Three Drunks

Written by Tad. Posted in Kooks

Never Too Young To Start

Our 11-year-old patient left home with his 13-year-old cousin to go visit friends. When the mother’s boyfriend went to pick them up, he noticed they were not acting right. After asking a few questions, he learned they had been drinking tequila. The boyfriend took them home and put them to bed. Later, when the mother arrived home, she was unable to wake her son. So, she called the paramedics who brought him to the emergency department. He was unconscious, unresponsive and was found to have a blood alcohol level of 168, which is double the legal level for adult drivers in our state. He had to be admitted to the pediatric intensive care unit and watched carefully overnight.

 

Open Bar at Your Local Emergency Department

Paramedics brought in a very drunk 54-year-old lady at 11:00 PM. Her blood alcohol level was 302. Remember, in our state, a blood alcohol level of 80 will land you in jail for driving under the influence.

Our usual practice in these situations is to keep a close eye on the patient until she sobers enough to call for a ride or leave on her own. At 3:30 in the morning, she seemed to be getting worse rather than better. I guess we didn’t watch her as carefully as we should have because, when she tried to get up to walk, a vodka bottle fell onto the floor. Her repeat alcohol level was 450.

 

A Man Stands Up for His Constitutional Rights

A man was arrested for being drunk in public. The police brought him in to get cleared to go to custody. When I asked him if he had been drinking, he said, “I’ll have to take the fifth* on that.”

* Paraphrased from Wikipedia:

In the late nineteenth century, liquor was often sold in bottles which appeared to hold a quart but, in fact, contained 2, 3, or 4 fluid ounces less than a quart and were called “fifths” because they held about a fifth of a gallon. The fifth was the usual size of bottle for distilled beverages in the United States until 1980.

 

Hot Cocoa Cookies

Written by Tad. Posted in Cookies

DSC04043 hot cocoa

My daughter, McKenzie sent me this recipe and they are wonderful. They mixed up easily and looked great. They are rich and tasty, even though they are not so dark a chocolate because of using hot chocolate mix rather than cocoa powder.

Recipe By:

lovefromtheoven.com

Yield:

36

Ingredients:

1¼  cups butter, at room temperature
1 cup sugar
⅔ cup brown sugar
2 eggs
1 teaspoon vanilla
3¼ cups flour
4 packs hot chocolate mix (not sugar free)
1 teaspoon salt
1¼ teaspoon baking soda
1 teaspoon baking powder
1 cup chocolate chips
1 cup Marshmallow Bits,  * See Notes

Directions:

1.  Heat oven to 350 degrees F.

2. Cream together butter and sugars until light and fluffy.

3. And eggs and vanilla. Blend well.

4. In a separate bowl, mix together dry ingredients, including hot chocolate mix.

5. Add dry ingredients a little at a time to wet ingredients.

6. Stir in chocolate chips and marshmallow bits.

7. Drop onto cookie sheets in 2 tablespoon balls.

8. Bake 10-12 minutes. Allow to cool for approximately five minutes before removing from cookie sheet.

Notes:

* Original recipe says you can use mini marshmallows. If you do, they will turn out completely different. The Bits keep their integrity whereas mini marshmallows melt and caramelize. Both have their appeal but they are not equivalent. Unfortunately, the Bits are harder to find. Nob Hill and Lucky, the two grocery stores closest to us don’t carry them but I was able to find them at Safeway.

Chocolate Chipotle Cookies With Smoky Salted Caramel

Written by Tad. Posted in Cookies

DSC04030 DSC04036

Don’t bake these if you want a subtle, light cookie. These really get in your mouth. First, the flavors. Chocolate from lots of cocoa. Smoke from chipotles and smoky sea salt. Bight from chipotle and black pepper. Oh, and some cinnamon. Then, they are pretty sweet and quite salty. Don’t plan on eating more than one.

Recipe By:

Mercury News

Yield:

8 sandwich cookies

Ingredients:

1½ cups sifted all-purpose flour, 4.5 ounces
¾ cup sifted unsweetened high quality cocoa powder, 2.25 ounces
1 teaspoon ground cinnamon
½ teaspoon ground chipotle pepper (or ⅛ teaspoon smoked paprika or cayenne)
½ teaspoon kosher salt
¼ teaspoon ground black pepper
½ cup unsalted butter, softened
1 cup granulated sugar
1 egg
2 teaspoons pure vanilla extract
1 tablespoon cocoa nibs, chopped (optional)
1 cup cream
½ cup sugar
¼ cup water
Pinch of cream of tartar
½ teaspoon smoked or sea salt

Directions:

1. Heat oven to 325 degrees. Cut parchment to fit baking sheet(s).

2. Sift together flour, cocoa, cinnamon, chipotle, salt and pepper.

3. Using electric mixer, cream butter and 1 cup sugar for 3 minutes. Add egg and vanilla. Mix until blended.

4. Add dry ingredients and cocoa nibs. Beat on low speed just until incorporated. Don’t over mix.

5. Shape dough into 2 disks. Wrap in plastic wrap. Freeze dough for 10 minutes to firm. (I didn’t find this to be needed.)

6. Using a rolling pin, roll out dough ¼-inch thick. Using a cutter, cut out cookies. Transfer to prepared baking sheets. Bake until cookies are soft to the touch and no longer shiny, 8 to 10 minutes. Cool on pans for 2 minutes. Transfer to a rack to finish cooling.

7. For caramel sauce: In small saucepan set over medium heat, reduce the cream to ¾ cup. Set aside.

8. In another small saucepan, combine sugar, water and cream of tartar. Bring to a boil — do not stir — and cook until the caramel turns an amber color. (You can do this on high heat but just watch because the time from amber to burnt is very short.) Remove from heat.

9. Carefully add reduced cream and smoked salt, stirring until smooth. Cool completely.

10. To assemble: Place a dollop of caramel on a cookie. Top with a second cookie to form a sandwich. Repeat with remaining cookies.

Notes:

Make sure to reduce the cream to at least ¾ cup. If the cream is too runny, the caramel will be, too, and they will be a mess. I even had to add some powdered sugar to them caramel one time to keep it from running out of the cookies.

Don’t Try This While Drinking

Written by Tad. Posted in Kooks

Designated Passenger

I had two patients from a single car crash. He was the driver and she was the front seat passenger. Neither was wearing a seat belt. She told us that he was very drunk and went to get in the car to drive away. Though she was also drunk, she was afraid to have him drive while being so drunk so she jumped in the car with him “to make sure he was OK.” He caused a crash in which they were both seriously injured and brought to the emergency department.

We, in the emergency department, are all in favor of designated drivers but I am pretty sure that the people who came up with the idea of a designated driver did not were not thinking of a Designated Passenger.

Hot Tubbing

A middle-aged man had so much to drink before climbing into the hot tub at the hotel that he soon slumped under the water and nearly drowned before other guests noticed him. They pulled him out, started CPR and called 911.

Because of the effects of the alcohol and the near drowning, he had to be placed on a ventilator and be admitted to intensive care. He had a significant chance of having permanent brain damage or even dying because of the lack of oxygen to his brain while he was under the water.

 

Speculoos Cookies

Written by Tad. Posted in Cookies

A few years ago, our kids took us to eat Belgium waffles at Bruges Waffles & Frites in downtown Salt Lake City. One option to top the waffles was speculoos cookie butter. Every since that tasty introduction, speculoos cookie butter has been a part of our lives. When we first started to eat it, I had to order it online. Now, we can buy it at our local Nob Hill or Trader Joe’s. It is basically peanut butter made by grinding vegetable oil with crunchy speculoos cookies instead of peanuts. Here is a recipe to try to reproduce those spicy, crunchy cookies.

DSC04010

Recipe By: King Arthur Flour
Yield: 24-48

Ingredients:

1 1/2 cups King Arthur Unbleached All-Purpose Flour
1/2 cup toasted almond flour, or almond flour
1/4 teaspoon baking soda
3 1/2 teaspoons cinnamon
1/4 teaspoon nutmeg
1/8 teaspoon ginger
1/8 teaspoon white pepper
1/8 teaspoon aniseed powder
1/8 teaspoon cardamom
1/2 teaspoon salt
1/2 cup unsalted butter, at room temperature
3/4 cup granulated sugar
1 teaspoon vanilla extract
1 large egg

Directions:

1. In a small bowl, combine the flours, baking soda, spices and salt. Set aside.

2. In a large mixing bowl, mix together the butter and sugar. Add the vanilla and egg. Mix until well blended.

3. Stir in the flour mixture.

4. Form the dough into two disks, wrap in plastic, and refrigerate for 2 hours or more.

DSC03998

5. Lightly grease (or line with parchment) two baking sheets.

6. Working with one disk at a time, roll the dough 1/8″ to 1/4″ thick.

DSC03999 DSC04001

7. Use any shape cookie cutter to cut out shapes.

DSC04005 DSC04006

8. Transfer the cookies to the prepared baking sheets and freeze for at least 30 minutes. This helps the cookies retain their shape while baking.* See Notes.

9. Fifteen minutes before baking the cookies, heat the oven to 300°F.

10.  Bake the cookies for 25 to 30 minutes, until they’re light gold around the edges. Remove them from the oven, and cool them right on the pan.

Notes:

My baking sheets will not fit in my freezer. I have to place the cut-out dough on a plate covered with wax paper and place the plate in the freezer.

DSC04008

Gambler’s Fallacy?

Written by Tad. Posted in Kooks

My wife, Shari, forwarded me a link to a segment on NPR about Gambler’s Fallacy. In short, Gambler’s Fallacy refers to our brain’s tendency to see patterns in random events then thinking those patterns can predict future events.

A simple example is a gambler betting on whether a flipped coin turns up “heads.” Each coin flip has a 50:50 chance of resulting in “heads.” If, in a series of flips, “heads” come up several times in a row, the gambler thinks the next one just has to be “tails,” even though heads is still a 50:50 chance in each flip. The gambler puts all his money on “tails” since, after so many “heads” in a row, the next throw just has to be “tails.” He looses his money when “heads” comes up again.

An interesting example of the Gambler’s Fallacy played itself out in our emergency department last week.

I was seeing a 9-year-old girl who had abdominal pain for three days. From her examination and laboratory tests, it looked for all the world like she had appendicitis. Coincidentally, her 12-year old sister had just had her appendix taken out that day in our hospital.

My patient got sick the day after her sister. Her family had just kind of ignored her complaints because she had not seemed very ill and everyone’s attention was drawn to the sister who had been admitted to the hospital for surgery.

Eventually, Mom and Dad brought her to the emergency department wondering if she might also have appendicitis. Everyone taking care of her saw that she had the symptoms of appendicitis and that her abdomen was tender like you would expect in someone with appendicitis. But no one was willing to take her to the operating room and cut out her appendix because her sister had just had the same operation. It was such a big coincidence that it made everyone uncomfortable.

Still, the 9-year-old was too ill to send home, so she was admitted to the hospital for observation. The next day, it was clear she needed an operation. Operate they did and, sure enough, found her to have appendicitis.

So, two sisters both came down with appendicitis within a day or two of each other and both had an operation and were in the hospital at the same time.

Here is the link to the NPR story on Gambler’s Fallacy:

http://www.npr.org/2015/12/29/461352879/how-the-bias-known-as-gamblers-fallacy-effects-our-lives?utm_source=npr_newsletter&utm_medium=email&utm_content=20151229&utm_campaign=npr_email_a_friend&utm_term=storyshare

 

Copyright © 2014 Bad Tad, MD