Fall is the best!

Today is one of those stunning fall days, with a clear blue sky, chill in the air, and trees ranging from green to yellow to red. After a gorgeous bike ride through a nearby neighborhood, my housemate and I stopped at a happening farmer's market that reminded us of former days in Brooklyn and Seattle. We indulged this feeling with freshly fried hot, greasy, soft cider doughnuts (perhaps the best I've ever had, not hard and cakey at all), tiny end-of-season strawberries, and a start-of-season potato pancake with applesauce. Top notch.

All this to forget the squirrel seen investigating the mouse traps in our kitchen at 9 am today.

I've been trying to buy even fewer processed foods, and learn to make what I can quickly at home. I figure it's far cheaper and often better this way. Thus the homemade bread, and today I decided to finally try granola. As I made this today, I realized that it's perfect for someone like me who loves to bake, but holds back in favor of more practical cooking. The process of measuring and stirring is about the same.

Homemade granola

• 1.5 cups oats
• 1/4-1/2 cup chopped nuts
• 1/4-1/2 cup seeds (flax, sesame, pumpkin, etc.)
• 2 tablespoons honey, maple syrup, brown sugar, etc. (this makes for a fairly-unsweet granola)
• 2 tablespoons canola oil, melted butter, coconut butter, etc.
• 1 teaspoon vanilla
• 1 teaspoon cinnamon or other spice
• 1/2 teaspoon salt
• 1/4-1/2 cup raisins or chopped dried fruit

Mix everything except fruit together in a large bowl, first dry then wet ingredients. Spread thin on a baking sheet and bake at 300 degrees until golden, stirring about every 10 minutes, about half an hour. Granola will harden as it cools. Mix in dried fruit at the end.

Scattered thoughts

I had lunch with a friend today, who has moved on to her intern year, and we talked about the sense of disorientation we sometimes have that we're actually doing this. Studying to be (or practicing as) doctors, that is. For her, it's the power to order tests and make diagnoses and prescribe, and the thrill of having her own patients. I sometimes wake up and wonder what I'm doing here, how I ended up in my small green bedroom in Albany, New York, going to med school. My friend said that for the first few months, she would forget that her patients were not standardized patients (paid actors pretending to be patients as part of medical school training); I had a similar thought with a stage IV cancer patient who came to speak to our class earlier this week. On the one hand, kudos to our standardized patients for being so believable; on the other hand, why is it that we're forgetting that real people come to us with problems? Their lives revolve around them, and we are there to help -- their lives do not revolve around us.

I suspect it's because we're so busy all the time, with hardly a moment to stop and think. We lose track of where we are and what we're doing and why. Real patients pull us out of ourselves too quickly for us to adjust; it is hard to give another person your full attention when you are stressed.

The solution, for her, was to come back from two weeks of vacation to emails from her real patients awaiting their doctor's response. Real patients, real problems without pause.

Meanwhile, baking bread. Is it real or an olfactory hallucination?

Blog-worthy fall salad

My farm share arrived today, and rather than let the veggies rot at the bottom of my fridge, I decided to chop and wash them all now. Not a bad antidote to learning about leukemia and lymphoma all day: it's all very interesting, until you fall asleep wondering what it would be like to receive such a diagnosis.

Fall harvest salad:

• 2-3 small beets, washed and sliced thin (see use for beet greens below)
• 1 small sweet potato, washed and sliced thin
• thyme, rosemary, or other herb
• handful of toasted almonds or walnuts
• salad greens (farm share gave me frisee and lettuce)
• olive oil, salt, pepper, balsamic vinegar
• garlic or shallot optional

Toss the beets and sweet potato with olive oil, thyme, salt, and pepper in a roasting pan, then roast at 400 degrees until soft with crisped edges (move them around a few times to prevent burning).

Meanwhile, wash greens (three times, if yours have as much dirt as mine!) and toast nuts. Making a salad dressing of olive oil, balsamic, plus garlic or shallot is optional.

Serve everything warm over the greens. Add goat cheese or lentils or chicken breast or sausage, etc. for protein! I will be having a white bean soup with beet greens (from above) on the side.

Familiar flavors

Since my grandmother died this summer, my dad has continued undeterred to imitate her voice. It's freaky to hear that strong Brooklyn accent now that she's gone.

I can't imitate voices, but I do have a knack for imitating flavors, whether or not I set out with the intention. It's comforting to work your way through a recipe (off-book or on-book) and end up with a flavor that is almost shockingly familiar.

This week it was turkey chili, cooked from habit, without a single thought or creative decision, that tastes exactly like dinner at home. What a way to hit the first of fall and mitigate the stress of lymph-heme. A couple of weeks ago, it was a Jewish apple cake from Smitten Kitchen. If Deb's mom didn't read the same recipe as my grandmother, then I don't know what. Could the same mutation have arisen independently twice?

Can we apply this to our patients? Is there anything we can do to offer a degree of familiarity and comfort in an otherwise foreign and scary situation? A story, a familiar word of advice, something cultural we share?

Embryological development of an apple cake

So as not to feel alone

My favorite med school activities are potluck dinners and running with friends. Most of the time, I don't actively study with other people -- passively alongside, at best. Recently there has been a lot of reading, a lot of studying alone, a lot of yoga, a lot of cooking and eating alone -- time in my own head.

The appeal of stupid websites such as What Should We Call Med School and Facebook and The Onion, all of which I frequent more -- or only, really -- as a test approaches, is that they remind me that there are other people who are going through what I'm going through.

Anyway, I found this clip of Louis C.K. charming.

Schadenfreude

After 10-hour library days and piles of new material, we don't want to hear about people having fun. We want to hear about people suffering. Last Saturday night, my housemates and I were regaled with stories of third years' surgery rotations: five a.m. call, days spent dodging residents and falling asleep standing up, watching surgeries well past lunch, jumping at pimp questions, hiding in the library. Tales of suffering and hijinks, with a subtext of, "aren't we hardcore?"

Other things that make us feel better are listening to first years struggle through the monotony of molecular and cellular biology (wouldn't you rather be studying patient care than tyrosine kinases?) and imagining those first years who complained, "I studied too much -- the test was easy" in our sorry shoes next year. We'll see how they're talking then.

Fortunately, we have a couple of clinical years after boards to bring us back to the proper levels of empathy that everyone wants in their physician. To reintroduce us to society, if you will.