Monday, May 27, 2013

Can't unsee.

It's official: we're joining Andy's family at the end of June for a beach vacation in North Carolina! I haven't had a true vacation in... well, a very long time. I haven't gone swimming in even longer, and the house we're staying in has a pool. Luckily it's also near the ocean, because the CDC MMWR had to go ruin my fun with this. Yes, yes, I know we're constantly covered in a fine patina of dried skin, cockroach feces, and dirt, but that doesn't mean it's fun to be reminded that every time you swim in a pool, you're taking a bath in a nice, warm, highly dilute lake of sewage.

I returned to this recipe, since nothing says comfort like massive amounts of cheese and onions.

After way too much cheesy onion bread and popcorn while out with friends, though, I semi-atoned with this vegetarian Cobb salad with honey mustard dressing:

Yes, that salad is in a wok.

It's not the lowest-calorie of salads, but damn is it delicious. Protip: soak the onion in ice water for 15 minutes or so to remove the thiol funk. I tossed the tofu cubes in paprika, salt, and a bit of cayenne before baking, but I bet tempeh would work perfectly fine as well. There were some thyme and brown sugar sweet potato home fries at one point that disappeared into someone's gullet too quickly to end up on top of the salad.

Honey mustard dressing
1 egg yolk
1/4 to 1/3 cup olive oil
1 tbsp honey (more to taste)
2 tbsp Dijon mustard
ground mustard to taste
1 big clove garlic, minced very fine
juice of 1/2 lemon

In a medium-sized bowl, whisk the egg yolk a bit. Add the olive oil a little drizzle at a time, whisking all the while; the goal is to emulsify some oil in the egg yolk without making a true mayonnaise. When the oil is in, add the remaining ingredients slowly, whisking constantly. I like my honey mustard more on the spicy side, so I added nearly a tablespoon of ground mustard for a serious kick.

Let's talk about this thread on reddit. I've got the good fortune of exercising in the male-dominated basement gym of one of the med school's dorms. Say what you will about the notorious redditor personality disorder (RPD), even people in my relatively limited community can be, well, creepy. I've only gotten sporadic direct comments that make me feel uncomfortable, and a few that don't ("Hey, I saw you in the gym yesterday. You've got mad high reps" is a great gender-neutral comment to offer a woman if you really want to say something, gentlemen!). But over and over I hear groups of guys having conversations that range from mildly misogynistic to prurient to just gross. Whether or not the rear end in question belongs to me is immaterial when some jerk four feet away from me is talking about the nurse he plans to manipulate into sleeping with him. I wish I were exaggerating. It's uncomfortable to hear, and it makes me wonder what gets said when I or the lady next to me aren't around. The point is, the combination of med school gym commentary and Internet evidence is making me very, very nervous about attending a Real Person Commercial Gym about one year (!) from now, particularly since Andy and I may not be in the same city for at least my first year of residency.

The other day, I was describing to a friend the use of non-antibiotic empiric therapy in simultaneously diagnosing and treating vague or inscrutable combinations of symptoms. He pointed out that most people would be unhappy if their doctors proffered this option. Who wants to feel like a guinea pig, much less a guinea pig whose doctor appears to be out of ideas? Despite having sworn to myself that I would not lose sight of what it's like not to think like a doctor, I didn't anticipate his discomfort with this concept (perhaps because he's a rather analytical person); after all, empirically administering a relatively safe medication saves the time, monetary costs, and risks of performing various diagnostic procedures that may or may not be definitive, and might be able to direct the physician to the most helpful diagnostic procedure. From my perspective, it's not tinkering at all, but I took a step back and realized that I'm no longer being careful to ensure that my patients don't feel as though we're playing fast and loose with their parts for our own curiosity, entertainment, or scientific satisfaction. I'm somewhat disappointed in myself.

Therefore, it is with the utmost solemnity and respect that I link you to this.

Sunday, May 19, 2013

The Doldrums

""Ordinance 175389-J: It shall be unlawful, illegal, and unethical to think, think of thinking, surmise, presume, reason, meditate, or speculate while in the Doldrums. Anyone breaking this law shall be severely punished!"

The past couple weeks have been rather terrible. For one thing, Andy got quite ill with some pharynx-attacking bug. I'm on tenterhooks waiting for the moment when I'm laid low, but in the meantime, watching him suffer is its own punishment. And then to top it off, I'm increasingly torn up over this residency thing, and Andy's having to prepare for his qualifying exams while ill, and the housework is piling up... long story short, I haven't been in a particularly perky or productive mindset lately. The only inspiration to create was our new wok and George Foreman grill, bought on the cheap from an exiting fourth-year.

Thai stir-fry of barley and vegetables

Tofu marinated in turmeric, sesame oil, and fish sauce,
then grilled until crispy.

And then Andy asked me to make something to commemorate his newfound ability to get out of bed. I used this recipe, substituting 2 tsp agar-agar for the gelatin. The tamarind-lemon flavor was fantastic. The texture... not so much. The candies turned out soft and grainy rather than firm and chewy. Either the acidity of the mixture broke down the agar, or I didn't use enough agar, or I didn't cook the final agar-containing mixture, or some combination of the above. This means, of course, that I have to keep experimenting...

Friday, May 10, 2013


Andy is in Pittsburgh for the weekend, which means I have 400 square feet all to myself with which to study and clean and eat big salads. So naturally, after coming home from my last day of my last core rotation*, I took a five-hour nap, futzed around with some practice questions while watching a very scary movie alone in my apartment, and ate a third of a pound of edamame**. This was compounded by the consumption of way too many of these.

I have made sweet potato cinnamon rolls in the past. Then and now, I eschewed butter in favor of olive oil and used half whole-wheat flour in the dough. I have no idea what recipe I used (and I don't seem to have blogged about it), but I don't like the way this one came out. People reassured me that they were delicious, and the pastry portion was soft and light; no tough, dense whole-wheat dough up in here! But I was hoping to get a richness even without using butter, not that I was expecting anything like the product Joanne Chang came up with. I tried using an extra egg yolk on top of an egg, which helped, but this stuff still needs work. Ergo, I am not posting the recipe until I have experimented sufficiently.

*Surprisingly emotional. For one thing, I worked with a great attending who also happens to be a great human being. I'm going to miss her guidance and the enormous respect she gave me. For another, there's a patient who ended up on our unit for unusual, organic reasons; I've been working with her closely, both psychiatrically and medically, and unfortunately I did not get to see her through to discharge. For a third, we found out today that a patient who seemed to be a success story in the making has had a huge setback very, very soon after discharge. Feels bad, man. These things happen, of course, especially in addiction psychiatry, but I think everyone had counted on this being one of those stories that carries them through other dark times in their careers.
**After bemoaning to Andy that my diet isn't what I want it to be, and my study habits aren't what I want them to be, and my housekeeping isn't what I want it to be, he says, "'Be perfect at everything' is a refusal to decide, not a choice." I'm going to have to ruminate on that one, particularly in the context of still not nailing down what I am doing after graduation.

You complete me.

Look, a big heap of complete protein!

There are few dishes more simple or delicious than beans 'n' greens, or more thoroughly nutritious. For the vegetarian, beans are a convenient (if digestively challenging) source of protein. Most legumes, however, contain low levels of the essential* amino acid methionine (garbanzo beans, for some reason, may also have lysine as a limiting amino acid). According to a delightfully nitpicky website I found, kale contains about 8 mg methionine per ounce. The daily value is about 10 mg: yet another excuse to chow down on as much kale as I want. My favorite green to use in this dish, broccoli rabe, has even more, about 16 mg per ounce. For a redundant source of complimentary protein, though, why not serve this with a little brown rice to soak up all that tasty broth?

Allie Brosh of Hyperbole and a Half has published part two of her first-person account of severe depression.  It's incredibly honest, raw, and revealing. Understanding what it is like to be deeply, intractably depressed can be nigh-impossible for someone who's never felt that way. From this misunderstanding are born offensive and totally unhelpful suggestions**. In my fantasy world, given the prevalence of major depressive disorder alone, these posts should be required reading for... well, pretty much everyone.

Beans 'n' greens

I will sometimes use fresh basil in this, if I happen to have it in the house, but honestly I think the dish does best without any spices whatsoever. Ditto re: Parmesan.

3 or 4 cloves garlic, minced
2 to 2 1/2 lbs broccoli rabe, kale, or similar green, with the woodiest part of the stems removed
about 1 oz white wine
olive oil
2 15-oz cans cannellini beans, rinsed, with about 1/2 cup canning liquid reserved
juice of one large lemon
black pepper
red pepper flakes
optional: 1/2 cup vegetable broth
optional: 3 to 5 oil-packed anchovy fillets, finely chopped (to taste)

Chop the stems of the greens and set the leaves aside. Warm some olive oil in a very large pot, and briefly saute the minced garlic therein. Add the chopped stems, lemon juice, wine, liquid from cannellini beans, and broth (if using; water is fine, too). Meanwhile, chop the greens into one- to two-inch pieces. As soon as the pot's contents are simmering, add the greens and toss. Turn the heat to low and cover the pot. Simmer just until the greens or tender, 5 to 10 minutes, tossing the greens once or twice. Add black pepper and red pepper flakes to taste; you will only need salt if you don't use the anchovies. Add more lemon juice to taste.

*Meaning your body needs an exogenous source of it.
** "Just stop it!"

Sunday, May 5, 2013

Just a number

This year has flown by. Yesterday was already Andy's birthday. One more year, one more chance for culinary celebration of my lifting buddy/idea tester/personal assistant/ambulatory heat blanket.

Unfortunately, the birthday chemist was continuing to work status-post all-nighter at lab, and I was coming off a quality three hours' sleep. Celebration was deferred. After the caffeine jitters wore off enough for us to imbibe large amounts of water and pass out for about twelve hours, I made a wish-this-were-ironic birthday dinner of quinoa burgers with green goddess dressing on vegan buns.

Green goddess dressing has a large number of variations as interesting as its history. Traditionally, it contains mayonnaise and sour cream; most modern updates are lighter on the saturated fats. I opted to use egg yolk and just a bit of nonfat Greek yogurt, with just enough acid to bind the whole thing together. It was just a touch too garlicky (probably the fault of the garlic/chive duo), and the parsley didn't speak as much as I wanted it to.

It's also an expensive proposition, unless you have an herb garden*. Either plan for a week of herbaceous dinners or make this for a crowd. Then again, I may or may not have eaten it by the spoonful...

Quinoa veggie burgers
1 cup quinoa, well-rinsed
1 cup cooked spinach
1 medium sweet potato, baked until barely tender (but not fully squishy
1 egg white
2 cloves garlic, minced (omitted this time because the dressing is so garlicky)
1.5 tbsp wheat gluten (optional)
paprika, salt, and pepper to taste

Cook the quinoa as directed and allow to cool. Make sure there isn't much residual moisture therein. Squeeze as much water as possible out of the spinach and chop it finely. Grate or finely chop the sweet potato and squeeze as much moisture as possible out of that as well. Mix all ingredients together, pulsing a few times in a food processor if necessary for good structural integrity. Shape into six patties. Bake at 400 degrees F for 10 minutes per side, or until firm and crispy but still moist at the center. Cool slightly before removing from the cookie sheet.

Vegan whole wheat flaxseed buns
1 cup warm water
1.5 tsp yeast
2 tbsp brown or turbinado sugar
4 tbsp olive oil, or 2 tbsp olive oil + 1 egg, or 2 tbsp olive oil + 1 egg's worth of vegan egg substitute
2 cups bread flour
1 cup whole wheat flour
1 tsp salt
1/3 cup flaxseeds, divided

Mix together warm water, sugar, and yeast; let sit until the yeast has bloomed. Mix in the flours and knead until the dough is springy and smooth. Let rest 20 minutes, then mix in the salt and about 2 tbsp of the flaxseeds. Cover and let rise in a warm spot for about an hour and a half. Punch down and divide into six even portions. Shape into a ball by pulling the edges of the dough together at the bottom. Smack the dough ball firmly onto a flour-dusted surface, seam-side down. Spray the top of the unbaked buns with olive oil and sprinkle them with the rest of the flaxseeds. Let rise for half an hour, or until doubled in size. Give another spritz of olive oil. Bake at 400 degrees F for 12 to 15 minutes, or until golden brown.

Green demigoddess dressing
(Makes about a cup)

2 cloves garlic
juice and zest of 1 lemon
2 egg yolks (The original recipe uses mayo and sour cream; if you're sketched out by raw egg yolk, use more yogurt instead)
2 tbsp yogurt
4 anchovy fillets
1 minced shallot
1 tbsp white wine vinegar
1/2 cup olive oil
1 medium bunch chopped fresh flat-leaf parsley
1/2 cup fresh tarragon leaves (not the stems)
1/4 cup fresh basil leaves
1/3 cup fresh dill sprigs
1/3 to 1/2 cup fresh chives (I used 1/2 and found it a little too garlicky)
1/4 cup fresh spinach (optional)
pepper to taste (you likely won't need salt)

In a food processor or with an immersion blender, blend the garlic, lemon, egg yolks, anchovy, shallot, and olive oil. Add the remaining ingredients and blend until smooth; thin with more olive oil if necessary.

*Oh, happy day!