Capturing Manhattan

I’m been driving my family crazy for the past month or so, as I try to get a great night shot of the Manhattan skyline for my blog banner. Of all the possible views of my fair city, I’ve decided to go for the view from Queens, because it’s the one that stirs my heart the most. You know the view if you’ve ever driven into Manhattan at night on the Long Island Expresswway. It hits you straight on, smack in the face, as you head over the last hill toward the Midtown Tunnel. Awesome.

Of course, I can’t set up a tripod on the LIE. So, I’ve been making my husband stop the car on the 21 Street on-ramp of the upper level of the Queensboro Bridge as we are schlepping the kids in from theater classes on Roosevelt Island. He pulls over and puts the flashers on, and I lean out the window and do my thing. We’ve done this about 4 times now, and this is the best shot I’ve gotten so far using this approach. Still not good enough for the banner, but with some cropping and zooming, it’s getting close. See?

So far no one has hit us, and no cop has stopped us, but I get the feeling my days are numbered if I keep trying this approach. Plus, I can’t get the photo sharp enough because of the constant vibrations of the on ramp and the car. I’m afraid to get out and set up a tripod for fear someone will “clip me”. (That’s my Grandmother’s term for getting hit by a car).

What I really need is a rooftop in Long Island City. Or maybe I’ll head down to the water in LIC and see what view I get there. If anyone has any suggestions as to where I can go to set up a tripod, let me know. Of course, at that point, finding the time to do it will become my biggest problem.

Until then, If you see me parked on the Queensboro on-ramp, try not to clip me.

Category: Considerations

Spaghetti with Asparagus and Lemon Cream

Here’s another very simple recipe from Donna Hay’s book Off the Shelf that we made for dinner last night. This version of the classic recipe takes advantage of the gorgeous asparagus we’ve been seeing in the markets lately. I’d never had lemon cream sauce before, and I really liked it. Made with veggie stock, it makes a great veggie main dish. We served it with a simple salad of greens, balsamic vinegar and oil, with shaved parmesan. The kids had bread, but I did not, I am proud to report. (I am also proud to report that I went to the gyn today, and as I am typing this, my daughter is eating ice cream and I am not. Those of you who know me well know that this is a good thing.)

That’s Donna’s photo of this dish over there on the right. It is of course no suprise that her photo is much prettier than mine. I love how she curls the pasta in that little tower. And I don’t know about you, but I’ve never seen such white spaghetti before, and certainly not when it’s coated with a lemon cream sauce that has this much parmesan in it. Just shows you want the right lighting and food styling (and photo retouching) can do for a dish.

But you know what? I’m not jealous. Because mine tasted just great.

Spagetti with Asparagus and Lemon Cream
1 1/2 cups cream (we used half and half, I bet it would taste just as good with milk)
1 1/2 cups chicken stock (You can use veggie stock if you want)
1 tsp grated lemon zest
1/4 cup lemon juice
3/4 cup finely grated Parmesan cheese
14 oz spaghetti
500 gm (1 lb) asparagus, trimmed
1/4 cup parsely, chopped
pepper and salt to taste

Plcae the cream, stock and lemon zest in a frying panover medium heat and allo to simmer rapidly. Gradually whisk in the lemon juice, then stir in the parmesan cheese and cook for another 10 minutes or until the sauce has thickened.

Place the spaghetti in a large pot of lightly salted boiling water and cook till al dente. Drain.

Cut the asparagus into thirds and steam over boiling water until tender. (We just cooked it in a flat pan with just enough water to cover, like we always do.)

To serve, toss the spagetti with the asparagus, lemon cream, parsley and salt. Serves 4.

Category: Food

Sweet Potato Curry Puffs, Chili Fish with Sweet Lemon Salad

It’s only taken me three years to finally make something from Donna Hay’s beautiful cookbook Off the Shelf, which I received some time ago as a holiday gift from Irene. It’s not that I don’t look at the book – I do. The photos are gorgeous, and the food looks really good. Donna Hay started her career as a food stylist, and it shows. I swear, she could make a dirty pot look appetizing.

But the book is almost too gorgeous to be called a cookbook. It reminds me more of a coffee-table book about cooking. Think of a paper verion of Giada De Laurentiis’ show on the Food Network. I hate that show. It’s over-edited, over-produced, perfect knife sounds overlaid whenever she slices an onion, fancy angle shots on the food, that perfect little smile every time she looks at the camera. Annoyingly perfect. And nothing like a real kitchen.

But I do like Off the Shelf. Why? Because, despite the styling, the recipe ideas in it are wonderful. Really. And they’re different, yet often very simple to make. Recipes like warm potato and tuna salad, spaghetti with asparagus and lemon cream, salmon on fennel salad, crisp rice omelet. There are a lot of light recipes in here, too.

The book is organized atypically, if not exactly intuitively, according to category of staples that you might have on your kitchen shelves. (Some might argue that miso paste is not really a staple for most of us, but we’ll let that go.) Chapter titles are Pasta, Rice, Grains and Lentils, Mediteanean, Asian, Pastes (harissa, miso and curry pastes, mustards), Bake (flour, baking powder, nuts chocolate)and Sweet (sugar, honey and the like). Within each chapter, there is a section called Basics, then Tricks and Tips, then a whole lot of recipes.

Hay’s point in organizing her book this way is to get you thinking about ingredients in your cupboard not just as something on a shopping list for one recipe, but as inspiration for meals. That’s a good idea for cooks who might buy Asian Red curry paste for a single recipe, then stick it in the fridge and forget about it for a year. If you find yourself asking “What else can I use this stuff for?” then Off the Shelf is the book for you.

Every single recipe in this book has an accompanying photo. To make room for the photos, the recipes are written in the briefest of form, anywhere from 4 – 9 on a page. This means that there are few instructions. For example, the recipe I made last night starts out “Cook 1 tablespoon peanut oil, 1 chopped onion and 1 tablespoon Thai green curry paste for 1 minute.” Cook it where? On the stove? In the oven? And in what kind of pan? And what size onion? Now, I knew to saute it, and because I read the recipe, that I’d need a pan big enough to hold the sweet potatoes that were coming up next. And I used a medium onion. So if you know a bit about cooking technique, the recipes have all you need, and you’ll appreciate the opportunity to do your own thing without being spoon fed. But if you’re a fledgling cook, this book may not be for you.

One other thing – Quantities are often weight, not volumes. But I don’t mind that, I have a great little kitchen scale with a bowl attached. And I feel so European cooking by weight…

In addition to her cook books, Donna has a web site and a magazine. Her motto is “Turn simple into special”. Here’s a quote form her bio:”…cooking has allowed her to create a brand that is accessible to anyone who has a kitchen.” When I read that, I realized what exactly it is that annoys me about her book – she is using branding techniques on simple foods, selling us capers and flour and sugar as something more than the plain ingredients they are. She doesn’t need to do that, anymore that Giada needs to overlay sizzling sound clips when she throws a pice of meat into a pan. It’s over-styling. She should have put the energy into writing the recipes, as far as I’m concerned.

…But I’m rambling. The whole point of this post was to tell you that I finally got over myself enough to actually make a few items from the Off the Shelf, specifically from the Pastes chapter. I made Chili Fish with Lemon Salad, and served it with Sweet Potato Puffs. The meal was absolutely delicious, and my family loved it. The three items were a great combo on the plate and on the palate.

So now, depite my complaints about it, I’m totally sold on this cookbook as a great source of ideas, and can’t wait to make something else from it.

Sweet Potato Curry Puffs

These are like samosas. They have a nice bite to them. Since the recipe itself was written as a single paragraph with ingredients in the sentences, and lacked basic intruction or an ingredient list, I’m re-writing it here the way I think Donna should have.

1 tbsp peanut oil
1 chopped onion
1 tbsp Thai green curry paste
600 gm (about 3 cups) peeled and finely diced sweet potatoes (I used yams)
3/4 cup coconut cream (I assumed that meant coconut milk)
1/2 cup thawed frozen peas
2 tbsp chopped cilantro
1 beasten egg
5 inch puff pastry rounds (Sorry, that’s all she says. Actually, what she says is “Place [mixture] in the middle of 5 inch puff pastry rounds.” Not how much filling, or how much pastry. I’d say you need pastry enough for about 24 rounds, but have no idea how much pastry I’d need to make to get that. I used store bought pastry, got 16 puffs, and had some filling leftover.)
8 oz Yogurt
2 tbsp chopped fresh mint (or more)

Preheat oven to 350 degrees F. Heat 1 tbsp peanut oil till hot, then saute 1 chopped onion and 1 tbsp Thai green curry paste for 1 minute. Add sweet potatoes and coconut cream and cook, covered, over medium heat for 10 minutes. Add peas and chopped coriander and allow the mixture to cool. (Actually, I added the coriander with the potatoes.) Meantime, roll out puff pastry and cut into 5 in rounds. Line a baking sheet with parchment paper. Place round onto sheet, and place about 2 tbsp filling into it. Fold over pastry and press edges to seal. Brush with egg wash. Bake for about 20 mins till puffed and golden. Serve with plain yogurt blended with some chopped fresh mint.

Chili Fish with Sweet Lemon Salad

The real star of this dish is the lemon salad, so I’m giving it it’s own photo. It is absolutely an amazing little side dish that I know I’ll be making again and again. You can really use any Asian spice rub on the fish. It’s the combo with the cucumber and the lemon salad that makes it special.

Sweet Lemon Salad
4 lemons
1/2 cup sugar
1 red chili, seeded and chopped (That may be too hot. We used red chili pepper flakes, about 1/8 tsp)
1/4 cup chopped mint
cracked black pepper and salt to taste

Peel the lemons, removing and discarding the white pith. Chop the flesh into a dice. (Hard to do this without losing all the juice, so we just used a grapefruit knife to get out the sections and served them whole. In Hay’s book, it looks like thye used a tiny melon baller to get the lemon pieces.) Combine with sugar, chili, mint, pepper and salt.

Chili Fish on Cucumber
4 – 7 oz pieces firm white-fleshed fish (We used Telapia)
2 tbsp Asian red chili paste
2 tbsp cilantro (chopped)
Salt and pepper to taste
1 tbsp peanut oil
2 sweet cucumbers, sliced to serve

Spread the chili paste on the fish and sprinkle with coriander. Heat oil in a non-stick frying pan over medium heat. (We used a regular saute pan, and needed a little more oil) Add fish and cook for 2-3 minutes on each side or until tender.

To serve, place the cucumber slices on plate, top with the fish. Spoon some lemon salad on the side and serve.

Category: Food

Phone Tag

(This is an old post, recovered from my blog crash. I just now found it, but you may have already read it . If so, sorry.)

On any given day, the black chart rack on my desk behind the phone is stacked full of charts waiting for call backs from patients.

Here’s how it goes – They call me, but I’m in a room with a patient. I get the message. I call back. All I get is their voice mail. (This happens even if I call back a scant 15 minutes later.) I leave a message, put the chart in the rack.

Sometimes when I call back, my patient’s secretary, used to playing the wall, gives me the “She’s in a meeting ” line. Can she call me back? Or a family member answers and tells me the patient is in the shower (or sleeping or busy). Can I call back? Or the patient has a call on the other line. Can I hold?

No, I can’t. I’m busy, I’m important, I’m the doctor!

What ever happened to the waiting for the doctor to call back thing? I remember as a kid, my mom would call our family doc because one of us had a sore throat, or the chicken pox or God knows what else. She’d leave a message.

And at that point, the entire family would go into Doctor-Call-Back Alert. My mom didn’t leave the house. No one moved. No one breathed. If the phone rang, and and it wasn’t the doctor, my Mom would shout “Get off the phone! I’m waiting for the doctor to call back!” And he always did. But our lives went on hold till it happened.

Now they put me on hold.

Category: Second Opinions
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COMMENTS

Schruggling :March 18, 2006
Just a quick St. Patrick’s day observation…why aren’t your file folders green? Red? This isn’t the Russian High Holy Day after all…

You may not be able to get through to your patients right away, but I am sure that when they get your message, they not only feel bad to have missed you, but probably hit themselves in the head with their palm, and yell “doh!” like Homer Simpson.

If it makes you feel any better about how busy the world has gotten, I am an average Joe in a sales job trying to do the best I can. I am not an executive. Yet, I find that I cannot take one day off without consequences. Here it is nearly 1 AM, and I just retrieved the 19, (let’s say that out loud, and together) again, 19 messages that I got today. And when I call these people back, I will, without fail, get at least 15 voice mail services…ugh. As an up note, I think I may steal your organizational system with the file folders behind the phone. My system is just a scrap paprer with notes all over the place. No where near as meaty and impressive.

shuna fish lydon:March 18, 2006
wow when can I make You my doctor? at kaiser we cannot even get through directly without secret permission. but a new doctor gave me his email address the other day. this I find amusing and intriguing!

TBTAM :March 18, 2006
shuna: Use that email, its a gift. Though I must say I am not a big fan of the whole email thing. For quick simple questions, it’s fine. But I like to hear the tone in a patient’s voice, and the phone allows for much more back and forth QA than email does. That said, I get and answer about 8 patient emails a week.

Schtruggling:
I feel you pain… Those red charts (whose patient identifies I easily smudged away using the smudge tool on my photo software, thank you very much) and my system are going bye-bye very soon, as we are going to an online medical record. Prepare for massive whining when that happens. For someone as organized as I am, to have to throw it all away for someone else’s system, even an online one, well, ask OBS what that would feel like…

Tara’s World: March 18, 2006
Im the same way as your mother was, If I leave the house the Dr will call when im out, SO I dont leave. But in a quirky twist of fate when I dont leave he wont call until 6pm or later

BigMamaDoc:March 18, 2006
I, too, play phone tag all day with patients (usually the same 20-40 patients every day). Every time I try to return a call, I document it in EMR (takes only a second). My absolute favorite thing is when the patient reports me to the Patient Services Cop, who calls me to the carpet to discuss my bad call return habits. I love to show up with my printout of my 15 attempts in 4 hours to get back to pt. Ha! I WIN!

Janae:March 21, 2006
I try to stay around the house when I’m expecting a call from my pediatrician, but sometimes it doesn’t work that way. If I know when I’m going to be gone at a certain time, I let him know when I leave my message. I also let him know when the best time is to call back just in case he’s available at that time. It’s works for us because I can only think of one time when I’ve missed his call. –

Ragging about Ragout

Found and made this recipe from Epicurious tonight. The vegetable combination (pearl onions, peas and artichokes) really appealed to me. It paired nicely with some smashed red bliss potatoes and chicken. However, I think it needs something in the way of spices. I did add a bay leaf to the sauce, and kosher salt and ground pepper, but something was missing.

I had looked around the web for similar recipes to get some ideas, but found nothing. I thought about spicing up the onions a bit more, maybe tossing the artichokes onto the baking pan with the onions to brown them a bit also. Maybe some balsamic vingear or lemon? But I couldn’t decide what to do, and truth be told, on a week night I wasn’t feeling adventurous enough to risk spoiling it and having to start all over. So I pretty much made it as written (though I did cut back a bit on the butter, and used both pearl and chopotle cipollini onions.) It really was good, but next time I’d like to take it up a notch, as our friend Emiril would say.

Suggestions, anyone?

Ragout of Pearl Onions, Peas and Artichokes

1 1/2 pounds pearl onions
1 tablespoon olive oil
5 tablespoons butter
1 teaspoon minced garlic
2 cups chicken stock or canned low-salt broth
1 10-ounce package frozen artichoke hearts, thawed, drained, halved lengthwise (I used canned)
2 cups fresh peas or frozen, thawed

Cook onions in large pot of boiling water 2 minutes. Drain and cool. Peel onions.

Preheat oven to 400°F. Transfer onions to rimmed baking sheet. Drizzle with oil. Sprinkle with salt and pepper. Toss to coat. Bake until tender and golden, shaking pan occasionally to turn onions and brown, about 35 minutes.

Melt 1 tablespoon butter in heavy large skillet over medium heat. Add garlic; sauté 1 minute. Add stock; boil until liquid is reduced to 1 cup, about 10 minutes.

Add onions, artichokes and peas; simmer until onions and peas are crisp-tender, about 4 minutes. Add 4 tablespoons butter; stir until melted. Season with salt and pepper.

Makes 6 servings.

Category: Food

Getting Through

She is a tiny, sweet-appearing student on summer break from a Small Community College – we’ll call it SCC*. Short, curly hair pulled back in a cloth hairband, soft ringlets springing out around her forehead. Pretty eyes. Wears a long cotton skirt and cowboy boots. A bit of a throwback, I think.

She asks if every 3 months is frequent enough for HIV testing. I look at her chart, and see that her last HIV test was just 3 months ago.

Why?” I ask. “Have you had a new partner since your last visit?”

“I’ve had a few,” she says.

“Well,” I prompt, “how many in the past month? ”

“A lot.”

Ah, I think. She’s in that post-high-school wild phase. We’re going to have to talk about this. “Give me a number.”

She looks upwards for a few seconds. “I don’t know,” she says finally.

Oh, c’mon, I think. Tell me. I recall my own post-college wild years. You can’t top me. So, let’s play numbers. “More than 10 or less than 10?”

“More than 10.”

In the past month? “More than….20?” I keep my voice steady, my tone neutral, non-judgemental.

“More than 20,” she replies.

The light bulb went on. “You’re a prostitute,” I say.

She nods. I look up to be sure the door is closed. “May I ask why?” I inquire.

“I’m saving for college tuition,” she states, also turning to check the door.

We settle in for the discussion.

She got accepted at a Brand Name University. You know the kind of school – may or may not be Ivy League, but very hot, suddenly impossible to get into. We’ll call it BNU. Dad cannot afford the high end tuition at BNU, but makes too much money for her to qualify for financial aid. He can only afford the local community college. Hence the freelance job.

She earns $1,000 a day, and has saved over $40,000 so far. When she gets enough, she’ll have finished her associates at SCC and will re-apply to BNU.

“Didn’t you talk to the financial aid office at BNU? Can’t you take out loans?” I suggest.

She doesn’t want to borrow money, and turns up her nose when I press the idea further. As for BNU’s financial aid office, they were mean, she says. Said “Just tell us if you’re coming, because if you’re not, we have a waiting list full of other applicants.”

I begin to get angry for her. “How can they be that way? Don’t they know how much their decisions affect people’s lives?”

I have an idea. “Let me call the Dean at BNU.” (Not that I even know who the Dean is, but when you get to be my age, you feel you have the right to talk to anyone, whoever they are. My tone conveys this conviction.) “If he knew this was what BNU’s high tuition has led to, I’m sure he’s get them to help you out.”

But she refuses to let me intervene. That’s okay, I still believe that I can work this angle for her, and I think perhaps I’ll just call that Dean anyway and feel him out. But in the meantime, I offer to refer her to a college counselor. No response.

I start running my rolodex through my head, trying to figure out who I can call to help this poor kid out. Then it occurs to me. She is not homeless, she is not starving, she is not a kid with no future. She is just a really bright kid whose only option right now is a local community college and not a Brand Name University. This is not such a terrible place to be. Certainly it can’t be bad enough to justify the risks of prostitution.

I tell her this. She seems to be listening, so I go on. I tell her that where she gets her degree does not define whether or not she will be a success in life. If she really is as good as student as it seems she is, she will learn what she needs to know just as well at SCC. She wants to go into business (no comments, please). “Do you really think they will teach you to put the debits on the credit side of the ledger at SCC?” I ask her. This elicits a smile.

I figure she still hasn’t tuned me out, so I tell her my story. How I didn’t even get an interview at the Hot Shot Medical School. How I ended up going to the Local University Medical School and Very Local Community Hospital Residency Program. And how my first job post-residency was on the faculty of that very same Hot Shot Medical School. Not bad for a low-end degree, huh? “Where you go to college does not determine your life,” I tell her. “You do.”

No go. Because as we talk further about the risks of her behavior, it becomes clear that the real problem is that she does not think what she is doing is at all stupid. After all, she uses condoms religiously. And what’s the risk, anyway, of getting HIV if you always use a condom? I’m not sure of that number when one has as many partners as she does, so instead I tell her a story about a patient who got HIV when the condom broke. I’m not sure she believes me.

“Besides”, she contends, “I’m not having anal sex, and I don’t swallow. And the condom has never broken.”

We talk more, juggling numbers, estimating risks, talking odds. Then it is clear she is finished the discussion.

So I wind it up, taking one final stab at my own argument. “Look”, I say. “Think of it this way. That degree from BNU is like a pair of Calvin Klein jeans. You can get just as cute a pair on sale at Old Navy. And you’ll still be alive to wear them.”

She smiles. “I love Calvin Klein.”

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*This is a story I had posted and immediately pulled awhile back. (See this post about why.) I’m reposting it now because I asked for and obtained her permission to tell this story. Of couse, identifying details have been changed, personal information disguised, and HIPAA privacy rules maintained.

Category: Second Opinions

Physician, Feed Thyself…

All this medical food blogging has gotten me to thinking about the similarities between chefs and doctors.

What is the same

1. They’ve got the whites and the chef’s hat, we’ve got the greens and the caps and masks.

2. Both require intensive training with a clear hierarchy of ascent.

3. The chef and the surgeon are captains of their respective ships – the kitchen and the OR.

4. Skill with sharp instruments is necessary for both professions.

5. We both work long hours, including nights and weekends.

6. If we both do our jobs right, our clients walk out feeling better than when they walk in.

7. We have JCAHO, they have Frank Bruni.

8. A knowledge of organic and biochemistry is essential in both cooking and medicine.

9. Medicine and the culinary arts have many aphorisms and truths: For example, “If you hear hoofbeats, it’s a horse, not a zebra.” and “The oven can wait for the cake, the cake can’t wait for the oven”.

10. Classic texts: We have Williams Obstetrics, they have Lourousse Gastronomique.

11. Clogs. We love ’em.

What is not the same:

1. Doctors should not take care of family members, but chefs should (and do) cook at home

2. They don’t have to worry about malpractice.

3. They cause food poisoning, we cure it.

4. Iron Surgeon? Nah, it’d never fly…

5. We only talk about food (“A fibroid the size of a grapefruit”).

6. We call a thymus a thymus. They call it sweetbreads.

7. We call it fatty liver disease and treat it with a low fat diet and exercise. They call it Fois gras and treat it like a delicacy.

8. Let’s see…Clients leaving restaurants pay a $20 co-pay and their dining out insurance picks up 80% of the reasonable and customary cost of their meal? Hmm…

Category: Second Opinions, Food

Meat Loaf – I Can See Paradise by the Oven Light

Ain’t no doubt about it, this meat loaf is doubly blessed – mushrooms flavor both the meat and the gravy. Because I am beginning to look like our friend Meat Loaf over there, I started Weight Watchers today, and thus have no intention of blowing an entire days points on dinner by actually making this particular meat loaf tonight. But I had mentioned it in a previous post, and a reader has requested the recipe, so here it is.

Although this is not Irene’s only meat loaf recipe, it is a particularly interesting, if not a bit fattening, one. She’s got another good meat loaf recipe in her short-lived blog Cooking with Grandma. Maybe you guys can convince her to restart her blog. The world needs her recipes. Until then I will continue to leak them to you through my blog. (Carl Rove, step aside.)

MEAT LOAF
Oliver Clark’s from the New York Times
With variations by Irene

3 cloves garlic
2 tbsps. olive oil
2 medium onions
1 red pepper
salt and pepper
5 oz. fresh mushrooms
1 lb. Ground beef
1 lb. Ground pork or sausage meat
½ cup matzo meal
1 tsp. Dijon mustard, heaping
1-1/2 tsp. Old Bay seasoning
1/3 cup Parmesan cheese, grated
3 tbsps ketchup
1 tbsp. Mayonnaise
2 tbsps. whipped cream cheese
½ cup chicken or beef broth
2 eggs, lightly beaten
¼ lb. Bacon

Ingredients for gravy:

2 small cans tomato sauce (8 oz. cans)
5 oz. fresh mushrooms, sliced
1 tbsp. Sugar

1. Preheat oven to 350 degrees.
2. In food processor, coarsely chop garlic, onions and red pepper.
3. Saute garlic, onions and red pepper in 1 tbsp. Olive oil. Take out.
4. Coarsely chop mushrooms in food processor. Then saute in 1 tbsp. Olive oil until they give up their liquid. Take out. Place in large mixing bowl with garlic onions and pepper. Sprinkle all with salt and pepper.
5. Stir the whipped cream cheese into the warm vegetables until the cheese melts.
6. Add all remaining ingredients except the bacon.
7. Toss lightly until well mixed but do not overmix.
8. Shape into loaf shape in baking pan.
9. Lay about 8 half strips of bacon on top of loaf just to cover.
10. Pour 2-8 oz. cans of tomato sauce alongside of the loaf.
11. Bake for 1 hour. Turn bacon to brown other side.
12. Slice another 5 oz. fresh mushrooms and add to tomato gravy and return to oven for 20 minutes.
13. Remove meat loaf to serving platter. Let rest 10 minutes while preparing gravy.
14. Pour tomato/mushroom gravy into saucepan. Add 1 tbsp. Sugar. Skim fat from surface and keep warm.
15. Slice meat loaf. Serve gravy separately.

Yield: 4 to 6 servings.

Category: Food

In Search of the Perfect Scone

SCONES 007

Perfect scone update – I found it!

Chocolate chip scones have pretty much replaced chocolate chip cookies as the thing my daughter Natalie and I bake together. This is a good thing, I believe, for several reasons. First, less sugar and fat. Second, much quicker and an easier clean up. Third, only one baking time, as opposed to cookies where it’s in and out, in and out, onto the cooling racks, and then we tend to burn half of them because we lose track of the time. Finally, we love to drink tea, and scones are pretty much perfect with tea, although they also pair quite nicely with a tall glass of cold milk.

Still, I am not entirely happy. For, although I have tried at least four different recipes, I have yet to make the perfect chocolate chip scone.

Last Saturday, because Irene and Marvin left behind some buttermilk on their recent visit, Natalie and I decided to try buttermilk scones. Here’s the recipe we used, barely modified from a very nice web site called Baking Sheet. The scones in the picture looked pretty perfect to me, and I liked that the recipe only makes 4-6 small scones. Although they apparently freeze well, scones are best eaten the day they are made, so a smaller quantity seemed better to me.

Buttermilk Scones
1 cup flour
1 tsp baking powder
¼ tsp baking soda
1/8 tsp salt
2 tbsp sugar
3 tbsp butter, cold and cut into small pieces
5 tbsp buttermilk
1 tsp vanilla
1/4 cup chocolate chips

For topping:
1 tbsp buttermilk
1 tbsp coarse sugar

Preheat oven to 400F. Line a baking sheet with parchment paper. In a large bowl, combine flour, baking powder, baking soda, salt and sugar and whisk to combine.

scones 001

Rub butter into the flour mixture with your fingers or a pastry cutter until the mixture resembles very coarse meal.

scones 002

Mix vanilla into buttermilk and add to the dry ingredients.

scones 003

SCONES MIX

Add chocolate chips. Turn out dough onto lightly floured surface, knead a very little and form dough into a disc 1 inch thick. Cut the dough disk into 4-6 wedges using a knife or a pizza cutter.

scones 004

Brush with 1 tbsp buttermilk

SCONES 005

and sprinkle liberally with coarse sugar.

CONES 006

Place on baking sheet and bake at 400F for 15-18 minutes, or until lightly browned. Let cool for a few minutes before serving.

The end result, shown at the top of this post, was quite tasty. Everyone, including Natalie and her friend, enjoyed them immensely. But I was a bit disappointed in the texture. It wasn’t light enough, I thought. So, I decided to try again.

Most scone recipes I’d seen that originate in the UK called for Castor sugar, which is a very fine sugar. I figured that since scones originated in England, they might be onto something. I didn’t have any superfine sugar, but I read you can make your own using a food processor, so that’s what I did.

I also decided to add an egg to the recipe to see if that made a difference. Some scone recipes have an egg, others don’t. I wasn’t sure why, but I read in Harold McGee’s On Food and Cooking that in baking, eggs act as leavening agents because they expand while they cook.

So back I went to the kitchen, and whipped up another batch of scones using these two modifications – the superfine sugar and the egg. Confirming my belief about the superiority of scones over chocolate chip cookies, they were into the oven in less than 10 minutes. And here was the result:

SCONES 008

Here are the results of the two recipes side by side (with egg on the left, without on the right):

COMPARESCONES

To be honest, I really couldn’t see or taste much difference. My husband Paul thought the ones with an egg tasted better, but that may have been because they were still warm when he tried them. Don’t get me wrong. Both scones were quite tasty. But they were heavier than I’d like, and a little more cakelike than I expected. I decided to do a little more research into the scone-making process, so that I could better choose a recipe next time.

There are many scone recipes out there. What seems to be common in all of them is flour, leavening (baking powder, soda or both), sugar, butter and a liquid. According to the very well-written Joy of Baking Newletter on scones, the ratio of liquid to dry ingredients is 1:3. The liquid can be cream, milk, or buttermilk. Interestingly, eggs are not a consistent ingredient of scones.

According to the CIA’s The Professional Chef, one makes both scones and biscuits using a “rubbed dough” method, similar to that used in making pie crust. Dry ingredients are well-blended, either by sifting or whisking together. Shortening is chilled and then rubbed into the dry ingredients to create layers. The Professional Chef actually recommends putting the butter back into the fridge after cutting it up, so that it remains hard until you actually use it. It is extremely important not to let the fat melt and mix evenly into the rest of the ingredients; thus the liquid must also be very chilled.

The best results are achieved by working the dough as little as possible. This means that after adding the liquid, you only mix the dough enough so that it is a “shaggy mass”. Some recipes call for rolling and cutting the dough, but the traditional method for scones is to just knead the dough slightly, pat it into a flat circle and cut it into triangles.

As for the leavening agent, most recipes call for baking powder. When buttermilk is used, however, baking soda is also added. I did a little reading in McGee on the difference between baking powder and baking soda. Without getting too much into the chemistry, the acidity in the buttermilk causes the baking soda to react and start bubbling right away (I felt it as I was working the dough). The problem with baking soda is that the reaction is short-lived, and if you don’t work quickly enough after adding the liquid, is over before the real baking starts. Baking powder, especially double acting baking powder, has two different ingredients that have different rising reaction times. The first reaction occurs on addition of the baking powder to the batter, the other later on at higher temperatures that occur in the baking process. I also found that you can test your baking powder and soda for freshness. I did both, and mine were fine, so that wasn’t my problem.

So, now that I am an expert on scones and baking, I have the following insights into why the scones I made last Saturday were still a little far from perfect (though not that far…):

1. We didn’t have the butter or the buttermilk cold enough
2. We worked the dough just a little too much (I thought the “shaggy mass” was a shaggy mess and kept working the dough. Now I know that a shaggy mass is just what I am aiming for.)
3. I think we cut up our dough into too many scones, so they may have overcooked due to the higher ratio of surface area to middle.
4. I think more baking powder is called for. I’ve checked dozens of scone recipes. The ratios of flour to leavener vary greatly, but some definitely call for more that what I used.

I found a recipe that claims to be an “authentic” scone from Devon, England, and that calls for a full tbsp of baking powder plus 1/2 tsp soda per cup of flour! It will be the next recipe I try. I’ll let you know how it turns out.

In the meantime, if anyone has any better insights, or can help me out in finding the perfect recipe, please feel free to comment. Because I am definitely on a mission here.

Next : Still Searching for the Perfect Scone…

Caegory: Food

Thai Salad Swings Both Ways

This particular evening, I was in the mood for Thai Beef Salad. But my eldest daughter is a vegetarian – I knew she wouldn’t eat it. So I decided to make two versions of the salad – one for the Carnivores (with beef), and one for her (with tofu). As it turns out, we all loved the tofu, Carnivores and Veggies alike. So the meat eaters mixed some of the tofu into our salads along with the beef. Luckily, this still left enough tofu for my Daughter the Veggie to take some salad to school for lunch the next day. And it tasted just great.

Thai Salad Both Ways

One of my all-time favorite recipes is the Thai Beef Salad from the Frog Commissary Cookbook. The Commissary was Steven Poses’ cafeteria-style gourmet restaurant cum wine bar/bakery that, along with its upscale companion The Frog, led the Philadelphia Restaurant Renaissance in the 1970’s. Some wonderful restaurants opened in those years in Philly, and put the town on the map forever as an amazing place to dine out. The Frog, Astral Plane, The Aspen Café, Judy’s, The Blue Moon, The White Dog, Jack’s Firehouse – Mr. TBTAM and I have fond memories of many wonderful meals at these great restaurants, some of which are still around today. (Not to mention Le Bec Fin…)

The Frog Commissary Cookbook features Poses signature dishes from his two vanguard restaurants. It is one of those cookbooks of mine whose pages are stained and torn, whose cover has long since come off its bindings, and whose recipes I return to again and again. The recipes are an eclectic mix of East and West with great appetizers, dinners, soups and amazing desserts and party food. The carrot cake recipe alone is a national classic. Poses designed all the recipes in an apartment kitchen, not a professional kitchen, and every dish is worth making.

The original recipe calls for already-cooked beef, so I’ve modified the recipe to include how I cook the beef and tofu for this salad. I didn’t have scallions, so I used red onion. My daughters ate up the cucumber before I could add it to the salad, and the bean sprouts were not fresh enough at the market, so you don’t see them in the photo. Otherwise the recipe is the same as the original.

Spicy Peanut Dressing
½ cup unseasoned rice wine vinegar
1/3 cup corn oil
1 tsp salt
1 tbsp sugar
¾ tsp minced garlic
½ tsp crushed red pepper flakes
1 ¼ tsp soy sauce
1 ¾ tsp Thai hot sauce or Tabasco
1 ¼ tsp minced fresh ginger
2 tbsp lime juice
1/3 cup coarsely chopped salted roasted peanuts

Whisk together all ingredients (except the peanuts). Refrigerate. Add ¼ cup peanuts to the dressing just before mixing with salad. Reserve the rest to sprinkle on top (see below).

Beef or Tofu
1 ½ pound sirloin beef (don’t slice it till after you cook it) or 1 block tofu (cut into 1 x ¼ inch strips before you cook it)
Peanut or vegetable oil
2 tbsp Salt
1 tbsp pepper
1 tsp ground fennel (I wanted to add some ground star anise, but didn’t have any)

Combine salt, pepper and fennel.

Beef: Rinse beef and pat dry. Rub in a little oil, and the spice rub. Heat 1 tbsp oil in saute pan till hot over med-high heat, then add beef and cook, about 8 mins. per side, till rare. Remove to cool a bit, and cut into 1 ½ x ¼ inch strips.

Tofu: Sprinkle spice rub over tofu slices. Heat 2-3 tbsp oil over medium high heat. Add tofu, and saute, turning once after about 4-5 minutes. Cook till nice and crispy on both sides. Remove to drain on paper towels.

Salad
2 medium-large cucumbers, peeled, seeded, and sliced into ¼ inch thick crescents (about 2 ½ cups)
¼ pounds snow peas, semmed, blanched 20 seconds
½ pound bean sprouts
1 ¾ cup julienned red peppers (about 2 medium)
2 cups finely slice red cabbage
1 cup thinly slices scallions (I used red onion)
Romaine leaves
½ cup chopped salted roasted peanuts

For the beef salad: Just before serving, combine the beef, the cucumbers, snow peas, bean sprouts, peppers, cabbage and scallions with the dressing. Plate the romaine. Arrange the salad ingredients atop. Sprinkle with the remaining peanuts. Serve.

For the tofu salad: Just before serving, place the tofu on a flat plate or low bowl and pour a little of the dressing on top to flavor them. Combine the cucumbers, snow peas, bean sprouts, peppers, cabbage and scallions with the rest of the dressing. Plate the romaine. Arrange the salad ingredients atop, tofu slices last. Sprinkle with the remaining peanuts. Serve.

Chocolate Butter Cookies

I know, I know. It’s a whacky idea for a blog – sort of culinary gynecology. I didn’t plan it that way, I swear. It just sort of evolved this way. You can use the categories at the right to find the medical posts if you don’t like to read about the food. Don’t worry – you won’t hurt my feelings (much).

Anyway, on to the cookies…

On this visit, Irene also brought us some of her famous homemade cookies. She makes amazing cookies, having honed her skills over the years making beautiful holiday cookie platters for Marvin’s office staff. On any given day, you will find one or more rubbermaid containers of cookies in one of her kitchen freezers, cookies arranged carefully on wax paper layers, often a masking tape label on the side.

This particular cookie is an adaptation from a recipe in Cook’s Illustrated Magazine. Irene gives us a yearly gift subsciption to Cook’s, and I highly recommend it to you.

Chocolate Butter Cookies

20 tablespoons unsalted butter (2 1/2 sticks), softened to cool room temperature
1/2 cup cocoa powder (Cook’s recommend Dutch-processed as best) (about 2 ounces)
1 teaspoon espresso powder
1 cup sugar (7 ounces)
1/4 teaspoon table salt
2 large egg yolks
1 tbsp vanilla exract
2 1/4 cups unbleached all-purpose flour (11 1/4 ounces)
Chopped nuts (hazlenuts, almonds and pistachios mixed)

1. Adjust oven rack to middle position; heat oven to 375 degrees. Melt 4 tablespoons butter in medium saucepan over medium heat. Add cocoa powder and espresso powder; stir until mixture forms smooth paste. Set aside to cool, 15 to 20 minutes.

2. In standing mixer fitted with paddle attachment, mix remaining 16 tablespoons butter, sugar, salt, and cooled cocoa mixture on high speed until well combined and fluffy, about 1 minute, scraping sides of mixing bowl once or twice with rubber spatula. Add yolks and vanilla and mix on medium speed until thoroughly combined, about 30 seconds. Scrape sides of bowl. With mixer running on low, add flour in three additions, waiting until each addition is incorporated before adding next and scraping bowl after each addition. Continue to mix until dough forms cohesive ball, about 5 seconds. Turn dough onto counter; divide into thirds and roll into logs, 2 inches in diameter and about 12 inches long. (Correction: Roll it in the nuts before you chill it. The nuts will adhere better. Thanks, Irene.) Chill until very firm and cold, at least 1 hour.

3. Roll the chilled cylinder of dough into chopped nuts. Slice cookies 1/4 inch thick and place on parchment-lined baking sheets.

4. Bake until cookies show slight resistance to touch, 10 to 12 minutes, rotating baking sheet halfway through baking time; if cookies begin to darken on edges, they have overbaked. Cool for 5 minutes, then, using spatula, transfer cookies to wire rack; cool completely.

Doing the Work that Has To Be Done

I was asked by a colleague the other day if I would be willing to head the medical advisory committee of which I am currently a member. The committee is part of a large organization whose mission includes provision of family planning services. As chair of the committee, I’d have some additional responsibilities, and would have to start attending board meetings for the organization, in addition to the twice yearly advisory committee meetings I already attend.

I don’t like to spending evenings away from family, and try to limit outside responsibilities as much as possible. I never go to drug company dinners, resent my boss for making me join our local medical society (which has monthly dinner meetings), and aside from my voice lesson and choral rehearsal (which I combine on the same night once a week) have no outside evening activities. I told my colleague that I’d think about it and get back to her, because I didn’t think it was nice to say no right away. I promptly forgot our conversation.

A few days later, I was privileged to listen to an esteemed gynecologic oncologist give a lecture about his life’s work. Amidst his tales of the lab, the operating room and the chairman’s office, he told us stories of the old days before abortion was legal. In those days, the hospital wards were packed with septic abortion patients. He told us how many lives they saved by not waiting for cultures to diagnose clostridial sepsis. They used to mix the patient’s secretions with milk right there in the ER, and look for bubble formation (clostridia is a gas forming bacteria). He told of how he stayed up all night long in the ICU with women who had attempted self-abortion with lye, only to have them die in the morning despite all his efforts. And although he had enormous responsibilities in his specialty, he served for years on the board of his local Planned Parenthood. “It was just something I felt I had to do”, he said. “I hope you never live to see the things I saw”.

That same night, I learned that South Dakota has passed a law that outlaws abortion under any circumstance.

Today, I emailed my colleague that I would accept the position.

According to the Alan Guttmacher Institute, in 1962 alone, nearly 1,600 women were admitted to Harlem Hospital Center in New York City for incomplete abortions, which was one abortion-related hospital admission for every 42 deliveries at that hospital that year. In 1968, the University of Southern California Los Angeles County Medical Center, another large public facility serving primarily indigent patients, admitted 701 women with septic abortions, one admission for every 14 deliveries. (AGI also source for graph above)

Category: Second Opinions

Shrimp Louie Salad, Mac & Cheese

Every couple of months or so, my mother-in-law Irene, the Greatest Home Cook in the World, visits us. She and her husband Marvin never arrive without the Blue Cooler. And in that cooler they carry, along with Irene’s special cereal, Marvin’s buttermilk and a few tasty leftovers from their fridge, the ingredients for the dinners Irene has planned for us during her stay. These are often supplemented with items bought by us from the short shopping lists that Irene phones up ahead of time.

I long ago gave up feeling insulted that Irene feels the need to bring food along or plan the meals for her visit with us. I love her cooking too much, and just enjoy both their company and their food. Every once in a while I do put my foot down and insist that she let us feed her, but mostly I just join in and chow down. And what better treat than to walk in the door from work at the end of a long day, and find Iene in the kitchen, Marvin and my husband Paul setting the table, the kids happy and the smell of garlic in the air? If there is a heaven for working mothers, this is it.

This particular night, my in-laws were headed to see “The Odd Couple” with my kids, so dinner was “a quick meal”. Shrimp salad like no shrimp salad I’ve ever had before, and a test run of the latest macaroni and cheese recipe from the NY Times, served with garlic bread. (Susan, no comments please, you’re just jealous you weren’t here to eat it.)

Irene’s Shrimp Louis Salad

This recipe is based on the classic Crab Louis Salad, the origins of which are not entirely agreed upon, but which seems to have been created sometime at the turn of the 20th century in a restaurant on the West Coast. Some say it is named after King Louis XIV who was known for his enormous appetite. It is always pronounced Loo-ey. (Let’s sing it together, shall we? Louie, Louie…)

Irene uses Trader Joe’s frozen shrimp, which are really delicious. She keeps them in her freezer at all times. (One of these days, I will do a post about her two, count ’em 2, kitchen freezers and what’s in them… ) The amounts and proportions of ingredients will really depend on how many people you are serving and what you like, but do keep her proportions of the shrimp and celery, and obviously the dressing and artichoke recipes are made as written.

Ingredients
Shredded romaine lettuce
1 ½ pound cooked shrimp, cut into bite sized pieces
3 stalks crisp celery, cut up
Some sliced scallions
Louis Dressing (recipe follows)
Marinated artichoke hearts (recipe below)
Cherry tomatoes
A few hard boiled eggs, cut into quarters
Black olives
Cucumber, peeled and sliced
Red onion, slivered (salted or not, your preference)
Slices avocado
Lemon or lime wedges

Toss the shrimp and celery together with just enough Louis dressing to hold it together, really just a little. (You’ll serve more dressing on the side late, so keep it light at this point.)

Plate the lettuce on a large serving platter. Heap the shrimp salad in the middle. Arrange everything else prettily. Scatter scallions atop everything. Serve with lemon wedges and Louis dressing on the side.

Irene’s Louis Dressing
1/3 cup French vinaigrette Dressing (Made using the ingredients below)
– 1 ½ tbsp Dijon
– 1 tbsp Worcestershire
– 1 tbsp honey
– ¼ cup olive oil
– salt and pepper to taste
1 cup mayonnaise
¼ cup chili sauce
1 tsp Worcestershire sauce
¼ cup sweet India relish
1 tbsp minced scallions

Mix well.

Irene’s Marinated Artichoke Hearts
Trader Joes again, this time a bag of their frozen artichoke hearts. (Manhattanites, take heart – a Trader Joes is coming to Union Square, finally!)

Put artichokes in just enough water to cover, with some chopped garlic and a little olive oil. Simmer till most of the water is evaporated and artichokes are tender. Add 1 to 1 1/2 tbsp champagne vinegar, and salt and pepper to taste. Cool before using.

Creamy Macaroni and Cheese (adapted from the NY Times)

Julia Moskin wrote a really nice article in the NY Times recently about her search for the ideal mac and cheese recipe. This was one of the ones she made. Some minor changes were made for this meal. Irene left out the butter and the extra cheese for the top, and baked it in a 9 by 12 glass baking dish instead of a smaller pan as called for in the original recipe. This change in pans results in lots of the crispy top and bottom of macaroni and cheese that is my favorite part of the dish. It was still quite rich, and I’m going to make it myself sometime soon using a little less cheese.

1 cup cottage cheese (not lowfat)
2 cups milk (not skim)
1 teaspoon dry mustard
Pinch cayenne
Pinch freshly grated nutmeg
½ teaspoon salt
¼ teaspoon freshly ground black pepper
1 pound sharp or extra-sharp cheddar cheese, grated
½ pound elbow pasta, uncooked.

1. Heat oven to 375 degrees and position an oven rack in upper third of oven. Use 1 tablespoon butter to butter a 9×12 inch glass pan.
2. In a blender, purée cottage cheese, milk, mustard, cayenne, nutmeg and salt and pepper together. Reserve ¼ cup grated cheese for topping. In a large bowl, combine remaining grated cheese, milk mixture and uncooked pasta. Pour into prepared pan, cover tightly with foil and bake 30 minutes.
3. Uncover pan, stir gently, sprinkle with reserved cheese and dot with remaining tablespoon butter. Bake, uncovered, 30 minutes more, until browned. Let cool at least 15 minutes before serving.
Yield: 6 to 8 servings

Category: Food

Another So-Called “Teen” Pregnancy

She’s 16 and 9 weeks pregnant, having come to the resident’s clinic this afternoon complaining of bleeding after intercourse 2 days ago. The baby is fine (very cute on sono, we all agree), but it’s clear by her exam that she has a rather severe infection of her cervix, most likely due to Chlamydia. On further questioning she admits to having been treated for Chlamydia not too long ago.

“Did your boyfriend get treated?”

No, he didn’t. He told her that his doctor told him he didn’t have Chlamydia, so he didn’t need to be treated. This of course, cannot be true, because we treat anyone potentially exposed. Which means that her boyfriend did not go to a doctor – he basically lied to her.

He’s 21, the FOB. That means “Father of the Baby” in OB chart-speak, although I could think of a similar acronym that might be more appropriate. He also sleeps with his other baby’s mother, who is 15. She has a 3 month old baby girl.

I ask my patient why she still sees this guy, if she knows he sleeps with another girl. “He’s my baby-father”, she says. “So when I get the urge, he’s the one I go to.”

So this means they all have chlamydia – her, her baby-father, and her baby-father’s other baby-mama. I tell her this, and ask to consider whether she really wants to continue sleeping with him.

And although our former surgeon general was forced to resign for suggesting that teens be taught about masturbation, I take my chances and tell her that there are other things she can do to satisfy her urges that don’t involve exposing herself and her baby to serious infection. I don’t know if I got through, but I hope so.

We treat her infection, talk to her about getting her partner treated, send some labs, talk to social work and make her a follow-up appointment. Her baby is due the end of September.

According to the Alan Guttmacher Institute, fathers of babies born to teens are often significantly older than their female partners. It is estimated that, among girls who have given birth to a child by age 15, 39 percent of the fathers are between the ages of 20 and 29.

Category: Second Opinions