Merry Christmas Everyone

Merry Christmas Everyone

Have been busy.  Things happened.  Including not blogging and delivering my first set of triplets.

Andy and me after we finished running.  Look tired? I can't walk.

Running a lot.  Every Sunday a 10 mile jog around the lake leading up to running a half marathon yesterday, and now limping around.  I think I bummed my knee.  Anybody know a good orthopedist?

My publishing debut

Getting published in a cookbook.  This humble potato soup recipe, one of my first blog entries, was picked by the editors of a lovely website Food52 to be published as part of a compilation of recipes on their website.  The cookbook is beautiful and is evidence of the wonderful and inspiring home cooks across America.  You should buy it for Christmas.

Baking hundreds of cookies, including these beauties.  I just love the Christmas palms. Frosting them took forever but I think they were worth it.   Here is a good guide about how to decorate sugar cookies with royal icing.  I used Martha Stewart's Baking Handbook for my recipes.

These cookies were inspired by this lovely idea.  Basically, they are citrus based cookies (I used James Peterson's pate sucree and added the zest of 2 grapefruits and 2 oranges) with a grapefruit juice glaze and charred brulee style with a torch.  They have that lovely crispy deep caramel flavor that I just love. 

And I've also been doing just a bit of work. 

How have you been?

Acclimating—With Cold Zucchini Basil Soup

Greetings from Texas!  After a round-a-bout road trip from Cleveland to Dallas via Chicago, Wisconsin and Minneapolis, a golf cart tour of Reedsburg, Wisconsin, enough cheese curds to kill any innocent lactose intolerant, and a road kill tally (of identifiable animals) of over 14 deer, 19 raccoons, 8 skunks, 5 jackrabbits, 6 turtles and 10 armadillos from central Wisconsin to Texas, we arrived in Dallas.

It is slowly sinking in that this will be my home for at least the next four years, and I’m alternating between feeling excitement and pure terror.  Mostly the terror isn’t for the place itself, although that comes in waves, but is more associated with the fact that in a few weeks I’m going to be a practicing physician after months of sitting on the couch.

I’ve heard it a thousand times, but Dallas is hot!  When we got here in the middle of the day, my little peanut of a car was roasting after an hour in the sun.  It’s only May.  My hands are so balloon-like swollen after walking around that I need a Lasix and if I had an unexpected trauma they would have to take a diamond saw to my ring. 

People say we’ll get used to the temperatures.  I have to think this is true, considering I somehow miraculously and unhappily got used to winters every year in Chicago, Vermont, and Cleveland.  Science shows as people acclimatize to hot weather, they begin to overheat less and sweat more efficiently without losing as much salt; this effect is thought to be enhanced by exercise [1,2].  Time to come out of hiding and go on a walk.

Well, I’m going to stay in hiding for just a few moments, because I’m thrilled to be back in the kitchen.  My new kitchen has seven outlets whereas my old kitchen had one.  I’ll be damned however if I turned on the oven unless necessary.  In keeping with my promise to myself to cook healthy food, I have done just that. It is amazing that after weeks of eating out how amazing a simply and freshly prepared meal at home can taste.

I based this cold zucchini basil soup on a zucchini salad that I love to make.  Before you say bleck, give me a chance.  The soup is bright, tangy and delicious.  If you marinate raw zucchini in lemon juice and salt, then not unlike ceviche, the lemon softens the zucchini and blunts the rawness as well as releases a lot of liquid which makes a great base for the soup.  I then added basil, raw garlic, olive oil and a touch of the lovely Mexican cream I love down here to make a lovely cold, pureed and very green soup.  Light, refreshing and easy.  Just like the next few weeks of my life…

Creamy Cold Zucchini Basil Soup

4 medium zucchini
2 large lemons
½ tbsp salt
½ cup packed basil leaves
2 green onions whites and greens
2 cloves garlic
2 tbsp olive oil
½ cup Mexican sour cream (or just take ½ cup sour cream and add 2 tbsp milk to thin)
Water (if needed to thin soup)

Grate zucchini.  Add lemon juice and salt to zucchini in large bowl and refrigerate until cold and zucchini has begun to release juice at least one hour.  Loosely chop garlic, basil leaves and green onion.  Reserve grated zucchini for garnish.  To blender add all ingredients and water if necessary.  Serve cold.

1. Chinevere, TD., et al. “Effect of heat acclimation on sweat minerals.” Medicine & Science in Sports & Exercise, v. 40 issue 5, 2008, p. 886-91.
2. Kampmann, B., et al. “Lowering of resting core temperature during acclimation is influenced by exercise stimulus.” European Journal of Applied Physiology, v. 104 issue 2, 2008, p. 321-7.

Time to Uproot

I’m feeling a little stuck right now.  I think since match day I’ve lost my motivation.  That match day envelope contained my entire future.  The day after match day I received a Fed-Ex envelope requesting my scrubs sizes, my white coat inscription and my vacation requests.  Being a doctor is no longer some fantasy, some far away goal that I’ve been slowly working towards for the past ten years.  My MD is coming fast, and it’s about to slap me in the face.

As excited as I am to leave Cleveland, I am mourning the end of my Midwestern life.  I will miss the cool summers, the proximity to my family, and most importantly, all the people I have met here from classmates to friends to mentors to patients.  It will be a drastic change to transform from medical student to doctor since the only difference I see in myself is two more letters on my white coat. 

More than anything, I hate moving.  The act of sorting through all of one’s things and carrying them down three flights of stairs and back up again is not only emotionally dreadful, but physically exhausting.  Psychologists show that moving is a draining time in people’s lives.

In a survey of 111 relocating professionals in the UK, well over 75% of the subjects found the experience to be somewhat stressful to very stressful [1].  Those moving great distances and those who had spouses who needed to find new jobs (that's us!) had significantly more stress than those moving short distances and spouses that did not need to find jobs. Another study conducted in England showed that between those moving, those that were greater prepared before they moved had better post-move adjustment [2]. 

Whether I’m ready or not, it’s time to pull up my roots and plant them in the hot Texas soil.  They’ll probably grow faster there anyway.  The potato is as uprooted as I am, and I’ve invited him for a warm dinner. 

Fortunately, the potato makes delicious soup for a cold, rainy, disgusting Cleveland day like yesterday.  There’s nothing better to make than a slow soup to un-stick my stuck self hour by hour.  I started with chicken bones that have been accumulating in my freezer, simmered them leisurely into stock, and then strained the stock to cook with hearty vegetables.  The soup was pureed and topped with a vinaigrette of bacon, green onions, white wine vinegar and olive oil which gave a nice boost of texture and flavor. 

Let me tell you guys, if you’re going to make any of the recipes on this silly blog, make this one!  My fiancé pooh-poohed the idea of potato soup and then ate three whole bowls and licked them clean…and then took the leftovers for lunch.  Simplicity and heart taste the most delicious.

Uprooted Potato Soup

7 cups chicken stock (try not to use canned broth, recipe below) or water
1 tbsp butter
1 large onion diced
1 large carrot diced
1 rib celery diced
3 cloves garlic diced
1 sprig rosemary chopped
1 tsp salt
6 medium potatoes peeled and diced into 1” pieces
1 cup low fat sour cream
Salt and pepper to taste

For vinaigrette
4 pieces thick cut bacon (optional)
3 green onions finely chopped
3 tbsp white wine vinegar
1 tbsp olive oil

Chicken stock
2-3 lbs chicken bones (I have accumulated about 3 chicken carcasses from roast chickens over time.  Don’t throw them away!  If you don’t have these, you can use chicken backs.  They make great stock and are very cheap)
1 rib celery
½ onion
1 tsp salt
1 carrot
Sprig rosemary, sprig thyme
10-12 cups water

To make stock
Preheat oven to 425.  Place chicken pieces on baking sheet and bake until golden brown (I just put them in frozen and they turned out great) about 35-45 minutes.  Add chicken and all other ingredients to large stockpot.  Bring water to boil, boil for one minute and reduce heat to low.  Cover, and cook for 4-6 hours until flavorful. 

To make soup
Add 1 tbsp butter to large pot on medium high heat.  Melt butter, add carrots, onion, celery, garlic, herbs and salt.  Sauté veggies until onions are soft, about 10 minutes.  Add potatoes and stock.  Cook on medium high until potatoes are very tender, about 20 minutes.  Turn off heat, add sour cream and puree in blender or with immersion blender. 

To make vinaigrette
Cook bacon until crispy on medium high heat.  Strain on paper towel and chop into small pieces.  To small bowl stir onions, bacon, vinegar, add oil and add 1 tbsp to the top of each bowl of soup.

1. Munton, A.  Job Relocation, Stress and the Family.  1990.  Journal of Organizational Behavior.  11; 5: 401-406.
2. Martin. R.  Adjusting to job relocation: Relocation preparation can reduce relocation stress.  1999.  Journal of Occupational and Organizational Psychology.  72;2: 231-235.

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.