I worked in the kitchen at our church girls camp for several summers. Along with other general kitchen work, I was the cookie baker. It was there I became friends with Heather Judd. She shared this wonderful recipe with me. I don’t know why it has taken me so long to share it with you. Like most cookies that have a lot of real chocolate and a little flour, they are very rich, fudgey and cook up with a shiny, cracked surface. Though this recipe called for them to be “Giant,” I made them scooped with my usual 2-tablespoon scooper and they turned out great for sharing in the emergency department.

Yield:

About 18 large cookies

Ingredients:

½ cup all-purpose flour

1 teaspoon baking powder

¼ teaspoon salt

1 pound semisweet chocolate

¼ cup butter

1 ¾ cups brown sugar

4 large eggs

1 tablespoon vanilla extract

8 ounces Heath toffee chips*

1 cup walnuts or pecans, toasted and chopped (optional)

Instructions:

Combine flour, baking powder and salt in small bowl. Set aside.

Stir chocolate and butter in top of double boiler set over simmering water until melted and smooth.  Set aside.  Cool to lukewarm.

Using electric mixer, beat brown sugar and eggs in bowl until thick, about 5 minutes.

Beat in chocolate mixture and vanilla.

Stir in flour mixture.

Stir in toffee (and nuts.)

Chill batter until firm, about 45 minutes.

Heat oven to 350 degrees F.  Line baking sheets with parchment paper.  Drop batter by ¼ cupfuls, (or large cookie scoop) onto sheets, spacing 2 ½ inches apart.  Bake just until tops are dry and cracked but cookies are still soft to touch, about 12-14 minutes.  Cool on sheets.

Notes:

When recipes call for the dough to be chilled, I usually skip that step. I have found that they usually do just fine without chilling if you are using a cookie scooper, as I always do. This recipe is an exception. Without chilling, the dough is runny, more like batter. It really needs to be chilled.

* Original recipe called for 5, 1.4 ounce Heath bars, chopped.

About 4:30 in the morning, I heard an overhead announcement, “Help at triage for a patient to Labor and Delivery, right now!” It was repeated with a true sense of urgency.

The last time I heard a similar page, I went out and caught a baby, just before it hit the tile floor in the waiting room.

This time, rather than finding a woman about to give birth, I found an anxious looking triage nurse and an even more frantic father-to-be. I was told the patient was still out in the car and the baby was coming.

Now, this would be exciting enough at the best of times, but the hospital is doing construction right now. So, there is no way for a car to pull up near the entrance to the emergency department. I grabbed the supply pack we use for precipitous deliveries and yelled at someone to get a wheelchair. I then hurried off, already some distance behind the father.

In order to get to the street, we had to run out the door to the curb, along a temporary sidewalk flanked by construction fencing, down an even longer sidewalk and then through a final walkway between more temporary barriers. As we came to the end of the passageway, which opened onto the street, I turned to make sure someone was following with a wheelchair.

When I turned back around, I was disturbed to not see the father. I quickly scanned the temporary patient drop off area. No one was in any of the cars. Where had he gone?

A holler drew my attention up the street where a minivan was parked around the corner, just out of my sight.

When I finally got to the minivan, the patient refused to get out, saying, in her Ethiopian-accented and limited English that the baby was coming out. I quickly sized up the situation. Her fundus (top part of the womb) was still high and no fluid seemed to be wetting her pants or the car seat. I told her it looked like she was OK and she had to get out of the car so we could help her.

With prodding, the patient allowed us to slowly help her out of the minivan and into the wheelchair, which was now parked in the flowerbed next to the curb. With some effort, as she would do nothing to help herself, we got her feet up on the little footrests. Then, I took control of the wheelchair and we headed back the way we came towards the emergency department.

The patient was clearly in distress. She was not holding on or doing anything to keep from being dumped on the ground as we went cross-country in the wheelchair through the flower beds, over the sidewalk, across the street, up the temporary sidewalks and around corners. I realized I needed to be a bit careful so that I didn’t dump her out of the chair onto the ground.

Fortunately, she stayed seated until we got her to the trauma room and the only open bed in the unit.

The staff got the patient up on the gurney and pulled off her stretch pants. I grabbed some sterile gloves and was just pulling them on as the baby squeezed out onto the gurney. I grabbed him and started drying him off while the respiratory therapist suctioned his nose and mouth.

For someone who rarely delivers a baby, the most anticipated thing is to hear it cry. A good strong cry means that the baby is not going to need any immediate care from me. After a couple of weak tries, this little boy was hollering just like I wanted to hear. Then, I was able to relax a bit, hand him off to a nurse and turn my attention to the mother. Soon, they were all off to Labor and Delivery.

It was not my doctoring that made the difference in this situation. I am sure that none of the other staff would have been so confident and aggressive in expediting the patient’s extraction from the car or her cross-country trip into the hospital. However, without that, the baby would almost certainly have been delivered into the mother’s stretch pants in a dark minivan or trodden flowerbed. Everything would probably have turned out all right anyway, but I was glad for the patient that she delivered on the gurney in the trauma room with us all there ready to handle any medical emergency that she or her new baby might have had.

A seventy-four-year-old woman was brought to the ED by her daughter. I approached them and introduced myself. The patient didn’t look at me or respond. She stared off in an angry or disgusted way. So, it was the daughter who told me the patient’s story. She said her mother’s behavior had been bizarre for the past five months. This included not paying her rent, and accusing her daughter of being abusive and stealing from her. The daughter said her mother had even threatened to kill herself.

During the previous week, the patient’s grandchildren, of whom she had custody, had been taken into foster care by Child Protective Services. Since then, the patient had been telling people her daughter had kidnapped the girls. Then, when the patient began running back and forth in the streets, saying she had nothing to live for, the daughter brought her to Emergency for help.

After listening to the daughter recount this story, I interviewed the patient with the daughter in the room. The patient said she was the guardian of two young grandchildren who the daughter had sent to Washington without her permission. She stated that her daughter and the daughter’s boyfriend were verbally abusive and had been taking unfair advantage of her financially. That day, while getting off a bus, she saw her daughter and a teenage granddaughter drive up and get out of their car. They started to yell at her, so she tried to run away. The daughter allegedly grabbed the patient and pushed her into the car. The patient said she had an ache in her arms and shoulders from being roughed up. She had no medical problems and she denied being suicidal.

I examined the patient and found no serious injury or any evidence of a medical problem that would cause bizarre behavior. I was not sure which of the conflicting stories to believe, so I did what any good emergency physician would do: procrastinate. I went to see someone who needed more urgent medical care and put off deciding what to do about this woman.

It was a good thing I decided to wait.  A while later, a second daughter arrived.  She said the first daughter was trying to make their mother appear insane. She was apparently doing this in order to get custody of the granddaughters who were in the patient’s custody. This second daughter seemed believable and her story was in agreement with the patient’s. When I looked for the first daughter, she was nowhere to be found.

I notified Adult Protective Services. A police officer came and took a report. He told the patient how to file for a restraining order against her accusing daughter. Since the patient had no need of medical care, we discharged her with the second daughter who said she could keep her safe.

Kind of a fun little blue bag with yellow tabs.

Backed Over by a Good Samaritan

A 62-year-old lady was lying in the road in the middle of the night. A man, driving by in a car, saw her as he drove by. He stopped and backed up to render assistance. He was so excited that, as he did so, he accidently ran her over. One witness said that after he realized what he had done, he freaked out even more and drove forward, driving over her again. The patient did not remember any of this. It was not clear why she was lying in the street at 2:00 in the morning. She suffered extensive injuries requiring hospital admission and surgery.

Remember to Put the Car in Park

A 24 year-old lady was driving her car in reverse in the driveway. She looked in the rear view mirror and saw her two children playing behind the car. She freaked out and jumped out of the car in an effort to protect them from the moving car. Unfortunately, she did so without putting the car in park. The open car door immediately knocked her down. The car continued in reverse and the open door knocked over both of the children before coming to a stop across the street. Fortunately, none was run over by the car. The driver suffered only a badly bruised knee and the children were all unhurt.

Run Over Twice by Same Car or Could This Really Have Happened?

A two-and-one-half-year-old boy came in by ambulance. His mother said she saw her car slip out of gear with no one in it. The car was parked on an incline and rolled down the hill, running over her child who was playing behind it. The car then went up an opposing hill where it stalled out then rolled back over the child again, continuing back up the hill on which it started. She said she was able to move the child before the car came back down the hill when it would have run over him a third time. He suffered multiple severe injuries.

I like malted milk balls. I have been looking for a cookie that is really malty. Here is one that I got from a friend at church. They are firm and traveled well to the emergency department where they were greeted with enthusiasm. If you like your malt more chocolaty, throw in a cup of chocolate chips.

Source:

Child Magazine’s cookie contest in 2003 via Margaret

 Yield:

30 cookies

 Ingredients:

1 cup butter, softened

¾ cup firmly packed brown sugar

1/3 cup granulated sugar

1 large egg

2 teaspoons vanilla extract

2¼  cups all-purpose flour

2 tablespoons instant hot chocolate mix

1 teaspoon baking soda

½  teaspoon salt

2 cups crushed malted milk balls (Leave pieces large.)

1. Heat oven to 375 degrees.

2. Cover baking sheets with parchment paper. Set aside.

3. In a medium bowl, cream butter and sugars.

4. Beat in egg and vanilla.

5. In a large mixing bowl, combine flour, hot chocolate mix, baking soda, and salt. Gradually add flour mixture to butter mixture.

6. Stir in malted milk balls.

3. Shape dough into 2 tablespoon balls. Place 2 inches apart on baking sheets. Bake 10 to 12 minutes, until firm to the touch. Cool for 5 minutes and then transfer to a wire rack to cool completely.

My daughter volunteers for the International Quiddich Association. * After helping out with their World Cup earlier this year, she ended up with a banner that

she turned into some cool bags. Here are some picture of one of them that I think turned out especially nice. Quiddich fan or not, don’t you wish you had one?

* http://www.internationalquidditch.org

About 4:00 in the morning, the paramedics brought in a twenty-six-year-old man who had been beaten by bouncers who kicked him out of a bar where he had apparently caused a commotion. Police, called to the scene, may have also added to his injuries when he became combative with them.

He was a thin man who was very drunk and uncooperative. He had clearly been beaten about the face, which was swollen, discolored and scratched. He had bruises and scratches on his shoulders, back, arms and legs. He refused all efforts to calm him down. He was uncooperative as we tried to convince him to let us evaluate him to make sure he had no serious injuries. No matter what was said to him, he would strike out at the questioner and say something like, “F— you!” Almost every sentence or proclamation included the “F” word.

Since he was not competent to refuse care, I could not just let him leave as he asked to do. At this point, I had to make a decision. If there was little likelihood of a life threatening injury, we could restrain and/or sedate him until he sobered up. However, if his injuries might be life threatening, then I would need to do more to diagnose and treat him. Since this patient was so uncooperative, I would have to use more aggressive means to control him so he could be x-rayed and scanned.

I decided to just keep an eye on him. I asked the patient if he had anyone sober who could come and take him home. He said he did. I asked him who. He said, “My fuckin’ parents!”

“Your what?” I asked. He repeated his disrespectful answer. Then, he sat up, looked me in the face and went off on me personally. He started by telling me he could tell I was a “fag.” He pointed out my blue eyes (I actually have green eyes) and my ponytail as evidence that I was “a queer.” He then said, using most offensive words, that he could tell that all I really wanted was to have sex with another man but had never been able to do so. “I can tell just by looking at you!”

I walked away from him so he didn’t have me as a target for his nastiness but it was not helpful. He talked with everyone the same way. He said foul, hurtful and untrue things about Hispanics, blacks, women, everyone. He was taken out of the trauma room, placed in a regular room and was assigned someone to sit and keep an eye on him.

A while later, I started to wonder if I had made the correct decision about just letting him sober up. Rather than relaxing and falling asleep, as most drunks usually do, he just got more obnoxious. He refused to stay in bed and he actually became more violent. While standing in his boxers at the bedside, he screamed that everyone there had touched his private parts and molested him. He said he was leaving. Four security guards and a sheriff deputy stood in the hall outside his door. They asked me what they should do about him.

The patient was still way too drunk and injured to be allowed to leave. Yet, my impression remained unchanged that he could safely be observed until he was sober. I told the officers to put the patient in four point leather restraints and then stay out of his sight so he was not tempted to insult anyone.

A while later, I was informed that his parents had arrived. I went in the room, wondering what I would find. They told me he had no medical problems and confirmed that he was an alcoholic and had been through rehab several times. As we talked, the patient would interrupt, repeating his accusations about having been sexually molested while under our care.

“Oh, shut up!” his father scolded.

I explained that their son was being held, against his will, because he was injured and too drunk to be safely discharged alone. I told the parents they could take him home if they were willing to take responsibility for him. Otherwise, our plan was to keep him until he cooperated with the scanning and x-rays and was sober enough to be sent out alone.

The parents didn’t even need to discuss the situation. They declined to take responsibility for him and went home.

The patient finally fell asleep. He woke up a couple of hours later and was much more pleasant. Now, it was “Yes, sir” and “No, thank you.” He agreed to x-rays, which, fortunately, didn’t show anything broken.

When it was time for him to be discharged, he wanted to know where his wallet and cell phone were. No one had seen either of these items when he came in and we were unable to find them. As I was giving him his final discharge instructions, I was very careful to not say anything judgmental. However, when he accused us of stealing his belongings, I pointed out that, perhaps, he had some responsibility in keeping track of his items.

As he turned and walked out, he said, “You are a douche bag and I hope you die today.”

A twenty-six-year-old man with mental problems was taken by his family to emergency psychiatry. Before they could get him inside, he broke away and ran off. The sheriff was called. They chased him down and, in order to subdue him, shot him with a TASER. By the time they got him under control, he was not breathing and they rushed him in to us. We did our very best to revive him but were not able to do so.

The worst part of my job is telling people their loved one is dead. When I got to the family room to do my duty, I met a middle-aged mother and several other people who turned out to be siblings, cousins, uncles and aunts. I briefly reviewed what had happened then told them he was dead. When this happened, the mother, who was sitting right in front of me, screamed, threw herself on the floor and started to flail around. Everyone else (and I mean EVERYONE) immediately pulled out their cell phones and started dialing. One aunt, as she dialed, pointed to the mom and said something like, “Can’t you get someone to do something for her?” A younger brother, also while trying to dial, started hollering at the sheriff deputy who was standing in the hall outside the room, blaming him for the death. It was the most surreal situation, standing there, watching everyone dialing and talking on his or her cell phone while the grieving mother moaned on the floor.

I finally pointed out to every one in the room that all they were doing was calling on their phones while the mom was crying on the floor. I recommended they put away their phones long enough to give her some comfort. There was some half-hearted effort to respond to my recommendation.

I told them I was very sorry then excused myself to go back to seeing my other patients. A while later, as I was writing up a note on the computer across from the dead man’s room, I heard the mother, from behind the curtains, hollering in Spanish, commanding her son to get up and walk.

My wife was in a weird mood one night and went online looking for bizarre ingredients in cookies. “Wasabi peas!” she thought and Googled away. Much to her surprise, up popped this recipe. What fun cookies! They have unusual ingredients. Rather than the usual creaming of butter and sugar, you actually boil the butter, sugar and corn syrup before stirring in the flour. They look interesting and the lime butter cream icing just makes them. Go for it!

Source:

http://www.instructables.com/id/Wasabi-Lime-Lace-Sandwich-Cookies/

Ingredients:

½ cup wasabi peas, hammered into coarse pieces

½ cup pecans, coarsely chopped

¼ cup Rice Krispies, optional

1/3 cup all-purpose flour

¼ cup butter

1/3 cup brown sugar, packed

2 tablespoons light corn syrup

1 teaspoon vanilla extract

½ cup butter, at room temperature

2 cups powdered sugar

2 tablespoons lime juice

½ teaspoon lime zest

Instructions:

Heat oven to 350 degrees.

Line 2 baking sheets with parchment paper.

Place the wasabi peas in a plastic bag. Use a kitchen mallet or rolling pin to hammer them into coarse pieces.

Combine the peas, pecans and Rice Krispies in a bowl. Set aside.

Combine ¼ cup butter, brown sugar, and corn syrup in medium saucepan over medium heat. Bring to a boil while stirring constantly. Remove from heat.

Stir in vanilla.

Stir in flour until smooth.

Stir in wasabi peas, pecans and Rice Krispies.

Using a 1 tablespoon cookie scoop, place balls of dough onto parchment-lined baking sheets, spacing 2 inches apart.

Bake 11 to 12 minutes until flat and lightly browned. Cool on sheet 10 minutes. Transfer to rack and cool completely.

Combine ½ cup butter, powdered sugar, lime juice and lime zest in a large bowl. Whip with an electric hand mixer until light and fluffy.

Spoon a generous amount of lime butter cream filling onto the bottom of one cookie. Spread the filling to the edges, then top with a second cookie and gently press them together. Repeat this process with the remaining cookies.

Notes:

The author of this recipe says that these cookies soften and taste the best when made a day in advance. I found this to be very true.

I made a quadruple batch to take to the emergency department. By the time I baked the last batch, the dough was cooling enough that they didn’t flatten well and had to be pressed down before baking in order to come out flat.

One of the places I found this recipe on the Internet, they omitted the butter from the cookies. I am glad I caught that, as they probably would have been a flop.