Wednesday, March 3, 2010

Uncertainty Soup

The last couple of weeks have been wrought with anxiety.  Match day is only two weeks away.  I have full intellectual capacity to understand that my chances of matching are extremely high and that wherever I end up I will get excellent training. 

Emotionally though, I’m a wreck from the uncertainty of it all.  Not only does my life depend on the match, but my fiance’s life completely weighs on it. He has an established career where we live, and he is willing to give it up to support me.  I’ve been constantly up at three in the morning strangled by my down comforter from turning around it forty times, I’m highly dependent on carbohydrates, and I appreciate a cold beer like never before. 

I’m certainly not alone in feeling nervous and frantic.  My guess is that 80% of senior medical students in the US feel exactly the same way that I do.  But we have to snap out of it!

Being a doctor is equivalent to uncertainty.  Every diagnosis, prognosis, and treatment decision that we make as physicians has the potential to be incorrect and can be extremely harmful. We have to counsel patients on the risks and benefits of procedures, and be able to handle the possibility of a disaster.  The ability to deal with this daily struggle and accept the chance of error is critical to becoming a successful, happy doctor. 

Studies show that when physicians that struggle with uncertainty they can provide substandard care [1,2].  A Swiss survey of about 1200 doctors in varying levels of medical experience showed that stress about uncertainty was highest in women, those with relatively few years of experience, and those in surgical sub-specialties.  Similar results were shown previously by Gerrity, an expert on uncertainty. The study illustrated that stress with uncertainty was directly related to lower job satisfaction and perceptions in abilities to make decisions.

Compared to the uncertainty that we will face on a daily basis, hopefully this puts the stress from match into perspective.  Good luck on getting through the next couple of weeks.  We’ll know soon enough.  No matter how stressed you are, one thing to be certain about is what to make for dinner.  This hearty, spicy, red soup is chock full of roasted red peppers and tomatoes.  It is easy, vegetarian, and is the perfect antidote to stress.  It’s topped with homemade garlicky croutons.  Simply delicious.


Certainly make this Roasted Red Pepper Tomato Soup

4 red peppers halved and seeded
2 medium/large shallots diced
2 medium carrots diced
1 sprig fresh thyme
1 sprig fresh rosemary taken off stalk and chopped
4 cloves garlic
2 tbsp olive oil
6 oz can tomato paste
1 ½ tbsp sriracha
1 cup dry vermouth or sherry
28 oz can diced/crushed tomatoes
2 tsp salt
1 tsp brown sugar
3 cups water
1 cup half and half
Juice from ½ lemon

For croutons
1 round loaf sourdough
¼ cup olive oil
½ tbs salt
¼ cup grated parmesan
1 tbsp paprika
4 cloves garlic smashed into paste
1 sprig fresh rosemary finely chopped

Preheat the broiler.  On a large broiling pan or cookie sheet place red pepper halves skin side up, and press down to evenly expose all parts. Broil peppers until completely charred on skin side, about 10-15 minutes.  When done, peel charred skin which should come off easily and dice.  Preheat large pot on medium heat and add olive oil.  Add shallots and garlic.  Salt and cook, stirring frequently until carrots are tender and shallots are translucent, about 10 minutes.  Increase heat, add sriracha and tomato paste and cook for 2-3 minutes.  Add vermouth, diced tomatoes, red peppers, salt, brown sugar and water.  Bring to a boil, and reduce heat to medium, simmer for about 10 minutes to meld flavors.  Turn off heat, add lemon juice and half and half.  With immersion blender or blender, blend until all large chunks are gone.  Serve with croutons.

To make croutons:
Preheat oven to 400.  Cube bread to about 1x1x1 inches.  In large bowl add olive oil, garlic, paprika, parmesan, salt and rosemary.  Stir to combine.  Add bread and stir to coat all pieces.  On large cookie sheet, spread bread cubes.  Bake until crispy and brown, about 15 minutes.  Serve on top of soup.

  1. Bovier, P., &  Perneger, T. (2007). Stress from uncertainty from graduation to retirement--a population-based study of Swiss physicians. Journal of General Internal Medicine, 22(5), 632-8.
  2. Gerrity, M., DeVellis, R.,  & Earp, J. (1990). Physicians' reactions to uncertainty in patient care. A new measure and new insights. Medical Care, 28(8), 724-36.

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