HPV Vaccine Rates Will Go Up: Middle Management as Performance Art – Dr. Plastic Picker

HPV Vaccine Rates Will Go Up: Middle Management as Performance Art

| Posted in Office Politics/Leadership Development

Making Huckleberry/Blackberry Pie Bars helped me think through my presentation.

October 22, 2020

by drplasticpicker

Two unicorn-like things happened yesterday. I made Huckleberry/Blackberry Pie Bars from scratch, and I convinced fellow middle and upper managers to provide flu and HPV vaccines at our “flu tables.”

When I was in 8th grade in Junior High, we took US History and for some reason I was assigned the project of making a colonial-era dish with huckleberries. My partner for this project was also a fellow student from a immigrant-nonEuropean background. We had no idea what huckleberries were. This was well before the internet. We used blueberries. The dish did not turn out quite what we expected. I always had this nagging question, what were huckleberries? I stored it in the back of my subconscious for the next three decades. I honestly thought the recipe probably didn’t work out because huckleberries were likely more like a cranberries, or maybe they were more of “nutty” or a savory berry.

And then one of my close highschool friends now lives in Montana, and placed on facebook a picture of his huckleberry bush and I was amazed! There was the unicorn ingredient that I had always wondered about. There was the mythical food that separated me from being truly American, and understanding colonial history. My friend dropped off a tupperware with about 1 1/2 cups of huckleberries and sent a recipe via Facebook of a suggested recipe. His wife is a nutritionist, so I take his food recipe suggestions seriously.

A few days passed, and I kept on thinking about the huckleberries. Presentations. Work emails. COVID-19 Pandeimc. There are things that get in the way of the things we want to do it life. But yesterday morning I had a pressing presentation on HPV vaccination efforts in our HMO, and needed to convince power-brokers outside of pediatrics to lend me some resources. I had slept on the presentation a few nights and visualized all sorts of storylines for my presentation. Sleeping I thought about it. Plogging I thought about it. I talked about it with Mr. Plastic Picker a few times. RN Plastic Picker had already done her part of the presentation, and I had about 7 minutes to fill. I had the right audience that was virtually captive, and I needed to make it worth their while.

So what did I do at 5am the day of the presentation? I made my first pie for the first time. I made my first pie for the first time because those Huckeberries were calling to me. I had already purchased the cooking spray we needed, more flour, and blackberries (as the recipe called for 2 1/2 cups of berries and I already had 1 1/2 cups of huckleberries that grow wild in bushes in Montana).

This is the recipe my good high-school friend sent me from FabulesslyFrugal. I have put in parenthesis my Dr. Plastic Picker minor changes.


4.9 / 5 (9 REVIEWS)PREP TIME: 20 mins |COOK TIME: 35 minsYIELD: 9×13 pan | SERVES: 24


  • 2 1/2 cups all-purpose flour (12 1/2 ounces)
  • 1 teaspoon salt
  • 1/2 cup shortening (I skipped this as I could not find it at the store)
  • 1/2 cup unsalted butter (used slightly less than 1 cup of unsalted butter instead)
  • 1 egg, separated
  • 2/3 cup milk (actually a little less)
  • 1/2 cup cornflakes cereal, crushed (skipped, couldn’t find it at Costco – turned out fine without it)
  • 3 to 4 cups blackberries (used 1.5 cups of huckleberries and 2 cups of blackberries)
  • 2/3 cup sugar (used just 1/2 cup)
  • 2 1/2 tablespoons cornstarch
  • 1 to 2 teaspoons lemon zest (optional) (didn’t have time, had a presentation)
  • GLAZE (totally skipped this and it was already so delicious without glaze)
  • 1/2 cup powdered sugar
  • 1 tablespoon water or milk
  • 1/2 teaspoon vanilla


  1. Preheat oven to 350 degrees. Line a 9×13 pan with foil, overhanging on the ends so you can easily lift to remove the bars from the pan. Lightly spray the foil with cooking spray.
  2. Add the flour, salt, shortening, and butter to a large bowl and mix with a pastry blender until it looks like cornmeal with pea-sized and smaller pieces.
  3. Place the egg yolk in a small liquid measuring cup and lightly beat with a fork. Then add milk to the mixture until it reaches 2/3 cup. Stir the milk mixture into the flour mixture.
  4. Divide the dough into two equal portions. Lightly cover one portion with plastic wrap or other so it doesn’t dry out, then roll out the other portion until it is close to 9×13 size or a little smaller. Carefully place the rolled out dough into the prepared pan as the bottom crust, gently press it out to cover the bottom of the pan, if needed. Spread crushed cornflakes over the bottom crust.
  5. In a medium bowl, gently stir together the blackberries, sugar, cornstarch, and lemon zest (if using). Pour the berry mixture into the pan and spread on top of the cornflakes and crust.
  6. Roll out the other portion of dough to 9×13 size and place in the pan over the berries. Lightly beat the egg white, then brush over the top crust.
  7. Bake at 350 for 35 to 45 minutes, until crust is golden brown.
  8. Meanwhile, in a small bowl, whisk together the powdered sugar, water or milk, and vanilla for the glaze. Pour the glaze over the bars after the bars have cooled a bit. Serve warm, at room temperature, or refrigerate and serve cold.


Yesterday morning was so peaceful. In the dark, with just enough kitchen lights to cook – I had the kitchen to myself. My mind could wander from HPV vaccine rates to looking at the bowl that I was going to make my pie crust. I pulled out the food processor and thought about using it, but it would wake up the entire household. Instead I just used two butter knives and that worked to choppily mix in the butter into the pastry dough. I used my red matching metal mixing bowls I had purchased at Good Will this month. I noticed that some of the fiery red color that I love is chipping at the botton, and it made me even happier. Those bowls are still lovely and they match my teakettle. I have given them a second life in my kitchen. For the pie filling, I didn’t have powdered sugar and just used a bit less of the granulated sugar. Everything turned out perfectly. Those Huckleberry/Blackberry Pie Bars were worth the three decades it took.

The process of making pie bars.

And during the process of making the pie bars, my mind was able to wander. My subconscious was able to sort out what I needed to do at the vaccine talk. I even cleaned the entire kitchen and no one saw the inevietable disarray that comes with making anything from scratch. I stored my cleaned and dry Goodwill mixing bowls in their place on their shelf where they now belong.

I had already prepared the slides for the talk the day before, but I quickly typed out the comments I was planning to make. In highschool, I had been a state level Impromptu and Foreign Extemporaneous Speech competitor. In fact, the friend that gave me the huckleberries was my former Team Debate partner who is now a very successful attorney. I channeled that early training from high school. And making the huckleberry pie bars in the morning helped me to sort out the speach in my mind.

So yesterday afternoon I gave my pitch. I sold the story of HPV vaccines as analogous to mammograms. HPV vaccinations are simply cancer prevention. If we miss screening mammograms, we are missing cancer. If we miss HPV vaccine opportunities, we are missing cancer prevention. RN Plastic Picker had given the audience numbers and reminded them the efforts we had already deployed. And then I showed them graphs and colored charts. Then I told them my story that as a peditrician I am a child advocate. I advocate for teens, and why were teens not getting a fair shake in our HMO? Why did not they deserve to have cancer prevented? We will have inadvertetnly caused HPV morbidity and mortality by missing these vaccine opportunities. The Pediatric vaccine centers at four locations were not enough. Every flu table that gives vaccines, should check to see if teenagers are missing their HPV and they should be given. I implored them half jokingly but half serious, who do I talk to? Where do I go? I failed this season, but we still have November-February to do this. How do I make this happen? I showed them pictures of me with 2 big squash that my Russian/Korean/American family had given me. Look I told them! Patients give me squash, because I care and I vaccinate them. Why am I here at this meeting if I can’t convince you to care about my teenagers? The rest of middle-management work is noise if I can’t get vaccine rates up. Should I just go back to clinic and get more squash? That isn’t the exact text of my pitch but it’s the heart of it.

And dear friends, Dr. Plastic Picker was successful. We got agreement. Suddenly the wheels of our very big HMO are moving. This is how we get things done. Middle management at it’s core is performance art, and I performed on behalf of teenagers and my fellow pediatricians. I risked looking ridiculous by telling the truth. After all that and making Huckleberry Pie for my family. I felt pretty good.

Two unciorn-like things happened yesterday. I made huckleberry/blackberry pie bars. And we got buy-in to have HPV given at the flu vaccicenters. And all those positive things we do in life, including all those positive things that you dear readers do, please celebrate them. Please celebrate yourself and acknowledge all the good things you do for the world. By celebrating and owning the wins, it gives you strength to whether those microaggressions that women in leadership in particular have to deal with. Don’t be like teflon though. I tried that a year ago. It never slides off. You remember it and it can fester. Don’t let it fester. Acknowledge those microagressions. But don’t touch them. Use a metal grabber and pick it up and put it in the trash receptable. Not everything can be recycled. And move on to the next part of the world that needs to be cleaned.

That helped a lot. HPV vaccination rates are going to go up, and middle management is performance art. And huckleberry pie helped me figure it all out. And sneaking an extra piece of home-made pie yesterday, because sometimes homemade food makes one realize how wonderful the world is.

My reward with my coffee.

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