October 27, 2022

by Dr. Plastic Picker

I’m sitting here at 539am and I’m on drop-off duty this morning!!! I’m not usually asked to do drop-off because we have three adult drivers in our family. It’s kind of a competition in terms of who gets to drop off the two teenage children at their little bubble of a private school high school. Mr. Plastic Picker loves to drop-off when he can, and the next is my father-in-law, and I’m last. I think it’s mostly they want to share in the child-rearing tasks and they don’t necessarily trust my driving. But I haven’t gotten into a car accident since at least 20, and I drove all the way to LA for the first time in my middle-aged life last weekend! But old habits die hard, and they remember the Medical Student me who refused to drive in Boston/Cambridge.

So here I am in the morning excited about driving the kids to school, and trying to time things so I can dye my roots in the morning and do some important tasks and send some emails. I am reminded that the whole world needs to prioritize. I think this is one of the most underrated skills in the universe, and a skill I am very good at.

We have to prioritize! And that’s the problem with poor leadership. Leadership needs to prioritize or they start confusing everyone who is not in leadership and does not have the access to to the information leadership is given nor the time to process the information. When poor leaders fail to prioritize, then they need to own up to their complicity in causing the problems for whatever they are leading. That’s a whole other world I’ll leave to fester in it’s stink. This can be applied to many parts of our world right now.

As for my life where I am leading myself, my family, my finances, and my budget of $0 volunteer advocacy group that is trying to save the earth – I am prioritizing this morning. I am prioritizing by drinking matcha green tea soy latte, which makes me so happy and gives me a steady amount of caffeine without the highs and lows of coffee. I am paying my quarterly taxes in an orderly manner. I invested some money in a cool education start-up in a country that means a lot to me. We have a new possible renter to our downtown condo, and it will start cash-flowing again. I spent an extra three hours yesterday off the clock taking care of my own patients and my own results, because the patients right in front of me are really important and that is why I get my paycheck.

And I was trying to figure out love. I’m still confused and delighted and at times sad and happy about our recent family pseudo kdrama. I know this will be at least a decade in unfolding. But I realized something last night as I was tossing and turning and thinking about events, in that it’s okay to think about who your children will eventually love. It’s okay to talk to them about values and traits, and share stories. Guiding them is okay. In the end my daughter felt absolutely loved. I hope that the other protagonist felt that too. I honestly felt the universe guiding me to my actions. I could not explain it. I would not usually do what I did, and draw that much attention and be so persistent. But what is done is done and it’s now the 20th text message stream on my daughter’s phone. Pumpkins have been exchanged. Impressions have been made. And two children are moving on with their lives. And I’m honestly left with a sense of peace. In the end of the day, its true what everyone says. People always remember how you made them feel. And feeling loved and opening yourself up to another family that mirrors one’s values, I hope reaffirmed how important those values are.

I was talking to my mother-in-law yesterday morning and she comforted me with her words. It’s a simple word in Korean, and one she uses all the time. But for me it’s such a powerful word. 괜찮아요 It means it’s going to be okay.

괜찮아요 

I'm sitting here this morning with tears streaming down my face. For me parenting our youngest has been every day a reminder that there is goodness in the world. However you want to understand it, the hand of God, the hand of Buddha, the universe or the earth. And that Sunday as we were wandering around Balboa Park and she was processing emotions and holding my hand and restoring her sense of self, I questioned my parenting.  I questioned my common sense.  Other parents made me question it again. But my mother-in-law and my husband and my children reassured me, that it was okay and that I had made a good judgement.  

And with that reassurance, I'll go forth today and tuck my daughter back into her bubble. She has speech team competition coming up, and I'm excited to judge. She's helping her older brother weather some academic storms. She reminded me to get her eczema cream and take care of her skin. And I know when she wakes up, I'll get to look at her beautiful face with her profile and her smile. She'll worry about her skin and she'll wear her uniform.  And I'll get to keep her all to myself at least for another few years.  I didn't want to share anyway. But the amount of love and absolute goodness that radiates from this child, I almost can't understand how it's possible.  I know it's because of all the love that has been poured into her by her grandparents, her father, her brother, myself and the entire extended family.  When you're born so early and were so sick, and emerged as a healthy and bright and beautiful child - that is what happens.  And she wants to go forth to help the world. She understand that to those that much is given, much is expected.  And she can do it herself and does not necessarily need someone like her father to protect her.  And that's what I was looking for. Because the world is still scary for a young girl. 

But I'm reminded to live in the present and not to let the worries of tomorrow rob me of the beauty of today. She was asking already about internships for later on in high school, and worried about how safe it would be to be away from me.  I told her and I'll remind myself.  Let's enjoy you being a freshman. We have to figure out all your stuff this year before we worry about next. And how absolutely beautiful and surprising and challenging and memorable has freshman year been already.

Thank you for reading dear readers.  I'm going to dye my roots now and get my two teenagers off to their little bubble of a private school high school and see some patients. I have climate work to do as well, one patient of mine is going to be on a major morning news show regarding air pollution and asthma! Pays to be Dr. Plastic Picker's patient! Green hugs to everyone and I hope you have a sustainable day!

October 25, 2022

by Dr. Plastic Picker

I haven’t been blogging as much lately. The reason why is that I’ve been exchanging emails with a now family friend about our children, my own family’s pseudo-kdrama. The story has come to a beautiful end/pause/conclusion/season 1. One of my patient families was telling me truly that if we ever published the emails (which I would never do without said other person’s permission) it would make a great teen angst novella. As the ending is something unexpected, friendship.

Which makes me realize that I’m a pretty convincing person that lives in my very active imagination. When I was young and in between English and Vietnamese, the world was very silent. During that time I think I was learning English by immersion as a Vietnamese-speaking child and somehow emerged in 1st grade fully fluent without an accent, I just remember silence. I remember my imaginary friends that I would make up from the paisley swirls of the brown sofa in our Clairemont living room. I remember faces of friends and images, but those memories are strangely silent. I don’t remember any words neither Vietnamese nor English? I’ve always been curious about that. Maybe I should make some more friends with neurologists or speech pathologists or linguists?

But I do realize I have an active imagination, as I’m always imagining that I can literally save the earth. I someone induced myself and another very intelligent family to go along with a kdrama-like series of events that ended up beautiful and innocent, but gosh really took up a lot of time of a very busy academic. I’m not sure if I really feel guilty about it, but more bemused and very child-like – were you binge-watching the same show as I was? But in the end I know the association and the connections between us will help move the world toward equity and justice and hopefully a livable planet. It’s been very nice being the do-gooder Dr. Plastic Picker. I get forgiven many things, and I am hopeful and confident that this family has forgiven me my kdrama shenanigans.

I’m back in the world of occasional daydreaming, but awake now and blogging again rather than daydreaming. But the daydreams were so beautiful dear readers!!! I would sit and smile by myself and giggle in between patients. It was such a beautiful dream that I’ll hold dear in my heart. But when I realized those dreams were not productive for those that are the inspiration for those dreams, the pediatrician adult in me – did put it all to a stop. I’m mature enough to do that.

But I’m continuing to dream about our planet and our children’s future, and realizing I’m pretty good at selling my dream. I hope it’s your dream as well. I was selling this dream of climate and health advocacy and activism as an antidote to physician burnout. I was selling it at the HMO Regional Pediatric Symposium. Gosh this last Saturday was impactful. I’m still floored that it happened. Our climate friend Dr. Elizabeth Friedman from Kansas City was flown out and given posh accommodations to give a talk on climate and health. She was in our HMO space now, and her off-beat and somewhat sarcastic and intelligent take on the climate crisis was honestly pitch perfect for our clinical practice crowd. Then we came in, the three physicians from San Diego Pediatricians for Clean Air with our panel discussion and twice really knocked it out of the park with a “Deeper Dive in Climate and Health Advocacy.” I honestly did not know how it would go, and just putting our hearts and our full-selves into this work, it resonated. It absolutely resonated with other physicians in our large regional group.

At the same time I was collaborating again with Dr. Elizabeth Friedman, and she was able to get me involved with a paper that hopefully will be published soon. I’m trying to focus on how I can be most impactful and I’m working on the fossil fuel divestment side. At least I can help try to get us off investments in coal!!!! Pollution from coal mining and the GHG emissions from this are the absolute worst! The edits to the paper were scattered and I tried to help paint the divestment story as more grassroots to tell the real story of how divestment happens. My edits I have sent in but here are some of the notes I had jotted down while thinking of what I could add to this paper.

“Scope 3 Investments, 8% of GHG emissions in from the health care section. Indeed, there was a recent white house event joined by major health care organizations calling for the decarbonization of the health care sector. but of that scope 1, scope 2, scope 3. 28% of healthcare emissions are from investments.

For pediatricians to be involved in addressing GHG from healthcare section investments, we must be familiar with not only the health effects from GHGs but also how we can influence GHG emissions from healthcare sector investments.  We are investors ourselves who choose funds. We are members for healthcare organizations and sometimes physician groups that have retirement committees. We are administrators and managers, who have influence over funds. 

We must become familiar with the nomenclature of healthcare sector investing. Only then, can be understand and advocate and unravel.  For example, for those that are part of retirement committees they have fiduciary responsibilities. (list what is talked about in the slide?). Due diligence and green washing ((slide).”

And then I got to have a wondrous late lunch with my also friend Dr. Elizabeth Friedman now at Balboa Park. We walked and chatted and shared. We shared about our lives, but we mostly talk about the earth. Yes I’m one of those. I’m a crazy environmentalist. That’s all I think about. And as I was updating her on the end/pause/season 1 of my family’s pseudo-kdrama, she told me the ending was because of the patriarchy! I don’t believe it, but having green friends and working together – I listened to her and I considered it. And when I told my daughter about Dr. Friedman’s thoughts on the patriarchy. My daughter truly perked up. “It was the patriarchy mommy!”

I don’t pretend to know the answer to saving our earth, but I do know that it includes environmentalists who are as diverse as myself and Dr. Elizabeth Friedman. We are such an diverse and off-beat group. But we all know it will take all of us, right-wing and left-wing, religious and irreligious, patriarchy and matriarchy, and all those ying and yang terms that balance each other out. As I was leaving my friend after an absolutely lovely late afternoon walk, lunch and brain-storming and dreaming session, we gave each other the tightest green hugs. I also gave the same hugs to that family that dreamed with me in our pseudo-kdrama. After you get past the climate anxiety and climate grief and how bad the state of the environment is, than the only hope we have is to dream together. We can have a group psychosis together, that we can avert this code red for humanity.

And I believe it. I absolutely do. Still doing so much just me a single pediatrician picking up plastic in San Diego. And I just need to convince a few people who will convince a few more, than you can make a difference. It has to be grassroots. Every great endeavor begins with the people. And pediatricians and UC system provosts, we are pretty great people to influence others. Can you sell your dream? I absolutely am. But my dream is 100% free hence the free entertainment on this blog. All you have to do is read and care, and think about helping out one piece of ocean bound plastic at a time.

It’s 6:43 now and I’m going to dream by myself about my daughter’s future, but I hope you’ll dream together with my about our earth’s. Much love from your pediatrician who is going to work soon! My matcha green tea tastes great this morning with a side of macaroons.

October 17, 2022

by Dr. Plastic Picker

Blogging helps me organize my thoughts. I’m in the midst of editing and co-creating a power point to present to the HMO Chiefs. It’s an interesting group and we’ve gotten conflicting advice about what to talk about. I was struggling with the presentation last night, and then decided to set things aside at about 830pm. We are up in our Oregon tree farm, and it gets gloriously dark very early. The last load of laundry was in the dryer as we are getting ready to leave for the next day (which is today), and I turned off the lights and looked at a few pictures of my children and fell asleep.

I sleep blissfully these days, mostly dreaming about a real-life kdrama. But those details are precious and the ending will be over a decade in the making. But I sleep truly the sleep of someone who lives a joyous and purposeful life.

These last few days up here have been wondrous. I did so many things that I had not done in a long time, or have never done. I laughed and chatted, and was just my real self with my family members here. We came here to work, but in between found adventures. We visited a lighthouse that was closed, but wandered around the sand dune trails flanked my tall grasses. That short trail led to a long stone pier that led into the Pacific Ocean. Seagulls were flying above braving the strong winds, and the waves crashing on the stone piers were powerful and exciting. We visited cute gift shops and said hello to shopkeepers. I bought unique quality gifts for several children that I love, including mine. I tasted an interesting piece of fudge that looked like chedder cheese, and it’s the top selling item in that gift shop. I looked out at rock formations that are some of the most beautiful I have ever seen.

We also did a lot of work on the farm. A family member was making custom cutting boards from the wood from our forest (we technically own it but it belongs to the collective us really). I rode the ATV, and then drove the ATV. I mowed a few acres of pastureland in a John Deere, while another family member was doing the heavy lifting was a monstrous tractor that we bought. We own a small sawmill now, and how cool is that? Probably one of the moments I will most remember is driving with another family member to where the tree house platform resides that sides on the most northern edge of the pastureland. I had seen pictures of the tree house platform but had not been there. We climbed up and gazed down at the farm, with the Umpqua National Forest behind us. Our land abuts national forest. And I imagined what the tree house will eventually look it. The plan is a 250 SF tree hose with a loft bedroom to sleep. Even now one can have a pretty nice picnic on the platform.

With all those memories, I am ready. I am ready to dive into the presentation I have been putting off. It’s an important presentation to bend the arc toward a sustainable future. So I need to give it the time it deserves, since nature has given me so much.

October 15, 2022

by Dr. Plastic Picker

I’m home. I’m home in our Oregon farm/ranch home. Primarily my life is in San Diego and Southern California, but we truly are Oregonians too since we own two properties up here in Oregon and one is an almost 200 acre tree farm/ranch that we love dearly. I’ve always been part of a real estate family, where that is all we talk about at dinner. But climate work made me realize the dangers of climate change, and honestly some of this is us getting ready for our own family’s climate migration. We’d like to avert the apocalypse, but just in case it’s good to have several contingency plans. There are never any guarantees, but there is water here and there is land.

I have so much more hope these days than when I was in the midst of burn-out and after emerging and beginning to work in climate and health. I think the importance for me is to keep on dreaming about the world I want for our children (including my daughter’s own Kdrama that I’m making up in my head that includes homecoming!!! LOL) and our world. Up here on our farm, I can dream. I wandered yesterday just walking around and around the pasturelands and getting good exercise. But I was just also just thinking my own thoughts. We need to restructure the entire way we live, and involve everyone in the process. We can’t save the planet with just half of us.

But I’m happy this weekend to disconnect a bit with some in my family. We are dealing with some interesting property issues specific to having an Oregon tree farm. I’m looking forward to meeting one of the Oregon fish biologist to talk about our plans to continue to preserve some riparian habitat on the Upper Cow Creek that transverses our property. It originates from the Cascades.

But it’s 616AM and I’ve had a gloriously restful sleep. I always have the earth in mind and I have to put comments in for a divestment paper, and also editorial comments for the economic impacts of climate change (a billion dollar disaster paper out of Harvard). I also need to get in the rest of my tax information to our accountant. The deadline is Monday! Darn, I’m cutting it close! But so is the world with climate change. But I’ll deal with both today, our own family’s finances and the finances of our planet (or at least make comments on it).

This is a short trip but so needed. I haven’t been up in 6 months, but I’ve had two climate friends both named Rachel come up with their families. It was so nice to be able to provide their families with sustainable travel and free accommodations just because they are green friends. It was better for the earth as well, because they are like me – fighting for a sustainable planet for all of us. Only green friends welcome here on our Oregon farm!!! And also the other protagonist of my daughter’s Kdrama but their family is pretty green too. But that’s the 100 episode Kdrama and they don’t hold hands until episode 50! Maybe someday up in Oregon they can hold hands.

Green hugs to you my friends. Thank you for delving into the world of Dr. Plastic Picker!!!

October 6, 2022

by Dr. Plastic Picker

Do you really want to know what I’ve been up to? I’ve had this perpetual smile on my face for at least the last few weeks. I’m being a mother of a pretty teenager that wants to go to home-coming. She wants to wear a pretty dress and pretty shoes, and take innocent pictures with a boy that is tall enough that she can wear heels. And I’m happily living in this space. The details I’m keeping close to my heart, and it’s so beautiful and innocent and my cheeks hurt from the smiling and the email exchanges.

Mindful of privacy and not sharenting (sharing on social media my parenting) too much, I’m keeping the details private. But the beautiful email exchanges could be a book one day and I’m keeping them all in a digital folder.

But back to saving the world!!! As an environmentalist, it’s beautiful when we are able to dream of a future for our children. It’s a good sign when environmentalist are having children, because the ultimate expression of climate grief is to believe the world is unsafe to bring a child into it. That despair absolutely cannot be the answer. Children give us hope. My teens and their future gives me purpose to continue to #fightfor1point5.

So Dr. Plastic Picker has been very very busy. I took a great risk and prepared four iterations of a talk on ESG investments for our regional green team. The funny thing that it ended up we already have that option in our retirement accounts? After all that, we have those options already? I was very brief as all the iterations of my talk had been paired down multiple times for well-meaning friends. It was for the best though, because the CFO and head financial folks had already heard the angry climate and health person. They had not heard me. I was more humble and quiet and questioning. It takes a multi-pronged approach to get things done. I’m completely new to this space so still learning and figuring things out. I’m still going to run for the retirement committee, because I think they need someone like me there. I said at the end of the meeting, “I care about the earth and climate, and I care about money. And I didn’t know these options existed? I wonder if others know. What can I do to help?” And I think that was actually a helpful comment and the two big financial people left the meeting I think with a reminder how important this work is, and a parting comment that they too cared deeply about our environmental mission.

But in between I was rereading email exchanges about home-coming and looking at pictures and thinking about shoe-shopping with my daughter. I missed so much of her early years, being a young working pediatrician and trying to navigate a still male-dominated hierarchy. I’ve decided these days that joy is important, and what brings me joy is saving the planet for our collective children and thinking about her first homecoming.

And here she is pouty when she was little. I was extolling on what a wonderful student and kind person she is. And she is truly that. The best of both Mr. Plastic Picker and myself.

September 27, 2022

by Dr. Plastic Picker

It was happening while I was watching K-dramas. It was happening while I was trying to shift in a more comfortable position due to some minor back aches. The last volleyball tournament I had sat down for a while, and my back has been bothering me since. I likely need to do more yoga. I know how to listen to my body and I know I’ll be okay.

This morning with some minor back aches, I’m sad. I’m sad because I’m missing my nephew and niece who are in Florida. They are military kids and their family achieved a big professional milestone that is important for them and the country. But I’m their aunt and they are my sister’s children and I just miss them.

I know it was a big day for them with lots of people throughout the country who came in to see them. There are a lot of people who love and care for them. But I wonder if they really know how much I love them? I love them so much since they were little babies. It’s different for me because I’m close with my sister, and the way we raise our children is similar. We were raised by the same mother.

We couldn’t be there and honestly I think it would have been exhausting to fly over there to see them during this very very busy time in their lives. But I’m missing them and I want to be there in the early morning soon, watching them wake up and drinking a Florida version of my matcha green tea soy latte. I want to notice what pajamas they are wearing. I want to see the busyness of their lives as my sister rushes off to drop them off and pick them off for their various activities. I want to see them have dinner and see what kind of cups they are drinking water out of. I want to be able to pick a different mug every morning when I have a different matcha green tea soy latte from my sister’s always organized kitchen.

It’s really hard on military kids, but it’s really hard on their aunt as well. I’ve missed so much of their lives because they have lived far away, and I’m a working mother too. Just letting myself be sad today because some pictures popped up on facebook. I’ll be there soon and I’ll bring their cousins, and we’ll hang out in Florida.

September 25, 2022

by Dr. Plastic Picker

It’s 759am and we just returned from gathering 5 bags of pollution from the ocean’s edge. I sat with my daughter after a very pleasant walk from our house to the beach, where I recounted some of my silly dreams to her. It’s was a very nice walk and we helped the earth and had a nice morning. We are having breakfast now as I’m typing away some quick thoughts.

Due to various reasons I’m not in Florida watching my brother-in-law reach a professional and personal milestone. It seemed safer to stay in San Diego and not risk the other guests getting COVID. I don’t have COVID but others in my family had COVID and because they were vaccinated and boosted and treated in time, they are doing okay. But there was the risk of spreading it to a lot of wonderful people, and honestly I had so much stuff to catch up on – I appreciated the time at home and being able to be here with my children. Case in point, I would not have gotten to go on this morning’s walk if I had gone to Florida.

So today will be a quiet day, but I’ll make sure to make time for the various students that I’ve somehow found and come under my sphere of influence. The above is probably the most impactful right now. One of the third year UCSD medical students is applying to be an editorial fellow for an AMA Bioethics magazine and is looking for my guidance. I agreed to be the faculty advisor/sponsor and help in whatever capacity they needed me, as the proposed focus is going to be bioethics surrounding Environmental Justice work.

Then yesterday I had a premedical advising call with one of our advocacy interns at UC Berkeley and it was very powerful to plan her medical school application. She’ll be incorporating work on waste reduction in her academic portfolio, and we have a large HMO waste reduction project we want to do together. It’s very niche. It will save our HMO lots of money, provide an opportunity for her, and I just saved her personally hundreds of thousands of dollars of unnecessary debt from an unnecessary post-bac. Hopefully her premedical advocacy work will save the earth lots of unnecessary future trash as well!

And then another daughter of a close family friend and one of my patients is going to join in on our youth and art’s exhibition, but the poetry section. This will be just very close children in our family and friends, as I need to keep this contained and doable for my own children. I’m putting them to work for the earth, but need to balance with their other responsibilities.

And that is it. Just thinking of things I need to today and things I already did for the earth!

September 22, 2022

by Dr. Plastic Picker

Green spaces are important for human health. The proximity to parks especially those parks with trees, is highly correlated with improved health incomes especially cardiovascular and respiratory health. Through environmental health work, I’m realizing more and more how incredible fortunate some of us are and that is why life has turned out easier for us. If you live near lots of trees and parks and an area with relatively little air pollution, your life probably turned out better.

For the residents of Barrio Logan, someone who did not look like them nor lived in their neighborhood decided to put the I-5 right through their neighborhood and immediately changed the course of an entire neighborhood’s character and health. Some of the highest rates of asthma are in Barrio Logan. It is known as an environmental justice neighborhood. I have many close friends who are from Barrio and continue to fight for their neighborhood.

Sometimes when I think that I’m at the mid 700s to 1000 bags of trash that I’m at the end, and that my part in this fight is mostly done. But then super interesting issues come up that I’m able to have a say in, and I realize – this is still fun and I’m still needed.

SanDiego350.org reached out to get co-signatures for a SANDAG grant support letter to request 2 million for an I-5 Freeway Cap over Barrio Logan, that would create a large urban park and try to reconnect the community.

So I replied to SanDiego350.org with our agreement to co-sign that letter. It’s a powerful text group that I’m texting, even though my thought is that it’s just my friends. It’s a member of the San Diego Air Pollution Control Board, the head of the Child Abuse and Neglect committee, an executive member of the AAP San Diego leadership, two of our pediatric hospitalist, and head of pediatric after hours clinic. And I did more reading on it this morning, and feel 100% comfortable putting in our support. The deadline is October 10 and we are two weeks ahead of schedule.

I am so grateful for SanDiego350.org, what a powerful and well run organization. I am so grateful to SANDAG. And I’m mostly grateful to my friends who responded to my text message at 530pm. Can you imagine when and if San Diego get’s this grant? We’ll know we were a part of this all!!!

September 20, 2022

by Dr. Plastic Picker

I must be doing something right. I worked on Saturday afternoon from 130-5pm and was still able to joyfully make dinner with Mr. Plastic Picker’s fancy radiology friend and pharmacist wife at 630pm. I wore a pretty dress and heels, and we talked about our mutual children and life. I had fun listening to them chat, and they listened to me – avidly at times as I recounted some of my adventures. Then last night I worked the staggered late shift, part of a shift I helped pilot and design. The system is not perfect but it’s certainly better for the five years I devoted to trying to make it more livable. I worked last night and it was certainly busy. I even had a resident that I mentored. All the patients were seen on time. A late newborn that had checked in over 4 hours late, I saw as well. I just asked our nursing staff to remind the parents I needed to see everyone in order. That baby ended up needing me anyway, for some simple lab follow up and saved them from having a drive back and the earth some carbon. Oh and the Saturday afternoon shift? I had one of the sickest patients I’ve had in a long time check in at 4pm. The nursing staff and I were able to turn around that patient within 45 minutes, and get them into the ambulance and off to the hospital already stabilized. I had dinner plans and our clinic technically closes at 5pm. I’ve been a doctor for a long time now and I know what to do quickly. At 530pm as the child and mother were safely in the care of the EMTs, I had my backpack with both straps on and walking out the door with most of my charts done.

I know I must be doing something right because last night I was working, I happened to glance an appointment access. There are absolutely no appointments and it’s absolutely horrible right now. I was initially irritated and began to get angry. I had been tasked with this integral part of management for four years. Like any responsibility given to me, I had done it with care. I had made sure there were at least 100-150 appointments available every day. I had recruited per diem pediatricians and kept an eagle on their credentialing to make sure they got through. I learned the intricacies of our system from nursing staffing, to our schedulers optimal work schedules when they were easiest to reach, and created a well-oiled machine on appointment access. It all came tumbling down when I made the decision not to let others take credit for my work, and not involve me in giving out positions and credit to those pediatricians who had taken these part-time positions for our department. When I own it, I own it completely. I literally said at a meeting, you want to take it – then you take it all. And then four years of proper access that lasted through some of the most horrible flu seasons I’ve been through and holiday schedules where we had one new doctor quit unexpectedly, yet everything still opened up with enough appointments – it all came tumbling down.

So last night I was just trying to find appointments for follow ups for my own patients I was seeing, and I happened to be looking at the different clinic schedules the way I used to look at things – and there were no appointments. I was angry initially. I could have written several different versions of scathing blog posts about this. When one is emotional, the writing actually comes out very well. Those are blog posts that get clicked on.

But I know I’m doing something right when I choose positivity and I choose beauty. I chose to let those thoughts meander in my brain as I numbed it with two Kdrama episodes last night. I chose to let the HMO middle management system try to right itself. I choose to be like my father, forever the small business owner that did not let the union machinery nor corporate largesse take credit for his work. He went out his own and built something beautiful. I choose this morning to blog and to remember the beautiful parts of yesterday.

The beauty yesterday as I left clinic was getting to really look at the decals in one of my new exam rooms. It’s a slow project and all I did was buy the decals. I love them and the new nursing partner I have. She also brings beauty and chooses positivity. I chose to chat with a young father who is a Family Practice doctor about his new baby, and give him some advice about life. And I choose to not get involved again in a system that needs to cleanse itself. And if the system doesn’t, than a new system will come. And I got to talk to my daughter last night, and my son as well – and oh yes Mr. Plastic Picker too. We all gathered at 830pm and had a late snack as everyone had a busy Monday. Volleyball tournament for our daughter, AP Biology homework for my son, invitation to speak at Harvard/MGH grand rounds for me, and the continuing adventures of the private school lunch line.

I’m up at 642am and finished a short blog to sort out my thoughts. My matcha green tea soy latte is delicious, and I’m going for a short jog to get my heart rate about 160. I remember pushing myself to run after working until 10pm, and then falling for the first time in my life after running about 7 years ago. I came home scrapped and bloodied, yet still forced myself to work the next day after having worked the night before. Back then my freshman daughter was 7 years of age, and I’m sure it scared her to see me scraped up and pushing myself. But now I’m not scaring anyone anymore, especially not myself.

September 17, 2022

by Dr. Plastic Picker

It’s Saturday morning and 635am. I’m wearing a brown flowery shirt with ruffled short sleeves that is physically very cooling, and my mother-in-law while chopping some radishes said it was very pretty. I’m going to just blog for a bit, and then plog to the beach. I’ve slowed down my litter-picking as I’m at bag #730 now. I’m not rushing to get to #1000 which has been my goal. I’m enjoying the process and realizing that I’d like to jog a bit more so I can really get my heart rate up more. I am in my mid-40s and staying really active in your 40s is vital to ensure that I live well into my old age.

What’s the point of saving the earth and raising great kids, if I’m not healthy to see my grandchildren and see how the world turns out? It’s going to be an epic few decades to come. We’ve made great strides in combating climate change and personally I’m proud to have had a role, and to continue to have a role. But I’m aware that I’ve done more than my fair share now.

This week was again epic for climate work and environmental health work. We had a meeting of the Public Health Advisory Council (now called P-HACK), of Climate Actions Campaign to focus on our next year’s priorities. We are still going to work on building electrification and active transport, but now going to focus on resiliency. The recent heat waves drives home the point that this is where health care voices need to be at. I’m so proud to be the Chair of PHAC, and the amazing thing is that day I was just a participant. I reached out to the Vice-Chair, and honestly told her that I had almost fallen asleep driving home that afternoon. It was too much. I also had to be at a college counseling admissions meeting for my son at his posh private school, so it would be hard to lead the meeting. Most climate and health advocacy is volunteer. We all have full time jobs otherwise and this is the work of the heart. And the loving Vice-Chair said she could lead the meeting and it went so well. And one of our other PHAC council members is going to be on the panel of a large meeting Nexus, and her beautiful picture is on the social media ads for it. I’m so proud to know them both and to work with them. The other epic advancement is that everything is coming out fine for the Climate Ride that Dr. Sally Kaufman with a little help from myself, is planning. This is to raise awareness about the effects of climate change on pediatric health. Getting approvals and bringing up the proposals took a lot of bravery and persistence. I’m proud to have helped with that. A few more emails, gathering more sign-ups and getting the AAP Banner to fly for the actual day. (Just emailed the AAP San Diego folks to borrow the banner for two free publicity events).

And the I got to meet Alexander Nguyen, who is an Emmy-award winning journalist now with KPBS. He interviewed me for the anti-vaping legislation at Chula Vista City Hall. Our student Laisha Felix had her op-ed published in the Chula Vista Star News. Looking at her letter again, I am so proud of her for finding her voice. Our team did really well, and contributed a lot to the passing of the legislation 5-0. For this effort, it was myself, Dr. Dear Friend and our premed intern Laisha Felix. We were all over the news in Spanish and English, and Dr. Dear Friend brought it home in an emotional testimony that has now gotten her invited to testify at the state level for Proposition 31.

But in all those victories this week for the earth and the children, I learned to say no. I realize I want to run a bit more, and after almost falling asleep while I was driving home one afternoon – it’s not worth dying to help save the earth. It’s really all our jobs. I’ll continue to do it at a sustainable pace, but I need to sleep and exercise to get my heart rate up and healthy past 140!!!

So there are all the things I said politely NO to this week. These are all things that are not required for my job and nothing I’m actually responsible for. And actually, all these things are things that other people actually either get time or paid to do. So I’m not going to do their job if it does not bring me joy. I said NO to a presentation to nursing education on implicit bias. Its an HMO thing and I already lead two big committees for FREE. And I’m speaking at two regional conferences for FREE. And I’ve been of the news gathering publicity for our group at least 8 times for FREE. So to the actually beautiful person who went me the request, I politely said NO this year. They can ask me next year. I said NO to going out with the family practice residents for dinner last night. I already managed their first rotation for FREE. Gave a two lectures for FREE. Helped provide their breakfast for FREE. We even took them out to eat (although I did not get paid). They have faculty that actually I know get paid a lot of money to manage them and since this was my off time and Friday night, I spent the evening with my own children. I love the residents but would not love having dinner with them when my own children were at home. I also said NO to a conference for another peripherally related outdoor events advocacy group. I want kids to get outdoors and this work is important. But I’m actually hyper-focused on climate change and more impactful legislation, and none of the premed interns want to do this project. So I said NO. We are staying on their email list. I said NO to officially joining the physician wellness committee. I can do wellness events without actually being part of the actual committee. Wow, it’s really fun to say NO.

But the reason it’s important to say NO, is so that I can say YES to other things. So this weekend I’m saying YES to exercising my heart. I’m going on a run soon. I’m saying YES to working a shift at La Mesa, because we still have to work and the powers that be that are running the department (well, they are doing the best they can with the resources they have). I actually don’t mind working this afternoon because I’m going to get to see two friends that I haven’t seen in a while. They might call me off though. I’m the most expensive doctor. When I used to run things, I saved the HMO thousands and thousands for dollars. I have email evidence of all that. But no one really cares anymore. But I CARE!!!! So I’m saving myself money by taking care of my own health today! I’m off to the beach to plog!!!

Thank you for following along on the continuing adventures of Dr. Plastic Picker, your no longer burnt out pediatrician who finds the trashy world – fascinating! But let’s make it LESS TRASHY!!!