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.

Recipe By:

Liz Harris

 Ingredients:

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*

 Directions:

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.

Notes:

* 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.

Makes:

24 cookies

Ingredients:

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

Instructions:

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.

Notes:

* I used a glass, buttered on the bottom and dipped in sugar.

The woman was middle aged. Her presenting complaint was “Eye Problem.” She was ill-kept, making me think she might be homeless. She said she had been having “parasites” coming out of her eyes for a long time. At first, they were right inside her eyes and now, they were in the eyelids. Sometimes they were black and other times they were white, shaped like a string, probably when they were laying eggs. She had seen many doctors before but no one had ever been able to help her. It was unclear why she had decided to try again that night.

I talked to her for quite a while, looked at her eyes and skin, and then gave my honest impression. Her complaints didn’t fit any sort of parasite infection I was familiar with and I was not going to be able to help her. I told her it was probably all in her head, though I could be wrong and maybe some day somebody would discover with what she was infested.

I shared with her information on finding a doctor in a clinic, reassured her and sent her on her way.

The very next patient I went to see was listed as “Rash.” In the room was a man who was about the same age and apparent social status as the lady with the eye parasites though I made no connection between the two. He launched into a prolonged story about being infested with mites. He told me how they migrated around his body, showing up in different places at different times and looking different as they moved around and came out of his skin.

When I had heard enough and looked at his “rash,” I started into my “you may have something but it is probably all in your head” explanation when I was interrupted by someone in the hallway outside the room.

“He don’t believe us! He ain’t gonna do nothin’ for us!” It was the lady! They were living together on the streets and had developed a shared delusion about being infected with parasites.

I went over things with them, again, and they left, complaining that nobody ever believed them.

Here is a link to our old friend, Wikipedia, to explain that this sort of shared delusion is a well-described condition: http://en.wikipedia.org/wiki/Folie_à_deux

This reference has a couple of case studies that provide insight into how this can present itself: http://www.minddisorders.com/Py-Z/Shared-psychotic-disorder.html#b