Sunday, August 31, 2014

Crostini

When I saw these gorgeous crostinis on Honestly Yum I knew I had to make them. Crostinis are a great way to impress people on your next party. And I love sampling different flavors! Similarly, I love sampling all my medical rotations. And well, folks, after agonizing forever, I made my choice.

I have decided to go into ... *drumroll* Internal Medicine!
At the start of medical school (and even before that) I had always assumed I'd go into internal medicine. When you pick a residency after medical school, your major divisions are medicine vs surgery. It's more complicated, of course, (ie opthalmology, psychiatry, anesthesia), but that's the overall gist. For fun, here's a nice flowchart cartoon explaining how we pick our specialties.

Rotations are like buffets - you get to sample a bit of each flavor. And I looooove variety. So when I started clinics, I thought "ok, I'll see what other specialties have to offer." And turns out that sampling each specialty muddied up my perfect plans. I thought I would hate psychiatry. Enjoyed it. Thought I would die on surgery. Loved it. Never heard much about ENT (ear, nose, throat). Seriously considered it as a career.

Ok, I didn't like ophthalmology because eyes scare me. But pretty much everything else was great.
When people ask "why internal medicine?", it's tough to articulate. There's so many factors going into my decision. In the more immediate future, the ease and flexibility of matching into a residency with B. And in the long term, marriage and family - will I be able to see and be involved with my kids? Take time off for vacations? What if I get injured, and something happens? Would my career be threatened if I get arthritis or carpal tunnel or sprain a wrist (hope not!)?

So basically, after waffling around forever with my decision, I went back to where I was at the beginning regarding my choice of career.
In picking a specialty it's hard to really imagine, "ok, can I do this everyday and work with the schedule when I'm 40 years old? 60 years old?" The great thing about internal medicine is that I can put off choosing a speciality a few more years, and continue rotating on a buffet of specialties.

Alas, I'm just as undecided with food as with my career plans, so until then, I'll just have to eat every flavor. I'm horribly indecisive that way.

Ingredients
Baguette, sliced
Greek yogurt (or ricotta cheese)

TOP ROW TOPPINGS (above photo): 
hard boiled egg, green onion, freshly ground black pepper
tomato, pesto, basil
carrot, cilantro, black sesame seeds
raspberries, blueberries, honey

BOTTOM ROW TOPPINGS (above photo):
smoked salmon and dill
apricot jam, almonds
nectarine, mint
cucumbers, paprika, chives

Directions
Toast your baguette slices until golden brown. Spread your Greek yogurt or cheese on top of each piece. Top with desired ingredients. Enjoy!

Sunday, August 24, 2014

Pork Tonkatsu

In Japanese restaurants, I always order sushi and never anything else from the menu...except for pork tonkatsu. This is stuff is better than any chicken fried steak or chicken nuggets or whatever breaded fried meat you eat in the Western hemisphere. The panko bread crumb crunch is already great, but it's really the tangy tonkatsu sauce that makes it a winner.
Pork tonkatsu has a special place in my heart since it's what I ate on my first date with B. He knew I liked Asian food and sneakily took me to a Japanese restaurant (he did his homework!)
Mom (in all her Asian mom wisdom) always told us, "Don't eat too much or too fast when dining out, or people will think you don't have enough food at home."

So when on our first date B told me, "You know, I'm going to judge you by how much you eat..." I definitely felt nervous until B then continued, "... and the more you eat, the better."
Well, then, I certainly demolished my tonkatsu (and sushi and gyoza and tempura). I ate a LOT. More than him actually. I still judge him to this day for letting a tiny Asian girl half his size beat him in eating (he claims he was sick and had an "off day").
Anyways, this tonkatsu recipe is adapted from Rasa Malaysia. Since we couldn't find tonkatsu sauce, we made it using this AMAZING recipe from Serious Eats. I might never buy bottled tonkatsu sauce again.

Ingredients
TONKATSU:
2 boneless pork chops
Salt and pepper
Flour for dredging
1 egg
1/2 tbsp oil
Panko bread crumbs

TONKATSU SAUCE:
1/3 cup ketchup
2 tablespoons Worcestershire sauce
2 tablespoons brown sugar
1 teaspoon Dijon mustard
1/4 teaspoon garlic powder
1 tablespoon teriyaki sauce

Directions
TONKATSU: Preheat ove to 350 degrees F. Line baking sheet with foil

Cut meat into thin slices and rub with salt and pepper. Rub flour until the meat is just coated, shaking gently to remove excess flour. In a bowl, whisk oil and egg together, and dip your pork in the egg mixture. Dredge the pork in panko, pressing gently and removing excess panko. Place all the meat on the baking sheet.

Heat oil in a wok over medium high heat. When oil is very hot pan, sear for 30 seconds to 1 minute on one side and flip, so both sides are golden brown. Place the pan seared pork on the baking sheet and place in oven for 15-20 min, until meat is cooked.

TONKATSU SAUCE: In a small bowl, stir together ketchup, Worcestershire, soy sauce, mirin, sugar, mustard, and garlic powder. Use immediately or store in the refrigerator up to a month.

Sunday, August 17, 2014

Blueberry Cheesecake Chunk Ice Cream

It's soooo hot here in Texas. And even better, humid too. Which means running is torture, unless I run at 8pm at night (while avoiding getting run over or mugged) or run at 8am (which is torture in itself - everyone should get at least one day to sleep in during the week in a 6 day workweek!).

But, that heat makes ice cream a perfect summer snack.
I normally make ice cream with eggs and have to temper it, but this cheesecake ice cream adapted from Emeril Lagasse doesn't have eggs, so it's super easy and requires no heat. No one wants to use the oven or stove on a hot day. Ew. Plus my AC bill is ridiculously high already.
Literally all the recipes I saw, including Emeril's original version, for cheesecake ice cream meant mixing cream cheese with the base. Um, the best part of cheesecake ice cream is the chunks of cheesecake. So that had to be remedied ASAP. Cheesecake needs topping and a crust of course, and I went with the classic blueberry.

Because of the cheesecake bits, mine has to be the best blueberry cheesecake ice cream ever!
Now, I'm eating this after my runs, so I used light cream cheese and sour cream to make it a little more guilt free. Recently, my gait must have changed somehow since running places so much force that my left big toe is literally as purple as a blueberry. This is a brand new problem which has never occurred before, but now I must add this to my list of running injuries *sadface*.

If I'm not plagued by huge bubble blisters, twisted ankles, or stress fractures, then it must be blueberry bruises. I prefer the blue-purple color of a subungal hematoma in my blueberry cheesecake ice cream rather than my poor foot, thank you.

Ingredients
8 ounces light cream cheese, softened
3/4 cup sugar, divided into 1/2 and 1/4 cups
1 cup cold light sour cream
1 cup cold heavy cream
3/4 cup milk
3 tablespoons fresh lemon juice
1/2 teaspoon vanilla extract
1 cup fresh or frozen blueberries
6-8 graham crackers

Directions
Prepare an ice cream maker according to the manufacturer's instructions.

Beat the cream cheese and sour cream at medium speed until soft and smooth, gradually adding 1/2 cup of sugar. Add the lemon juice and vanilla; beat until smooth.

Divide your cream cheese mixture into two halves. Take half and freeze it - this will be your cheesecake. Once frozen, cut the cheesecake into small chunks with a knife. With the other half, beat in the heavy cream, milk, and the remaining 1/4 cup sugar - this will be your ice cream base. Cover and refrigerate until very cold (2 to 3 hours).

Pour base into ice cream maker and process according to manufacturer's instructions. In the last few minutes of churning add your cheesecake bits and blueberries to obtain a pretty swirl (instead of a pureed mash). Enjoy as soft serve or transfer to an airtight container and freeze until ready to serve. When ready to serve, add crushed graham crackers (otherwise, if left mixed in with ice cream, the crackers will become soggy).

Sunday, August 10, 2014

Easy Beer Bread // Butter Compound

I'm not a beer person, or any type of alcohol person, in general, but I had leftover beer I needed to use up after a pool party. Well, after this bread, I like beer. A lot. If it's possible to get drunk off of beer bread, I'd be the first to go.

This recipe adapted from Food.com has a crunchy, buttery crust and a lovely golden brown color thanks to the poured butter on top. It's the easiest bread recipe ever and absolutely foolproof. Plus, all the ingredients are probably in your kitchen right now.

I thought beer bread was the most bizarre idea, but both beer and bread are similar in that yeast is used to turn sugars into carbon dioxide and alcohol. We've been drinking beer since forever; in fact, there's a pictogram on a seal dating from the 4th millennium BC found in Mesopotamia. Beer has been mentioned in ancient texts in Egypt, Greeks, Germans, English, and pretty much everyone. The only exception seemed to be those fancy Romans, who preferred wine (Ekaloria, Foodtimeline)
 Sifting 101
- Sifting flour for bread recipes prevents compacted flour, which can turn your bread into a "hard biscuit."
- If you do not have a sifter, use a spoon to spoon the flour into the cup measure or a whisk to fluff up the flour.

- my secret: I sifted and didn't sift two batches and both tasted good. Perhaps the sifted version was marginally flufflier (or maybe it was the fact I used a freshly opened can of beer).

Fun fact - how to check if your baking powder is still good. Add a little to some very hot water and see if it fizzes.
Now bread goes with butter, but an easy way to kick it up is to make compound butter - basically mix softened butter with whatever ingredients of choice and chill in the refrigerator. It makes for a pretty gift if you wrap it up as the directions indicate.

Or you can just mash it in a bowl like I did. I'm sure ancient civilizations didn't waste time tying perfect bows around their butter.

Beer Bread

Ingredients
3 cups flour, sifted
3 teaspoons baking powder
1 teaspoon salt
1/4 cup sugar
1 (12 ounce) can beer
1 1/2 Tbsps melted butter

Directions
Preheat oven to 375 degrees.

Mix dry ingredients together with a whisk. Open and pour your can of beer. Mix until just combined (do not overmix).

Pour into a greased loaf pan. Pour melted butter over mixture. Bake 55 min, remove from pan and cool for at least 15 minutes.

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Compound Butter

Ingredients
1 stick unsalted butter, room temperature for each butter roll

ROSEMARY GARLIC
2-3 cloves garlic, finely chopped
1 1/2 tablespoons freshly chopped rosemary
salt and pepper, to taste

SWEET CRAISIN AND WALNUT
1 1/2 tablespoons brown sugar
1 tablespoon craisins, chopped
1 tablespoon walnuts, chopped

JALAPENO PAPRIKA
1 tablespoons paprika
1/2 small jalapeno, finely minced
1 teaspoon black pepper, or to taste

Directions
Add your ingredients to a bowl and combine with a fork or a mixer.

Set in the fridge for 15 minutes and you're done.

To make logs, place a piece of plastic wrap onto a clean, flat surface. Spoon the butter mixture onto the center of the plastic wrap. Wrap the plastic around the butter, rolling and forming a log shape. Twist the ends of the plastic wrap  like a tootsie roll and place butter in the fridge to set.

Thursday, August 7, 2014

Pollo a la Brasa (Peruvian Roast Chicken) // Aji Verde Sauce

Peru was probably the highlight of my year. Also, food always just tastes better when you're on vacation (and not washing dishes).

We spent plenty of time in Lima, and our first meal was the famous the famous Peru Pollo a la Brasa (Peruvian Roast Chicken). The Peruvians do love their chicken.
We also tried strange/unique cuisine like guinea pigs (yum), beef hearts (yum), a purple corn drink called chicha morada (sugar high), lucuma aka eggfruit (the fruit flesh is literally the texture of boiled egg yolk), and grilled alpaca (basically, a llama,... yes, the kind that can spit from 3 feet away).

Me: Hey guess what! We ate guinea pigs!
B: Do you want me to drive to Petsmart and buy you some more to roast?

We saw options to eat kidneys, thyroid (yay endocrine!), and bull testicles... but we declined that for another time.
Although we spent two weeks straight eating nothing but Peruvian food, when we came home, dad wanted to go to our local (and only) Peru restaurant immediately to "prolong our vacation." I scoffed at dad and said what a ridiculous idea. After I drove back to my own city, I decided to check if my local grocery, which carries lots of ethnic food, had Peruvian cuisine for funsies. And it did! There's a lot of ingredients, but I chose aji amarillo paste, which cost me like $3....try your local ethnic market before Amazon!
So I cooked my own Peruvian food, after eating two weeks of Peruvian food, and dad got the last laugh. I defend myself saying it was a culinary endeavor. Recipes for the chicken and aji verde are adapted from Daring Gourmet, and here's my sweet potato chip recipe for the side.

Pollo a la Brasa (Peruvian Roasted Chicken)

Ingredients
1 whole broiler/fryer chicken (2-3 pounds), or bone-in/skin-on chicken pieces of your choice

MARINADE
2 tablespoons soy sauce
Juice of 2 limes
5 cloves garlic
1 teaspoon fresh ginger, minced
¼ cup dark beer
1 tablespoon extra virgin olive oil
1 teaspoon balsamic vinegar
1 tablespoon aji amarillo paste
1½ teaspoons ground cumin
1 teaspoon dried oregano
1 teaspoon dried rosemary
salt and pepper to taste
½ teaspoon cayenne pepper

Directions
Combine all the marinade ingredients in a food processor and blend until smooth.

Place the chicken or chicken pieces in a large ziplock bag and pour the marinade over, evenly coating the pieces. Marinate for several hours or overnight.

Preheat the oven to 425 F and roast the chicken pieces on the middle rack of the oven until chicken is done, about 45 minutes. If the skin begins to brown too much, you can move the roasting pan to the bottom rack or tent with foil.

Serve the chicken with Peruvian Aji Verde Sauce and Sweet Potato Chips.

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Peruvian Aji Verde Sauce

Ingredients
2 green jalapeno peppers, minced (remove seeds to make less spicy)
1 cup loosely packed fresh cilantro leaves
1 small clove garlic
1 green onion, chopped
1 tablespoon aji amarillo paste
2 teaspoons fresh lime juice
1 tablespoon extra virgin olive oil
2 tablespoons feta cheese
salt and pepper, to taste
½ cup sour cream (I used Greek yogurt)

Directions
Combine all ingredients in a food processor and blend until a smooth paste. Keep refrigerated for up to a week.

Saturday, August 2, 2014

Black Forest Cake (Schwarzwälder Kirschtorte)

Delicate. That's how I would sum up my month of Pulmonary, Critical Care, and ICU.

I saw an incredible variety of cases - from hepatic encephalopathy, hepatorenal failure stage II, Charcot Marie Tooth, chronic idiopathic eosinophilic pneumonitis, pediatric sarcoid, hyperosmolar hyperglycemic non-ketosis state, and all sorts of shock (cardiogenic, hypovolemic, septic), to just name a few.

And if you don't know most of these diseases, well don't worry... neither did I beforehand.

Now the nature of Critical Care/ICU is that these people are sick. While it's incredible to see someone in a coma intubated with drips wake up and walk out the hospital, there's also tough moments. Sitting in family conferences discussing end of life and palliative care, I couldn't help but feel oddly intrusive. Like, if I breathed too loudly, I would disturb the balance of life.
Sometimes choices are clear cut. As my attending told me, one can be stable and fight for life in the ICU only for so long before the body gives up.

After two weeks, one woman, Mrs. L, suddenly declined as her brain waves on the EEG got slower and slower. Her incredibly frail 90 year old husband (honestly, I kind of wanted to put Mr. L in the ICU too) had the legal power to make decisions on her behalf...barely. So he had to rely heavily on his nephew. Mr. L looked so sad during the conference but nodded almost imperceptibly to take off all aggressive measures. There's so much formal legality and documentation about codes and family decisions which I had no idea before.
Sometimes it's not so clear. One devoted grandmother fretted about her husband Mr. W, who had been in the ICU for weeks, neither improving nor worsening. "Do I let him go? Do I give him a chance? I don't know... help me doctor, please tell me what to do." Unfortunately, doctors have no crystal ball, and even they were arguing amongst themselves on the next options.

Initially, Mrs. W chose to let nature take its course after talking to my attending, then later she chose the more aggressive procedure after another doctor changed her mind. Mr. W thus got better, and when I saw him open his eyes for the first time and wave feebly at me from his ICU bed, I couldn't believe how close he had been to meeting death. A second chance seemed clearly the right choice.

Alas, a few days later he decompensated, and the wife doubted her choice, "What can I do? He's depressed about life and giving up, but I can't just let him go at this point - his body is falling apart but his mind is now alert. Did I miss my chance to let him go peacefully?" It's as grey as can be. All I could do was offer hugs and tissues.
Clinical judgement is managing medications (give Ms. K pressors to raise blood pressure to keep her heart and brain alive....but sacrifice her hands and feet as the constricted vessels no longer could deliver blood anymore) and even harder, managing mismatched expectations. Ms. K's family was absolutely convinced she was going to wake up and walk out the door in perfect health with fervent enough prayers, despite all the doctors stating she was going to die soon.

During the family meeting, the family asked over and over that we transfer her to another hospital to for even more aggressive care for her stage 4 cancer, and my attending said, "You can't possible move her anywhere, she is too unstable! I'm sorry, but I promise we are doing all we can."

Delivering compassion with honesty in the face of death is really the hardest task of all.
Anyways, here is a Black Forest Cake (Schwarzwälder Kirschtorte) adapted from Joy of Baking. I wanted a truly authentic German cake - I can't stand the fake American chocolate cakes with sugar sweet buttercream and fake cherries. Alas, I didn't have the cherry liquor, but cherry syrup will do.

Layer cakes take a LOT of work. Cutting the cake evenly is tricky, and balancing them so they stack up nicely is even harder. While photographing, I was so frustrated it wasn't perfectly straight and fought with it for half an hour. Since it was soaked in syrup, the longer time went on, the more delicate and precarious the base layer became.

Finally, I gave up, so you can see a little lopsided tilt in this fragile cake. I guess it's kind of like life in the ICU.

Ingredients
CHERRIES / SIMPLE SYRUP
1 cup canned cherries, with 1 cup syrup reserved from can
1/8 cup granulated white sugar

CHOCOLATE GENOISE:
3 tablespoons hot melted unsalted butter
1/2 cup cake flour
1/4 teaspoon salt
1/3 cup unsweetened cocoa powder
4 large eggs
scant 2/3 cup granulated white sugar
1 teaspoon pure vanilla extract

WHIPPED CREAM
1 cup heavy whipping cream, cold
1 teaspoon pure vanilla extract
1 tablespoon granulated white sugar

DECORATION
chocolate curls
fresh cherries

Directions
CHERRIES: Drain the cherries, reserving the liquid. Place 1 cup of the reserved cherry syrup in a small saucepan, along with the sugar, and heat until sugar has dissolved.

CHOCOLATE GENOISE: Preheat oven to 350 degrees F. Grease a 9 inch round cake pan and line with parchment paper

In a bowl, sift the flour, salt and cocoa powder.

In a heatproof bowl whisk the eggs with the sugar. Place over a saucepan of simmering water, and whisking constantly, heat until lukewarm (about 5 minutes). Remove from heat and transfer to the bowl of your electric mixer. Beat on high speed until the mixture is thick and pale yellow; batter falls in ribbons (about 10 minutes). Beat in the vanilla extract.

Sift the flour mixture over the egg mixture 1/3 at a time and and gently fold. Take 1 cup of the batter and fold it into the melted butter (to lighten it). Then gently fold it into the egg batter.

Pour into your pan, smoothing the top. Bake for about 20 - 25 minutes or until a toothpick inserted into the center comes out clean (cake starts to shrink from sides of pan). Cool before removing from pan.

WHIPPED CREAM: In your mixing bowl beat the whipping cream, vanilla extract, and sugar until stiff peaks form.

ASSEMBLE CAKE: Using a sharp knife, cut the genoise horizontally, into two layers. Brush the cake layer with 1/4 cup cherry syrup. Spread the whipped cream and cherries evenly on top. Brush the cut-side of second genoise layer with 1/4 cup syrup. Place cut-side down on top of the cherries, gently pressing to compact.

Cover the cake with your remaining whipped cream over top and sides of cake. Refrigerate the cake for several hours (or overnight) before serving. Decorate with fresh cherries and shaved chocolate.

Monday, July 28, 2014

Shrimp Pesto Pizza with Feta Cheese

Pizzas come in two types: the normal (classic cheese or pepperoni anyone?) and the gourmet. Obviously, I'm a fan of the latter.

On my very second date with B, he wanted to take me to a dinner at a pizza place at the Stanford Mall. Now, Stanford Mall is filled with fancy, expensive stores which no college student can afford - like Neiman Marcus, Crate and Barrel, and Louis Vuitton. And they have nice upscale restaurants, which serve things like gourmet pizza.
So B picks me up in his car like a gentleman (ah, the days when he still tried) and we sit down. I then inform him I have to fast for Ash Wednesday, which I had forgotten to tell him.

B: What?! You're just gonna sit and watch me eat?
Me: Yup.
Waiter: Would you like anything miss?
Me: Um, no.
Waiter: Ah, are you sharing?
Me: No, he's eating by himself actually... I'm just ... observing.
*waiter staring*
B: ...  Please eat something? I'm being judged here as a man.
Well, B tried to coax me, but, hey, I didn't make up the Catholic rules. He looks at the menu and sees nothing but fancy pizzas.

B: They have weird pizza topping here. Um, is there normal pizza?
waiter: normal pizza?
B: Like... pepperoni? Or sausage.
waiter: no.

Long story short, B ordered a gourmet pizza and raved about its deliciousness. He later admitted he didn't like it at all, but pretended he did, so I would try some and thus share - like a (more) normal dinner date. It didn't work, lol.
So here's a nice fancy shrimp pesto pizza from here which I thought was an unusual combo (pizza without mozzarella? gasp!). I'd never really eaten feta cheese before, but I enjoyed the twist. And I ate it all by myself, like B did so many years ago. Even better, I didn't have to pretend to like it.

Ingredients 
Pizza dough, homemade or bought
3-5 tablespoons pesto
5 oz shrimp, peeled and deveined
1 large clove garlic
2 teaspoons lemon juice
3 oz feta cheese, crumbled
1 tablespoon toasted pine nuts
1 bunch cilantro

Directions
Preheat the oven to 550 F. Coat a baking sheet with no-stick spray.

Unroll the pizza dough and spread on the prepared sheet to make 2-3 individual pizzas. Spread the pesto on the crust, leaving a 1/4" border.

Toss the shrimp with the lemon and garlic. Sprinkle the shrimp mixture, feta cheese, and onions on the crust. Top with the pine nuts and cilantro. Bake for 14 to 16 minutes, or until the bottom is browned and the cheese is melted. Cut into slices and enjoy fresh.

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