It's All Relative

So I don't think I've ever really exposed the exceedingly dorky side of me on this blog as of yet. Granted, the random medical school related stories are fairly nerdy in themselves, but this is completely unrelated to learning and school. In fact, this is definitely extracurricular. ;)

What in the world am I blabbering on about? First, let's start at the beginning.

I was 18 and it was our second trip back to China. We had just gotten home from a banquet and it was midnight or so. Our parents were still downstairs entertaining guests but my brother and I had been shooed upstairs to go to sleep (as if we were actually going to do that). Instead, we turned on the tv and tried to find something in English. After a few weeks in China and only each other to talk to, it was getting to the point that we didn't want to watch any more Asian dramas.

Guess what we end up watching? I vaguely remember the episode, but I clearly remember the Doctor and Martha. It was my very first introduction to Doctor Who and I loved it. We watched two episodes that night but it would be another few years before I got back into it. During undergrad, I caught random episodes but it wasn't until starting medical school and meeting one of my best guy friends that I got back into it.  In the span of the next two years on Sint Maarten, I watched all of the episodes available for the current reincarnation of Doctor Who.

And you know what? It was amazing. While I haven't always been a lover of pure science fiction, the quirky nature of the Doctor and the adventures with his Companion have an element more of fantasy than science which draws me in like a fly to honey.

I fell in love with David Tennant, the 10th Doctor and it was a while before I could find myself enjoying the series as much. It was still good, the stories were still enthralling and the terror of finding stone angels hiding in the corners of the shadows still kept me on my toes, but I missed his blue suit, the messy hair and the way he was so quintessentially the strange but incredible man I could completely see myself following into the threads of time.

Now I find myself laughing along with Matt Smith, the 11th Doctor and I can't imagine him without Amy and Rory. His erratic nature is very different from David Tennant, who was more stoic but oh how his emotions ran deep; Matt is more the fanciful dreamer, a smile always at his lips but harboring enough wisdom and power to destroy a race if needed to protect those under his care.

Alright, so that's enough dorky gushing for one day. But no worries, there's a definite reason for this post. Just wait for the next one, which hopefully gets written soon. I do realize that I'm about two weekends behind in stories at the moment but the next will be full of knitting, train rides and things you never thought would happen (well, something I didn't think would happen at least).

Fruity Friday

So this is a bit of a belated post but I had a very eventful weekend so you'll just have to excuse me. For the second week in a row, I made a fruit inspired dessert. Generally I'm not one for fresh, juicy, oozing pieces of sweetness, but seeing them at the store on the shelves with stickers that say 2 for 4 (pounds that is) makes them irresistible. After having fruit ripened into mush almost instantaneously on the island, it's nice being able to store produce for longer than a day on the counter or table. Especially when there's not that much room in the fridge or freezer.

I fairly certain that when I get settled down in the future, I will NEED a full fridge and freezer. There is absolutely no way I'll be able to deal with any sort of food storage contraption that isn't higher than I am tall and twice as wide as me. For someone who cooks as stress relief, I need space for everything before I dole it out and feed everyone around me. It's at the point now where I'm seriously considering taking a look into the mini fridge in the breast clinic and using that to store my goodies before friday when I bring them in.

Yeah, yeah. But desperate times call for desperate measures. Don't judge a girl just because she wants more kitchen space. It's perfectly reasonable.

In any case, this Friday was better than last week. The morning was a little sad but the afternoon wasn't so bad. And then Mike and I practiced some clinical cases. They might not be entirely realistic but for history taking, catching all of those small little details you don't always think about and going through the basics of doing a physical, it's quite useful. I think the most useful part for me is just thinking of differentials and diagnostic tests. While eliciting histories has gotten easier, I still find it difficult to think of a slew of different possible diagnoses on the fly. I know that it's tucked away in my brain somewhere but I suppose it's something that comes with practice.

So today's recipe has some added benefits. Not only are anthocyanins neuroprotective but they have anti-oxidant properties. Lab based studies on dark berries have shown some positive correlation between the ingestion of berries and the health effects on aging, inflammation, bacterial infections and even cancer. So toss in a few more berries, dust the top with a bit of sugar and have a slice for breakfast.

Lemon Blueberry Cake with Lemon Glaze

Cake

1 1/2 cups (195 grams) all-purpose flour

1 teaspoon baking powder
1/4 teaspoon salt
1 tablespoon grated lemon zest (outer yellow skin of the lemon)
1 cup (240 ml) fresh blueberries
1/2 cup (113 grams) unsalted butter, room temperature
3/4 cup (150 grams) granulated white sugar

2 large eggs

1 teaspoon pure vanilla extract

1/2 cup (120 ml) milk

Lemon Glaze:

1/2 cup powdered (icing) sugar

1 tablespoon fresh lemon juice

1 tsp lemon zest

In a large bowl or mixer, cream together the butter and white sugar. When lighter in color and creamy, add the eggs one at a time. Combine all of the dry ingredients in a bowl and alternately add the flour mixture and milk/vanilla in 3 batches. Toss in the blueberries with the last addition of flour and mix gently to distribute the berries. If you use frozen, you can take them straight out of the freezer and add them into the batter. It doesn't make a difference to the recipe.

Pour the batter into a lined 9x5 loaf pan and bake for 50-60 minutes at 180 C (350 F) checking at 45 minutes or so depending upon your oven. (I know I've been stressing it more recently but different ovens work at different temperatures and sometimes have hot spots which require rotation during baking. But you know your oven best).

While the cake is in the oven, combine all the ingredients for the glaze. When the cake is done, a toothpick inserted in the center will come out clean/with a few crumbs attached. Let it cool before drizzling with the glaze. Pour half over the cake, let it set up for a few minutes before pouring the rest over the top.

Lemony, fresh, definitely the perfect slice of heaven on a busy Friday morning.

I must say that one of the most uplifting events of the day wasn't even medically related. It was just the camaraderie of the entire team and the way they joke around and tease each other. At the end of the day, despite occasional name calling and stealing slices of cake, it's obvious even to an outsider the ability of everyone to work together.

Except in the case of cake... As you will see from the following message written on the foil covering this week's cake, it's supposed to be Fabio's Cake and at the dire threat of a skull and crossbones, "DO NOT TOUCH."

Unfortunately, the message was tossed to the side, cake was sliced into and it was definitely touched. Although in retrospect, everyone did work together.... against Fabio to eat cake. :)

Healthy Eating

Is it strange that the healthier I eat, the hungrier I am? Somehow, it doesn't seem to work out. If I'm hungrier then I'll eat more. If I eat more, that means it could potentially be unhealthy. Granted, it all depends on what I'm eating.

Yesterday and this morning probably made up the healthiest eating I've had since I started surgery. It's definitely on of the most well rounded meals I've had in all of my pre-test studying experience. I know, it sounds impossible, doesn't it? At some point, I must have made a healthy meal before an exam, but truthfully, some of the quickest meals were also the most fat laden comfort foods known to man. Mmm... fat.

Anyway, onto the pseudo-recipes of the day. It's more of a compilation of ingredients which you could switch up however you like, and it's not completely homemade, but for the quick meal before sitting down for 12 hours in front of the computer, it's simple and yummy.

And for the time when I'm not studying, each of the individual pieces will be made from scratch in the future. They've been on my list long enough that it's just a matter of time before I get the proper tools to create them.

So, yesterday's dinner was full of protein AND vegetables.

Lamb/Falafel Open Faced Pitas

Pita bread (prepackaged from store)

Hummus (homemade/storebought)

Red pepper (sliced)

Cucumber (sliced)

Plain yogurt

Falafel and/or lamb meatballs

Turn the oven on to the lowest setting and place the pita bread on the rack to warm through while prepping everything else.

Slice the red pepper into strips and cucumber into thin rounds.

In a pan with a bit of oil, cook the lamb meatballs until medium/medium-rare or however well done you want them. To better fit on the pita, I took the spatula and pressed them into a disk while cooking. The same follows for the falafel which I just bought premade as well and only needed to reheat.

When everything is ready, place the pita on a place and spread a generous amount of hummus on top.  Layer the vegetables and meat as you like. I placed the cucumber slices first, scattered the peppers randomly and then laid the meat/falafel out in a row on top. With a fork, I also drizzled a little plain yogurt on top of everything. You could really use anything you like in terms of veggies and toppings in general. :)

And then this morning, don't know what got into me, but I decided that a smoothie was in order. Perhaps it was because I was so incredibly tired and I figured a cold burst of sugar would wake me up (in addition to the shower of course). It was definitely one of the best ideas I had this morning as opposed to getting coffee and a yumyum, which was one of the options I considered...

Strawberry Peach Smoothie

1 cup strawberries (I used frozen)

5 small peaches (I used 2 peaches and 3 nectarines)

1 cup ice

¼ cup yogurt (Greek Honey)

¼ cup apple juice

Smattering of cranberries for some tartness

Toss everything into the blender and let it run until there are no more giant chunks floating around. Pour into a cup, stick in a straw and slurp away! I only drank half and put the rest into the freezer.

 

Orange You Glad It's Friday?

Oh wow.... that was kind of a terrible title... But I just couldn't help it. :D And there was a good reason behind the orange, just a little hint for the  recipe to come, which is actually quite healthy in light of my previous posts.

So this week was an introduction to vascular surgery. I must say, it's a lot of ulcers... Diabetic ulcers, ulcerated varicose veins, ulcerated vein graft sites. Just... lots and lots of ulcers. While I may not be 100% sure what I want to go into at the moment (still leaning towards pediatrics), I do know that vascular surgery is probably not going to be the route I take. Just watch, in a few years time, I look back on this post and that's exactly where I am. Would that not be ironic? Granted, I shall not cut it off my list completely since I have yet to go into theatre. Hopefully Tuesday will be interesting with Gianluca and Mr. Caruana even though I have no idea what the list is like. Sadly, due to a nationwide attempt to localize certain specialties to regional centers, most of the larger vascular surgeries are performed at Brighton.

On the other hand, some of the post-surgical treatment in vascular surgery is quite interesting. I saw a vac dressing for the first time. Vac dressings, aka Negative-pressure wound therapy, promote healing by applying a vacuum to the wound through a sealed dressing, usually with a foam interface. The vacuum created by the sealed dressing draws out the fluid and increases blood flow to the site of injury/surgical wound. For people with decreased arterial blood flow, this is an asset to the healing process since more blood will be directed to the wound by the negative pressure.

Speaking of decreased blood flow and slow wound healing, Bad News Friday was worse than usual. Stitches which were perfect just a week ago and surgical sites which were dry somehow decided that this week would be the week to get wet again and split. We're not talking just one patient, but several. Interestingly enough, apparently the breast care nurses and surgical team can pretty much tell the smokers from non-smokers just from their post-surgical healing. Because smokers have less effective microcirculation, the wounds heal much slower.

On the happy, healthier side of things, this friday's cake was Cranberry Orange Bread. Trying to find the perfect recipe for the tart berries was a bit challenging since the primary association with fresh/frozen cranberries is cranberry jelly for Thanksgiving. That was definitely not going to be the recipe for these berries. Dried cranberries work like magic in oatmeal cookies and with white chocolate, but the whole frozen ones would be too wet for that application. So to Pinterest I went, searching for a recipe.

I ended up modifying the original recipe I found and adjusting the dry/liquid ingredient ratios with another cranberry bread recipe.

Cranberry Orange Bread with Orange Glaze
*adapted from kitchenmeetsgirl's Orange Cranberry Bread (with Honey)

Bread

2 cups all-purpose flour

1 cup sugar

2 teaspoons baking powder

1/2 teaspoon salt

1 teaspoon orange zest

1 tsp vanilla

2 eggs

1/2 cup oil

1 cup Greek Honey yogurt or other low-fat Greek yogurt

Juice of half an orange – about ¼ cup juice

1 cup cranberries (I used frozen, left them whole)

Orange glaze

2-3 tbls fresh squeezed orange juice

½ tsp orange zest

1 cup powdered sugar

In a large bowl, combine flour, sugar, baking powder, salt, orange zest and gently sift/mix together. In another bowl, combine eggs, oil, vanilla, yogurt and orange juice. Add the liquids to the dry ingredients and mix until everything is just incorporated. Add the cranberries (I just took them straight from the freezer and tossed in about a cup) and gently mix to distribute the berries.

 

In the pan, ready to bake

Pour into a 9x5 loaf pan and bake in a 350 F (180 C) oven for 50-60 minutes, checking at about 45 minutes depending upon your individual oven. When a toothpick comes out clean, remove from oven and let cool.

While the loaf is cooling, combine the orange juice, zest and powdered sugar. Start with half the cup and add more powdered sugar to get the consistency you want. It should be thin enough to pour but thick enough that it doesn't just soak into the bread.

Out of the oven, one layer of glaze

When the loaf is cool enough (the glaze will just soak in if still hot), pour half the glaze over the top, letting it spill over the sides. Let this set for a few minutes before continuing to glaze otherwise it will not dry on the surface. Top with a few extra cranberries if desired, otherwise, dig in!