bit odd. The large stuffed animal/bean bag animal is some kind of anime/Pokemon formerly loved object my millenial brother dropped off at my house. His 2-bedroom-2-bath downtown condo was getting too filled, and he passed this on to us. It’s an interesting piece of human artifact. Honestly, I did it more to keep it out of the landfill. If you want it , it’s in excellent condition so just let me know and I’ll clean it up (it’s pretty clean) and send it over after the COVID-19 crisis if you have kids who will love it. The other object is a plastic bag I made from scraps of plastic I save. I know it’s weird, but I have embraced my off-kilter personality. The Plastic Picker children consume enormous amounts of clementines now known universally as cuties. They actually do have fiber. My daughter and son pointed out to me about 1.7 grams per clementine https://drplasticpicker.com/squeasy-gear-1-tackling-the-pediatric-fiber-deficit-with-real-fruit-and-not-plastic/. But those cuties come in this god-awful orange plastic mesh bags with an elongated plastic product label strip that is a third the size of a piece of paper. Every time we throw these away, I have this irrational sense of guilt. I think it’s having picked up now 178 bags of ocean bound plastic. I’m not sure how a peditarician who picks up trash and pays my taxes and has not ever had an extramarital affair and never fake-called in a sick-day feels guilt? Not sure what my parents did to me when I was young.

But I feel guilty about those orange plastic mesh bags. I save bits and pieces of plastic that come with some of our food packaging. We stopped buying plastic bags months ago, and I reuse a lot of the plastic bags that come with the Veggie Sticks and Kettle Corn we still buy occassionally at Costco for my litter picking. I wrote a blog post about it 5 months ago, which I don’t think anyone read. You should check it out! https://drplasticpicker.com/plastic-bags-are-slowly-disappearing-around-me/ But there are bits and pieces from the rare ramen package, sliced cheese, and the small organic pasta plastic packaging I buy at Costco. Those are hard to reuse for my litter picking even as make-shift “gloves.” Now I am a master at the glue gun which is how I mostly make my trash art https://drplasticpicker.com/trashy-art-poor-chirp-chirp-the-joy-of-the-unexpected/. The glue gun sticks I buy in bulk and cost me about $0.05 a glue stick. So I reuse those bits of plastic and use the cutie’s plastic mesh bags as my base, and I make these pretty sturdy bathroom trash liners! They are amazingly sturdy! And every time I finish one I walk around the house showing my father-in-law, mother-in-law, my high school son who is taking AP Computer Science, my daughter and sometimes Mr. Plastic Picker if he is home – and they all exclaim at how marvelous my bags are. My father-in-law has been doing the same with used cardboard for years, as he is able to fashion used-paper-product trash-can liners. Isn’t that odd but interesting?

Anyway, I bring up making these trash-can liners out of used plastic because I understand everyone’s anxiety over the COVID-19 crisis. It’s easier to DO SOMETHING rather than to be asked to sit at home and social distance. I have embraced my middle-aged middle-mananger wisdom, and I have been a student of not only medicine but of human nature for the last 15 years. It is so hard to be asked to do nothing, even when that nothing can save lives.

We have two children, and they are healthy now. I was on bedreset for both of them for about 8-12 weeks each. I was placed on strict bedrest at home and sometimes in the hospital for cervical incompetence to try to have those babies stay in and not fall out of my uterus prematurely. Having your cervix called incompetent is hard even though it’s your cervix and not your brain. I felt no pain and had minimal bleeding, but the ultrasound showed an increasing shortened and effaced cervix. There was less than 0.5cm of cervix keeping these still not viable fetuses in. This was over a decade and a half ago, and I think they’ve done more reserach and have more treatment modalities than just asking a pregnant woman to put a few pillows under your hip and stay still. But I did for the most part, and got up to go to the bathroom and a few times a day just to change the room I was in. But mostly I laid on the 20-year-old still pristine white Italian sofa set that belongs to Mr. Plastic Picker’s parents. It has custom made plastic covering and it surprisingly comfortable or our full mattress on the floor that we still had not bought a bedroom set. My sister will tell you I got up more than I was supposed to, but I followed those bedrest orders pretty well.

COVID-19 social distancing orders are very much like bedrest for cervical incompetence. You don’t see the danger when you look out the window. The weather looks fine and the sky is clear, and there are not dead bodies on the street. But the public health officials are telling you that the signs don’t look good, that soon there can be catastrophic social change as the immuncompromised and the elderly will die if we don’t #flattenthecurve. They are asking you to stay home, like the high-risk Ob-Gyns asked me – did I want to abort now my 18 week fetus or did I want to try to save her and go on bedrest? I opted to try bedrest even though my body felt fine and I couldn’t actually see the dangers because I trusted my Ob-Gyn colleagues.

When I went on bedrest it was one of the hardest things I ever did. Everyone thinks bedrest is easy. It’s horrible and nerve-racking especially since it was pre-social media. I had to lay flat on my back and dwell on my racing and jumbled thoughts of the possibilities of how life may or may not end up. One painfully sees the world go about it’s rhythms while one just lays there. I did finish one scientific paper while on bedrest. But my other grand ideas about brushing up on Korean or Vietnamese did not happen. I watched a lot of Law and Order. Maybe that is why our son is so rule oriented? I’m surprised I didn’t scar him for life since sometimes Law and Order can be gruesome.

But I made it through bedrest mostly because I am a very analytical person and I wanted that beautiful baby however they came at the end. I was not willing to be the one to make the call to abort her. If I was not meant for me to have children, than a higher being than myself would have to make my cervix efface. But it wasn’t going to be me. I did what many of you are doing now holed up at home. I made schedules for myself. I did ankle exercises and arm lifts, because that it what they told me I could do. I talked to my mom and sister a lot. I read every article there was on cervical incompetence and treatment modalities, and emailed back and forth with many of my old medical school classmates who were Ob-Gyn. I cried and thought about how unfair the world was, that I just wanted a baby and I had studied so hard and had taken care of so many other people’s babies -why couldn’t God give me just one little girl and/or one little boy? But what got me through the hardest times was my analytical brain. I had calculated out roughly that for every minute I stayed on bedrest, a certain number of alveoli (the end-unit of respiration where there is gas exchange at the capillary level in the lung) were opening up for my fetus. Every day the baby stayed in was a better chance than when it emerged, it would breathe and might survive. I had been on the NICU receiving end of the delivery team and helped resuscitate enough preemies to know well what a difference alveoli make when a 26 weeker usually needs lot of supportive care and can have untold complications but a 28 weeker and certainly a 30 weeker does pretty well. It all has to do with it’s lung maturity. So when I wanted to give up, I would sing to myself “pop pop pop” and I knew alveoli were opening up if I did nothing.

So to all of you , dear readers, who are going crazy social distancing and staying at home. I realize that you want to do something. Just like my making the mish-mosh plastic bag with my glue gun because I want to do something about the plastic pollution crisis. Doing something anything makes us feel good. You want to do something, so you are hoarding toilet paper and sometimes writing or reposting crazy conspiracy theories on line. You are not bad, you are just reacting to this theortical existential threat that we are telling you that exist. But my advice is think that for every hour you stay in and social distance, every time you are washing your hands, think of the breath of a grandmother or the tap of their cane as they make their way down the nursing room hallway still alive. Think of that incremental life and human moment you are saving by doing nothing.

For me though, I have been on bedrest and have two beautiful children. Both came and did not need any intubation during the first day. Enough alveoli popped open that I am the lucky mother of two. Over a decade later, the world is in a similar situation. You have to stay home to social distance and I feel your pain. But I am a doctor who is healthy and my uterus is voluntarily closed for business, and I get to go to work tomorrow and help save the world. My middle-manager friend whose name rhymes with Gong, asked me if I was ready to go back to work after a week of vacation to jump into this COVID19 maddness. I told her in essence that I felt that this was our moment in history and we were lucky to be bit players. I had wanted to join the CDC as an epidemic intelligence officer when I was young, but Mr. Plastic Picker had wanted a more conventional life and asked me to marry him right when I was about to make the critical decision. I had spent a glorious summer in Vietnam working in public health with the CDC on the HIV/AIDS crisis, and I think I had been proposed to at least three times that summer by other men! I think they honestly wanted a green card, but I was also vibrant and alive that summer. I was a good student and just did research and worked and traveled, but was so alive! So now I live in a Southern California suburb with my two children and near my mom, and I am an HMO middle-manager married to the love-of-my-life Mr. Plastic Picker. I have written before how I was raised as an activist https://drplasticpicker.com/drplasticpicker-remembers-i-was-weaned-on-activism/. And perhaps some of my conversative friends are right that this is a mission of folly, and I’ve at times felt like Don Quixote https://drplasticpicker.com/don-quixote-is-this-a-cautionary-tale-for-drplasticpicker/. But I am excited tomorrow to go to work and dive on in. But for you friends who are not in healthcare, who are brilliant attorneys, educators, engineers, I know you want to DO SOMETHING. But the best thing you can do is do nothing. Social distance and stay home. You will be saving lives each day you stop the spread and #flattenthecurve. Think of the sound of your grandmother’s breathe or the tap of an older friend’s cane. Tap tap tap. Whoosh whoosh whoosh.

Here is a previous post regarding what enviromentally-friendly actions you can take at home during social distancing! Try it. It will make you feel like you did something! https://drplasticpicker.com/covid-19-five-things-you-can-do-for-the-environment-while-you-are-social-distancing-staying-home/