Living with uncertainty

I recently met a patient whose credit card wouldn't go through as she was checking out. The problem was with the machine, not her card, but she was instantly on high alert for credit card fraud. "You have to understand," she said, "as a paralegal, I see identity fraud every day, and I'm paranoid that it will happen to me." We (the other students at the clinic and I) got it: we study diseases every day, with signs and symptoms that often appear relatively benign and familiar (fatigue, enlarged lymph nodes, etc.). Thus, med student syndrome. Yes, the possibility exists that one has lymphoma or lupus--but probably, hopefully, not.

Similarly, failing an exam--and with that, losing your summer or having to repeat the year--is always within the realm of possibility. Before med school, "failing" for many of us meant a bad grade; now, passing is a one-shot deal, determined by one exam at the end of the course. There are relatively few questions on that exam, and it's up to your best guess as to what material will be covered. This makes med school is a relatively unique and stressful experience.

So what do we do? One thing we can to is to accept the possibility and let go. Find activities that are pleasurable, soothing, distracting--like cooking! And if you choose to cook, don't worry so much about getting it exactly right: even if it's not perfect, it will likely taste just fine. G = MD.

Refreshing "mud season" salad (before spring veggies have quite hit their stride):

• fresh spinach
• handful of cilantro
• 1/2 apple
• 1/4 lemon
• olive oil or balsamic vinegar optional

Chop the spinach and cilantro. Cut the apple into 1-cm cubes. Pack up with the lemon wedge. Before eating, squeeze the lemon over the leaves and toss together. For added substance, serve with: cheddar or goat cheese, toasted walnuts, pumpkin seeds, lentils, quinoa, or yogurt on the side.

Adds a little bit of sunshine to your day!

Transformations II

The other night a friend from home asked me what we're studying these days. "Blood disorders--like bleeding and clotting--and leukemia and lymphoma," I replied. "Blood clots--ew!" was his response.

His reaction reminded me that not too long ago I couldn't have a conversation about a blood clot without feeling sick and faint. And yet without realizing it I've completely changed. We've zoomed in on clots, so that I now think about how you build a clot and how you take one down, almost as if it's construction work. What are the heritable or acquired diseases or drug interactions that impact clotting and bleeding? There's so much more than "clot--gross!" Thank goodness.

For many years I thought eggplant was gross. I didn't like the flavor, texture, or anything about it. Now I love how it's soft and meaty--a great vegetarian substitute!

Barley salad with fall vegetables:

• 1/2-3/4 cup barley, cooked in a rice cooker with 2:1 water:barley
• 6 chard or kale leaves, steamed and chopped
• 1/2 or 1 slice small eggplant, sliced 1-cm thick and roasted in the oven (I used leftovers from this sandwich that I did end up having time to make)
• few cherry tomatoes, sliced small
• feta cheese to taste
• olive oil to taste, about 1 teaspoon

Cook ingredients separately and toss together with olive oil. Enjoy warm or cold!

 

Neither of you scare me now!

Fried green tomatoes

Even I sometimes run out of time to cook. But this doesn't mean that I'm not still thinking about food, that the green tomatoes my friend and editor gave me aren't calling out to me from the fridge. I had some great plans for these beautiful tomatoes before it struck me just how little I knew about chemotherapy for leukemia and lymphoma.

Here is what I would be cooking if I were cooking.

Fried green tomatoes:

• green tomatoes
• 1 egg
• flour
• breadcrumbs
• canola or olive oil
• salt and/or parmesan

Arrange three shallow bowls or plates side by side: flour, then egg, then breadcrumbs. Slice large tomatoes into 1-cm slices or cherry tomatoes in half. Dip in flour, then a beaten egg, then breadcrumbs. Heat a generous layer of canola or olive oil in a large frying pan; when hot, lay the tomatoes out side by side in the oil. Fry at high heat until crisp on one side, then flip over (using two forks) and fry the other side. Cool on a paper bag or paper towels. Sprinkle with salt or parmesan cheese and serve right away. I'm salivating just thinking about it.

Roasted eggplant sandwiches:

• 1 small eggplant
• 1 tomato
• feta cheese
• bread or pita
• olive oil, salt, pepper

Slice the eggplant and tomato 1-cm thick. Place the eggplant slices side-by-side on a baking sheet and brush with olive oil, salt, and pepper. Bake at 400 degrees for 5-15 minutes, until soft or crispy (as you like it) but not burned. More oil = crispier eggplant. Toast your slices of bread and create a stack of eggplant-feta-tomato slices. Drizzle with olive oil if you're feeling really luxurious. Ah, the combination of textures and sweet-and-sour flavors, mm!

I did toss these into a quick stir-fry -- and yum!

Tricks for when you run out of time to cook: keep frozen soups, chili, ravioli, even prepped veggies in the freezer. Try stir-fries. Stock your fridge with snackable fruits and veggies and proteins such as yogurt and cottage cheese. Hunker down. But you know all this!

Don't stress eat!

Last night I had one of those horrible nights where bacteria- and virus-laden nonsense raced through my head as I lay in bed, in powerful mockery of my lame attempts at meditation and mind-clearing. Once an hour this was punctuated by becoming fully awake, getting up, and then laying down once again to the same as soon as my head hit the pillow.

I've been trying to do everything right, too: yoga, running, studying, dinner out, tea with a friend, reading David Sedaris stories before bed. Despite all this, the stress of having an exam every two weeks is overpowering.

So today I am allowing myself to bake a pie, make a fresh salad for lunch, and then resume studying. I will beat these pathogens!

Simple Greek salad: one chopped tomato, crumbled feta, some chickpeas, toasted almonds, romaine lettuce, oil and vinegar dressing. Each bite gives a satisfying crunch!

Another exam week

Do we eat poorly because we're stressed out, or are we stressed out because we're eating poorly? I think both. Today, I treated myself to a decent lunch to trick myself into feeling relaxed for the upcoming test. It actually took only a few minutes, and was made entirely from ingredients I had lying around.

I stopped buying cheese for a long time because it's not very good for you and it's too expensive for my budget, but I recently bought a couple of "sampler" pieces from the co-op for $2-3 each. They're actually much better suited for one person. The following recipes are heavy on veggies, light on cheese.

Mushroom toasts (my dad makes these all the time):

• 5-6 small mushrooms, sliced or finely chopped
• 1 clove garlic, minced
• 1/4 onion, finely chopped
• ~1 tsp olive oil
• 2 slices toast
• few slices hard cheese
• black pepper

Saute garlic and onion in the oil until translucent, then add the mushrooms and saute until they've shed their water. Spoon onto lightly toasted slices of bread, add cheese, and broil in toaster or oven until the cheese melts and bubbles. Add black pepper to the top.

Meanwhile...

Salad with goat cheese and radishes. Simply toss together:

• chopped romaine, arugula, salad mix, etc.
• small handful of almonds or other nuts, toasted and chopped up
• 2 radishes, sliced thin
• small piece of goat cheese, crumbled
• balsamic & olive oil

I'm feeling better already.

"I cannot responsibly answer this question"

My parents, who are both clinicians, of different sorts, frequently debate how much knowledge one should have before suggesting an answer to a question. There are certain questions (such as, "Daddy, why are there tides?") which they historically refused to answer, and others on which they are happy to speculate ("why haven't we passed gun control yet?").

I have one professor, in his late 70s or early 80s, who seems to revel in the phrase "I cannot responsibly answer this question." Some of my classmates seem frustrated with this answer, perhaps supposing that the professor would be able to answer the question responsibly if he kept up with the latest research. I think, however, that he's trying to be a role model for us, to discourage us from BS'ing when we don't know an answer -- the consequences in medicine, after all, are significant. Yet the key difference is that this elderly gentleman has the confidence and authority to profess ignorance -- whereas we, still unproven and largely incompetent, are going to be spending the foreseeable future getting asked "pimp questions" (pop quizzes) to which we will have to come up with reasonable answers on the spot. You can see how bullshitting seems tempting.

What do I know a little bit about? Cooking. Running at a nice easy pace. Tidying up the apartment. Etc. It's nice to have a few arenas where I feel some confidence, to which I can retreat for a few hours when the facts being thrown at me seem overwhelming.

Here's a nice Sunday evening supper.

Roasted eggplant parm (also simplified from Mario Batali):

• 1 eggplant, sliced into strips or rounds about 1/4-inch thick
• 1 ball of fresh mozzarella, also sliced thin
• tomato sauce, or:
• 1 can tomatoes
• 1 clove garlic, chopped
• few tbsp olive oil
• olive oil
• salt & pepper
• basil optional

Preheat oven to 400 degrees. Arrange eggplant slices side by side (not overlapping) on a baking sheet, then brush each one with olive oil and sprinkle with salt and pepper. Flip slices over and repeat on the other side. Roast in the oven for 10-20 minutes, until eggplant is soft (some pieces may be crispy) but not burned.

If you are making your own tomato sauce, heat the olive oil in a pan, add the garlic, cook for a minute or two, then add the tomatoes and simmer for a few minutes until the eggplant is ready.

Layer eggplant: eggplant-sauce-cheese (and throw basil in there if you like) in a smaller pan and bake at 300 degrees until mixture is bubbly. Serve with bread or pasta to mop up the sauce.