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Category Archives: Desserts

Craziness and Cookies for Peace

This story does not make me look like an angel. Yesterday, I was severely annoyed by a patient. This patient drove me so crazy that I wanted to pull out my hair, ignore her completely, or worse, make her disappear. It wasn’t that bad from the beginning. While I knew she had a psych history, and had been to multiple ERs with the same complaints, and had same tests done and had been medically cleared any number of times, it’s not in my nature to immediately distrust a patient that I have never met. But with a large load of patients already, and a busy day ahead, it soon became clear to me who was the truly ill and who fell to second (or fifth) priority. And with a steady stream of complaints and demands with seemingly no relief, I soon grew exasperated. Probably more so than I have felt ever before in this setting. It is not a good feeling, and it colored the quality of my care for this patient and tinged my mood for the entire day. I was not at my best. Less than super nurse, to say the least. She was with me all twelve hours, my lovely lesson of the day. She was constantly telling me how sick she was – as if I could forget. She told me again and again that the regular doses of pain and anti-nausea medication that I was giving her had done nothing at all and she would rate her pain as ten out of ten, and later twelve out of ten. When I paid attention to her it was almost worse than when I ignored her. I hate to say it, but I realized that I had to be firm and set limits with her so that I could safely care for my other patients as well. It was a hard lesson, but very necessary. And when she was finally medically cleared (with yet another CT scan, that she demanded) she still wasn’t ready to leave. Multiple physicians tried to use reason, and I did my best as well, but we could not get through to her.

Then suddenly, while I was in the midst of drawing up medications for another patient, an old man appeared at my side. He said he was her father. He looked nearly as tired as me. But with a sweet smile, he asked me if she was medically cleared, and if so, could he take her home? Unanticipated, a huge sigh whooshed out of me. I told him that yes, she had been cleared. Another sad little smile and he said, “If she is clear, then I can take her off your hands.” This small stocky man with the unruly grey Einstein-esque hair and disheveled appearance–sweater pulled taut over a slight paunch–was my knight in shining armor. And after a full day of caring for this patient with no relief or remission of symptoms, arguing with her about her diagnosis (or lack thereof) and just generally sweating over her care, she meekly followed her father out the door. That easy? For me, it was. That was one day for me. One hard day and then I get to wash my hands of it. But guess who doesn’t get to do that? Her kind mother who called earlier in the day to inquire about her status and her sweet father who came to escort her home and ultimately ended the circular game of discharging someone against his/her will, sick or not. Mother and father will never wash their hands of their daughter’s illness and neither will this woman herself, who is clearly sick in a way that the medications in our Pyxis simply cannot treat. I left very sad, and frustrated. Our system isn’t very good at dealing with the mentally ill. In fact, I would even go so far as to say that the system failed this patient, despite our well-intentioned efforts, and that makes it fundamentally flawed. Clearly, I don’t know the whole story. I only saw a small piece of the puzzle. But, I know something different should have occurred to stop the cycle of her using the ER like a revolving door. Should she have received a psych consult even though every complaint she had was physical in nature? The clues of prior visits point to yes, although clearly this is not a means to a permanent end since prior psych consults have not yielded answers or an end to the behavior. And should she have been assessed for an addiction? Perhaps. It is hard to say without knowing more of the story than her singular ER visit.

What I do know is that the very next day, while putting a chart away at the charge nurse’s desk, a little piece of me shriveled up inside when I heard her voice behind me saying, “Oh, Rachel…I’m back. This time I am really sick!” There she was, brought in by EMS…AGAIN…on a stretcher. She told me that she was still feeling terrible, and that “they” had called her back because they had seen something on her CT scan when re-reading it. I have to admit, I held my breath and crossed my fingers that our team wouldn’t be assigned to her care. And it wasn’t. But the Communications nurse later told me that the look on my face was priceless when the patient called out my name, she said she cracked up, and only for that reason was the patient not assigned to our team again Only in blog-land can I admit how grateful I was. After another 12 hours of her in the ER, with so many other patients, I may have quit my job on the spot. Obviously, I need to learn to better outlets to control my frustrations, because not every patient is pleasant or kind. I am working on learning not to let my crazy patients make me crazy as well because then i really can’t help them!

And now, a recipe for peace. Tea and these cookies, combined with a little yoga on the side help me stay externally peaceful in the ER.

simple lemony cookies

Ingredients (I doubled this recipe and kept one log in the freezer for later use at a future tea party date!) From: VodKitchen
  • 9 Tbsp. butter
  • 1/2 cup fine sugar
  • 1 large egg
  • Barely less than 1 cup all-purpose flour
  • 1/4 cup quick cooking oatmeal
  • 1/4 tsp. baking powder
  • 1/2 tsp. salt
  • 2 lemons for zest
Preparation
  1. Put your softened butter into a food processor with the rest of the ingredients (save the lemon zest) and process until smooth.
  2. Finely grate your lemon zest. Stir the zest into the cookie dough and mix together well. Spoon on to a piece of plastic wrap and roll into a sausage shape with a roughly 2 1/2-inch diameter. Chill the dough in the freezer for 30 minutes.
  3. Preheat the oven to 375°. Get your chilled dough out and cut it into 1/4-inch thick slices. Place these on two cookie sheets, making sure you leave a good bit of space between the slices because they’ll spread while cooking. Place the cookie sheets in the middle of your preheated oven and bake for about 10 minutes, until the edges of the cookies are golden brown. Let them cool down slightly before transferring to a wire rack to let cool completely.

Also great made with orange zest instead of lemon, and served with tea, coffee, or hot cocoa!

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A fruit tart for my sweetheart

I think some recipes tend to make themselves overly complicated and therefore, scary. For example, I made a Challah recipe the other day (stay tuned: soon to be blog-worthy) and just because I was running short on time, I skipped some steps and mixed everything together instead of in separate bowl, and just in general, stressed less. It turned out great!

Same goes for this tart. The original 5 recipes that I looked at gave me heart palpitations just scanning them. I got ADHD just trying to read through them in one sitting. So, for you today, I will attempt to distill these five recipes into one condensed version: the one that I ultimately made. Maybe the more complex versions are more delicious but in ignorance bliss I contentedly remain.

Who doesn't love a hidden chocolate surprise?

Sweetheart Tart

Pastry Crust

  • 9-inch fluted tart pan with removable bottom (or four tartlet pans)
  • 1 1/3 C. flour
  • ¼ tsp. salt
  • 2 Tbsp. sugar
  • 1 stick (8 Tbsp) unsalted butter, cut into ½ inch cubes
  • 1 large egg yolk
  • ¼ teaspoon vanilla
  • A few tsp ice water (add as needed)

Pastry cream

  • 1 ¼ C. milk
  • 1 tsp. vanilla extract
  • ¼ Tbsp. sugar
  • 3 egg yolks
  • 1/8 C. flour
  • 2 Tbsp cornstarch
  • 1 generous Tbsp liqueur (Grand Marnier, Amaretto, Brandy…)
  • 3 tablespoons corn starch
  • (I also melted half a bag of semisweet chocolate chips in a double boiler to spread in the tart crust before adding the pastry cream. This is a nice addition and also serves a dual purpose of preventing soggy crust)

Sweet Pastry Crust:

1)    Mix all the pastry crust ingredients. You don’t need to do it in any special order, but try not to over mix, and just crumble it into pea-size bits with your fingers until all the elements are equally dispersed. Flatten into a disc and cover with Saran wrap, and refrigerate for 20 minutes. (Meanwhile, start your pastry cream.)

2)    Have ready an 8 – 9 inch (20 – 23 cm) tart pan with removable bottom. On a lightly floured surface, roll out the pastry into a circle. The pastry should be about an inch larger than pan. Lightly roll pastry on your rolling pin and unroll onto top of tart pan. With a small floured piece of pastry, lightly press pastry into bottom and up sides of pan. Roll your rolling pin over top of pan to cleverly and neatly get rid of excess pastry.  Prick bottom of dough (prevents puffing). Cover and refrigerate for 20 minutes to chill the butter and to rest the gluten.

3)    Preheat oven to 400 degrees and place rack in center of oven. Fill tart pan with pie weights, rice or beans, making sure the weights are to the top of the pan and evenly distributed over the entire surface. Bake crust for 20 to 25 minutes until crust is dry and lightly golden brown. Remove weights and cool crust on wire rack before filling.

Pastry Cream:

1)    In a medium-sized stainless steel bowl, mix the sugar and egg yolks together with a wooden spoon. Add the flour and cornstarch and mix to a smooth paste.

4)    Meanwhile, in a saucepan heat the milk and vanilla on medium heat until boiling. Remove from heat and add slowly to egg mixture, whisking constantly to prevent curdling.

5)    Place the egg mixture back into a medium saucepan and cook over medium heat until boiling, whisking constantly. When it boils, whisk mixture constantly for another 30-odd seconds until it thickens dramatically.

6)    Remove from heat and immediately whisk in the liqueur (if using). Pour into a clean bowl and cover the surface with plastic wrap to prevent a crust from forming. Cool. If not using right away refrigerate until needed, up to 3 days. Beat before using to get rid of any lumps that may have formed.

Apricot Glaze:

1)    Heat the apricot jam or preserves and liqueur/water in a small saucepan over medium heat until liquid (melted). Remove from heat and strain the jam through a fine strainer to remove any fruit lumps.  Let cool until it is only slightly warm.

To Assemble Tart:

1)    To remove the tart from the fluted sides of the pan, place your hand under the pan, touching only the removable bottom not the sides. Gently push the tart straight up, away from the sides. The fluted tart ring will fall away and slide down your arm.

2)    Spread a thin layer of the apricot glaze or melted chocolate (if using) over the bottom and inner sides of tart. Let dry.

3)    Spread the pastry cream into the tart, filling about 3/4 full.

4)    Go wild with your amazing decorating skills!

5)    After arranging the fruit, gently brush a light coat of the glaze on the fruit. Do not put it on too thick or it will look like Jell-O. The idea is to make the fruit look shiny.  If not serving immediately, refrigerate.

This fruit tart is best eaten the same day as it is assembled. Cover and refrigerate any leftovers. Serves about 8 – 10 people. Bask in the glory of the completed fruit tart.

 
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Posted by on August 22, 2010 in Desserts

 

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Klickity Klack Kittity Kat

We had our going away party this weekend. It was such a great event. All of our friends and family (excluding my favorite sister) helped us celebrate the next big step in our lives, and were kind enough to partake of the fancy appetizers we provided at the wine bar, and of the desserts we baked and brought. While our friends were there to celebrate us, the real celebrity of the evening were the so-called Kit Kat Bars* that my mom baked. They seriously stole the show. Amid well wishes and hugs, there were requests for the recipe to be emailed asap. I’ll do one better than that by posting it for the world to woo. I seriously vouch for these little guys…they weaseled their way through my low-sugar diet and stole my heart.

*Who named these kit kat bars? The only kit kat bar aspect of them is the appearance. But they have a serious identity crisis and I hereby identify them as Layered Peanut Butter Twix.

Here they be:

Identity Crisis Candy Bars

Originally encountered by: My lovely sister Sarah

Ingredients:

  • 60 buttery crackers, such as Keebler Club Crackers
  • 3/4 cup butter
  • 3/4 cup granulated sugar
  • 3/4 cup firmly-packed brown sugar
  • 1/3 cup milk
  • 1-1/2 cups crushed graham crackers
  • 2 cups semisweet chocolate chips
  • 1/2 cup peanut butter

Preparation:

  • Generously butter a 9 x 13 baking dish. Line with a layer of crackers.
  • In a small saucepan, bring butter, sugars and milk together to a boil over medium heat. Stir in crushed graham crackers. Let boil 5 minutes.
  • Pour half of the sugar mixture over the crackers. Cover with another layer of crackers, pressing down lightly. Pour remaining syrup mixture over crackers, smoothing to coat.
  • Top with a third layer of crackers, pressing lightly.
  • Melt chocolate chips and peanut butter in a small saucepan, or over a double boiler.
  • Pour evenly over the top layer of crackers, making sure the crackers are completely covered.
  • Refrigerate until kit kat bars are firm. Cut in kit kat bar shape and style.

Makes 36 kit kat bars.

Simply Glorious

And of course, my sister’s cake truffles made an appearance at our party. In allllll sorts of different colors.

Luvin the Sprinkes

Simply white tastes just as sweet

 
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Posted by on May 4, 2010 in Desserts

 

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New Jersey & Cake Bites

What does the state of New Jersey have to do with these tasty little morsels?

Well, let me tell you.

After months and months of waiting in grim anticipation, the waiting game was finally up. Match Day, January 25th, informed thousands of dental school grads whether they had made the cut into their selected specialty program.  Matt and I had pondered all the possible permutations: he would get in (spin the globe, where will we end up?), he won’t get in (try, try again), or I would get in to a few nursing schools and we would choose a place for him to reapply the following year…the possibilities were endless and it was agony to wait. But the 25th brought relief, and yes, SO MUCH excitement. Matt will become an oral surgeon in the state of New Jersey (although, I still say I am moving to New York) and we will be temporarily “closing shop” in Seattle in only a few short months! To celebrate this momentous occasion, I baked these little cake bites (which Matt promptly renamed  Cake Truffles) and brought them to the oh so luxurious “Court Cafe” at the University of Washington, where all the dental kids hang out during lunch. Despite the abysmal sugar content, and near-obsessiveness about keeping their pearly whites in mint condition, the soon-to-be dentists devoured these cute lil’ puppies in mere minutes. Never say no to free food!

Cake Bites

found in: http://buttercakes.squarespace.com. By: Evan Davis, courtesy of Bakerella

A Spoonful of Simple Steps (I am sure that the excitement of my new blog title will wear off soon…)

1) Bake whatever flavor cake you desire. Even cake from a box, which I did.

2) Let it cool, then crumble it all up in a big bowl. Mix in about a cup of frosting (again, your choice – homemade or store-bought) and mix well with your hands.

3) Roll smallish-sized balls of the cake mixture until it is all used up, then chill the balls to help them firm.

4) Melt your favorite chocolate, or combination of chocolates, over a double boiler and dip the balls to your heart’s content. Place on waxed paper or aluminum foil. Decorate now, or after you have chilled the balls. (I poured decorative sprinkles on some and piped contrasting chocolate on others.)

5) Chill cake bites for about 3o minutes, or until the toppings have set.

6) Enjoy! Yum. You can’t feel guilty for have just a “bite.”

 
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Posted by on January 27, 2010 in Desserts

 

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