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

Happy New Year’s Resolutions!

Like most of you, my New Years resolutions in past years have been something like “Exercise every day” or “Eat fruits and vegetables with every meal.” And, I bet that you had the same experience I did… a few weeks of “success” and then they seemed to fade away. The problem with these kinds of goals are how they are structured. They end up being “either-or” goals … you are either able to do them or, more often, you miss a day (or two… or three) and feel like a failure.

I recently read a blog post by Ryder Carroll, the originator of the Bullet Journal which profoundly changed the way I think about goal setting and New Year’s Resolutions

Photo credit

It’s a simple, but very powerful concept. Set your goal as a destination… as a “lighthouse” in the distance, and then head in that direction every day. As Ryder Carroll explains, “When goals are lighthouses, success is defined by simply showing up, by daily progress no matter how big or small…”

So instead of the usual New Year’s Resolutions, pick a few “lighthouse goals”. Write them down and keep track of how you are doing (every journey needs a map). This can be as simple as one piece of paper for each goal, but I am such a fan of the Bullet Journal, I hope you consider using it.

When you get up every morning think about how to move towards your goal(s). If you veer off course, that’s part of the journey…. look up, find your lighthouse, and correct your course.  Every once in a while (maybe monthly?), look at the progress you’ve made and celebrate it! If, on the other hand, the goals you originally chose don’t make sense for you any more, pick some new goals, draw a new map and start over.

Potential New Year “Lighthouse” goals

  • Learn more about compassion and practice it
  • Be a better friend
  • Write genuine thank you notes to people who have helped me
  • Become more fit
  • Eat real food for as many meals a week as I can
  • Find out more about who I really am through meditation
  • Keep a “stop doing” list
  • Be better at my work through deliberate practice (practicing and learning the things I don’t like and aren’t good at until I’m better)
  • Stay organized so I don’t waste time (and end up focusing on trivial things instead of what’s really important)
  • Read things that bring me joy
  • Learn about and use a Bullet Journal
  • Find a community to support me
  • Learn the names of as many people at work as I can
  • Take the stairs as often as I can
  • Make my living spaces enjoyable spaces
  • Keep a journal to remember milestones and work out struggles
  • Get good sleep as often as possible
  • Learn Spanish (or any new language)
  • Be on time
  • Remember people’s birthdays and send a card
  • Start the day with intention
  • Appropriately limit email and social media time

Holiday Gifts for Medical Students, Residents, Physicians and Other Busy People


Every year I try to post gift suggestions for the family and friends of people in medicine (and all other busy professions).  Here are this year’s suggestions!

Image result for empathetic listening
Photo credit (and article on the Art of Empathetic Listening)

Listen.  A great friend of mine told me once that human beings heal by telling stories. There are lots of stories in medicine that go untold, but I promise you there are stories. Listen mindfully, without judgment and without trying to “fix” anything. Start with “Tell me a story about something that amazed you”… and then take it from there. 

Image result for letter writing
Photo credit

Write a letter.  Write a “letter of recommendation”. Yes, I’m serious! Not a letter to “get” or be elected to anything, but a letter that shows you know who they really are and how amazing it is that they have dedicated themselves to something so important. Make it a love letter, a letter of support, a letter with family history to encourage them… but a real letter. Write it on a computer and then print it, or use some beautiful stationary and a pen, but create a physical letter that will sit on their desk. Put the letter in a special box (something you might add to from time to time with other short letters?). 

Image result for instant pot
Photo credit

Instant Pot. There are kitchen conveniences, there are fads, and then there is the Instant Pot. This has taken on almost cult like status among users for a reason. It’s a 6 in one device (pressure cooker, slow cooker, rice cooker, saute, steamer and warmer) that makes it easy to cook healthy food. For students and residents, the 6 quart basic Instant Pot does everything you need it to do, but feel free to choose one with more bells and whistles if you want. 

A cleaning service. No one likes to clean toilets. And, if you are working 80 hours a week, housework takes away precious personal time to socialize, exercise or restore your batteries in other ways. If you are in a position to do so, see if you can make this a win-win by working with a church, refugee placement group or another social justice group to find someone specific who really needs this kind of work. Whether it’s a one time “deep clean”, a monthly clean, or weekly cleaning and laundry, any help will be a deeply appreciated gift. Another approach is to do a little “sneaky” homework – your loved one may have a friend who has already found someone wonderful who might need more work.

 

Photo credit

The Gift of Organization.  I have become a huge fan of the Bullet Journal. It is incredibly easy, very versatile and, I believe, a perfect system for medical students, residents and docs. (especially when paired with a list on your smart phone when you are separate from your Bullet Journal). Choose a good Moleskin journal and the new book by Ryder Carroll, who developed this technique, and wrap them together as a perfect gift. If you want to really make their day, include a package of good (but not too expensive) pens

A gym membership (and other related gifts).  It’s really hard to find time to exercise if you are busy, but it’s critical for mental and physical health. There are a lot of options here, but they need to be specific to the likes and dislikes of your loved one. If they are a runner, maybe a gift certificate for new shoes? Do they like spin classes? If so, check out where the good classes are near them. Same for yoga, dance, ice skating, tennis, swimming, etc. A membership at a YMCA ( if there is one near them) will give them access to weights, classes and often a pool. Would they commute to school/work if they had a good bicycle? Can you get them a new watch or fitness monitor that will help count steps and flights of stairs? Would an “on the go” exercise kithelp them? 

A Meditation App.  I tell my students that if they can only pick one thing on the self-care list to choose, that this would be it. There are plenty of data that show the stress-reducing benefits of meditation. What is amazing is that if you have a meditation practice the other self-care is easier, too. This is a great tool to help meet the goal to be better and happier physicians. 

Photo credit

Your time.Can you cook some meals once a month and put them in their freezer?  Do laundry? Bake cookies and mail them? Get their car washed every once in a while? Make an elaborate certificate with something you could do for them and wrap it as a present?

 Need other ideas?  Here are links to some previous lists: 201720162014,

You’ll never buy stock again

This may be one of the easiest kitchen tricks I’ve learned in the last few years.  I haven’t bought any stock since I figured this out. It saves money, but more importantly, this stock tastes MUCH better than anything you can buy.

Step 1:  As you peel, chop, and otherwise use any vegetables for recipes or salads, save all the pieces you would normally throw away.

The vegetables that help the most with umami (and make your stock great) are the classic mirepox (carrots, celery and onion), garlic bits, and mushrooms.  There are a few vegetables you should avoid using for stock. Some vegetables will make the stock bitter or impart a strong, very specific taste that may not work in some recipes (e.g eggplant, turnips, cilantro, ginger). If you happen to be someone who buys Parmesan cheese with a rind, those rinds are wonderful in stocks. If you use fresh herbs when you cook, make sure you throw the stems in the stock. 

Photo credit

 

Step 2:  Keep a big ziplock bag in the freezer and toss the washed bits you saved into the bag.  When you drain beans, tomatoes or other vegetables from cans, put the juice in the bag, too.

Photo credit

 

Step 3:  When the bag is full, put the frozen vegetable bits in a big pot with water to cover them, bring to a boil and then simmer for about an hour.

 

If you have an Instant Pot, you can make stock in less time.  I don’t add salt while making the stock because it lets me season the dishes I make to taste.

 

 Step 4:  Freeze the stock you don’t use in a day or two.

 I usually freeze my stock in 1-2 cup plastic containers.  Alternatively, use freezer bags if you want to take up less space in your freezer (Push the air out of the bags and lay them flat on a cookie sheet to freeze).  Another trick is to freeze the stock in ice cube trays or muffin tins and then put the frozen stock in freezer bags.

Photo credit

In addition to recipes, use this stock instead of water when you make rice or grains. Thaw your stock in the refrigerator (if you remember) or in the microwave (if you don’t).

We eat a mainly plant based diet, so I only make vegetable stock.  If you eat meat, you can save the bits from the meat or fish you cook – or ask your butcher for stock worthy bones and add them to the vegetables to make great chicken, beef or seafood stock.  If you want perfect chicken or beef stock, you may have a bit more work to do… 🙂

Enjoy!

 

 

Hate cooking but want to eat better? (By the end of this post I bet you buy this app!)

It is hard to eat well when you are a medstudent, resident or busy doc (also true for busy people not in medicine  The key to eating well if you are busy is planning.. but it takes time.  As I’ve written before, here are the basic steps that you need to follow to eat well if you are “too busy to cook”.

  • Use a calendar to organize which days you need to have dinner ready
  • Find the recipes you want to cook
  • Fill in the calendar with what you will take to work for lunch and your planned dinners.
  • Make a shopping list.
  • Shop once, then follow your plan

To follow these steps, I’ve used the internet to find recipes, Evernote to map out the week, and Grocery IQ for the shopping list.  I’ve gotten pretty efficient, but it’s still takes a non-trivial amount of time… and who has that kind of time, right?

Photo credit

And then I read Jane Friedman’s post “My Must-Have Digital Media Tools: 2018 Edition” and I saw this…

I was skeptical, but I downloaded it.

Here’s the bottom line… this app is “expensive” ($25).  But I promise, even if you are medical student without much money, it will be the best $25 you’ll spend this year.

Here’s why – this app takes the five steps listed above and puts them all into one place.  It not only makes it easy to choose recipes, plan your week and shop, it almost makes it fun.  Here’s how:

Use a calendar to organize which days you need to have dinner ready.

Start on the “meals” tab and put notes in for your week.  If you share cooking with a significant other or roommates, you can share the account with them so everyone is (literally) on the same page.

Find the recipes you want to cook and put them in the calendar for the week

Click on the browser tab to find new recipes.  As you gather recipes in the app, it becomes your  own personal “cookbook” which is searchable by category, name, or  ingredients.

Fill in your calendar with what you will take to work for lunch and your planned dinners.

This was the first moment I knew I was really hooked.  All you do is drag and drop the recipes you want into the appropriate day.  Wow.

Make a shopping list and go shopping.

This is when I was completely sold.  When you pull up the recipes you’ve chosen, there is a little “hat” icon at the top:

When  you click this icon EVERYTHING IN THE RECIPE appears in a shopping list.  Unclick what you don’t need and repeat for all the recipes.

Because this app is on your computer and your phone, just take your phone with you to the grocery store.  As you pick up the item, click the box next to it and move on to the next item. If you are sharing the app with your significant other or roommates, anyone can add to the grocery list or unclick things they have bought.

 

 

Here’s the official website for Paprika: https://www.paprikaapp.com/.   Enjoy your healthy eating!!!!  Try this plan (instead of the bagels, pizza, peanut butter and other “free” foods in the hospital) for a week or two.  I promise you’ll feel better, learn better and have more energy to take good care of your patients.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

How to Succeed in Clinical Rotations (and residency, too)

Today I have the incredible joy of talking to the medical students on our rotation.  No agenda, just a conversation that they requested for some “advice”. They just started their surgery rotation last week and it’s their first rotation.  First rotation, beginner’s mind, unbridled enthusiasm… it is so wonderful!. I decided I would come up with what I wish someone had told me at the beginning of my rotations…

Photo credit

 

Be mindful, deliberate and excited about learning.

This is probably the most important piece of advice I can give.  Clinical rotations are often a whirlwind of work and you can be swept away without realizing it. Residents can ignore you, people can be cranky, patients can be difficult… and in the midst of all this, you are expected to learn to be a doctor.  You have to stay in charge of that mission, no matter what is happening around you.

Take a little time to reflect on why you are doing this and what kind of person/doctor you want to become.  When times get tough (and they will) hold on to it.  If it helps you, come up with a slogan to repeat, keep on a piece of paper in your wallet or on your wrist

Photo credit

 

Learn about the practice of mindfulness.  Mindfulness has been shown to be effective in decreasing stress and may help to prevent burnout.  It’s not hard to learn, but it’s hard to master … which is the point of a “practice”. (e.g. the practice of medicine)

Learn to keep a “beginner’s mind”.  When I was a student on core medicine I had a senior resident that showed me what beginner’s mind looks like.  It was 2am and I was tired.  We were seeing a gentleman at the VA hospital for his diabetes, hypertension and some electrolyte abnormalities.  I presented the patient to the resident and then we went to see him together.  He had a rash, which I thought was so insignificant that I didn’t even include it in my presentation.  But, instead of scolding me, this resident got excited.  Yes, you read that correctly, 2am and excited about a rash – because he didn’t know what it was. (This next part will date me, but it’s a great example to make us grateful for the access we have to information now).  He called security and had them open the library.  We spent a wonderful hour looking through books – like a treasure hunt when we were little kids – until we found the rash in one of the books.  We were laughing, excited and couldn’t wait to get back to start the appropriate therapy.

 

Understand what you are going to learn (the big picture)

On every rotation, you will be given a list of learning objectives.  By all means, know them, study the things listed and make sure you know them (they will be on the test).  BUT… please realize that diseases don’t stay conveniently siloed in a single specialty so this is not learning “surgery”, it’s learning about how surgeons approach a specific disease you will see elsewhere, too.   You also need to know that what is listed as learning objectives today may well be obsolete tomorrow  (if they aren’t already).

You have chosen a career that ethically demands life-long learning.  That means that one of the most important skills to learn is how to develop a system of learning that you can use in medical school, residency and later in practice.

Photo credit

 

Develop a system for lifelong learning now

Learning is iterative.  You will learn broad concepts on each rotation along with a “fly over” of the entire terrain of the specialty  You will need the information you learn on your surgery rotation on your medicine rotation when you are consulted on a patient with an ischemic leg who needs surgical treatment, or on your pediatrics rotation when your patient with a pneumonia develops an empyema.  If you choose surgery at your career, you will read and learn the same topics throughout your residency (and after) but with increasing depth.

The practical points on how to develop a system to learn during your rotation are here: How to Ace the NBME Shelf Exams: How to Ace the NBME Shelf Exams, In-Training Exams and Your Boards, but the key points are summarized below:

  • Remember it’s school.
  • Make a list of all the topics in the textbook.
  • Breathe deeply. You are not going to read every page in the textbook in addition to your assigned reading.
  • Create a schedule to SKIM every chapter
  • TAKE NOTES. All the time.
  • Figure out how to store your notes so you can find them in the future
  • Go through your daily notes in the evening and then store them in your system
  • Review, review, review

Photo credit

 

Take care of yourself.

Pay attention to ergonomics, diet, exercise and sleep.  Most importantly, take care of yourself emotionally and spiritually.  You can’t learn or serve others if your tank is empty.  Come up with what is important for you and make a list.  Seriously.  Make a list of what you find helps you stay on track and then check it off every day.  Look at it before you go to bed.  Celebrate the things you did and don’t be hard on yourself for the ones you didn’t get to.

Don’t forget to take a “Sabbath” every week.  True time off is critical for recovery from this stressful work.

If it gets too hard, seek help.  It’s a sign of strength, not weakness, and most (if not all) of the people around you have been there.

We have the most amazing job on earth.  When the administrative issues or political conflicts get to you (and they will), just remember – you get to take care of another human life with the goal of relieving their suffering.  What could be more important than that?

Photo credit

 

 

 

 

Top 10 Holiday Gifts for Busy People (including medical students and residents)

What’s the best gift for a medical student or resident (or any really busy person)?

Photo credit

Seriously, anything that frees up time for them is the best present you can give them.  If it supports their health or decreases stress, it’s even better!

Here are my top ten choices for best presents for medical students and residents – or any really busy person:

  1. A service or person to help clean their home.  Once a month?  Once a week? Any time they don’t have to vacuum or clean the bathrooms is a true gift.

Portrait of man with cleaning equipment

Photo credit

 

  1. An Instapot. I’ve long been a fan of pressure cookers, but the Instapot takes it to the next level.  This is my new favorite kitchen tool and it’s high on my list because it both saves time and increases healthy food consumption!

Photo credit

 

  1. A subscription to Headspace. This might seem counter-intuitive since it adds a 10 minute task to their day… but there are data (and lots of testimony) that a daily mediation practice “expands time” by decreasing stress.

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

 

  1. If they live close enough to walk or bike to school/work, think about something that might help them combine that commute with getting some exercise. How old is their bicycle?  How about panniers to store gear on a bike? Would a great backpack help if they are likely to walk?  How about a gift certificate to a bicycle shop?

Photo credit

 

  1. A gift certificate for Whole Foods or any place near them that has good, healthy prepared food.

Photo credit

 

  1. Cookbooks with quick but healthy recipes like Thug Kitchen or Mark Bittman’s How to Cook Everything Fast.

 

  1. A Roomba vacuum cleaner. Plus, they may go viral with a cat on a Roomba video if they have a feline roommate.

Photo credit

 

  1. A gift certificate to have their car washed and vacuumed every few months.

Photo credit

 

  1. If they are a coffee drinker who spends time stopping at Starbucks, think about a really good coffee maker. I prefer Nespresso because the pods are recyclable (and the coffee is delicious).

Photo credit

 

  1. Your time. Can you cook some meals once a month and put them in their freezer?. Do laundry? Bake cookies and mail them? Get their car washed? Make an elaborate certificate with something you could do for them and wrap it as a present.

Photo credit

 

Photo credit

 

Bell Peppers

 

Photo Credit

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.

Photo Credit

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.

Photo Credit

 

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

 Photo Credit

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

 Photo Credit

 

 

 

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!

Share this: