I am not a big raisin fan. Still, on occasion, I have eaten an oatmeal raisin cookie that was just delicious. What I like is a chewy texture, almost like eating candy and not too spicy. I offer to you my best effort so far to achieve that sweet chewiness that goes so well with raisins.

Makes:

72

Ingredients:

2 cups butter

1 ½ cups sugar

1 ½ cups brown sugar

½ cup honey

1 tablespoon vanilla

2 eggs

3 cups flour, 13.5 ounces

2 teaspoons soda

2 teaspoons cinnamon

3 cups oats, 9.5 ounces

3 cups raisins

Directions:

1. Heat oven to 300 degrees.

2. Cream melted butter,  sugars and honey until combined.

3. Beat in eggs and vanilla.

4. In separate bowl, sift together flour, soda and cinnamon.

5. Stir flour mixture into sugar mixture.

6. Stir in oats and raisin.

7. Form into 2 tablespoon balls on parchment-lined cookie sheets.

8. Bake 20 minutes or until just turning brown on the bottom and around the edges.

I am a better copier than originator. I saw a bag in a store that was fourteen inches across the top and two feet wide on the bottom. This is my first try at trying to create something like that.

This is the front.

And the back.

What it looks like on the shoulder.

And again.

Nary sent me these pictures showing her husband, Joe and daughter, Lily  making Tad’s Mallow Bits S’Mores Cookies from the recipe posted last week. I asked if I could share them with you since they are so fun.

I have not had a chance to do much sewing recently. This week, I finally had a chance to make up some bags for some friends who had asked.

Tara, one of our physician assistants, asked for a large orange and black, which I view as my “classic” bag.

Chris, one of our emergency techs, asked for a large one with a flower for someone special.

Here are the bags I got to sew this week.

Another S’mores Cookie recipe. What I really like about this, over all the others I have tried, is that it really resembles campfire S’mores. The cookie is the the most grahamy I have made. The gelatin-free marshmallows don’t melt but keep their presence as actual marshmallows. The milk chocolate is present like a Hershey bar. And they look fabulous, don’t you think?

Recipe By:

Tad

Yield:

36

Ingredients:

2 cups graham cracker crumbs

1½ cups flour

1 teaspoon baking soda

½ teaspoon salt

1 cup butter, softened

¾ cup sugar

¾ cup firmly packed brown sugar

2 eggs

1 teaspoon vanilla

1 bag gelatin-free marshmallows, cut in half*

bulk milk chocolate, gently melted and tempered**

 Directions:

1. Heat oven to 350° F.

2. Combine graham cracker crumbs, flour, baking soda and salt in small bowl. Set aside.

3. Beat butter, granulated sugar and brown sugar in large mixer bowl until creamy.

4. Beat in eggs and vanilla extract.

5. Gradually beat in flour mixture.

6. Scoop a tablespoon of dough onto parchment lined baking sheet. Flatten.

7. Place half-marshmallow in the center of the flattened dough ball.

8. Scoop another tablespoon of dough and press it onto and around the marshmallow, sealing the edges all around.

9. Bake for 12 to 14 minutes or until set. Cool for 2 minutes on baking sheets. Remove to wire racks to cool completely.

10. When completely cool, dip the bottoms of the cookies into the tempered chocolate to cover the bottom and a bit up the sides. Wipe the excess chocolate off before placing on waxed paper to cool completely.

Notes:

* I bought these at Whole Foods.

** If you are not familiar with tempering chocolate, it is not hard. Here are a couple of references for you to chew over.

• http://www.davidlebovitz.com/2005/08/tempering-choco/
• http://www.youtube.com/results?search_query=how+to+temper+chocolate&sm=3

The medics brought in a middle-aged woman who was in cardiac arrest. Her husband had found her down and called 911. The medics found her in arrest, started CPR, injected her with adrenalin and brought her to us.

When medics bring in such a patient, it causes quite stir in the emergency department. Pretty much everyone stops what he is doing and goes to help. The patient has to be transferred onto our gurney, chest compressions continued and oxygen has to be blown down into the lungs. The patient has to be hooked up to the cardiac monitor and checked to see if there is any sign the heart has started beating again. All of this has to be done as fast as possible and the more hands helping, the faster it gets done.

As everyone was pitching in doing all these things for this lady, I turned my attention to her airway. It was obvious right away that, during CPR, she had vomited and there was liquid vomit in her mouth and the back of her throat. I suctioned that out, looked in with a laryngoscope* which is a curved, lighted blade designed to move the tongue out of the way to be able to see the vocal cords**. Once the cords are seen, a tube can be passed through them in order to get oxygen-carrying air down into the lungs and keep vomit out***.

As soon as I had got the tube in place, I turned my attention to the patient’s heart. I asked that CPR be paused while I looked at the monitor, listened for heart sounds and felt for a pulse. Not finding any evidence the heart was beating, I put an ultrasound probe on the chest wall, over the heart, and confirmed no cardiac activity. She was dead.

I took a minute to look over her, to make sure I hadn’t missed anything. I thanked everyone for helping so efficiently, then went to write a note about what had happened.

As I was sitting at my desk, the registration clerk came to me and told me the patient’s husband had arrived with a boy who looked to be about twelve years old.

“He knows,” she said.

In reply to my quizzical look, she told me the husband had asked her if his wife was alright. When she told him she had not been taking care of the patient but she would have the doctor talk to him, he turned to the boy and said, “She’s dead.”

After the husband and son were escorted to the Family Room, I went to meet them. I introduced myself, made sure he was the husband, then told them she was dead. I told them the medics had done everything they could to revive her but that she was already dead when she got to us.

“No!” the man hollered as he stood and threw his head down into his hands. “No!”

He then collapsed back onto the couch and moaned with his eyes closed and his hands on his pained face.

The boy leaned over his father, put one hand on his arm, patted him gently on the back and said, “It’s OK, Papa. It’s OK.”

Going and telling someone that his or her loved one is dead is one of the worst parts of my job. I never know what to expect. I certainly was not expecting this and it made my interaction with them especially poignant.

* This is an image of such a scope:

** Here is what I see when I get a good look at the vocal cards. The endotracheal tube is passed between them, through the opening.

***Here is what the tube looks like.

Last week I posted about a woman so obese she couldn’t be taken out of the ambulance to try to resuscitate her from cardiac arrest. Today I share another obesity-related story.

My patient was a man in his early twenties. He was complaining of having trouble sleeping at night and having sores “by my penis.”

As for his first complaint, it was pretty obvious he had obstructive sleep apnea, a common condition where the airway closes down at night causing people to wake frequently. It is usually not life-threatening but it makes people miserable by keeping them from resting. It is much more common in obese people and this kid was massively obese. I made arrangements for him to be referred to the sleep clinic for evaluation.

To evaluate the sores by his penis, I pulled the sheet down and saw what I thought was a huge, inflamed scrotum hanging down almost to his knees. However, when I pushed his belly fat up to get a better look, there was no penis by the scrotum. That’s when I realized that what I originally thought was his scrotum was actually his mons pubis, the area where  pubic hairs grow. I could then see that his sores were caused by inflammation of the hair follicles of his pubic hairs, or folliculitis.

With two hands, I lifted the mons up off his thighs and looked underneath it. Then, I could see a little penis and scrotum way down between his legs.

Amazing.

Amazing and very sad.

I have been on kind of a S’mores cookies adventure since eating a cookie of that name in New York. Here is the latest attempt. They are easy to make, if you can find the Mallow Bits. They are made by Kraft, Jet-puffed. I was unable to find them at Nob Hill or Lucky but Safeway had them. They are harder than normal marshmallows and don’t melt as much so they provide a marshmallowiness that doesn’t disappear when you bake them.

Recipe By:

Tad

Yield:

36

Ingredients:

2 cups graham cracker crumbs

1½ cups flour

1 teaspoon baking soda

½ teaspoon salt

1 cup butter, softened

¾ cup sugar

¾ cup firmly packed brown sugar

2 eggs

1 teaspoon vanilla

1 package chocolate chips

3 ounces Mallow Bits

Directions:

1. Heat oven to 350° F.

2. Combine graham cracker crumbs, flour, baking soda and salt in small bowl. Set aside.

3. Beat butter, granulated sugar and brown sugar in large mixer bowl until creamy.

4. Beat in eggs and vanilla extract.

5. Gradually beat in flour mixture.

6. Stir in chocolate chips and Mallow Bits.

7. Scoop in 2 tablespoon balls onto parchment-lined baking sheets.

8. BAKE for 12 to 14 minutes or until set. Cool for 2 minutes on baking sheets. Remove to wire racks to cool completely.

A 56-year-old lady went down on the floor at home and was unable to get up because she had injured her foot. It took eight medics and firefighters to get her out of her home, onto the ambulance and into the emergency department. They transported her on the floor of the ambulance, as they were unable to get her onto an ambulance gurney.

Spine boards were used as ramps to get her from the floor of the ambulance to an emergency department stretcher, which could hardly tolerate the weight. She was incontinent of urine and stool and was so foul smelling she stank up the entire emergency department.

After she was cleaned up and a medical evaluation was performed, she was admitted to the hospital because she was not able to get up and around on her injured foot.

I am not sure what happened to her during her hospitalization but two days later she was back at home and took ill again. This time, she was found unresponsive and the medics tried to keep CPR going while they loaded her, again, onto the floor of the ambulance and brought her to the hospital.

When they got to the emergency department this time, she was still in cardiac arrest. Since it was would have taken too much time to get her into the emergency department, one of my partners went out to the ambulance to try to revive her. His efforts were in vain as he was unable pass a breathing tube or start and IV. She was pronounced dead in the ambulance.

Last month, we were in New York visiting our daughter and her husband who live in Manhattan. We went to Momofuku Milk Bar. I was impressed that every cookie they had on display I had made myself, including Cornflake Chocolate Chip and Marshmellow, Blueberries and Cream, Compost and Corn. I also made their decadent crack pie, which was also for sale. These people really make unusual and interesting cookies. If you are interested in such things, Google their recipes and have fun!

http://milkbarstore.com/main/press/recipes-and-how-tos/