October 9, 2021

by drplasticpicker

General Comments

It is indeed October 2021. HALLOWEEN!!! There are many scary things in the world, but we all know that the Climate Crisis is the scariest!!! But not to worry, by receiving this newsletter and working together we are boots on the grounds, #fightfor1point5. Hope is earned through action. This group is all about ACTION. Here is what the AAP/SCPCA pediatricians and premed interns are up to. We are earth agents, literally cleaning up this earth!   October 14: Children’s Environmental Health Day! Dan Spencer Knocks It Out of the Park and The Great Succulent Give-Away October 14 is Children’s Environmental Health Day, which is an effort of the Children’s Environmental Health Network (which AAP and Eco-America are a part of). Dan successfully applied to have the following recognize and issue proclamations recognizing CEH Day. City of San Diego, County of San Diego, La Mesa, Solana Beach, Encinitas, Chula Vista, and Lemon Grove. There are 3 proclamation press events (Encinitas, Solana Beach and Chula Vista), and we are dividing and conquering. Thank you to Dan and those that volunteered to show up and hold the AAP-CA3 banner, and smile for the photos!  In honor of that day, we are also doing a succulent give-away.  I received an honorarium for speaking at the AAP California Chapter Chat, since that money really belongs to all of us – Laisha Felix and I purchased 120 succulents (there is a great farm in Vista for $1 a piece) and will be dropping off 5 succulents per committee member. It will have a paper explaining CEH Day, and it serves as a moment of connection when you as an MD give to a child. You are making a commitment to that child and the earth, to be on the side of good. To #fightfor1point5.  Let me know at or text me if you want 5 succulents! We will give a succulent to each of the politicians as well!  

SDAFP Members Move to Join SDPCA/AAP in Rewild Mission Bay Coalition

Ben Schleifer has been hard at work being our Wetlands Liaison.  Ben met up with Andrew Meyer, from Rewild Mission Bay and the San Diego Audubon Society. Rachel Abbott, from Family Practice and UCSD rep were also there.  Our amazing AAP-CA3 Executive Board officially approved AAP-CA3 to join. Rachel Abbott is working with Family Practice doctors at UCSD FP and Sharp to lobby San Diego Academy of Family Physicians to also join Rewild Mission Bay.  Rachel and I both live in Jen Campbell’s city council district, and her support is crucial in making this happen. We wrote a joint advocacy letter and have initiated a meeting with her.  Thank you to the 30 folks out there that cosigned.  Ben is writing an op-ed for Climate and Health Blog, regarding wetlands restoration and plans to submit it to SD Union-Tribune as well.

Peony Liu Joins as our Anti-Tobacco and Anti-Vaping Liaison

Only great things come out of UCLA, including Peony Liu! Peony Liu is a pediatric hospitalist and well known to many of us. She has agreed to lead SDPCA’s partnership with an effort led by the American Lung Association and American Cancer Society, San Diegans vs Big Tobacco.  Peony will work closely with Nancy Graff, AAP. We have a team that includes Alice Nguyen, a high school senior, and Riley Gilbertson, our advocacy intern.

Intern Updates!

Our premed intern group is 8. We are trying to keep it at that but did interview and accept Nicole Escamarilla (UCLA) and Ashley Calderon (UC Berkeley). They are San Diegans and passionate about climate and health. Ashley Calderon completed the Eco-America training. Nicole will join Hakim in the Youth Arts Project, as Ashley Teo is transitioning to an HPV vaccine advocacy project with me at Kaiser. Riley has been hard at work on a project with Rachel Ireland, on reducing lead pollution from aviation gas around the Montgomery-Gibbs Executive Airport. It’s an urgent issue from a developmental pediatric lens.  This will be a separate update later, as it’s a stellar effort and we will have more news. Stay tuned! Welcome to Ashley Calderon and Nicole Escarmarilla! Vivian Nguyen our phenomenal student Co-Founder is presenting a poster at AAP NCE this weekend on our work. Please stop by her virtual poster entitled “Blueprint for a Volunteer Climate Health Advocacy Group: San Diego Pediatricians for Clean Air. “ Congrats Vivian.    

YOUTH ARTS CONTEST!

It’s happening! It’s happening! Nicole will join as the new intern and she is strong in social media skills, and organizational skills. Hakim is rounding up our motley crew. Andrei is collating all the entries onto a PDF. We have 50 entries and almost enough prizes, as Rachel Ireland knows the director of the Children’s Museum in Escondido and we will ask for some tickets (crossing our fingers) and Rewild Mission Bay will donate some kids’ hats.  Kalpana and Jamie Rhodes are big environmentalist and donors, and Jamie is a scientist working on climate resiliency now on the Texas coast and formerly on renewable energy.  Their daughter Leela Rhodes is joining our youth arts council, and they have agreed to help us to try to get the Children’s Museum in Downtown San Diego to help host our event or display some of the pieces. Stay tuned! This is going to happen!!! https://sdpediatriciansforcleanair.com/youth-art-contest Air Keepers Program? Our next big effort is trying to deploy this already established EPA program to hopefully all of San Diego, but especially our environmental justice neighborhoods. Also to find funding. We are going to apply for some climate awards and maybe present to the APCD to ask for money?  This program is essentially having kids “take a vital sign for the earth” – the PM2.5 level around their schools.  It would mostly be to purchase the PM2.5 monitors (which I believe are only about 150-200 a piece?) and a set of flags. Local middle school science classes would monitor PM 2.5 exposure, and hopefully act as a catalyst for hyper-local changes.  Students raise different colored flags outside of the school depending on air quality measured. We are in the thinking and building phase, so reach out if you want to help review the materials that AAP montana via Lori Byron (the National AAP Climate Advocate lead) sent over.  More hands make light work.

UPCOMING MEETINGS: General Committee Meeting: Q2MONTH Climate Change & Health Meeting November 9, 2021 at 6:30 p.m. via Zoom. (I think? Sally is going to correct me if I’m wrong)

October 8, 2021

by drplasticpicker

I’ll be honest with the blog readership. I’m pretty financially savy, but I’m no savant. Actually most phyisican personal finance bloggers are full of hot air. My personal finance journey has been simple. I’m super frugal (hey, I make trash art for fun!) and we are a dual income physician family, and our savings rate is in the 50% range. And everything we save, we invest back into safe target date mutual funds, retirement accounts, 529 college saving funds, and real estate. I bought fancy Challa bread at the local bakery yesterday, but buying a $8 loaf of bread is a luxury for us. We drive paid off cars. Indeed Mr. Plastic Picker still drives his 2012 Toyota Prius with a small scratch on the side that my father-in-law had a great time coloring in with a special kind of car coloring marker?

I wanted to share with you the funny story of the San Diego downtown condo we just sold in the fancy Fahrenheit building. I love real estate, because each property we buy and sell is a story. And it’s the story of my life. Real estate is in my blood because that is what our family does. Some of why I love the earth so much, is that the earth is all of our real estate. Our collective real estate. So this particular condo was a studio in East Village. It was not particularly a good buy. But I still made money off of it, because in general real estate prices in San Diego are skyrocketing. It makes sense right now to sell my single family house rentals and reinvest in other parts of the country.

This particular condo I bought five years ago. We had already had a larger downtown condo that we still own, and that one was a good buy. I guess I got greedy or overconfident. We had saved a sizeable downpayment about 80K because we just don’t spend money from our take-home pay. So I went shopping, and I found this condo. In retrospect, I think I was just trying to get attention from my older brother as he was my broker back then because he said he’d buy me lunch if we were looking for condos. I’m the younger sister and as the younger sister, I’m always trying to get attention from my brother. This particular condo was modern and concrete, and the building had won the coveted architectural Orchid award. And it was literally within spitting distance to Petco Park. Only a large studio though and one parking spot. But I bought it, and was happy. Didn’t get a particularly good nor bad deal, and I thought my older brother was going to take me to lunch. Instead, he took me to Carls Junior drive through because he had another meeting and got me a burger. I remember being so sad that day, and realized some of my real estate shenanigans were due to trying to get attention from him as he is a REAL real estate investor. He is a much better real estate investor than all the physician supposedly real estate savants masquerading on the blogsphere. They are so annoying.

Fast forward five years, I just sold this condo and used the proceeds to pay off my portion of the Oregon Farm. Now that’s a LIFETIME INVESTMENT. I love love love our Oregon farm! But I sold this condo, and I’m reviewing the numbers are trying to figure out if I made money? And indeed, even this “not great investment” – I did make money. These are my back of the envelope calculations.

55 000 (property appreciation after 6 years) – 22 250 (real estate agent commission) – 7500 (cash for keys) = 25 250 (net proceeds but closer to 20K because there were other fees)

20 000 (gain after 5 years in my pocket) / 97 000 (original investment) = 0.206185567 (percent yield I made)

20%/5 years = 5% gain per year?

So in this transaction I made about what you would make just on normal real estate apprecation or a little less than the stock market in a normal year. The real estate brokers always do well. But I did decently. Our renter made out like a bandit, given I had to pay him off to get him out of the condo so I could sell it. I always had a good mortgage, a 30 year fixed at about 4%.

But the reason that this condo ended up being a great buy, is that the 80K that I used as the downpayment is money we had saved from our takehome pay that most other physcians would have spent. The key to financial independence is easy, save a good chunk of your take-home pay and invest it in things that are safe and will grow. And for 5 years, it did grow and I made money even though the property was vacant for a few months. Those were painful months. Real estate is not for the feint of heart and you need a good sized emergency fund. But I now have paid off a family member the rest of our portion of the Oregon farm!!! Yippee!!!! I am so happy. And I still have about 20K extra to do something. And see, with that 20K – I am going to “spend” it. But I’m going to “spend it” improving something on the farm which continues to raise it’s value. We are finally going up sometime in November and we’ll decide as a family whether to build that bridge across the creek or fix up the small guest cottage.

That is it. That is the story of the Fahrenheit condo. You were not a good buy, but because I had equity in Fahrenheit, I got to be a FARMER and buy half of an Oregon Farm!!!!!

October 6, 2021

by drplasticpicker

That’s my girl. My former preemie, born at 2 lbs and many illnesses during her first few years of life. I’m having too much fun in the mornings trying to save the earth. Posted on several sites about the upcoming October 14, Children’s Environmental Health Day. Hopefully will get a shout out on the AAP newsletter and also twitter and Instagram account. I received $250 from the AAP California as an honorarium for being a part of a panel discussion. It’s such a kind gesture from them and I replied back after being inspired by thinking about October 14 and wandering around my succulent garden,

This is incredibly kind of AAP-California and unexpected and much appreciated.  I will gladly accept on behalf of our san diego committee. my address is xxxx.
I am inspired and since october 14 is children’s environmental health day, which one of my colleages Dr. Dan Spencer applied successfully to have recognized by several cities in the San Diego area – we hadn’t decided on an “event” yet.  So I know this super affordable and family owned place that sells succulents for $1 a piece.  I’m going to use the $250 and buy 250 succulents, and hand them to 25 of our pediatrician members to hand out to 10 kids on that day.  It’s going to be the great pediatric succulent give away!!!!
Thank you for inspiring this event!
Super excited and grateful to have worked with everyone on that impactful day.

Texted one of our premed interns who needs a project to work on, and she can do this easy project. Maybe create a social media ad, and help me distribute some of the succulents. Maybe to Breda Velasquez who is the head of pediatric psychiatry. I really like her.

But in this fun and creative time I have in the morning, I wanted to share something with the blog readership. I know I talk about my children a lot, and you’ve all heard about my teen daughter. She has made me a better pediatrician, as she has helped me understand a bit better how scary it is to have a sick child. She was sick a lot when she was young. Hospitalized several times for pneumonia, surgery for ear tubes, meningitis supposedly in the NICU which ended up being a line infection. White count at some point of 90K. That’s a high white count.

She made the Wave Volleyball Club 14U-5 team. She had started volleyball about six months ago at a small supportive club in the southbay. She had a great start, and I appreciated mostly the time we had in the car together chatting and this new adventure that I, as her mother, was a part of. Right now she loves volleyball. Her life is volleyball. She is making excellent grades as well. She wanted to go out for this club, where the other girls are much taller and have been playing much longer. She has grit and she is determined. I’m inordinately proud of her. She is now a member of USA Volleyball, and signed a commitment letter with the San Diego Regionaly Volleyball Association. And that is it. Lots of environmental work and projects, but here I wanted to share this moment of mommy happiness. She’s my why. Just like likely your children are your why. We are trying to save the earth for them, so they will have a liveable planet.

October 3, 2021

by drplasticpicker

I went back to it yesterday. I have always wanted to write a book. I started a word document a few months ago, but the work with Rewild Mission Bay inspired me to go back to it. Andrew Meyer the conservation director for the San Diego Audubon Society had suggested we title our advocacy letter one of the local city councilpersons Paging Dr. XXX. For an advocacy letter, I thought it would not go over as well. Paging a physician who does not want to be paged about what they don’t see as an urgent matter, is not the best way to convince them. But it really did inspire me as I realized for non-medical people – it captures their imagination. Plus, at different presentations for the HMO Green Team, I’ve used the phrase “we are always on call for the earth.” And I do believe that.

But that’s pretty much what I’ve done. I’ve settled on a working title and acknowledgements, and thinking about it. I’m at bag #565 about, and it will probably take me two more years to get to #1000 personal bags. That works out perfectly because that is the summer I am planning on taking my well deserved sabbatical and go on my electric car tour around the country. In the craziness of medical training, I’ve never traveled cross country and that is one of the things I’ve always wanted to do. Since this blog has been about taking risks and trying new things, I figured I could do that while spreading my message about physician wellness and climate and health advocacy. Dr. Plastic Picker has always been the ultimate mulit-tasker. Getting exercise and cleaning the earth at the same time!

I have to have San Diego Pediatricians for Clean Air designated as an official non-profit with tax exempt status. I’m not even sure how much a book would make, but I just want to make enough to buy stethoscopes for all our premedical advocacy interns. We have nine interns now! They are really wonderful. I want to be able to buy them each a nice stethoscope when they matriculate to medical school from SDPCA and AAP-CA3. But it is getting expensive as I have more interns now! I figure the book sales can go to buying their stethoscopes and otherwise maybe fund a picnic for the children’s arts council, and maybe some Tshirts.

The book can’t be too long. People have very short attention spans. I think 150 pages is enough? What do you think? I’m going to stop by Barnes and Nobles and browse the Physician Wellness section and see about how long those books are. The blog has been a beautiful endeavor and I’ll try to repurpose some of my blog post, but it’s kind of all over the place. I think a book should have some kind of cohesion. I need to figure out my character arc. And I want to sprinkle in tons of local color. I’m pretty sure I can pull off a national book tour (at small independent book shops OF COURSE!) but I know for sure I can do a local tour of San Diego. The local tour would be the most important, because the entire point is to local climate and health advocacy.

That is it. I just wanted to let the blog readership know that I’m continuing to plug away at the climate work, but I’m not forgetting my dream about writing my book! Every Crimson University grad needs to write a book especially before the 25th class reunion. Especially since the idea for this all came during one of the sessions at our 20th class reunion!

October 2, 2021

by drplasticpicker

The San Diego Union-Tribune videographer was looking for me. Well, they were actually looking for San Diego Pediatricians for Clean Air. While I’m not SDPCA, and indeed this wonderful thing that has become SDPCA is my brainchild – it really belongs to all of us https://sdpediatriciansforcleanair.com/ . In my heart, I know that. It can’t belong to me, it has to be a group endevaor and no egos/ no show-boating, and that is the only way we grow and we #fightfor1point5 . So when my colleauge asked if I wanted to speak with them or needed to speak with them, I know there is so much to do and we divide and conquer. I told her that I’m good. She speaks for all of us, and just reviewed important developments that the San Diego Union-Tribune may want to know. I know things will go well, and this person in our group is eloquent and passionate and committed to climate and health.

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September 30, 2021

by drplasticpicker

I’m usually up later these days since forgoing coffee. My sleep is deeper. I sometimes miss the 4am writing sessions, but overall this is better for my health. I’m still writing a lot, but more advocacy letters and emails regarding climate. Please know that this blog and the writing practice and your support, has meant the world to me. I could not have done it without this virtual audience. You gave me the strength to speak up. You made me realize that people will respond to my writing, my letters, my words, my speaking.

I am sipping my “Green Awakening” right now which is my matcha soy latte. It’s this beautiful green warm cup of plant-based goodness that greats me in the morning. I also hope I caused a “Green Awakening” amongst some of the pediatricians who showed up at the California AAP State-wide Chapter Chat. It was on climate change, and very powerful. A coordinated effort amongst the four california AAP chapters. Primarily the talk was Dr. Aprana Bole who is a national figure in climate advocacy, and the head of the Council on Environmental Health. I was on the panel discussion along with someone I admire so much Dr. Amanda Millstein, founder of Climate Health NOW.

I received text messages and emails from friends yesterday after the talk. I could tell that my comments paired with those big personalities and figures like Drs. Aparna Bole and Amanda Millstein resonated. I just told them my simple story about burnout and finding meaining in medicine through climate and health advocacy. I shared with them that for me it is a spiritual journey. I notice the butterflies and I notice the snowy egrets. The earth leads me to different projects, and I just grab all my friends and we try to do it together.

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September 25, 2021

by drplasticpicker

My back was bothering me on Thursday night. I had been working virtually or doing climate virtual work Tuesday through Thursday, and that relative inactivity and my seating posture really did a number of my back. But I try to listen to my body now. I made sure to sleep on the floor with the thin mattress pad that is really comfortable. I did some yoga stretches on Thursday night and then Friday morning. I wore good solid shoes I got from the Goodwill on Friday, and wore comfortable scrubs. I made sure to walk around and take care of my plants at home and at the HMO parking garage. Walking around and visiting plants, it very good for my mental and physical health. It’s fun to have a destimation to go to, and to visit.

I named the blogpost this morning the “Green Awakening” because our teen daughter was discussing her history class with us. They are learning about “The Great Awakening” and that term really resonated with me. I truly believe we are all going through “The Green Awakening.” I can’t explain it more than that. For me this entire journey has not been religious but spiritual. I listen to nature and the earth tells me what to do, and where to do. And she is trying to heal me and us at every corner, as long as we allow her and we listen to her.

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September 21, 2021

by drplasticpicker

I’m going to find money. Yes I am. Dr. Sabrina Perrino and I are going to find money for our AirKeepers for South County Schools project. A new grant became available from Eco-America and looking at the application – I think we can easily do it. I have all the material from Dr. Lori Byron from AAP Montana as they had deployed the program throughout Montana. I had presented this program at our HMO talk and it went well, but no one offered to give me money to do this program. Therefore I will work the AAP angle, which makes more sense. There is also a grant through the APCD board I believe. I just need to synthesize this information and actually apply for the grant. I am going to pitch this grant as AirKeepers program deployed in EJ middle schools, and a partnership with pediatricians for the AAP Climate Change and Health Committee and the South Bay Middle School teachers and elementary schools in the south bay. I need to work with one of my great parents who is one of the middle school science teachers. Probably the next thing would be to draw up an interest list from the middle school science teachers.

That is all. That is what I am working on. Oh also two other great projects, but I needed to figure out this one in my brain.

And then our student Co-Founder for San Diego Pediatricians for Clean Air and I put the finishing touches on her poster. Super proud. We’ll review her audio recording soon. Just proud of these students and what they are able to accomplish.

September 20, 2021

by drplasticpicker

I’m feeling selfish today. I am fundamentally a giving person but I’m a bit tired right now. Some of it was this wonderful weekend, and as an introvert – it took me emotionally most of the weekend to recover from the coastal clean up. I can’t explain it. I love organizing it and it is the right thing to do. I was energized from it, but also drained. I want to create these experiences for friends as this is a way to activate more physicians and it pushes me out of my comfort zone. But honesetly, it was emotionally draining and I can only do these a few times a year. Yesterday morning I walked by myself along the beach and gathered three bags of trash. That actually refreshed me. Even after I literally stepped in doo doo. But that is an entire saga that is detailed on Instagram.

Anyhow. My sister-in-law has a very productive passion fruit vine, and my mother-in-law as well has a beginning vine. I did not realize how wondrous passion fruit is! My mom showed me how to put the passion fruit innards in a blender, and yesterday I made the kids passion fruit and grape fruit juice with a bit of honey. It was wondrous!!!

Let me look up the nutritional content of passion fruit. [PAUSE] It continues to be wondrous!!! And here is some information I found on the internet. So wondrous!!! We’ll be eating all the passion fruit from our vine, thank you very much!

From Healthline https://www.healthline.com/nutrition/passion-fruit#nutrition

Passion fruit is a good source of nutrients, especially fiver, vitamin C, and provitamin A.

A single purple passion fruit contains:

• Calories: 17
• Fiber: 2 grams
• Vitamin C: 9% of the Daily Value (DV)
• Vitamin A: 8% of the DV
• Iron: 2% of the DV
• Potassium: 2% of the DV

Though this may not seem like much, keep in mind that these are the values for a single, small fruit that has only 17 calories. Calorie for calorie, it’s a good source of fiber, vitamin C, and vitamin A.

It’s also rich in beneficial plant compounds, including carotenoids and polyphenols.

September 19, 2021

by drplasticpicker

It’s 558am, and it’s the day after the 2021 Coastal Clean Up Day. It’s a symbolic day where the community is invited to come together to pick up trash and plastic pollution to help the oceans. I organized a work group to clean up on the bayside of the southern part of San Diego Bay at the Chula Vista Boating Launch Ramp. It was a long process that included sending emails to our department, posting on our MD Facebook group. I figured out how to use sign-up genius, and posted during our differerent work presentation reminders. I considered different areas to clean and texted RN Plastic Picker about advice about where to clean. I drove to two different areas to scope out which areas would be the most approrpriate and settled upon an area in the South County where I grew up, that had plenty of plastic pollution at a scenic walkway. I exchanged emails and text messages with various people. Mr. Plastic Picker and I went to the grocery store Friday night late, after a long day of work to get supplies and snacks for the event. My father-in-law happily agreed to come with me to help set up, mostly to put up our tent that we needed. RN Plastic Picker convinced her tween daughter to come, and another nursing manager came. We arrived at 740am right on time, and quickly set up in about 20 minutes. We didn’t leave until about 1130am, so a good four hours of our time. About 15 people of various ages came with their family and I’ve detailed the beauty of the day on different facebook pages and there are plenty of wonderful pictures of the day. This is one I’ll always remember, because I feel like I found this tree and I got to help clean around her roots and tell a child that I love that I found it for her and she should sit on it.

The actual amount of trash that we gathered was respectable. Here is what it looked like, and given the wind conditions – I know that it would have all gone into the ocean.

Was it worth it? Was it worth all that time? I’m sitting here and it’s 608am now and it’s still dark and I can’t go out by myself to the beach to clean just yet. It’s too dark. But the memories of yesterday and everything that led up to yesterday are washing over me, and every moment was worth it. Every part of the efforts that led to yesterday were worth it. There were so many moments throughout the entire process that I will never forget. I’m closing my eyes again and letting it wash over me. I get kind of choked up when I think about it.

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