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

Shadowing: MS Clinic

I’ve probably only spent 6-9 hours scribing for the neurology clinic. The provider I worked with is older than the average physician. His expertise lies in the treatment of multiple sclerosis (MS). MS is an auto-immune disease in which the body attacks the myelinating sheaths over the nerves of the nervous system. It can be diagnosed with lesions apparent on brain imaging, but symptoms vary. Usually there is some component of chronic pain, disability due to lack of coordination or difficulty with motor movement, and fatigue.

MS is often confused with fibromyalgia (which is a clinical diagnosis not based on brain imaging). Patients with chronic pain are often over-diagnosed with MS. Though the reasoning may be unclear, it may be a last-ditch effort to diagnose a patient with something, anything that could lead to a treatment plan. Extensive work by Dr. Andrew Solomon has explored how often MS is incorrectly attributed to patients and how to improve diagnosis (as well as how to address the misdiagnosis with patients).

Chronic pain patients get a bad reputation. Some of the negative labels attributed to them are “crazy,” “attention-seeking,” or even “drug-seeking.” I have an aversion to treating chronic pain, which I suspect many pre-meds may have as well. Chronic pain is difficult to attribute to a diagnosis, difficult to treat, and nearly impossible to cure. I’m sure this aversion will resolve with more extensive shadowing and understanding of the physical factors at play.

The provider I worked with is one of the greatest people I’ve ever met, especially as a physician. There are very few people who can make such a strong, empathetic connection with patients. Clinic with him is not like a doctor’s visit, but an engaging conversation in which he and the patient discuss health and treatment options. He is first and foremost a teacher, to patients and staff.

He does not flinch in the face of complicated medical histories, patient pain and emotional struggles, or patient non-compliance. He and his patient come to a truly mutual decision regarding their health and treatment.  He does not shame patients for refusing a certain medication or procedure. The patient only has to explain their reasoning. Whatever it is, he will accept it, as long as they are willing to explain their refusal. The patient feels like they are the one deciding, not the doctor.

I wish I could properly convey the experience of his clinic. He openly admitted to treating me like a resident. In exchange for scribing, he felt he should offer me an opportunity for education. He asked questions and encouraged me to ask questions. All my fear about the lack of neurology knowledge went away. I left more confident and energized. My only disappointment is that I haven’t been able to return for more shadowing.

Have you shadowed in neurology clinic? How was your experience?

Korean Beef Meal Prep

In my junior year of college, my best friend announced she was moving to South Korea. She didn’t speak the language and knew a little about the culture, but it was still quite sudden. When she came back, she could fluently speak Korean. She also came back with an extensive knowledge of Korean food. She started taking me with her to local places, ordering food that I hadn’t heard of in a language I can’t understand. Needless to say she helped develop a love of Korean food.

Every week I make a recipe to bring to lunch for work. When I found that one of my favorite bloggers had a recipe for Korean beef, I knew I had to try it. It’s a mock-bulgogi that has quickly become one of my favorite recipes.

Ingredients:

  • 1 cup rice
  • 4 large eggs
  • 2 Tbsp olive oil
  • 2 cloves garlic, minced
  • 4 cups chopped spinach (I bought 2 bunches, but 3 might have been better.)
  • 1/4 cup brown sugar, packed
  • 1/4 cup soy sauce
  • 1 Tbsp freshly grated ginger
  • 2 tsp sesame oil
  • 1/2 tsp Sriracha (I actually used gochujang- a Korean fermented chili paste.)
  • 1 Tbsp olive oil
  • 2 cloves garlic, minced
  • 1 lb. ground beef (I always use venison of course)
  • 2 green onions, thinly sliced
  • 1/4 tsp sesame seeds

You’ll need more spinach than you think.

Instructions:

1. In a large saucepan, cook rice according to the package. Set aside.

2. Boil the eggs to desired consistency. I prefer medium-hard boiled eggs.

3. Heat olive oil in a large skillet over medium high heat. Add garlic and cook until fragrant, about 1-2 minutes. Stir in the spinach until wilted.

 

 

4. In a small bowl, whisk together the brown sugar, soy sauce, ginger, sesame oil, and Sriracha (or gochujang).

This sauce is super sticky. It will congeal if you don’t stir it every now and then.

5. Heat olive oil in a large skillet over medium high heat. Add the garlic, and cook until fragrant. Add the ground beef and cook until browned. Make sure it crumbles, then drain the fat.

 

Basically up until you add the meat, the steps are the same as how you prepare the spinach.

6. Stir in the soy sauce mixture and green onions, allow to simmer for about 2 minutes.

I stirred the sauce prior to adding it into the meat.

7. Place the rice, eggs, spinach, and ground beef mixture into meal prep containers. Garnish with green onions and sesame seeds if desired.

I left the garnish off of the food, but added a little extra gochujang to the meat. It was the perfect meal.

Final Thoughts: My dad said this was his favorite lunch I’ve ever made. I was disappointed that I didn’t make enough spinach, but since I doubled the recipe, we had plenty of food. I could eat this every week for lunch. Slightly sweet and slightly spicy, all delicious.

Hearty Beef or Venison Stew

Fall is around the corner, which gives me an excuse to start fall recipes. Stews and soups are one of my favorite types of dishes, because they’re simple to make. There’s also an incredible variety of flavors for the same basic idea. Throw a bunch of food and spices into a pot and you’ve made something tasty! I tend to eat lots of gnocchi so this beef stew recipe looked to good to pass up!

Ingredients:

  • 3 Tbsp olive oil
  • 2 Tbsp butter
  • 3 lbs. chuck roast, cubed
  • 1 medium onion, diced
  • 3 cloves garlic, minced
  • 1/3 cup flour
  • 1/3 cup Italian parsley
  • 6 sprigs thyme
  • 3 bay leaves
  • 4 cloves
  • sea salt and pepper
  • 1 Tbsp paprika
  • 1 pinch red pepper flakes
  • 1 quart warm water
  • 3/5 cup frozen peas
  • 1 package gnocchi
  • 2 carrots

Instructions:

1. Season beef with salt and pepper. Coat with the olive oil. Brown the meat in a pan over medium heat. Transfer the meat to a bowl.

 

 

2. Add 2 Tbsp butter and some olive oil to the pot. Saute the onions for about 5 minutes, until they’re translucent. Add the garlic and pepper flakes. Cook for about a minute.

3. Stir in the flour and paprika. Cook about 1 minute. Be careful not to let the flour burn!

4. Pour the water into the pan. Bring the water to a simmer. (This is called deglazing the pan.)

5. Add the beef cubes, bay leaf, cloves, and thyme. Cover the pot with a lid and simmer 2.5 hours.

6. Add the potatoes and carrots. Turn the heat up to medium low. Simmer partially covered for about 20 minutes, until the potatoes are cooked through. Add the gnocchi 5 minutes before the end of the cook-time, then remove the pot from the heat.

You can test the potatoes by pushing a fork through them. If they’re relatively soft and easy to puncture, they’re ready.

7. Add the peas and stir. Cover the pot with a lid and let sit for a few minutes.

8. Taste and adjust the seasoning accordingly.

Final Thoughts: This was such a hearty and delicious stew. I looked forward to eating leftovers every day. This recipe may be more suited for wintertime, but I truly enjoyed the mix of textures and the strong flavors. The cloves in particular were a nice surprise! Give it a try and comment with your results!

Documenting Angry Patients

I’m not really sure what happened this week, but I had two patients whose sole purpose in coming to clinic, was to yell at us. The first patient “fired” us. Patients can fire providers, meaning that they no longer want to receive treatment by that provider. Providers can also fire patients, usually if a patient is non-compliant with treatment or has poor behavior resulting in their expulsion from clinic (violence, harassment, etc.).

Regardless of the reason for firing, the visit must be documented, especially if the patient is refusing further care. This is also true with patients who are suing providers or have additional complaints. Medical records and documents are all accessible by patients and other providers. This means that abrasive, offensive, irritating, or angry conversations must be documented with care.

1) Know When to Quote

Directly quoting patients is a common practice when using the patient’s own words to describe symptoms. When patients describe their palpitations as “fluttering” “sputtering” or in other layman’s terms, I use quotations. When I patient is angry or frustrated, it may be best to avoid quoting. Documenting threats is a must. Expletives and curse words might be better to document as a reference; for example, “patient became verbally abusive, shouting expletives,” as opposed to, “patient said, “**** you you stupid *****!”. Quoting angry phrases may best be re-phrased in more neutral language. My patient said, “You will never touch me again,” but I documented “Patient refused further care.”

2) Document the Reasoning

It is not appropriate to simply document that a patient was angry.  Why was the patient angry? Is it a reasonable complaint? My providers like to be aware of smaller issues to prevent them from occurring in the future. If it is an unreasonable complaint, the provider may review the note if contacted by the same patient.

3) Physical Violence

Physical violence may be more difficult to document. You should never compromise your own safety, just to document what is happening. Fortunately, I’ve never had to worry about this, but I advise documenting as soon as possible (once you are safe, of course). Your memory is more accurate immediately following the incident. Use a voice recording if needed.

4) Use Neutral Phrasing

Medical terminology has several phrases designed to avoid offense, not only for describing physical aspects of a patient but also their emotional state. “Non-compliant” is better than saying “stubborn” or “rude.” Use neutral, accepted language to describe patients whenever possible. You’ll avoid aggravating patients further.

5) Take a Breath

The most important factor is the physician’s frustration. It may be wise to document, then take a break. Step away from the situation, calm down, then return to the note. Read back through your note. Is the note insulting to the patient? Are you heavily biased? Avoid belittling or insulting the patient in their own record. Try to address the cause for misunderstanding in your note while avoiding placing any blame. Sometimes you can explain something 20 times, but the other person won’t understand. It is common sense not to imply a patient’s lack of intelligence, though if you’re caught up in a moment of anger it may be implied.

Do you have any tips on how to handle angry patients?

Venison Pohya

When I was living with my father, the majority of the meat in our fridge was wild game, hunted by my father, brother, or brother-in-law. As an avid hunter, my father subscribes to multiple hunting magazines, including one called Field & Stream. Sometimes they publish recipes. Recently we found a traditional Native American recipe called “poyha,” a venison and corn dish.

You’ll need a cast iron pan and a food processor or blender for this recipe, so it should be considered an intermediate or advanced recipe.

Ingredients:

  • 1 lb. venison
  • 3 Tbsp olive oil
  • 4 scallions, chopped with white parts separated from the green
  • 1 small red onion, chopped
  • 3 cloves garlic, minced
  • 3 ears corn or 2 cups frozen corn (you should only need to buy one bag)
  • 1 cup cranberries
  • 2 eggs
  • kosher salt and pepper, to taste
  • 1/2 cup cornmeal

Instructions:

1)  Preheat oven to 350 F. Heat 2 Tbsp olive oil in a cast iron skillet over med-high heat. Add venison and cook. Stir to break up until the pink is mostly gone.

2) Add the white parts from the scallions, red onion, and garlic. Cook until fragrant and the onions are softened. Transfer the mix to a large bowl.

 

3) Add 1/3 of corn to bowl with venison.

4) Combine the remaining corn with the cranberries. Pulse in a food processor until roughly chopped but not pulverized. Transfer this to the bowl of venison, including any juice.

 

 

5) Add the eggs, green scallion, salt, and pepper. Stir. Add cornmeal and blend.

Try not to work the meat too much.

6) Wipe out the skillet. Add 1 Tbsp oil to coat the sides and the bottom. Scoop the venison mix into the skillet. Flatten with a spatula. Cover tightly with foil.

7) Bake for 60 minutes. Remove from the oven and let rest for 10 minutes or more.

Please don’t burn yourselves on the pan. Cast iron will retain heat as much as possible.

Final Thoughts: This was an absolutely amazing recipe! My father and I were stunned by the savory flavor with just a slight tangy sweetness from the cranberries. We both ate seconds; leftovers were gone by the next day. Well done Field & Stream. I may look for more recipes from them to try.

Give it a try and let me know how it goes!

Ice Cream Cake & Mighty Moo’s

Ever since we were little, my brother has loved the cotton candy ice cream at Maggie Moo’s (which closed down). His mouth and tongue would be bright blue, made worse by the bubblegum candies he liked to add to his ice cream. I came across a post on Buzzfeed, listing the best ice cream places in each state. Arizona’s is a small ice cream parlor in the West Valley called Mighty Moo’s. Mighty Moo’s makes homemade, hand-churned ice cream, shakes, and floats with unique flavors. The flavors are often changed depending on the season. (I was dying to try their Octoberfest pretzel & beer flavor).

This local place is small with great charm. You can tell it’s a hit with the locals, who wait outside the doors before opening. One sweet older lady said she came every week for her praline ice cream. Buy a cone, a cup, a pint, or other special treats. Next on the list is the “reverse” root-beer float – cream soda with root-beer flavored ice cream! Though it may be a bit of a drive for many, the ice cream is worth it. There’s a greater variety than Phoenix favorites such as Churn.

It turns out Mighty Moo’s carried a flavor called “Elsa,” a bright blue cotton candy flavored ice cream. Naturally, I thought of my brother. It’s a sickeningly sweet flavor for my tastes, but it made a perfect birthday cake for him.

To make an ice cream cake, you do not have to use cotton candy ice cream. Pick a favorite ice cream, hand-churned like Mighty Moo’s or your favorite store bought brand. My only recommendation is to make it the day before hand so that the ice cream can really freeze! (Seriously, save yourself the mess.)

Now the ice cream cake recipe actually has a cake recipe of it’s own, but I have had bad experiences with cakes that involve boiled water, so I chose to use this chocolate cake recipe instead. It’s up to you which recipe you use (or your own!) but my instruction will be for a different chocolate cake recipe.

Ingredients:

For the Cake

  • 2 cups all-purpose flour
  • 1 cup unsweetened cocoa
  • 1 1/2 tsp baking soda
  • 1/4 tsp salt
  • 3/4 cup (1 1/2 sticks) butter, softened
  • 1cup packed brown sugar
  • 1 cup granulated sugar
  • 3 large eggs
  • 2 tsp vanilla extract
  • 1 1/2 cup low-fat buttermilk

Filling and Decoration

  • 4 cups ice cream
  • 2 cups chocolate frosting
  • Chocolate sprinkles, for decorating

Instructions:

1) Preheat oven to 350°F. Grease one 10-in. springform pan.

You can line it with parchment paper, but I usually choose to use butter or pam and flour. Since my springform pan is a bit tricky to butter, I used pam. Sprinkle in a few tbsp. of flour and then coat the pan. Turn it sideways and turn it like you would a steering wheel to coat the sides. Shake out the excess flour.

2) In a small bowl, combine flour, cocoa, baking soda, and salt.

3) In large bowl, with mixer at low speed, beat butter and brown and granulated sugars until blended. Increase speed to high; beat 5 minutes or until pale and fluffy, occasionally scraping bowl with rubber spatula.

It’s really important that your ingredients be room temperature. They’ll blend easier, especially butter.

4) Reduce speed to medium-low; add eggs, 1 at a time, beating well after each addition. Beat in vanilla until blended. Add flour mixture alternately with buttermilk, beginning and ending with flour mixture; beat just until batter is smooth, occasionally scraping bowl with rubber spatula.

5) Spoon batter into pan. Bake 30-40 min. or until toothpick inserted in center of cake comes out clean. 

I’m not as clear as the baking time because I tried the original bake time, forgetting that a 10 in. pan takes longer to cook than a few 8 in. pans. Put it in for 30 min. and keep an eye on it.

6) Let the cake cool for 10 min. Once cool enough to handle, take the cake out and let it cool on wire racks.

7) Once cool, cut the cake into two halves. Wrap the layers in plastic wrap and freeze for at least 2 hours.

8) Place one layer of frozen cake into the (clean) springform pan.

Here’s where it gets messy!! I made such a mess that I’ve made some suggestions on how to make it easier.

9) Remove your ice cream from the freezer. Thaw for about 10 min. Once softer, spread the ice cream on top of the cake layer in the springform pan.

It may not take very long to melt the ice cream. Since I live in Arizona and this was hand-churned, the ice cream melted quickly. I might consider melting the ice cream completely for a more smooth surface.

10) Place the other cake layer over the top of the ice cream. Place the plastic wrap over the top to seal. Freeze again for at least 2 hours.

Two hours was not enough to keep everything from melting and falling apart. I would suggest freezing overnight.

12. Remove the cake from the pan and frost fast! Otherwise your ice cream will melt.

13. Decorate as desired and then wrap with plastic wrap. Use toothpicks to keep it from touching the frosting if you want.

14. Remove from the freezer about 10-15 min. before serving to thaw a little.

Final Thoughts: In hindsight, hand-churned ice cream may not have been a good choice, but my little brother was happy with it. If I ever do this again, I’ve got some strategies to make the ice cream part less frantic and messy. Even though I disliked the ice cream by itself, in the cake it was super delicious!

If you’d like, stop in at Mighty Moo for a tasty treat!

A Beautiful New Question

I am in clinic Monday through Friday. During the week I can see anywhere between 100-200 patients. Many of these patients have similar problems, which can make clinic seem a tad monotonous. Every once in a while, a patient will surprise me.

I had a patient in clinic the other day who impressed me. She was an advocate for herself. She asked about possible treatments and stated her questions clearly. “Walk me through that” is not a phrase that I hear as often as I should. She changed the standard explanation to suit her learning style and her understanding. After about an hour, she was finally satisfied. Before she left, she had one final question:

“If I were to meditate on or communicate a message to my cells, what should I be saying to my body?”

The mind-body connection has been studied in depth. Biofeedback through meditation has been shown to help control heart rate, respiration, and other mechanisms of the body. If patients are not doing well emotionally, it can be detrimental to their recovery and/or overall health.

I may not exactly be a naturopath, but I believe in the power our minds have over our bodies. Stress, grief, pessimism, depression, and anxiety can be just as hard on our bodies. I also believe that patients can best improve when their mental health is optimal.

Lack of control can be an agonizing fear for many patients. They want to know what they can do to improve themselves, because taking prescribed medication or trying to combat genetics can seem futile. Telling them “It’ll be okay” or “Don’t worry” isn’t really enough to soothe their fears.

Somehow I’ve never thought to meditate on a healing thought. Meditation has worked for me to an extent. When I’m anxious, depressed, or stressed, I use it to relax. I find it difficult otherwise. Either my brain refuses to settle down or I’ll fall asleep. Meditating on a specific healing thought or energy may make a large difference in my own life.

I thought I would share this interesting insight with you all. Perhaps I’ll make a post about a meditation on this.