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


  • 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


  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!


26 thoughts on “Angry Patients and Arrabbiata Sauce

  1. Who could blame the poor patient? That seemed rather condescending on the part of the doctor. Also, patients are sometimes angry not simply at the care they’ve received in the past but at the care they’re presently receiving….things to keep in mind as a doc..I know it must be difficult to keep the patient’s perspective in mind when you’re up to your eyeballs in crap, but it is worth remembering how you would feel in that position. Too many patients feel like cogs in a machine, I’m afraid, and that’s too bad.
    Looks like a great recipe, by the way…will have to try it. 🙂

    1. I’ve actually recently been a patient myself at my own hospital so I’m quite familiar with being in those shoes. It’s actually pretty common that patients who are sedated will not respond appropriately and it’s pretty crucial for us, especially in terms of knowing when the patient can be extubated, to know how coherent the patient is. I didn’t include it in the story, but we always tell patients first why we are going to ask them questions and why it’s relevant/medically necessary. The important thing we always tell our patients and their families is to ask questions if we aren’t explaining things well. I think that’s why as a patient I prefer teaching hospitals- doctors, residents and medical students normally have more time to explain things and answer questions. 🙂

      Glad you liked the recipe!

  2. my brother is an angry patient, but not angry at the doctors, but at me for speaking about him to a doctor. it doesn’t matter if i tell him before we arrive that we will be talking about him, or how nicely i say things, his mentality only sees me as talking about him, as he says it

  3. I too love your stories and the way you write them, and I am sure the above dish tastes delicious too. But as an Italian I have to say I really mind that you call it “arrabbiata” — it’s nothing like an arrabbiata, which for starters contains no meat or cheese. Shades of Shakespeare and Juliet asking herself What’s in a name … and whether a rose would smell just as nice if it were called by another name. In Italian cuisine, names DO matter, they mean a particular dish, done a particular way. Which is not to say people can’t invent something new — but then baptise this ‘new’ dish with another name. Sorry to sound so prissy.

      1. O thanks for the ‘no worries’ ! I didn’t want to come over as … well, you know …!!! Keep writing, your are good for my immune system (your posts stimulate the endorphins)!

  4. I love pasta so that dish looks great. I would never treat my care givers wrong. I would be totally afraid to do that. that is an awesome story and very funny. 🙂

  5. Heyyyyy… so I know you’re busy and have about 4,862 comments to respond to, but!!! I wanted to let you know that I moved the hosting for Sugar Dish Me so it won’t appear in your reader anymore. The address is still the same and it would be super great if you re-subscribed via email or rss feed. Thaaaank you! Looking forward to more recipes outta your kitchen and super funny stories.

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