July 2, 2021

by drplasticpicker

I’ve let middle-management worry me (it is 18.75% of my job description – literally) the last two days. It is a complex system and it’s easy to become a creature of said system. I’m definitely strong enough to manuever within it and still stay effective and impactful. But it is so annoying. That’s all I can say about it. So many committees, office politics, minutiae. In the end, it’s the children that get the better care at the end that make it worthwhile. It’s my colleagues and trying to improve their lives, which give me strength. I know I have been a transformational leader and have given the HMO monolith bang for their MD Middle Management buck. But I had an epiphany this morning, just sitting here at 4AM and typing away. I finished watching a NetFlix series which was really heart-warming and touching, and should have slept more – but I didn’t because I have to help a student with an abstract for the upcoming AAP meeting. My epiphany as I roused myself to do something that was important for a student and the earth, is that if I “fail” at this Middle Management or I chose to “opt out” it is 100% the system.

This exact same system is what happened to by father when he was a young welder and union rep. He had a safe job and had been promoted to look after the welfare of his co-workers. And at a critical juncture when his fellow welders were getting respiratory diseases and sick, the seemingly progressive union bosses that paid their democratic party dues – they were wrong. They did not stand up for what was right. They were creatures of the system. At that moment, my father who had a young family to feed and the sole bread-winner in the family made a critical decision – do you compromise your values knowing that keeping just yourself safe and keep your safe leadership position or do you tell the workers to strike. They had been all getting sick with bronchitis and coughing up blood. The working conditions were not safe. They went on strike, and slowly the organization that had promoted him into a leadership position began to undermine him. The Union bosses were in cahoots with the monolithic company and their shareholders. They gave him the bad shifts. Little micro-transgressions at work began happening. He was stripped of his leadership title.

But my father is hardworking and brilliant. I think he had been immersed in nature his whole life. He swam across the Mekong as a kid and remembers floating in it’s silt-rich waters. He was nourished on food that was grown in the earth of a society and culture that has understood composting and good food comes from good earth for generations. I truly think this that gave my father strength, plus an innate frugality and the love of his beautiful young wife that believed in him. So he left. He just left. And now he is the brilliant businessman that he is , building jobs and building infrastructure and building community. He isn’t driven by money but by curiosity. He finds everything he does so interesting.

I am so like my father in some ways that it is scary. And so I realized that this morning. It’s so much the system and do you bend to the system? I’m at that critical jucture. Do I compromise and waste mental energy continuing to navigate this middle-management? It almost broke me two years ago. A similar time of micro-aggressions and petty office politics. I can’t be in a position and not do the job that I want. I just can’t. I can’t just see a patient and give “standard care.” I care so fundamentally. I treat each patient like I would my child. So I realized that I won’t compromise on who I am. I won’t be quiet. I’ll state my opinion, and maybe tone it down just a notch so I don’t have to keep on apologizing for hurt feelings. But I am who I am, and the greatest tragedy would be to give into the system. And why should I? My father was a blue collar worker at that juncture with a young family to feed, and he had courage. I’m an MD and could work anywhere. I have a broad skillset. And we are financially free anyway (although I do need to pay back a big chunk to my brother for the rest of the Oregon farm which I will have soon). But that is just shifting funds here and there.

But yeah, I just realized this morning. I’m not scared and I’m not compromising. Because if it’s time to leave Middle Management, I’ll leave. But I’ll make sure that the deficiencies in the system are glaringly obvious to those that take over and hopefully it will improve it. And I’ll do my climate work and take care of patients. That was what I had always wanted anyway, just to take care of patients. I think things will work out though, but I refuse to try to navigate this system to the point of burn-out or to seek empty titles. And I really feel sorry for those that seek titles and doing the office politics jockeying. Because in the end, I’m my father’s daughter. If I don’t get paid for it and I don’t have the title and the work is not meaningful, I won’t do it. They will have to do what I do, and honestly – I’m curious to see what they think I’ve been doing for the past four years? Really good luck. The literal cr@p is going to hit the ceiling fan. It happened six years ago when you had ineffective middle management. Yeah, good luck.

But honestly most people just show up to work and don’t look up. I’ll just keep on showing up everyday with joy. I’m so happy now. I even enjoy watching the middle management back and forth. Yes I do.

I’m so excited about other various projects. I’m waiting to hear from the engineer about the bridge we are building across Upper Cow Creek, the stream that criss crosses the timber parcel. We are doing a creative refinancing with our mortgage broker, and I find this new type of loan really interesting. I have to final edit an abstract for the upcoming October American Academy of Pediatrics (AAP) meeting for one of our premed students. Our academic paper will be published published soon. The interview with the think tank Children’s At Risk will be made public soon. The other four co-authors of our paper are so excited. I have some projects on our sustainability team that we want to get started on. Albuterol canister recycling. Need to open up the national conversation. Trying to figure out who decides on energy policy at the hospital, as we want to have our HMO buy into Community Power and not the large local fossil fuel company. I have to arrange the mock interviews for our two premed interns. They are going to do great! And there is a grant I want to work with on with one of the other pediatricians to mimic what AAP Montana did in their state. They got a similar grant for a program called AirKeepers. I need to contact Dr. Lori Byron and ask for her advice.

And then there are my kids. Sometimes I doubt myself and I doubt why I am so vehement about somethings, and am I being too extreme? But it’s really important. It’s really important to know the difference between right and wrong. My parents were very strict with us, and imparted to us that hard-work and honesty and doing what is right is so important. That’s why we are financially prosperous. It truly is. There is no magic to financial success for us. We study and work hard. There were fewer structural racism issues with us. We never cheat nor lie. We spend less than we make. And we save and invest. Then I look at my children now in their teens and they are so fundmentally good kids that it brings me to tears. At so many times I worried about them. I could care less about the grades (they do have really good marks) but it’s about them. And every night we have dinner and say our gratitudes, and I look at them and know that we are doing a good job. A darn good job. And one of the things that keeps me going everyday and keeps me in middle management is that mommy doctors should be leaders. We should 100% be leaders and raise our kids well at the same time. And I’m keeping the seat warm for the next generation as you are raising your young children. People are trying to push me out, the non-mommy doctors but please know that I’m trying my hardest to keep sitting where I am so that you can take your place. I am.

So another morning of reflection and strength, and Dr. Plastic Picker is HERE!!! I’M STILL HERE!!! And I’m grateful for all of it. I made it across the other side of burnout. Isn’t that a wonderful thing? Okay. Making blueberry muffins this morning. Home-made breakfast vegetable pockets with my home-made pizza dough. And then finishing the abstract. And that’s just my free time and unpaid work! Oh, also need to save the earth. Yes, everything is about the earth.