Rape and Threats of Suicide

Written by Tad. Posted in Kooks

When a rape is reported somewhere in our county, police investigate and, if they think a forensic rape exam is indicated, the patient is brought to our emergency department for that exam. The victim is not seen by our emergency physician unless some issue comes up that the specially trained Sexual Assault Response Team (SART) nurse is not able to deal with.

Recently, while the SART nurse was doing the exam, the patient said that being raped had made her suicidal and, when she got back home, she was going to kill herself.

This information was passed to me and I went to talk with her. She was emotionally upset, as you can imagine. She admitted to saying she was going to kill herself but she had just said it because she was upset, not because she was going to follow through on the threat. She just wanted to go home.

This put me in a tough position. By law, if I think patients are suicidal, I have to place them on a psychiatric hold and get them to our psychiatric emergency room for help. If I don’t do so, I have broken the law. This also offers a challenging moral dilemma. If I sent such a person home and she did kill herself, I would certainly be at fault and would feel terrible about it.

We see people all the time who come in on a hold with clear documentation of suicidal behavior who totally deny it once they get to the emergency department. They either change their minds or they lie because they just don’t want to be on a hold. Was this patient like them or was she really just upset and misunderstood by the SART nurse? I had to decide whether to believe that she had just said something that she didn’t mean and let her go home or put her on a hold and send her to emergency psychiatry.

After talking to her for quite a while, I told her I was obliged, under law, to send her to psychiatry to get her help that would not be available if she just went home. When I told her that, she pleaded and begged to be allowed to go home. When that didn’t work, she went ballistic and started hollering and screaming that she was just going to leave.

When she went off, the staff called security. Soon, three big guys in blue uniforms were standing at the door of her room, which only made her more hysterical.

You can imagine how bad I felt. First, she is raped, which is horrible. Now, instead of the calm, understanding environment we try to provide victims of rape, we are threatening to tie her down to a gurney with leather restraints. It made me feel really bad, though I recognized I made the right decision, given the circumstances presented.

Fortunately, she quieted down and went peacefully off to talk with the psychiatrist. When she got there, she was calm and cooperative. She told the psychiatrist she felt safe and was glad she was there. She acknowledged she really needed help.

 

Trauma Strap Chimp Swing

Written by Tad. Posted in Trauma Strap Bags

Susan took trauma straps with her to a chimpanzee reserve in Gabon. She shared these pictures of baby chimps swinging on the straps. What a great use of these straps that otherwise would have ended up in the trash!

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Sincere Apology

Written by Tad. Posted in Kooks

I was just looking back at my last few posts. They are pretty sad. I decided to share this with you as it lifts my heart a bit.

This is a letter that was mailed to our department from a patient. I think it speaks for itself:

To the Emergency Room Staff of The Medical Center

My name is John Smith. I was a patient at your hospital the night of July 4th, 2008. I am writing this letter to apologize for my verbal and physical abuse to the members of the staff working that night. I have to admit that I do not remember much of what happened that night due to being extremely intoxicated. I am told that I made threats to kill and that I was spitting on staff members. I cannot capture with words how sorry I am for saying those hurtful things and spitting on people that were only trying to help me. I am extremely embarrassed about my behavior and will be paying for it for a long time to come. You guys have a hard enough job as it is and the last thing you need is some drunk kid making that job even harder. I obviously was having a problem with my drinking and it turned me into a person that I never want to be. I have a long road to recovery ahead of me. I understand that forgiveness might be out of the question for some of you, but I hope that in time you can find it in your heart to forgive me. I would never knowingly want to hurt anyone that is trying to help me and feel a great amount of shame for acting as I did. I just want to say sorry and thank you, thank you for helping somebody who needed it whether they knew it or not.

 

Double Chocolate Anise Cookies

Written by Tad. Posted in Cookies

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Recipe By: recipe4living.com

Ingredients:

2 cups flour
1 cup cocoa
1 teaspoon cinnamon
1 teaspoon baking soda
1/2 teaspoon salt
1 1/4 cups butter, softened
2 cups sugar
2 eggs
1 1/2 teaspoon anise extract
1 teaspoon vanilla extract
1 1/2 cups semi sweet chocolate chips
1 1/2 cups chopped walnuts (optional)

Directions:

1. Preheat oven to 350 degrees.

2. Mix together flour, cocoa, cinnamon, baking soda and salt. Set aside.

3. In a separate mixing bowl, beat butter and sugar until fluffy. Add eggs, anise and vanilla. Beat well.

4. Gradually add flour mixture, beating well.

5. Stir in morsels and walnuts.

6. Drop by rounded teaspoonfuls onto ungreased cookie sheets. Bake 8-10 minutes. Do not over bake. Cool on cookie sheets 5 minutes. Remove to wire rack. Cool completely.

What a Mess

Written by Tad. Posted in Uncategorized

If you look at all the great cookies recipes I have shared on this blog, you might get the idea I am an expert and alway make perfect cookies. Not so. Thursday, I had a cookie catastrophe. I took the recipe for Chewy Oatmeal Cherry Toffee Chocolate Chip Crisps. I made them exactly by the recipe except that I substituted three cups of cooked quinoa (left over from cookies from two weeks ago) for the oats. The original cookies needed to be flattened a bit before cooking. These spread out and ran together, almost forming a sheet cake. Even when I let them cook long enough that they were dark brown, they were still soft. When I scraped them off of the parchment with a spatula, they came off like putty or clay. I put them in a big Tupperware in the refrigerator where they formed one, big, amorphous blob. There they sit, teasing me with the challenge of coming up with something to do with it. I quickly made up a batch of Tad’s Oatmeal Chocolate Chip Cookies to take to the hospital.

Lesson learned: you can’t just substitute quinoa for oats.

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A Mother’s Day Fire Hose Bag

Written by Tad. Posted in Trauma Strap Bags

Here is the bag I made for my mother for Mother’s Day. The blue straps are an unusual color and I used every inch of that type of strap I had to make the bag. In fact, I used short handles because I didn’t have enough of the blue to make two long handles.

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My New PR Guy

Written by Tad. Posted in Uncategorized

I just hired a PR guy to help me promote my cookies. Here is what I am going to put on every bag of cookies I make from now on:

The Art of the Cookie

Begin with a baker’s soul. Seek the finest ingredients. Explore nature’s infinite variety of flavors and textures – crunchy, sweet, rich… oh, and chocolate.

Entertain inspirations. Embrace decadent cravings. Reward yourself. Open…Taste…Delight.

 

Actually, I got this off a package of Pepperidge Farms cookies someone left lying around the emergency department. Who the heck writes stuff like this?

 

University of Virginia Graduation Bags

Written by Tad. Posted in Trauma Strap Bags

Our son, Philip graduated in May from University of Virginia. I made three bags to give to the families of three of his classmates. These bags are the perfect color and, which the logo decals, look like they might have come right out of the UVA bookstore.

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Bon Appetit’s Best Peanut Butter Cookies

Written by Tad. Posted in Cookies

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I am not a big fan of peanut butter cookies but these are good. They are quite a bit more complicated to make that “normal” peanut butter cookies so you will have to make them and decide if it is worth the effort or not. I got this recipe from our son’s mother-in-law. I had it quite a while before I got around to making it but I finally did and it was fun.

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Recipe By:

Sandy

Serving Size:

24

Ingredients:

½ cup roasted salted peanuts
6 tablespoons butter
¾ cup all-purpose flour
¾ teaspoon kosher salt
½ teaspoon baking powder
¼ teaspoon baking soda
1 large egg
1 large egg yolk
1 teaspoon vanilla
¾ cup granulated sugar
½ cup light brown sugar
¼ cup water
16 ounces all-natural creamy peanut butter
Demerara or raw sugar,  for sprinkling
Flaky sea salt , for sprinkling

Directions:

1. Heat oven to 350°. Toast peanuts on a rimmed baking sheet until browned and fragrant, 6–8 minutes. Let cool, then coarsely chop.

2. Meanwhile, cook butter in a medium skillet over medium heat, swirling pan often, until butter foams, then browns, 4–6 minutes. Transfer brown butter with solids to a medium bow. Chill, stirring every 5 minutes, until cooled and beginning to solidify, about 15 minutes.

3.  Whisk flour, kosher salt, baking powder, and baking soda in another medium bowl. Set aside.

4. Using an electric mixer on high speed, beat egg, egg yolk, vanilla, granulated sugar, brown sugar, and ¼ cup water in a large bowl until mixture is light and falls back on itself in a slowly dissolving ribbon, about 2 minutes.

5. Reduce mixer speed to low and gradually add dry ingredients, then increase speed to high and beat 1 minute to develop gluten and hydrate flour.

6. Add peanut butter, toasted peanuts, and brown butter. Mix on low speed, scraping down sides of bowl as needed, until fully incorporated, about 30 seconds. Let dough rest at room temperature until slightly firmed up, about 10 minutes.

7.  Portion dough into 2 tablespoon balls and transfer to 2 parchment-lined rimmed baking sheets. Using the tines of a fork, dipped in cold water, flatten cookies to ½” thick, making a crosshatch pattern on the top of each. Chill, covered, 1 hour.

8. Arrange racks in upper and lower thirds of oven; place a dry, medium skillet on the bottom rack, then increase oven temperature to 375°.

9.  Sprinkle cookies with demerara sugar and sea salt.

10. Working quickly, transfer one sheet of cookies to upper rack, then carefully pour 1 cup water into hot skillet. Water will bubble and sizzle violently. Bake cookies until browned and edges are crisp, 12–15 minutes. Let cool slightly on baking sheet, then transfer to a wire rack and cool completely. Repeat with second sheet.

Notes:

Cookie dough can be shaped and frozen 1 month ahead. Freeze in an airtight container. Let rest at room temperature 1 hour before baking.

Copyright © 2014 Bad Tad, MD