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 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.

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.

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.

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.

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.

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.

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.

A middle-aged man with a black eye and scrape over his cheek sat on the gurney, obviously upset. He said he went into the local McDonalds to take a dump. Just as he was settling in to do his duty, a “crazy guy” he had never seen before broke into the stall hollering at him and accusing him of some insult.

The crazy guy got even more upset when my patient denied what he was being accused of and hit him across the face.

It was clear my patient’s face was not seriously harmed, so I asked if he had been injured anywhere else. In response, he pulled the sheet off his lap and showed me a large gash in his leg and a big blood clot on the end of his penis.

My mind started to spin. Something didn’t make sense. The man’s pants were clearly not cut, but he had serious injury to his genitals. I actually opened my mouth to ask him to explain. Then, I remembered an important detail and shut my mouth again. The patient had told me right at the beginning that he was attacked while taking a dump at McDonalds. In that situation, his pants might have been removed from danger but he would have been even more vulnerable.

I have never seen a penis injury like this before. The knife cut the foreskin in two and nipped off the very tip of his penis. It was still bleeding quite a bit.

We cleaned him up. I stitched the laceration on his leg. I put some stuff called Surgicel on the bleeding part of his penis. It helps promote clotting. And I had him hold pressure on it. Then, I made arrangements for him to be taken to a larger hospital for evaluation by a urologist. I really have no idea what sort of treatment they might recommend for this injury. If you cut the tip of your finger off like that, you just need to keep a dressing on it and it will heal up fine. But a nipped penis? I have no idea.

So, lesson learned: keep your pants up when you are taking a dump at McDonalds.

For years, I have been taking cookies to the emergency department. Usually, they are stacked in gallon-sized Zip-Lock bags, carried in my Cookie Bag. The other day, when I came home from the hospital, I noticed that some of the seams were coming apart. I took it to my sewing room to mend it, like I have done with other bags a few times in the past.

As I started to sew up the splitting seams, I was surprised at what happened. The nylon straps just crumbled rather than sew together. The bag was literally falling apart. That lead me to do two things: 1. sew a new bag. 2. look to find out how old the Cookie Bag was.

Looking back, I was able to find a picture of my newly created Cookie bag: 20 August 2012. Almost seven years ago. That bag took a lot of cookies to the ED in its time. Now, it has been replaced. We will see how long this one lasts.

Dead Cookie Bag

Same bag when new in 2012

Replacement Cookie Bag 2019