Poop 1

A 33-year-old man was brought in by his family because of bizarre behavior. They said he had a mental breakdown years ago but had no psychiatric problems or known substance abuse since then.

The family said he was constantly swearing at people and being argumentative. He had also been drinking heavily, which was unusual for him.

I found him to be loud and aggressive. He would not talk with me but demanded I go outside with him to fight. He got more agitated as we talked until he pulled down his pants, defecated in his hand and threw the feces on the floor.

After appropriate sedation, he was taken to emergency psychiatry.

Poop 2

A man in his early twenties came in by ambulance complaining of abdominal pain, nausea and vomiting. I see people all the time with those complaints so I was expecting to see someone with food poisoning, an intestinal virus or something like that. This was different.

The patient told me that after defecating, he scratched an itch on his face by wiping his index finger across his upper lip and nostrils. It was only then he realized his finger was dirty and he had rubbed feces on his face. He immediately developed crampy abdominal pain, nausea and vomiting. By the time I saw him, he had washed up and was feeling fine.

Jessica is very happy to take a bag with her back to SoCal!

I had never heard of schmaltz before coming across this recipe. Yes, it is rendered chicken fat. How could I resist the temptation to try this unusual ingredient?

I first tried to buy schmaltz on the Internet. This is the first cooking ingredient that left me frustrated as I tried to purchase it online. No luck. Then I found we had a kosher grocery not too far from the hospital. I was so excited when I walked out with it and was still excited when I finally got to make them.

Making them cooled my excitement. The schmaltz is very strong smelling and, for me, not at all appetizing for cookies. Still, they turned out well and people liked them, at least before they knew what was in them.

Source:

The Book of Schmaltz: A Love Song to a Forgotten Fat via Epicurius

Yield:

18

Ingredients:

3/4 cup schmaltz, well chilled or frozen

1/2 cup granulated sugar

1/2 cup brown sugar

1 large egg

1 teaspoon pure vanilla extract

1/2 teaspoon cinnamon

1 teaspoon kosher salt

1/2 cups all-purpose flour

1 teaspoon baking powder

2 cups oats

2/3 cups dried cherries or other garnish*

Instructions:

1. Heat oven to 350°F.

2. Cut schmaltz into chunks and put it, along with the sugars, into the bowl of a standing mixer fitted with a paddle. Mix on high until the fat is fluffy, 2 minutes or so.

3. Add egg, vanilla and cinnamon. Mix on low, to incorporate.

4. Combine salt, flour, and baking powder. Add to the mixing bowl. Paddle on medium to combine, 30 seconds or so.

5. Add oats and paddle to combine.

6. Add cherries and paddle to combine.

7. Shape into golf-ball-sized orbs and put on a cookie sheet. Flatten to your desired thickness.** They won’t spread much but they will puff.

8. Bake about 15 minutes.

Notes:

* raisins, dried cranberries, walnuts, pecans or a mixture of any or all of the above

** Remember my recommended method of flattening. Butter the bottom of a glass. Dip in sugar. Flatten the ball of dough. Redip in sugar before flattening the next one.

*** Read More http://www.epicurious.com/recipes/food/views/Oatmeal-Cookies-with-Dried-Cherries-51150230#ixzz2dWWEAzTy

People often ask me when how I learned how sew and how old I was when I started. I learned to sew by just doing it. My mother always had a sewing machine and she showed me how to use it but I was never taught how to sew. In reality, I have never really sewn, like, you know, using cloth and a pattern to make clothing. My sewing has always been to create something I wanted. This I started doing when I was pretty young. As evidence I reluctantly share with you a picture I recently got from my parents. It shows me at about age ten or so, sitting at my mother’s sewing machine.

Mr. Rodriguez was 38-years-old. He slipped and fell on the floor of his house and was unable to get up. He was alone so his only recourse was to call 911. When the medics arrived, he told them he only needed to be helped back on his feet so he could get into bed. They refused to do this, however. They felt he was too disabled to be left in his home alone so they pulled out their large yellow tarp, specifically designed with handles for lifting and moving heavy people. They called the fire department for help and brought him to the emergency department. He had no medical complaint and did not want to be there.

He told me his sad story. Besides being morbidly obese, he had developed lymphedema of his right leg. It had gotten so large that he was only able to move back and forth between his bed and a chair. He had home care providers who came daily and even a doctor who visited him once a month. He had not been out of his house for years. He had been told there was nothing that could be done to fix his leg.

When I determined that he had not injured himself and was in no need of medical care, I made armaments for an ambulance to take him back home.

He gave me permission to take pictures of his leg to share with you.

For some perspective: here he is on the ED gurney, still on the yellow tarp they used to get him out of his house. His head is at the top of the gurney, covered with a sheet. His right forearm can be seen on on his right, sticking out from under the sheet. His good leg is on his left and is bent at the knee, hiked up around the right leg. Everything else you see is his right leg. You can see his right foot at the bottom.

Here is another view with the good leg on his left and everything else is his right leg. You can see that the tissue above his foot actually hangs down farther than his foot so would drag on the floor if he were standing.

I refer you to my favorite medical resource:

http://en.wikipedia.org/wiki/Lymphedema

Last week, I posted a recipe made entirely with turbinado sugar. This recipe has turbinado but also white and brown sugars. I used a dark chocolate we bought last Christmas to dip candy but we never used. It made them really rich. This makes a firm textured, moist cookie that I had a hard time resisting. Usually during the shift at work when I take cookies, I eat one or two. I am embarrassed to admit that I think I ate five of these!

Recipe By:

Notwithoutsalt.com

Yield:

48

Ingredients:

1 cup butter
1/4 cup white sugar
1/4 cup turbinado sugar
1 3/4 cups light brown sugar, packed
2 eggs
2 teaspoons vanilla
3 1/2 cups all purpose flour (1 pound )
1 1/2 teaspoons baking soda
3/4 teaspoon salt
1 pound chocolate, cut into ½ inch chunks
1/2 teaspoon good quality salt*, for sprinkling on top before baking

Instructions:

1. Cream butter and the sugars until very light and fluffy, about 5 minutes on medium high. Scrape down the side of the bowl.

2. Continue mixing while adding the eggs one at time. Make sure each egg is incorporated before adding the next.

3. Stir in vanilla. Scrape down the bowl.

4. Combine flour, soda and salt in another bowl. With the machine on low, slowly add flour mixture. Mix until just combined, taking care not to over mix.

5. Fold in chocolate.

6. Form into 2 tablespoon balls with a cookie scoop. Place balls on parchment-lined baking sheets. Sprinkle with a very fine dusting of good quality sea salt.

7. Bake at 360° for 12 minutes. They should be lightly golden on the outside but still look gooey on the inside.

Notes:

* Fleur de Sel or Murray River Pink Salt are recommendations.

I finished up my latest batch of bags. They were a bit of a pain to make because these shiny yellow straps are too limp to make good bags. To give them more rigidity, I sew two together. That makes them heavy and nice but it really taxes my machine and my patience to sew them double thickness.

What? Me? Stabbed?

A 27-year-old woman said she woke up in bed with 9 stab wounds. She said she had no idea how she got them.

Fire!

A 55-year-old man with schizophrenia who had stopped taking his medicines tried to start a fire in the emergency department lobby in order to burn himself to death.

Make That a Cracker Sandwich

A young woman said she was unable to swallow pills. She asked for two crackers. She put the pill between them, making a pill sandwich, which she ate.

Call me John

I introduced myself to a middle-aged man. “Hello. I’m Dr Tad. Are you Mr. Smith?” He looked at me but didn’t say anything. Rather, he presented me with a well-worn 3 by 5 inch piece of cardboard, edged in black electrician’s tape, on which was written, “Do not call me Sir or Mr.” He refused to say anything to me until I agreed to his demand. He wouldn’t say why he refused to let himself be called Sir or Mister.

Pen or Pencil?

A 43-year-old man who complained of suffering from “delusions” stabbed himself in both temples simultaneously with a pen and a pencil.

That’s Not Your Penis

A 29-year-old man came in with cuts on his hand from punching a wall. He said that when he went to urinate, a female voice in his head said, “That’s not your penis. That’s my penis.” This made him mad so he slugged the wall.

You Never Know if You Might Get Pregnant

A 30-year-old woman had a hysterectomy soon after giving birth. Four years later, she was pumping her breasts daily to keep the milk coming in case she got pregnant in her abdomen.

I frequently look for a recipe based on some ingredient I want to use. In this case, it was turbinado sugar. I was given a couple of bags of it by our friend, Lisa. She got it from her neighbor who inherited it when the neighbor’s mother died. It might bother some people to use a dead lady’s sugar and I had no idea how old it was. It looked, smelled and felt great and I doubt it was haunted so I went looking for a recipe to try it in.

Recipe By:

Adapted from Savory Sweet Life

Yield:

48

Ingredients:

1 cup unsalted butter, at room temperature
2 cups turbinado sugar
3 tablespoons blackstrap molasses
2 large eggs, at room temperature
1 teaspoon vanilla extract
2¾ cups unbleached all-purpose flour
1½ teaspoons baking powder
1 teaspoon baking soda
1 teaspoon sea salt, plus more for finishing
12 ounces bittersweet dark chocolate, cut into ¼-inch chunks

Instructions:

1. Heat oven to 350 degrees F.

2. Line two baking sheets with a silpat or parchment paper.

3. In a medium bowl, whisk together the flour, baking powder, baking soda, and sea salt. Set aside.

4. In a large, heavy bowl or the bowl of a stand mixer fitted with a paddle attachment, beat the butter on low for 3 minutes.

5. Add the sugar and beat for 3 minutes more, until ingredients are light and airy. With mixer still on low, drizzle in the molasses.

6. Add the eggs, one at a time, then the vanilla extract, scraping down the sides as needed. Slowly fold in the flour, mixing just until combined.

7. Fold in the chocolate chunks, making sure they are well dispersed throughout the dough. Cover dough and chill in the refrigerator for 1 hour.

8. Use an ice cream scoop to shape the cookie dough into 2-tablespoon balls, and set on the prepared cookie sheets 3 inches apart. If desired, sprinkle each cookie with a small pinch of sea salt.

9. Bake 12 – 13 minutes, or until the edges are golden and the centers of the cookies are still soft. Cool on baking sheet for 3 minutes, and then use a spatula to set cookies on a wire cooling rack.