Gluten Free but Gluttonous

Gluten free for many people brings to mind bland and tasteless, a similar connotation that vegan desserts have associated with them. But that's completely untrue. Granted, flavors and textures are not the same when it's a gluten-ful baked good, but GF baking has its own charms and the experimentation is endless.

This little crunchy cookie has its base in almond meal, essential blanched almond ground into flour. Such a concept opens up a whole new can of worms. Almonds, pecans, walnuts, hazelnuts - if you have a food processor or blender, a completely new arsenal of nut flours could be at your fingertips.

I used a store-bought almond meal because that's what I had on hand and wanted to use up, but you could substitute any nut flour you desire.
Chocolate Chip Almond Crunchies

1 cup almond meal (ground almond flour)
1/4 cup granulated sugar (I bet brown sugar would have made them chewier)
1 egg
3 tbls oil/melted butter
a dash of salt
1 tsp vanilla
1/2 cup chocolate chips (milk, semisweet, dark etc)

In a bowl, combine the flour, sugar and salt. Mix lightly. Add the rest of the liquid ingredients and mix until fully incorporated. Add in the chocolate chips. The batter will be more liquidy than the usual cookie batter made with all-purpose flour since there's no gluten.

Preheat the oven to 340 degrees. Line a baking pan and drop teaspoons of batter onto the cookie sheet. These will spread, so place them 1-2 inches apart from one another. Baked for 12-15 minutes or until the edges begin to brown.
They're crispy, not overwhelmingly sweet and have a hint of almond that could be enhanced by using almond extract instead of vanilla. Perhaps the next time I come across almond meal, this will have to be tweaked to become a soft chewy cookie.


**there will be pictures... I promise. :)

Jail Time

August 18, 2011

It was time to face the facts. We were going to the slammer. There was no getting around it. We had been caught. Perhaps learning Spanish in high school instead of French would have been a better idea... =( Our hands were tied and there was no escape from the inevitable.

Alright, alright. I'll stop with the melodrama. But the slew of status updates on facebook were great fun without added explanations. =)

Alive, well and going to jail tomorrow! XD
We're going to JAIL!!! YAY!!!!!!!

So perhaps we were also a bit too excited for the update to be believable, but it was definitely a memorable experience.

A bit of background:
The previous night, we counted heads and broke into 4 groups. To be more precise, 3 pairs and one group of 3.

Group 1 - Naddi and Mike
Group 2 - Steve, Tram and Dr. Shupe
Group 3 - Daniela and Andrea
Group 4 - Jen and Dimitry

Groups 1/2 were to go to the mobile clinic in the morning while Groups 3/4 went to jail. In the afternoon, after lunch, the groups would switch.

After breakfast, we all split up and headed out in our respective taxis. Daniela, Andrea, Dimitry and I met up with Armando, our translator for the day, and went to the jail.

Jail (looks innocuous, doesn't it?)

Steve, Tram, Naddi, Mike and Dr. Shupe went to the mobile clinic.

When we arrived in front of the jail, it didn't seem like we were anywhere near a prison. In fact, it was merely a few blocks away from Pinocho. As it was our first day, we were unsure what was required of us. Standing in the street, we waited for the nurses to motion us into the building. The officers just changed shifts and things were a little chaotic as we waited to get permission to enter.

Once we got the ok, we walked to the wrought iron gate. We were also patted down before we were allowed to continue further into the courtyard. Armando had to relinquish his cell phone into the possession of the guard on duty.

A few tables had been set up with benches along the wall to receive the inmates. After delegating tasks, we took our spots and waited for the inmates to be let out of the cells.

Daniela, as our resident Spanish speaker, took charge of filling out the medical forms with the vital signs Andrea, Dimitry and I took. Name and weight was recorded for each individual while blood pressure was only measured if they had a history of high/low BP or were new inmates. The same principle applied to taking temperatures. Unless they reported feeling feverish or were new, temperatures were assumed to be normal. A fever was considered to be an increase from normal temperature of about 37 degrees Celsius to 38 degrees or higher.

Temperatures were taken using mercury thermometers which had to be shaken down after each reading. We used the axillary route as opposed to oral and used alcohol wipes to wipe down the thermometer in between each patient.

The basic procedure
- the patients signed in on a sheet and told their names to the nurses who found their medical record in a large binder
- Daniela received the records and asked if they felt feverish
- Andrea and I took turns practicing our numbers in Spanish and weighing the patients
* basic vocab to follow this post
- Dimitry, Andrea, and I took turns taking blood pressures and temperatures

Dimitry taking BP

- All the numbers for temperature, BP, weight were reported to Daniela who returned the completed form to the nurse- patients continued on to speak with the doctors at another table
It was in this way that we passed our entire morning. We got to see a lot of interesting things and apply the knowledge we've learned so far in basic sciences.

A little later in the morning when there was a slight lull, another individual was brought into one of the cells. While we only caught a brief glance, Andrea and I instantly began thinking of questions for Armando when we saw the enlarged mass in the man's left cheek. We wondered if it was hard or soft, and the possible causes. Turning to Armando as a pair, we asked what the warden had said about the man when he was brought in. Apparently, he had to see the dentist because his tooth was hurting. Instantly, our mind turned to Actinomyces israelli. However, we were unable to get a closer look since he was in a cell that we were not taking vital signs for that morning.

Another one of our patients had a chalazion that was pretty large. While it was hard not to stare, the second half of block 1 of med micro was a little difficult to ignore. It was most likely another bacterial infection like the inmate with A. israelli. Given the lack of sanitary conditions in the jail, it could be either P. acnes or S. aureus with equal possibility.

In the meantime...

At the mobile clinic, Groups 1/2 were being worked equally hard.

When we think of a mobile clinic in the US, most individuals probably think of the giant vans which the blood banks use when drawing blood for donations. However, the mobile clinic we worked at that day was nothing like the white vans filled with equipment so commonly found during deficits of blood and during large emergencies.

It was truly mobile.

Putting white sheets over open window frames for more privacy

An abandoned building which the nurses and doctors took possession of for a day to provide health care to those who lived too far to make it to the clinics on a regular basis. The windows were devoid of glass, merely the wooden frame where windows would have sat. The doors... yet again, only the door frame.

A screen set up in the smallest room for more privacy during exams

At the mobile clinic, we serviced mostly the elderly and young children. As with the jail, we took vitals and filled out forms consisting of: neighborhood, name, age, birth date, blood pressure, temperate and weight. The forms were then passed to a nurse who placed them in order of their arrival. After vitals were taken, the patients waited to see the doctor who was set up in the smallest room with sheets and a screen to provide more privacy especially during physical exams.

Tram taking the blood pressure of a patient

Steve and Naddi working together with a patient

Dr. Shupe holding a young patient

Both groups spent approximately 4 hours each at the mobile clinic and in jail. After a full day of seeing patients, interacting with another culture and learning numbers and simple medical questions in a foreign language, we were exhausted. In some ways, it was harder than studying and in others, it was easier. But despite still recovering from finals and the plane, we were oddly energized. Our first day opened our eyes, made us laugh and showed us the reason why we had decided to go on a medical mission.

A Basket of Bananas

It's been a while since I made use of my little red riding hood basket. There hasn't been much of a chance to bake in large quantities given the amount of time I spent at school in MPR and LH1 last semester. Luckily it's still the beginning of the semester right now and I don't have to cook dinner, which gives me time to bake in between studying and blogging.

But perhaps a basket will be going out tomorrow morning given how much this batter has risen. I should have done a test batch first... but 3 dozen is still a good amount. It just doesn't have the same ring to it as 6 dozen plus 2 though. *sigh* Those were the good days.

I'll stop with the reminiscing and start the recipe now.

Banana Muffins

1 cup butter, softened (2 sticks)
2 cups granulated sugar
2 eggs
6 ripe bananas, mashed
1 tsp baking powder
2 tsp baking soda
1/2 tsp salt
3 cups all-purpose flour
1 tsp vanilla
dash of cinnamon

Cream together the butter and sugar until lighter in color and fluffy. (You can substitute and use 1 cup brown sugar and 1 cup granulated sugar for a muffin that has a more molasses-y touch to it.) Add the eggs one at a time, making sure everything is incorporated before adding the next egg. Mix in the mashed bananas. (I like to mash half the bananas until they disintegrate and leave the other half of the bananas as slightly larger chunks).

In a separate bowl, combine the salt, baking powder, baking soda and flour. Sift and add to the banana mixture. Stir to combine without overmixing. Add a dash of cinnamon and vanilla at the end.Place a heaping tablespoon into each muffin tin. Bake at 350 degrees for 15-20 minutes or until done.

The tops will be nice and golden, the muffin soft and moist. Yum. Feel free to add chocolate chips or nuts as desired.

Gringos Everywhere

August 17, 2011

Afternoon

So after lunch, we headed out to tour the clinics. As mentioned in the main Bolivia page, CSRA has three clinics in Montero - Cruz Roja, Distrito 2 and Villa Cochabamba.

We started off after lunch to Cruz Roja.In the beginning, the Red Cross building consisted only of a few rooms.

Original section of Cruz Roja

Daniel (our on-site coordinator/translator)
Listening to the history of Cruz Roja

However, they expanded over the years, now a larger building consisting of a maternity ward,

Learning about the maternity ward

several rooms for consultations and dental visits as well as a place for doctors and nurses to cook and rest.

Soccer stadium viewed from the kitchen on the top floor

Neighborhood surrounding Cruz Roja

Our second stop yielded one of the best quotes of the trip by far.

Distrito 2

Distrito 2 serves mainly pergnant women and children in the area, including children who attend school in the neighborhoods surrounding the clinic since their visits are covered by the government. As we took a tour around Distrito 2, we also wandered over into the park across the street.

Naddi and Mike running across the street.

Naddi and Mike even joined in on a soccer game that just started.But the best part had yet to come. Walking back to the front entrance of Distrito 2, we saw a full car drive by. The next thing we knew, everyone was keeled over laughing as Steve and Daniela translated what they had yelled.

It's raining gringos!

Our last stop of the day was Villa Cochabamba. Here, at this clinic, they have a TB room where they keep track of the residents with tuberculosis, monitor their health and distribute their medicine. As part of the Tb program, medication and treatment is free if a patient lives in the area; therefore, many families moved into the area to take advantage of the available services. However, due to the cost and the fear of spreading Tb as well as the possibility of becoming resistant to the medication, patients are sometimes jokingly cautioned against leaving the area or missing a day. Family members are also held responsible for the infected patient.

After looking at the facilities, we walked back to Pinocho, stopping by the market along the way. And so, we passed our first day in Montero. But the best had yet to come.

Tomorrow, we would enter locked gates, surrender our electronics and join the jailed.

Creepy Cookies

The first baked good of any semester must have a story behind it.

This one starts with stories about creeping people out, knocking on doors in the middle of the night and scaring them as they sit alone in their apartment at night. The best part comes when you see someone coming down the path whom you've never encountered before, you watch them go into a previously empty apartment and set down bags of luggage. Now those are the best "victims."

Unaware (ok... not all of them, only the ones who haven't heard of me and my oddball ways), they ask "who is it?" and I respond in a perky voice. Clearly, something is off. The best part is when the door opens and a puzzled face peers from behind the door. =D

I know... perhaps I take too much pleasure in it. But the best time to bake is the midnight hour. And anyone who is awake at that hour deserves a treat, no questions asked. =)

So, to ring in a new semester and welcome the newest members of our Regency family, here's a creepy chocolate cookie for late nights.
Salted Double Chocolate Cookies

8 oz. semisweet chocolate
4 tbs unsalted butter (1/2 stick)
2/3 cup all-purpose flour
1/2 tsp baking powder
3/4 tsp fleur de sel (sea salt)
2 eggs
3/4 cup packed light brown sugar
1 tsp vanilla
12 oz. semisweet chocolate chips or chunks

Preheat the oven to 350 degrees. Line two pans with parchment or foil.

In a double boiler, melt the 8 oz of chocolate and butter together until smooth. If you don't have a double boiler, place a heatproof bowl over about an inch of simmering water, making sure the bottom doesn't touch the water.

In a separate bowl, combine the flour, fleur de sel and baking powder. Mix until incorporated. Set aside.

In a small bowl, whisk together the eggs, brown sugar and vanilla until thoroughly mixed. Once the chocolate and butter has melted, quickly incorporate the egg mixture into the chocolate mix. Stir to combine and add the dry ingredients. Mix until no more streaks of flour remain.

Stir in the chocolate morsels.Drop tablespoons of dough onto the cookie sheets. Bake for 10-12 minutes or until the top is crackly but the cookie is still soft.

It's like a decadent brownie in cookie form. Nom nom nom.

It's Raining Gringos!

August 17, 2011

Morning

Weaving down one way streets, we made our way to our hotel for the next 12 days. Still mildly dazed from the plane and bus ride, it took a few moments before it was apparent that we were to get off, grab our luggage and go inside.Residencial Pinocho

First order of business was to decide where each of us would stay. Thankfully, the math worked out perfectly. 4 males. 5 females. Three 2 bed rooms. And one 3 bed room.

Boys were divided as such. Naddi/Dimitry and Steve/Mike.From left to right: Steve, Mike, Dimitry, Naddi

Girls had the luxury of a three or two bed room. Dr. Shupe had the pleasure of spending her 2 week Bolivian break with Daniela and Andrea. Tram and I shared the last room.From left to right: Tram, Daniela, Dr. Shupe, Andrea, Jen

With a few hours until lunch and meeting up together again, some of us took an early siesta while the rest decided to venture out in search of the plaza, money changers and a possible market despite being unable to speak Spanish.

Walking straight up the street about 5-6 blocks, Dr. Shupe, Andrea and I found the plaza. An open space with benches, a few statues and giant murals, it looked like the perfect place to stop after a late breakfast on the weekend. We made the most of our time, finding a money lender and exchanging some dollars for Bolivianos before exploring. The rate during our trip was about 6.8. With about half an hour to spare, we decided to walk back to Pinocho and get ready for lunch.

The trip was just beginning...

Désolée

Oops! Pardon, je suis désolé. Perhaps I should have preceded the last post with a little background. For those who haven't visited the facebook group or seen LMSA's blog, here's a little snippet about the medical mission to Bolivia, courtesy of Mike.

The Latino Medical Student Association (LMSA) here at the American University of the Caribbean School of Medicine has organized in conjunction with Curamericas Global a trip to Montero, Bolivia for this coming August. We are planning on leaving August 17th (right after semester finals) and returning August 30th (right before the next semester start).

We are planning on serving the people, specifically the women and children, of rural Bolivia. We will be working closely with "El Consejo de Salud Rural Andino" in educating and training the local people with regards to public health, health education, vaccination promotion, perinatal care, and in assisting with whatever needs may arise.

Bolivia is the poorest country in the western hemisphere, we are traveling to an area that is rural and quite under-served with regards to medical care.

This is an invaluable experience for us who will be physicians in the not too distant future:

* we will be able to appreciate the US health system more
* we will be able to help and make a difference for the people who need the most help
* we will be able to interact with and learn from patients with the unique perspective of living in a third world country
* we will be able to experience serving people in the Spanish language.

謝謝. Gracias. Merci. ;)