How ocean plastic picking made me a better pediatrician [PODCAST]

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“It has been over a month since I started this new hobby. I told my middle-school-aged daughter tonight, ‘I am going to write a post about how ocean plastic picking has made me a better pediatrician.’

She replied, ‘You mean better than other pediatricians?’

‘No, I mean a better pediatrician than I was before,’ I answered in all seriousness. I know where her thoughts were coming from. I have always thought that anyone who makes it through the medical training process, including her mother, must have some level of narcissism and arrogance to make it and succeed. We have to convince parents, patients, and colleagues that we are just special enough to deserve their trust, their respect, and that we know what we are doing. Being mid-career, I certainly know I am competent. But the regular ritual of collecting ocean plastic has helped me be a better and more humble pediatrician.”

Vi Thuy Nguyen is a pediatrician who blogs at Dr. Plastic Picker.

She shares her story and discusses her KevinMD article, “How ocean plastic picking made me a better pediatrician.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show we have Vi Nguyen. She is a pediatrician, and she wrote the KevinMD article “How ocean plastic picking made me a better pediatrician.” Vi, welcome to the show.

Vi Thuy Nguyen: Thank you so much, Kevin, for having me here. I just feel so privileged to be able to be in your space, and thanks for being so welcoming.

Kevin Pho: Thank you so much for contributing all the articles to KevinMD, and we’ll certainly talk about one of them later on. We’ll get to that in a bit, but first off, can you share your story and your journey to where you are today?

Vi Thuy Nguyen: Oh, thank you for asking. My name is Vi Nguyen. I’m a second-generation Vietnamese American, born and raised in San Diego. I went off to Boston through the Harvard system, was there for 15 years, and came back to Southern California, to where I grew up, in my little home suburban town, as a general pediatrician. I’m pretty far along in my career, so I’m assistant chief of pediatrics at Kaiser.

The reason why I started blogging was that I actually went through a really hard time, personally and professionally, about two years ago. I went through a period of burnout. I didn’t realize that back then, but just a lot of things happened. I had a toddler who died of cancer, actually. These things happen, you know. Another one got diagnosed with a very rare cancer around the same time, and there were just a lot of work stresses.

I was one of those Southern California kids who never really appreciated the beach, which is why I went off to Boston to train. I live near the beach, so I started just walking toward the beach and decided to pick up some trash, because the climate youth movement and Greta Thunberg were on the national scene at that point. Something weird happened: I just started feeling better, getting exercise and quiet. I started blogging about it, and that’s the beginning of the story. I started self-healing, and then I realized how bad the state of the environment was and thought to myself, “Wow, I feel better. I should really try to do something to help the kids and the earth,” because I think it is an existential threat.

Kevin Pho: So let’s lead into that KevinMD article, “How ocean plastic picking made me a better pediatrician.” For those who haven’t read that article or know about your story, can you share a little bit about it and share why you decided to write it?

Vi Thuy Nguyen: I had actually been reading blogs, and I thought of myself as pretty financially savvy for the last decade or so. I love the FIRE blogs, so financial independence, retirement blogs, and we had reached our financial independence number. I always tell people my dad’s an accountant, so I’m pretty smart with money. But at this time I was burnt out as well, and so the question is, do you throw in the towel? I thought to myself, “Wow, if I am who I am, with as much support as I have, and I’m burnt out, if I can’t make it, who can?”

It’s funny, because there was a lot of self-wellness, and physician wellness was in the national conversation, but it seemed kind of hokey to me. How can you just go to a course and be well, right? You fundamentally have to deal with the situation. I was already in management. I was actually controlling the schedules, hiring physicians, and controlling multimillion-dollar budgets, and I thought to myself, “Wow, if I throw in the towel, what’s going to happen to all the young physicians behind me if I’m not looking out for their well-being?”

It’s kind of weird, but through the process of self-healing on the beach by just picking up trash, kind of like multitasking, where I’m getting exercise and picking up, I don’t know what it was, but it just fixed my brain. It fixed my thought processes. I started sleeping better and became more effective. So the whole point of everything is that rather than leaning out, retreating, and quitting, or just not being as much of a doctor as I wanted to be, I actually leaned in. I joke around on the blog, but it’s true: I’ve just declared that I’m going to save the earth along with everyone else.

It’s funny, everything gelled together. Clinical work became more meaningful. I fundamentally enjoy being a physician again. I really connect with my patients more. I listen better. I think that has something to do with listening to yourself on the beach and listening to nature. Management’s much easier, I think just because I’m able to communicate a lot better. I’ve written over 400 blog posts. I think communication is so key, and they don’t teach you how to be a manager if you’re a physician, right? They just throw us in. I think that’s why a lot of physician leaders get burnt out. But the department listens to me better just because I’m listening to them, and I tell them, “I don’t know the answer. Let’s do it together.”

I’ve already picked up 350 bags of trash, and it’s more symbolic than anything, but I realize that in the environmental space, it’s all volunteer, right? Very few of us are paid to be environmentalists. I’ve been amazed how, as one person just being very sincere and honest and checking my ego, I’ve been able to do a lot just because of committing. I really feel like the ocean healed me, and it’s my turn to heal the earth. I know it sounds hokey, but it really is my story.

Kevin Pho: So tell me about those walks on the beach, because your life really seems to have turned around after making those trips and picking up the trash on the beach. Tell me what goes through your mind as you’re walking down the beach, and what kind of healing thoughts did you have?

Vi Thuy Nguyen: It’s funny. I tell people you have to really try it, right? I think with our background, our training as physicians, we know that stuff, right? We know about physiology. I actually trained in pediatric endocrine, so I know about stress hormones and cortisol, circadian rhythm, and thyroid. I actually did research in sleep. I didn’t even realize it was all related, but I actually worked at an NIH sleep clinic. I did research on depressed women, bone density, and sleep. With research, you have this little niche area, right? So I did the typical thing a lot of young physicians do.

Then, when I started walking on the beach, I realized it’s all related, because I didn’t know what was happening, but I felt better. What goes through my mind is that I have a destination to run to, rather than just being a runner. I had been a runner for 30 years, so rather than just running for time or training for a half marathon, I ran to the beach. I go when it’s totally quiet and no one’s there. I go really early, like 5, 5:30, 6 o’clock, and I go on the same stretch of beach. I think because I live near a college town, the kids litter a lot, so there’s always trash. I walk from Crystal Pier to Tourmaline, where the surfers are. We’re actually a marine protected area, so it’s beautiful. There are a lot of endangered birds, there are always surfers early in the morning, and it’s just super quiet. It’s just me and my time and my own mind and my thoughts. You have to really concentrate on little pieces of glistening plastic. My goal is not an amount, and every day it’s different, but I just fill a bag and bring recyclables home.

There’s something about slowing your mind. With social media, and we had gotten iPhones at work, we were always on. Especially as management, I was always on, and I was not sleeping well, my back hurt, just all these middle-age issues. Then I think going to the ocean and hearing the waves and seeing the birds, literally, time slows down. It slows down, and your mind slows down, and I think that’s what happened. I got exercise, and I slept better, I think because of this idea of circadian rhythm, in terms of your body being tuned with the sun and moon. There is something to it.

It’s funny, because my husband and I, we’re a two-MD family, and I always tell him that he’s the last one to, if I can convince him, I can convince anyone. It’s this cascading effect, because I started feeling better with every walk, and I started incorporating a lot of things that a lot of sustainable people incorporate: more plant-based eating, minimalism, not buying things, turning things off. I’m actually more on social media, but I use it as a tool rather than just mindlessly consuming it. I can say the cascading effects in my own family, and actually my whole department and my patients, are amazing, because it really is this idea that we are just part of this large community, and that’s really given me a lot of strength.

It’s funny, I write about him a lot, and we’ve been together for a long time. It’s hard to be two MDs together, balancing family and raising kids that are OK, you know? When I read him something, or have a thought, and he sees it, I’m like, “Gosh, I’m on the right path.”

Kevin Pho: How long would each of these walks be, and how often would you go?

Vi Thuy Nguyen: Initially, it’s funny, because I’m kind of like a financial, personal finance blogger, but not because I’m on Crispy Doc’s blogroll or whatever. I like to keep track of things. It’s kind of weird, but on my blog I keep track of the exact number of bags and the exact number of items I picked up. So I picked up about 300, I calculated 365 bags a day, and items, about 100, 1,400 items.

Initially I had to pick up a lot, I think because I needed to pick up more, because I was self-healing. Now I’m actually in a very beautiful part of life where I don’t think I really need to go over there for the exercise, but I commit to doing at least 20 bags a month. Before, I used to do 50. Right now I do at least 20 bags, because I do a lot of other environmental stuff. So I just go whenever. I know I don’t have, that’s the nice thing about this plastic picking, or litter picking: If I don’t pick it up, no one else does, so there’s no pressure, right? Because it’s just going to sit there. Literally, I’ve jogged by the same can five times just for fun, and no one picked it up, you know? I usually walk, so it can go anywhere, usually at least 45 minutes: jog to the beach, pick up trash, come back. On the weekends I go longer, so I really have a great time and walk up and down the coast. I live in a very beautiful part of the world, and on those days it could be up to two hours. So it’s whatever my body tells me I need. I usually go at least three times a week, if not sometimes five, depending on how busy things are.

Kevin Pho: So you also blog about your experiences at Dr. Plastic Picker. Now, you said you had over 400 entries, which is a huge amount for a blog. What kind of stories do you share on your site?

Vi Thuy Nguyen: It was kind of a roundabout thing. I started picking up plastic and doing litter picking and committing to the environmental movement. I started writing about it, and it was this whole other part of myself I didn’t realize I had wanted to tap into. I’ve always liked my sister. She has a podcast. She’s a very, I mean, I admire her a lot. My younger sister is an attorney and trying to change the world and everything, and she always reminded me. She’s like, “You used to journal all the time.” I said, “Oh yeah, you’re right.” When I was a little kid, I would journal.

So pretty much my blog is just my journal. I don’t purposely look for a lot of followers. It’s so funny: Sometimes the blogging can be very painful, right, emotionally, so I really put it out there in a very supportive way, really just for my patients, and other people have since come onto the blog and read it. I try to be mindful of what I share about my family, but my family is part of my life, and my kids have made me who I am, right? Because I think as a pediatrician, as we go through parenting and motherhood, it changes how we practice. So I pretty much just blog about what I do. It’s just kind of random.

It’s kind of weird. I oddly enjoy it. It’s helped me in my career quite a bit, because when I send emails out or when I go to a meeting, I’m able to effectively communicate my opinions very clearly, and sometimes irreverently, which is funny. What I realize is people accept ideas and opinions if it’s not threatening, you know? I think as a woman physician, before, I thought I had to be more abrasive, more man-like, because I came up in the ranks when there weren’t a lot of women leaders. Now that I’m in my mid-40s, I get a lot more just by being funny and just doing things, and talking about trash, because it does all relate, right?

When you manage a department, or anything, it’s about efficiency, and that’s what drives me crazy about plastic: It’s so inefficient. The whole process of plastic is inefficient. So, as an example for peds, I realized that if I can get every kid to eat more vegetables, unprocessed, it’s cheaper for the family, cheaper for the planet, less plastic for me to pick up, and the kids are better, right? So it’s all related in this idea of my management work and the earth and everything. At work I’m usually not tangential, but in my blog, sometimes I am.

It’s really fun. The funniest thing is my most popular blog post has nothing to do with the environment, because you can track it, right? I wrote a fan fiction about “Star Trek.” That thing gets like a thousand hits. It’s crazy, and it’s so funny. So whenever this is over, I’ll make it a “Star Trek” fan thing. I just, my dog, like a Vulcan, so I got a lot of likes.

Kevin Pho: What have some of the responses been from, say, your clinician colleagues to some of the adventures that you have on the beach and the plastic picking initiative? What are some of the responses that you get from your colleagues?

Vi Thuy Nguyen: I think it’s interesting. I referred before to this time of burnout, right? I think you’re at a place of true pain, and not darkness, but when you’re really hurt, it can’t get worse, right? Literally, I was like, “Do I just throw it all in and be a stay-at-home mom, now that my kids are already grown?” I mean, this is ridiculous, right? I was questioning my abilities, or, not my abilities, but questioning how long I have in my career. So initially, I hadn’t blended it together, right? It was supposed to be semi-anonymous. Nothing’s really anonymous; it comes up, you know? But what has been so heartwarming for me is that the response has been phenomenal, just so supportive throughout the whole organization.

What I realize is that a lot of physician burnout issues, or, because I deal with, I’m HR, right? So I deal with all management issues. It’s hard to look at a colleague and say, “There was this error that happened, and there was this clinical outcome, and now you have this thing on your record.” You deal with all these issues, like sick call: What is sick call? Who should take sick call? Whatever. It’s just ridiculous. I think my being very vulnerable and sharing these things, and my own struggles when I was a younger physician, has made me more understanding of other people. It’s funny. I fundamentally don’t judge as much. I actually took another personality test, and my personality, Bristol My, or whatever it’s called, shifted.

So I think the response has been heartwarming. Initially it was just my colleagues that slowly found out, and my patients and the families I take care of. I mean, they’re the ones who join me on the beach when we do group beach cleans. I think the most beautiful part is that medicine is so commercialized, right? There are so many layers between us and the patient. We’re no longer the small family doc in this small town anymore. But just by saying, “Hey, join us on the beach. Just go do a beach clean.” I make it really easy. It’s one hour, right? I get breakfast for people from Costco, hopefully vegan, not a lot of plastic. People come up. I get grabbers from the local NGO that lets us use their stuff, and we just pick, really quick, 30 minutes, 45 minutes.

But there’s something about being together as a community and seeing each other in the light of the real world, outside the walls of the office, and not literally, like I used to, looking at a patient and seeing their medical record. You know, right? Because you use the EMR, you see their med list, their drug interactions, and all this other stuff. But now, having seen so many patients on social media and just picking trash together, I see them differently. Medicine truly is holistic, right?

So it changed the way I even approach constipation. I mean, it’s such a simple thing, right? But it drives us crazy. We see a lot of constipation in pediatrics, right? The kids are just constipated, and it’s this revolving door. They come in, to the point that the kids have rectal prolapse in the ED. As a pediatrician for 15 years, I’m like, “You know, I’m sick of this. I’m sick of it. I’m just going to deal with it.” So literally, at the four-month visit, I say, “Let’s sit and talk about it. Let’s really sit and talk about fiber,” because I don’t want to deal with the stuff on the beach. I’d rather just walk without picking up trash.

Also, now I know that I’m the answer, right? Just like I’m the answer to picking up trash, for my patients, I’m not thinking that, I don’t really need to save the world. I can show people how to do it, but for my patient, that’s my problem. And even though I’m in management, I realize that management is not the answer, right? We can’t solve everything. We can’t fix everything for everyone. So now I approach patient care in a fundamentally different way, and I take the time. It’s funny how it all works out: I still finish on time, just because my mind is more clear, and I just zero in on the issue. Pages come, and they have a list of 10 things, but really it’s just one thing right now. If I can deal with the one thing. Or sometimes I just listen to them, and I realize they’re not going to listen to me, which is fine. I say, “OK, let’s just move on, and we’ll deal with it when they’re ready to receive the message.” So it’s been very amazing.

I think for us as physicians, we have to stay in management. We have to stay in the conversation, because if we don’t, a bunch of MBAs, a bunch of nonclinical people who don’t have that tactile, that emotional, moral responsibility to patients, are making decisions. So for me, I feel like I sit there and try, just every decision, right or wrong: pick it up or not pick it up, you know? And being financially independent helps. It does. Sometimes I joke around: I walk. What are you going to do? I can go back to clinic. I fundamentally love patient care, so if I lose my management job, whatever, you know?

Kevin Pho: Sure. We’re talking to Vi Nguyen. She is a pediatrician, and she wrote the KevinMD article “How ocean plastic picking made me a better pediatrician.” Vi, for those clinicians who want to be more involved with climate action, what are some actionable things that they can do to do so?

Vi Thuy Nguyen: I think you have so much power and social influence. I really want to thank you for putting yourself out there. I think it’s kind of hard, you know? It’s kind of weird, right? Someone picks up trash, and you put them on your blog, right? I think that if there’s anyone out there who is curious about the environment, who wants to work on the environment, what I can say as someone who’s deep into the environmental movement now is that there are not enough people like that. As an MD, you don’t need a master’s in anything. You don’t need any special anything. By virtue of being a physician, you are an influencer. It’s crazy, right? Part of the reason I got into social media is because I saw the Kardashians, and I said, “Wow, people listen to them. They should listen to me. I’m the doctor,” right?

I think that if you, as a physician, want to get involved in the climate movement, there are tons of opportunities. Definitely reach out to me. There’s the Physicians for Sustainable Future Facebook group, which is this great melding of a lot of minds together. There’s Physicians for Social Responsibility. There’s Health Care Without Harm. The American Academy of Pediatrics is very active. So there are lots and lots of venues, and just like with anything, you’ll find your niche, whatever it is. I found mine through picking up trash and blogging and making trash art. It’s weird, but there’s a place for me, and whoever you are, whatever field you are, there’s a place for you.

And environmentalists, I can tell you, are so nice. Vegans are so accepting. I can’t tell you of a more positive community. It seems kind of crazy, but I switched over to this non-plastic shampoo just because I want to reduce plastic, and my hair is great now. I don’t know why, but people see it, and they’re like, “What are you doing?” I’m like, “I just became an environmentalist, and my hair looks great.” I get a lot more people coming into the environmental movement because of my hair than anything. So that’s it.

Kevin Pho: My final question: What’s your take-home message that you want to leave with the KevinMD audience?

Vi Thuy Nguyen: Since the KevinMD audience is so large and diverse, and there are some who are into the environmental movement or not, my message would be just take care of yourself. Whoever you are, as a doctor, you’re doing good. Just take care of yourself. Take that time to sleep. Take that time to be with your family, because in the end, your role as an MD can be replaced, right? But your role as a person, as a mother, as a father, as a son, as a daughter, can’t. I think it took me almost 15 years into my career to realize that. So just take care of yourself. That would be my message.

Kevin Pho: That’s well said. Well, thank you so much for sharing your time, story, and insight, and thanks again for being on the show.

Vi Thuy Nguyen: Well, thank you so much, Kevin, and I hope you take care of yourself too during this last surge.

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