Key Lime Pie

Today I’d like to share a recipe I made a while back  – key lime pie! For those down in Florida and the Caribbean, I hope you and your loved ones are safe from the hurricanes and storms. I’ve been following the weather as several of my patients were from Florida while I was on the Hematology service (they had traveled to Yale for cancer treatment).

How was Hematology? A busy, though rewarding, month. The patients could be quite sick, stuck in the hospital for months due to complications, and a few of mine sadly passed away during my time there. 

The Hematology team also carries the code pagers – anytime there’s a code blue (cardiac/respiratory arrest) you stop what you’re doing and immediately run to the location of the code to do ACLS (advanced cardiovascular life support).

There was one sad case where we ran the code – my first one. It was a shock for everyone given how unexpected the case was – the patient had cancer, but he was very young, had come in for an elective surgery, and was actually in the process of being discharged when something (most likely a clot to the lungs) caused him to stop breathing and lose his pulse.

After resuscitation attempts for almost an hour failed, we eventually pronounce him dead. Hearing his wife’s despair was heartbreaking – she had come to the hospital expecting to pick him up and take him home.

Even though it’s what I’ve trained for my whole life, it’s still so surreal for me to be telling so many people, many older than me, what to do to try save a life acutely.

After the code ended we did a debriefing. The whole staff had been phenomenal; the nurses, techs, and doctors had run like clockwork. Although the ALCS had been very well organized and we could walk away feeling like we gave him the best chance, in the end, we could only do so much.
Every intern’s first code is a big point in their training, mine particularly so given my involvement and the unusualness of the case. I was certainly tired and had lost my appetite, but there were no tears, just a resolution to continue the rest of the day’s work after a brief 5 minutes of mourning.

I’ve had to come to the point where I need to decide my speciality soon. Having an uncle who recently passed away from leukemia and doing art therapy with cancer patients in college had piqued my interest; I’ve definitely enjoyed my Hematology patients this month.

While B thinks adult cancer is awfully “doom and gloom,” there are many happier stories too (really!). In a few years, we’ll see what I end up doing for fellowship … but I wouldn’t be surprised if I do end up a cancer doctor.

Key Lime Pie recipe adapted from epicurious.

Key Lime Pie


Ingredients
CRUST
1 3/4 cups graham cracker crumbs
4 tablespoons sugar
8 tablespoons unsalted butter, melted

FILLING
1 1/2 (14-ounce) cans sweetened condensed milk
6 large egg yolks
3/4 cup lime juice, fresh
2 limes, zested

TOPPING
1 cup chilled heavy cream
3 tablespoons sugar

Directions
Preheat oven to 350°F.

CRUST: Stir together graham cracker crumbs, sugar, and butter in a bowl with a fork until combined well, then press mixture evenly onto bottom and up side of a 9-inch removable tart pan. Bake crust in middle of oven 12 minutes and let cool. Leave oven on.

FILLING:
Whisk together condensed milk and yolks in a bowl until combined well. Add juice and whisk until combined well. Pour filling into crust and bake in middle of oven 25 minutes. Cool pie completely on rack (filling will set as it cools), then chill, covered, at least 8 hours.

TOPPING
Just before serving, beat cream and sugar in a bowl with an electric mixer to stiff peaks. Serve pie topped with cream. Garnish with additional zest and lime slices.

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36 Comments

  1. This pie is beautiful. Thanks for sharing this story of rotating in hematology. Death in the hospital is always sad, but even worse when it's a young patient.

  2. Natalie, hearing about your first code was heartbreaking, it doesn't get much tougher than that, the unexpected ones are always so difficult to deal with. Thanks for sharing your experience and of course thanks for sharing this pie, it looks wonderful.

  3. I hope you are able to confidently choose a specialty for your career. Working with cancer patients can certainly be draining but if you are passionate about helping others than you are just the person for the job. 🙂 Thanks for the recipe, looks delicious!

  4. This looks delicious! I keep meaning to make this, but forget. I definitely will though, and will let you know how it goes! Could you use biscuits instead?

  5. Oh my! The story is so touching 🙁 I witnessed my first code blue and it was surreal. Luckily the patient survived. The "doom and gloom" is one of the reasons I chose to do outpatient pharmacy. Good luck on your career decisions!