Angry Patients and Arrabbiata Sauce

Sometimes, patients can express anger quite simply.

In medicine, you get quite used to dealing with angry patients. Sometimes patients are angry because they’re frustrated with care they received in the past. Other times, patients think that by yelling, they can bully the physician or nurse into doing what they’d prefer (whether or not it’s providing them with prescription drugs or lying to their insurance companies)…though you can probably imagine that as person like me yells back. ;)

And then, you have the patients who are just plain sassy.

I was recently on a consult month, which means that we’re asked by primary medicine and surgery teams to see their patients as “experts” in a certain organ system. For this consult, we were asked to see a patient who was currently intubated.

Patients are at different levels of “awakeness” when they’re intubated. Some patients are completely sedated, others are able to follow simple commands, while still others are awake enough that they can write responses to your questions.

As part of our assessment of an intubated patient, we need to determine how “awake” they are. If we already know the patient isn’t at the writing stage, we’ll normally ask patients questions and see if they can respond appropriately.

Fellow: Sir, squeeze my hand if you can hear me right now.

*patient squeezes hand*

Fellow: Sir, squeeze my hand if you are in a hospital right now.

*patient squeezes hand*

Fellow: Sir, squeeze my hand if the sky is orange.

The patient did not squeeze his hand. Instead, he glared (or as well as you can glare with an endotracheal tube in your moth) and slowly raised his hand towards our fellow.

Only his middle finger was pointing towards the sky.

Simple Gestures Arrabbiata Sauce

because everyone knows how to show displeasure

Ingredients

  • 1 lb hot Italian sausage (removed from casing if that’s the only way you can find it)
  • 1 lb lean ground turkey
  • 1 tbsp olive oil
  • 1 really large onion or two medium onions, diced
  • 3 tbsp minced garlic (feel free to add more if you’d like)
  • 2 large cans diced tomatoes
  • 1 small can whole tomatoes
  • 1/4 c sugar
  • 1 c red wine
  • 2 tsp red pepper flakes (again, feel fee to add more to kick up the spice)
  • 1 tbsp dried oregano
  • 1 tbsp dried basil
  • Salt
  • Pepper

How-to

  1. In a large saute pan, brown sausage and turkey. Drain the fat and put into a really large crock pot (if it’s the largest size you can find, that’s the way to go. I know it might seem crazy to have a crock pot that big, but you can cook an ENTIRE CHICKEN, enough chili for a party, or enough of this sauce to last you for a few family dinners. Or, in my case, enough to have friends over for one meal.).
  2. In the same saucepan, add in the olive oil over medium heat. Add in the onions until they start to sweat. Add in the garlic and saute until they become translucent. Add these to the crock pot.
  3. Pour in the 2 large cans of tomatoes. Add in the smaller can of whole tomatoes after breaking up by squeezing with your hands (get out that anger!).
  4. Stir in sugar, wine, red pepper flakes, oregano, and basil.
  5. Cook on low for 6 hours or until your entire house smells of delicious tomato sauce.
  6. Salt and pepper to taste. Serve over a good large pasta with ridges (see the rigatoni, above!). Top with some freshly grated parmesan and my family’s favorite- cottage cheese (yes, I know it sounds weird, but that’s how we do it in my house. It’s the only way I’ll eat cottage cheese).

P.S. This sauce freezes beautifully!