Winter salad to beat those mid-February blues

I can't even talk about renal. Renal is very difficult to understand because all of the processes happening within the kidney, within the nephron, are interrelated, and so content overlaps and is not presented clearly because it cannot be presented all at once. I'll get there. On the other hand, every morning we go through cases that demonstrate how a hospitalized patient can rapidly deteriorate from a relatively healthy state if someone orders the wrong hydration or diuretic treatment. Never before have I felt the extreme importance of a subject as someone who, in two and a half years, will be writing orders for hospitalized patients. That daunting impending responsibility!

My preferred coping mechanism is avoidance -- I can get so much done! Mostly I have spent time in the woods moving quickly so not as to die of hypothermia and breathing so heavily that renal is the last thing on my mind (aka blowing off CO2 to prevent acidemia). 

Monday I went grocery shopping with a friend, who told me that she planned to make roasted tofu over spinach for dinner. I was intrigued; a quick glance at the recipe she sent me yielded this inspiration. I don't usually make new things, but making something new that tastes great is always a fun surprise. 

I wasn't sure how to dress this salad: I didn't want to mess with the strong flavors of the tofu marinade. I almost didn't dress it at all, but I ended up going with a simple sesame paste and lemon that I liked very much.

Roasted sweet potato and tofu over spinach:

• 2 small sweet potatoes (or carrots), cubed
• ~1/2 block firm tofu, cubed
• 6 garlic cloves, peeled

Marinade:

• fresh ginger, about 1 tablespoon, grated
• soy sauce
• canola, sesame, and/or olive oil
• white vinegar
• sugar or honey
• cayenne powder and/or chili flakes
• garlic powder optional
• black pepper

Salad:

• cilantro and/or scallion
• fresh spinach
• 1/2 lemon
• 1 tablespoon tahini

This can be a one-pot dish. In a large square baking dish, toss together your cubed sweet potato, tofu, and peeled whole garlic cloves. Grate ginger over the top, then add your marinade over the top: about one tablespoon each of soy sauce, oil and white vinegar, then a sprinkling of sugar and spices. Marinate in the fridge for a few hours or bake at 400 for about 20-30 minutes, tossing every 5-10 minutes to prevent burning.

Serve over chopped spinach with a cilantro or scallion garnish, and a simple dressing of lemon juice and tahini. Toss to coat. Could also serve over quinoa or brown rice for a heartier dish, but I found this plenty hearty as it was.

Sources of iron

Med school often feels like that book or movie I read or watched when I was a kid, where whatever the characters read about in a book came true for them in real life (was it "Jumangi"?). To illustrate, I got a headache the day we studied headaches and reflux the day we studied reflux.

Since taking hematology in September, I've been convinced that I have iron-deficiency anemia. I sleep all the time, I hardly any meat, I eat a lot of fiber and drink a lot of tea (both inhibit iron absorption). Three months later, we're studying GI and I find myself reviewing mechanisms of iron absorption. I was reminded that we absorb heme iron (Fe2+) much better than nonheme iron (Fe3+), and that what matters is not just that we each iron-rich foods, but that we eat foods containing the right form of iron.

Well, I looked up heme and nonheme iron here, and it turns out that I eat virtually no heme-iron-rich foods regularly (they are all meats). However, I do eat a lot of nonheme iron, such as oatmeal, lentils, raisins, and kale.

Tonight's dinner is super easy, will last you the week, is a perfect antidote to the snow, and is centered around nonheme iron. Some iron is better than none!

Lentil soup (consider this a 'kitchen sink' recipe: these ingredients are just suggestions)

• 1 large onion
• 4 cloves garlic
• 1" piece of fresh ginger
• olive oil, chili flakes, cumin, salt, pepper
• 2 tablespoons white vinegar or lemon juice
• lentils (I used about 2.5 cups, but didn't measure)
• 1/2 can chopped tomatoes or 1 chopped fresh tomato
• 1/2 sweet potato, cut into large chunks (or 2 carrots)
• 2 celery stalks, cut into 1/2" pieces
• 1 bunch of kale, parboiled and chopped
• chicken stock

Chop the onion and garlic into large pieces and the ginger into small pieces. In a large pot, saute onion, garlic, ginger, chili flakes, and cumin in a few tablespoons of olive oil. (In retrospect I think caramelizing the onion first would add a lot of flavor, so do that if you wish.) Add in lentils, celery, and sweet potato and continue to stir at high heat, then add several cups of water and chicken broth to cover. Simmer at high heat, adding water as needed, until lentils are soft to your liking. Add in the tomatoes, kale, and vinegar/lemon along the way and season as needed. Garnish with cilantro and feta cheese, if you like.

Come for the policy, stay for the food

Over the past year, I've had a great experience getting involved with Students for a National Health Program, a national and on-campus advocacy group. The organization's long-term goal is to reform health care financing in favor of a single, public insurance offering for all Americans (the "single payer" movement). Its short-term goal is to increase grassroots support among physicians and health professional students (see www.pnhp.org).

One thing I've learned in this experience is that a tight social bond around an issue can provide much of the ongoing impetus to keep pushing the work forward. As a group, we keep each other on task; more than that, I actually look forward to our meetings. Without this group of friends I would lose the reassurance that I have peers who are interested in the same broader questions as I am. As one friend said tonight, “I don’t want to be forcing single payer down people’s throats, I want to be having intellectual discussions with my classmates.”

Comparing this project to so many other ideas that I've had, started to work on, and then deprioritized, it's not the passion that I lacked, it was the social support.

Tonight we had a big potluck dinner and discussion. The food was great, the conversation even better -- I even had one of those "out of med school moments."

Potato latkes: You can use any online simple recipe, with a couple of simple tips. After grating the potato and onion together, fold them into a large kitchen cloth and wring out as much water as possible. Then toss with other ingredients (you can use flour instead of matzoh meal). Fry at high heat and don't be afraid of oil!

Apple sauce: Wash and core apples. In a large pot with a lid, add the apples, about half a cup of water, and cinnamon to taste (or one cinnamon stick if you have them). Leaving the lid on, cook over medium-low heat for about half an hour, until the apples are completely soft and falling off the skins. Stir occasionally and add more water as needed to prevent apples from sticking. At the end, use an immersion or regular blender to puree the skins. 

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.

Happy Swiss Independence Day!

Today I studied pharmacology (think Geneva-based pharmaceutical industry), ran some hills with the housemate, and finished the day off with a homemade potato-and-green-onion soup (using CSA ingredients! the most flavorful potatoes of recent memory) topped off with Gruyere cheese and black pepper, followed by cherries for dessert.

Potato leek soup (vaguely following what I remember from a Julia Child recipe):

• 5 small potatoes
• 1 leek or 2 green onions
• water or chicken stock
• sour cream, regular cream, whole milk, or Greek yogurt
• salt and pepper

Peel the potatoes; chop both leeks and potatoes into large pieces. Boil in just enough water or stock to cover the vegetables until potatoes are soft enough to mash with a fork. Puree using an immersion blender or food processor. Add cream, salt, and pepper to taste. Not exactly a summer dish, but do I have any say over when my CSA delivers me potatoes? At least it has been threatening rain all day.

Picnic food

"Home alone" for a few days without the 'rents, I naturally raided the fridge. In this case, for an airplane picnic for an overnight flight. The outcome: a beautiful picnic that will look almost as good on a plastic tray as it would on a blanket spread over grass.

German potato salad (no mayonnaise!):

• fingerling potatoes
• grainy mustard
• 1 lemon (or any type of vinegar)
• olive oil
• chopped parsley or other herb
• ground black pepper

Steam the potatoes (washed but not peeled) over boiling water or in the microwave until a fork pierces them easily but they are not mushy. Cool and then slice into quarters.

Mix together mustard, lemon juice, olive oil, chopped parsley, and black pepper -- adding ingredients to taste. Toss with the potatoes and serve warm or cold.

The other components of my picnic: chopped watermelon, a peach, cold noodles with sesame oil and soy sauce, and homemade trail mix (one dried nectarine chopped into pieces, dark chocolate chunks, toasted almonds). I definitely went overboard but I've got almost two days of traveling ahead.

Vegetarian feast

In the summer, vegetables are plentiful, but I find that it's not always obvious how to get the most out of them. Two summers ago, when I had a CSA share and more vegetables than I knew what to do with, I found myself making some pretty inedible vegetable soups and longing for more substance. In previous years, I've been enamored with the same corn, tomatoes, and salad every night. Here in my small town in Guatemala, vegetables are fresh and abundant, meat is scarce, and staples such as rice, beans, and flour are cheap and easily available.

I think I've figured out what to do to: buy whatever looks good; cook most vegetables separately with onion or garlic plus one other spice; supplement with a simple starch or protein. Cooking separately keeps flavors fresher and makes for a more varied and interesting meal.

On Saturday night, I shared a vegetarian feast with some friends. Many people to chop and to share in the variety of dishes, all freshly made from scratch with a bit of local flavor:

• smoky eggplant dip
• guacamole (recipe below)
• sweet potato chips (recipe below)
• white bread
• cheese and butter for my German friends
• salad consisting of chopped tomatoes, carrots, and zucchini (the latter sauteed first with onion in a bit of butter and oil before tossing with the other raw veggies)

A feast!

Sweet potato chips and eggplant dip 

Freshly baked bread

Simple guacamole:

Mash together avocados, lime juice, one clove or less of chopped garlic, salt & pepper. Fewer ingredients brings out the flavor of the each.

Sweet potato chips:

Peel sweet (or regular) potatoes and slice 1/2 cm thin. Toss in olive oil, salt & pepper, and an herb (such as rosemary or thyme) then spread out on a baking dish so that pieces are not overlapping. Bake at high heat until pieces are crispy, turning each piece over to cook on both sides. Recipe courtesy of Nick Haas.