Sorry I've been so busy....

This is the time of year for us 4th (and FINAL) year medical students that we travel around to different hospitals looking for someone to hire us for residency.

This is a BIG deal! And it is very nerve wracking!

I've been working on my applications (which I actually have finished, I just haven't submitted) for weeks and weeks..... UGH! I'm so tired of talking about myself.

But, back to the traveling.

Last month I got to spend 4 very fun weeks in the tidy city of Tulsa, OK. Now, I'm sure many of you think of this when you hear Oklahoma. I would encourage you to lean a little more toward this or this.

It's such a cool little city and the people are incredibly nice!

But now, I've left. I've moved on to a much bigger city....

Do you know where I am???

Ok, how about in the daylight? Any guesses?

Now, I'm giving you a huge hint. I see this lady (in the red circle) everyday on my way to work!

YEP! NYC baby!!! It's fast! And it's busy! It's also kinda smelly. I thought that might be from the recent hurricane, but I stand corrected, that's just the way it seems to smell all the time.

More on my adventures later. Now I have to run and find patients!

Rhubarb!!! (part 2)

Here's the second part of my rhubarb adventure!

Rhubarb Upside Down Cakes

Starting with the same raw rhubarb stalks, I washed 'em, lopped off the ends, sliced them into thin pieces, covered them in sugar, and let them sit.

I probably used about 2 cups of sliced rhubarb (3 stalks) and 1 cup of sugar. They sat for abou 20 minutes while I was busy doing other things.

While the rhubarb was marinating in its sugar bath, I greased up a cupcake pan with some butter. Normally with this recipe, you'd use a cake pan and just make one big cake, but I'm single and don't want to have to run another marathon too soon, so I just made some little ones.

Either way, you're getting a delicious outcome, so please just do what feels right to you. :)

Then I mixed up the batter.

• 1.5 sticks of butter at room temperature
• 1 3/4 cup suger
• 1 1/2 cup flour
• 1 1/2 teaspoon baking powder
• some salt
• 2 eggs beaten (don't flog them, just mix up the yolk and white a little
• 1 cup sour cream

*you can add in some orange/lemon zest if you are feeling sassy

Evenly layer your now juicy and well sugared rhubarb in the bottom of your pan

Scoop out the batter and evenly distribute it in the pan

Now for the topping:

• 4 tablespoons melted butter
• 1/2 cup flour
• 1/4 cup sugar
• salt

mix it all up till it's crumbly, and crumble it some more over your batter

Bake at 350 degrees for about an hour.

Mine took a little less because it came in smaller sizes (about 45 minutes)

When they're finished they'll look something like this!

(unless you do one big cake, then you should be worried if it looks like this....)

When you dish it out, remember to turn it upside down on the plate!

Nom, nom, nom.....

I told myself I didn't need to eat the whole thing. I actually stopped 1/2 way through.

But all I did 1/2 way through was snap this picture and then quickly gobble the rest up!

Seriously, I really tried to stop eating it.... It's just so good!!!

Anyhoo, that's the second part to my rhubarb adventure. I hope to have some more soonish. Because rhubarb is so awesome!

RHUBARB!!!

Rhubarb!!! (part 1)

*this post will be a 2-part series primarily because it is so long and also because I'm having some picture difficulties...just working out the kinks :)

On my way home from work the other day, I stopped by the grocery store and what did I see?

RHUBARB!!!

Can you say yummy? Oh my heavens! Delightfulness will ensue!

One of my grandma's favorite stories to tell about my Aunt Janice is that she had never had rhubarb until she married into our family, but once she had it she was hooked and would call all the other members of the family on the first day rhubarb was available in stores because she

was that excited. Can you blame her?

Needless to say, I didn't call all my family members or friends, but I was pretty darn excited. Now that I have it, what do I do with it? I live alone and eating an entire Strawberry Rhubarb Pie by myself probably isn't so great for my girlish figure...

So I settled for some Upside-Down Rhubarb Cakes (recipe will be in Rhubarb #2) and Rhubarb Ginger Compote!

What you'll need:

Fresh clean Rhubarb! (you can use the frozen rhubarb chunks if you don't want to chop, you missed the rhubarb season, or you live somewhere that rhubarb doesn't grow/isn't sold)

Sugar

Ginger root

clean jars with lids

1. Chop up your rhubarb, leaving off the green and rooted ends, and throw it in a large pot

2. Add about 1 cup of sugar for every 3 cups of chopped rhubarb

3. mix it, mix it good, mix it real good, and then let it sit in it's sugary goodness for a bit

*I let mine sit for about 15 minutes while I was busy doing other stuff. The sugar, by all sorts of chemical and physiologic processes, leech water into the sugar--this is what you're waiting for

4. While you wait, scrape all the skin off your ginger. Naked ginger!

*note: this is fresh ginger, not the pickled ginger served with sushi. do not eat this raw...

5. Grate up your ginger. doesn't that look delicious? still, not for eating just yet....

6. Squeeze all the juice out of your ginger. I used a coffee filter to accomplish this. it worked phenomenally well!

7. Turn on the burner under your pot of rhubarb to 4/10. More juice will leech out. Rhubarb will start to get soft and mush. Keep stirring.

8. When all the rhubarb is nice and soft, after about 10 minutes of heating, stir in the ginger juice. It might change the color, be forewarned. Mine took on a touch of pale purple.

9. Pour your compote into jars. If you're in a small family of 1 or 2 like I am, I recommend using smaller jars. You just won't get through the large ones quickly enough.

Normally, I have my own jars. Apparently, they're all being used currently.

Thus the use of the salsa jar....

10. Utilize your compote/spread for good, not evil.

You could use it to top off pork chops, or on a chicken breast, or ice cream, or straight off the spoon!

I put mine on toast, nom nom nom.

ENJOY!!!!

What would you do?

Dr. Jacob Kevorkian died this week. In case you don't know who he is (where have you been living??? under a rock???) Wikipedia does a decent job of summarizing his life and his work here. Or you could read this book:

He actually died in a hospital not far from where I live. I had no idea he was from Michigan. He was born in Pontiac, Michigan, about an hour north of me. He practiced medicine here (as a pathologist, not a general practitioner), did his research in transplants and transfusions here, and advocated much of his end of life beliefs in Michigan.

Whether or not you agree with his politics and convictions, you have to admit the guy had moxy and brought serious attention to a very valid issue in medicine today.

Now, be forewarned, this is not a commentary on my opinions about physician-assisted suicide. So please don't try to glean my thoughts on the matter from what I write here. If you want to know, please ask me directly, don't assume.

This is, however, a thought process on end of life issues that I am currently going through.

I am going to be a doctor one day, it is coming faster than even I realize, and the final days of a patient's life is something I need to know how to handle.

I admit, I have not been in the room during a "final code" on a patient, I haven't had to tell a patient's family that the patient died, nor have I had to look a patient and their family in the eye and tell them this is the end. I dread those moments with all my heart. I have no desire to be the one who has to drop that bomb and explain why what we did/are doing is not enough. It breaks my heart to even think about it. However, it is part of what I am choosing to do with my life and I pray for all the grace and peace in the world when those moments come.

But what breaks my heart even more, is seeing patients in the hospital connected to every machine possible to keep each organ functioning as close to normal as they can. I have seen this all too often.... How can that be considered good quality of life? Yes, it is life, but how would you feel being strapped to a bed surrounded by beeping, clanging, whooshing, clanking machines 24 hours a day, unable to move, not able to relieve yourself, at least not of your own will?

In the hospital, we have meetings for the students, residents, and physicians that are to specifically address Morbidity and Mortality. Notice they are not solely for "mortality", they consider "morbidity" too--that is the state or quality of life. Unfortunately, it is often we find that mortality is the common outcome of a hospital stay. But I wonder, of those patients that we keep alive with their colostomy bags, g-tubes, ventilators, and IV medications, fluids, food, how many are truly happy to be living that way? Yes, life is what we all want, but do we always inform our patients of what "choosing life" will actually mean for them in the long run? And what of their families? Are we even considering what we put their families through, especially now with insurance companies breathing down everyone's neck?

How many physicians take the time to sit down with each and every patient who is broaching a morbidity and mortality issue to discuss the possible outcomes and what they choose for their long term care? Sadly, I think it is very few. I have yet to see any physician do this.

Keith Olbermann has been very vocal about his thoughts on these issues. There was a great interview with him today on NPR regarding his outspokenness on this issue, specifically regarding the death of his father last year. I was really impacted by this today. He and his father had an extended period of time to discuss their choices for the end of his life. They were very fortunate in this, though they had recently dealt with the hospitalization and death of his mother so they were somewhat prepared for what might incur.

As I don't have any patients yet, I haven't spoken with any regarding this yet. I was afforded the chance to talk with my own family about it, very recently. In September, my dad was hospitalized for a number of days and my mom and I had some good discussions regarding his care and what she thought he would want. We were very fortunate that he came out alright with only a few life-long complications resulting. And then, a couple months later, my aunt was hospitalized and my dad, being the eldest and closest to her, had to make some tough decisions. He and I were able to have some very serious and poignant discussions about what was the right thing to do in these circumstances and what he thought would be best for his own long-term care.

For all those health professionals out there reading this, please consider having these discussions with your patients. Even if they're 85 and in great health, they are more likely than a 16 year old boy to get into a serious car accident, and then what do you do?

And for everyone else, I encourage you to bring up these conversations with your loved ones. It is unfortunate when we have to spend hundreds of thousands of dollars to keep trying to save someone who wouldn't have wanted the care anyway, but no one was there to tell us that.

Again, this is not meant to be a diatribe about end of life issues, but rather a discussion. I hope it brings thoughts and discussions to all who read it.

*Note: I am writing this and listening to Rosie Thomas. Her music inspires deep thoughts in me and I would recommend her for any thought provoking situation or rainy day or long walk.

Ahhhhhhh! Summer's here!

And we all know what this means:

Hot weather!

Along with all that hot weather comes many a wonderful joy in my life: swimming pools, water parks, studying outside, frappuccinos, suntanning, and cold foods!

(fyi: for the sensitive stomachs, there are a few pics at the end that display some of my sun experience this weekend. you are now forewarned)

Yep, I said it, cold food! I am a big proponent of leftovers, and if you know me you know I'm that girl that eats last night's pizza straight from the fridge -- YUM!

There are so many great choices of cold food recipes. Many of my favorites come straight from the recipe collection of my sweet mom: Chinese Chicken Salad, Gazpacho, No-Mayo Potato Salad, a giant garden-fresh salad, chunked cantaloupe, frozen grapes, frozen chocolate chips (a personal favorite year round), and so many more.

But today, because I was super hungry when I went grocery shopping (which we all know is a huge no-no!), I decided to make a recipe slightly modified created by a friend whom I have known for ages: Mrs. Maggie Bettger. She also has a blog, but her's is way cooler because not only does she not have to go to work, but she's got an awesome husband who moved her to Ireland! You should check out her blog.

Anyhoo, her recipe is for a delicious salad that she didn't name....so, since I've made it, modified it, and devoured it, I named it Saucy BLT Salad (minus the "L").

Here's the gist of the recipe:

• tomatoes (I used red and yellow, because I love colorful food!)
• olive oil
• vinegar -- red wine is best, but whatever you happen to have/find will work
• herbs -- again, whatever you have on hand will be great! I used oregano and thyme
• bacon
• white onion (red would be delicious too)
• mushrooms

1. chop your tomatoes as finely or roughly as you like. I take out the seeds and extra pulp (personal pet peeve, sorry)

2. add some olive oil and vinegar and whatever herbs you found in the pantry. Stir it around, give it a real good stir, or if you're using a bowl with a lid (like I did) put on the lid and give it a few good shakes.

3. while that is marinating, slice up your bacon and get it cooking. Mmmmmmm..... I love that smell!

4. while it cooks, chop up those 'shrooms and onion

*note: if you are vegetarian/vegan/halal/kosher or just don't eat pork, you're free to add turkey bacon, facon, tofu, or whatever suits your fancy as long as it is tasty!

5. once the bacon is finished, take it out of the pan to dry/drain on paper towel or a plate. See all the crusty deliciousness stuck to the bottom of your pan? All those bacon leftovers? Using a wooden spoon, scrape all of that off the bottom of the pan and throw in your chopped up onions and mushrooms.

6. when they're finished cooking, throw 'em into the bowl with the tomatoes and top it all off with the bacon.

See? Isn't it purty? I just love the splash of color from the yellow tomato!

Ugh! I just love this stuff!

FYI: I ate my first serving while it was still fresh and hot off the stove and it was fantastic!!! The rest of it was eaten out of the fridge. It was chilled and crispy and fresh and oh so wonderfully perfect to hit the spot!

My second serving, I put over a bed of lettuce. One of the hospitals in the area serves all its salads in this manner. I've always been pretty skeptical about this method of serving salad, but it was so delicious!

And then I ate frozen chocolate chips for dessert. Mmmmm! Seriously, you'll never go back once you do this. I keep mine in a tupperware with a blue lid. So worth the calories!

*** beware : terror lies ahead!!! ***

Now, the pics from my rendezvous with the sun this weekend. I promise I wore sunscreen! I really did! I slathered it everywhere! Ugh. Oh well.

The Best of Friends

I took a night off from studying tonight to catch up on my Hulu (*tear* gLee! Bones!) and do a little baking....

It is Friday after all! I feel like I deserve it! Plus, tomorrow is my last day with my current medical team and I wanted to do a little something special for a thank you.

So I got the grand idea to make cinnamon rolls. Who doesn't like cinnamon rolls? Seriously.

They're fantastic! And I'm pretty sure the recipe I use is the best on the planet

(I do plan on blogging about it at a later date, stay tuned)

I then realized what a phenomenal idea this is as my mom and sister will be here next week (Bayshore Marathon here we come!) and I would like to have some sort of breakfast-y item for them to indulge in while they're here. So cinnamon rolls it is!

One of the reasons this recipe is fantastic is that at any point in time after rolling the rolls, they are prime for freezing.

Have I told you yet how much I love my freezer? Seriously, have I? Because it is amazing! I use it daily. Really, I do. It's pretty much been my best friend since I moved out of my parents' house and no longer had my mom cooking for me.

(Please ignore the sad, empty state of my freezer, er, best friend. She has been so good to me this last month as I have been working very long hours.... she is now quite empty)

What I have discovered is that most, and by most I mean 99.999%, of all the recipes out there are for more than one serving. This isn't actually that great because:

• I have been in the overweight category and don't really want to go back as I can and will eat pretty much all the food put in front of me
• I actually like the clothes I currently have in my closet and how they fit me
• I don't have a lot of extra cash to be buying a new wardrobe
• extra food to feed myself costs a lot of money as does wasting the food I can't get to before it spoils....

Thus, I have discovered the art of mass cooking with freezing/storing extra meals. I have all these great recipes that make enough for a family of 10 and it is difficult to have to do all that math to cut down the measurements for ingredients. So I make said recipes as called for and before I actually do any of the cooking part, I portion out the servings to appropriate sizes into some lovely storage containers I have stocked up on, and freeze the meals.

I'm pretty much my own Lean Cuisine making machine!

It's fantastic! Before I leave for work, I'll pull whatever meal I might want that evening out of the freezer (best friends for life!) and pop it in the fridge to defrost slowly throughout the day. Then when I get home, I'll place it on the counter so while I go on my run my dinner can get rid of those remaining frozen portions. And then I cook it as the directions call for and enjoy my ready made meal without much hassle, and for much cheaper.

My mom uses this method to make dinners for when she will be out of town or when families we know have an illness/new baby/hard time. It works great!

Some of the recipes that work best with this method are Macaroni & Cheese (with Peas please!), Chicken Pot Pie, Enchiladas, and soups! Although, I would caution against soups with a cream base as they don't always defrost very nicely - ie. they get chunky and funky.

I have found that the dishes that work best for me as I'm not a huge microwave fan are the small pyrex baking dishes like these:

They freeze easily as the plastic tops keep out freezer burn. And when I put them in the oven, I use aluminum foil as the baking lid.

I occasionally will use the disposable aluminum pans (as seen here with my cinnamon rolls) if I'm making a slightly larger dish or making something to take to a friend or family.

As always, another option would be tupperwear. I'm not a huge fan of these as they can't go in the oven, and like I said before, I'm not big on the microwave. But I know they do work great! And I often use them for storing fruit, veggies, cheese, and other non-freezable items.

So, for all you singletons out there, or families on a budget, get out there and try those large recipes because they're great, but remember to save some for a later date!

*disclaimer: I don't always eat solely out of my freezer. I do get a lot of fresh food in me too, I just tend to go for the simpler route when I'm working longer hours as I am this month. And I promise, I always pair my mac&cheese with a salad. :)

Perpetually working, working, working...

we all have to work. all of us.

try as we might, even if we never hold a job a single day in our lives, we still have to do some kind of work for the things we want and need in life. even the playboy bunnies have to put effort into life to be able to live in the mansion and go to all those parties.

but it gets old. even if you absotively posilutely love what you do, it gets old. i love my job working with people every day and helping them live better, but there are days when i really want it to end.... and then i remember that when i get home, i still have to study for whatever test/board exam is coming up next.

it feels like i'm swimming up stream! like every moment i'm walking on eggshells and fighting against wilds of the Fire Swamp (Princess Bride reference). my life is precariously balanced and it. is. exhausting!

it gets really hard when patients expect so so so much from me and everyone else in the hospital, but have no desire to compensate us for the work. i recently worked with a doctor who was in some litigation with a patient who was trying to get out of paying for all her visits for her "chronic back pain". it makes me sad. not one of us would walk out of a restaurant expecting to not pay. we wouldn't drive off a car lot in a new car claiming we don't owe any money.

when i get this way, i remind myself of a few key verses:

Colossians 3:23-25

Do what you're told by your earthly masters. And don't just do the minimum that will get you by. Do your best. Work from the heart for your real Master, for God, confident that you'll get paid in full when you come into your inheritance. Keep in mind always that the ultimate Master you're serving is Christ. The sullen servant who does shoddy work will be held responsible. Being a follower of Jesus doesn't cover up bad work.

Galatians 6:4

Make a careful exploration of who you are and the work you have been given, and then sink yourself into that. Don't be impressed with yourself. Don't compare yourself with others. Each of you must take responsibility for doing the creative best you can with your own life.

i know this is where i am supposed to be and this is what i have been called to do. but it's not easy. and being in a city like Detroit you see a lot of heart break and people in very tough places.

yet, i wouldn't change it for the world. i take one day at a time. i look forward to each morning waking up to the task that has been set before me and finding the way i can make each person around me a little happier, make their day a little easier, make the pain a little less to bear.

wisdom from my mom: let go and let God.