I found this recipe in a cookbook my sister-in-law, Cathy, sent us for Christmas. It is called Calico Cooking from the Calico Corners fabric stores. I am not sure why a fabric store makes a cookbook but…

When I Googled the recipe, I found it all over the web including at epicurius.com.

I am too lazy to roll out logs, refrigerate and cut them. I took the unrefrigerated dough, scooped it onto the baking sheets with a 1 tablespoon cookie scoop. I then buttered the bottom of a glass, dipped it in sugar and gently flattened each dough ball to the prescribed ¼ inch thickness, redipping in sugar before flattening each subsequent ball. I also skipped the powdered sugar because it is a mess.

These cookies are firm but not dry. I wonder if some coconut flavoring, in addition to the vanilla and lemon flavoring, would have been good.

Yield:

4 dozen small cookies

Ingredients:

1 cup unsalted butter, softened

½ cup sugar

1 ½ tablespoons freshly grated lemon zest

1 teaspoon vanilla extract

½ teaspoon lemon extract

2 cups all-purpose flour

1 teaspoon baking powder

¼ teaspoon salt

1 cup sweetened flaked coconut, toasted and cooled

Confectioners’ sugar for dusting

In a bowl with an electric mixer cream the butter with the sugar until the mixture is light and fluffy.

Beat zest, vanilla, and lemon extract.

Add flour, baking powder and salt. Beat until it forms a dough.

Stir in coconut.

Chill dough for 1 hour, or until it is firm enough to handle.

Divide the dough in half. On a sheet of wax paper, form each half into an 8-inch log. Chill the logs, wrapped in the wax paper, for at least 4 hours or overnight.

Heat the oven to 300°F.

Cut the logs into ¼-inch-thick slices with a sharp knife.

Arrange the slices 2 inches apart on parchment-lined baking sheets.

Bake the cookies in the middle of the oven for 25 to 30 minutes, or until they are pale golden.

Transfer them to racks and sprinkle them generously with some of the confectioners’ sugar.

Let the cookies cool then dust them lightly with the remaining confectioners’ sugar.

We see lots of people who harm themselves. The most common ways of doing so are taking an overdose and cutting. Sometimes the cutting is in troubled people trying to let off stress rather than really trying to kill themselves. Often the cutting is more a cry for help or to get attention rather than a truly serious attempt at committing suicide.

Only occasionally do we see someone who really seems to be serious about killing himself by cutting. One such patient was a troubled young man who took a box cutter and cut his neck from one ear, across the front, over his Adam’s apple, to the other ear. He refused to say why he had done so.

The cut was really amazing. It was a serious attempt at suicide that cut down to but not into every vital structure he had in the front of his neck. I could look into the cut and see his carotid arteries, jugular veins, thyroid gland and larynx (voice box.) Somehow, he managed to perfectly expose all of these structures without injuring them other than a nick in the thyroid cartilage, which is what causes the Adam’s apple bump.

As I gazed into his wound, I was struck with how much detail I could see in his anatomy. Then it struck me there was no blood! After he cut himself, he ran through large sprinklers in a park. By the time he arrived in the emergency department, the bleeding had stopped and the wound had been washed clean in the sprinklers. It looked more like an anatomy specimen than an injured person.

He was taken to the operating room where the wound was carefully explored to make sure there were no important injuries and put him back together. He then was transferred to psychiatry.

When we lived in Alabama, our next door neighbor had a “Man Cave” in one corner of his garage. He had the walls covered with Crimson Tide memorabilia, a TV to watch the games and a comfortable chair where he could smoke his pipe, which was not allowed in the house. I wonder what he would think of my Man Cave?

We recently did some painting and reorganizing in our house. That gave me the opportunity to redo my sewing area so I have good lights and a glass-covered table where I can sew and cut straps with my hot knife. I got new drawers and shelves for organizing. I bought bins from The Container Store and built a rack in the closet to hold straps. It is quite the Man Cave, don’t you think?

This shows the sewing/cutting table, radio and a work table where I layout and measure. You can also see the pin board where I have the nice thank you notes grateful bag recipients have sent me.

Another view of the sewing table.

This is half of the closet with drawers, shelves and bins. An organizer’s delight!

The other half of the closet with my angle iron strap rack. The best set up I have ever had for having the straps organized and accessible.

I got this recipe from a Quaker Oats advertisement in a magazine. If you do a Google search, you will see it is all over the Internet. They are very buttery and need be cooked until they are more brown than I would normally bake a cookie because they are soft. I don’t really like butterscotch chips but these are very good. With all the oats, no wonder Quaker is promoting them!

Yield:

40

 Ingredients:

1 ¼ cups all-purpose flour

1 teaspoon baking soda

½ teaspoon salt

½ teaspoon ground cinnamon

1 cup butter, softened

¾ cup granulated sugar

¾ cup packed brown sugar

2 large eggs

1 teaspoon vanilla extract or grated peel of 1 orange

3 cups oats

11 ounces butterscotch chips

Directions:

1. Heat oven to 375° F.

2. Combine flour, baking soda, salt and cinnamon in small bowl. Set aside.

3. Beat butter, granulated sugar, brown sugar, eggs and vanilla extract in large mixing bowl.

4. Gradually beat in flour mixture.

5. Stir in oats and chips.

6. Drop 2 tablespoon balls onto ungreased baking sheets. (I always use parchment.)

7. BAKE for 9 to 10 minutes. Cool on baking sheets for 2 minutes. Remove to wire racks to cool completely.

Notes: I have not tried the orange zest version which really might be tasty. They would probably be wonderful with chocolate rather than butterscotch chips. I don’t make bars so I have not tried the bar version which follow:

BAR VARIATION:

Grease 15 x 10-inch jelly-roll pan. Prepare dough as above. Spread into prepared pan. Bake for 18 to 22 minutes or until light brown. Cool completely in pan on wire rack. Makes 4 dozen bars.

All three of our kids had the same kindergarten teacher. Mrs. Goldsmith was great. One of the things I learned from her was the importance of children learning to recognize patterns.

Pattern recognition allows us all to function in life. Experience teaches us what to expect and that allows us to fluidly move through life.

When we don’t find what we expect to find, it sets us back.

One time, one of our nurses was interviewing a young woman at triage. On the nurse’s list of questions was, “Do you have any pain in your ears?”

The patient replied, “I don’t have any ears.”

When the nurse didn’t know how to take the response, the young woman pulled back her hair, showing that, indeed, she had been born with no ears. Who would have expected that?

Let me tell you about a time when I didn’t find what I was expecting to see. A young woman came in complaining of lower abdominal pain. I asked her all the usual questions and examined her, including feeling her abdomen. I then informed her that I needed to do a pelvic exam.

She told me that would not be possible, as she had no vagina. I am not sure if I was too proud to listen to her or if the idea that a young woman would not have a vagina was too bizarre for me to take seriously. Either way, I just blew off her response.

When the nurse had the patient all set up in the stirrups, her legs and crotch covered by the sheet, I stepped in between her legs and grabbed the speculum. I put some KY jelly on it and pulled back the sheet. I am sure I must have looked really stupid as I peered up between her legs, lubricated speculum in hand, and found nothing. Well, not really nothing. She had normal external genitalia and pubic hair. But there was no opening into a vagina.

After recovering from my shock and embarrassment, I apologized to the young woman and did what I should have done earlier: I asked her some more questions.

She had been born with no vagina. Further investigations showed that, inside, she had a normal uterus and ovaries. When she was a little girl, this caused her no problems.

After she became an adult, she consulted doctors to see if they could fix her problem. She had been told that a functional vagina could be surgically created for her but there was no way to do so and preserve her uterus. She would be able to have sex but never able to have children.

She really wanted to have kids so she had declined the offered surgery with hopes that someday, she might find a way to have a vagina and keep her uterus, allowing her to get pregnant and bear children.

So, she faced an interesting dilemma. She was unable to have sex or get pregnant because she had no vagina. Yet she refused to have a vagina created, holding onto the hopes that someday she would be able to get pregnant.

It has been twenty-five years since this experience. I wonder what happened to her. I also hope I have become more humble and skilled in dealing with situations where I find, or don’t find, what I am expecting.

Last week, we did an eyeball case. Let’s do more this week.

Exophthalmos is a condition where the eyeballs bulge out of the eye sockets abnormally.* It is frequently associated with hyperthyroidism.

One night, I saw a woman who had such severe exophthalmos that the eyelids caught behind one of her eyeballs. This caused the eye to protrude even farther. As a result, she was not able to close or move the eye. I had to gently press her eyeball back into its socket and work the eyelids back over the front of her eye.

*

This is an image from the Internet, not my patient.

The other eyeball patient was a one-hundred-year-old lady who fell out of bed in the middle of the night. She hit her face on something and ruptured her globe, which is the medical term for the eyeball. Her eye was so bulged out and had so much chemosis** (swelling of the surface of the eye) that, like the first patient, the lid was caught behind the eye so she couldn’t close or move it. The entire front portion of the eye was full of blood.

She was admitted to the hospital to have the eye removed.

**

Again, not my patient.

These are easy to make and come out rich and moist but firm. With all of the kinds of M&Ms available, you could make then with any you like and they would be different and interesting. When I fist saw this recipe in the newspaper, it was at Christmas time and they were supposed to be made with Holiday M&Ms.

Recipe By: Family Circle

Yield: 5 to 6 dozen

Ingredients:

2 ½ cups all-purpose flour

¾ cup unsweetened cocoa powder

1 teaspoon baking powder

¼ teaspoon salt

1 cup unsalted butter, at room temperature

¾ cup packed light brown sugar

¾ cup granulated sugar

2 large eggs

2 teaspoons vanilla

¼ cup hot coffee or water

1 ½ cups M&Ms

Directions:

1. Heat oven to 375 degrees.

2. Sift together flour, cocoa, baking powder and salt. Set aside.

3. Using an electric mixer, beat butter until smooth and creamy.

4. Add both sugars. Beat until light and fluffy.

5. Beat in eggs one at a time. Mix in vanilla.

6. With mixer on low speed, mix in flour mixture.

7. Stir in coffee.

8. Fold in M&M’s.

9. Drop batter by heaping tablespoonfuls onto ungreased baking sheets. Press a couple of M&M’s into the top of each little mound of dough.

10. Bake for 8 to 11 minutes or until set. Cool briefly on baking sheets. Transfer cookies to wire racks to cool completely.

Notes:

For Christmas cookies, use red and green M&Ms.

I walked into the Accident Room of Charity Hospital in New Orleans. A young man sat in one of the old, wooden, high-backed wheelchairs they used at that time*. He was thin and pale. His shoulder length hair was greasy and unkempt.

He sat still and showed no emotion. His left eye was covered with a large paper cup, which had been taped in place by emergency staff. Under the cup was the wooden handle of an old ice pick, the point of which had been thrust into his eye. The cup had been placed over the handle to prevent it being bumped, possibly making his obviously serious injury worse.

I asked him what had happened. In very flat and unemotional words he told me he suffered from psychotic depression and had wanted to die for a very long time. He recounted how he had seen a show on public TV that showed cross-sectional images of the brain. This made him realize his brain sat immediately behind his eyes. He reasoned that poking an ice pick into his brain would clearly kill him. So, he planned to drive an ice pick through his eye and into his brain, in order to die.

He denied being in any pain unless he moved the eye, which he found difficult to do. He said, as far as he could tell, his vision was OK.

When I gently lifted the eyelid open, I could see an old, dirty, rusty ice pick entering the lower part of his eye. The rest of the eye, above the ice pick, seemed to be working fine.

I had three problems. The most immediately life-threatening was brain injury. He was right in recognizing the brain does sit behind the eyes. The bones of the orbit, which surround the eyes, are thin and could easily be pierced by even an old, dull ice pick. From the looks of how far the ice pick seemed to have entered his head, it looked like he probably had stabbed himself in the brain.

My next worry was his eye. Though his vision seemed to have been unaffected so far, I was concerned that trauma and potential infection might threaten his vision.

The third problem, very real but not so acute, was his depression and suicidal ideation.

There was no good way to fully evaluate either his brain or his eye with the ice pick in place. I was afraid to pull it out without addressing the possible brain injury, so I called the neurosurgeon who went with me to the CT scanner. The neurosurgeon placed one hand on the patient’s forehead, grabbed the ice pick handle with his opposite hand and gently pulled, twisting slightly to get it to let go.

After the ice pick was removed, the CT scan was done which showed no bleeding or other problem in the brain that required neurosurgery.

I then made arrangements for ophthalmologists, the eye doctors, to see the patient. They took him to the operating room where they cleaned out the wound. They found only a small nick in the lower part of the globe, which they cleaned and repaired. The patient was then admitted to the hospital for a few days to make sure no complications arose. Afterwards, he was transferred to the psychiatric ward.

This poor man must have been at the end of his rope to get the nerve to do such a horrible thing. He really wanted to die and, by all rights, he very well could have.

However, when he stabbed himself, he hit just low enough that, rather than puncturing the eyeball, it was displaced upwards. The ice pick passed under the globe, missing the vital parts of the eye, so his vision was not affected.

A small hole in the bone of the orbit would heal with no treatment. Ironically, the part of the brain he punctured, the frontal lobe, is probably the most forgiving part of the brain to damage. So, rather than dying, he ended up fine with no permanent damage done at all.

I certainly hope his psychiatric care ended with the same good results as his medical care did. I think that was not too likely, as this sort of depression is very hard to treat.

*

I found this in Google images. It is exactly like the wheelchair my patient was sitting in that sad  day.

When Philip was watching Elizabeth sew her bag, he came up with the idea for polka-dots. Pretty soon, he had worked out and put into action his plan for yellow on black.

Here he is sewing at the dining room table.

Here he is, justifiably proud of his creation.

A great bag, especially for a beginner!