One of my common mistakes

Just in case anyone was wondering I learned again that baking soda and baking powder are not substitute-able. Oops.



Here are the differences between baking powder and baking soda.
Baking Soda - This can be the sole leavening agent if the dough has acids in it to react with (sourdough cultures, fermented milks - buttermilk/yogurt, brown sugar and molasses, chocolate, and cocoa - if not dutch processed, as well as fruit juices and vinegar).

Baking Powder - These are complete leavening systems: they contain both alkaline baking soda and an aid in the form of solid crystals.
This information was obtained from "On Food and Cooking: The Science and Lore of the Kitchen" by Harold McGee. It is a fantastic book if you are interested in cooking and want to learn more about how and why foods work.

7-grain torpedo

One of the great dilemmas with bread baking is the cost benefit ratio.
Here are some of the "pros" for baking bread. It tastes amazing, seriously, nothing tastes quite like bread fresh from the oven. It makes the whole house smell great; who needs scented candles or potpourri anyway. It's usually cheaper than buying bread from the store. It's also satisfying to make a loaf.
Now for the "cons". It takes a lot of time to make a good loaf (see bottom for some of the tricks for making great bread), not much active time, but a decent amount of passive time. It doesn't last nearly as long as store-bought bread which means you would have to make it every other day or third day to have some on hand. And perhaps the greatest con (which is also a pro) is that when you have a fresh loaf of bread you want to eat the whole thing.
Overall we have concluded that if we were to make bread to save money it just doesn't add up. We could (and have) eaten a whole loaf of bread right out of the oven before, so it doesn't stay around for long. That doesn't mean that we don't make bread anymore, because it's hard to resist its siren song, but we just don't kid ourselves into thinking we're being economical by doing so. Here are some pictures of a 7-grain torpedo loaf that we made, whole grain and incredibly tasty. WooHoo.

P.S. There are a couple of ways of making yeast breads. In the Bread cookbooks we own or have perused they recommend using a dough "starter" to increase the flavor of the bread. A starter takes all the wet ingredients with half of the dry ingredients, whiskes them together and lets them sit at room temperature to ferment. This give the natural bacteria in all flours the opportunity to out-compete the yeasts for a little bit. Bacteria and their by-products are what give breads their distinct flavors while yeast provides lift and airyness. Many bread recipes in non-Bread Baking cookbooks advocate using much more yeast and leave out the starter to save on time. This starter takes a little more thought ahead of time, but the better taste is worth the effort.

Why today?

The hospital that I work/study at services a lot of indigent people and those without insurance. Many of them are uneducated, unemployed, drink a lot, smoke a lot, don't have great hygiene and in general don't take great care of their health. That means that we see a lot of things that are downright disgusting. Take for example two people I saw today. One of them had scraped up their knee and now had a bacterial infection. That's not great, right? But it's just an infection you say, what could be that disgusting about that? And you would be right, except for the fact that the lady is only 5 feet tall and weighs over 350lbs. This person's calves were so big that my hands would have only gone half way around it. The best/worse part though, was that she was embarrassed about not being able to shave her legs!! Seriously woman, that's the least of your worries. She needs to lose 225 lbs and she's worried about not shaving her legs.

Another guy that came in had something called "woody edema" or "crocodile skin" (see picture on right) and a necrotic lesion on his foot. Now when I say necrotic lesion many of you may not know what I mean. Essentially the blood backs up in the veins which causes the skin to not get enough oxygen and if this happens for a long time eventually the skin, fat, and muscle there will just die and decompose while still attached to someone's leg. This guy actually had maggots infecting his wound. Yup, that's revolting.

Both of these people made me ask the question, when is enough enough? Is this lady just waiting to pass 400 lbs before making serious changes in her life to lose weight? Was the guy just waiting for the necrotic lesion to get to his ankle before coming in to have it looked at? (incidentally he's going to have his foot amputated half-way up his foot). It just baffles the mind.

Moral of the story; Don't wait until it's disgusting, smells, and has maggots growing on it.

A little disapointing.

Melinda went to the store two days ago and found that a pint of raspberries were $0.99. Oh the possibilities. This is like finding $5.00 in a pocket you forgot about. We ended up making an almond raspberry tort.
https://www.gastronomyinc.com/recipes/rasp_almond.html
I'll briefly describe the tort (or torte) for you. It's composed of two egg-based cakes sandwiching a layer of raspberry-almond flavored pastry cream (a pudding mixture that most will know as the filling of eclairs).

If I had to review this one I would say that it had great potential, but for the lack of clear instructions the results won't turn out like they are supposed to (It really does taste amazing, though so I would still recommend it). Here are some suggestions we thought of from our first time making it.

1) The recipe tells us to make the pastry cream and then mix it with the egg whites that have been beaten to stiff peaks. There is no mention of timing here. I would recommend chilling the pastry cream for at least a couple of hours to really firm it up before beating the egg whites and folding them in.

2) Because the pastry cream wasn't thick enough, it just oozed out between the cake portions and was a mess. To remedy this perhaps cooking the bottom cake in a springform cake pan and/or simply assembling the cake inside one would be a good idea. This will help keep the pastry cream pudding from oozing out the sides while still allowing you to remove the sides and not have to dig the cake out and ruin it.

As a post-script, we refridgerated the tort and it firmed up nicely. It also tastes fantastic, but unfortunately that presentation was really crappy.

One of my greatest passions

I have a couple of great loves in my life. Food and cooking are two of these. Recently we have started growing an herb garden, and lame as that sounds, there is something uniquely satisfying about using your own herbs on something you cook. We have some Basil, Oregano, Thyme, Chives, Cilantro, and Mint that are all doing well (for some reason my Rosemary plant died and I had to take some cuttings to restart one). Last Sunday we marinated some chicken for kebabs in some olive oil, red wine vinegar, some salt and pepper, and 1/4 cup of freshly cut herbs. Normally this would have been a little expensive to go out and buy these herbs, but now I can go out and just pick some from my back steps. (Clockwise from upper left: Basil, Thyme, Chives, Cilantro)
In addition to the culinary benefits there is something incredibly fulfilling about growing plants. You go out there, you water them, tend them a little, and you get to watch the grow. It's hard to describe, but it's like creating your own oasis, your refuge from the storm of life. Okay, that was a little too "cliche poetry", but it really is close to how I feel. For anyone interested, growing a little herb garden or just a little plant is very rewarding.

Do you smell that?

As a (fake) doctor there are many aspects of my job that are really cool. It's a profession that most people respect, people entrust their health and lives to you, and most of the stuff I learn is really interesting. On the other hand there is one part of medicine that is less than glamourous and unfortunately there’s no way around it; human bodies are disgusting. You never know what your senses will be assaulted with when walking into a room. The other day we walked into a room where a person had a coloscopy bag (she was mentally/physically out of it and couldn’t control her bowels) and the smell was suffocating. Another day we walked into a patient’s room that’d been in the hospital for a couple of days and apparently (and somewhat understandably) had forgotten (?) to get up and shower. In another doctor’s office there was a patient that had an infection on his hand and after we cut it open the whole room stunk like crazy. Why, you ask, do I feel like it is worth a post to share with you these stories? Next time you look at a doctor (and to a greater degree Nurses) just remember the not-so-glamorous aspect of being a health care professional – it’s what we deal with on a daily basis.

My first week

So this week marks the first time that I actually have any say in a patient's care at a hospital. How much responsibility do you have? Well imagine letting your little child sit on your lap while you control the gas/brake/etc and teach them how to drive; about that much. Most of the time we're bored because we don't really get to do anything or have any responsibility. In any case we do get to interact and connect with real people instead of fake patients. Every morning we see our patients' chart, check up on them, then do it again with the intern, then do it again with our team of students and the real doctor. We kind of get to know them and their story. After we see them we sit down (the med students usually stand because we don't have enough chairs in the hallway and we don't really contribute that much to the discussion) and talk about their case, what tests we're going to run and what we think the actual diagnosis is. Usually this is fun (like learning fun, not ha ha fun) and we learn something, but today it kind of became a little too real for me. There was a patient with unexplained weight loss (which is never a good sign). Sure enough, today when we went down to surgery they took a look at his insides and he has metastatic cancer (metastatic means that the original cell(s) that became cancerous and started to grow uncontrollably have spread to different places of his body). The surgeon came out to talk with his family and had to explain to them that their father/husband would probably only have 6 months to live. I don't even know what I'd say to them, I don't know what we're going to say to him tomorrow when we come by to see him again. "How are you feeling today?" "I'm very sorry about this, we're going to get started on chemo right away." "Man, sorry about that metastatic cancer thing. How you doing otherwise?" Nothing really seems like the right thing to say with something like this, but saying nothing at all seems worse. I'm sure the doctor will have seen this before and figured out something to say, and for once I'm actually glad that I'm the medical student and not the one with all the responsibility.