First farm share

Farm shares and zucchini go together like summer and apple pie. I decided to revisit this recipe for cold zucchini soup. This time, I started by sauteing half a head of garlic and an onion in two tablespoons of butter, added one roughly chopped huge zucchini, and finished by boiling in a cup of miso broth. Then I pureed the whole thing and added a few spoonfuls of Greek yogurt. And that's it.

(Over the last year I started using miso broth instead of chicken broth. Usually I'd start with olive oil and finish with sour cream, but being out of sour cream I decided to switch my fats and started with butter, ending with nonfat Greek yogurt. No extra shopping trip needed.)

See? Not all cooking has to be ambitious.

Fresh pea soup

It's summer! What happened to May? I can't remember... something about a big exam...

It was raining and cold all last week in Albany, however: fresh pea soup seemed like the perfect compromise between summer expectations and a more chilling reality. This soup can be whipped up in about 15 minutes.

Fresh pea soup:

• 1-2 cups fresh or frozen sweet peas
• 1 small onion
• 1 tablespoon butter (this recipe calls for no cream, so use the butter)
• dash of olive oil
• chicken or miso broth (1 tablespoon miso paste dissolved in 1 cup boiling water)
• salt and pepper to taste

Chop the onion, melt the butter and olive oil in a small saucepan, and saute the onion on low heat for for several minutes until translucent, stirring occasionally. Add the peas (frozen right out of the bag is fine), stir, and saute for a few more minutes. Add about a cup of broth (just enough to cover the peas and onions), cover the pot with a lid, and leave it alone for a 5 minutes (I took a shower during this time). Cook just long enough for the peas to soften a bit so that the skins will puree more smoothly, but not so long that the peas turn that sickly yellow-green color. Turn off the heat and remove the lid to cool, then puree with an immersion blender and adjust seasonings. Serve hot or cold!

The soup will be this color! 

(Flowers at the summit of Sleeping Beauty mountain by Lake George, NY.)

The Best Soup

I read an interesting article this weekend entitled, "Why Nutrition Is So Confusing" that described what all med students know: nutrition data is largely inconclusive, often contradictory, and falls short of strong claims that would make for truly useful recommendations. Trials are often done for a few years and then extrapolate to decades or, conversely, populations are followed for decades and then analysts try to pull out a few recommendations. Although many of us philosophically favor diet and exercise modifications over medications, medications are not only often easier for patients, but also easier to understand as med students. We memorize pharm for the boards; we don't memorize the benefits of garlic. That doesn't mean that we should give up, just that it's a complex problem.

Intrigued by this op-ed, I decided to test just how confusing nutrition is. I looked up "garlic" in the Natural Medicines Comprehensive Database, and didn't find it confusing at all. The database ranks claims in terms of varying levels of safety and effectiveness, and concludes that garlic is "Possibly Effective" (this is a good thing) at slowing atherosclerosis and lowering blood pressure. Is it the chemicals within garlic that lower blood pressure, or is it the deeply relaxing experience of eating something comforting and delicious after a long day?

Lately I've taken up snowshoeing, which lends itself to comfort food. This soup has everything that you’d want in say, a French onion soup—umami, salt, a rib-sticking effect—and yet it’s a trick: it’s so deeply flavorful that you achieve the same satisfaction without cheese or beef stock. I didn’t set out to make a healthier version than Smitten Kitchen’s original, but being limited by what I had on hand, I’m glad that I did! I don’t think this soup needs a drop more than what I put in it.

Makes two very small bowls of soup:

• 2 small garlic heads
• 1 white onion
• 1 teaspoon dried or fresh thyme
• 1 teaspoon miso paste
• 1 tablespoon butter
• 1 tablespoon olive oil
• drop of cream optional
• salt and pepper

Preheat the oven to 350 degrees. Separate the garlic heads into cloves. Peel one-third of the cloves and set aside. Place the remaining two-thirds of the garlic cloves, unpeeled, into an ovenproof dish and toss with olive oil, salt, and pepper. Cover tightly with tin foil and roast 30-40 minutes until golden brown (but not burned!). Remove from the oven, cool, and peel the cloves.

In a small pot, melt the butter over medium heat. Add the onion and thyme and cook about six minutes until translucent, stirring occasionally. Add a drop of water if needed to prevent the onion from browning. Once the onions are clear, add the raw and roasted peeled garlic cloves. Cook another three minutes, stirring occasionally.

In a mug, pour one cup of boiling water over miso paste and stir to dissolve. This is my dad’s trick substitute for chicken broth; feel free to use chicken broth instead if you like. Pour the miso broth and another half cup of water over the garlic and onions. Cover the pot, turn the heat to low, and simmer for 20 minutes until the raw garlic cloves are soft.

Puree the soup. Stir in a drop of cream if you like, although not needed. Serve with freshly baked dark bread.

Recipe adapted from Smitten Kitchen.

Garlic soup waiting at home.

Two heads of garlic, one cup of soup.

Eating more fat (and protein)

Home over winter break, my parents picking up the tab, I found myself eating more protein. Instead of ordering soup out (usually the cheapest item on the menu), I'd order a salad with chicken or a fish sandwich. At home, we had protein every night: lots of fish, tofu, turkey, and bacon, duck, and lamb for the holidays. I felt more full at the end of each meal, and then noticed that I was snacking less throughout the day. My net intake seemed to be about the same.

As a med student, it's easy to develop a fear of fat, both in your food and on your body. (See Mulling on lipids from last April.) When I described my typical school diet to my mother, a family doc, she noted that it's strikingly low in fat--leaving me at risk for staying hungry throughout the day and eating more overall.* That rang true.

Since returning to school, I've made it my goal to eat more protein and to finish each meal feeling satisfied. It helps that my dad sent me back with two beautiful pieces of fish--tuna and swordfish steaks--which I cut into small pieces (about 3 oz) and served on top of noodle soup or with an Italian pasta dish. The nice thing about high fat fish? You can eat a small piece and feel full. The additional protein does not have to dominate.

Instead of a purely vegetarian split pea soup, this week I made split-pea soup seasoned with chicken sausages. Absolutely the easiest recipe I know. This comes from my dad but it is also the recipe on the Goya bag (sorry, dad!).

Split pea soup with sausage:

• 1-1.5 cups dried split peas
• 1 onion, sliced in half or chopped
• 1 carrot, sliced in half or chopped into large chunks (optional--makes the soup slightly sweeter)
• 1 chicken sausage, in large pieces
• tablespoon olive oil

On high heat, saute all of the ingredients in the olive oil. Add several inches of water and boil until the split peas are soft, adding more water as needed. Season with salt and pepper.

Food for tonight and the week: swordfish, tomato 

sauce, pasta pot, split pea soup with chicken sausage.

(*In terms of weight loss, low fat diets are no more effective than other diets, according to the American Academy of Family Physicians. In terms of heart disease, low fat diets are more effective at lowering total and LDL cholesterol, while low-carb diets are more effective at lowering triglycerides and raising HDL cholesterol--both are important strategies.)

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.

Doctoring is harder than I thought

Last night I saw a few patients at Dr. Bob's student-run free care clinic that takes place Wednesday nights. Every time I get a little bit better at one thing, it just gets harder: for instance, I've figured out how to fill a syringe and deliver an injection at the proper 90-degree angle, but then I realize that I've done none of the hard work to coo at and calm down the screaming toddler receiving the shot. Or, I've learned to read a blood test and identify iron-deficiency anemia, and I even flexed my "depression screening-stress counseling" skills for the first time, but then I realize that I did nothing to determine the underlying cause of the patient's anemia or counsel her as to prevention. In a chart it notes that a teenage girl had a negative pregnancy test a few weeks back: do I assume the provider at the time counseled her as to birth control and safe sex, do I take that on myself, or do I schedule a follow-up for more counseling?

Thus my feelings at the end of a clinic night are ambiguous or mixed: pride is followed by awareness of gaps and subsequent disappointment in myself. Do I end the night feeling optimistic or downtrodden? This is where I'm grateful to the residents and attendings, who witness the night and are our immediate role models. Their support and encouragement comes when it's most needed: it's okay, they say, and I should feel good about it.

You know what does get easier each time? Chicken soup. That universally makes me feel good. This time I tried an ultra-simple recipe: 1 whole chicken, 2 celery sticks, halved; 2 carrot sticks, halved; half an onion, 1 turnip, chopped; salt and pepper. Boil all together for 90 minutes, then serve with chopped celery, carrot, and onion, cooked in the soup for about half an hour, and rice, cooked separately.

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.

Summer vegetable soup

Back in Albany!

Exciting news: while I was away, I signed up for a CSA (community-supported agriculture) share from the local Patroon Land Farm. This means a fresh load of vegetables each week: beautiful kale, fennel, corn, lettuce, lots and lots of squash and zucchini, etc. For only $100, I will have fresh, local vegetables through October. I like CSA's because they take the decision about which vegetables I need to buy (which, as you might imagine, occupies a lot of brain power) out of my hands. Instead, I am presented with the challenge of how to use different (and abundant) vegetables.

This recipe comes from my friend Sasha's grandmother, the source of many delicious vegetable dishes.

Summer vegetable soup (two small servings):

• 1 large zucchini or squash or several heads of broccoli (really any vegetable you like)
• 4 cloves of fresh garlic
• 1 small onion (I used three large scallions from my farm share instead)
• 1-2 tablespoons olive oil (or butter)
• 1-2 tablespoons sour cream or Greek yogurt
• (chicken stock optional)
• salt & pepper

Chop the garlic and onion into small pieces. Heat the olive oil and add the garlic and onions, cooking for a minute, until fragrant. Meanwhile, chop the zucchini into 1" pieces (skin on), then add to the hot pan. Saute over high heat, adding a 1/4-cupful of water (or chicken stock) as needed, until the zucchini is soft, much softer than usual for eating. You should be able to crush a piece using just the back of a spoon. Season with salt and pepper.

Turn off the heat and allow the zucchini to cool. Using a food processor or immersion blender, puree the zucchini entirely, then add sour cream or yogurt to taste. Enjoy warm or cold.

Everything has grown much greener since I left

Pepian

So, what did we cook?

The request (again, this dinner party was not my idea), was for pepian, the traditional Guatemalan stew made with chicken and vegetables. I think of it as the Guatemalan equivalent of mole: a thick sauce with many ingredients -- sometimes with chocolate. We served this with salad (including avocado), a basil salad dressing, seasoned rice (with diced onions, carrots, tomatoes, and cilantro), and tortillas. The plating was beautiful, per Paulina's experience at the luxury hotel.

Pepian (or, Guatemalan chicken soup):

Amounts not exact

For the soup:

• 1 chicken
• several potatoes
• several carrots
• 1 chayote or small squash

For the sauce:

• 1/4 head of garlic
• 1 dried ancho chili
• 1 dried red chili
• 1 cinnamon stick
• 1/2 cup sesame seeds
• 1 cup pepitas (shelled squash seeds)
• 1 tomatillo
• 5 plum tomatoes

In a large pot, get a chicken soup going: cover the chicken with water, add salt, and boil. Peel and chop the potatoes, carrots, and chayote into large pieces.

In a pan that you don't mind burning (like a cast iron), begin browning the tomatoes on all sides. Blacken the skin -- you will discard it later -- and cook the tomatoes through. In another frying pan, begin browning the seeds. Slice each chili pepper lengthwise to flatten -- discard the seeds if you don't want a spicy sauce; keep them if you do. When the seeds are toasted, replace them with the garlic, then the chili peppers, then the tomatillo, as you have space. You will toast all of the sauce ingredients separately before blending them together. When they are cooked through and cool, slip the skins off the tomatoes. In a food processor with some water, blend the sauce ingredients together.

When the chicken is cooked and the soup has flavor (see tips for basic chicken soup here), remove the chicken to prepare for serving (take the meat off the bones and shred it with your fingers). Add the veggies and your pureed sauce to the stock and boil until the veggies are cooked through. Add the chicken back in to serve. Season to taste.

Serve with cilantro, lime, and avocado, if you like. This dish can be made veg by adding the sauce to a vegetable broth.

Paulina toasting sesame seeds and tomatoes

Plated dinners for 20

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:

Another raucous Friday night in Albany

Every Friday evening my housemate and I go to an extremely relaxing and yet challenging yoga class; we come home ready for dinner and bed.

White bean soup is one of my all-time favorite dinners. It's so simple and yet it took me a long time to get my version to taste as good as my dad's: the key is to use a LOT of garlic. This recipe makes a delicious base that can be easily modified -- see suggestions at the end.

White bean soup (1-2 servings):

• 1/2 head garlic, peeled and chopped
• 2 cups reconstituted white beans (equal to 1 can, drained)
• red pepper flakes
• 1-2 tbsp olive oil
• parmesan
• salt & pepper

On medium heat, saute the garlic and red pepper flakes in the olive oil until fragrant, then add the white beans. Add about 1-2 cups of water and simmer for 5-10 minutes. Mash half the beans or puree half with an immersion blender so that the soup becomes thick but retains some texture. Season with parmesan, salt & pepper, and a few drops more of olive oil if you like. Substantial on it's own or with crusty bread.

Variations:

• Caramelize an onion with the garlic at the beginning -- this will make the soup sweeter
• Season with fresh chopped rosemary
• Add chopped kale along with the white beans; do not mash or puree the beans at the end

The multipotent version:

Differentiated to kale-and-white bean soup:

Comfort food

After I heard about the marathon on Monday, I felt a strong, seemingly random, craving for ice cream. Halfway to Stewart's (the local ice cream joint) I turned around to get a diet root beer instead, my other indulgence.

But I still had to eat dinner, and peering over into the steaming pots my housemate had on the stove, I decided to go for noodles, my comfort food of choice. I basically imitated what she had going on.

Housemate's miso noodle soup:

• 1-2 tbsp miso paste or mix
• Handful of dried noodles (whole wheat soba, udon, etc.)
• Napa cabbage or lettuce (this is a point of contention: housemate says she "hates lettuce"; I used iceberg and think it came out great)
• Vegetable such as mushrooms (she used enoki) or edamame
• Tofu cubes optional
• Additional seasoning optional: cilantro, hot sauce, sesame oil, soy sauce (use just a drop)

According to my dad the food writer, the proper way to make a miso soup is to boil kombu (thick dried seaweed) and bonito (dried fish) flakes in water, fish them out, and then add your miso paste. Sometimes I'm feeling too lazy for the additional 3 minutes this requires and just skip to the miso paste. Tip from Japan: pushing the paste through a strainer as you add it to the water allows it to diffuse in the soup rather than clump together, and the result is that you can use less miso (and sodium) overall, since it mixes better.

Add water to a pot, add your veggies, boil, then add your noodles (cooked separately) and season with miso and other sauces. Lettuce (or napa cabbage) is an ingredient I noticed my Chinese-American friends using; when I tried it for the first time, I was surprised at how much flavor it added. My housemate makes this at least once a week.

I bet this would also be great with some fried garlic or ginger sprinkled on top. From a restaurant in Cambridge a few weeks back:

Luscious legumes, indeed

Sitting in the student lounge scarfing down hot, flavorful soup, it seems almost cruel not to share the recipe. The people to my left are playing foosball and pool; the women to my right are studying; others wander around in short white coats (short coats indicate students, not yet MDs). It's low-key.

Black bean soup:

• 1/2 bag dried black beans, reconstituted, or 2 cans of black beans
• 1 onion, roughly chopped
• 2-3 cloves garlic, peeled but whole
• 1 celery rib, in half
• 1 chopped carrot, optional (will make the soup sweeter)
• 3-4 tbsp ground cumin
• chili flakes
• salt
• canola oil

Heat the oil in a large post, then add onion, garlic, celery, and spices, and saute until soft. Add carrots and beans, then cover with lots of water and simmer for about an hour (enough time to watch one lecture). Puree with an immersion blender (or a food processor) such that the soup is about half whole beans, half pureed beans. Season with salt and more spice, and continue to boil off water as necessary to thicken the soup. This is hearty enough on it's own, but you could also serve it on top of quinoa or brown rice, or garnish it with some cilantro, hot sauce, and/or shredded cheese.

You'll notice a theme to these recipes: this is not that different from the chicken-chickpea curry below. To make split pea soup, skip the spices and use dried split peas -- otherwise the recipe is the same. For white bean soup I skip all the vegetables and increase the amount of garlic to about half a head... etc. So easy even a med student can do it!

Chicken soup for the modern med student

It continues to snow, so I will continue to talk about soup. I love soup: it's easy to cook, usually healthy, and makes enough food for several days. These recipes are really from last week, when I made chicken matzoh ball soup for a Seder, then gave the leftovers a makeover later in the week.

In school, we've recently been talking about cultural competency and the use of interpreters. Unsurprisingly, it turns out that many of my classmates are fluent in an Asian language. I'm trying to learn Spanish. Asian languages are intimidating, but Asian home cooking less so; between friends and my dad's interest in Japan, I've tried to pick up some tips. Familiarity with food and holidays is a start towards cultural competency: maybe one day I'll learn some language skills as well.

Jewish doctor soup:

In a large soup pot, boil the following vegetables with a whole chicken until the meat falls off the bone and the soup tastes brothy.

• 1 large carrot, peeled and cut in half
• 1 celery stalk, in half
• 1 onion, in half
• 1 or 1/2 celery root
• several cloves of garlic, optional
• handful of fresh parsley
• handful of fresh dill
• whole peppercorns

At the end, season with salt and pepper and serve with rice, pasta, or matzoh balls. I prefer to make the soup the night (or a few hours) before serving so that I can chill it in the fridge overnight and skim off (and discard) the layer of fat that rises to the top.

Asian doctor soup: Starting with the leftover chicken soup from above, reheat chicken broth with chopped mushrooms and celery and shredded leftover chicken. Serve in small bowls with hot sauce and a drop each of sesame oil and soy sauce, plus cilantro or lime if you have it.

Check out Guatemalan doctor soup here.

Exam week

Too panicked (positive spin: focused) to do anything but study the week before an exam, we regress to a hunter-gatherer state. There's often free food in the student lounge if you can be there in the 30-second-to-two-minute window before it disappears. If you sign up for a lunch-time talk or panel for visiting students, the school will supply you with cold wraps and stale cookies to sustain you until dinner. There's the 10% staff discount at the hospital cafeteria: my roommate prefers the $0.89 mac-and-cheese deal.

I've identified the fresh-food options at the convenience store and Italian deli on my block: eggs and dairy at Stewart's; onions, cabbage, and green peppers at Sainato's. It's not like living in a big city, but neither is the rent. Combining these with whatever produce I have left on the bottom shelf of my fridge usually gets me through the week. This recipe makes a lot, all the better to share with your stressed-out friends.

Cabbage soup:

• Head of cabbage, cut off of the core and sliced into thin strips
• 1 onion, sliced
• 1/2 head of garlic, cloves peeled and sliced or rough-chopped
• some other chopped vegetable: I used half a celery root; you could use a potato, carrot, or celery rib
• something sour: white vinegar or half a lemon (I used both)
• cooking wine if you have it
• salt and pepper (whole peppercorns if you have them)
• herbs on hand, such as chopped dill, parsley, thyme, or rosemary
• white beans, rice, pasta, or crusty bread optional
• few tablespoons of olive oil
• 1-2 tbsp butter

In a large soup pot with a lid, melt the butter and olive oil at medium heat, then add the garlic and onion. Saute for a few minutes before adding the cabbage plus vegetable. Add the vinegar and wine, then cover the vegetables with cold water. If you're using thyme or rosemary, add them now; dill or parsley can be added at the end instead. With a lid on the pot, cook at low heat for 30-60 minutes until the vegetables are soft (or until you reach a good study break). Separately, cook the beans, rice, or pasta, or toast a few slices of bread. Before serving, season the soup with lemon juice, herbs, salt, and pepper, and serve with the starch of your choice! 

A little bland-looking, but then again so is mac-and-cheese, and I'd argue that this is just as comforting: