Sudden Unexpected Call Syndrome

Picture this… it’s 6:42 this morning, my cat is snuggled in my lap, my coffee is delicious, the music is wonderful. And then… I looked at my calendar.

Really? 

I’M ON CALL?

Between call and business travel this is the first weekend in 5 weeks I’ve been home.  I was totally psyched for a weekend off and then…

If you are in medicine, you will immediately recognize that this is an important syndrome which, up to now, has gone unnamed.  If you aren’t in medicine it’s important to know what happens next.  When a physician, nurse or other provider suffers from SUCS, it only takes 10-15 minutes to have the paradigm shift of “Oh, well….. “ and then move on to how you are going to take care of others.  (Trainees – when, not if, this happens to you, the worst thing you can do is turn this into a chronic condition by letting this torture you during your call day.)

I took a deep breath, reorganized my thoughts and my emotions.  I went from my hierarchy of needs for the weekend to the well recognized hierarchy of needs for being on call.

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 Then I texted my fellow.

And she responded….

On to the rest of the day, including my Saturday tradition of going to the farmer’s market!

As I was at the farmer’s market, looking at all the wonderful produce, having breakfast and soaking in the sun, I pondered my rapid recovery from SUCS.

And then I had a thought I will pose to my readers…. what should we call the opposite syndrome?  You know, the one when you get to the hospital and realize you made a mistake and you aren’t on call?

Dancing Doctor Video

p.s. It turned out my call yesterday was listed as an “all day” event for two days on Outlook.  Whew!

Bell Peppers

 

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Bell Peppers, also known as green peppers, red peppers, sweet peppers, and capsicumis, are relatively large in size.  According to Epicurious, the bell-shaped pepper is green and slightly bitter in its immature state. As it matures, it turns bright red and becomes sweeter. You can also find yellow, orange, white, pink, and even purple varieties.  Bell Peppers have a high water content and, despite the name, they are not spicy.  Peak season runs from July through September but you can find bell peppers year round at your local grocery store.

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There are several ways to prepare a bell pepper, depending on how you’d like to eat or cook it. Either way, you will likely want to remove the seeds.

Here’s a great videos on how to prepare for different recipes

Once you have cut the bell pepper, you have a lot of options for how to eat or cook them.  LiveStrong.com has some suggestions:

Stir Fry/Saute’– heat a small amount of oil in a heavy skillet and add smaller bell pepper pieces. Cook for 8-10 mins. on medium heat, stirring occasionally so they cook evenly. Consider adding other vegetables or a sauce for more flavor. This website says that a Saute’ allows for the best concentrated nutrient retention.

Grilling– use whole peppers or large pepper pieces. You can make kabobs by skewering the peppers with with various meats and other vegetables. Brush on a light coating of oil and season with salt and pepper before you place the peppers on the grill.

Roasting- this gives peppers a smoky flavor and works well in salsas or other dishes, as well as on their own. In an oven, brush the peppers with a light coat of oil and broil them, turning to crisp evenly. See the above link for charring instructions.

Steaming– often used to prepare bell peppers for stuffing or a side dish. Preparing to stuff? Cut out the stem and seeds. Steam the peppers upright for approx. 4 minutes in a steaming basket.  Then stuff the peppers with a filling and bake them according the recipe. The filling typically includes rice, chopped vegetables, seasonings and cheese.

Raw– add to salad or cut into strips or petals and enjoy with hummus or a veggie dip.

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Easy recipes

Roasted Bell Peppers

6 Ways to Stuff a Pepper

Quinoa Black Bean Stuffed Peppers

Philly Cheesesteak Stuffed Peppers

Skinny Tex Mex Black Bean Quinoa Casserole

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Trivia about Bell Peppers

  • Peppers have between 2 and 5 lobes. Bell peppers with 3 lobes are generally considered to be better when cooked whereas the 4 lobed peppers are usually quite a bit sweeter, with many more seeds than their counterpart.
  • Peppers do not have a “gender”, as some websites suggest
  • Peppers are actually fruits! Why? Simply because they are produced from a flowering plant and contain seeds, though, most people think of them as vegetables.
  • Bell peppers can be eaten at any stage of development.  Vitamin C, carotenoid content and the flavor of bell peppers tends to increase while the pepper is reaching its optimal ripeness.
  • The sweeter the bell pepper, the more calories it has. This means, red peppers have the highest number of calories.
  • Bell peppers are an excellent source of vitamin C.  They have 117 milligrams per cup, which is more than twice the amount of vitamin C found in a typical orange!
  • One serving of this colorful fruit will provide you with plenty of Vitamins K, C, A, E, and B6, potassium, and a generous amount of dietary fiber.

Information from DurableHealth.net and TipHero.com

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This is a wonderful guest post from Joanna Theilmann, MSW, published originally on 1000vegetables.org.  If you are interested in contributing a guest post, please feel free to contact me!

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“I don’t have time to cook”… Oh, yes, you do!!!

I just got back from vacation and had the pleasure of attending a session where Shawn Brisby, the demo chef for Canyon Ranch in Tucson, gave us a great piece of advice …

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“Have you ever gotten raspberries home and within a day they are mush with white stuff on them?”

He had my attention.

“The problem is that home chefs don’t keep their refrigerator cold enough.  They should be set at 40 degrees.”

Hmmm…

 

So I’ve been experimenting and … it works!  (not that I doubted you, Shawn :-).

 

Step 1.  Decide what you are going to eat for the week.

This planning is essential.  It takes me 20-30 (very enjoyable) minutes to find recipes in a magazine (Clean Eating and Cooking Light are my favorites), one of my cookbooks or on line.  Here’s what we’re cooking this week:

Pasta with sardines and fennel

Kale salad with apple and cheddar

Moroccan butternut squash chickpea stew

Pumpkin soup with almonds and sage

Fall salad with apples, walnuts and stilton

And, for breakfast for the week…

Sweet potato casserole with crunchy oat topping

 

Step 2. Make a shopping list and go shopping.

 

Step 3:. Prep all the food for the week

This is what makes it work in terms of efficiency. For the rest of the week, when you get home, everything will be washed, cut up and ready to throw in the pan.  I timed myself and it took 1 hr 22 minutes to turn the pile of veggies you see above into this:

An hour and a half is nothing compared to the time it takes when you get home late and really don’t want to do it.  Turn on some music, chop while you are watching some football.. it is a great return on investment to insure you eat well!

Other helpful hints

  1. Get some fun containers. These are the ones I bought, but any food quality containers will work.
  2. Wash the other produce, cut everything up for all the recipes, spin dry them and put them in your 40 degree refrigerator. (If you don’t own one, get a lettuce spinner.)
  3. Wash the fruit and dry it before you put it in the refrigerator.

One other tip…. Make stock! I throw all the vegetable bits (peels, seeds, etc) into a pot with water and make vegetable stock while I’m working. In addition to using this stock for any soup we decide to make, we use it instead of water for rice or pasta to increase the flavor.

#HoustonStrong

For the last few days I’ve been part of the amazing “ride out” crew of doctors, nurses, and support staff covering Texas Children’s Hospital during Hurricane Harvey and the overwhelming aftermath of flooding in Houston.  Since I live in Houston, I have been asked by many, in person and on Twitter, what they can do to help.

Please let me know via Twitter (@drmlb) or in the comment section below if you have recommendations to add to the list below.

 

Houston has an amazing mayor, who has established a fund which will be distributed to groups by the Greater Houston Community Foundation.  To donate to this fund:  https://ghcfdisaster.kimbia.com/hurricaneharveyrelieffund

Houston Food Bank   A marvelous charity that provides food to anyone who needs it.

Plant It Forward  This wonderful organization provides urban farmland for refugees to grow food for themselves and to sell.  

 

Texas Diaper Bank . It’s amazing how this is always a big need in crisis situations. This group does a great job keeping baby bottoms covered!

 

 

Houston Coalition for the Homeless A group dedicated to caring for the homeless in Houston.  Unfortunately, there is little doubt that we will be seeing an increase in homelessness after this disaster, so their work will be even more important. 

 

Houston Humane Society . There are always lost and frightened pets after a flood.  This group takes care of them.

 

Hospital chaplaincy programs are always in need of resources and provide important spiritual support during times of crisis.  You can donate to spiritual care or other programs for the hospitals in the Texas Medical Center here:  

Texas Children’s Hospital

Ben Taub General Hospital

Michael E. DeBakey VA Medical Center

Baylor St. Luke’s Medical Center

Houston Methodist Hospital

Memorial Hermann Hospital

 

 

If you live in Houston, you might think about volunteering by registering with Volunteer Houston or  giving blood.

What’s for dinner? How to eat well if you are too busy to cook….

I wish someone had taught me this when I started medical school.  Seriously, I would have loved it…  Let me walk you through what I did today to prepare for my week, and I think you will understand.

So, first… it’s summer… In Houston.

The weather makes a difference in how this unfolds, since I’m talking about cooking… i.e. (usually) adding heat.

So here’s what I did today..

  1. I spent about 20 minutes looking through what is my current favorite cookbook for three recipes that a) I liked b) were easy and c) were summer appropriate.

2. I entered all the ingredients I needed into GroceryIQ, … plus stone fruit (that is so ripe and delicious right now), a watermelon (because it’s summer and I love them), bread and ingredients for sandwiches for lunch.

(how can you not love a cookbook that says “Heat a big glug of olive oil in a skillet”?)

3. I went to the grocery store and bought everything on the list. When you have a list, it’s really fast, so you make up the time you spent looking up the recipes and making the list. Also, you are much less likely to buy more than you need (which leads to interesting microbiology experiments in your refrigerator) or things you really don’t need (i.e. junk food).

4. I took a nap. (I was on call Friday, up all night, so I’m still catching up). Plus, Sunday          naps are amazing… so don’t think you EVER have to justify them!

5. I spent about 20 minutes preparing the ingredients for Joshua McFadden’s recipe for the tuna melt “casserole” and for one of my summer favorites, ratatouille. Every time I make ratatouille, I think of Maryvonne, Monique and Maddy, my French “mothers” who taught me this recipe when I lived in France as an undergraduate.

6. Here’s where the Houston weather comes in. To minimize stove top and oven time, I roasted the squash for the tuna melt and the vegetables for the ratatouille at the same time – while they were cooking, I sautéed the onions and garlic for the ratatouille and added the tomatoes (canned). (In case you were wondering, the sweet potato is for snacks or something else TBD.)

So, we’ll have the tuna melt tonight, with some store made coleslaw (Brussel sprout and kale), and there is enough for the same meal another night, or lunches if we choose.  The ratatouille can be sides to our sandwiches, or can be another meal with a protein (we are mostly “pescetarian” so probably fish… but you can choose what you want).  Ratatouille is also delicious cold on it’s own or with cottage cheese, or you can add it to broth with chicken meat and make a great soup/stew.Bottom line… maybe an hour today for a week’s worth of amazing food… which is what I wish I’d been taught when I started medical school.

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 p.s. Since you were wondering…  The other two recipes for this week are cooked seafood salad with fennel, radish basil and crème fraiche (p115) and crunchy mixed bean salad with celery, tarragon and soft boiled eggs (p260).

p.p.s Do not get intimidated if you don’t know how to cook. YOU CAN LEARN.  (and you should).  Find someone to help you.

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Good advice I have gotten over the years…

Dr. Jennifer Dietrich, who is the Chief of Pediatric Gynecology in the Department of Obstetrics and Gynecology at Baylor College of Medicine recently showed me a list of advice she’d been given in the past. It’s a great list, so I thought I’d share it! 

  • Give important emails 24 hours for a well thought out response.
  • Say yes to the things you want to do and that make a difference in your career.
  • Find time to protect yourself.
  • It is ok to say no sometimes.
  • Ask for help if you have reached your limit.
  • Try not to bring work home or at least confine work to the weekdays and weekends you are assigned to be on call/on service.
  • Make an appointment with yourself to exercise, relax, go out to dinner, etc.
  • Plan each year to go to the dentist, doctor, address medical needs and protect that time.

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Applying to Residency: Tips for Medical Students (from MS1 to MS4)

Applying for a residency starts with choosing your specialty.  The application for residency includes personal statements, curriculum vitae, letters of recommendation, transcripts and all the other components required by ERAS.  This application is then used by the NRMP to match medical students to their residencies.  It’s a fairly complex process on a relatively short timeline.

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The prezi below was put together to walk medical students through the process – from picking a specialty to matching in the specialty and program which is the best fit for you.

 

I’d love feedback from anyone if I’ve missed something or could explain this in a better way – please comment below!

Best of luck to the students who are starting this process to match next spring – and thanks to all the faculty, administrator and deans who help them along the way!

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