When on vacation in the Florida Keys last week, we were always on the lookout for wildlife. We saw many birds and fish and even got a good close look at some manatees. We had our eyes open for alligators and were amazed that, when we finally found one, it had a Tad Bag in its mouth!
Actually, the story about the trip to the Keys is true but this is another fun picture sent in by Daniel, the guy who helped keep me from going insane when I was learning to use our new computer system.
I don’t know where I got this recipe so I can’t give anyone credit. Sorry. They are tasty but very soft and tender. If you like your cookies to be cake-like, these are for you. The glaze here is doubled from the original as I always run out of glaze and I don’t want you to have that same frustration.
Ingredients:
2½ cups all-purpose flour
1 teaspoon baking powder
1 teaspoon salt
4 ounces butter, softened
2 cups sugar
2 eggs
15 ounces whole milk ricotta cheese
3 tablespoons lemon juice
zest of one lemon
3 cups powdered sugar
6 tablespoons lemon juice
zest of two lemons
Directions:
Heat the oven to 375 degrees F.
In a medium bowl, combine flour, baking powder and salt. Set aside.
In a large bowl beat butter and sugar until light and fluffy, about 3 minutes.
Beat in eggs, one at a time, until incorporated.
Beat in ricotta cheese, 3 tablespoons of lemon juice, and zest of one lemon.
Stir in dry ingredients.
Line baking sheets with parchment paper. Spoon about 2 tablespoons of dough for each cookie onto baking sheets. Bake for 15 minutes, until slightly golden at the edges. Remove from the oven and let rest on the baking sheet for 20 minutes.
Combine powdered sugar, 6 tablespoons of lemon juice, and zest of two lemons in a bowl and stir until smooth. Spoon about one teaspoon onto each cookie and gently spread toward the edges. Let the glaze harden for about 2 hours.
I work in a place where we may see patients from almost anywhere in the world. This richness in humanity is one of the reasons I have stayed working at the same place for almost a quarter of a century. Interacting with people from all over the world is interesting and enriches me. It also presents significant challenges
A Bangladeshi man brought in his elderly mother for evaluation. He made some notes, which he gave to me so I could understand what had been going on with her. He said she had been suffering for forty years with these problems. She had just arrived from Bangladesh a few days before and he brought her in for evaluation. Here is the note he gave me, transcribed as best I can from his neat handwriting:
* IF SHE FEELS HUNGRY, GETTING DISSYNESS.
WANT TO EAT MORE, BUT CANNOT.
EVERY HALF AN HOUR EATING.
JUST LITTLE AMOUNT, WAANT TO EAR MORE.
* BURNING INSIDE STOMACH/ GAS, HOT
* FEELS VOMITING BUT COULDN’T THROUGH UP.
* STOOL IS HARD/ GOING TO THE RESTOON ONCE EVERY AFTER ¾ DAYS
* CAN’T EAT ONLY RICH FISH, VEGETABLE
* IF TAKE PRE-COLEDG (stool softner) GOING TO THE RESTROOM NORMALLY.
* VERY WEAK, SHECKING.
****SLEEP IS NOT ENOUGH/ 4-5 HOURS EVERYDAY
* 4-5 YEARS AGO, GOT LOT OF EXAM FROM HERE. DOCTOR SAID, COULDN’T GET SERIOUS.
ANTHING, ONLY STOMACH/ PARS ARE VERY WEAK
* WANT SOME VITAMINS
You can see that this sort of presentation would be a challenge for any doctor but, as an emergency physician, I need to see through the forty-year-old things and make sure I don’t miss anything that needs to be discovered today. These people and this note represent a part of what makes my job so interesting.
As I have pointed out before, the trauma straps I use to make my bags have a buckle on one end and a tab on the other were the strap is folded back and sewn to itself. I have enjoyed using those tabs as design elements. Here is the first all yellow bag with multiple tabs.
President Obama was in our fair city this week. I became aware of this when it was pointed out to me that there was a Secret Service agent hanging out in our intake room. Since we were one of the designated hospitals to which he might be taken if need arose, they had checked the place out and an agent was hanging out there the night before the visit.
Since it was Thursday night, my cookies were to be had. One of our clerks asked me if she could take one to the agent. After he ate a Wasabi Pea Lace Cookie (recipe to be posted next week) I went to see if he liked it. He said he had never eaten a cookie like that before and said he really liked it. I told him about my blog, pointed out that Michelle Obama’s favorite cookie is one of my postings and jokingly told him to make sure she was aware of that.
He spent quite a while reading my “Kooks” postings and seemed really excited to read about all the crazy stuff we see in the emergency department. It is fun for me to share my cookies and stories with visitors like this.
I wanted to share with you all an amazing medical story that hit close to home for me, though I had nothing to do with it myself.
Our middle daughter’s best friend is Jessi. She recently married a young man named Trevor who was in the throws of trying to get into medical school. He was a healthy young man who had been training all summer for a triathlon.
They were at a family reunion at Bear Lake in northern Utah. He was standing in shallow water next to a ski boat, surrounded by cousins, when he collapsed. Those closest to him kept him from going under the water and hoisted him into the boat.
One of the cousins was a nurse and a second had just recently taken a CPR class. They found him to be unresponsive and with no pulse so they started CPR. This continued for about fifteen minutes until the medics got there. They found him to be in ventricular fibrillation, which is a chaotic heart rhythm that is ineffective in pumping blood and soon leads to death. Fortunately, when they shocked him, just like you see on TV, his heart started beating normally again. He went back into that same deadly rhythm one more time in the helicopter on the way to the hospital. He was shocked again back into a normal rhythm.
I first found out about him when he was in the ICU with his temperature being kept artificially low and in an induced coma. My daughter called and wanted to know what his prognosis was. I told her it was grim. Most people who suffer a cardiac arrest die. Most of those that survive do so with brain injury from lack of oxygen from the time their heart was not beating. I wanted to tell my daughter there was no hope but realized it was time for hope so I didn’t share with her my true, fatalistic expectations.
Trevor remained stable until it was time to warm him up and see if he would awaken. Everyone was hopeful as he immediately started to follow commands and ask what had happened. He soon managed to bend his head down close enough to his restrained hand to pull the ventilator tube out of his windpipe. He then looked up at the nurse and asked, “Where is Jessi?”
By the next day he was eating and asking over and over again, “What happened?” as his short term memory was gone. The next day he was remembering better and was able to be involved as they made the decision to give him an implanted defibrillator. This is a machine, like a pace maker but designed to shock him from inside if his heart goes into that death rhythm again.
Trevor fully recovered. He is in medical school and the father of the child Jessi was carrying when this all happened. This is really an amazing story with an almost unbelievable ending.
I can put myself in the place of the emergency physician who took care of Trevor. I am sure as he was taken out of the emergency department and up to the ICU, the doctor had to be asking if they had really done any good in reviving him or if they had just kept alive a brain-injured nightmare.
In the emergency department, we don’t usually see the whole story and have to keep emotionally distanced to a certain degree as we deal with this sort of difficult situation. This event gave me a chance to be emotionally involved in a way I would never have been able to had this been one of my patients. It helps renew my optimism and not see every patient who survives cardiac arrest as a future vegetable in a nursing home.
Diane A. sent me this picture of her bag enjoying the beach.
I had this recipe for a long time but skipped making them because I have never been a great fan of peanut butter cookies and don’t really like pecans. Still, I love Liz Harris who gave the recipe to me so I finally made them. I ground the pecans pretty finely and used raw sugar to coat them since I was out of turbinado sugar. Turbinado is more interesting than raw sugar so I can see they may be even more interesting with it.
Liz Harris
1 cup butter, softened
2/3 cup peanut butter
2/3 cup sugar
2/3 cup brown sugar
2 large eggs
1 tablespoon vanilla
¼ teaspoon kosher salt
2½ cups flour
1 teaspoon soda
2 cups chocolate chips
2 cups pecans, chopped
1 cup turbinado sugar*
1. Heat oven to 350 degrees.
2. In electric mixer, combine butter, peanut butter and sugars. Whip until fluffy.
3. Add eggs, vanilla and salt. Stir well.
4. On low speed, slowly add flour and soda. Beat for another minute.
5. Stir in chocolate chips and pecans.
6. Form into balls and dip one side of the ball in turbinado sugar. Place on baking sheets lined with parchment paper, sugar side up.
7. Butter the bottom of a glass then dip in sugar. Use it to slightly flatten each dough ball, redipping in sugar after each flattening.
8. Bake for 10 to 12 minutes until bottoms and edges are just brown.
* Raw sugar is good substitute and is readily available.
Our hospital recently installed a new computer system. A young man named Daniel, an employee of the software vendor, spent several nights helping me as I struggled trying to get the hang of a new way of doing business. After he went back to computer land, he was caught on camera using one of my bags to steal a statue. As far as I know, this is the first documentation of one of my bags being used for a nefarious purpose.
These are basically a sugar cookie with a zing from ginger. I made them with lime rather than lemon and they were very good. I might try them with more zest as they were really mostly ginger cookies when made like this. Makes me wonder what my Taku Ginger Cookies would be like with crystalized ginger pressed into the top of them.
24 cookies
½ pound butter at room temperature
¾ cup sugar
3 tablespoons grated fresh ginger
½ teaspoon finely grated lemon zest
5 drops lemon oil, optional
¼ teaspoon dried ground ginger, optional
¼ teaspoon salt
2 large egg yolks
½ teaspoon vanilla extract
2½ cups unbleached all purpose flour, 11¼ ounces
¼ cup crystallized ginger, minced
¼ cup raw sugar
2 egg whites, beaten lightly
1. Heat oven to 350 degrees F. Line baking sheets with parchment.
2. Beat together butter, sugar, fresh ginger, lemon zest and salt. Cream together until light and fluffy, about 2-3 minutes.
3. Scrape down bowl. Add dried ginger, lemon oil, egg yolks and vanilla extract. Beat until combined.
4. Add the flour and mix on low speed until well blended and dough just comes together.
5. Scoop 2-tablespoon balls of the dough and set 1½ inches apart on cookie sheets.
6. Mix together raw sugar and crystallized ginger in a small bowl.
7. Press down on dough balls until flattened to about ¼ inch thick.*
8. Brush with egg whites. Sprinkle with raw sugar/ginger mixture. Pat down with fingertips to get ginger topping to stick.
9. Bake 11 to 13 minutes. Remove from oven. Let cool for five minutes before removing cookies to cool completely on wire racks.
* I used a glass, buttered on the bottom and dipped in sugar.
