April 16, 2020

drplasticpicker

Twenty-five years ago this month, I was seventeen and would lie on a hammock in our back yard that overlooked the winding road that led to our mailbox. My father always complained about that road because it was asphalt and technically private, so all the neighbors had to agree and contribute money anytime the road needed repairs. It’s a windy road that is shaded by a canopy of non-native eucalyptus trees. I remember seeing those same trees in Austalia with koalas. I saw these same trees in Peru last year up high in the Andes during a medical mission trip. They are non-native to Peru, encouraged by the government in the 1970s as a fast growing cheap source of fuel-wood. Those trees have contributed to the disruption of the water cycle there. In Australia and Peru, I oddly felt at home because I knew those trees despite their invasive nature.

Twenty-five years ago the teenage me was laying on the backyard hammock with one foot slowly pushing off to power the rhythmic motions. I would just quietly watch the windy road below . I loved hammocks as a child. As a mother, a few years ago I had this moment of determination and marched to Home Depot with my skeptcal non-hammock- loving husband. That weekend, I taught my half-grown children how to correctly use one. Seeing them try to sit and subsequently fall onto the ground, dazed and laughing as the hammock continually flipped over was wonderful. Laying correctly on a hammock is an artform that I mastered as a child. When you lay on a hammock you have to move with it, and somewhat let go of control which is difficult for uptight people.

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April 15, 2020

by drplasticpicker

We are in the middle of unprecedented times, when much of the world is in quarantine and COVID-19 is a menacing danger. I am sitting at home in Southern California, and most of my department are not doing any heroics. Most outpatient pediatrics is doing virtual visits. As Dr. Plastic Picker, I don’t know when I can return to the beach to start picking up plastic again. As Pediatricians, we don’t know when we will return to seeing face to face patients or what medicine will be like after this is all over. We are blessed that for the most part children are doing okay. Rates of respiratory illnesses are down because kids are not swapping germs anymore, a side effect of quarantining. Even with New York City still in the midst of a true crisis and the rest of the country is anxiously watching to see if the curve truly flattening – I still have hope.

It’s easy for me to have hope, because I have not been asked to do much. I have tried to help as much as I can but it seems woefully inadequate in comparison to the sacrifice others are making. I have helped distribute a few thousand masks, tried to make sure my little corner of the medical world is flattening the curve, and continued to have the environment on my mind. But I have hope because from great hardship the world can change. It sometimes takes momentous challenges for us to reach our true potential. Personally for me, the greatest times of personal growth have been after great personal and professional failures. So I am hopeful that we will make a better world post COVID-19.

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April 14, 2020

by drplasticpicker

This is definitely one of those topics that Dr. Plastic Picker is a much better pediatrician now than I was at the beginning of my career. It helps that I myself have gone through puberty, completed a clinical year of pediatric endocrinology, and am semi-successfully guiding my own two children through this process.

This can be both a stressful and wonderful time in life. There is a sense of loss for the littleness of your children. I had this profound sense of loss because I worked so much when they were little. I miss the warmth of those young bodies snuggling up to me at night. The promise of that time would often get me through the long overnight calls or urgent care shifts. Our daughter had a profound sense of loss as well. When her body began changing she said that she did not want to grow up. Our son was very nonchalant about the whole thing, which is true to his easy going personality.

But as I tell my children and my patients, puberty is a wonderful thing because it means the body is working! It means that your hypothalamic-pituitary-gonadal axis is functioning as it should and you’ve reached this milestone. If you didn’t go through puberty by a certain time, it would be a medical problem. I would have to start getting blood work, radiographs and maybe MRI your brain. As a pediatrician, I am aware of the dangers of being little as well. You are more susceptible to diseases which is why there are more vaccines when you are young. Little children can’t physically protect themselves as well. So I look at puberty, as a wonderful time that children are gaining bodily strength. They are developing themselves to be adult people. Because in the end the purpose of raising children and protected them while they are young is to get adults, and then they can protect and fend for themselves. And now my own teenagers can get things I need from the upper shelves that I can’t reach! Score!

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It is the 5th week of essential lock-down for our family. We started social distancing prior to the general order in California and our city. I had been following the COVID-19 MD Facebook groups closely. Before most were social distancing, we had cancelled our early March vacation and cancelled Mr. Plastic Picker’s parents trip to New York. Thank goodness, as New York is now the epicenter of COVID-19. California has done remarkably well, but even with hundres of thousands of cases averted and thousands of deaths prevented – we have many dissenters. Probably there are not many, but they are taking up a sizeable share of the blogsphere. I had a high school friend post on facebook COVID-19 misinformation. I replied but didn’t have the energy to have a prolonged facebook discussion. I ended it with let’s just be grateful that we in California are doing okay.

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April 12, 2020

by drplasticpicker

It has been a wet spring in Southern California, and our rain barrels have been overflowing. The country is still under COVID-19 quarantine orders, but I have been gratified that this blog has seen an uptick in traffic – hopefully providing everyone with some entertainment. This has motivated me to keep on writing. Anyway, our rain barrel makeshift collection system caught 395 gallons of water yesterday. My mother-in-law will use it over the course of the next few weeks to water her garden. Her garden is truly a work of wonder where in the normal sized front yard she is able to yield enormous amounts of lettuce, kale, onions, tomatoes, lemons, and different varieties of squash.

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April 11, 2020

by drplasticpicker

I’ll be blunt here. Physicians are not for the large part good stewards of their own money. Physicians often think other fields are easier than our own work. I hear this a lot. Some of my colleagues think there is easy money in real estate investing, yet rarely do those same people have actual real estate outside of their primary home. It’s kind of a minor insult to true real estate professionals, just like a parent telling you they could drain an abscess better than you could with a sewing needle and exacto knife.

To actually support a middle-class or upper-middle-class family solely through the real estate boom and bust cycles of the market is not easy. Like performinig surgery, real estate investing requires a very specific skill set. It requires negotiating, managerial skills interacting with skilled laborers and tenants, having good accounting skills and being able to take on financial risks. You need to know about the specific tax laws, termite inspections, cost by the square footage of decking material and on and on. It also requires time and focus and attention to detail.

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April 8, 2020

by drplasticpicker

There is much to be hopeful for Wednesday. In the end we will never know what the death toll would have been if we had not #flattenthecurve and #stayhome. But as an outpatient MD following along, I do believe it would have been in the order of 500,000 to 1,000,000 lives lost. We still have at least a month left of mandatory quarantine, but we should recognize that the community accomplished many hundreds of thousands of lives saved by pulling together already. I thank our state and local leadership for putting in shelter in place orders early. It has been a remarkable thing to see how well California has done. Still a lot of work to do, but this Golden State, that embraced our immigrant family even before my birth and formed me as a person, has made me so proud. I have always and continue to be even more so proud to be from California!

With that, there is hopeful news for the environment. I wanted to highlight today how the practice of medicine can be more sustainable after COVID-19. We have learned that we can practice effective medicine and environmental stewardship. I apologize for skipping last week’s Hopeful Wednesday post. I was feeling down last Wednesday, but today I am happy.

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April 6, 2020

by drplasticpicker

This blog series is monthly. This month I am 5 days late. Forgive me as there is this thing called a pandemic going on. But in all seriousness, I am so happy to be forced to write a non-COVID19 post. When I started this blog called Dr. Plastic Picker, I really wanted it to be more about Plastic Picker – but it’s become more about Dr these days. I try to deny it, but I am one and am doing my due dilligence these days to be a competent one. In fact, I held the On-Call COVID Pediatric walkie-talkie for our large outpatient building today. I decided my code name is Dr. Spock and I asked the nursing manager to call me that when she needed me. This is why this series is so important, because it keeps my tangential brain on earth and not in outerspace. This series keeps me accountable for making real changes in our lives that are good for the environment. I am responsible for reporting out monthly 15 changes that I have made in our daily lives that help the environment.

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April 4, 2020

by drplasticpicker

It is good to have a rhythm to the month, and blogging has given me this structure in life. There is a world-wide pandemic going on, but let’s leave that somewhere else for a bit. I did pick up ocean bound plastic at the beginning of the month so at least I have something to report out for March. Now that I am reviewing my notes, I was really doing a lot of litter picking at the beginning of March – and I’m glad I did because for various reasons that everyone knows, there was not much litter picking or beach cleaning from mid month. I expect April to be really nothing since the beaches are closed. I think I could do it safely, but I don’t want to set a bad example and someone copies me and doesn’t wear the right protection and then gets sick. Dr. Dear Friend https://drplasticpicker.com/drplasticpicker-goes-to-the-aap-national-conference-in-new-orleans-and-tries-to-use-less-plastic/ is cleaning her office, which is a great idea for April. I’m thankful for this blog series, because I’m accountable to report out to our readers even if the total is 0. This is the entire purpose of this blog! I have to be accountable to you and the environment.

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March 31, 2020

by drplasticpicker

Dr. Plastic Picker knows a lot more about cortisol than the average outpatient pediatrician. I did two years of pediatric endocrine fellowship, and here is the blogpost that explains why I left in good standing https://drplasticpicker.com/covid-19-social-distancing-is-like-bedrest-dr-plastic-picker-understands-but-this-time-you-stay-home-and-i-get-to-do-something/. Cortisol is a stress hormone and is often referred to as almost how doctors in the 1700s would speak about “humours” that would float in the body. This is before we knew about germ theory. It’s somewhat accurate though, because we refer to cortisol in general but to actually get an accurate cortisol level is very difficult. It fluctuates through the day, and to really get an accurate level of one’s cortisol level one has to admit a patient short-term to do an ACTH stimulation test. The cortisol or “stress humors” are running rampant in your body right now if you are in healthcare. In the end of the day, Dr. Plastic Picker is still a middle manager and I’m hearing all about it. I’m calling in the Great Freak Out. Yes, you are all freaking out about COVID-19.

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