Every year at Thanksgiving, I make my great-grandmother Sallie’s cornbread recipe. She and my great-grandfather were “dirt farmers” who lived in Oklahoma during the depression. This bread, some beans, and vegetables from their sustenance garden (if there were any), was all they had for dinner most nights.
As I mix the ingredients for this cornbread (and then use it to make stuffing), I can’t help but ponder their life…how hard it must have been and how, as my ancestors, they made my life possible.
I don’t want you to just sit down at the table. I don’t want you to just eat and be content. I want you to walk out into the fields Where the water is shining and the rice has risen. I want you to stand there far from this white tablecloth. I want you to fill your hands with mud, like a blessing.
-Mary Oliver
Mix together with a big spoon
1 cup cornmeal
1/2 cup flour
1 tsp soda
1/2 tsp baking powder
1/4 tsp salt
Make a large “hole” in the middle of the dry mixture with the spoon
Beat one egg with a fork, add 1 tablespoon of oil (which is what my great-grandmother used) or melted butter (which tastes better IMHO) into well in the middle of the dry mixture and mix with a fork
Add 1 cup of buttermilk
Let rise while heating the oven to 450 degrees (about 10 minutes) with your cast iron skillet in the oven.
Gently whip the batter down with a fork
Pour any excess oil from the pans into the batter and then pour the batter into the hot cast iron skillet.
Bake 20-25 minutes (until a toothpick or knife comes out clean)
So that’s my great-grandmother’s recipe (and yes, the photo at the top of this post is of her and my great-grandfather). This recipe makes the right amount for a weekday dinner but it doesn’t make enough for Thanksgiving. So I did the math to make enough for everyone (and the stuffing, and breakfast the next morning!) If you don’t have enough cast iron skillets, no worries. Use muffin tins, cake loafs, whatever you have.
The recipe is the same but starts with melting a stick of butter in the microwave (It’s supposed to be 7 tablespoons but a stick of butter = 8 tablespoons and I can’t imagine a little extra butter hurts!)
Dry ingredients:
One bag of cornmeal (2lb)
3 1/2 cups of flour
7 tsp of baking soda
3 1/2 tsp of baking powder
2 1/2 tsp of salt
Wet ingredients:
7 eggs
“7” tablespoons of butter (see above) – or use oil if you prefer
“7” cups of buttermilk – the batter should pour but not be thin
If you don’t know about the amazing Kate Bowler… you’re welcome! Her take on the “secret of life” (yup, for real) is one of the best I’ve ever heard. (Click on the image to hear it)
“Tiny plastic pellets called nurdles – each about the size of a lentil – are washing up on Texas beaches in alarming quantities. These pre-production plastics are the raw material used to make everyday items like bags and bottles. But when they spill during manufacturing or transport, they escape into the environment, becoming one of the most widespread sources of microplastic pollution.”
This is a scary situation I knew nothing about. These little pieces of plastic “act like tiny sponges, absorbing toxic chemicals such as pesticides and heavy metals”. So it’s not just that we take in microplastics by eating fish that have confused these objects with food, we also consume the poisons the nurdles have absorbed.
A reminder that forest bathing is wonderful (and so easy)
I spent some time yesterday in a park near my home and, while there, decided to try the Japanese practice of shinrin yoku, known in English as “forest bathing.” (Which is therapeutically known as sylvotherapy!)
It’s a practice that involves all five senses, one by one, intentionally…
Listening to sounds, birds, insects, wind in the leaves
Touching the ground, the trees, and the leaves.
Smelling flowers, plants, the dirt
Seeing plants, birds, animals, clouds..
Tasting by breathing through your mouth
If you work in a hospital or another building, a small green area or a single tree will suffice.
We have powerful tools on our digital phones, particularly in medicine. But the relationship with our phones is complicated…and not always beneficial.
The first time I ever came across the word alexithymia was in this New York Times opinion piece about digital phones by Steven Barrie-Anthony. As a physician, I love learning new clinical words with Greek roots – in this case “a” for not, “lexis” for words, and “thymos” which means “feeling” or “spiritedness”. Alexithymia (a word invented in 1970 by psychotherapists), is also known as “emotional blindness”, and means not being able to recognize your emotions.
Dr. Barrie-Anthony noted that the “vast majority” of his patients were experiencing an “alexithymic fog” due to the “gravitational pull” from their phones and social media, a condition that affected “the most important aspects of who they are, their relationships with others and how they move through the world.”
Do we really have agency when we get pulled in by the gravitational force of our phones? For our non-work related time, we pick the app…but then we fall into the dopamine feedback loop of whatever game we’re playing, or algorithms that are foundational to social media.
I think it matters more that I’ve realized, and not for the reasons I thought:
Being used by the tools of the digital world is different from using them as tools because it separates us from our authentic emotions.
“One constant I’ve found is how technology brings a kind of alexithymic fog — alexithymia being the condition of having difficulty identifying or being able to express one’s emotions. This isn’t universal, and the emotions we’re pushing away aren’t always the same. But it happens in a startlingly consistent way.”
To tackle the problems of technology we have to return to our emotional lives for their own sake, and not always leap to doing or changing or fixing. This is the only viable pathway if we are to remain in touch with our humanness and to preserve love, empathy, emotional and spiritual richness, and the capacity to create art and music that reflect our inner lives.
I have yet to experience awe in the digital world.
“When medieval Christians gathered in cathedrals, the soaring architecture and stained glass were designed to lift their thoughts toward the divine. The shared narrative included an image of the good life that directed one to love their neighbor as oneself. Today’s digital architectures are designed with a different purpose – to keep our attention firmly earthbound, focused on consuming content and generating data. The “infinite scroll” isn’t just a design feature; it’s a spiritual technology that trains us to value quantity over quality, novelty over depth, reaction over reflection.”
You’ll enjoy exploring this online tool (assuming you are enough of a history, map, and/or liberal arts nerd). It’s an interactive map developed by a multidisciplinary group of European researchers for scholars (and the rest of us) to explore 299,171.31 km of roads built during the roman empire.
Ordination
Tomorrow is my ordination in the UCC… which is not just a genuine calling but, for me at least, is also a form of resistance in a world that right now has a lot of “not-love”. I’m so grateful.
Cloth hats for the win!
I hope the tide is turning, but due to a misdirected effort to improve quality (see this article, which is one of my favorites!) many operating rooms still force surgeons, anesthesiologists, nurses, techs (and everyone else who enters the OR suite) to wear bouffant hats.
I was delighted to read this recent article showing yet another reason to wear cloth hats in the OR… they were studying communication and camaraderie in the OR and showed that cloth hats with names and roles on them helped with both.
The Fractal Foundation describes a fractal as ““a never-ending pattern that repeats itself in different scales. This property is ‘self-similarity’”. These repeated patterns are found in the “roughness” of nature and the structure of our bodies, creating an order which is thought to be the subconscious reason we have such deep emotional responses to the beauty of nature.
Human beings are fascinated with the symmetry and beauty of fractals despite (or perhaps because) they are mathematically incredibly complex. Benoit Mandelbrot, a mathematician and polymath, coined the term “fractal” while working to understand the “roughness and self-similarity” in nature. Well, actually, his first work was looking at the “wild randomness” of the stock market… but as he explained, his formal work at IBM for 35 years allowed him to ask deeper questions.
“Dramatically referred to as “the fingerprint of life,” their repetition of patterns across multiple scales forms the basic building blocks of many of nature’s patterns ranging from clouds, trees, and mountains through to our brains, blood vessels, and lungs.”
Most of us haven’t heard of fractals… but knowing about them allows us to see the world and our studies in medicine through (literally) a different lens. How cool is that?
I’ve always thought we missed a great opportunity in medicine for collective nouns… A flow of urologists? A clot of hematologists? …😂
Day Light Savings Time. It’s easier for your body clock to adjust when flying east to west through time zones which is why it is easier to adjust to the “fall back” to standard time that we just experienced. There are lots of theories about how daylight savings time got started and why. It’s also known that a) it’s better for us to not go back and forth between daylight savings and standard time and b) if we have to pick one or the other, standard time is the one to choose.
Eco Divina. Lectio divina is a powerful tool for meditation and/or prayer, a four step practice that uses the words of a text (usually a sacred text) to lead you to insight and inspiration. (If you haven’t ever tried it, here are some great instructions. Although these instructions refer to the Bible, any text, from sacred writings to poetry can be used. I had heard of visio divino, where art serves the same purpose… but eco divina was new to me (at least by that name). Like sitting with words, or with images, eco divina is sitting deeply with something in the natural world in a way that reminds you of the beauty of creation (and your part in it).
The moon. Make sure you go outside tonight and look at the moon. It’s a supermoon and worthy of a little “eco divina” (aka awe).
I love this app to know when the moon rises and sets (and in which direction).
The best hospital signage I’ve ever seen.
I was recently part of a survey team that visited Savannah Children’s Hospital and I have to share how patients and families find their way in their hospital!
There is a “tree” in the entrance that defines the color scheme for the entire hospital (green = surgery, brown = diagnostic imaging, blue = ER/ICUs…etc ). There are also symbols associated with each color.
(the family gave me permission to take this photo)
Then you follow the path!
Every corridor has tiles that confirm you are still going in the right direction based on the colors.
We often forget that 21% of adults in the US are illiterate, which means they won’t be able to read signs pointing them to different areas in the hospital (or any building for that matter). In addition to being incredibly effective, this attention to design is also an act of kindness.
Still thinking about Game 7 of the World Series…
I have never seen a game like it and probably never will again…
I recently came across the powerful concept of “hourglass learning” in this post by two professors who teach teachers and, not surprisingly, wondered how it might apply to teaching physicians and other healers.
That being said, if you love learning (or love someone who is trying to learn), these concepts can be applied at any age to anything – from bird watching to learning math!
Basic Sciences (Medicine taught in a classroom)
For basic sciences, the hourglass paradigm works well, but I added some practical points from the equally powerful SQR3 (Survey, Question, Read, Review, Repeat) system using a typical hour-long lecture and assigned reading as an example.
Survey (Establish a purpose).
It’s easy to forget that you don’t actually study medicine to pass a test… you are learning to heal, to serve those who need you. In that light, the first step – “establish a purpose” – can be thought of in two ways. The first is to set an intention, to remember why you are studying. And then, more specifically, to ask “What is the purpose of this lecture?” That’s where the tool of “surveying” comes in.
This is an exercise in curiosity not “studying”. Skim over everything to get the big picture. Look up words you don’t know (and their roots). Look at how the lecture is organized. Are there obvious sections? Are there lists that look like they will be important? Can you tell what the most important points will be?
Question (Extract evidence)
This is an interactive process that starts with your survey.
Before the lecture: As you are surveying make notes (on the slides, in the margin of the notes, or as a separate list) with what questions the lecture will and, more importantly, won’t answer about the topic.
During the lecture: Listen for and jot down the answers to the questions you wrote down the night before. If there are questions that aren’t answered in the lecture, ask the professor afterwards.
Read (Make sense)
After the lecture but on the same day (don’t wait!), add to your notes to make everything as clear and as organized as possible, look up anything that is missing, and then make a one page “30,000 foot” review of the lecture.
Review (Form meaning).
The 4th step is to return to the “why” by linking the lecture to how the information applies to actual human beings. Even though search engine AI may point you in the right direction, it should never be your sole source as a professional. (That’s in bold for a reason.) As a professional you need to make sure the information you have is vetted (i.e. peer reviewed).Start with PubMed or UpToDate to find a review article on the topic.
Repeat (Reproduce knowledge).
Real learning only happens with repetition, so setting up a schedule to review your notes with progressively longer gaps between reviews is the secret to success. This is where Anki or other similar systems can really help.
An important note on question banks… You can’t learn medicine from UWorld. (Again, in bold for a reason.) BUT, question banks are an awesome way to confirm you’ve learned the important stuff – and to identify where there might be some gaps. So please use them as an adjunct to, but not core of your studies.
Explain (Reproduce knowledge).
A great way to make sure you have “metabolized” what you are trying to learn is to share it with others. This is where study groups come in. They take as many forms as there are students, but in general, the most effective groups work as “out loud” reviews of the topics after everyone has spent time reading, reviewing, and repeating.
Teach (Share knowledge)
Teaching in the basic sciences is not as easy as in the clinics (other than “teaching” each other in study groups). But having a goal to to teach makes you organize your material in a way that insures you really understand it.
Rotations, Residency, Fellowship, and Practice (Medicine taught in clinic and hospitals)
The same “basic science” style of learning continues in clinical training, but there won’t (usually) be hour-long lectures or assigned reading. Instead, you’ll be seeing patients, attending conferences, and, yes, you will still be taking tests (shelf exams, in training exams, board exams, maintenance of certification tests, etc).
We want to and need to stay current in our field… but how? Here’s the best way I’ve found to do it, a practice that will serve you from starting rotations in medical school until you retire:
Find the most current and thorough textbook for your specialty
Make an Excel spreadsheet of every section/chapter
Set a goal (and make a plan) to cover the entire book in a year (which will look something like covering 12 sections/ week with weeks off for vacation and holidays)
Repeat every year! (It gets progressively easier after the 1st year since you are editing or adding to your notes)
Here’s the good news… Most of the 12 sections for the week (or whatever it works out to be for your textbook) will be chosen based on the patients you are seeing (It makes it a lot more fun…). The bad news is that all textbooks have really boring sections that still need to be learned, so spread them out over the year to make sure you cover them (but not all at once).
Repeat (Reproduce knowledge). Teaching and explaining on rounds is a built in way to make sure you understand enough to explain it to others. (Plus you look really good). This is where one page summaries and/or mindmaps really help since they make it easy to remember (and teach).
(Share knowledge) In clinical medicine, there are many opportunities to share … rounding, informal teaching for medical students on our rotations, formal lectures, presentations at conferences, handouts, etc, etc. Take advantage of this unique form of “group studying”!
“To study the phenomena of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all.” William Osler
Science can be beautiful! I am absolutely not an “RNA-Seq nerd”, but I understand why an experimental result like this is delightful! This is beautiful basic science to understand a cool question … with millions of different smells how do we know the difference between a rose and petrichor?
So easy, sort of healthy, and delicious. I went searching last week for a dessert recipe that was sort of healthy, wasn’t too sweet, and would be a perfect bite after dinner.
p.s. I used a can of corn (instead of fresh) and substituted 2% milk for half of the condensed milk which was a perfect level of sweetness for my taste.
The definition of “knowledge” in English is pretty straightforward – To “know” something means being familiar and/or aware of it in a way that lets us understand. I find it fascinating that English has only one word for “knowledge”, where other languages use multiple words to reflect the depth and nuances of the concept. “Once widespread in Germanic, the verb [to know] is now retained there only in English, where it has widespread application, covering meanings that require two or more verbs in other languages (such as German wissen, kennen, erkennen and in part können; French connaître “perceive, understand, recognize,” savoir “have a knowledge of, know how;” etymonoline
How we understand “knowledge” affects how we teach, how we learn, and how we see the world.
The philosophers of Ancient Greece saw acquiring knowledge as an important part of the human quest for wisdom. Enter episteme, techne, phronesis, gnosis, and doxa. These nuanced ways to think about knowledge and wisdom have a lot to offer us as we navigate the misinformation and philosophical chaos of our time. For those in medicine, these nuanced definitions add beautiful complexity and understanding to our work, with special inspiration for those who teach the healing arts.
Techne refers to the technical skills of a profession – the grasp of grammar for a writer, pedagogical skills for a teacher, the ability to perform specific procedures for a surgeon.
I recently read this remarkable essay by Sami Sinada in which he states: “Medical school teaches episteme. Residency builds techne. But phronesis? We assume it appears through osmosis. It doesn’t.”
The entire essay is well worth your time to read, but Dr. Sinada makes an important point – Our medical school and residency curricula have gaps when it comes to teaching practical wisdom (which is the core of doctoring). He goes on to argue that we can close that gap with five important pedagogical choices:
What strikes me about doxa is that it has no moral weight associated with it. Doxa can refer to the deep orthodoxy of thousands of years of tradition in a culture … everything from how we greet each other to what we believe… as well as culturally accepted, politically motivated lies.
Gnosis is most often associated with gnosticism, a religious and philosophical movement in the 2nd century. But I wonder if the concept of a deep inner knowing (whether or not you view that as divine) isn’t worth refurbishing for our time as an important way to “know”. Contemplation, meditation, prayer can all open spaces that defy our intellectual understanding, leading to a way of “knowing” that, in some ways, we need now more than ever.
One of my favorite accounts on Bluesky. There’s no other site I know that posts photos of the daily salad given to a 40 year old tortoise who is constantly looking for true love, goats in Halloween costumes, and political commentary. They sell great cajeta (IYKYK) on their website (and there are super cool photos, too).
The 12th annual Theology Beer Camp took place last weekend, with the 50th anniversary of Monty Python and the Holy Grail as a theme. I posted my “Top 10” from this amazing conference here.
The Highest Court in the Land? I learned on the PBS Newshour this week that “The Highest Court in the Land”is the name of the basketball court on the top of the Supreme Court building. It somehow seems important that it’s not a regulation size court?
This recipe! I made this for the first time this week and it was AMAZING. In case you are wondering, I use the hashtag #CallFood on both Bluesky and Instagram for recipes that (usually) follow my “Pizza Rule” i.e. healthy and delicious food that takes less time to make than ordering a pizza.
