Saturday, December 1, 2012

Thursday, November 22, 2012

Happy Thanksgiving!

6am yoga at virgin America terminal in SF

Monday, November 12, 2012

Half Moon Bay

With Uncle Noel!!!!

Tuesday, November 6, 2012

Who won tonight?


We voted an unprecedented number of women into the Senate (19 and counting).

We voted for all female representation in New Hampshire.

We voted for equal pay.

We voted for women's health to remain between women and doctors, not mandated by predominantly male legislators.

Most importantly, we moved one step closer to the tipping point.  Generally it's noted that 30% representation is the threshold at which women's issues (ie democratic issues like education, income equality, health care) to become front and center and truly championed and implemented. 19 is better than 17, but still short of 30...

Thursday, November 1, 2012

Happy Halloween!

Abbey's costume was so impressive, made from scratch!!!

Wednesday, October 31, 2012

In case you needed more convincing...

(Just a couple of) the Obama Administration's accomplishments: 

taken from Obama for America...

1. The first bill President Obama signed was the Lilly Ledbetter Fair Pay Act, to help women fight back when they don't get equal pay for equal work.

2. His Recovery Act supported millions of jobs and helped to stave off a second Great Depression.

3. He pushed for and won middle-class tax cuts that benefitted every American worker, and saved the typical family $3,600 in taxes over the last four years.

4. President Obama rescued the auto industry, and now GM and Chrysler are healthier than they've ever been. The American auto industry has added nearly a quarter of a million jobs since June 2009 -- and they most likely wouldn't exist right now without President Obama's leadership.

5. He doubled funding for Pell Grants, helping to make college more affordable for nearly 10 million families.

6. His student loan reform ended billions in subsidies to banks serving as middlemen and reinvested those savings directly into students.

7. The President established the American Opportunity Tax Credit, worth up to $10,000 over four years of college.

8. His Race to the Top Initiative helped spur nearly every state to raise academic standards.

9. His tax cuts, social-welfare programs, and economic policies lifted nearly 7 million Americans above the federal poverty line in 2010. 

10. President Obama has signed 18 tax cuts for small businesses since taking office.

11. We've seen 5.2 million new private-sector jobs over the last 31 months.

12. The unemployment rate is at the lowest level since President Obama took office.

13. Health care reform -- passed after decades of failed attempts by every previous President -- provides affordable health coverage to every American and will lower premiums by an average of $2,000 per family by 2019.

14. Obamacare expanded access to lifesaving preventive care such as cancer screenings and immunizations with no out-of-pocket costs for 54 million Americans.

15. Obamacare ends insurance discrimination against the 129 million Americans with pre-existing conditions. 

16. Because of Obamacare, over 3 million more young adults have health insurance today than would if the new law hadn't passed.

17. The parents of over 17 million children with pre-existing conditions no longer have to worry that their children will be denied coverage.

18. President Obama has ordered the overhaul of federal government regulations to make them smarter, practical, and more efficient. Just a fraction of these commonsense initiatives will help save businesses $10 billion in the next five years alone.

19. His historic investments in clean energy have helped more than double the amount of electricity we obtain from wind and solar sources and helped increase biofuel production to its highest level in history.

20. President Obama is doubling fuel efficiency standards, which will save drivers more than $8,000 at the gas pump, not to mention lessen the impact of automobiles on our environment.

21. President Obama has taken unprecedented action to address climate change, reaching historic international agreements to curb carbon emissions, and taking action here at home to reduce carbon pollution from our vehicles and promote clean energy production.

22. He has taken historic action to protect our environment -- signing one of the largest expansions of protected wilderness in a generation and putting in place standards to reduce toxic air pollution that will save thousands of lives.

23. President Obama fought for and won landmark Wall Street reform that reins in the abuses that led to the financial crisis and ends the era of taxpayer bailouts and "too big to fail."

24. Wall Street reform created the Consumer Financial Protection Bureau, the nation's first federal agency focused solely on consumer financial protection -- and the Bureau is already protecting families from unfair and abusive financial practices from Wall Street banks and shadowy corners of the financial industry.

25. As part of President Obama's commitment to transparency, the White House has posted its visitor records online for the first time ever.

26. President Obama's all-of-the-above approach to energy has helped cut the United States' dependence on foreign oil to its lowest level in 20 years.

27. President Obama responsibly ended the war in Iraq.

28. He announced a plan to end the war in Afghanistan and transition security responsibility to the Afghan people.

29. President Obama sent the largest security assistance package to Israel in history and funded the Iron Dome system, which is protecting Israeli homes and schools from rocket attacks.

30. President Obama rallied the international community to implement the toughest sanctions on Iran in history.

31. Through the President's historic increases in Veterans Affairs funding, he has expanded and improved healthcare and job training access for our returning veterans.

32. President Obama negotiated the New START Treaty with Russia to reduce the number of nuclear weapons in both countries. At the same time, he also secured commitments from dozens of other countries to lock down nuclear materials.

33. His administration naturalized 11,146 military service members as U.S. citizens in 2010; more than in any year since 1955.

34. President Obama set a bold new plan for the future of NASA space exploration, using the skill and ability of the private sector for short trips to the International Space Station, while building a new vehicle for exploration of distant space, and doing everything in his power to support the economy on Florida's Space Coast.

35. President Obama recognizes that tourism is one of America's largest economic engines; he's worked to encourage international visitors to come here, maintaining our security while keeping millions of Americans in good, paying jobs.

36. He has affirmed his personal support of marriage equality, directed the Justice Department to stop defending DOMA in federal courts, and took the practical and compassionate step of extending hospital visitation rights to same-sex partners.

37. He fought for and won the repeal of Don't Ask, Don't Tell, allowing gay and lesbian members of the military to serve openly for the first time in history.

38. When Congress failed to fix our broken immigration system, his administration did everything in its power to improve it, streamlining the legal immigration process and announcing a policy that lifts the shadow of deportation from hard working young immigrants brought to the U.S. as children.

39. Oh, and he gave the order to send troops in after Osama Bin Laden -- and has decimated al-Qaeda's senior leadership.

Hog Island Oyster Company

Who knew I liked oysters? I think I'd like anything after our kayaking session!

Saturday, October 27, 2012

Waiting for home runs

MLB World Series game 2

Tuesday, September 25, 2012

Decision Fatigue

Doctors taking care of patients who are hospitalized make a lot of decisions every day.

Here is a very conservative estimate for a common hospitalized patient on their first day of admission:

Each medication: Is it necessary? how much? how often? what route? hold parameters?
x10 meds = 50 decisions
Each lab result: Is this normal? If not, do we need to do anything? What should we do?
x15 lab results =45 decisions
General work up of hospital illness -should we treat? do we need more diagnostic tests? do we need a consult?
x3 med issues =9

1 patient = >100 decisions per day

x5 patients = >150 decisions per day

or if you're the senior resident or attending x20 patients = 1000 distinct decisions in a day!

Thus, after a call day, when a friend asks you where do you want to go for dinner -your response: anywhere, as long as you decide!

I think this decision fatigue is an under recognized but significant cause of fatigue, stress, and burn out in the hospital for residents. I know many of these decisions become much easier over the years, but they are still distinct decisions, for which you are accountable for in a court of law. Not so easy in my opinion.

Sunday, September 23, 2012

Did you know?

A piece of women's history and medical history...

The first woman accepted into medical school, Elizabeth Blackwell, was only accepted because her admission was put to a vote by the class at Geneva College of Medicine. As a joke, the class unanimously voted for her acceptance.

Turns out the joke was on them, as she went on to graduate 1st in her class in 1849.

Wednesday, September 5, 2012

Quote(s) of the Day

Elizabeth Warren was awesome tonight, so awesome she gets two quotes of the day

"No, Governor Romney, corporations are not people. People have hearts, they have kids, they get jobs, they get sick, they cry, they dance. They live, they love, and they die. And that matters. That matters because we don't run this country for corporations. We run it for people," -Elizabeth Warren, DNC 2012

“There is nobody in this country who got rich on his own,” Warren told them. “Nobody. You built a factory out there? Good for you. But I want to be clear: You moved your goods to market on the roads the rest of us paid for; you hired workers the rest of us paid to educate; you were safe in your factory because of police forces and fire forces that the rest of us paid for.” 

The second quote encapsulates 100% what it means to be a democrat. Perfectly put. Thank you future Senator Warren!

Wednesday, August 22, 2012

Angel Island!

20 mile bike ride, climbing Mt Livermore with Steph and Scott, now enjoying the ferry ride back to SF! What a day!

Sunday, August 19, 2012

What if?

Every Wal-mart was turned into a Public Library?

Death of a Wal-Mart, Birth of an Award-Winning Library

Courtesy of Boston Magazine
"Who says death can’t be beautiful? Okay, so maybe this Wal-Mart in McAllen, Texas, didn’t die, per se, but it did move, leaving behind an empty warehouse. Rather than let this space be a pox on the community landscape (such as Wal-Marts tend to do) or wait around for another big-box store to move in, these McAlleners transformed the space—greater than two football fields in size—into the largest single-story public library in America. Touchdown."

Wednesday, August 15, 2012

Quote of the Day

"In everyone's life, at some time, our inner fire goes out. It is then burst into flame by an encounter with another human being. We should all be thankful for those people who rekindle the inner spirit."Albert Schweitzer

I've taken the last 3 weeks "off" from clerkships, spending time talking to attendings, mentors, friends, family about life, career, perspectives. It's been nothing short of awesome. So rarely we remember to take the time to do so, to ask the important questions, to ask those we respect and value their opinions and views. Something that hopefully you don't need time "off" to do. I thank everyone for helping rejuvenate and rekindle my spirit!

Monday, June 11, 2012

Video: 75-Year-Old Bodybuilding Grandma Proves Age Is Nothing But A Number

Sent to you via Google Reader

Video: 75-Year-Old Bodybuilding Grandma Proves Age Is Nothing But A Number

World's Oldest bodybuilder

"If ever there was an anti-aging pill, I would call it exercise," says 75-year-old Ernestine Shepherd, of Baltimore, who runs 10 miles per day and is more ripped and strong than most 20-somethings. But here's the most inspirational part: the bodybuilding grandma didn't start training until she was 71. So…what's your excuse for not hitting the weights today?

Shepherd, who says she loves to help her fellow churchgoers discover exercise and a healthy lifestyle, made it into the Guinness Book of World Records for being the oldest female competitive bodybuilder in the world. She says she started exercising at age 56, because she wasn't happy with how she looked in a swimsuit. But following the death of her sister, Shepherd says she became more dedicated.

This awesomely inspirational woman is living proof that, as she tells her fellow congregates during their workouts today, "age is nothing but a number." Super-fit, lively, and able to wake up at 2:30 am (yup. In the morning. Every morning) to go running, the cheerful grandmother demonstrates what the human body is capable of achieving, even years after "retirement age."

Watch this amazing video by the BBC, and think about what you'd like to be doing at age 75. My newfound goal: have arms like Ernestine.

Related posts from: Blisstree

Sunday, May 13, 2012

Happy Mother's Day!

After a brunch at Bistro Vida!

Wednesday, May 2, 2012

The 40 Runner’s Commandments

Found this, and I had to share it, because it's right on the money!

The 40 Runner’s Commandments
by Joe Kelly
1. Don’t be a whiner. Nobody likes a whiner, not even other whiners.
2. Walking out the door is often the toughest part of a run.
3. Don’t make running your life. Make it part of your life.
4. Keep promises, especially ones made to yourself.
5. The faster you are the less you should talk about your times.
6. Keep a quarter in your pocket. One day you’ll need to call for a ride.
7. Don’t compare yourself to other runners.
8. All runners are equal, some are just faster than others.
9. Keep in mind that the later in the day it gets, the more likely it is that you won’t run.
10. For a change of pace, get driven out and then run back.
11. If it was easy, everybody would be a runner.
12. When standing in starting lines, remind yourself how fortunate you are to be there.
13. Getting out of shape is much easier than getting into shape.
14. A bad day of running still beats a good day at work.
15. Don’t talk about your running injuries. People don’t want to hear about your sore knee or black toe.
16. Don’t always run alone.
17. Don’t always run with people.
18. Approach running as if the quality of your life depended on it.
19. No matter how slow, your run is still faster than someone sitting on a couch.
20. Keep in mind that the harder you run during training, the luckier you’ll get during racing.
21. Races aren’t just for those who can run fast.
22. There are no shortcuts to running excellence.
23. The best runs sometimes come on days when you didn’t feel like running.
24. There is nothing boring about running. There are, however, boring people who run.
25. Distance running is like cod liver oil. At first it makes you feel awful, then it makes you feel better.
26. Never throw away the instructions to your running watch.
27. Don’t try to outrun dogs.
28. Don’t wait for perfect weather. If you do, you won’t run very often.
29. When tempted to stop being a runner, make a list of the reasons you started.
30. Without goals, training has no purpose.
31. Go for broke, but be prepared to be broken.
32. Spend more time running on the roads than sitting on the couch.
33. Make progress in your training, but progress at your own rate.
34. “Winning” means different things to different people.
35. Unless you make your living as a runner, don’t take running too seriously.
36. Never tell a runner that he or she doesn’t look good in tights.
37. Never confuse the Ben-Gay tube with the toothpaste tube.
38. Preventing running injuries is easier than curing them.
39. Running is simple. Don’t make it complicated.
40. Running is always enjoyable. Sometimes, though, the joy doesn’t come until the end of the run.

Saturday, April 28, 2012

Mini Blockie Reunion!

With an awesome picnic and walk in Edgewood Park!

Friday, April 27, 2012

Quote of the Day: Believe

"Believe that you can run farther or faster. Believe that you're young enough, old enough, strong enough, and so on to accomplish everything you want to do. Don't let worn-out beliefs stop you from moving beyond yourself." 

John Bingham

Monday, April 23, 2012

Happy Earth Day

In an attempt to enjoy the outdoors on earth day, I drove to the beach. It's 80 degrees, picture perfect at Stanford today, but once arrived at said beach, it was cold, howling winds, no sun in sight. That's northern california beaches for you. I'll never be fooled again!

A quote from John Muir, the consummate naturalist, to honor Earth Day 2012:

"God has cared for these trees, saved them from drought, disease, avalanches and a thousand tempests and floods. But he cannot save them from fools"

Friday, April 20, 2012

The Harvard Red Book

I received my copy of the Harvard Red Book in the mail this week. It's my 5th year reunion this May, and for every reunion, Harvard asks alumni to update their contact information, and if you want, indulge your fellow classmates with what you've been up to since graduating.

As soon as I opened the book, I couldn't put it down, so interesting to read personal accounts of my friends and classmates. I'm sorry I didn't update more than where I'm currently living and doing. Reading the entries made me smile, I truly am so fortunate to have attended Harvard. I have made so many wonderful friendships with interesting, creative people who are all driven in their own, unique way.

I feel uplifted, and reminded that no matter what I do, as long as I continue to follow my gut, I can do whatever I want, and absolutely love it. Now that is a privilege.

Tweet Tweet!

Resolved to use Twitter more, and have had a blast doing so this last week! Updated a link to my twitter feed on this blog (look right), my twitter handle is @juliapederson

Wonderful 5 mile run today. Every day I'm thankful that it stays light past 8pm.

Monday, April 9, 2012

Quote of the day

While I was doing a neurologic exam on a cute 4th grade boy, I asked him to smile, he smiled cutely. Then I asked him to make a mean face.

Response: "But I don't like to make mean faces!"

You can't get more adorable and lovable then that!

Sunday, April 8, 2012

The Hunger Games

I was compelled to go see The Hunger Games on the big screen during it's opening weekend. Not because I read the books, more because I was intrigued that such a popular movie had a female as its lead. Not too often that happens when the female is both the lead character and portrayed as a strong character audiences want to root for.

I liked it the movie, mostly because I really liked Katniss as a character. I liked that she stuck up for her younger sister, I liked that she had stellar bow and arrow skills, and I liked that she didn't give in to the killing mentality of the Games. Between the big sister mentality, my javelin skills and my general aversion to violence, I think I identified with Katniss.

With that said, I'll definitely be rooting for her again when the 2nd movie comes out.

Friday, April 6, 2012

Coyote sighting!

Awesome 3 mile trail run at Arastradero this evening. 7 deer and a coyote = one happy Julia! Terrific way to start the weekend. If only my iphone hadn't died this week, I would have a nice photo to post. My coyote wasn't as cute as this little guy:

Thursday, April 5, 2012

Cute Barbie sightings

Little girl in the neurologist office using a reflex hammer on Barbie.

Little girl in the hospital for several months has built a shrine to Barbie and Justin Bieber. "Barbie's better" she instantly responds when asked which is her favorite.

Lessons learned:
1. Barbie = timeless.
2. Little girls = adorable addition to my day.

Wednesday, April 4, 2012

6 Best Shows on TV

Or at least the most addicting...No matter how tough my medical school schedule may be, I never miss my favorite shows! Thank goodness for Hulu.

In no particular order:

  • Castle
  • Grimm
  • The Middle
  • Modern Family
  • Grey's Anatomy
  • Fringe

Tuesday, April 3, 2012

How would your sister describe you in a sentence?

My 13 year old sister's one liner...

"A running-machine is Julia, wants to be a Dr. and a home decorator, watches a lot of HGTV."


Affordable Care Act

Quite a few folks have asked my opinion on the Affordable Care Act. My bottom line on health care: providing health care for citizens is a fundamental component of a fair and just society. On a daily basis I am horrified at the disparities in care and outcomes I witness.

The details of how we provide universal health care for citizens of the United States are just that, details.  I agree 100% with Ted Kennedy's philosophy:

"...Quality care shouldn’t depend on your financial resources, or the type of job you have, or the medical condition you face. Every American should be able to get the same treatment that U.S. senators are entitled to." 

Ted Kennedy

The most difficult specialty in medicine

Family Medicine.

Are you surprised at my answer? Here are my 5 top reasons, see if you disagree by the end.

1. Breadth of knowledge. 
General practitioners like to say they care for patients from "womb to tomb". It's impressive. Knowing pediatrics, preventive medicine, all specialties, geriatrics, end of life care. On any given day in the clinic I would see cases that spanned the entire first two years of medical school.

2. Early infancy of disease processes.
It's easy for the specialist to look back and say, how did the PCP miss this? The tough part of primary care is that you see disease in it's early phases, often before the easy hallmarks become apparent. It's really difficult to diagnose some diseases in their early phases.

3. Behavior change.
We all know how to stay healthy: diet, exercise, sleep, joy in our life, avoid stress, good relationships, no evils like smoking, alcohol or drugs. Easy eh? These are the things that GPs deal with every day, they are in the trenches trying to improve health care in the U.S.

4. Keeping pace with changes across medicine.
How many studies and policy changes occur every year? How do you decide which ones to follow, to change your management of patient care? Keeping up with the NY Times controversies, from cancer screening to statin side effects to HPV vaccines and contraception -a frontline doc needs to stay on top of the headlines and have a critical take to inform their patients.

5. Current structure of healthcare delivery.
GPs bare the brunt of the disaster that is currently known as American health care delivery. They're also going to be the area of medicine most transformed in my life time, no doubt about it. Change is hard.

PS. Family medicine, general practitioner, primary care provider, pediatrician, general internist are all generalists, first line doctors who help keep America healthy.


Here's a sampling of the surgeries I had the privilege of scrubbing in on during my surgical rotation this winter:

Open Heart Surgery (CABG)
Mitral valve replacement
Kidney transplant
Arteriovenous fistula
Below the knee amputation (BKA)
Gallbladder removal (Cholecystectomy)
Colon cancer removal (Sigmoid colectomy, hemicolectomy, colostomy)
Lung cancer removal (VATS thoracotomy)
Stomach cancer removal (Partial gastrectomy)
Umbilical hernia repair
Inguinal hernia repair

I hope everyone has recovered and is doing well!

Children have strokes?


I met several children who have suffered from strokes recently, which was shocking to me. Here is a good NY Times article that goes over one such a case: Children Don't Have Strokes? Just Ask Jared

Fortunately, with arduous rehabilitation, many of the kids can make strong recoveries. 

Sunday, January 29, 2012

Cardiothoracic surgery = Baller

Cardiothoracic surgery at the Palo Alto VA. Open heart surgeries, helping with the venous graft is awesome. I'm really loving surgery so far. It's the first rotation where I'm not groaning immensely at the absurd hours I have to wake up. Probably because there's no time to groan! It's 0 to 60 in 5 seconds on surgery.

Still running despite the crazy hours. My rule: if I get home before 8pm I run. Ran 9+ miles today, felt good! But it always feels good to run. I think my coronary vessels were happy about it too. They also appreciated the kale & white bean soup I made for dinner. 

Monday, January 23, 2012

Who would you give your kidney to?

Transplant surgery is incredible. I saw a living donor kidney transplant, which is  a win-win because no one needs to die and the person still gets a new kidney! I would definitely donate my kidney if the situation every came up. Now, thanks to the strong immunosuppression drugs (thanks tacrolimus, the infamous IL-2 inhibitor!), you  only need to have the same blood type to donate your kidney. Amazing.

What was even more impressive is that the surgery to transplant the new kidney took under 2 hours! Transplant surgery is really impressive, including the doctors, nurses, PAs, pharmacists and of course the patients, and the altruistic donors.  It takes a TEAM to get someone a new organ!

On to cardiothoracic surgery. Great first day, should be an exciting two weeks! I somehow got two of the most intense surgical specialties, really enjoying it so far.

In other exciting news, I think I've just about beat the cold I've been battling, went on my first run in a while. Felt SO GOOD.

Tuesday, January 10, 2012


Started my surgery rotation this week. Transplant surgery, Cardiothoracic, and General surgery. Wish me luck!

Sunday, January 1, 2012

Happy New Year!

Finished reading 50/50 by Dean Karnazes, I liked this quote he found by Darwin: " It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change"

Something to keep in mind as we make our resolutions for 2012!