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!

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.

Weekend hiatus

The results of the healthy food contest are in, and I won Best Meal! A strong endorsement of my chicken and chickpea curry. I insist that my dish was also the healthiest, but as it did not taste particularly healthy, that went to ants-on-a-log instead (you see what I was up against. The ants-on-a-log were delicious though. Classics are classics for a reason).

Friday afternoon I was exhausted (post-exam) and hungry, so I made a vegetarian stew that I will claim is the healthiest, easiest, and cheapest delicious stew out there, though not particularly refined. Once you have a well-stocked cupboard, it doesn't even require a trip to the grocery store.

Vegetarian stew from the cupboard (inspired by this Persian stew from Serious Eats):

• 6 kale leaves, washed and chopped (or other vegetable, such as tomatoes or peppers)
• 1 tbsp ground cumin (or other spice, such as curry or chili powder)
• 1 tbsp chopped garlic
• 1 tbsp chopped fresh ginger
• 1 small onion, chopped
• 1 cup lentils, cooked
• 1 cup chickpeas, cooked
• 1 cup brown rice, cooked
• juice of 1 lemon
• handful of chopped parsley (or cilantro or scallions, etc.)
• hot sauce and/or sour cream for seasoning -- this stew is an extremely flexible base and could be seasoned with a variety of things
• 1 tbsp canola or olive oil
• salt & pepper

I cooked the rice, lentils, and chickpeas the night before.

On medium-high heat, heat canola oil in a large soup pot, then add garlic, ginger, and onion. Saute until translucent, then add cumin and stir a few minutes until fragrant (you may need to add some water to keep everything from burning). Add the kale; once it has cooked down a bit, add the rice and beans. Cover with water and simmer on low-medium heat for 15-30 minutes. Add lemon juice and chopped parsley. Season with salt and pepper. Serve with hot sauce and/or sour cream.

                                                   Before:                                   After:

My excuse for not blogging this weekend:

Easter salad

Before I move on from the arugula-beet-lemon combo that I love so much, I thought I would add a couple more salad ideas:

Easter salad, named for the egg:

• 1 hard boiled egg (cooked while I was making my coffee and oatmeal before lecture this morning -- place the egg in cold water and boil the water and egg together, 10-12 minutes)
• 1/2 beet, peeled, sliced, and cooked through (you can drop this in the water with the egg or steam it in advance)
• handful of toasted almonds, chopped (popped in the toaster for 5 minutes)
• arugula
• 1/2 lemon to squeeze over the salad

This salad is fresh and colorful and adds almost no time to your morning. Other variations include arugula, beets, and lemon with steamed lentils (cooked in a rice cooker the night before) and sauteed mushrooms (sliced thin, cooked in some chopped parsley and olive oil for 2-5 minutes on the stove top). Excellent with a slice of bread or a yogurt.