The Healing Power of Farmers Markets

Rituals have great power, but some more than others. For me, going to the Farmers Market has become a ritual that is almost as important as the food I buy there. So I spent some time this morning pondering why…

It’s outside. Sun, clouds, breeze. Sometimes a little cool, sometimes too hot… but always the season that matches the fruits and vegetables being sold that day.  

There is music. And dancing… people dancing with children, children dancing alone, folks dancing in their wheelchairs.

Everyone is happy. Seriously. Not a dour face anywhere!

There is delight in the colors, odors, and tastes.. It’s beautiful… and that sensual beauty evokes all kinds of good emotions – delight, joy, and even awe. 

It anchors you to the season. We don’t have peaches in January at the farmer’s market. So when they show up in May it’s a day of celebration! Eating what is being grown in the season keeps you somehow anchored to life around you and, according to some traditions, is better for your body. It’s certainly better for the planet, since this is food grown within miles of where it’s sold… not half way across the world. 

You develop relationships with the people that grow your food. Lisa’s new tortoise gets a spectacular salad every day, so we chat about his salads and her goats. I get to practice my French with the Congolese farmers who grow their produce on an inner city farm developed to provide new refugees a place to farm. Some of the vendors know my name, most of them know and recognize me with a smile (even if they don’t know my name), and all of them are happy to share how to prepare their food and what’s happening on the farm.

And then there is the food. There is no question it’s often (but not universally!) more expensive to buy your food at the farmer’s market, but for the reasons above it’s worth it. But there is one other reason … which is probably the most important reason of all.

How to Harvest and Store Potatoes -- Harvest to Table
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One of the very first times I went to a farmer’s market, I bought potatoes. I remember distinctly thinking that it would not be worth the extra money because “it’s just a potato”… but I did it anyway.  Every potato I had ever bought in a store tasted the same as every other potato … so I didn’t expect these to be any different. Wow… I was SO wrong. A potato that has been pulled out of the ground the day before you cook it is absolutely amazing. A light went on. Fresh food raised in smaller quantities by people who are devoted to doing it tastes better. It just does. 

Plant It Forward CSA shares ready to be picked up

There is most likely a farmer’s market near you if you live in a city, but if there isn’t you have a other options (The USDA Local Foods Directory is a wonderful way to find farmers markets, gardens, and local farms near you if you need help. )

CSAs (Community Supported Agriculture). Google “CSA’s near me” to find farms that make up boxes with small portions of anything they are harvesting that week to distribute to people who have signed up with them. 

Community Gardens. If you love to garden (and you can spare a few hours every once in a while) you might want to actively participate – it’s also pretty soul soothing to dig in the dirt and grow your own tomatoes. But it’s also worth asking if you can buy any produce that isn’t otherwise promised. 

A local farmer or neighbor who has a big garden. You don’t know unless you ask. Offering to buy some of their produce might end up being a win-win. They may have too much produce, need a little extra income, or both. And you end up with fresh produce and a relationship with the person who grows it!

Why don’t we do the things that bring us joy?

All of us have a list of things we know we should do every day… and usually don’t. They shouldn’t be that difficult to fit into our day, but we somehow end the day holding our intentions and the struggle rather than the completed task. I’m not talking about the things other people need from you, or the requirements of jobs or school. I’m talking about the things that bring you joy (whether immediate or delayed), things that are really important to you. 

Why don’t we do the things that bring us joy? The first step to conquer this paradox is to make a master list of the things that bring you immediate joy (e.g.prayer/meditation, reading, journaling, playing music, calling or writing to a friend you haven’t seen in a while, walking in nature, checking in with older relatives if it’s been more than a couple of days, learning something new, cooking for your family and/or friends) …and things that might be hard at the moment but will bring you joy in the long run (e.g. working out, organizing and cleaning your living spaces, working on a big writing project)  

Once you’ve made this master list, acknowledge there is no way you are going to be able to do all these things in a day. It’s important to name these things, to make this list and revise it as new things are recognized… but it’s equally important to acknowledge that you are going to have to make some choices.  Pick what you currently think are the two or three most important things on this list and make a covenant with yourself that you will do them “every” day. The “every” is in quotes because let’s be real… life happens. Promise yourself that you will do these things every day, but give yourself grace for the occasional day when it’s just not possible. 

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Next, pick a way to remind yourself and keep track of your progress: 

Schedule them on your calendar. This is probably the best way to do this for most people, but you have to build in a “what if” plan. If for some reason you don’t accomplish it at the time you scheduled it, it doesn’t break the promise you made to yourself. Move it on the calendar, commit to doing it later, but don’t blow it off. 

Keep a “routine checklist. This is separate from any other to-do list you create. This is for you. Not the things you have to do for other people, but the things you are doing for yourself, the things that add goodness to your days. 

Morning is best (if you can). There is an adage in finance that you should pay yourself first. In other words, the first thing you do with your paycheck is to put money aside for investment in your future. Time is no different. Doing the important things first, the things that are just for you, is an investment in the day and your future. 

The power of streaks. Put an X on a calendar every day, like Jerry Seinfeld or get the app that lets you put the Xs on a digital calendar. (There are other streak tracking apps, too.) Alternatively, create your own visual record of a streak with Excel or a Word document. The power of a streak is that you become more and more invested in not breaking the streak as time goes on. 

Final thought. We are all busy, and we are all tired. This era, more than most,  is one of being pushed and pulled in so many directions and in so many ways. Take the time to identify the things that bring you joy. If that’s all you do, it will be a good start, because just making that list will make it more likely you will add joy to your days. When you are ready, make a real covenant with yourself, a promise that you will do the one, two or maybe three (no more that three!) things at the top of that list every day. And then, do your best. Give yourself grace when you stumble… and start over. 

Gifts for folks about to start medical training – of any kind!

Every year about this time I put out a list of the best presents for folks about to start medical school, nursing school, physician assistant school or any medically related school … as well anyone “leveling up” to the next level of training in their field (i.e. internship, residency, fellowship, etc). This is my edited post for 2023. I hope it gives families and friends ideas on how to support the people they love who are learning how to heal.

The Gift of More Free Time

The everyday needs of a household can become oppressive if you are working 80 hours a week. And, because bathrooms need to be cleaned, and floors need to be vacuumed, this is time that takes away from downtime needed to recover from hard work.

Here’s a list of things that just about every healer or healer in training would appreciate to help free up time:

  • A cleaning service. Hire someone to do a “deep clean” of their home once a month. Look on the internet for bonded cleaning services or call people who might know the best companies.
  • Car washes. Who doesn’t love a clean car…. and who has the time to wash and vacuum their car?
  • Roomba vacuum cleaner. One task taken care of!
  • Someone else to cook meals (see below!)

The Gift of Nourishing Food

  • Instant Pot. The number one time saving kitchen appliance for busy people is the Instant Pot. My Instant Pot has fundamentally changed the way I cook – and has made it easier to eat well.
  • Air Fryer. I’m a new convert to air fryers. 15 minutes to get wonderful roasted or air fried veggies is amazing! Hard to choose between this and the instant pot. There is an instant pot with both, but I’m not sure it does quite as good a job as an air fryer.
  • Gift certificates for food. Do a little sleuthing and find a healthy grocery store near where they live. Other ideas might be a smoothie or juice shop, their favorite restaurant(s), or coffee shops
  • Prepared meals. Most cities have small, local companies that deliver prepared meals to your door. That would be my first choice (support local!) but there are also national companies and do this, too. Most companies offer gift certificates which is probably the best plan to give flexibility between a subscription or a la carte ordering.
  • Home cooked meals. If you live near, think about cooking a batch of favorite food(s) and putting them in single serving containers to freeze. You might also want to create a certificate for your personal “cookie/meal/soup of the month club” with a promise to deliver food once a month.
  • A Good Cookbook. Mark Bittman’s cookbooks are all wonderful, but How to Cook Everything Fast is a particularly good choice for busy people.
  • Vitamix. It may seem expensive for a “blender”… but this is much more than a blender. These are the blenders you see in professional smoothie stores. Smoothies become a lifesaver for busy healers. (The Vitamix also makes great soups, sauces, etc…..)

The Gift of Good Beverages

  • Insulated Coffee Mug. Rounds in the morning often starts with “running the list” around a computer, often at “dark thirty” when the rest of the world is just thinking about getting up. Having good coffee or tea from home or a local shop that stays warm for several hours is such a pleasure. The mug of choice for just about everyone I know is a 10 or 16 oz Yeti tumbler.
  • Water Bottle. No one drinks enough water at work in the hospital (and we all agree on this). Again, having a great water bottle that you can fill in the morning with ice water (and a slice of lemon if you like) makes the day better.
  • Nespresso (or other) coffee maker. If they are a coffee drinker, a good coffee maker is key. Nespresso is my personal favorite, but be creative and look at all the options!
  • Good coffee (or tea). There are local roasters in most cities, so rather than support the big chains, look for them and consider a gift of coffee.

The Gift of Music

For those who find solace and joy in good music (and isn’t that just about all of us?):

  • A good Bluetooth speaker for their home or study space. I love the Klipsch The One II speaker I have at home, but I’m sure there are other equivalent speakers, including some that aren’t as expensive.
  • Air pods or noise cancelling headphones
  • A subscription to one of the many streaming music services like Spotify or Apple Music.
  • Tickets to the symphony, ballet, jazz performances, or opera in the city where they live.

The Gift of Good Sleep

  • Good mattress, pillows, sheets. How we sleep determines how well we function the next day, particularly in high stress jobs. Is it time for a new mattress? Is there a better mattress that might help? High quality sheets are usually a welcome gift, too.
  • Light blocking curtains or shades. Post-call sleep is during the day and sunlight can interfere with sleep. Special curtains or shades to block the sun really help.
  • A Weighted Blanket.
  • Nothing Much Happens. This is a free podcast with the subtitle of “Bedtime stories for adults”. Since it’s a present, think about supporting this wonderful series with the very cheap subscription (which means you get the stories without ads.)

The Gift of Healthy (and not aching) Feet

Working in the hospital means a lot of time on your feet. John Wooden, probably the most famous basketball coach of all time, spent the first week of training every year teaching his players how to put on their socks…. because he recognized that if you didn’t pay attention to your feet, it would affect your game. The same is true in medicine.

  • Comfortable shoes for the hospital which can be thrown  into a washing machine. High on the list are Atoms, AllBirds, and Merrells. I have shoes from all three companies and so, for some one like me (a surgeon) who walks and stands a lot, I can recommend these specific shoes! Atoms Sneaker, Allbirds Tree Runners, Merrell Encore Breeze, Merrell Antora 2 Rainbow,
  • Good socks. Don’t go for cute, go for high quality, well padded, and functional.
  • Compression socks. There is some debate about whether compression socks can really prevent varicose veins, but there is no debate that your feet feel better at the end of a long day when you wear them!
  • Pedicures. Lots of women (and some men!)  have learned the joy of a professional pedicure for tired feet. Don’t underestimate the power of a gift certificate for  pedicures. But, as an alternative, put together a kit for home pedicures.

The Gift of Fitness

This might not apply to everyone, but most people who work hard know that they feel better if they exercise a little every day. But – a word of caution – tread lightly with fitness gifts since they can be misinterpreted as conveying a “need” to exercise.

  • A bicycle. For many people a good bicycle can make it easy to add some exercise by commuting to work by biking instead of driving. Regardless, it’s a great way to get some exercise outside. If they have a bike they use to commute, you might think of some ways to make it easier such as
  • A gym membership. You may have to do a little detective work to find the right gym that is close to where they live, but it’s worth it.
  • New shoes. Runners are supposed to get new shoes every year or so. Give them a gift certificate from a running store near them, if there is one. Or, be creative and put cash in a tiny toy shoes and wrap them in a shoe box.
  • Fitness equipment for home. Resistance training is important for all of us, regardless of gender or age. Although a bench and weights are part of the classic home gym, they take up a lot of room (and weigh a lot!). I’m a big fan of the TRX system, which makes a great present. Since it has become almost a cult among physicians during the pandemic, I have to at least mention Peleton as another potential fitness gift for healers and healers in training.

The Gift of Calm

Massage and/or Spa Services. This, too, may take a little effort to find the right place, but this is a wonderful gift for stressed people.

Headspace. This might seem a little unusual as a gift idea, but I can’t recommend it enough. Meditation is discussed in most medical schools and hospitals as a tool to gain insight and recover from the depletion that is part of the work we do. The best way I’ve found to learn this practice, and then stick with it is Headspace, which is a great app. The first 10 lessons are free, but for a gift, go ahead and get the annual subscription.

The Gift of Time and Stories

Human beings heal their hearts and souls by telling stories. Although there are many stories your loved one can’t tell you (at least not the specifics) you can totally ask how what they are seeing and doing is making them feel. Set aside some time for a coffee or another beverage and ask – with intention – “How are you doing?” And then just listen. Don’t try to “fix” anything … just listen.

Along the same lines, think about a letter… yes, a handwritten letter or note. Maybe a long one for a specific holiday or birthday, maybe a series of shorter ones through the year. Imagine how you would feel after a particularly hard week if you had a letter to reread that talked about how proud someone was of you, filled with funny stories and words of support.

#MedGradWishList

Revised March 6, 2022

Every year about this time, I try to put together a list for people trying to find the right gift for someone they know who is graduating from medical school.

If you haven’t heard of @medgradwishlist on Twitter, it’s an amazing grassroots effort to create Amazon wish lists for URM medical students with financial needs to help them get ready for their internship. This is a brilliant “pay it forward” initiative. I’ve been a Program Director and a Dean of Student Affairs and I know how many new grads finish medical school with enormous debt and empty bank accounts. The ~17,000 students graduating from medical school this year are about to start on the exciting – but stressful – path of becoming a physician. Not being able to afford the things that make that journey possible just isn’t acceptable. You can buy things on their list anonymously (or not). When you find the right thing for the right person, don’t forget to include some memories of your internship, advice, and words of encouragement!

If you are a student (or even a struggling resident) in need, please join this effort to get what you need. We are sure you will pay it forward to extend this support future classes! If you are a student who can afford to support others, please do. And regardless of whether you participate in #medgradwishlist or not, the following ideas will help with graduation presents.

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I spent quite a bit of time looking at all the #medgradwishlists on Amazon, and I’m happy to share what I learned. In addition to their great ideas, I have some suggestions to add…

@drmlb‘s Top Ten #medgradwishlist suggestions

Instant Pot. This was on a lot of the Amazon lists, and I agree!!! II had to suggest one item to make life as a resident easier, it would be this. Several people asked for air fryers on their Amazon lists. I love my air fryer and use it all the time so please put it on your list if you think it will help. Just as an FYI, you already (sort of) own an air fryer since your oven set on convection does close to the same thing!

Someone to help clean and do laundry. I know you can’t put this on an Amazon wish list, but if you have a family member who either can do this for you, or pay someone to do this for you, it’s one of the best gifts you will ever receive.

Digital gifts to make communicating and studying easier. The single most important tool for an intern is their phone. If they don’t have a new phone that can reliably work with WIFi and cellular, this should be at the top of the list. A computer that works, has the ability to do streaming well, and is reliable is also key since it’s how they will study, write, and watch educational videos. They’ll want the flexibility of studying in a coffee shop (once we get COVID19 under control) or on their couch so make sure it’s a laptop and not a desktop computer.

There were some great ideas on the Amazon lists for items that aren’t quite as expensive as computers that you might consider as well: ring light for Zoom meetings, LED study light, lap top desk for your lap, iPad Pro, Apple pencil.I should add that buying a large quantity of pens to be “borrowed” by attendings would be a big win, too.

The kitchen (other than the Instant Pot). It’s so important to eat well when you work as hard as interns work (and to stay well caffeinated). There were some great ideas from my new colleagues on their Amazon lists including single serve coffee makers, pot and pan sets, nonstick bakeware set (if they are a baker!), wine opener :-), food storage bags and containers. A box or two of Kind Bars (my favorite) or other meal replacement bars is a great gift, too. And for the times cooking is just one task too many – Door Dash, Uber Eats, and/or Grub Hub gift cards are a great gift. One other must have… a Yeti mug to keep coffee hot during rounds!

Clocks and watches. We all have phones that can serve as alarm clocks, but an alarm clock that gently lights up the room is a much better way to wake up than sudden noise. I wouldn’t say an Apple watch is essential (and if you do a lot of procedures it might be easy to lose) but it is worn by a good percentage of docs.

USMLE3 study book. If you are a family member who is thinking about getting this as a present, you might also want to include a check for $895 as a “bookmark” to cover the cost of registering for this exam.

Make your home a stress-free zone. If you are setting up a new home, this list can be really extensive. You’ll need to go home to a clean, happy space, so whatever you can do to make that happen is important. There were a lot of good ideas in the Amazon wish lists including self-cleaning cat boxes, pet hair removal brushes, furniture, shower curtains, towels, and a video doorbell. I’d add a Roomba vacuum cleaner to this list, too! BTW, a good TV is important, too. We all need to binge watch the Great British Baking Show as therapy sometimes.

Sleep. In this category I would include good quality pillows, a new mattress, light blocking curtains, white noise machines, and electric or weighted blankets.

Music. Most people fill their space at home with sound as well as light, so think about good WiFi speakers like Sonos and/or gift certificates for ad-free music services like Apple Music, Spotify, Pandora.

Health. Last but not least! The most important thing on this list in my opinion is a great water bottle since, particularly with masks on all day, none of us drink enough water. A new Sonicare toothbrush or WaterPik for dental health will be appreciated. Foot care is another important part of being a healthy resident, so consider gifting compression socks, new shoes for the hospital, work insoles and/or a foot massager. Anything that promotes or makes fitness easier is also a good gift – a new bicycle for commuting, workout gloves, free weights, resistance bands. You might also consider a meditation app like Headspace, or subscription to yoga classes on line.

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p.s. What NOT to buy or ask for

  • Scrubs. I noticed a lot of folx asking for scrubs. Nope – don’t do it! You will be required to wear the scrubs from the hospital since there are rules about them being washed in the hospital laundry. Ditto for things to wear under scrubs. You’ll get too hot, they get dirty, and they are against the rules in all operating rooms (and many hospitals)
  • Textbooks. You are pretty much guaranteed to have access to a library where these books will be in digital format and free. These books are heavy! You aren’t going to take them to work and when you get home, you may have other things to read that take priority.
  • Printers. Printers (and printer ink) are expensive and you just won’t use them. You are going to have to stay digital to really learn what you need to learn as a resident. Besides, if you do need to print out the return slip for Amazon, there will always be a printer at the hospital you can use!
  • Black bag. If you are a family member thinking of getting one of these… don’t.

And finally…

For my new colleagues matching this month and starting your internship in June …

May your journey through this liminal time be as stress free and as joyful as possible. May every day as an intern bring you hearts to heal and hands to hold, new learning, and a sense of wonder and awe.

We are so happy you are joining us in this noble and sacred work!

Top 10 Holiday Presents for Medical Students, Residents and Physicians: #COVID19 edition

Every year about this time, I create a list of presents I think busy healers (and healers in training) would appreciate. I don’t have to tell you that this has been a year that for all of us, but especially for everyone in medicine, has brought a new level of stress and sadness. The healers need healing… and in that spirit, here are some ideas of what you can send your friends in medicine for Hanukkah, Kwanza, Christmas, the Winter Solstice… or to celebrate the end of 2020 and beginning of a new year of hope.

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#10.  White coat, jacket and/or scrub “bling”.  Everyone who works in a hospital has a badge that must be worn all the time. And we all need pens (except for the attendings… we just “borrow” pens that students and residents keep in their pockets for us … just kidding … mostly). Here are some suggestions: Find a lanyard or badge holder from their favorite sports team or that will otherwise have meaning for them. Buy a box of cheap pens (that can be given away to needy attendings)  + a great pen that will remind them of you every time they write with it. For white coats, find a meaningful or humorous pin that could be worn on other clothes as well.

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#9 Happy Feet.  Think about putting together a “happy feet” box – include things like warm slippers, good socks, a certificate for a pair of shoes to wear in the hospital, compression socks, toenail clippers, and any other foot care products that sounds right. 

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#8 Better sleep. Sleep can be hard if you have had a really hard stretch at work. It’s especially hard if you’ve worked all night and have to sleep during the day. You can put together a combination of gifts like new high-count sheets, eye covers and ear plugs for sleeping after a night shift, a certificate for a new mattress, a white noise machine or a weighted blanket.

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#7 Work food. Busy students and residents frequently miss meals. Think about creating home made “snack packs” for the hospital by combining options like nuts, dried fruits, and high quality candy into small zip lock bags. Or buy healthy meal replacement bars in bulk. Make sure they are high quality, real food bars. My favorites are Kind bars but there are many other bars that are healthy and delicious.

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#6 Gift cards. When you ask students and residents which gift cards would be most appreciated it’s pretty consistently these three:  Amazon, Trader’s Joes, Whole Foods or other grocery stores, and Starbucks.

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#5 Digital upgrades. A high-quality phone is a critically important tool in the hospital. Everyone in medicine spends a good part of the day texting each other, looking up patients on Haiku (the Epic phone app), checking UpToDate for the latest treatments, finding other medical information in many other places and – of course – staying in touch with our teams, friends and families. Up to date computers, iPads, and AirPods (or equivalent) are also great gift options for any student or resident.

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#4 A cleaner house. Pre pandemic, I recommended someone to help clean as the number one gift for medical folks. But, even with the limitations imposed by COVID, there are still gifts that can help! Number one on this list would be a Roomba so they don’t have to vacuum.

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#3 Healthy meals at home that don’t take time. The Instant Pot has been my top recommendation as a gift for students, residents and busy healers for several years. Another wonderful gift I’ve recommended before is How to Cook Everything Fast: A Better Way to Cook Great Food by Mark Bittman. This year, I would add a certificate to meal delivery plans. The one I use is Clean Creations (because I like to have vegetarian options), but many of my friends swear by Freshly. Every city has companies that are similar, so do some homework and you’ll find several to compare. If you are a good cook, you might consider creating your own “meal deliveryservice” for your loved one, especially if you live in the same city.

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#2 Caffeine. This comes in different forms for different people, but unless they avoid caffeine for religious reasons, almost every healer and healer in training I know has a go to form of caffeine they love. For most people, it’s coffee. The number one gift on the list (my opinion) for coffee lovers is a Nespresso machine (and some pods to go with it). You can also get them a metal “pod” for their own coffee rather than the Nespresso pods which will save some money. There are other options for pod coffee machines, so you might want to read about them all before deciding. Having tried coffee from a variety of machines, I personal think Nespresso makes the best cup of coffee, but I am partial to espresso. Another great gift option for serious coffee drinkers is programmable coffeemaker so their coffee is ready when they get up at “dark thirty” to get to work. For tea drinkers, there are many options for teas, brewing systems, and pots. For all healers, regardless whether they are coffee or tea drinkers, a gift at the top of the list would have to be a Yeti or Contigo tumbler. These tumblers keep coffee or tea hot for hours… so your drink is still there and still hot when you get pulled away from that first sip.

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#1 Money. Students and residents, with rare exceptions, don’t have money for special things. Some don’t have enough money after rent and loans for things most of us would consider essentials. Giving money may seem a bit impersonal, but you can make it personal with a letter, a card, or creative packaging.

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p.s. If you want to check out my pre-quarantine lists for other ideas here are the links to last year’s list, and the year before.

p.p.s Thanks so much to my Twitter friends for helping me with ideas!

Making Sourdough Bread as a Resident (or anyone with a crazy work schedule)

I just waved goodbye to a dear friend as she started the drive to her new residency – with a jar of “Tamar”, my sourdough starter* in her cooler. I was going to print some instructions to send with the starter, but decided it might be better to put those instructions here for her – and for all of you who have thought about making sourdough bread (but think you are too busy).

Why bother?

This is a legitimate question. What I’ve learned from making my own bread during the pandemic is that it’s more than just having delicious, warm bread to sustain you.  I won’t wax too poetic, but there are three reasons I think you should ponder baking your own bread:

  • A sourdough starter is a living thing who is there to help feed you
  • Making the bread is an act of self-care, a gift to yourself
  • This is a  profoundly slow and deliberate act. Mindfulness doesn’t get any better than this.

So, if you are intrigued, I’ve thought about this for a while and here is how I think this could work for residents – even during a crazy 80 hour week.

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Step 1: Get or make a starter

There’s a decent chance that someone where you work bakes sourdough bread. If they do, they will be delighted to give you some starter. It’s not a bad way to make some new friends and/or expand your circle of friends.

If you don’t find someone with starter, make your own. Sourdough starter comes from the bacteria and yeast that are in our environment so it’s a matter of mixing flour, water and time. If you want to help out some scientists while you make your starter, check out the NC State Sourdough Project.

Step 2: Understand the big picture

  • Sourdough starter is a living thing. You need to feed it once a week by adding some water and flour. Period. If you want to stop here and just have the starter around “in case” you decide to bake, this is all you have to do.
  • You are going to love the science of this. I’ll even predict you’ll end up using a scale to make sure your grams of ingredients are exact… but remember, as much as this will feel like science, its also how our ancestors made bread thousands of years ago. Don’t lose that perspective.. or that connection… when you bake.
  • It’s a four-step process with variations depending on the recipe:
    • Mix the 4 ingredients (starter, flour, salt and water) to make dough
    • Rise – long and slow. Overnight in the fridge, 2-6 hours on the counter. It varies by the recipe.
    • 2nd rise – usually. for 1-3 hours and in a container to shape the dough
    • Bake

Step 3: Find an easy recipe to start with so you don’t get overwhelmed…

Here’s a really easy first recipe:

  • Mix the dough (1 cup starter, 1.75 cups lukewarm water, 5 cups of flour, 1 tablespoon of salt)
  • Let it rise for about an hour then stretch it out and fold it onto itself several times. The recipe says repeat this once an hour for a total of three times, but you can skip the 2nd and/or 3rd times if you need to.
  • Put it in the refrigerator overnight.
  • Flip it over, seam side up into a bowl or loaf pan (to shape it) and let it sit for 2.5-3 hours.
  • Flip it back over (seam side down) into your pan, slash the top to provide a controlled way to expand and bake.

Step 4: Map out a schedule

Let’s say it’s Thursday evening and you are off on Friday. Here’s how this recipe might work for you…

  • Thursday when you get home, mix the dough. If you don’t have time to let it rise on the counter for an hour and stretch it, just put it in the refrigerator. (Trust me, it will work). Take the starter that didn’t go into the recipe, feed it, and put it back in the refrigerator.
  • Friday when you wake up put the dough in a bowl or loaf pan and let it sit for 2-3 hours on the counter. This will mold it into whatever shape you want.
  • Heat up your cooking container (dutch oven, oven proof pot, tray) as you preheat the oven.
  • Put parchment paper on top of the bowel and flip the dough out of the bowl onto the parchment paper.
  • Use the parchment paper to lower the dough into your hot cooking container.
  • Score the top and bake!
  • (Don’t forget to let it sit for an “hour” before you slice it… no matter how good it smells)
When you overproof dough (too long with too vigorous a starter) is gets REALLY liquid and REALLY sour. It isn’t worth trying to salvage it.

It’s an art. Everyone has bread that bombs.

Don’t worry! Just keep the starter alive, regroup and try again!

If you find you are having issues with getting a good rise, it’s ok to put some dry yeast in as “insurance”.  Poilâne’s famous sourdough includes it as part of the recipe, so it can’t be a “failure” in the sourdough world!

Comparing stater activation between white flour (dotted line) and whole wheat (solid line)

What to study next

If you are reading this, there’s a good chance you are Type A. You’ll probably get a notebook and treat this like a science experiment … like I did. Go for it! It turns out that even though sourdough bread has only 4 ingredients (starter, flour, water, salt) there are lots of variables that can affect the loaf e.g. temperature of the water, humidity in the room, etc. There is real joy in paying this much attention while creating something that is so sustaining. On the other hand, if this doesn’t make you happy, just make the bread!

Did I mention?… it’s not just bread…foccacia, pizza dough, pancakes… just wait until you find all the cool things you can do with sourdough starter and discard!

Blogs and websites that have helped me a lot

King Arthur Flour – Sourdough Baking: The Complete Guide  (Check out their blog, too)

The Perfect Loaf

Here are some of my favorite books so far (all links are to independent bookstores)

Artisan Sourdough Made Simple, by Emilie Raffe

Do/Sourdough/Slow bread for busy lives by Andrew Whitley

The Tassajara Bread Book

Poilâne by Appolonia Pouilâne

Starter Sourdough: The Step-By-Step Guide to Sourdough Starters, Baking Loaves, Baguettes, Pancakes, and More 

I wish you mindful baking and joy from your sustaining and delicious bread!

*There is a tradition of naming sourdough starters.

Self care in the time of #COVID19

It’s so important, and so very hard, to care for yourself when times are tough. When routines are disrupted and fear and anxiety are present, our usual ways of caring for ourselves seem to (appropriately) fly out the window.  So, here are some ways to think about caring for yourself in the time of COVID19, whether you are working (at home or in the hospital) or isolated at home.

Connect with nature. Long after this pandemic is over, the earth will still be here and spring will continue to happen every year. Make sure you get a good dose of the smell of grass, the sight of a blue sky, the feeling of a cool breeze on your face at least once a day (but hopefully more).

Move. It’s normal that workout schedules are disrupted right now, but it’s not a good time to completely give up on your physical wellbeing. There is nothing good about being sedentary – not only does it make you feel physically bad, it also contributes to sadness and anxiety. A good, brisk walk outside may be the best “workout” right now since it combines movement and getting a dose of nature… but please make sure you practice social distancing and stay six feet away from everyone.

Eat well and enjoy good chocolate. You may be limited in your choices and your ability to get real food, but do your best. This is not a good time to succumb to the junk food as comfort food diet. Nor is it a good time to be overly restrictive. Splurge on small doses of the foods that make you feel comforted, but make sure it’s the best version of that food possible! Now is not the time for cheap chocolate… just sayin’.

Keep your spaces clean. Our homes need to be a safe sanctuary now more than ever, and that means we need to know they are clean. In addition to creating a ritual to enter your home, come up with a plan to keep your home neat and cleaner than usual. If it helps, what we’ve done is set a mindfulness timer to ring 3 random bells an hour when we are home. Every time it rings, we do one small bit of cleaning (or one set of an exercise) e.g. vacuum one room, clean the countertops, wipe off all door handles or do some pushups. What you lose in efficiency is made up for by breaking up an otherwise boring task and by the “surprise” of the random “request”.

Dose your news. We need to know what’s happening, but we don’t need to know it all the time. The human brain doesn’t like being continually bombarded with potentially dangerous information. It promotes the physiologic stress response and pushes us towards fight, flight or freeze… none of which are helpful in this time. I love Twitter, but I have to be careful right now… it can be an echo chamber of sadness and stress. The news I’ve found that is the most informative, most accurate and least stressful is the PBS News Hour.

Guard your spirit. Find a place and a way to keep your heart full, your #EyesOpen and your compassion alive. This is not a sprint… it’s clear we are in this new world of COVID for a while. #WeNeedYou so please protect yourself in body, mind and soul.

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Last minute holiday gifts for busy people in your life

There’s still time!

If you have a medical student, resident, physician or anyone who is super busy in your family, here are few last minute gift ideas for you….

A Letter

I’m starting with this one because even though it’s obvious, we forget the power of stories in our lives to heal and support each other. Consider writing a long letter with stories about how they inspire you, when they decided on their career, funny events, etc.  Stress joy, humor… and gratitude.

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Spotify and/or Pandora without commercials

Many of us study with music, and most of us work (at least sometimes) with music in the background. These two platforms are currently the most used in the hospital. Being able to listen to the music of your choice without commercials is a great gift!

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InstantPot

Of all the cooking appliances and gifts, this one is the best for people who want to eat well but don’t have a lot of time. Even if you have to wrap the “IOU” (i.e. a picture of the InstantPot), it will be a very appreciated gift!

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A clean home

No one likes to clean their home, but all of us need this!  Even if it’s a deep clean every 3 months for a year, this is a great gift for anyone. Although there are professional services you can find, consider contacting local places of worship or non-profit organizations who may know responsible individuals who need the work.

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A subscription to Headspace

This one might seem a little strange, but you’ll have to trust me. For anyone who is “too busy” this is an easy way to really stop – even for 10 minutes a day – and “refuel”. BTW, get yourself a subscription (or at least try the first 10 lessons which are free). You’re welcome 🙂

Link to Andy Puddicombe’s TED talk (the founder of Headspace)

Other ideas for gift certificates

  • A healthy grocery store
  • A smoothie or juice shop
  • Their favorite restaurant(s)
  • Car wash
  • Starbucks (or even better, a local coffee shop near them)
  • Prepared healthy meals from one of the many companies that do this now
  • Membership to the YMCA or a gym near them
  • A new bicycle? (we never get too old to love this!)
  • “Date night” certificates for movies, plays or music and a meal
  • A favorite museum

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Shopping for the Week (and Your Soul)

Whenever I can, I go to our local farmers’ market on Saturday morning to buy food for the week. There is the obvious benefit that the food is organic, healthy and fresh, but there are some other benefits you might not have thought about. First, there is something special about eating with the seasons. Right now is peach season and they are amazing… but they will be gone in a few weeks, to be replaced in the fall and winter with citrus fruits. Secondly, you learn the names of the people who raise your food – and they will recognize you after a few weeks of shopping with them. The farmers’ market becomes a social connection, created through food, that Is sustaining in a different way. Finally, the experience of the market itself is so different from the stress of the work week – bright colors, happy people, music, food trucks, etc.

Now what exactly did I buy? When I get home, I put all of the food out on my kitchen counter and take a photo. The task of taking the photo is just fun for me (I love the colors and how beautiful it looks) but, to be honest, I started doing this so I could remember what I bought. So the next thing I do is make a list from the photo.

First one home starts cooking! I use a program called Paprika 3 to plan the week. It includes a browser to look for recipes, a weekly planner to list when I’m (tentatively) planning to cook each recipe, and a shopping list. Even better, the app is shared with my significant other so we both have all the info.

Link to this website

So, what are we cooking this week? After trying different combos in the browser such as “okra and sweet peppers recipe” or “papalo recipe”, here is what our menu looks like for this week. There is never a week that we follow the menu exactly – and I think that’s really important. This is the destination, but not the journey! We swap evenings, trade lunches for dinners, whatever works for the week. Note also, that since we aren’t on call this weekend, we are cooking a lot on Sunday to have leftovers during the week.

Need anything else? I make a separate shopping list for the missing items in the recipes (if they aren’t in the pantry already) and go to pick them up at a nearby grocery store.

If it’s going to be a busy week, we get ready. Most of cooking is the preparation, right?  When you walk in the door exhausted at 7:30, it’s hard to have enough energy to cook. That magically changes if everything is already cut up and ready to throw in the bowl or pan. We’ll make stock from all the leftover vegetables peels and ends and spend some time cutting things up to have them ready.

Link to website

I hope this helps! It’s true for anyone who is busy, but medical students and residents have a particularly hard time finding the time to eat well. Give this plan a try… it will not only give your body the kind of food it craves (and needs)… you’ll be surprised at how it refuels you in other ways, too.

Link to website and photo credit