Feet First

“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Monday, May 30, 2011
    So Delicious. Must Share.

    Last week I returned from a two-week vacation in Italy. Half of said vacation involved a cooking class, which was great fun. It was taught by Arthur Schwartz, a food writer from New York who loves Italy and Italian food. Arthur doesn't do fancy or complex recipes and neither do I, which is a big reason why I was attracted to the class. We made a few different kinds of frittata over the week, but my favorite was this spaghetti and broccoli rabe frittata. We made it with regular broccoli, as the broccoli rabe wasn't available; but tonight I made it with the rabe and OMG, people. You have to try this.

    We were blessed with some great kitchen staff who helped out during the class (they washed a lot of dishes and did some of the prep work). One of the women helping out could flip a frittata like nobody's business. She took a big, flat metal pan lid, slid the frittata out of the pan onto the lid, then flipped the whole thing back into the pan to cook the other side. All of us amateur cooks in the class instantly worshiped her. And tonight, by golly, I successfully flipped the frittata myself. Someone should give me the Nobel prize for cooking, I am telling you. (The secret is to cook it until it is really set, which means you have to be patient.)

    So, here is my recipe, adapted from Arthur's.

    1 bunch broccoli rabe
    3 T. olive oil, divided
    1 large clove of garlic
    salt, black pepper (or you could use hot red pepper flakes)
    5 eggs - I used six
    1/4 cup of grated Parmesan
    about 6 oz of spaghetti, cooked
    recipe calls also for 6 oz mozzarella, which I skipped.

    There is some prep work involved here, but not that much, and it is oh so worth it. First, clean the broccoli rabe and peel the thick stems. Bring a large pot of water to a boil, salt it and throw in the veg. Boil for five minutes and drain. Then, add the chopped garlic to 2 T. of the oil in a 10-inch skilet, preferably nonstick. When garlic is sizzling add the chopped, drained broccoli rabe and stir it around for a few minutes until tender. Add some salt and pepper.

    While you are doing all this, boil the spaghetti till done - I broke it in half first, which worked well.

    Beat five eggs in a large bowl very well, add the cheese, cooked and drained pasta and the broccoli rabe. Add another tablespoon of oil to the frying pan and then put in the mixture. You can poke it with a fork now and again to make sure any loose egg on the top filters down. If it looks like there is not enough egg to bind the mixture, beat and add another one. (The egg is not supposed to be the main ingredient, but more of a binder; it is supposed to be heavy on the pasta and veg.)Cook over low to medium heat.

    Give this a good seven to ten minutes, then loosen the frittata, slide it onto a plate or a pan lid, then pray to your deity of choice, carefully flip the frittata back into the pan and cook the other side. Try not to eat the whole thing by yourself. Leftover frittata makes a great lunch or snack.


    Thursday, May 26, 2011
    Medical Twittergate

    Those of you who don't inhabit the medical Twitterverse may be surprised to know that quite the storm broke loose in that sheltered cove these past two days. An anesthesiologist who tweets under a pseudonym posted a few comments about a case she was called in on (it involved priapism, to be specific) and a self-anointed social media medical cop named Dr. Bryan Vartabedian called her out on it. I should emphasize here that there was absolutely no way to identify the patient Doctor #1 referenced and the patient's privacy was not violated. If you want to see the tweets in question, they are linked at the end of his article. I am revealing the name of Dr Vartabedian specifically because he used Doctor #1's tweets and identity without disguising them, despite wondering aloud whether the patient's privacy had been violated (again, in my opinion, it was not). The word "unprofessional" was tossed around - very carelessly, I should add.

    I read the posts and was not convinced that Doctor #1 had done anything unprofessional or inappropriate. If you read the comments at the end of Dr. V's post (there were over 130) you will see that there was a vast divide between the "appropriate" and "inappropriate" sides of the debate. Doctors, nurses, pharmacists and even patients felt that the idea of making even mildly joking anonymous comments about patients and work frustrations was either human and understandable or appalling and horribly unprofessional, depending on what camp you fall into. My comment was the last of the bunch (I guess Dr. V. got his nuts kicked in and decided to close the comments. How... unprofessional!) and I supported Doctor #1.

    The best way to explain my take on all this is, I think, to reference the movie and TV show M*A*S*H. Healthcare professionals are under fire on a daily basis (metaphorically speaking). The show is a perfect reference for what we go through all the time. Black humor is our only defense. Doctors, nurses and everyone else in healthcare have been making sick jokes and complaining about patients since the dawn of time. That doesn't mean we aren't dedicated to what we do. I love my interactions with patients and I love primary care, but if you cut off my ability to crack wise, I'd quit tomorrow. It's a stressful profession and we see terrible things. That's just all there is to it.

    Medical "social media," and how I hate that term, is an updated version of the doctors' lounge. However, Dr. V is correct in that now anyone can peer in to see what we're saying and we do need to watch ourselves. I limit my posts about specific cases for this very reason. When I do post I change ages, genders and other minor details. The underlying issues, though, are the same and will remain the same no matter how many changes I make. It's a relief to air my frustrations and a relief to see that other healthcare professionals face the same problems I do. Were Dr. V to make the rules, I daresay none of us would be allowed to post. The hell with that. I need my vent just as much as my fellow posters do. Instead of complaining, Dr. V should observe more... he might learn something.

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    Sunday, May 01, 2011
    Osama Eats Lead


    Unapologetically, I'm thrilled that asshole is dead. And thank you President Bush (and to our current president, who authorized the mission). So freakin' glad this guy is dead. Click here to join the celebration.

    What with this and the recent missle attack on Khadafi, I do rather wonder what the folks who voted Obama the Nobel Peace Prize are thinking right now.



    About a year ago the food writer Mark Bittman published an intriguing-sounding article about yakisoba, a quick meal involving noodles and vegetables. Japanese food has always intimidated me - I am not a big fan of sushi, and I would never make tempura at home. (Why mess with a deep fryer if you don't have to?) But this sounded simple and quick, a good dinner for one. As is my wont, I printed his article and added it to my overstuffed notebook of recipes. There it sat patiently waiting for months while I kept forgetting to look for the noodles and mirin mentioned in the recipe.

    What really attracted me to yakisoba was Bittman's encouragement to personalize it. I must confess that I like to play with my food, and any recipe that tells you to improvise and experiment is a recipe that I will probably try. You can basically add any vegetable and/or protein that you want to the noodles - I used onion, cabbage and mushrooms. I think thinly sliced celery would also work. You cook the add ins first, then take them out of the pan and put in the noodles. I finally found fresh yakisoba in the refrigerated section of my local Albertson's. Any grocery with a decent selection of ethnic/Asian foods should have them. You do have to add some water to the pan as you cook the noodles to help separate them. Then add your veg back in, add the sauce (which you have mixed prior to beginning the cooking process) and voila!

    Ah, the sauce. What to put in it? My noodles came with a packet of powdered flavoring, and I might try this next time just to see how it tastes. But Bittman's description of the sauce is really what inspired me to try the recipe. He says that yakisoba recipes "use everything from applesauce to mustard, neither of which works for me" and recommends a combination of ketchup, soy sauce, Worcestershire, mirin and Tabasco. To me this tasted kind of like Spaghetti-O's, but I think I used too much ketchup. I'll use less next time. I like mustard much more than ketchup, so I may go hunting for a mustard-based sauce to see if this works better.

    If you think this combination sounds high in sodium, you would be correct. I found a low-sodium recipe for yakisoba here; you may want to give this a try if sodium is an issue for you. All told, this was a worthy experiment and one I will make again. Yakisoba is the sort of thing I can tweak and polish for years, and that's just the kind of recipe I like.