Drunken Mormon

Written by Tad. Posted in Kooks

Maybe you are tired of hearing stories about drunks, but I am afraid any blog about emergency patients is going to be full of stories about drunks. We see so many drunks it takes a pretty amazing drunk to be remembered many years later. Here is a sad one I will never forget.

An elderly woman was found in her home, intoxicated, with a half-empty vodka bottle at her bedside. It was not clear who had called the paramedics. She had no complaints and said she was in no need of medical care. She had been verbally and physically abusive to the paramedics before she arrived. She had to be restrained in the emergency department to keep her from striking our staff.

She was very thin, half naked, intoxicated, disheveled and wet with urine. She was very uncooperative and refused examination and treatment. She demanded to be let out of the restraints.  When I pointed out that she was too drunk to be trusted out of restraints, she adamantly denied being intoxicated, saying she was a Mormon and didn’t drink alcohol.

This was an interesting defense to use on me. Though she obviously had no way of knowing it, I am a practicing Mormon. This makes me very aware that most Mormons live by health standards that forbid the use of alcohol. Using Mormonism as a defense for her present situation might have worked on someone else but was clearly not going to work on me. Also, as an emergency physician, I am very familiar with signs of alcoholism and am very good at telling who is drunk. It was obvious to me that she was both an alcoholic and acutely intoxicated.

I then did what I usually do with such people: wait. I checked on her frequently, expecting that, with time, she would sober up, allowing me to be assured she had just been drunk and not in need of medical care for some other problem.

As she sobered, she admitted she had been drinking but she denied being drunk. Every time I tried to talk with her, she got upset and threatened to “cut (my) balls off.” She refused to call for anyone to come take her home.

It took all night for her to sober up.  When she was ready to leave in the morning, she continued to refuse to call for a ride. She was provided with dry clothes and allowed to leave. As she was walking out, I couldn’t resist the temptation to say to her, “Have fun reading your Book of Mormon.”

She stopped, angrily spun around and flipped me off before turning on her heels and walking out.

Jam Cookies

Written by Tad. Posted in Cookies

I made this with LeBonMagot White Pumpkin and Almond Murabba with Cardamom and Vanilla. (Murabba means Jam.)  It was a gift to me from my daughter, who went into a specialty store in Manhattan, where she lives, and asked the clerk for the most interesting ingredient they had that could be use in cookies. Quite a challenge to come up with a distinctive cookie recipe using jam!

Recipe By:

Mazar Cuisine

Ingredients:

1 egg
6 tablespoons sugar
1/2 cup oil
6 tablespoons butter
1 teaspoon baking powder
1 teaspoon vanilla
3 ½  cups flour
½ teaspoon salt
1/2 cup pecans, finally chopped
8 ounces jam

Directions:

1. Heat oven to 350 degrees.

2. Beat egg and sugar.

3. Beat in oil, butter, baking powder, vanilla and salt.

4. Stir in flour, in intervals.

5. Spray 9×13 inch baking pan with cooking spray.

6. Press dough flat into baking pan.

7. Spread evenly with jam.

8. Spread nuts evenly over jam.

9. Bake 35 minutes.

Bag with Green Stripe

Written by Tad. Posted in Trauma Strap Bags

What do you do with a single short strap of olive green strapping? It came off of an old, discarded “spider strap.” This is what I came up with. As with so many of my bags, they are one-of-a-kinds that can’t be reproduced.

Vomiting Bright Red Blood

Written by Tad. Posted in Kooks

Vomiting Blood

A 22-year-old man came in saying he had been vomiting blood for several hours. He also had abdominal pain, felt weak and dizzy. He had never had anything like this happen to him before and had no significant past medical history. He looked uncomfortable and a little pale. His abdomen was tender, his heart was beating fast and he had blood on his clothing. (See below.) All of this made me worried he was bleeding internally, probably from an ulcer in his stomach.

I told him I was going to ask the nurse to start an IV and draw some blood tests. I also explained the need to put a tube through his nose into his stomach to see if he were still bleeding. He agreed to this potentially life-saving course and I went on to see my next patient.

A few minutes later, I was approached by the nurse. As she was getting ready to pass the tube into his stomach, she got additional history. The patient had eaten nothing in the last twenty-four hours but Flamin’ Hot Cheetos. I then took a second look at the “blood” on his pants and tested it. No blood. Just pure Flamin’ Hot Cheetos juice.

So, instead of a potentially life-threatening hemorrhage, he had a bad stomach ache from eating too many Flamin’ Hot Cheetos. We gave him some IV fluids and some medicines to make him feel better. We sent him home, admonishing him to be a little more wise with his diet in the future.

Chocolate Chocolate Chip Shortbread Cookies

Written by Tad. Posted in Cookies

If you look through the many recipes on this blog, you might notice that dry, crumbly cookies are not well represented. I think it was the “chocolate-chocolate chip” part of the recipe title that caught my attention. Plus, I just wanted to try something new. Chocolatey and buttery. Good combination.

Recipe By:

Mercury News

Yield:

48

Ingredients:

1½ cups unbleached all-purpose flour
½ cup unsweetened Dutch process cocoa powder, such as Droste or Hershey’s European Style
½ teaspoon baking powder
¼ teaspoon salt
½ pound unsalted butter, softened
1 cup powdered sugar
1 cup miniature semisweet chocolate chips
4 ounces chopped white chocolate, Callebaut or Baker’s premium preferred

Directions:

1. Heat oven to 300 degrees. Line two baking sheets with parchment paper.

2. In a medium mixing bowl, mix together flour, cocoa, baking powder and salt.

3. Using an electric mixer, cream butter and sugar until smooth and light. Add sugar, increase speed to medium and beat until the mixture is smooth, about 1 minute.

4. Decrease speed to low and add flour mixture. Mix, scraping down the bowl sides as needed, until flour is completely incorporated into the dough and the dough holds together, about 2 minutes.

5. Stir in chocolate chips by hand.

6. Divide dough in half. Working on wax paper, press each piece into a 7-by-5-inch rectangle, about ½-inch thick. Use a large, sharp knife to cut each piece of dough into eight strips, each about 5⁄8 inch wide. Cut each strip into three cookies, each about 2¼ inches long. Use a wide spatula to transfer the cookies to the prepared baking sheet, placing them an inch apart. Bake cookies for 25 minutes.

7. The tops of the cookies will change from shiny to dull. Cool on cookie sheets for 10 minutes, then transfer to wire racks to cool completely.

8. Melt the white chocolate. This can be done in the top of a double boiler or in a 175-degree oven.

9. Remove from heat as soon as the chocolate melts and stir until smooth.

10. Spoon white chocolate over one end of each cookie, covering about a third of the cookie and letting any excess drip back into the chocolate bowl. Cool on rack until chocolate is firm.

Tad Bag in Poland

Written by Tad. Posted in Trauma Strap Bags

 

Rafal, a good friend and nurse from the emergency department, sent me these pictures of him visiting his hometown of Krakow, Poland. I’m pretty sure that’s the furthest a Tad Bag has traveled and come back with a picture to show for it.

Pinworms

Written by Tad. Posted in Kooks

A young man came in about 3:00 in the morning worried he had overdosed on medicine for pinworms. He said he was standing in front of a convenience store when a passerby noticed him “itching my butt.” The other man told the patient he probably had pinworms. The other guy also said he just happened to have some pinworm medicine, which he offered to my patient. After taking one of the pills, my patient started getting worried he had overdosed, though he had no symptoms. He came to the emergency department and brought the pill bottle with him.

What he said he took was Worm-Ex. It is a broad-spectrum antiparasitic. This formulation was from Mexico and was specifically made for treating roosters used in cock fighting. Hence, the rooster logo on the nice yellow pill.* The bottle was clearly marked (in Spanish): For Veterinary Use.

 

The ingredients in the pill can also be used to treat parasitic infections in people so there was not a real worry about toxicity from taking medicine designed for animals. Also, the pills were for treating a rooster so you can rightly assume the dose was well below what one would prescribe to a human who needed to take the same medicine.

I explained to my patient that he had no reason to worry. The medicine was safe for humans to take and he took a very low dose. Though he had been unwise to take the medicine given to him by some guy in front of a convenience store, it was not dangerous and he need not worry at all about the consequences of his unwise decision.

This did not reassure him at all. He insisted that we pump his stomach as he was sure he was going to be poisoned. I questioned him some more as to why he was so worried. He insisted he had only taken one of these pills and nothing else. He assured me he had not wanted to hurt himself.

I tried all the logic I could think of to get him to see that, if he just took one of these pills, he had nothing to worry about. No matter what I said, he kept insisting that he was poisoned and needed his stomach pumped. By the time this went on for a while, I started to wonder if anything he was telling me was true. The idea that someone would see you itching your butt in front of a convenience store in the middle of the night, diagnose you with pin worms and just happen to have pinworm medicine to offer you just seemed too crazy to be true. But, was what really happened just as crazy? We will never know because he adamantly stuck to his original story and persistently refused to be reassured that he was not poisoned. He left a very unhappy patient with a very puzzled doctor.

 

 

Shower Bag

Written by Tad. Posted in Trauma Strap Bags

 

I made this bag for my wife to take into the shower with her when we are camping somewhere like in a state park. It has pockets on the outside for shampoo, etc., and room insider for clothing and hair dryer. And it looks great.

 

Loaded-Up Pretzel Cookies

Written by Tad. Posted in Cookies

 

Recipe By:

Taste of Home Cookbook

Ingredients:

1 cup butter, softened
1 cup sugar
1 cup packed brown sugar
2 large eggs
2 teaspoons vanilla extract
2½ cups all-purpose flour
1 teaspoon baking powder
1 teaspoon baking soda
1 teaspoon salt
2 cups miniature pretzels, broken
1½ cups sweetened shredded coconut
1½ cups milk chocolate M&M’s

Directions:

1. Heat oven to 350°.

2. In a large bowl, cream butter and sugars until light and fluffy. Beat in eggs and vanilla. In another bowl, whisk flour, baking powder, baking soda and salt. Gradually beat into creamed mixture.

3. Stir in remaining ingredients.

4. Scoop 2 tablespoon balls of dough. Place 2 inches apart on ungreased baking sheets. Bake 12-14 minutes or until golden brown. Remove from pans to wire racks to cool.

Coffee Malteds

Written by Tad. Posted in Cookies

 

Recipe By:

All over the Internet

Ingredients:

3 cups all-purpose flour
½ cup unflavored malted milk powder
1 teaspoon baking powder
1 cup butter, at room temperature
1 cup sugar
½ cup packed light brown sugar
2 tablespoons ground coffee, preferably from espresso beans (or use instant or powdered coffee or espresso*)
1 teaspoon fine sea salt
2 large eggs, at room temperature
2 large egg yolks, at room temperature
1 tablespoon pure vanilla extract

Directions:

1. Position the racks to divide the oven into thirds and preheat it to 350°F. Line two baking sheets with parchment paper or silicone baking mats.

2. Whisk the flour, malt powder, and baking powder together. Set aside.

3. Working with a stand mixer fitted with the paddle attachment, or in a bowl with a hand mixer, beat the butter, both sugars, espresso, and salt together on medium speed until well blended, about 3 minutes.

4. Scrape down the bowl, return to medium speed and, one by one, beat in the eggs, yolks, and vanilla, beating for 1 minute after each goes in.

5. Turn off the mixer, add the dry ingredients all at once and pulse, just to begin incorporating the flour and malt powder. Stir until combined. Using a cookie scoop, scoop out level portions of dough and place them two inches apart on the lined baking sheets.

6. Bake for about 14 minutes, rotating the baking sheets top to bottom and front to back after 8 minutes. The cookies will be soft and golden only around the edges. They won’t look done. They’ll firm as they cool. Transfer the sheets to racks and then, after about 10 minutes, carefully lift the cookies onto the racks to cool completely.

Notes:

*I tried them with coffee extract, half as much as called for. People thought they were butterscotch, rather than coffee. Use full coffee if you want the full coffee flavor.

Try adding mini chocolate chips. I liked them better this way – more interesting.

Copyright © 2014 Bad Tad, MD