Archive for October, 2014

Frozen Cookie Balls

Written by Tad. Posted in Cookies

I have been encouraged to share a cookie-baking trick with you.

After mixing up a batch of cookies, scoop balls of cookie dough onto a plate. Put the plate in the freezer. When the balls are frozen, transfer them into a Ziploc bag and return them to the freezer.

They will keep in there indefinitely and can be pulled out in any number to be baked. This allows for fresh, hot cookies in a few minutes.



Brown Butter Salted Caramel Cookies

Written by Tad. Posted in Cookies

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We recently became grandparents for the first time. When we were in Virginia to welcome the newest member of the family, our daughter-in-law gave me this recipe. I love caramel and “salted carmel” is all the rage so I was really excited to they these. They are great! Several people in the emergency department Thursday night said they were their new favorites. I made some with Peter’s caramel and some with Kraft. The Peter’s tastes way better and the Kraft are firmer and melt less so they are very different. I recommend Peter’s or some other higher quality caramel over Kraft, if you have it available. I buy Peter’s at Cash and Carry. You definitely need to avoid the temptation to over cook them. They are flat and soft. And that sprinkle of salt –  no wonder salted caramel is so popular.

Recipe By:

Two Peas & Their Pod




2½ cups all-purpose flour
1 teaspoon baking soda
2 teaspoons cream of tartar
½ teaspoon ground cinnamon
½ teaspoon sea salt
1 cup unsalted butter, sliced
1¼ cup dark brown sugar *
½ cup granulated sugar *
1 large egg
1 egg yolk
1 tablespoon vanilla extract
1 tablespoon plain Greek yogurt **
1 cup caramel squares, cut into ¼’s ***
¼ cup granulated sugar
2 teaspoons ground cinnamon
Sea salt, for sprinkling on top of cookies


1. In a medium bowl, whisk together flour, baking soda, cream of tartar, ½ teaspoon cinnamon, and ½ teaspoon sea salt. Set aside.

2. To brown the butter, heat a thick-bottomed skillet on medium heat. Add the sliced butter, whisking frequently. Continue to cook the butter until melted. The butter will start to foam and browned specks will begin to form at the bottom of the pan. The butter should have a nutty aroma. Watch the butter carefully because it can go from brown to burnt quickly. Remove butter from the heat and let cool to room temperature.

3. In the bowl of a stand mixer, combine the brown butter, brown sugar and ½ cup granulated sugar. Mix until blended and smooth.

4. Beat in egg, yolk, vanilla, and yogurt. Mix until combined.

5. Slowly mix in the dry ingredients until just combined.

6. Form the dough in a ball and cover with plastic wrap. Chill in the refrigerator for at least 30 minutes or overnight.

7. When ready to bake, heat oven to 350 degrees F. Measure about 2 tablespoons of dough and roll into a ball. Make an indentation with your finger and place a piece of caramel in the center of the dough. Wrap the cookie dough around the caramel, making sure the caramel is completely covered with dough.

8. In a small bowl, combine 2 teaspoons cinnamon and ¼ cup sugar. Roll the balls in the cinnamon-sugar mixture. Place dough balls on a large baking sheet that has been lined with a Silpat baking mat or parchment paper. Make sure the cookies are about 2 inches apart. Flatten them a little so the sea salt sprinkle will stay on them. Sprinkle the cookie tops with  a pinch of sea salt.

9. Bake 13-15 minutes or until the edges of the cookies begin to turn golden brown.****  The centers will still be soft. Cool the cookies on the baking sheet for 2-3 minutes, or until set. Transfer cookies to a wire cooling rack and cool completely.


* I used 1¾ cups light brown sugar in place of the dark brown and granulated sugars.

** I have no idea what this little bit of yogurt would do for these cookies. If I had not had it, I would have just left it out.

*** I used a teaspoon of Peter’s caramel or a whole Kraft caramel in each ball of dough.

**** The cinnamon coating makes them look more done than they are.

Three Bad Ideas

Written by Tad. Posted in Kooks

Bad Idea 1

A 36-year-old man drank five beers then climbed up into a tree house at 10:00 at night. He pulled the ladder up, placed it on top of the tree house and used it to climb up into the top branches of the tree. At that point, the branch he was on broke and he fell, landing first on the roof of the tree house then the ground. The total fall was about the same as from the roof of a two-story building.

He was admitted to the hospital for a concussion and a broken arm


Bad Idea 2

A hospital housekeeper mixed Clorox and an ammonia-containing cleaner in the sink. A pungent chlorine gas filled the emergency department. The whole unit had to be evacuated.


Bad Idea 3

A man in his twenties fell at work and injured his ankle. He went home, thinking it was just a sprain. The next day, it was worse so he came to the emergency department. His ankle was swollen, bruised and tender. He also had nasty burns on his foot, ankle and halfway up to his knee.

He said that after the fall, his coworkers placed dry ice on his leg to keep the swelling down. The dry ice caused such severe burns he had to be admitted to the Burn Unit. As it turned out he did not have a sprain. He had a nasty ankle fracture requiring and orthopedist.

Lunch in Your Ear

Written by Tad. Posted in Kooks

I was doing my emergency medicine training in New Orleans. The nurse called me to see a teenage girl who was screaming hysterically, for no apparent reason. She was unable to talk but just cried uncontrollably.

When I was finally able to get her to relax a bit, she pointed to her ear. I looked inside and was horrified to see a cockroach that had crawled in and was unable to back out. As it tried to get out, it banged repeatedly against her eardrum, causing a terribly creepy pain.

Fortunately, there is a thin “alligator” forceps that works great to reach in the ear and grab a wayward bug. If you do it right, you can pull it out, alive and intact, very much to the horror of the patient and the satisfaction of the doctor.

Over the years, I have removed many ear bugs. One cockroach was so small it was actually running around in circles in there and we washed it out with warm water.

One night, a 42-year-old man came in complaining of having a bug in his ear. I peeked in and could see some insect body parts so the diagnosis was confirmed. I used the alligator forceps to deftly reach in, grab the bug and pull it out. As it came out of the ear canal, clasped tightly in my forceps, something else came out of the ear and ran down the man’s neck, shoulder and arm. It had just gotten to his hand by the time I reflexively slapped a spider, killing it and knocking it onto the floor.

The only thing I could figure was the spider had caught the insect and pulled it into the ear canal as a nice place to have his lunch, which I interrupted.

Thick and Chewy Chocolate Chip Cookies

Written by Tad. Posted in Cookies

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I know there are a million chocolate chip cookies recipes out there. I recently tried this one and decided it was good enough to share with you. I have noted in the past that melting the butter and baking at a lower temperature for a longer time makes a great texture for a chocolate chip cookie. I rediscovered this when I made these cookies. The pull-apart method of ball formation made for a really fun texture and cookies that are twice as big as the ones I usually scoop out.


Many close variations on Internet




4¼ cups unbleached all-purpose flour, (22 ounces)
1 teaspoon baking soda
1 teaspoon salt
1½ cups unsalted butter, melted and cooled until warm
2 cups packed brown sugar
1 cup granulated sugar
2 large eggs
2 egg yolks
4 teaspoons vanilla extract
3-4 cups semisweet chocolate chips


1. Heat oven to 325 degrees. Line 2 large baking sheets with parchment paper or spray them with nonstick cooking spray.

2. Whisk together  flour, baking soda, and salt in a medium bowl. Set aside.

3. Mix butter and sugars until thoroughly blended.

4. Beat in eggs, egg yolks, and vanilla until combined.

5. Add  dry ingredients and beat at low speed just until combined.

6. Stir in chocolate chips.

7. Roll  ¼ cup of the dough into a ball. Hold the dough ball with the fingertips of both hands and pull into 2 equal halves. Rotate the halves 90 degrees and, with jagged surfaces facing up, join the halves together at their base, again forming a single ball, being careful not to smooth the dough’s uneven surface. Place the formed dough balls on the prepared baking sheets, jagged surface up, spacing them 2½ inches apart.

8. Bake until the cookies are light golden grown and the outer edges start to harden yet the centers are still soft and puffy, 15 to 18 minutes, rotating the baking sheets front to back and top to bottom halfway through the baking time. Cool the cookies on the sheets.

Grumpy Nephew

Written by Tad. Posted in Kooks

A 26-year-old man was brought to the emergency department by his aunt. He said he had trouble sleeping and, because of that, had a “nightfall problem.” (See footnote.) He said all he needed was a sleeping pill. He seemed grumpy and was not really cooperative in telling me what was going on. The aunt was the one who gave me the interesting details about their sad situation.

After getting a degree in accounting six months earlier, he had been unable to get a job. The aunt felt sorry for him and took him in. She was providing him a place to stay and all his meals. She planned on this being a temporary arrangement until he got a job.

Since he moved in with his aunt, he had not even tried to get a job. He took over her family room where he spent his time, day and night, watching TV. He wouldn’t let her use the remote to watch the TV herself. Sometimes, he would sit for long periods of time throwing a basketball against the wall, banging it over and over again. Despite all the aunt did for him, he was demanding and unappreciative. And he didn’t sleep. The patient would not corroborate what his aunt said, but neither did he deny it.

My heart really went out to these people, especially the aunt. I wanted to help them and carefully considered my options. If he had been suicidal, I would have immediately sent him to see a psychiatrist. Since his condition didn’t immediately put him or anyone else at risk, I discharged him to go home. I gave him a prescription to help him relax and sleep. I also provided information about community resources where both the patient and his aunt could seek more long-term assistance.

When they left, I hoped they would find help. If not, I wondered if the aunt would kick him out before he finally did something that would really get him in trouble. One thing about emergency medicine, I usually don’t get the answers to questions like that.

* This was the first time I had heard of nightfall in men.


Two More Drunks

Written by Tad. Posted in Kooks

Unfortunately, a lot of the sad things I witness in my job come about because of alcohol abuse. Here are a couple of examples.


A thirty-five-year-old man came in burned. He was very drunk and had fallen asleep on a mattress in a homeless encampment. His cigarette caught the mattress on fire and by the time anyone noticed, he was badly burned.

A review of his hospital records showed he had recently been discharged from our burn unit after a prolonged stay there because of burns suffered in exactly the same scenario.

In addition to being very intoxicated, he had multiple serious burns on his previously normal skin as well as where he had received skin grafts during his previous admission.

He was admitted, again, to the burn unit.


A 34-year-old man was out drinking with friends. He got tired, so he decided to climb into a garbage dumpster and get a little sleep. In the middle of the night, he woke up as the dumpster was being emptied into a garbage truck. The compacter in the truck then smashed him multiple times. He managed to crawl to the top of the truck where a motorist saw him and stopped the garbage truck driver. 911 was called and he was taken to the emergency department.

In addition to being very intoxicated, he had bruises, lacerations, blood in his urine and a fractured pelvis.

Copyright © 2014 Bad Tad, MD