Grandsons and Pumpkin Bread

Sometimes, patients have ulterior motives.

I was trying very hard to discharge my patient, an up-to-this-point very pleasant, easygoing Thai woman.

It just wasn’t working.

We told her at 6am (I was, after all on a surgery month, where rounds start far earlier and thankfully are far shorter) that we’d be sending her home later that day once her paperwork was done.

I was done with her paperwork by 9am, with her discharge order in shortly afterward.

And here was where the trouble began. Now, most people don’t like being in the hospital. Yes, you do have a few people who attempt to work the system, but in general, being in the hospital is NOT like being in a hotel (more stories on that to come in future posts).

First, she wanted refills of every medication she ever took, along with having them hand delivered to her room. Accomplished.

Next, she wanted to stay through lunch, as her family wouldn’t be able to pick her up until the afternoon. Request granted.

Then she wanted both the flu shot and the pneumonia vaccine. Ask and you shall receive.

I kept getting paged over and over again to go into her room and answer questions. (Can I shower when I get home? Well, we let you shower here, so…Can I eat my normal foods? Well, we had you on a general diet here, soo…)

And then the real truth came out.

Patient: So, you no married, no? My grandson, he real hottie for young doctor. He be here soon! Make grandma proud! Nice doctor to marry!

I then had to politely decline her offers to grant me a husband.

Potential In Law Approved Pumpkin Bread

Pumpkin breadin case I ever truly find myself in that situation

Ingredients (makes 2 large loaves of bread)

  • 1 overly ripe banana
  • 1/2 c vegetable oil
  • 3 cups brown sugar
  • 4 eggs
  • 15 oz can pumpkin
  • 1 c whole wheat flour
  • 2 1/3 c white flour
  • 1 c dried cranberries
  • 2 tsp baking soda
  • 1 1/2 tsp salt
  • 1 tsp cinnamon
  • 1 tsp nutmeg
  • 2/3 c water
  • 4 tbsp roasted pepitas (pumpkin seeds)
  • 2 tbsp white sugar
  • Cooking spray

How-to

  1. Preheat oven to 350 degrees.
  2. Liberally spray two loaf pans with cooking spray (otherwise these puppies won’t come out, and you certainly don’t want that!).
  3. In the bowl of your stand mixer (though feel free to make this by hand if you so choose), beat together banana, oil, and sugar. Add in eggs, one at a time, then pumpkin.
  4. In another bowl, mix together flours, dried cranberries, baking soda, salt, cinnamon, and nutmeg.
  5. With the stand mixer running on low, alternate adding the flour mixture and water (I do flour/water/flour/water/flour).
  6. Equally divide batter between the loaf pans.
  7. Sprinkle each loaf with 2 tbsp pepitas and 1 tbsp sugar.
  8. Bake for 55-65 minutes, rotating one halfway through, until a toothpick inserted into the center comes out cleanly.
  9. Cool bread for 10-15 minutes in the pans, then carefully remove from pans (remember, I said they stick!). Let bread cool completely, then wrap in plastic wrap covered by aluminum foil and wait to eat until the next day (or immediately if you cannot wait). Slice thinly (or thickly if you must) and enjoy!
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And now, for a break from the usual…

…I’ve been nominated in the 2012 FriendsEat Best Blogger Awards in the Best Recipe Blog category!

Screen Shot 2012-12-08 at 3.23.33 AM

Please visit the website and vote for me before December 17th! You can log into FriendsEat using your Facebook account.

Much love and happy holidays (and new post tomorrow!),

~megs~

Mishearings, Part 1, and Carrot Cake Jam

Sometimes my patients don’t exactly hear what I’m trying to tell them.

I had a patient that the previous night had been having a difficult time breathing, and thus I was in his room discussing his care with his nurse. He was lying there calmly sleeping (or so we thought) while we were talking to his wife.

Me: So we’ll keep him on this form of oxygen now and then switch him later?

Nurse: Yeah, I’ll switch him when my shift is done to rest him.

All of a sudden our we-thought-he-was-sleeping patient shot straight out of bed.

Patient (yelling): RECTUM? YOU AREN’T GETTING ANYWHERE NEAR MY RECTUM! NO MA’AM! NOT TODAY, NOT TOMORROW!!

(confused looks shared by everyone in the room)

Me: But sir, we said absolutely nothing about your rectum.

Patient: Yes you did! I heard you! You can’t trick me!

Me: Sir, we were talking about resting you by putting you back on some better oxygen. She said “rest him,” not “rectum.”

Patient: Oh. That makes more sense. But you still aren’t going anywhere near my rectum!!! I won’t allow it!

As promised, we went nowhere near his rectum during the rest of his hospital stay.

You Heard Me Correctly Carrot Cake Jam

Carrot Cake Jam

no misunderstandings with this one

Ingredients

  • 1 lb carrots, peeled
  • 2 pears, peeled and sliced
  • 1 inch thick round fresh pineapple, rind and core removed and cut into large cubes
  • 3 tbsp fresh lemon juice
  • 1 tsp cinnamon
  • 1/2 tsp powdered ginger
  • 1/2 tsp fresh nutmeg
  • 1/2 tsp cloves
  • 1 c water
  • 1 package powdered pectin
  • 6 1/2 c sugar

How-to

  1. Dice carrots in food processor until just barely larger than your desired consistency. Add pears and pineapple and pulse until those are in small chunks.
  2. In a large pot, dump in carrot, pear, and pineapple mixture. Add in lemon juice, spices, and water.
  3. Prepare water bath canner with six pint jars, rings, and lids.
  4. Bring jam mixture to a boil, reduce to simmer, and cook for 15-20 minutes or until fruits and carrots soften and start to release their juices.
  5. Turn off heat and stir in powdered pectin. Turn heat back on and bring to full boil.
  6. Add sugar and bring back again to full boil. Cook for 1 minute, then turn off heat.
  7. Ladle jam into hot jars leaving 1/4 inch at the top. Wipe off rims then place on lids and rings.
  8. Place jars in water bath canner, bring water back to a boil, and process for 10 minutes.
  9. Remove jars and let cool for 12-24 hours. If jars not sealed within 24 hours, place in fridge and eat within a week.

P.S. This makes excellent holiday gifts!

P.P.S. If desired, you can stir 1/4 c nuts and 1/4 raisins into the jam mixture at the beginning of cooking.

Medicine and Pink Sangria

If you’re going to date me, you at least have to think my job is needed.

I was on a date with another guy from my online dating stint. The first date had gone quite well- met up for coffee and pie, good conversation happened, and then we agreed to a second date. I told amusing stories about my work, and he told funny stories about some of the things he dealt with (he had previously lived in a far more rural area before moving to the big city).

It was on the second date where things went wrong.

We met up at a bar for drinks and were at the point where we started talking about our families.

Date: So my dad works in alternative medicine…my family doesn’t believe in modern medicine.

I might have nearly choked on my beer at that statement.

Me: Nothing? Not one bit?

Date: Nope. No medications ever. We don’t see doctors. The dentist is fine, though. Gotta take care of your teeth.

Me (shocked): You do remember I’m a doctor, right? In particular an anesthesiologist? Where I use drugs all the time to put people to sleep for surgery?

Date: Oh, I thought that maybe you just didn’t use medications. Can’t you use alternative methods for all of that?

Now, don’t get me wrong- I use meditation and deep breathing with my patients all the time. I’m a big proponent But I also give them medications.

Shockingly, I did not see him again.

Alternative Strategies Pink Sangria

in case you want to go ahead and medicate yourself

Ingredients

  • 1 bottle rose wine
  • 1/2 c vodka
  • 1/4 c raspberry liquour
  • 2 lemons, sliced thin
  • 1/2 raspberries or blackberries
  • 2-3 c light pink or raspberry lemonade
  • 1-2 c soda water

How-to

  1. In a large pitcher, pour in rose wine,  vodka, liquour, and lemonade (start with 2 c).
  2. Add lemon slices and berries. Taste (you might need to add additional lemonade).
  3. Place in fridge and let sit overnight.
  4. Before serving, stir and add soda water to achieve however many bubbles you’d prefer. (I normally start with 1 c and go up from there.)

Romance and Chili

And now, for a slight departure from my usual blog posts…the most romantic story I ever saw in medical school.

I was on a consult month at the time, and every day we would round on a particularly sick patient in the ICU (intensive care unit). He was a relatively healthy middle-aged man until a few months before, and then all of a sudden he got more and more sick until he was eventually having muscle spasms so bad that he actually fractured some of his vertebrae into his spinal cord (you need to have REALLY strong spasms in order for this to occur). To protect his body (and skeleton) from any further damage and possibly permanent paralysis, the man was intubated, sedated, and medically paralyzed.

By the time I finally met this patient, he had already been sedated and paralyzed for a few weeks. They had tried lifting the paralytic drugs once, only to have him quickly begin spasming again with concerns for additional fractures.

Through it all, his wife was by his side. She was a shorter woman, hair pulled back in a ponytail, who sat in his ICU room in a chair wearing his big hunting t-shirts and the exhausted look of a family member with a sick loved one. To be honest, she was the sort of woman who blended into the surroundings, the woman you’d sit next to on the bus or plane and not remember any real features.

Towards the end of the month, we again decided to lift the man’s medication to see if he could wake up and not spasm. The process starts the night before, with the hopes of enough of the drugs to be out of someone’s system by the next morning to see if they’re okay, and if not the medication can quickly be restarted (which had already happened before).

That morning, I was getting a cup of coffee before rounds when I had a tap on my shoulder. I turned around and a beautiful woman was standing there. I had no idea who it was until she began speaking.

It was our patient’s wife. “I just wanted to thank you for all of your help. I hope he’s able to wake up today. Just in case, I wanted to look pretty just for him. Even if he only sees me for just a second, I hope he’ll have something to see in his dreams.”

Our patient woke up that day. While he couldn’t move much since some of the paralytics were still preventing that, he was able to do one thing.

Right after he opened his eyes, he saw his wife and kissed her.

There was not a dry eye in his ICU room, especially not mine.

Worth Waiting For Turkey Chili

true love…in food form

Ingredients

  • 1 lb lean ground turkey (I’ve also done this with chorizo with excellent results)
  • 1 large can (28 oz) diced tomatoes
  • 1 small can (14 oz) diced tomatoes with jalapenos
  • 1 can hot chili beans
  • 1 can red beans, rinsed and drained
  • 1 large onion, diced
  • 2 medium green peppers, diced
  • 1 tbsp garlic, minced
  • 1 tbsp cayenne pepper (feel free to use less if you don’t want yours as spicy)
  • Low-fat shredded cheddar cheese
  • Fat free sour cream

How-to

  1. In a large saute pan, brown the ground turkey and drain the fat.
  2. Get out a large crock pot while the turkey is browning. Add the tomatoes, hot chili beans (use all of the sauce!), red beans, onion, green pepper, garlic, and cayenne.
  3. Add in the ground turkey after draining.
  4. Cook on low for 6-7 hours or high for 3-4 hours, stirring occasionally. The chili is done with the onions and green peppers are tender and the tomatoes have mostly broken down.
  5. Top with cheddar cheese and sour cream, or whatever other chili toppings you prefer.

This recipe easily doubles if you’re feeding a crowd with a gigantic crock pot- normally then I’ll use 1 lb lean ground turkey and 1 lb chorizo. It also freezes great in individual portions!

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!

Boyfriends and Baked Potato Salad

You can never make assumptions in medicine.

I once walked into my elderly patient’s room, where she was accompanied by a gentleman sitting there caressing her hand. I went through the general questions of the admission: what brought her here, what other medical conditions she had, what drugs she took.

And then, I said the wrong thing.

Mind you, this patient was a fairly spry 98 year old woman who didn’t look a day over 80, accompanied by a man who looked to be approximately 60 (though I had no idea of his real age).

Me (to patient): And I’m assuming that this handsome gentleman here with you is your husband?

Patient (appalled): Excuuuuse me, missy, this man is my boy-friend.

Me (stuttering): I’m so sorry for making that assumption, ma’am. My most sincere apologies.

Patient (proudly): Yup, at my age I can still bag ’em and tag ’em. But I’m just here to have fun, you know? No need to waste good money on a wedding when we can waste it on other things, right doll?

This last bit said to the patient’s boyfriend, who had not yet spoken, but found it wise to answer a simple “yup”.

Bag ’em and Tag ’em Baked Potato Salad

Perfect for obtaining that significant other…no engagement ring required

Ingredients

  • 3 lb redskin potatoes, cut into 1-in chunks
  • 1 c reduced-fat cheddar cheese, shredded
  • 1/2 c fresh chives
  • 1/2 c light mayonnaise (I prefer the olive oil versions)
  • 1/2 c fat free sour cream
  • 1/2 c fat-free plain greek yogurt
  • 1/8-1/4 c fat-free milk
  • 1 tbsp garlic powder
  • Salt
  • Pepper
  • 5 slices cooked bacon, crumbled (optional)

How-to

  1. In a large pot, cover potatoes with cold water. Add a liberal amount of salt. Bring to a boil, then reduce to simmer. Cook for approximately 15-20 minutes or until you can pierce potatoes with a fork (not a knife!!).
  2. While potatoes are cooking, mix together mayonnaise, sour cream, and greek yogurt in a large bowl. Thin out with 1/4 c milk. Stir in cheddar cheese, chives, garlic powder, and bacon (optional).
  3. When potatoes are finished cooking, drain and rinse twice in cold water.
  4. Add potatoes to dressing mixture. Add additional milk if necessary to thin to desired consistency.
  5. Salt and pepper to taste.
  6. Chill potato salad for at least 2 hours to allow flavors to meld. Taste again and add additional salt and pepper if necessary before serving.

Feel free to halve recipe if you aren’t serving a crowd!