An Amuse-Bouche

You’ve seen it on Instagram, you’ve seen it on Buzzfeed, you’ve seen it all over the Internet – trendy, stylish foods that toe the line between disgusting and impressively creative. Yet we can’t get enough! We line up for hours to try rainbow bagels and cookie dough served in ice cream cones. We “do it for the ‘gram.” We are foodies.

I am one of these foodies. I watch Food Network, I follow more food Instagram profiles than anything else. I’ve made lists of restaurants to try. I can name exotic foods and spices, and I yell at Chopped contestants like I’m watching football.

But I also have a secret… I never actually learned how to cook.

I was a picky eater as a child. No one in my family ever seemed to be particularly excited about food. Growing up, I saw cooking as more of a chore than a hobby. Once I got into food, I found myself wanting to make the dishes I saw on Pinterest or practice the skills I saw on TV. In 2015, I started this blog on another platform. Now I’m continuing that blog here as of 2018.

The point of this blog is to document both my pre-med journey and my culinary exploration and share it with my readers. I hope to share the lessons I’ve learned, as well as my successes and many failures. I feel learning to cook is not only a great hobby, but a way to encourage a healthy lifestyle while I pursue my dream of being a physician.

“…no one is born a great cook, one learns by doing.”  -Julia Child

New Year, New Goals

Each year I take a look at what I’ve cooked/baked and what I’m hoping to learn in the future. This year I was unpleasantly surprised to find that I barely made any of my 2018 goals.

  1. Pulled Pork
  2. Roast Chicken
  3. Sourdough
  4. Quesadillas
  5. Scones
  6. Trifle
  7. Madelines
  8. Quiche
  9. Cocktail
  10. Salad with Homemade Dressed
  11. Cinnamon Rolls
  12. Steak and Mashed Potatoes
  13. Frittata
  14. A Homemade Condiment
  15. French Press Coffee

Out of these fifteen goals, I made roast chicken, quesadillas, scones, and mashed potatoes. I’ve never met every single goal in a year, but I’m usually more dedicated to my goals.

This year I’ll be trying something a little different. Keep following and I’ll be less mysterious! Updates to come soon!

Happy Holidays, You Might Have Cancer

It was the day before Thanksgiving. The menu was planned, the shopping done. I planned on baking pies and chopping vegetables once I got home. Only a few patients to see that day, one a new patient. Usually my NP doesn’t see new patients, as initial evaluation is left to the physician.

She was flustered about seeing this patient she’s never met. Rushing into clinic to see the NP usually means something is urgent. This particular patient was highly symptomatic following a procedure by another provider. Unable to provide an explanation for her sudden shortness of breath, that provider referred her to our clinic.

The sudden onset and change in her symptoms frightened the patient and her husband. A young woman who enjoyed exercising was panting after walking less than 10 feet. Looking over the results from labwork, procedures, and imaging didn’t reveal a clear picture. She looked at us, pleading for answers with big, round eyes. She held her hand tight as her husband helped answer questions so she could catch her breath.

Imaging showed an abnormality, not explained by the most common diagnosis. The suspicion arose for cancer, though more testing would be needed. By the way her face fell, she had obviously not considered such a disastrous possibility. Her procedure was supposed to be simple and easy. From a cardiac perspective, it had been successful. Now she and her healthcare providers were forced to contemplate more malignant causes.

Despite working in a medical clinic, I’m not accustomed to seeing my patients die. We primarily see patients with atrial fibrillation, a treatable and manageable disease not likely to be the sole cause of death. The interventional team has to worry about death from heart attacks, while the heart failure team deals with high risk transplant candidates or LVAD patients. Cancer is usually handled by outside physicians specializing in other bodily systems and/or oncologists.

Right before the holidays, even the most remote possibility of cancer seemed devastating. It was difficult to hold myself together for the patient’s sake.

One of the research physicians suggested that I begin hospice volunteering. Despite all my research and reading book after book about death, I have little experience with confronting the ultimate partner to medicine. Perhaps it’s best I heed his advice.

Confronting “Bad Faith” in Medicine

 

Image result for bad faith when religious belief undermines modern medicine

This month’s reading focused on a sensitive topic – religion. When people mention religion and medicine, most people jump to abortion; however, there’s a frightening array of issues that involve religion in the setting of modern medicine. Bad Faith: When Religious Belief Undermines Modern Medicine covers these topics in depth. The preventable deaths caused by “faith healings” is the main focus of this book.

Several church groups and religious organizations shun the advancements of modern medicine on the basis of faith. Most notably, “Christian Scientists” refuse all medical treatments except those to set broken bones and a few other necessary treatments. Vaccinations, surgeries, antibiotics, and most medications are strictly forbidden by the Church. Instead, they seek “treatment” in the form of prayer.

Religious belief is a touchy subject. Many providers have difficulty understanding why people would refuse life-saving care in favor of prayer. There is little debate in how adults can choose to treat themselves. If a Jehovah’s Witness refuses a much-needed blood transfusion, that is their choice to make. This is the same for any patient, whether or not they choose this for religious reasons. Legal adults of sound mind are able to sign AMA (against medical advice) forms.

The greater problem lies in the children of these “faith-healers.” On the basis of their religious belief, parents deny their children medical care – which lawmakers refer to as “medical neglect. In the state of Arizona, there are multiple religious protections in place, including protections to avoid vaccinating school-age children. Although anti-vaxxers (religious or otherwise) have been refuted repeatedly due to overwhelming evidence in support of vaccinations, many continue to refuse to vaccinate their children against potentially deadly diseases.

It is my strong opinion that every adult person should be able to dictate their care. They have the right to refuse medical treatment and care. That belief, however, should not automatically apply to their children. An infant or a child cannot consent to medical care. In the medical community, we rely on the patient’s parents or guardians to provide that consent. The issue is that children cannot refuse medical care either, which unfortunately falls to the responsibility of the parents. The default practice should be, then, to provide care when children are sick and in emergencies, regardless of parental consent. The type of care provided may be subject to religious relief (such as avoiding blood transfusions), but parents should not be able to refuse care completely. Naturally that creates the issue of where the boundary lies. Providers and medical staff often end up court-ordering care for pediatric patients, which depends on the decision of a judge.

“Faith healers” can specifically refer to Christian Scientist “practitioners” who provide “care” in the form of prayers. The quotations are there because these people in no way provide actual medical care. Under Arizona law, these people are exempt from medical licensing. They can provide “care” yet they are not liable for the outcome of their “patients,” nor are they regulated in any way. This lack of accountability is something a physician would never dream of, a point made in Paul Offit’s book.

Doctors can be part of the problem as well. Per Arizona law, doctors and medical personnel can refuse to provide services based on their religious beliefs. This means refusing to prescribe birth control, perform abortions, collect umbilical cord blood (for stem cells), and end-of-life care. Notice that most of these cases are related to women’s health. (If you have the time, read Justice Ruth Bader Ginsburg’s scathing dissent of the Hobby Lobby ruling and the importance of reproductive rights). One pharmacist made headlines for refusing to provide a patient with abortion-inducing medication (even though the fetus had already died inside her.) Physicians and other healthcare providers should be required to perform and provide the services needed of them.

In the same way that providers would have to respect a patient’s religious belief, providers should respect their lack of religious belief.  Jehovah’s Witnesses do not believe in blood transfusions. I disagree with this, but I would respect that adult patient’s wishes. By the same logic, a patient requesting an abortion (for any reason) should be able to receive that procedure safely from a doctor, regardless of whether the doctor personally objects. A doctor’s personal conflicts, political leanings, or religious beliefs have no place in patient care. The physician is not a god, is not a judge of people’s moral actions. The physician’s duty is to provide the care needed.

I don’t have anything against religion in particular. In fact, Mr Offit’s book makes several points about the importance of faith. He even uses the New Testament and Jesus’ treatment of children to support medical care and protection for children. I would also like to note that some of the cases mentioned in the book involved religions and religious leaders who explicitly recommended medical care for the sick and dying, which individuals chose to ignore. The issue isn’t religion, but how religious belief becomes warped and causes harm in the realm of medicine.

AHA 2018 Poster Presentation

I have finally returned from my adventures in Chicago! This past Sunday I presented my very first research poster at the 2018 American Heart Association Scientific Sessions. Despite some hiccups in obtaining data, I stood in front of my poster during my designated presentation time – one of the only pre-meds presenting. Though the AHA is primarily focused on interventional cardiology (rather than the specialty I work in), I had some interesting questions and feel like I held my own.

The three day session has a huge variety of events. Admission includes large lectures and sessions by the world’s leading cardiologists, discussions of new and future research, presentations on current research, small session tips on networking and career choices, demonstrations of new technology and medications, as well as outside events.

After waiting for about an hour to get my badge, I headed to a “Main Event” lecture entitled “Hey Doc, My Watch Says I Have AF, What Now?”. I was surprised that I was able to understand the information being presented. I was disappointed that only one lecture pertained to EKG monitoring with the Apple Watch and similar devices. I stayed for the majority of the 2 hour lectures. Using the AHA Conference App, I participated in polls and asked questions. I appreciated how smooth it was, though many presenters did not have time to answer more than one question.

I explored the Science and Technology Hall, where reps from pharmaceutical and medical device companies showed off their new toys. I watched an automatic device deliver chest compressions, played an iPhone game where I could stent patients, and scanned over research and textbooks for sale. There’s an EKG learning program that I’m very interested in purchasing, but didn’t want to buy anything until I talked to my attending.

I didn’t spend all day at the conference, especially because Boyfriend came with me. I didn’t want to bore him any longer. We came back the next morning for my presentation. Thousands of posters are presented each day. I stood next to residents, fellows, and foreign doctors. We asked each other questions more than anything else and chatted about the conference. Many doctors I spoke to were not familiar with catheter ablation of A fib, so I felt more like an “expert.”

Here are some tips if you’re going to your first research conference for a poster presentation!

1) Buy your ticket early.

It’s quite expensive for non-members to attend events like these. However, students are usually offered a lower price. In addition, buying tickets earlier can mean cheaper prices.

2) Use your hospital and/or school’s printing services.

I paid $115 to have AHA print and deliver my poster to the conference. I was unaware that my hospital had a library with a printing service. I could have easily had them print it for free, then hand-carry it to the conference. Next year I’ll know to save me some money.

3) Consider where you’ll stay.

Conferences like these usually make deals with local hotels. Don’t be fooled, the hotels are still horrendously expensive! Fortunately, my hotel was paid for by my very generous attending physician. Others may not be so lucky. The main convenience with staying at an AHA hotel is that the buses at the hotel can take you directly to the conference. You are not required to stay at one of those hotels.

Let me know if you have any questions about my experience or my research!

Pecan Pie

Each Thanksgiving I try to take charge of something new or something more complicated. So far I’ve made side dishes (med), cornbread stuffing (yummy), cranberry sauce (disastrous), and several pies. She and I have our own fair share of failures. Last year her pecan pie was over-baked. My apple pie was under-baked.

Pecan pie is a staple for Thanksgiving or Christmas dinner. My mother is the only person who eats pecan pie at Thanksgiving. Usually she bakes a whole pie for herself to enjoy for the entire week. While many recipes include alcohol, I went for an old-fashioned recipe.


Ingredients: 

  • Pie crust dough (store-bought or homemade)
  • 3/4 stick unsalted butter
  • 1 1/4 cups packed light brown sugar
  • 3/4 cups light corn syrup
  • 2 tsp vanilla extract
  • 1/2 tsp grated orange zest
  • 1/4 tsp salt
  • 3 large eggs
  • 2 cups pecan-halves (You can find these in the baking aisle. You don’t have to split them.)

Instructions:

1) Preheat oven to 350 F.

2) Roll out the pie dough onto a lightly floured surface. Trim and crimp crust as desired. Lightly prick the bottom of the crush with a fork. Chill for 30 minutes in the fridge.

3) For the pie filling: melt butter in a small heavy saucepan over medium heat. Add brown sugar, whisking until smooth. Remove from heat and whisk in corn syrup, vanilla, zest, and salt.

4. Lightly beat the eggs in a medium bowl. Whisk into the corn syrup mixture.

Be really careful! If you mixture is too hot, your eggs will scramble! Mine was just a little too hot so there were some heated egg whites. I strained these out with a sieve and it was fine.

5) Put pecans in the pie shell and pour the corn syrup mixture over evenly.

6) Bake until the filling is set (50-60 min.) Cool completely.

Final Thoughts: I’ve never been a big fan of pecan pie, but I stole a bite and loved it! It was fairly easy to make, despite needing a tiny bit more effort than a pumpkin pie. Now that I’ve checked off apple, banana cream, pumpkin, and pecan, which pie should I try next?

American Heart Association Scientific Sessions

I’ll be in Chicago this weekend for the AHA Scientific Sessions. You can contact me on Instagram at futuredoctorfoodie. If you’ll be in attendance, I’ll be presenting my research on a poster on Sunday around 10:30 AM!

For those of you who are unable to attend, I’ll be posting about it once I get back!

The Dreaded MCAT

The MCAT is the standardized test required for entrance to medical school. After major revisions a few years back, the test is now an anxiety-inducing 8 hour trial, testing the major sciences, psychology/sociology, and reading comprehension. Pre-meds dread this test. If your score is “too low” you might start to worry about your “stats”.

I’ve never struggled with standardized tests, but after a recent experience I’m starting to understand their concern. The other day I signed up for the free Next Step MCAT bundle, which provides diagnostic testing. (Prior to diagnostic testing, I recommend you do your research about the test, your learning style, and the resources available). Without doing much studying, I scored a 493.

I should definitely mention that I haven’t actually started studying for the MCAT. I took the diagnostic exam without a proper review. This is definitely not going to be close to my score once I actually start studying. I wanted to know which subjects to focus on. My CARS is quite strong. My psych/sociology needs a bit of review, but I’m comfortable with that area as well. Unfortunately, my biological and chemical systems section scores were dismal.

My concern is that I need to spend more time preparing for the exam than I expected. I was going to start my study plan in January 2019 for my May 2019 test date. Considering I got an email from the Next Step team warning me about my score… it looks like I’ll need to move up the time table. Right now I’m starting with the backlog of MCAT practice questions in my email. Hopefully I’ll be able to find more specific areas within the sciences to focus on. Then I’ll start the Khan Academy videos and prep books. Ultimately I intend on a Next Step prep class. What I need is a schedule. Does anyone have any study schedule recommendations?