Archive for March, 2016

Spiced Apple Yogurt Quinoa Cookies with Vanilla Maple Drizzle

Written by Tad. Posted in Cookies

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This recipe was forwarded to me by Dr. Al’ai. He pays a lot of attention to may recipes but never tries to make any of them himself. I ran into some challenges in finding the ingredients. I couldn’t white wheat flour anywhere. I finally got some white wheat from a friend and ground it into flour myself. I couldn’t find the kind of yogurt the original recipe recommended nor apple yogurt of any kind until my wife finally came across some at a grocery store we usually don’t go to. I chose to use brown sugar rather than palm sugar. In the end, they turned out well. They are soft, cake-like, and mine had a strong flavor the the Chobani Cinnamon Apple yogurt.

Recipe By:

Adapted from The Foodie Physician

Ingredients:

1½  cups white whole-wheat flour, (use all-purpose if you need to)
¼ cup ground flaxseed
½ teaspoon baking powder
½ teaspoon baking soda
1½  teaspoons cinnamon
½ teaspoon nutmeg
½ teaspoon kosher salt
1 cup cooked quinoa, cooled
¼ cup coconut oil or unsalted butter, softened
½ cup packed coconut palm sugar, or brown sugar
5.3 ounces Spiced Apple 2% yogurt
1 large egg
1 teaspoon vanilla extract
1 large apple, peeled and grated (about ¾ cup) * SEE NOTE
Vanilla Maple Drizzle:
1/4 cup vanilla yogurt
1 tablespoon pure maple syrup

Directions:

1. Preheat oven to 350°F.

2. Line two baking sheets with parchment paper. Whisk the flour, flaxseed, baking powder, baking soda, cinnamon, nutmeg and salt together in a large bowl.  Add the quinoa and whisk to coat all of the grains with the flour mixture.

3. Using an electric mixer, beat the coconut oil and sugar together until well combined.  Beat in the Spiced Apple yogurt, egg and vanilla.  Squeeze all of the water out of the grated apple and add the apple to the wet ingredients, mixing to combine.

4. Add the flour mixture to the mixer and mix until just combined.

5. Spoon the dough (about 2 tablespoons each) onto the prepared sheets.  Flatten them slightly with your a drinking glass. Butter the bottom and dip in sugar. Redid after each flattening.  Bake until golden, 15-18 minutes.  Transfer cookies to a wire rack and let cool.

6. To make the Vanilla Maple Drizzle, stir the vanilla yogurt and maple syrup together in a bowl.  Drizzle the glaze onto the cookies with a spoon.  Alternatively, you can pipe the glaze on.  To do this, pour the glaze into a small plastic bag and seal it.  Cut off a tiny corner and squeeze to drizzle the glaze on the cookies.  Store cooled cookies in an airtight container in the refrigerator.

Notes:

* I used Granny Smith

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Firehose Bags

Written by Tad. Posted in Trauma Strap Bags

My friend, Eric, came to own several firehoses. Though they had never been used, they were worthless unless someone could come up with an idea for repurposing. He offered one to me to see if they could be made into a bag. I was skeptical but gave it a try. Though they presented some interesting challenges, here is what I came up with on first pass:

First, what the firehose looks like:

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What the bags looked like:

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And it made me happy:

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And it made Eric happy:

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Oh, and here is a salt shaker I made out of the nozzle and a connector:

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Thirty-two to One

Written by Tad. Posted in Kooks

Emergency department staff deal with a lot of stressful situations. We kind of get used to it, after a while, so most of it doesn’t get to us. Only rarely is something so emotionally traumatic that it really rocks the whole department and each staff member personally. Let me tell you about what I think if one of the most stressful things we encounter in our job.

As I was walking in for my shift, there was a huge commotion going on in Room 6A. I quickly learned they were trying to resuscitate a nine-month old baby boy who had been found unresponsive at home by family members.

I put down my ice chest and Timbuk2 bag and slipped in to see if there was something I could do to help. It is hard for me to adequately describe what was going on. This is as stressful a situation as arises in the emergency department. A baby is dead or trying to die. Everyone is doing everything possible to save a little life with so much potential. Every thing that needs to be done on such a little thing is more difficult than in most adults. IVs are hard to start. The breathing tube is hard to get into such a little windpipe. CPR is difficult to do correctly. It is really challenging and the stress brings appropriate emotions to the surface.

At the bedside were two emergency physicians, an emergency medicine resident (specialist in training,) and two pediatricians. In addition, there were nurses, emergency department technicians, clerks, radiology technicians, and other curious staff. At one point, I counted thirty-two people in the room. I then walked out into the hall and counted sixteen more there, mostly cops and paramedics. You can imagine what a crazy scene that is and that nothing else was going on in any other part of the emergency department.

The team worked well together but, in spite of all of their efforts, there was no response and no signs of life. The resuscitative efforts were ended. That left the emergency physicians with the painful job of telling the family their baby was dead, which is one of the hardest things we ever have to do.

After the shift ended, those caring for the baby had a debriefing session where they could talk about things a bit and make sure everyone was OK. Since we almost never find that necessary, this illustrates how unusual and stressful a baby’s death is for us in the emergency department.

In deaths that are obviously from natural causes, we encourage family members to come see the patient before the body is carried off to the morgue. But in situations like this, there is always the suspicion of non-accidental death so the police treat everything like a crime scene. They won’t let any family members near the baby. That makes it really hard for the family and also for staff to start to come to a resolution. It is really tough.

 

Ranger Bars

Written by Tad. Posted in Cookies

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When I offered these to Dr. Pete last night, he asked what was in them. When I told him, he said he needed to time eating them, implying that he wanted to get home before the prunes worked on him. Why is it that prunes have such a functional reputation? Please don’t wait until you have bowel problems to try these delicious cookies.

These cookies are very moist, soft and very sweet. They were well received by the staff in the emergency department.

Recipe By:

San Jose Mercury News

Yield:

24

Ingredients:

2 cups flour, plus 2 tablespoons
2 teaspoons baking soda
1 1/2 teaspoons ground ginger
2 teaspoons cinnamon
1/4 teaspoon salt
9 tablespoons unsalted butter, at room temperature
1 cup light brown sugar, lightly packed
1 large egg
1/4 cup unsulphured molasses
1 1/2 cups prunes, chopped
3/4 cup raisins

  Directions:

1. Heat oven to 375 degrees. Line a baking sheet with parchment paper.

2. Sift together flour, baking soda, ginger, cinnamon and salt. Set aside.

3. Using an electric mixer, beat together butter and sugar.

4. Add egg and beat until combined.

5. Add molasses and beat, scraping down sides of bowl.

6. Slowly add dry ingredients, chopped prunes and raisins.

7. Mix until dough comes together, about 1 minute.

8. Divide dough in half. Shape each half into a log that is 12 inches long and 1½ inches in diameter.

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9. Arrange logs on prepared baking sheet, 3 inches apart. * SEE NOTE

10. Bake until golden and puffy in the center, but still very soft to the touch, about 20 minutes. The logs will flatten out as they bake. Cool logs on baking sheet.

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11. Slice into 1-inch pieces on a slight diagonal.

Notes:

* I found this to be a lot harder than you would think from the way this is written. The dough is very soft and sticky. I had to put the dough into plastic wrap in order to form the log, the carefully roll the log our of the plastic wrap onto the parchment. Don’t even think of trying to move or reposition the log after it is down on the parchment. This was such a pain that, next time, I would just try scooping them with a cookie scoop.

 

 

Is this You on TV?

Written by Tad. Posted in Kooks

At work this week, I took care of a middle-aged man who, as he left his house to go to work early in the morning, was beaten about the face and stabbed. He had three serious stab wounds on the L side of his abdomen and flank. The middle one had guts hanging out of it, which is a clear indication for going to the operating room. The surgeons have to cut him open, look around inside, clean every thing up, put things back in place and, most importantly, check for injuries to the bowel and other organs. Oh, and sew him back together again.

As the patient went off to the operating room, I walked out of the trauma room into the hall. I was approached by two young police officers with their standard question in such situations: Does he have life-threatening injuries? They need to know this because the way they proceed with the crime investigation is different if they think it might be murder as apposed to just assault.

After I told them the patient would probably be OK but there was no guarantee, one of the two officers asked me if he could ask me an unrelated question. He then took out his phone, pulled up several pictures he had taken of a talking head on TV and asked, “Is this you?” As he scrolled through the pictures, he told me that when this guy came up on TV, he thought, “That has to be that doctor in the emergency room!” He then took a bunch of pictures because, by his own admission, he was so excited about it. He was paying more attention to the picture taking than to the show so he was not even able to say who the TV said the guy was.

He seemed pretty disappointed when I assured him I was not the guy on TV. “I can see the resemblance,” I said, mostly to make him feel better. “But I am a lot more handsome than he is.” The cop laughed, as did his partner who added that he agreed.

It was pretty funny and I was surprised that a cop, who I would never have even recognized, would have been taking pictures of someone on his TV because he thought he was taking pictures of me.

 

Padded Blue and Black Bag

Written by Tad. Posted in Trauma Strap Bags

I mentioned before that I got some padding at Fabmo. Here is a bag that has padding sewn between the layers of the bottom and the first two rows of straps on the sides. The rest of the rows are made of double straps so it is heavy, thick and supports itself to stand up very well.

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Three guys in the Solarium

Written by Tad. Posted in Kooks

We used to put drunks in the little anteroom at the ambulance entrance. I lovingly called it “The Solarium.” The word “solarium” comes from the Latin, sol, meaning sun. I think I picked that name with obvious irony, given I only work at night.

Usually, the drunks would just sleep there until they woke up and could walk. One night, three drunks who were parked in the solarium didn’t follow this predictable pattern. I recorded the interesting problems that each presented.

First was a skinny, young guy with scrapes on his knees and elbows. He was brought in by ambulance after he was found on the ground, intoxicated. He was too drunk to safely walk but he kept trying to get out of bed. We were worried he might fall so he had to be restrained for his protection. When his ankles and wrists were tied to the bed, he went ballistic.

It is not unusual for us to have to restrain and sedate intoxicated people for their protection. I ordered a shot of droperidol, a commonly used sedative.

He relaxed a little after the shot but soon got more agitated. I thought he just needed more droperidol. He was given another shot but got even worse after that was given.

I then wondered if he were having what is called an extra-pyramidal reaction, a common side effect from this medication. The antidote for an extra-pyramidal reaction is a shot of Benadryl, which he got.

Rather than settle down, as I had expected, he got worse still. The Benadryl was repeated. He got even worse still. His pulse went up to 190. He was sweaty and agitated and wouldn’t talk. He pulled violently against his leather restraints.

I was then worried he might have some other medical condition, rather than just being drunk. Laboratory tests and a toxicology screen were ordered. His alcohol level was 215. (Remember that 80 is driving limit in our fair state.) That is high but I didn’t think it high enough to explain what was going on. Everything else came back normal.

Eight hours later, he sobered up and said he freaked out because he just hates to be restrained. He got himself dressed and walked out perfectly fine.

 

Next was a sixty-year-old man with huge belly. He was also brought in by ambulance for intoxication. He was unable to talk clearly.  He was watched until he was perfectly awake but still had unintelligible speech and could not walk. I noted a broken-down wheel chair at his bedside so wondered if he usually was unable to walk. He couldn’t tell me and he had never been to our hospital before so we had no old records on him. I offered him paper and pencil but he was not able to write, either. I then was concerned because I was not able to determine if this condition was from some old problem like a stroke or if he might be having some new, worrisome illness. What a nightmare!

I ordered tests on him that all came back normal. He still was not able to talk. I made a plan to just keep an eye on him over night and see if social services could find out something about him in the morning.

Eight hours later, he was sober enough to communicate. He told me he was fine and walked well enough to be discharged. He left, pushing his wheelchair in front of him.

 

Finally, I had a man in his 20s who had walked into jail then collapsed, unable to stand or walk. The jail nurse refused to accept him and the arresting officer loaded him into her patrol car and brought him to us.

The officer said he had been walking and talking when she arrested him and she felt he was faking. After I examined him, I was also suspicious he was pretending. He wouldn’t stand or walk but woke up when smelling salts were placed under his nose. When we forced him to stand, he let himself go to ground. We picked him up and put him back in the bed to sleep. Later, the officer called me when he climbed back onto the floor. When instructed to do so, he got up and crawled onto bed without any difficulty but would still not stand or walk.  The poor officer was super frustrated. She wanted to just give him a citation and leave him but, because she didn’t know his name, she was not able to just cite and release him. She had to sit with him all night long until he was sober enough to get up and walk out to the patrol car, still refusing to give his name.

 

$250.00 Plus Cookies

Written by Tad. Posted in Cookies

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I want to tell you about the cookies I made today to take to the emergency department. These cookies were wonderful but could never be recreated. Let me tell you why.

I was organizing my cupboard and was embarrassed to find a few things I really wanted to get rid of so I decided to put them in cookies.

1. Almost a pound of See’s Bordeaux. These are my wife’s favorite. I bought them for her for her birthday. She enjoyed a few then renewed her dietary determinations and never ate them. After six months, they were hard and not fit to eat.

2. A bag of Cadbury caramel-filled chocolate eggs. I guess I bought them on sale after last Easter. After almost nine months in the cupboard, something needed to be done with them.

3. Half a milk chocolate-bacon bar. I bought this on a lark. Even though it was good chocolate, I didn’t like it enough to finish it off.

4. A blob of left-over filling from the Chocolate Chipotle Cookies With Smoky Salted Caramel that I recently posted.

So, I had my goodies identified. What recipe to put them in? I went to my blog and took a look at all the recipes I have posted to find a good candidate. As if happens, the first recipe on the list is $250.00 Cookies. They are pretty basic oatmeal chocolate chip cookies but they also call for shredded milk chocolate. A great target for my creative cupboard cleaning.

I mixed up the butter, sugars, eggs and vanilla, just like usual. Then I chopped up the caramel-milk chocolate eggs and the bacon chocolate bar. I threw the Bordeaux into the food processor and, since they were dry, they ended up almost powdered. I then threw the chopped eggs, the bacon chocolate bits, the powdered Bordeaux and the blob of left-over filling into the butter mixture. I then mixed them in really well.

I followed this with the powdered ingredients, then the chocolate chips, as usual in the recipe.

I scooped them and baked then as recommended in the recipe.

They came wonderfully. They are good looking cookies. They are very sweet and have a nice chew. And, they can never be reproduced.

This is one of the reasons I like baking cookies so much. You can follow a recipe exactly for the exact result every time. Or, you can scheme on something crazy and see how it turns out. What fun!

 

Copyright © 2014 Bad Tad, MD