Monday, March 26, 2012

Chocolate Dipped Hazelnut Lace Cookies

It's been a while since I posted a nice cookie recipe.  Well this is certainly one I'm proud of.  You’ve gotta make these cookies.  Chewy and crispy, nutty and buttery, bathed in chocolate, these are worth the time.  I based them on the Lacey’s cookies, which are tubs of heaven at Whole Foods, purchased to soothe the pain of a busy night at the hospital.  The cookies capture the same lacelike look, with a slightly less sweet and chewier mouthfeel.  I used Rice Krispies for most of the starch, keeping an airy quality. 

These cookies are very candy-like, in fact the first step is the same as making toffee. In the humid and already hot days of Texas spring, they are best stored in the fridge.  The whipped egg white, which I realized if done by hand takes the same amount of time as a kitchen aid with the right whisk, adds a meringue like quality.  They need to be baked just perfectly, between 6-8 minutes until the edges are darkened but not burnt otherwise the texture isn’t right.  

Makes ~18 cookie sandwiches or 3 dozen unadorned cookies

1/2 cup hazelnuts
2 cups Rice Krispy
1 stick butter
1/2 cup packed brown sugar
1/4 cup honey
1/4 cup cream
Pinch salt
Tsp vanilla
1/4 cup flour
Pinch cream of tartar
1 egg white

6 oz chocolate (dark or milk)

Preheat the oven to 350.  Chop the hazelnuts until they are fine.  In a large bowl combine the cereal and the hazelnuts.  Over medium high heat in a heavy saucepan, combine the butter, sugar, honey and cream.  Bring to a boil and let boil for one minute.  Turn off the heat, allow to cool slightly, and whisk in the flour, salt, vanilla and cream of tartar.  In a small bowl, whisk the egg white until it makes soft peaks.  Add a small amount of the warm butter mixture to the egg and fold in.  Fold the rest of the butter mixture into the egg.  Combine the butter and egg mixture with the cereal and hazelnuts.  On a baking sheet lined with a silicon mat or parchment paper, add a heaping teaspoon of batter, spacing at least 2 inches between cookies as they spread when baked.  Bake for 6-8 minutes until the cookie is lacey and the edges are dark brown but not burnt.  Allow to cool, then transfer to a baking rack. 

Over a pot of simmering water on medium heat, add a snug mixing bowl and chopped up chocolate.  Stir constantly until barely melted.  Smear a teaspoon or so on a cookie and immediately sandwich another cookie on top.  Allow to cool and then place in the fridge for the chocolate to harden.  Enjoy!

Thursday, March 8, 2012

Texas v. Planned Parenthood

Poor Planned Parenthood.  I’m not a particularly political person, however I do care deeply about the health of women.  The de-frocking of Planned Parenthood by the Komen foundation, a Dallas based organization, is just another step that Texas took to halt preventive care for Texan women. The defunding of Planned Parenthood by Susan G Komen highlights the tragic rift that already happened between preventive health care and politics in Texas, written about today in the New York Times regarding Title X.

Last year, Texas legislature attempted to pass a bill that would halt all funding for the Women’s Health Program, a Medicaid associated program that provides annual exams and contraception for all reproductive age women that qualify, simply because Planned Parenthood participated in the Women’s Health Program.  This puts programs such as where I work in a bind.   The funding is in serious jeopardy of being eliminated completely. 

According to the Texas Health and Human Services Commission, the Women’s Health Program saves Texas at least $20 million a year.  By providing an annual exam, contraception, STD screening and cancer screening, patients also get their blood pressure checked, are screened for domestic violence and substance abuse and connected into a hospital system. 

As a second year resident in my training in OB/GYN at one of the busiest county hospitals in the country, Parkland Hospital in Dallas, I’ve seen a lot.  Parkland is a massive safety net for north Texas, catering to women of all races, creeds, nationalities and ages.  Parkland Hospital takes care of over 10,000 pregnant women a year alone, at a cost much below the national average, yet manages to have excellent outcomes including one of the lowest pre-term birth rates in the country.

Parkland maximizes utilization of state programs that fund preventive care. The Texas Medicaid Women’s Health Program allows uninsured women below a certain income level to qualify for annual well women exams and reproductive health maintenance.  Outlying clinics staffed by nurse practitioners provide these vital services.

Beginning last year, under financial and political pressure, Governor Rick Perry attempted to cut funding to the Women’s Health Program because the Women’s Health Program also funded Planned Parenthood.  Planned Parenthood, although providing abortion services, focuses on “[helping people] make responsible choices about their sexual and reproductive health”.  The main focus of Planned Parenthood in fact parallels Parkland’s ideals of health care by promoting prevention through screening and education.  (Parkland does not perform abortions.)

The consequences spell disaster.  Already, with decreased funding to family planning clinics in the Parkland Health system, the number of patients crowding the Women’s Emergency Room at Parkland has steadily increased for both low and high acuity issues.  Compared to a low cost preventive visit to a family planning clinic, the cost of an ER visit charges a base of about $1500.  The state eats this bill, as patients cannot pay.  Without preventive care or contraception, the unplanned pregnancy rate will rise, placing increased burden on a breaking Medicaid system.

Regardless of individual opinions of abortion, taxes or politics, I hope we can all agree that having healthy women who get pregnant when they want to is an important goal.   How did we let a bunch of stuffy men in suits and really ugly sweater vests start to hack away at women’s rights that we have been fighting for the last 100 years?

I am pro-choice but not pro-abortion.  I would love for every pregnancy to be loved.  Abstinence is a great option, and should be taught, however people are not going to stop having sex.  Our evolutionary drive to reproduce is stronger than morals or politics.  If we as a country of parents, educators and health care providers could teach our children, students and patients about safe sex and provide them with mental and physical resources to make healthy decisions for themselves, then we would reduce the abortion rate.

We are eliminating a program that saves money, increases patient choice, reduces unwanted expensive pregnancies and reduces abortion.  Even though abortion only encompasses 3% of the services provided by Planned Parenthood, sadly the almost 100% of women will be affected that participate in the Women’s Health Program.  The results of undermining Planned Parenthood—Unplanned (and very expensive) Parenthood.

Monday, March 5, 2012

Pickling it up--Italian style grilled spring veggie pickles

As my resident life advances and becomes more surgical, having clamped through my first few hysterectomies, tied and cut dozens of tubes of postpartum women, and delivered hundreds of babies abdominally through C-sections, I have had my share of complications.  My wise attending told me “if you haven’t had a complication from surgery, you haven’t done enough surgery.”

The inability to always prevent complications unsettles me.  An adverse outcome during a case provokes a feeling of desperation.  Sometimes I just feel like a stupid jerk that doesn’t want to operate anymore.  But I have to get over myself, because I’m going to be doing surgery for the rest of my life, and no matter how much I study and practice, things aren’t always going to go right. I am lucky to have great teachers who have coached me through fixing mistakes and counseling patients postoperatively. 

Thank god I have the kitchen.  Complications arise all the time, under-whipped egg whites, a cake that falls apart the second you invert it, awful tasting crab sauce, and overcooked T bones.  The beauty of the kitchen is the cauliflower won’t bleed, the chicken doesn’t need its ureters anymore (does a chicken even have ureters?), and best of all, there’s always Chipotle.

When I find myself in a funk at work, stressed or depressed, nothing distracts me like the kitchen, my improvised operating room.  Just like surgery, I gather my supplies, wash my hands, gown in an apron and begin.  The knife courses through pork fat and onions, on my feet for hours.   

The comparison between chefs and surgeons has been made more than once.  Both jobs heat up quickly, promote distended bladders and last long hours.   The stakes separate the two.  Kitchen failures are frustrating, sometimes depressing, but rarely scary or life changing.  I’m just fine with that. 

I’ll keep my day job and my hobbies separate, enjoying pickles in edible instead of existential forms.  These Italian style pickles with grilled spring vegetables taste salty, sour, oily and herby.  They make a great snack.  They are beautiful on their own or served over toast with ricotta for a wonderful bruschetta.  They would also taste great in a pasta salad, over grilled fish or a plethora of other foods.  They take a little effort, but they last for weeks.  I use a grill pan to grill the asparagus and eggplant, however roasting them in the oven or over an open grill would produce equally tasty results.

The veggies I use in the recipe below are just what I had in my fridge.  Surely other vegetables such as fennel, carrots, or zucchini would also be delicious.   The pickles do not taste sweet at all, the sugar merely softens the blow of the vinegar and salt, as does the water. 

Pickled Grilled Spring Veggies Italian Style

Half an eggplant
10 spears asparagus
1 red onion
½ head of cauliflower
2 ribs celery
4 birds eye chiles or other peppers
2 cloves garlic smashed
10 black peppercorns
½ tsp fennel seeds
½ tsp dried oregano
¼ cup chopped fresh parsley
¼ cup chopped fresh basil
1 ½ cup white vinegar
½ cup red wine vinegar
1 cup water
¼ cup plus 2 tbsp kosher salt
¼ cup sugar
½ cup canola oil, ¼ cup olive oil
olive oil and salt for grilling vegetables

To grill the eggplant, asparagus and onion:  Slice the eggplant into thin slices.  Cut off the woody end of the asparagus.  Cut the onion in half.  Salt and oil the veggies.  Over medium high heat on a grill pan, cook the vegetables in batches until they have grill marks and begin to soften, however they do not have to be completely cooked.  Cut the eggplant rounds in half, cut the asparagus into 1 inch pieces and slice the onions in strips.  Set aside.

Cut the cauliflower into small pieces and chop the celery.  Slice the chiles, keeping the seeds.  Over medium high heat in a medium pot, add the garlic, chiles, peppercorns, fennel and oregano until fragrant but not burnt, about 20 seconds.  Add the vinegars, water, sugar and salt and bring to a boil.  Add the basil, parsley, celery and cauliflower and cook for another 5 minutes. 

Pour the hot liquid in a large jar over the grilled vegetables.  Float the oil on top, if the oil does not cover the vegetables, add more.  Allow to cool on the countertop and then refrigerate overnight.