Tarts are for Tomorrow

All of this alliteration must be annoying but I must say that the words fell into place on their own as I walked home one late night.

From my last post, you surmised I was being a bit sentimental and reminescing but this post will be a bit of a 180, the complete opposite. I decided that tarts stand for tomorrow given that they are generally made with fresh fruit, which changes every season so every tart is always different.

Pears, apples, plums and peaches. Raspberries and blueberries. The list just doesn't end. And when paired with the perfect pastry crust made of pure butter and flour, it's like heaven. Sprinkled with dark brown sugar and dotted with butter, the fruit melts in the oven, releasing sweet juice which mingles with the sugar to create a delicious sauce that glazes the crust.

Ever since I have been introduced to the shortcrust pastry made by Jus-Rol like I mentioned in a previous post, it's what I've been using for quick desserts. Slicing all of the fruit takes more time than the baking. >.>

Apple and Pears from Normandy; dark brown sugar

Fruit Tarts
(I've made apple and pear; apple and plum so far but feel free to use any fruit you like. I think peaches and blueberries will be an amazing combo when I have the chance.)

1 shortcrust pastry - rolled out to about 15x20 inches and 1/2 cm thick
3-4 medium sized apples
3-4 medium sized pears
1/4 cup butter, diced
1/2 cup brown sugar

Take your shortcrust pastry out of the freezer to defrost while you prep the fruit. If you're using a home recipe then ignore this part.

I kept the skins on the fruit for a contrasting texture but feel free to peel them if you like. Just make sure you have enough fruit to cover the base of the tart. Both apples and pears were sliced into 1/4 inch slices. Don't worry about them being perfect; this is meant to be a bit rustic and easy. 

For the pastry, roll out into a 15x20 inch rectangle about 1/2 cm thick. You don't want it too thick because it'll be a lot of dough for once piece but don't roll it too thin because otherwise it may get soggy from the fruit juice. I trust in your discretion to roll out your pastry to the right dimensions for your baking sheet. 

If you want to make individual tarts, which I've also done, cut the pastry into 6 equal pieces before assembling.

Slide the pastry onto your baking sheet. Allowing for some pastry to be folded over the edges of the tart, begin to arrange the fruit. I usually do one row of apples, a row of pears etc etc with a little overlap within the row and also between the rows. If using berries, I suggest tossing them haphazardly among the sliced fruit. Once your fruit is arranged, sprinkle brown sugar and butter evenly over the top. Fold the sides of the pastry over to form a rustic edge and crimp slightly with your fingers. After all, you don't want to lose any of those wonderful fruit juices.

Apple and Plum prebaking; brown demerara sugar

Turn the oven on to 200 C (400 F) and bake for 15-20 minutes or until the fruit is soft, the sugar and butter have melted and bubbled into a glaze and the pastry crust is slightly browned around the edges. Remove and let cool. The fruit/sugar mixture is very hot, trust me.

Look at that sugery sweet soft goodness...

The Scent of Summer

After an amazing, absolutely gorgeous weekend of fun times with friends, midnight revels and SUNSHINE (I know, it just needs to be shouted to the world), I came back to the scent of ripe peaches filling my room. I could almost taste the sweet flesh as I walked in and dumped my bags onto the floor.

But I didn't think of writing a post until a few seconds ago. Now that I'm perched on the side of my bed and studying for my next exam, I keep catching whiffs of that sweet summery scent. There's just something about ripened fruit that brings to mind pictures of laughter and lemonade, of relaxing in the sun, dipping wiggling toes into cold water. It's like the seasons are changing within the walls of the apartment.

I remember the first time I ever made this recipe. It was on the island with Chey. We were knitting and thinking up a list for the store and while we were doing all of that, it seemed apropos that we had a drink. But what to make? After searching through her magazines, she found the recipe for a ginger peach sangria which we've made tons of times since then.

Simple. Sweet. And the perfect summer drink.

Ginger Peach Summer Sangria

Ingredients

1/3 cup sugar

1/3 cup water

3 tbs finely chopped crystallized ginger

¼ cup Grand Marnier

¼ cup peach schnapps

1 (750 ml) bottle white wine (like Viognier or Sauvignon Blanc)

24 oz chilled ginger ale

2 peaches, pitted and thinly sliced

¼ cup mint, chopped

Method

Heat sugar, water and ginger in a saucepan over medium heat. Simmer 5-10 minutes, until the sugar and ginger dissolve. Refrigerate until cold, about 2 hours. In a large pitcher, stir together ginger-sugar mixture, Grand Marnier, Peach Schnapps, wine, ginger ale, peaches and mint. Serve over ice.

It's supposed to serve 8.... but really, only two people are needed. :)

Baking, Breasts and the Beginning of Surgery

Two weeks ago, I wouldn't have thought that I'd enjoy surgery this much.

Alright, so that's not completely true. I knew I would probably enjoy going into theatre, observing and assisting. But I still had an innate fear of getting things wrong, of accidentally cutting something irreparable or causing a tear. I think that's one of the reasons why I respect surgeons so much. There are people who say that surgeons are egotistical, stick their noses up to others; however, it's understandable - it takes a lot of knowledge, courage and self confidence to be able to cut into another living, breathing, human being and trust in your own abilities to do the right thing and perform the surgery as stated during consent, irregardless of possible complications.

During these last two weeks with the breast team, I've learned a lot - clinically and personally. The sense of community and the camaraderie - of the consultants, Mr. Johri and Mr. Bonomi; the speciality doctors in surgery, Ms. Kalra and Mr. Rapisarda; the junior doctor I met while I was in my gastro rotation for Internal Medicine, Dr. Train; and all of the breast care nurses and radiologists - is amazing. Everyone on the team made me feel welcome from the beginning, taking me under their wing and teaching me.

Monday of last week, I watched my first lipomodelling. Last Wednesday, I scrubbed in for the very first time and assisted. And the following day, I got to do subcuticular stitches on a patient for the first time. It was rewarding, and educational. As I said before, I have had a longstanding fear of the fragility of human tissue - mainly stemming from my own encounters with accidents, especially the time I got run over by a bike in Davis. But that day, I got over my fear of accidentally tearing the skin while retracting. It still amazes me how resilient the human body is. No matter how much trauma is inflicted upon the tissues and organs, with time, a good blood supply and sufficient nutrients, the body heals itself.

The difference between a cadaver and living person is so unreal - one would imagine that the basic fundamentals of anatomy would be the same, and they are. But at the same time, very different. Our very first semester of medical school, anatomy was fun, exciting, a chance to see inside the body and explore things for ourselves. I must admit, we weren't the best of surgeons at the time, but we took chances and tried our best. In the end, I think we came out the better for it. We learned the basics of anatomy, insertions and origins, vascular supply and nerve endings while respecting our very first patient, the person who had donated their body to our education. Now that I have observed surgical procedures, I wonder how the very first surgeon got accustomed to warm bleeding flesh and obtained the nerve to continue with incisions knowing that the patient's life was literally in their hands. (Hmm... that was a bit of a graphic query wasn't it? I shall try to refrain for the rest of this post.)

In any case, back to learning.

I am absolutely certain now that patient interaction is a must. Despite having met some very knowledgeable and engaging pathologists, I know that I could never stay in a lab with the minimum of patient contact. Pediatrics taught me that I love talking to people (alright, so I didn't really learn that then). It showed me that I could piece together a jumbled story from a parent with patience and present the child's story with precision and confidence to my senior. It taught me that the simple act of talking, of engaging and offering reassurance goes a long way towards establishing rapport with both patients and family members.

This afternoon, I almost started crying in the middle of clinic.

Last week, I had dubbed it Bad News Friday, mainly because the multidisciplinary meetings (MDTs) between the surgeons, radiologist, pathologists and nurses occurred on Wednesdays thus leaving Friday for the presenting of results and final decisions to patients. Friday is the day we tell patients the results of scans and tests. Granted, it's not all bad news. Some are cysts (fluid filled sacs encased in epithelial tissue) or fibroadenomas (fibrous stromal/epithelial tissue that is rearranged into a well demarcated mass) - both benign findings which occur normally in breast tissue. But then there are the patients who must be told they have cancer. DCIS, LCIS, invasive, adenocarcinoma, Paget's. The names and acronyms are relevant to us but to the patient, the most significant thing is that they have malignant cells - cancer. To some, it is a shock. To others, they have wondered and prepared. But nothing truly prepares a person until the event occurs.

That is exactly what happened today. It was not unexpected. The patient knew the results and had a discussion previous to today regarding treatment options but nothing could have predicted the emotional storm I was swept into. Prior to this appointment, I had blinked furiously, sniffled a few times during consultations, but the moment I heard the fear and uncertainty in the patient's voice and saw the tears welling up, I had to forcibly control my own outburst. It was hard. Normally, with a friend or acquaintance, tears are acceptable from either party. But professionally, I knew that with the surgeon, breast care specialist nurse and breast team nurse in attendance, I had to put on a strong front for the patient, to show them that we were there for them, that we were in control of the situation and allow the patient to lean on us for support. And at the end of the appointment, a few more tears were shed but we reached a consensus on treatment, worked on a timeline and gave the patient the reassurance she needed and the knowledge that she was in good hands.

After the patient left, I couldn't bring myself to admit that I had been on the verge of crying. But it was true - I could have just as easily started sobbing alongside the patient. One of the things I have learned over the years - teaching at Ida B. Wells Continuation High School, volunteering at UCSF/UCD Medical Centers, listening to my friends and offering my advice - is that I cannot help but empathize with whomever I encounter. I know that it will serve me well in the future, that it will make me a better person and doctor - I have heard many a time that I am a compassionate person, but in the end, it's not the words and phrases that mean anything, it's my actions that will stand through time. In not shedding tears and offering tissues when required, I spoke wordlessly with the patient, telling them I was there, that they had my support and that I understood and was not judging them for their actions.

So that's some of the things I've learned outside of the books in the past two weeks, the next post might have more useful factoids. But to end this segment, here's the chocolate cake I baked twice in two days; once for a slice of happiness in the midst of Bad News Friday and once for the joy of feeding the people I love.

Hershey's Chocolate Cake
(I halved the original recipe)

1 cup sugar
7/8 cup flour (or 3/4 cup and 2 tblsp)
6 tbls cocoa
3/4 tsp baking powder
3/4 tsp baking soda
1/2 tsp salt
1 egg
1/2 cup milk
1/4 cup vegetable oil (I have also used olive oil)
1 tsp vanilla
1/2 cup boiling water

In a large bowl, combine all the dry ingredients and mix together. In a separate container, mix all the wet ingredients except for the water. Add the wet ingredients to the dry and mix until well incorporated. Add the boiling water to the batter. It will look very separated but stir well until the consistency of the batter is uniform. It will be very thin but don't be alarmed. Pour into an 8 inch round pan and bake at 350 (180 C) for 35-40 minutes or until a knife stuck in the center comes out clean.

Making it in the hospital accommodation, I've been baking things for a significantly increased time, so if you know your oven, adjust baking times and temperatures accordingly.

For both cakes, I made chocolate ganache to pour over the top. Just the basic recipe I use tweaked for a smaller amount.

Chocolate Ganache
1/4 cup whipping cream
100 grams (3.5 oz) dark chocolate
1 tsp vanilla/Irish Whiskey/the flavoring of your choice

In a pan or microwave safe bowl, heat the cream but not to boiling. Place the chocolate pieces into the cream and let sit for a few minutes before stirring. When all the chocolate is melted and incorporated smoothly, add the flavoring of your choice. Pour the ganache over the cake and place in fridge to set. Or... just consume. :D

Pies are for the Past

I have decided that pies are for the past. Why? Because I never make pies. But when I do, it seems that it's always a pumpkin pie. Not that I particularly like them but they're easy, and some of my favorite people really like them.

Pumpkin pie is just one of those iconic Thanksgiving additions you see all the time, on TV, in films, read in books. And Thanksgiving is supposed to be a remembrance of the bounty the Pilgrims had in making friends with the Indians. Yeah, yeah, so I have totally just messed up history and given the happy go lucky version seen in picture books, but that doesn't negate the fact that pumpkin pie is as much a part of our past as it is the present.

Last Thanksgiving, I was actually at home - the first time I've had turkey with my parents and brother in two years. And I loved it. The pumpkin pie for that year, I didn't make, but it came from a very good family friend who thinks of us as family.

Thanksgiving of 2011, I made pumpkin pie for Dillon. First time I had ever made it using those particular ingredients but it turned out pretty good and we even had a premade pie shell to boot. It took 3 grocery stores and two people but we finally found some in the Maho Market. (Never thought you'd hear me talk about the island again, did you?)

Thanksgiving 2010, I made pumpkin pie and spiced nuts with Candice. Gluten free and yummy to boot. This was my first foray into pie making in general.

In the two years of my time on Sint Maarten, I made pie each year and now it seems a bit like a tradition, even though it didn't start out that way.

This time, the pie was made at the end of April, the beginning of English springtime, and reminded me of the good times on the island, where we all shared our holidays together. I have met some of the most amazing people on that tiny little 37 square mile island and I know that even if we might not be together now, we'll definitely see each other again. After all, who could have predicted that I'd be in Worthing doing my core clinical rotations, and spending my evenings over at the Warnes Building with Chey or watching Mickey cartoons with Emma.

So without any more sappy stories, here's the pumpkin pie recipe I've been using consistently. In terms of crust, use it if you want or if you have it, but make sure you either make a deep dish pie or have two shallow tins.

Pumpkin Pie
3 large eggs
1 15-oz can of pumpkin puree (I use Libby's brand)
1/2 cup heavy whipping cream
1/2 cup light brown sugar
1 tsp ground cinnamon
1/2 tsp ground ginger
1/8 tsp ground cloves
1/2 tsp salt

Whisk the eggs with the cream and sugar. Add the pumpkin puree and spices and mix until everything is well incorporated.

Look at the speed of that whisking! Orange pumpkin yum!

Pour into pie shell and bake at 350 F (180 C) for 45-50 minutes.

** For those in the UK, Jus-Rol brand shortcrust pastry is AMAZING. It's buttery and all you have to do is take it out, let it defrost on the counter, roll it out and place it into your baking dish.

This is what my super amazing baking helper and I did for the pie. Rolled it out to 1/2 cm thick, placed it over the dish, cut off the excess.

Dill rolling out the dough

Then we re-rolled the pastry for a second dish. Split the pumpkin pie filling between the two crusts and I made some cute cutouts for the tops.

 

Prebaking; sitting on the stovetop

These took only about 35-40 minutes in a fan-assisted oven at 180 C since they weren't that deep.

Maple Leaf

Jack o' Lantern

And we obviously had to chop into Jack first.

Oh no! He's missing part of his face!

Sadly, poor Jack did not survive the night....

Back to Childhood

April is not yet half over and it's already been a busy two weeks, (Alright, this has been a post in the making for too long and it's actually the beginning of May now. But the rest still applies in terms of busy, what with starting Peds (or as the Brits spell it, Paeds), and planning sneaky dinners consisting of bill hijacking (I really did have to use the WC!) and baby shower baskets of sweet little newborn necessities.

As opposed to my usual food inclined posts, this will be more knitterly based. Yes, I realize that most of the words I'm typing aren't grammatically correct, nor are they real words. But as I've said previously, since I know what proper English language should be like, I continue to ramble along without heeding the rules.

It's been almost a year since we left the island and I had to say goodbye to all the babies and kids I've watched grow up for two years. It was definitely bittersweet. But just last month, I learned of more newborns who will be joining the world this year. That and my 6 weeks of pediatrics has changed the bittersweet feeling into excitement.

To start it off, I thought a little button-up vest in blue for newborn baby boy #1 in July would be absolutely adorable.

After looking through loads and loads of patterns on Ravelry, I decided on Pebble aka Henry's Cobblestone-inspired Manly Baby Vest. However, I may have un-manned it a little bit by duplicate stitching the whale from Save the baby whales! on the front. Since the chart was for working top down, the whale was upside down. Thankfully Adobe had the forethought to allow rotation of the page so that I didn't even have to transpose the chart myself. :) Lazy much? haha.

I hope it fits for a little while at least. :) And since I had quite a bit of the ball left, I thought a matching hat would be cute. There was only going to be one stripe but then I thought two would be even better. For the hat, I used the basic pattern of the Berry Baby Hat but instead of making the berry top, I just knit in the dark blue.

And now, the two together! Hopefully, baby's mommy will give me permission to post a picture of the finished outfit on baby boy when he is born. :)