A fourteen-year-old girl was the driver of a car that was involved in a motor vehicle accident. She was driving the car at a high rate of speed on the freeway. When the highway patrol went to pull her over, she tried to outrun them and ended up running into the concrete divider of the freeway. She and her passengers were brought in as trauma patients.

The driver was severely injured as were the two severely intoxicated adult male passengers. The patient was admitted to the hospital with her jaw broken in two places, a severe ankle sprain and lacerations on her face. Her blood alcohol level was negative so she had not been drinking but she seemed to be a poor choice for a designated driver.

Most of my bags are simple with non-closing, oblong openings. I bought some zippers and messed around making bags that would accommodate them. As us usually the case with such endeavors, the first bag was OK and each subsequent was better.

I am always looking out for a new cookie recipe to try. One thing that will catch my attention is a weird ingredient. That is what caught my attention in this recipe.

Adapted from: Raley’s/Nob Hill Magazine

Serving Size: 24

 Ingredients:

1 cup brown sugar

1/2 cup peanut butter

1/2 cup butter, softened

1 teaspoon vanilla

1 large egg

1  1/4 cups flour

1 teaspoon soda

2 cups Cocoa Puffs Cereal

2 cups chocolate chips

2 teaspoons shortening

Directions:

1. Heat oven to 350°F.

2. Line two baking sheets with parchment paper.

3. With a mixer on high, whip peanut butter and butter. Stir in sugar. Stir in vanilla and egg. Mix until creamy.

4. Combine flour and baking soda. Stir into sugar mixture.

5. Stir in cereal just until combined.

6. Shape into balls and place on prepared cookie sheets about 2 inches apart.

7. Bake for 10 to 12 minutes or until light golden brown.

8. Remove to racks to cool completely.

9. Place chocolate chips and shortening in double boiler over boiling water.

10. Stir while heating until melted and smooth.

11. Remove from heat and continue to stir while it cools some more.

12. Dip half of cooled cookie in chocolate, scrape the excess off the bottom and place on wax paper to dry.

 Notes:

Original recipe called for microwaving the chocolate and shortening which does work. I just like the control of the double boiler better.

I have made these buy just throwing in the unmelted chocolate chips with the cereal and omitting the shortening. They were good but the were much richer and more impressive to look at and eat when dipped in the melted chocolate.

People in ED went crazy over them though no one could guess they had Cocoa Puffs in them. I tripled the batch for ED.

This is, word for word, the note I wrote on this patient’s chart:

Family members called the ambulance when they found the patient chewing on her fingers today. The patient is demented, bedridden and completely dependent for all of her care. She was reportedly more agitated lately including spitting and chewing on things like her blankets. She had no history of self-mutilation but today the patient’s temporary caretaker found her chewing on her hands. The daughter, who normally cares for the patient, is ill herself and hospitalized elsewhere.

On the left hand, fingers 2 to 5 (index, long, ring and pinky) have extensive soft tissue damage. The fifth finger is essentially chewed off with just a strip of tissue left attaching it to the hand. Bones are visible in the other fingers with considerable amount of soft tissue damage present.

The patient went to the operating room for amputation of the fingers.

I don’t remember where I got this recipe but it is one of our favorites. The chocolate is rich but not too dark. They are nice and sweet but the tartness of the cherries contrasts the sweetness very nicely. They have a great texture. I buy several bags of the dried cherries at Costco when they have them. They don’t spread out too much and are firm enough to survive the trip to the emergency department.

Serving Size: 60 cookies

 Ingredients:

3 cups flour, 13 1/2 ounces

1 cup cocoa, 2 3/4 ounces

1 1/2 teaspoons baking powder

3/4 teaspoon baking soda

3/4 teaspoon salt

3 cups sugar

1 cup butter, softened

1 tablespoon vanilla

3 large eggs

2 cups dried cherries, 14 ounces

2 cups chocolate chips, 14 ounces

 Directions:

1. Heat oven to 350 degrees

2. Combine flour, cocoa, baking powder, baking soda, and salt. Set aside. (I like to do this with my fingers. It just feels good.)

3. Place sugar and butter in a large bowl. Beat with a mixer at high speed until well blended.

4. Add vanilla and eggs. Beat well.

5. With mixer on low speed, gradually add flour mixture. Beat just until combined.

6. Stir in cherries and chocolate chips until just combined.

7. Place scoops of cookie dough 2 inches apart onto prepared baking sheets.

8. Bake for 12 minutes or just until set. Remove from oven. Cool on pans until set.

I am most proud of a couple of these I made. Part of the reason is they turned out really nice. In addition, it was really a pain to make them. Getting the diagonal straps to line up evenly was difficult. Then I had to get the tube that forms the sides be the right size for the bottom. Pat, one of our dayshift nurses, got the best one and every time I see her carrying it, I am quite pleased and tell her she has the best bag I ever made.

I love caramel. I have been trying for years to make good cookies containing or tasting like caramel. I have tried caramelizing the sugar, which was a huge pain and changed the flavor but didn’t give that wonderful chew that caramel candy has. I bought caramel-flavored syrup, which was horrible. I added caramel ice cream sauce in place of maple syrup, which tasted good but I was not pleased with the texture. The best I have ever been able to do is buy a Peter’s caramel log from Cash and Carry, cut off pieces and plop one on top of each cookie a couple of minutes before they come out of the oven. This was especially fabulous with the coconut version of Tad’s Oatmeal Chocolate Chip cookies.

This recipe is fun because the marshmallows melt and caramelize while they bake.

Recipe adapted from: Raley’s/Nob Hill Magazine

Yield: 48

 Ingredients:

20 ounce chocolate chips, divided

1 cup butter

2 cups sugar

1 tablespoon vanilla

4 large eggs

3 cups flour, 13.5 ounces

2 tablespoon coffee grounds or espresso powder

1 teaspoon baking powder

3 cups miniature marshmallows

Directions:

1. Heat oven to 350 degrees.

2. Melt butter and 10 ounces of chocolate chips in microwave until melted but not hot. Stir to combine. Set aside.

3. Stir together sugar, eggs and vanilla until smooth and fluffy.

4. Stir in chocolate mixture.

5. In separate bowl, combine flour, baking powder and coffee.

6. Combine butter mixture and flour mixture.

7. Stir in remaining chocolate chips and marshmallows.

8. Scoop onto prepared baking sheets.

9. Bake 10 to 12 minutes.

Note:

The original recipe called for refrigerating the dough. When I did this, it came out hard as a rock. If you are going to refrigerate them, you need to scoop them first.

A young Hispanic man came in telling the nurse he had fallen and been poked in the buttock four days before. He was worried the wound might now be infected.

When I reviewed the story with him, he corroborated the nurse’s note, adding nothing else. Though I speak Spanish fluently, I didn’t have the vocabulary to understand just what it was he landed on. I decided it probably didn’t really matter.

At my instruction, he pulled down his pants and rolled over. He showed me a puncture wound on his left buttock. It was healing nicely and showed no signs of infection.

As I went to reassure him there was no infection, a little something prompted me to wonder if there might be something else going on. I asked him if he thought it possible that a piece of whatever he landed on might have broken off inside him. He answered affirmatively and I sent him off for an x-ray of the area. I had the idea there might be a small chip of metal under his skin causing him some discomfort.

A few minutes later, the x-ray technician called me in to have a look at the x-ray. She was as amazed as I was to see the outline of a metal bar almost an inch in diameter that looked like a round file. One end was right under the skin where he had the wound. The other end disappeared off the film heading towards his pelvis.

We called him back to x-ray where more films showed the metal went clear up into his pelvis. The other end of the file was sitting right in the middle of his bladder!

When I went to show him the x-rays and explain my plan to get it out, I asked him if he had been having any blood in his urine to which he sheepishly admitted.

I called the urologist to our assistance. They took him to the operating room and put him to sleep. They passed a scope into his bladder and took pictures, which he later shared with me. They showed the file coming up out of the floor of his bladder like an empty flagpole. He then cut into the patient’s buttock, grabbed the file with some pliers and, with some effort, pulled it out. The scope was then reinserted to make sure no repair was needed. He was kept in the hospital for a couple of days and left, good as new.

When I see things like this, I frequently ask myself, “What if…?”

He landed on this huge bar with such force it went up through his skin, the muscle of his buttock and the floor of the pelvis before it broke off. It entered the pelvis just off the midline. Had it passed through the center, it could have destroyed many important midline structures. The base of the penis with its blood supply and nerves important for erectile function, the urethra where the urine passes from the bladder to the penis, the prostate, and the rectum were all at great risk in an injury like this. He might have suffered some injury that could have caused him a lot of trouble for the rest of his life. Instead, he was just fine. I wonder how much he appreciates what good luck accompanied the bad luck that caused his injury that day.

This week, I thought I would show the largest and smallest bags I ever made. The size of the large one was determined by the mesh materiel with a draw string I salvaged from another bag. It ended up so huge, I didn’t know what the heck to do with it. Then one of our registration clerks said she would like a large bag for her kids beach stuff. Viola. An appreciative home for it.

The small bag was made to hold just what we need to take to the gym: car keys, wallet, phones, gym passes, gloves.

I don’t really like butterscotch chips or pecans but they are fabulous in these wonderful cookies!

Source:

This recipe was forwarded to me by my daughter, McKenzie. It was originally from King Arthur Flour Company

Yield:

4 dozen 3″ cookies

 Ingredients:

1  1/3 cups pecan halves

2/3 cup light brown sugar, firmly packed

2/3 cup granulated sugar

1/2 cup butter

1/2 cup vegetable shortening

1/2 teaspoon salt

1/2 teaspoon espresso powder

1 teaspoon baking soda

2 teaspoons vanilla extract

3/4 teaspoon butterscotch, vanilla-butternut, or butter-rum flavor

1 teaspoon vinegar, cider or white

1 large egg

2 cups King Arthur Unbleached All-Purpose Flour, 9 ounces

1  1/3 cups butterscotch chips, 11 ounces

2/3 cup granulated sugar

2 teaspoons salt

Directions:

1) Heat the oven to 375°. Prepare two baking sheets.

2) Place the pecans in a single layer in a pan and toast until darkened a bit and smelling toasty, about 8 to 9 minutes. Set aside.

3) In a large bowl, combine the brown sugar, 2/3 cup sugar, butter, shortening, salt, espresso powder, baking soda, vanilla, second flavor and vinegar. Beat until smooth and creamy.

4) Beat in the egg, again beating until smooth. Scrape the bottom and sides of the bowl with a spatula to make sure everything is thoroughly combined.

5) Mix in the flour then the chips and nuts.

6) If you’re going to refrigerate the dough, cover with plastic wrap and refrigerate for about 4 to 5 hours or overnight. Cookie dough refrigerated for 3 1/2 to 4 hours will spread moderately; chilled overnight, it will spread much less.

7) Mix the second 2/3 cup sugar and 2 teaspoons salt for the coating in a bowl. Scoop 1 1/2″ balls of dough into the sugar/salt mixture, rolling to coat. Transfer to the prepared baking sheets, leaving 2″ between them on all sides.

8 ) Bake the cookies for 10 to 11 minutes. Their edges will be chestnut brown and their tops a lighter golden brown. (For dough that’s been refrigerated, add 30 seconds to 1 minute to those baking times.) Remove them from the oven and cool on the pan until they’ve set enough to move without breaking.

 Notes:

I used regular, all purpose flour. I used raw sugar for the coating, which made them a bit crunchier. I didn’t refrigerate the dough and they came out great though the balls were a bit dicey to handle while dipping and placing on the baking sheets.

I bought the vanilla-butternut flavoring on line from, who else but King Arthur Flour Company