Archive for February, 2015

Millet Cookies

Written by Tad. Posted in Cookies

Sometimes, I get inspiration for a new cookies recipe based on what I have that I want to get rid of. I had some corn flour and freeze-dried corn so I made Momofuku Corn Cookies last week for choir. I had forgotten how WONDERFUL they are! If you have not tried them, take a look at the recipe on my blog.

This week, I decided to get rid of some millet  we have had around for a long time. I don’t even remember why I bought it. When you go online and look for cookies containing weird things, you almost always end up in the “health food” or “gluten-free” worlds. That was certainly true as I looked for a millet recipe. Most that I found called for millet flour, usually as a gluten-free replacement for wheat. This recipe caught my attention because, as you can tell by looking at the ingredients, it is neither “health food” nor “gluten-free.” The millet is also roasted and used whole, rather than ground into flour. That interested me and I was not disappointed.



Close up of millet grain.


A great looking dough ball!


And an interesting-looking cookie!


Recipe By:




1 cup millet
1 cup cashews, coarsely chopped*
1½ cups whole wheat flour
½ teaspoon baking soda
1 teaspoon salt
1 cup unsalted butter, softened
1 cup light brown sugar, packed
2 large eggs
1 teaspoon vanilla
1 cup chocolate chips


1. Heat oven to 350 degrees. Line two baking sheets with parchment paper.

2. Toast nuts and millet on a baking sheet while the oven heats. Because they toast at different rates,  scatter the cashews on the sheet and let them toast for about 5 minutes. Add millet, then let the whole tray toast for five more minutes.**

3. Remove from  oven. Set aside to cool.

4. In a medium bowl, sift together  flour, baking soda, and salt. Set aside.

5. Cream butter in a stand mixer until nice and fluffy, 3 to 5 minutes. Add the brown sugar and continue to mix until it becomes fluffy again, 3 to 5 more minutes.

6. Add  eggs one at a time, briefly mixing after each addition until incorporated. Stir in vanilla.

7. Add dry ingredients to the butter mixture, mixing as minimally as possible until everything is incorporated.

8. Add millet, cashews and chocolate morsels. Fold gently into the dough until evenly incorporated.

9. Scoop 2 tablespoon balls of dough onto prepared baking sheets.

10. Bake 12 to 15 minutes, or until toasty on the edges and set in the center. Remove from oven. Let cool on the baking sheet for a minute or so before transferring to wire racks to cool completely.


* My Nob Hill didn’t have raw cashews so I bought roasted, unsalted nuts and only roasted the millet.

** I kept waiting for the millet to look or smell toasty but even after 15 minutes that didn’t happen. Next time, I would just toast them for 5 minutes and be done. Does that much toasting even make a difference? Good question for future experimenting!

Bad Parenting

Written by Tad. Posted in Kooks

As a parent, I realize what a difficult job parenting is. Yet, at the hospital, I often see people who are clearly making bad parenting choices. Here are a couple of recent examples:


Twelve-Year-Old Girl with Discharge

The mother brought her twelve-year-old daughter in with a foul smelling vaginal discharge. There is really no way for a girl to have such a discharge other than from a sexually transmitted disease. This fact directs our evaluation of a girl with this complaint.

As I asked questions, the girl wouldn’t give any details and the mother seemed offended that we would ask her daughter such “personal questions.” When we tried to get the mother out of the room to give the girl a chance to open up a bit, the mother got upset and refused to leave. It seemed she was paranoid that we were going to do something to her daughter, something she felt determined to protect her daughter from.

The female nurse and I tried repeatedly to help the mother understand that we were there to help them, that her daughter probably had something that needed treatment and we really needed to find out what was going on. Still, the mother refused to let the girl be examined or tested.

At times like this, my fallback response goes something like this: “You brought your daughter here because you are worried about her. We are offering to help, yet you are refusing to let us do that. When you decided to come here today, what were you hoping we would be able to do for you?” In this case, the mother had no answer to my question. Rather than prompting some positive reflection, as I hoped, it just seemed to frustrate her. She left, saying she would take her daughter to their pediatrician.

As they walked out, I was presented with a dilemma. Did this mother’s refusal to allow us to diagnose and treat what was almost certainly a sexually transmitted disease constitute child endangerment? Should I call the police or send a report to Child Protective Services?

In the end, I decided to send an email to their pediatrician and let her try to help. I felt this would be better in dealing with this mother than having authorities come down on her. Who knows if I made the right decision or not.


Tattooed Girl

First, let me say that I don’t like tattoos. I am not morally opposed to them, I just don’t find them appealing. I have also talked to too many older people who express some remorse at having been tattooed in youthful exuberance. With time, both the images and their meanings blur. The permanent nature of tattoos would keep me from deciding to have one myself.

With that background, you can imagine my thoughts when I cared for a fifteen-year-old girl with abdominal pain who was COVERED with tattoos: hands, arms, chest, back, abdomen, and legs. Her face was about the only part of her body that I looked at that didn’t have tattoos on it.

First of all, it is amazing a mother would let a kid tattoo herself so extensively. What is the chance a fifteen-year-old is not going to have buyer’s remorse some day when she looks at her body tattooed with images she thought were cool when she was so young?

Another issue is money. I work in a public hospital. Most of our patients are poor and unable to pay for their medical care. It is amazing to wonder where people get money to pay for all the tattooing.

I think it is sad that a mother would spend money on tattoos, money she might not be able to afford. I think it is crazy that the child be allowed to make irreversible decisions, which she might one day regret. I also think it is a sad comment on a tattoo artist who would, even with parental consent, tattoo such a young person.



Record Setting

Written by Tad. Posted in Kooks

A two-day-old baby who was brought to the emergency department for being “fussy.” As a newborn, the baby had been discharged from the hospital only 5 hours before. This was record-setting! He was my youngest patient ever (except for those I personally delivered.) He was also the patient with the shortest time from hospital discharge to his first visit to the emergency department.

When I walked into the room, a young mother was standing by the gurney. A woman I presumed was the grandmother was also standing there, holding the little baby. The baby was definitely fussy. He was twisting his head to one side and making sucking motions with his mouth.

I spent only a minute talking with them before pointing out that the baby’s behavior showed he was obviously hungry. I suggested they feed him and then I would return to check him.

“How much should we feed him?” the grandmother asked. When I told her to feed him until he didn’t want any more, they expressed surprise. They said they had been told in the hospital to make sure not to feed him more than 20 milliliters so he wouldn’t vomit.

So, either from what they were told or what they misunderstood, they had been purposefully holding back on the amount they were feeding the baby.

My problem was they did not believe me when I tried to help them see that a hungry baby needs to be fed. My advice was at odds with what they understood from the hospital nursing staff. Finally, I called the Pediatrics resident to come spend some time with Mom and Grandma so they were comfortable feeding the poor kid. Once the baby had a full belly, he was fine and off they went. Hopefully, it would be more than five hours before they came back again.


Oreo Cheesecake Cookies

Written by Tad. Posted in Cookies

Some time ago, I posted a recipe for Cookies and Cream Cookies. At that time, my daughter-in-law, Elizabeth, sent me a recipe for Oreo Cheesecake Cookies. I just came across that recipe, which I had misplaced. I had Oreo crumbs left over from a holiday chocolate pie crust and cream cheese also left over from the holidays so this was perfect. It made me nervous that they had neither eggs nor leavening, but they turned out great. They are super rich and very interesting in appearance. They are also easy to make.

DSC03655 DSC03656 DSC03662

Recipe from:

Elizabeth via


16 cookies


½ cup butter, at room temperature
3 ounces cream cheese, at room temperature
1 cup granulated sugar
1 teaspoon vanilla extract
1 cup flour
½ cup mini chocolate chips
1 cup crushed Oreos, about 10 cookies


1. Heat oven to 375 degrees. Line baking sheets with silicone baking mats or parchment paper.

2. In a food processor, process the Oreo cookies until they’re fine crumbs. Set aside.

3. In the bowl of a stand mixer, cream together butter and cream cheese until smooth.

4. Add sugar and vanilla extract. Beat until well incorporated.

5. Gently mix in flour.

6. Stir in chocolate chips with a spatula.

7. Using a two-tablespoon cookie scoop, form into balls. Roll each ball in Oreo crumbs, covering the dough well.

8. Place balls on prepared cookie sheet.

9. Bake 12-15 minutes.

10. Remove from oven when you see  the edges are just getting browned. Let cool on baking sheet for 5 minutes then transfer to cool completely on a wire rack.

Latest Donation to RAFT

Written by Tad. Posted in Trauma Strap Bags

I just made my first strap delivery to RAFT in 2015. I dropped off 1541 trauma straps that I have kept from going into the trash in the last few months. Here is what they looked like in the back of my car.


Meth Ingestion

Written by Tad. Posted in Kooks

Trying to avoid arrest for drug possession, some people will swallow the evidence. The police bring these suspects to the emergency department because it is well understood (to everyone except the suspects, I guess) that this can be dangerous.

Recently, I had just such a patient. He was twenty-four-years-old and had swallowed small plastic bags containing crystal methamphetamine. He was OK when he arrived, but we have had such patients go on to die, so, we take it very seriously. This young man gradually got agitated, his blood pressure and pulse went up, and he became confused and combative.

There is no antidote for meth overdose. Our treatment was focussed on two things: flushing his system of any meth not yet absorbed and giving sedatives to control the agitation, high blood pressure and racing pulse caused by the drug.

Since the little packets keep releasing more and more meth as they pass through the intestines, we try to get it out of the intestines before it can be absorbed into the blood stream. This is done by a technique called “whole bowel irrigation.”

First, we placed a tube through the patient’s nose into his stomach. Through it, we pump the same solution used as a bowel prep for a colonoscopy. As the fluid passes down the intestine, it causes large volumes of watery diarrhea. In preparation for a colonoscopy, the solution clears out all the stool so the GI doctor can see the inside of your guts. In this case, we were hoping to wash the drugs out before they could be absorbed and cause the patient more trouble – maybe even death.

Though the patient seemed normal when he first came to the ED, he was soon thrashing around, out of control. He was sweaty and fighting against all our efforts to control him. Because of this, it was hard to start an IV, and even after we managed that, he pulled it out. We reinserted the IV and then secured his arms and legs to the bed with leather restraints. I ordered sedatives to help his body relax, but in these situations, there is no way to know just how much medication is needed to overcome the effects of the meth. I just continued to order more sedatives until we saw the desired effects. This is tricky as there is a serious risk of over-sedation, so we kept a very close watch on him.

A patient like this would usually be transferred to intensive care as soon as initial treatment and stabilization were preformed. On this particular night, all of the ICU beds were full so he couldn’t go upstairs. We might have transferred him to another hospital, but he was under arrest and we are the county hospital that cares for all local inmates. So, he stayed in the emergency department all night.

As night passed, the sedatives caused him to sleep, unless he was touched or moved. When that happened, he again thrashed around and screamed at the top of his lungs. The problem was that once the bowel irrigation started to take effect, he had a huge stool in the bed. The nursing staff had to roll him to clean him up, and he screamed and fought the whole time they touched him. I gave him more sedatives and, once cleaned up and left alone, he fell back asleep. A little later, he pooped again, and the whole scene would repeat itself. Eventually, all that came out if his butt was clear water which was more pleasant for the staff to clean up, but he still screamed and flailed around every time his bedding had to be changed.

The next day, he woke in our emergency department as if nothing had happened and went off to jail. He will never have any memory of the care we gave him to prevent the potential deadly consequences of swallowing the evidence.


Copyright © 2014 Bad Tad, MD