UCSD Health Is Keeping Medical Care Close to Home

You’re coasting home after a weekend in Rosarito Beach—still riding the high of vitamin D and Baja Med—and then comes a slap back into reality: brakelights and gridlock exhaust.

Small wonder, given that San Ysidro is the busiest land border crossing in the western hemisphere (fourth-busiest in the world). Otay Mesa’s no breeze either; it’s the busiest commercial port in California and second-busiest across the entire southern border. Smart Border Coalition says that each day last year, 41,800 vehicles crossed into the US at San Ysidro; 17,800 crossed at Otay Mesa, along with 1,023,000 commercial trucks.

Diana Pazos, a San Diego resident and adolescent psychiatrist working in Tijuana, says the northbound border wait at the San Ysidro crossing is often three to five hours Saturday through Monday—delays that modern humans and multinational maquiladoras alike aren’t built to endure. At the current Otay crossing, “commercial trucks may be in line for six hours or longer,” she says.

Needing to bake a couple hours of commute into the States doesn’t just affect vacations; tens of thousands of people cross the border each day for doctor’s appointments, work, school, you name it. The clog has personal and commercial ramifications.

But change is coming. Construction has begun on a new border crossing in Otay Mesa, which is expected to significantly reduce wait times across all San Diego border crossings, bolster binational trade, and improve the air pollution levels in the area.

Nikki Tiongco, an 18-year Caltrans veteran who oversees the Otay Mesa East project (aka Otay 2) for the agency, says the new border crossing will also be among the most high-tech, efficient, and secure border crossings in the nation.

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“We have already completed the roadway network within the Otay Mesa East region,” says Tiongco. Part of this project included building State Route 11, an extension of SR 905, which has been open to the public since August and will feed traffic to the new entry port. Otay 2 comes with a 21st century upgrade, too. Miles of fiber-optic cables have been installed underground, which gives the port the brainpower to efficiently sort and streamline traffic as cars approach the border. (Unlike the San Ysidro border, where lanes get organized by vehicle type, Otay 2’s lanes will be interchangeable. For example, if the system indicates that a high number of commercial trucks is heading to the border, passenger lanes could be converted to cargo lanes in real time.)

Otay 2, driven by a binational collaboration among government agencies (Caltrans, SANDAG, General Services Administration, and U.S. Customs and Border Protection), receives both federal and state funding, plus hefty contributions from Mexico. So far, funds from the $1.3 billion project have helped build new bridges and roadway interchanges that will guide traffic to the crossing. At this stage in the process, Caltrans is “laser-focused on building the facility itself,” Tiongco says.

Now, to the juicy part: the prospect of a “20-to-30-minute border wait time” at Otay 2, according to Tiongco. Currently, there are three standard ways to cross the border at San Ysidro: Ready Lanes, General Lanes, or SENTRI Lanes. Most travelers use either the Ready or General lanes. SENTRI Lanes require a form of pre-approval from the US federal government plus an additional fee. According to CBP, the average wait time in 2025 at the San Ysidro crossing, was as little as 15 minutes in the SENTRI Lanes, 45 minutes in the Ready Lanes, and 1.5 to 2 hours in the General Lanes. Those are best-case scenarios that vary based on lane type and time of day.

Otay 2 is about 12 miles east of the San Ysidro crossing and 2.5 miles east of Otay 1. Those not wanting to spend that much extra time on the road to drive to the new border crossing, despite the allure of an under-30-minute wait, are still expected to see some benefits. Tiongco says Otay 2 will “provide a relief valve” overall by spreading the burden across the three border crossings. As a result, SANDAG says, wait times at San Ysidro and Otay 1 could be cut in half.

It’s not just your time waiting at the border that matters. Multinational corporations that relocated their manufacturing plants (maquiladoras) to Northern Baja have claimed for years that the long delays at Otay 1 eat away at their profits. More than 600 maquiladoras, used by companies such as Samsung and Panasonic, currently use Otay 1 to transport products to US and international markets. Ambassador Alicia G. Kerber-Palma, the consul general of Mexico in San Diego, says the project will facilitate more than $60 billion in cross-border trade annually.

Previous reports say that Otay 2 also has the capacity for around 12,000 passenger cars and 1,500 commercial trucks daily. A shiny, new element to this port: Commercial and personal vehicles that choose to cross will pay a dynamic toll on both sides of the border. The fee will increase during busy hours and decrease during slower periods, Tiongco says. Caltrans estimates that the toll could range from $4 to $30 for passenger vehicles and higher for commercial trucks. Drivers will be able to see current rates before they reach the actual border crossing.

And, with these changes, there are environmental benefits, too. “With shorter wait times at all three ports, there’s less idling and congestion, which should significantly reduce air pollution on both sides of the border,” says Kerber-Palma. The main factor driving improved air quality would be decreasing dirty emissions from idling diesel trucks. This county’s air could use some sprucing up, anyway. A 2026 report from the American Lung Association named San Diego as the fifth-most particle-polluted county in the US. The bulk of that dirty air comes from the heavy-duty trucks and ships that pass through the area.

Otay 2 is not only expected to curb the acceleration of air pollution in San Diego; if the state’s legislature passes California Senate Bill 10, the border crossing could also restore local water quality. This bill would use a portion of Otay 2 toll revenues to fund ongoing maintenance of the South Bay International Wastewater Treatment Plant. Current media reports say, however, that it’s increasingly unlikely that SB 10 will become law.

Otay 2 has been in the works for over two decades and is finally nearing the finish line. Construction estimates show that it should be up and running in 2029. Tiongco says this border crossing is “a good example of how the state, federal and local governments are working together and with Mexico to advance our mutual goals in the region.”

Rub some dirt on it. Walk it off. Be a man. The tropes and reasons for men ignoring their health and doing preventive care are many, reinforced by action heroes and generational norms. As a result, compared to American women, American men live an average of five years less, seek healthcare treatment half as often, and die by suicide nearly four times more often.

Many national campaigns have tried to change this. This year’s “Relax Your Tight End” ad from Novartis during the Super Bowl—in which NFL legends advocated for early prostate cancer screenings—was a high-profile example. Meanwhile, in San Diego, Evan Miller seems to have figured it out.

Miller founded Gameday Men’s Health in 2018 as a small clinic in Carlsbad. The idea was to create a space men would actually want to spend time in. So he built Gameday to feel more like a sports bar or a man cave—snacks, sports on oversized, high-def flat screens in the waiting room. He personalized the care for each client, made the experience more casual, and, above all, efficient. If the wait for payoff is too long, Miller says, men won’t show up for their health.

“We need to feel better quick,” he says. “So that’s where the real hook with Gameday is: It’s fast; it works quick.”

The idea has worked. Big time.

Gameday now has 430 locations spread across 46 US states and parts of Canada, with hundreds more set to open over the next three years.

Prior to Gameday, Miller—who has a Ph.D. in clinical psychology—ran Akua Mind Body, an addiction treatment center in Newport Beach. After selling the center, Miller says he searched for a new way to help his community.

He drew from his behavioral health training and dispiriting past experiences with “sketchy” men’s clinics, albeit with a slightly different concept at first.

“My original idea for Gameday, funny enough, was men’s group therapy,” Miller says. “I wanted to put it in this ‘man cave’ environment because I knew guys wouldn’t show up otherwise.”

Initially envisioned as safe spaces to encourage men to open up emotionally, Miller pivoted to a more clinical approach with an athletic design that personally appealed to him. Soon, it evolved into a one-stop shop of compounded medication treatments for weight loss plans, hair loss treatments, anti-aging injections, sexual wellness strategies, and testosterone replacement therapy. The hotly debated trend of peptides—mini amino acid proteins that the FDA has yet to approve—has become a popular feature.

New patients undergo in-clinic assessments for testosterone and prostate levels with the goal of producing test results in just a quarter of an hour. “Our philosophy with our treatments is we only do what the research supports,” Miller says.

An Orange County native, Miller found Carlsbad to be a natural headquarters. He found a much bigger market in coastal North County of men seeking a boost—both in their marriages and their overall livelihoods. The pandemic proved to be a watershed moment, with front-yard gyms and outdoor, highly visible exercise sparking a wave of self-care. According to Cleveland Clinic, after the pandemic, about 20 percent of men started to exercise more and eat healthier, with a quarter of men reporting they scheduled more sleep and spent more time with family.

“When Covid happened, [suddenly] everyone looked in the mirror and was like, ‘I need to take care of my health; I have to do everything possible to get in shape,’” Miller says.

Two years after Gameday first began, Miller opened a second clinic in Temecula, followed by locations in Laguna Beach and Newport. Demand kept coming, so they started franchising in 2023. They sold 1,000 licenses in the first year. By 2025, they had over 400 clinics across the country.

When asked about the rapid growth, Miller cites the feedback he received along the way: “People were so excited about men’s health, cash-pay medicine, and not having to wait for insurance. They understood the model. It was for guys; it felt like ESPN meets healthcare.”

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Now Miller says Gameday is starting to map out a global expansion—to Europe, Latin America, and the Middle East. Since the company first cultivated a following, Miller says there have been persistent questions about whether Gameday would ever expand its focus to include women. Their answer: Her Way.

“We only offer a very narrow menu, almost like In-N-Out Burger, because we stay in our lane, we do it really, really well, and we gain trust that way,” Miller says. “So we created the Her Way model to do the same thing for women [that] we’ve done with men.”

Her Way Health & Hormones launched in 2024 in clinics with more neutral and calming décor. With locations in Carlsbad and Mission Valley, it will officially start franchising this summer. Miller seems incapable of thinking small and expects around 1,000 Her Way locations to open nationwide within a few years.

Edna Harper asked for one thing before she died: that the next owner of her iconic Mission Hills home keep the street-facing “garden.” Which is essentially asking the future residents to be curators of a whimsical and obsessive, delightful and strange, classic, cartoony and slightly unhinged sculpture museum. Harper, who died in January at the age of 87, poured her heart into this topiary bonanza, and it’s right there for everyone to see.

Like thousands (or millions, there’s no formal estimation) of others, I had scrolled through the photos of this topiary fantasia before I ever stood in front of it. As of this writing, Harper’s Topiary Garden is No. 227 of 2,686 Things to Do in San Diego on Tripadvisor, making it a popular tourist stop between fish tacos, a day at the beach, and a stroll in nearby Presidio Park. But crowdsourced photos quickly snapped in direct overhead sunlight tend to flatten the shapes that, while meticulously manicured, refuse to behave. In person, Harper’s figures seem to be in motion and, given that they’re sculpted out of bushes, they literally are. (I’d love to see a maintenance timelapse.)

Animals emerge out of shrubs as if they have impish ideas. A fanciful whale, a man in a sombrero, a random spiral twisting skyward, otherworldly creatures that defy categorization—all of these exist together in a neatly trimmed cascade pouring down the steep front slope of the property.

You don’t accidentally end up with a yard like this. You decide to create it and choose to cultivate it, and then you keep deciding and cultivating—for decades.

Although a consistent parade of looky-loos have visited over the years, most have never been inside the home, which is on the market for the first time since Harper and her husband, Alex (who died in 2020), bought it in 1969.

“It was and is a landmark,” says Christopher Delgado, Harper’s cousin and trustee of her estate. “She specialized in Chinese brush art and Japanese art called ‘sumi-e,’ a form of Zen art. She was a creator … she was very, very talented.”

I can’t stop thinking about Harper, sitting at the kitchen window, looking down at her masterpiece and the watchers watching it. The image of Harper enjoying the joy the public took from her handiwork makes me want to understand the woman behind the work. Because topiary, as an art form, has always been a little… loaded.

Topiary has always had a bit of an identity crisis—and that’s part of its charm.

When I think of topiary, I immediately think: Fancy. French bourgeoisie. Palace of Versailles. Mais non! Topiary has its origins in Rome. According to the Center for Architecture, the word “topiary” has its origins in late 16th century English, which combines the Greek word “topos” for place and the Latin word “topiarius” for ornamental gardner.

Topiary started as a flex, really. A Julius-Caesar-adjacent pastime for the most ancient one-percenters; an expression accessible only to those with land, labor (or, put more plainly, enslaved people), and spare time. In its earliest form, topiary was about control: bending nature into submission. It’s where symmetry and precision signaled order, taste, and money.

But with the collapse of the Roman Empire and the Dark Ages that followed, the topiary almost preceded the Dodo Bird in extinction. Monks quietly kept the art alive by growing herbs and manicuring the gardens and hedges within the courtyards of their monasteries.

It wasn’t until the Renaissance nine centuries later when topiary saw a resurgence—ah, Versailles!—and this form of pleasure gardening went into overdrive. Nature became architecture. The French pruned their foliage into iconic cones and obelisks, walls to keep out the riffraff, and ornamentation designed to impress. The Dutch got a little freaky, as they do, and sculpted complicated figures, animals, and even furniture.

Inevitably, the pendulum swung again, and topiary fell out of favor once it became viewed as excessive and even absurd. Even so, it never really disappeared. It just migrated to exist in a completely different paradigm. It was less Versailles and more, “What if this bush were a mouse?”

Fast forward to Disneyland in 1963. That year, the park opened a topiary garden in Fantasyland with verdant sculptures of giraffes, camels, elephants, and hippos all inspired by Denmark’s Tivoli Gardens.

Disney’s interpretation of topiary—which is still a fixture of park decor today—falls more into the realm of imagination and possibility than restrained aristocratic performance.

That’s one of the stranger throughlines of topiary: It moves from elite to everyday, from stiff and formal to playful and silly, from symbol of control to something steeped in personal expression.

Which is what makes a place like Harper’s Topiary Garden so compelling and the woman behind it utterly intriguing.

Born in 1938, Edna Harper was something of a Renaissance woman. She worked for two decades as a dental assistant, and she later became a notable painter, calligrapher, and stained glass artist (the house itself is adorned with her work). But she was also savvy in other ways.

“She graduated [with a degree in dental assisting] from San Diego City College and wanted to have her own money and her independence,” says Delgado. “Most people didn’t know that she was such a great businessperson, and for many years, she managed all of [the couple’s] properties on her own. She was great at building relationships … she touched a lot of people’s lives.”

Her friend and fellow artist Julie Roth attributes her artistry to her relationship with Harper. The pair met two decades ago at an art class at Oasis in Mission Valley.

“She was just the most encouraging person,” Roth says. “I didn’t know I could paint, but apparently I can. She was a tremendous person.”

I asked Roth what she’d want people to know about her friend.

“Her empathy and diplomacy,” she says. “[She had] a sharp eye for other talent. She spotted me, but I’m not the only one she encouraged.”

That sharp eye suggests attention, the same kind it takes to look at a bush and also see a whale. Or a spiral. Or something that doesn’t exist yet, but could.

Nothing about Harper’s life suggests someone chasing attention. And yet, she ended up creating something that demanded hers, and she took great pleasure in seeing people enjoy her creations.

The garden didn’t happen all at once. It grew out of years of travel, observation, and collaboration. Harper often traveled without her husband, always returning from trips to Japan, Thailand, and other parts of Asia with ideas and impressions captured through sketches in a notebook.

“She would get creative ideas from her travels … she’d come back with ideas and pictures, and they’d go about cutting that topiary bush into shape,” Delgado says.

For the past 25 years, she had the help of her gardener, Pedro Duran—who’s still employed by the trust and has maintained the garden since Harper’s passing.

In the early topiary years, Harper worked closely with Duran in what Delgado describes as a kind of shared “labor of love.” She would share her sketches and together the pair would shape the bushes into something deliberate.

“As she got older, she would increasingly draw her ideas and [Duran] would [carry them out],” Delgado says.

That collaboration reinforces that her garden was not an act of control, but one of creative collaboration and translation. From memory to sketch. From sketch to shrub. From something seen, somewhere else in the world, to something rooted in the soil of a steep hillside in Mission Hills.

Harper also made sure that the lawn’s boisterous energy made its way into the house on Union Street. Apparently, she threw legendary parties.

“Fairly regularly, in the late ’70s and ’80s, she would host Super Bowl parties with 200 people. She had TVs everywhere,” Delgado says.

It’s not hard to square that image with the stillness of the garden which, despite the careful pruning and intentional design, is voluminous and nearly vibrating.

And, damnit, I wish I’d watched some sportsball on her shocking number of TVs and wandered out front to the topiary—slightly wine-drunk with an orange smear of wing sauce on the corner of my mouth—to marvel at the leafy hippo and this woman’s elaborately creative life.

I can hear Delgado smiling as we talk on the phone. He’s going back to his childhood, when he talks about being one of the cousins Harper doted on when he visited.

“The adults were inside, and we’d be out in the camper,” he says, “and [Harper] would come check on us, make sure we were okay. She always had gifts for us. If it was Easter, there were chocolate eggs. If it was Christmas, stockings. We were the beneficiaries of them not having kids because they showered us with all their love.”

Knowing this and taking a look at her garden again, you can see it’s not the work of a shut-away curmudgeon. It’s wondrous, inviting, and the right kind of weird.

“Ultimately, she did it for herself and family, first and foremost,” Delgado says of Harper’s Topiary Garden.

Harper’s one request of whomever buys her home may seem like a focus on basic maintenance, about hedges and upkeep and preserving something visually striking. But it’s really about attention. And maybe, too, about legacy. Not hers, per se, but the legacy of community, relationships, art, creativity, possibility, adventure, culture, dedication, and love.

For now, it’s there for anyone to see, and its future is in the hands of whomever comes next.

Food is a notorious diva to photograph. The wrong lighting can make José Andrés’ paella look like a jaundiced grain bowl. You could be staring at the best sandwich of your life, but shoot it from above and—hey, congrats on that abandoned piece of lettuce bread. A cottage meme industry has been built around the hilariously bad photos on review sites that make Michelin-star food look like Michelin tires.

Especially in a visual modern media world, food culture depends on great photographers capturing the painstaking work in equally deserving ways. We asked four of San Diego’s top food photographers for their favorite shot from another year of documenting what we eat.

Kimberly Motos

Birdman Sandwich at Chick & Hawk

Getting this kind of shot takes a bit of yoga. Asana yourself into the corner, hold your breath, pray that a chef on the move doesn’t back into your light stand.

“You’re stepping into someone’s workspace during their busiest moments, so it’s a balance of being present to get the shot and being invisible to not slow anything down,” Kimberly Motos says.

The subject here is the Birdman sandwich from Chick & Hawk—hot fried chicken thigh, tangy slaw, kimchi comeback sauce, sweet and spicy pickles, potato brioche bun—getting a hearty dousing of its difference-maker seasoning. Motos captures the parts of the process that diners don’t usually see: the chaos behind something that looks so simple.

Lucianna McIntosh

Oysters + Jewel of the Sea Martini at The Fishery

“I love this image because it feels like a moment you want to step into,” says Lucianna McIntosh. A warm, sunny day at The Fishery in PB with oysters, caviar, and martinis. Yes, please.

The little details—the glass sweating a little, the direct afternoon light creating stark shadows, the oyster glistening on the tray—are the main characters. Instead of trying to overly control the setup, McIntosh “followed the light and lines that draw you in more,” she says. “This was one of those moments where everything lined up on its own for a second. I love it when the shadows end up being just as important as the food itself.”

Eric Wolfinger

Herb-Roasted Golden Chicken at Fleurette

La Jolla native Eric Wolfinger—who won a James Beard Award for Tartine Bread, one of the most stunning bread books of all time—says he doesn’t have a signature style. His style is a conduit.

“I see my job is to translate the chef’s point of view into something you can feel,” he says.

For this shot, Fleurette chef Travis Swikard had one directive: cuisine du soleil (“cuisine of the sun”). With a spread of leeks vinaigrette, herb-roasted golden chicken, and beets, Wolfinger wanted to create a scene that felt straight out of the French Riviera, relaying the light, bright style of Swikard’s new spot.

Some bonus additions here: Extra lights—to add lots of warmth—and a clipping from an olive tree.

Dee Sandoval

Espresso Ice Cream at Lucien

Timing and light are everything in food photography. In Lucien—La Jolla’s tasting-menu-only restaurant with moody ambiance—a single strobe flash creates the ideal spotlight.

Dee Sandoval says she uses the “natural, just-plated energy” of the dish to “create a portrait of moment and craft.” That’s why this Mostra Ghost Bear espresso ice cream—with San José dark chocolate mousse, soy-miso caramel, and koji shoyu chocolate sauce—looks like it might dissolve halfway to your mouth.

The floor is made of glass. Under your feet, you can see the cellar—15-foot ceilings, soft light, and stained white oak walls the color of desert silt.

Tucked behind the wood, inside the doors, and in the ceiling is a highly advanced and very specific network of tech assembled in San Marcos—perfectly calibrating the room for humidity and temperature with vapor barriers, specialized insulation, and LED lights. Along the walls on matte blag pegs lay 1,000-plus bottles of wine—some iconic collector vintages, some with stories, some earmarked for major life moments.

This is a very serious wine home, built by someone whose obsession eventually leads to a call with Chris Noel.

“We have some clients who have been collecting wine since the ’60s and the ’70s, and they have collections of 15,000 or 20,000 or more bottles,” says Noel, owner of Vintage Cellars, the San Marcos–based designer of custom wine vaults for some of the region’s top restaurants and super-collectors. “[For them], collecting wine is similar to Jay Leno collecting cars.”

Before the wheel, there was wine. Fermenting fruit sugars into alcohol was a thing as early as 4100 B.C. (wheel, circa 3500 B.C.), most likely a happy accident. Unsurprisingly, the tipsy breakthrough in juice arts was a huge hit. The challenge was that it was also hugely perishable.

The first efforts to save it from spoil were clay vessels called amphora, often fully or partially buried to create a sun-proof, temperature-stable environment. The terra-cotta pots were pointy-bottomed, which stacked and traveled better, encouraged gas circulation (thus preventing oxidation, the famed wine ruiner), and helped separate sediments.

Once basic preservation was figured out, makers noticed the aging process ushered in a moodier magic. So they engineered structures to tinker with the possibilities of the long haul. Those first wine holes in the dirt evolved into entire catacombs, tombs, quarries, and caves.

Ancient Romans engineered wine storage rooms called fumariums, built facing north to avoid the sun and filled with smoke to speed the aging process (no doubt rapidly aging the cellar workers in the process).

For centuries, specialized wine storage was mostly a commercial venture. Serious wine people would (and still do) outsource their collections to a bonded storage facility or turn to professional cellarers who run giant chilled warehouses of cabernets.

A few major social moments sparked a more serious at-home cellar trend. First, the “Judgment of Paris” in 1976 (California wines famously besting the French in a blind tasting) established US wineries as worthy of collections.

A few years later came the 1982 Bordeaux, one of the most-coveted vintages in history. It was championed by a US lawyer named Robert Parker, whose 100-point scale rating system would quickly become the gold-standard for grading wines, creating a huge boom of wine collectors for the next few decades (wine as an economic investment became a thing).

The US economy also boomed in the ’80s, while France hit a skid. With the dollar trading 6-1 against the franc, US collectors had a rare chance to pick up Grand Crus at serious bargains, which demanded equally serious storage.

Given that framing, 1990 was a fairly great time for Vintage Cellars to get into the game. Noel—who worked his way up at the company and then eventually took over as owner in 2020—and his team work with architects, designers, and builders to create cellars that both fit the space and act as an attraction in multimillion-dollar homes across the region, and at top restaurants like Pamplemousse Grille in Del Mar and Avant Restaurant in Rancho Bernardo Inn. They hide cooling systems in brick-walled enclosures, bend bottle racks around curved walls, create standalone pavilions—engineer structures for cabs.

Their cellars hover between 50 to 70 percent humidity to keep the cork appropriately moist. Air too dry, and a cracked cork will give up the ghost—O2, in excess, turns wine into vinegar. If the air’s too dry, it can shrink the cork, eventually evaporating the wine and creating a low pressure that will pull in destruction. Too humid, and mold contaminates the works.

Light’s a big no-no for wine, too. Incandescent or halogen lights were the norm for cellars 20 years ago, but they emitted heat. Like Schrödinger’s Cat, these bulbs would risk the subject in order to view it. Vintage Cellars adopts LED lighting and, for glass cellars in the sightline of bright windows, mechanized shades that lower during UV exposure times.

Custom circumference-cut cove trays, leather saddles, and pegs stabilize bottles in Vintage Cellars storage areas; movement disturbs the tannins and upsets the aging process. And these cellars are smart, with app-based monitoring, remote temperature monitoring, and eSommelier cellar management. Don’t fret, Siri’s got your Syrah.

The most important decision, however, is deciding when to uncork that special bottle.

“[A lot of times, people] are saving those wines for specific moments in life—maybe a 50th anniversary or when their firstborn turns 21,” says Noel. “That’s how they look at it: as social and also to create memories.”