Of Haircuts and Vaginas

So I’m at my friend Wendy’s salon in Philadelphia today, getting one of the wonderful haircuts that only she can give me (plus color and eyebrow and upper lip waxing), on a day that she came in special because I was in from New York, even though the salon was closed, when she tells me she’s really worried about a little something she felt on the outside “down there”.

The thing about hair salons? They have plenty of gloves.

So we traipse down to the basement, and armed with my IPhone flashlight, amidst the boxes of product and with Wendy propped up on a stepping stool, I take a look and render my diagnosis – basically, nothing to worry about.

Wendy is exceedingly grateful and I’m happy to have been able to do her a favor in return for her coming in on her day off to cut my hair.

Later, as I hand her a credit card to pay the bill, Wendy says “Aren’t you even going to look at what I charged you?” and I’m thinking “Honey, you can charge me anything you want for this haircut – I absolutely love it!” but I take a look at the bill and holy cow! she’s practically given the whole thing away. I look at her, shocked.

Wendy smiles and says  – “I gave you the vagina discount.”

I love my job.

And my friend Wendy.

Candied Sweet Potatoes

Just a quick post to share this wonderful family Thanksgiving favorite.

And to remind myself not to let the fabulous food distract from what this day is really about – giving thanks.

It’s hard to do sometimes, when those we love are taken from us, when the forces of nature (and man) lead to death and destruction, and when it seems that the insanity of war will never end.

And yet here I sit, with the sun shining down on me from a clear indigo sky, in a home that has heat, electricity, water and plenty to eat, in the city I love more than any place else on this earth, surrounded by my husband and children, preparing to travel to the city in which I was born to share not one, but two delicious meals with my brothers and sisters, nieces and nephews, father and in laws.

What else can I be but grateful?

Candied Sweet Potatoes

Modified from a recipe in Gourmet, Nov 1991. I double this recipe that serves 8. Although I cut the potatoes crosswise, lengthwise, as described below, is better for the shape of the pan.

3 pounds sweet potatoes, peeled
3/4 cup firmly packed light brown sugar
2 tablespoons water
3 tablespoons unsalted butter, cut into pieces
1 teaspoon salt
1/2 tsp freshly ground pepper (optional)

Peel the potatoes. Cut them lengthwise in half. Place cut side down on counter and cut lengthwise into 1/2 inch slices.

In a steamer set over boiling water (I use a pasta inset w/ my 8 quart calphalon boiler) steam the potatoes, covered, for 10 to 15 minutes, or until they are just tender. Let them cool, uncovered. Arrange the potato slices in one layer, overlapping them slightly, in a buttered shallow baking dish. Combine the remaining ingredients in a small pot and bring the mixture to a boil and cook it over moderate heat for 5 minutes, stirring while cooking. Drizzle the syrup evenly over the potatoes, and bake the potatoes in the middle of a preheated 350°F. oven, basting them with the syrup mixture every 15 minutes, for 1 1/2 hours, or until the syrup is thickened and the sweet potatoes have deepened in color.

May be made 1 day in advance, kept covered and chilled, and reheated.

Cranberry Apple Pie – Doing Double Duty at Thanksgiving

Once again, since neither I nor my husband has ever been willing to give up Thanksgiving dinner with our respective families, we are gearing up for our annual schizophrenic Philadelphia holiday celebration, in which we join my family for an early afternoon dinner, followed by another meal at my in-law Irene’s home  later that evening.

Like us, this particular dessert will be found  at both family’s celebrations this year. It is a true harvest pie, with apples, cranberries, raisins and nuts,and quite delicious. Irene makes it every year for her dinner. I made it once a few years back for my sister’s dinner, and she requested I bring it again this year.

SInce we save dessert for the evening meal, I won’t get to taste the one I made. That’s okay – I’ll just eat a piece of Irene’s instead.

Happy Thanksgiving!

Cranberry Apple Pie

This recipe hails from the November 1985 issue of Gourmet Magazine. Irene modified it by reducing the sugar.
  • 5 cups thin apple slices (Red delicious or other )
  • 1/2 cup golden raisins
  • 1/2 cup fresh cranberries
  • 1/2 cup chopped pecans
  • 1 tsp cinammon
  • 2 tbsp corn starch
  • 1/2 cup granulated sugar
  • 2 Pate Brisee pie crust recipes (top and bottom) – see below 
  • 3 tbsp butter, cut into small pieces
  • Egg wash – 1 egg + 1 tbsp cold water
  • 1 tbsp sugar

Combine first 7 ingredients in a large bowl. Roll out bottom crust and line an 11 inch deep dish pie or tart pan. Pour apple/cranberry/nut mixture into pan. Dot with butter pieces. Roll out the top crust and place atop the filled pie, sealing and crimping the edges. Cut 5 slits in a circular pattern around the middle. whisk egg and water together in a small bowl.Brush egg wash onto crust and sprinkle with 1 tbsp sugar.

Bake atop a baking sheet on the middle rack of preheated oven at 400 degrees fahrenheit for 20 minutes, then lower heat to 350 and bake another 50 minutes or until the juices start to bubble. Remove from oven and cool.

Can be made ahead and frozen. On Thanksgiving morning, remove pie from freezer and let thaw at room temp. Pop into a 350 degree oven to warm if you like.

Pate Brisee Pie Crust made with shortening and butter

This recipe makes one crust. For this pie, you will need to make this recipe twice for both a top and bottom crust . Alternatively, if your food processor bowl is large enough, you can simply  double the recipe and make it in one batch, then splitting the dough into two crusts.

If you want a butter-only Pate Brisee that is even easier to work with than this one, try this recipe instead.

  • 1 1/4 cups flour
  • 1/4 tsp salt
  • 3/4 stick cold butter, cut into equal size 1 inch pieces
  • 2 tbsp Crisco
  • 3 tbsp ice water

Pulse flour and salt once in food processor. Add butter and pulse till consistency of corn meal, about 15 secs. Add water through feed tube and pulse till dough comes together, about 10 secs. Remove dough from bowl, pat into a round and press flat. Wrap with plastic wrap and keep cold in fridge till ready to roll.

When the Pope Plays Doctor, Women Die

A pregnant woman presents to an Irish hospital with ruptured membranes and cervical dilation at 17 weeks of pregnancy.

This is called an inevitable abortion.

When the mother begins to develop fever and abdominal pain, infection has set in.  The treatment – antibiotics and delivery of the baby, no matter what the gestational age or viability of the fetus. Delaying delivery risks maternal sepsis and death.

There is no debate about how to manage this clinical situation.  There are clear standards. Even in Ireland.

In current obstetrical practice, rare complications can arise where therapeutic intervention (including termination of a pregnancy) is required at a stage when, due to extreme immaturity of the baby, there may be little or no hope of the baby surviving. In these exceptional circumstances, it may be necessary to intervene to terminate the pregnancy to protect the life of the mother, (italics mine) while making every effort to preserve the life of the baby.

(HT to @scanman for finding these Irish regulations.)

An yet, for some unknown, god-awful reason, doctors responsible for the care of Savita Halappanavar decided that in their “Catholic” country, they were required to wait until the fetal heartbeat had stopped before terminating her non-viable, life-threatening pregnancy.

“Savita was really in agony. She was very upset, but she accepted she was losing the baby. When the consultant came on the ward rounds on Monday morning Savita asked if they could not save the baby could they induce to end the pregnancy. The consultant said, ‘As long as there is a foetal heartbeat we can’t do anything’.

“Again on Tuesday morning, the ward rounds and the same discussion. The consultant said it was the law, that this is a Catholic country. Savita [a Hindu] said: ‘I am neither Irish nor Catholic’ but they said there was nothing they could do.

“That evening she developed shakes and shivering and she was vomiting. She went to use the toilet and she collapsed. There were big alarms and a doctor took bloods and started her on antibiotics.

“The next morning I said she was so sick and asked again that they just end it, but they said they couldn’t.”

At lunchtime the foetal heart had stopped and Ms Halappanavar was brought to theatre to have the womb contents removed. “When she came out she was talking okay but she was very sick. That’s the last time I spoke to her.”

At 11 pm he got a call from the hospital. “They said they were shifting her to intensive care. Her heart and pulse were low, her temperature was high. She was sedated and critical but stable. She stayed stable on Friday but by 7pm on Saturday they said her heart, kidneys and liver weren’t functioning. She was critically ill. That night, we lost her.”

Mr Halappanavar took his wife’s body home on Thursday, November 1st, where she was cremated and laid to rest on November 3rd.

What Savita’s husband is describing is medical malpractice, pure and simple, committed by doctors practicing medicine according to the standards of the Pope rather than the profession to which they belong and the country in which they are licensed to practice.

It is tragedy and an abomination.

Were these doctors practicing out of fear and ignorance of the laws, or out of their own religious beliefs?  Did they think they had no legal recourse but to ignore clear medical standards, or did they deliberately ignore them?

We will need to await the results of the investigation into this tragic case to learn the answers to these questions, but one thing is clear.

When the Pope plays doctor, women die.

My First Curry

I think I’ve just found a new weekly dinner staple for this family.

Curry.

Fast, delicious, comforting and spicy. Adaptable to almost anything you’ve got in your larder without a trip to the store. In this case, we always have a bag of shrimp and a box of peas in the freezer, a few onions and carrots in the drawer and a can of tomatoes on the shelf. (A potato or yam would not have been out of place added to this mix…) And while the coconut milk is delicious, it’s not essential to a great curry.

I do realize that I will have to start keeping cilantro around more routinely. I think I’ll add it to my herb garden in the spring.

Shrimp Coconut Curry

This is not an authentic Indian curry recipe. It started out as this recipe, but I forgot to use the open can of coconut milk in the rice, so I decided to add it to the curry instead. I also added garlic and a few more spices –  it just seemed like the right thing to do.

What I ended up with was not far from authentic. This curry is similar to those originating in the Kerala region of India. It’s pretty mild as curries go, and not bad for my first try at this genre of meals.

Coincidentally, a patient today dropped off a big bag of spices she brought back from the Kerala region of India, so be prepared for even more authentic curries to come.

Ingredients

  • 2 tbsp canola oil
  • 1 lb shrimp, peeled and deveined
  • Salt and pepper
  • 1 large sweet onion, diced
  • 2 medium carrots, diced
  • 3 large cloves garlic, minced
  • 1 large fresh tomato, diced (or a 14 oz can of diced tomatoes)
  • 1 cup frozen peas
  • 1 1/2 tbsp curry powder
  • 1 tbsp coarse grain mustard (or mustard seeds if you have them)
  • 1/2 tsp ground cinnamon
  • 1/2 tsp ground ginger (better yet, use fresh ginger if you have it)
  • 1/2 tsp turmeric
  • 1/2 tsp cumin
  • 1/8 tsp ground red pepper
  • 1 can coconut milk
  • Chopped cilantro for garnish
  • Cooked basmati rice

Directions

Start your rice cooking.

Toss shrimp with some salt and pepper. Heat 1 tbsp oil in a Dutch oven over medium-high heat. Add shrimp to pan; cook 2 minutes until just pink. Remove from pan.

Heat remaning tbsp oil in the pan. Add onion and cook 2 minutes, stirring constantly. Add garlic and cook another minute. Add spices and cook one more minute, stirring constantly. Add coconut milk, peas, carrots and tomatoes – bring to a boil. Cover and reduce heat to medium-low; simmer till carrots are soft, about 5-10 mins. Return shrimp to pan to heat for a minute.

Serve immediately over rice with cilantro garnish.

Chili – A Spicy Meal for A Bittersweet Season’s End

It’s always bittersweet, closing our Endless Mountain cottage for the season. We don’t get there enough even in season as far as I’m concerned, so this quick hello and goodbye is almost painful.

Our busy schedule in the city means we do not arrive till after dark on Saturday. Only one other house in our little enclave has lights on, and it feels strange and deserted – so different from summer.

The season is farther along here on the mountain – The trees are already bare and the back porch is awash in 3 inches of leaves. We can see our breath even in the house, and the olive oil on the kitchen shelf is thick and cloudy. Fortunately, the water is still flowing freely through the pipes. We start a roaring fire in the fireplace and set to work making a pot of chili for dinner.

A few minutes after Mr TBTAM heads off down the mountain for a few last minute ingredients, the power goes off, leaving me in darkness. I manage to quickly reset the circuit breakers in the electric panel on the front porch and then, feeling a bit unsettled, call my older brother Al on FaceTime to keep me company while I cook until Mr TBTAM returns. This was probably not a good idea, because every few minutes Al interrupts the conversation to ask me “What’s that face at your kitchen window?” (Big brothers never change…)

Finally Mr TBTAM returns. We forgo the frigid dining room and eat our chili from bowls while sitting together on the love seat that we have pulled over in front of the fireplace. It’s too cold to move much farther from the fire, so we just spend the rest of the evening on the love seat, reading. A few more electrical resets later (the blower attachment on the fireplace insert was the culprit) the baseboard heaters are finally cranking up and we retire, gratefully, to a warm bedroom.

Sunday dawns bright and unseasonably warm, and we set to work. I strip the beds, wipe down the bathrooms, empty the fridge and kitchen cabinets, scrub down and unplug the fridge, and sweep the kitchen floor. Having seen a few droppings on the kitchen shelf that morning, I decide to set a few mousetraps for our seasonal guests. Mr TBTAM runs the laundry and rakes the yard – an enormous job that takes him all morning. Then our neighbor offers me his leaf blower and I do the back deck and patio – a job that usually takes an entire afternoon –  in 30 minutes! We stop midway through our labors for another bowl of chili – this time sitting on the porch in the warm sun admiring the fruits of our labors. After that, we bring the porch furniture and bikes into the house, make one final sweep and get into the car for the long ride home.

Another season in the Endless Mountains has come to a close. Every year I fantasize about winterizing the place, but seeing (and feeling) the place so deserted has convinced me that I prefer to leave it as it is  – my little Brigadoon, disappearing in late fall and reappearing in Spring.

Basic Chili

While there are a lot more complex recipes out there, ours is a very basic chili. The recipe below is heavier on the meat than the beans, but we vary it.  You can substitute a 12 oz can of tomato sauce for the tomato paste and water. Add a second can of beans if you want to stretch it for a larger crowd.  Serve over rice to stretch it even more, and add a side salad for a complete meal. I’ve fallen in love with sheep’s milk yogurt and no longer use sour cream to top mine.

Ingredients

  • 1 tbsp olive oil
  • 1 large onion, medium dice
  • 1 large green pepper, medium dice
  • 2 cloves garlic, minced
  • 1 to 1 1/2 lb lean ground beef
  • 1-28 oz can whole tomatoes
  • 1 small can tomato paste +1  cup water, beef broth or beer
  • 1-15 oz can red kidney beans, rinsed
  • 2-4 tsp Chili powder to taste (some brands are spicier than others)
  • 1 tsp paprika
  • 1 tsp cumin (optional)
  • Kosher salt and fresh ground black pepper to taste
  • 1/2 cup sheep’s milk yogurt or sour cream
  • 1 cup shredded cheddar cheese

Cooking Directions

Heat oil in large pot and saute onions and peppers till soft (about 5 mins). Add garlic and saute another minute. Add ground beef and saute, breaking it up with a wooden spoon,  till no longer pink. Add remainder of ingredients and cook for 30 minutes over medium-low heat. Serve hot in bowls with with cheddar cheese and sour cream or yogurt topping.

You Grew On Me…

like a tumor. Tim Minchin on that malignant kind of love.

I’ve left it too late to risk an operation
There’s no chance at all of a clean amputation
The successful removal of you
Would probably kill me too

Brilliant as usual.

Report from Red Hook – Hard Hit by Sandy

Red Hook after Sandy – Image from redhookrevcovers.org

This report from my friend Jenny, who took off work yesterday to volunteer in Red Hook, a waterfront area in Brooklyn that was hit hard by Sandy.

I am very pleased I went. I was working with a community center and adjacent church to service the Red Hook Homes (Houses?) a vast public housing complex (7000 residents according to Wikipedia). Some of the complex hasn’t had heat or power for 10 days, and the parts with electricity didn’t have heat in some cases. The church and center were serving breakfast, lunch and dinner to the ambulatory, as well as giving out food and blankets and some other things. They had electric radiators, but the public housing authority (or Con Edison) told them not to give them out, because they would crash the grid for those with power. The demand for all this, including the heating of the center, appeared to be huge.

I helped set up for breakfast, then went out to deliver food with a partner to list of people who can’t get out because they can’t negotiate the stairs with the elevators out. The wisdom of the recommendation of having male-female pairs of volunteers quickly became evident – the male is useful given the probably high level of crime, and the female is useful to persuade people to open their door. There was quite a difference between the lighted and unlighted buildings – in the latter, some parts were in complete darkness even during the day (we had flashlights), and people were reluctant to open their doors. When they did though, they were so grateful for the ready-to-eat meals we had. Many of the buildings stank – the trash chutes are not being emptied. For this reason, some residents had windows open despite not having heat. Lots of the people I delivered to didn’t look very old for the state of their health. Generally, whether at home or in the center and church, people were miserable.

After finishing the list after a few hours, my time started to be used less efficiently and more volunteers showed up, so I decided to go home.

Jenny

If you want to volunteer in Red Hook, as Jenny has, you can contact the Red Hook Initiative (info@rhicenter.org) or NYC council  SRelief@council.nyc.gov).

You can also find opportunities at redhook.recovers.org, a website that links those in need in Red Hook with those who can help.  This site is part of a wider effort started by sisters Caitria and Morgan O’Neill, who have created a website in a box (Recovers.org) that communities can use to organize in times of disaster. Other NYC neighborhoods using recovers.org are Astoria, The Lower East Side and Staten Island.

Caitria and Morgan are trying to spread the word so that municipalities actually set up and learn how to run a recovery in advance of trouble, as part of the infrastructure for emergency preparedness. Thanks to TED.org for spreading the word about this amazing effort.

TBTAM Earns HON Certification

If you find yourself wondering if the medical information you’re finding on the web is trustworthy and reliable, look for the Health on the net (HON) certification. HON is a non-profit group based in Geneva, and is one of the first sites designed to guide both patients and doctors to reliable health information on the web.

HON-certified sites undergo a rigorous review to assure they meet the 8 standards set by HON for trustworthy medical information.

1. Authoritative: Any medical or health advice provided and hosted on this site will only be given by medically trained and qualified professionals unless a clear statement is made that a piece of advice offered is from a non-medically qualified individual or organisation.

2. Complementarity: The information provided on this site is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her existing physician.

3. Privacy; Confidentiality of data relating to individual patients and visitors to a medical/health Web site, including their identity, is respected by this Web site. The Web site owners undertake to honour or exceed the legal requirements of medical/health information privacy that apply in the country and state where the Web site and mirror sites are located.

4. Attribution: Where appropriate, information contained on this site will be supported by clear references to source data and, where possible, have specific HTML links to that data. The date when a clinical page was last modified will be clearly displayed (e.g. at the bottom of the page).

5. Justifiability: Any claims relating to the benefits/performance of a specific treatment, commercial product or service will be supported by appropriate, balanced evidence in the manner outlined above in Principle 4.

6. Transparency: The designers of this Web site will seek to provide information in the clearest possible manner and provide contact addresses for visitors that seek further information or support. The Webmaster will display his/her E-mail address clearly throughout the Web site.

7. Financial disclosure : support for this Web site will be clearly identified, including the identities of commercial and non-commercial organisations that have contributed funding, services or material for the site.

8. Advertising policy: If advertising is a source of funding it will be clearly stated. A brief description of the advertising policy adopted by the Web site owners will be displayed on the site. Advertising and other promotional material will be presented to viewers in a manner and context that facilitates differentiation between it and the original material created by the institution operating the site.

I’m proud to display my HON certificate in my sidebar, and encourage you to look for it in the sites you visit for medical information. But be careful – A lot of quackery sites may simply use the HON image and falsely claim they meet the standards. That’s why HON certificate displayed should always includes a verification link back to HON. And there are a lot of great sites out there that have not applied for HON, so its absence is not necessarily a bad thing.

I must admit that I am a bit disappointed to see that HON has certified Drugwatch.com – an ambulance chasing site put up by a bunch of lawyers looking to find clients to sue Pharma. Drugwatch shows up on the front page of almost any search for the drugs for which they are searching for litigants – Yaz, Accutane and the SSRI’s are frequent targets. I wish HON would take another look at that certification.

How to Use HON to Limit Internet Searches to Trustworthy Sites

Google is getting much, much better at preferentially displaying quality info sites at the top of medical searches, and distinguishing ads from real content. They came up with some great finds on the first page of searches I did for major terms such as HPV, herpes and Menopause.  But if you have concerns about what you are seeing in a search, you can use the HON tools to focus your results within HOn certified sites – and without ads.

HON Plugin – If you find yourself spending a lot of time separating the real info from the crap when it comes to medical info on the web, consider downloading the HON Plugin so your search results will display the HON certificate right in your search results.

HON Site Search – If you don’t want to use the toolbar, you can search directly from the HON site

HON Select – You can also use HON Select to conduct searches for medical information from MeSH® terms, authoritative scientific articles, healthcare news, Web sites and multimedia – all in one search.

Try a HON search for yourself and see what you get

Search only trustworthy HONcode health websites:

Hurricane Sandy Relief – Time to Pay it Forward

If, like me, you are feeling blessed and grateful that you made it through the storm last week unscathed, here are just a few websites to find opportunities to volunteer your time and resources to help those less who were less fortunate.

Add additional volunteer opportunities in the comments section. And pass it on.

Birth Control Pills Lower Uterine Cancer Risk

In a study of risk factors for uterine cancer,  prior use of the pill was associated with a marked reduction in risk among women having a prior endometrial sampling-

We observed that OCP use before the benign endometrial biopsy or D&C was associated with more than six times lower likelihood of endometrial cancer. Similar findings in the general population were reported by othe  investigators. Estimated protection with use of OCPs ranged from 20% with 1 year of use to 80% with 10 years of use.

This protective effect of OCPs against uterine cancer is not news to us docs, but bears repeating for the public. Between the recalls, the FDA rulings and the lawyers, women rarely hear anything good about the pill.

More good news about OCPs here.

Fracking and Drought – Bad Company

I recently heard a piece on the radio about farmers in the United States who are being forced to sell livestock because they cannot raise them in drought conditions that are plaguing America in the wake of one of the hottest summers in history.

It got me thinking about how fracking uses water. A lot of water – two to four million gallons per well. I found myself wondering how many areas of the country that are at risk for drought also have shale gas in play.

Notice how much overlap there is between the two maps?

Just sayin’….

______________________________________________________________________

Maps from droughtmonitor.com and gasland.com. Here is another map from the Energy Information Administration showing the same thing as the gasland map. 

Sisters – An Election Day Parody

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My four sisters and I gathered a few weeks ago for a girls-only weekend – the first time we had done so since our Fran died a little over a year ago. Fueled by wine and laughter, and inspired by the spirit of our exuberant contest-loving sister, we decided at the last minute to enter the Prairie Home Companion Duet contest with this little parody we wrote of Sisters from the movie White Christmas – a Polaneczky girls collective favorite.

Unfortunately, our duet (well, it’s actually a trio but don’t tell Garrison…), although graciously accepted a few hours past the deadline, didn’t make the finals.

That’s okay. We still think it’s great – if not off pitch in a few spots. (There was no time for perfection.)

We also discovered that if you play it say, 20 times in a row, especially when your companions are sick and tired of hearing it, or when they are trying to fall asleep, or when there’s a pleasant lull in the conversation – it’s even better!
________________________________________________________________
Music by Irving Berlin. Lyrics by Pat Federoic, Mary Lou Rittenhouse, Rosemary Jenkins, Ronnie Polaneczky & Peggy Polaneczky. Karoake Soundtrack from Pocket Songs Karaoke “Sisters in the Style of Better Midler & Linda Rondstadt.” Performed by Ronnie, Ro and Peg.