Tuesday, February 26, 2013

Whole Wheat Cherry Lemon Tea Cake

Ingredients
1 and 1/2 cups of whole wheat flour
1/2 cup of cornmeal
6 TBS granulated splenda
2 tsp baking powder
1/4 tsp baking soda
1/4 tsp salt
1 cup of low-fat buttermilk
3 TBS unsweetened applesauce
1 large egg white
1.5 TBSP lemon zest
1 cup of cherries (can be frozen and defrosted like the kind by Dole)

http://foodandfeminism.files.wordpress.com/2010/06/coconut-and-cherry-cake.jpg

Directions
1.) Preheat the oven to 350 degrees and spray cooking spray over an 8 x 4 loaf pan
2.) In a bowl combine the flour, cornmeal, splenda, baking powder, and baking soda. In a second bowl, mix buttermilk, applesauce, egg white, and lemon until blended. Add the second bowl to the first and then add the cherries.
3.) Spread the mixture into a pan and bake for 45-50 minutes. Let cool for about 10 minutes. Cut into 12 slices.

Nutrition Facts
Servings: 12
Serving Size: 1 piece
Calories: 90
Fiber: 3 grams
Fat: 0.33 grams
Protein: 3 grams

Monday, February 25, 2013

Bone Marrow Donation

      Obviously this is a serious topic, one that is very different from the things I have discussed in the past, but given the fact that I am currently on my pediatric hematology-oncology rotation, and that Robin Roberts was recently able to return to work, I feel that it is both appropriate and necessary to talk about bone marrow donation. I first learned about what organ donation was in third grade, because I used to love reading books by an author named Lurlene McDaniel. Lurlene McDaniel wrote books about sick children (I think her son had diabetes), and about how their illnesses affected their everyday lives. One of her books (I can't remember the name) was about a teenage girl afflicted with viral cardiomyopathy and in desperate need of a heart transplant. She joined a support group and met a friend who also needed a heart transplant. In the end, they were both very sick and they were both placed on the wait list for a heart, but only one heart became available in time. Because of this, one of the girls lived, and the other girl died waiting for a heart.
      Reading those books was how I learned about organ donation, how the process works, and how 18 people die every day, not because medical science is unable to save them, but because there are too few organs to go around. This is why bone marrow donation is so great- because no one has to die for another person to live. When I first started going out with Matt, my husband, he had just donated his bone marrow to a little boy he did not know the year before. He had signed up at the urging of his ex-girlfriend at a college drive, and was utterly astonished when they called him years later. They told him that there was a sick little boy that needed a bone marrow transplant, and that he had 48 hours to let them know whether or not he would do it. When he told me that he did not hesitate for a second, it made me like him even more, because I felt that his response was emblematic of his character in general, and the great person that he is. Believe me, not everyone would choose to say yes so quickly.
      I realized this at my medical school bone marrow drive. I just want to say this again- MEDICAL SCHOOL BONE MARROW DRIVE. I had already joined the registry years before when I first met Matt and he told me about what he did, but I tried to get my friends to sign up at school. Some of them did, of course, but to my dismay, many of them did not want to sign up to put their name in the registry even though all it took was a quick cheek swab. Why? Because they were afraid that they would eventually get called, and that they would have to say no. Why would they say no? Because they thought that the procedure to take the bone marrow would be too painful. I was appalled and I told them so. These people are supposed to be the future doctors of America. Their goal in life SHOULD be- to help people. To save people's lives. There are not many reasons to go into medicine these days unless you really care about people, so I was really surprised that they responded that way. I would understand their hesitation to donate an organ like a kidney, where they would be in life-threatening trouble if their remaining kidney failed, but not bone marrow, which replaces itself within 4-6 weeks of the donation.
      Furthermore, there are two different ways in which to donate your bone marrow.  The first, is donating your actual marrow, and the other, is donating peripheral blood stem cells. Both procedures have comparable outcomes in adults, but children experience better treatment outcomes if they receive the actual marrow. A bone marrow harvest is a minor surgical procedure usually done under general anesthesia, so the donor remembers nothing and experiences no pain except in rare cases. A needle is inserted into the back of the pelvic bone, and bone marrow is drawn out with syringes. It is a very low-risk procedure, however, most people actually choose to donate their peripheral blood stem cells. This requires one injection each day for five days of a drug called filgrastim, which increases the hematopoietic stem cells in the blood. During this process, the donor feels achy and sore due to increased proliferation of their cells. On the fifth day, the donor is connected to an apherisis machine, which draws blood from one arm, isolates the stem cells now circulating in the blood, and then transfuses the donor's blood right back into the other arm. This typically takes four to six hours. But the short time commitments necessary for either of those procedures could give a suffering patient a LIFETIME. The little boy that Matt donated his bone marrow to is not only still alive, but the treatment worked, and he is now able to live a normal life.
      There are things that you cannot take for granted in life, and health is one of those things. You never know when things can change, and no amount of money can buy you good health. In Robin Roberts case, her myelodysplastic syndrome was the result of the chemotherapy she received to treat breast cancer. Luckily, her sister was a match and was able to donate her marrow to her. It is always a relief when a family member is a match. It is the best possible scenario in a hellish situation, but family members are only a match about 30% of the time. Therefore, there are millions of people out there who do not have a familial match, and they are forced to rely on the kindness of strangers that they have never met. All I can say is to please BE THAT STRANGER. Be the person that is willing to take a few days out of your life to give someone an everlasting gift. You never know when you, or someone in your family will need such charity. 
      If you do want to enter the registry, you have to be in good health, and in between the ages of 18 and 60. There are many different registries that you can choose to join, most are international, and there are certain registries that focus on recruiting people of a particular ethnicity.  This is because certain minorities have much lower chances of finding willing and able donors, since they are not as well represented in the registry. Joining any of them is a step in the right direction in my opinion. Here is the registry that Matt and I are a part of: The Gift of Life. Only 1/540 people who join a bone marrow registry will ever get the chance to donate their bone marrow. I only hope that one day I will be given the opportunity to bestow such an incredible gift on another person in need. 

Monday, February 18, 2013

GOOP, Gwyneth, and the French Pharmacy

      First, for those of you who do not know, GOOP is Gwyneth Paltrow's lifestyle blog. I really love getting emails about her updates, because every topic she discusses has a positive spin to it. She recruits experts in many fields to talk about wellness tips, recipe's, shopping, style, and she also creates travel guides. One of her most popular posts in the past year and a half has been about her favorite things to buy at the French pharmacy. I not only read about the article online (which is how I first discovered GOOP), it was mentioned in Harper's Bazaar, Vogue, and other magazines. Many of the products she mentions are also cited under the list of essentials of many top makeup artists working at fashion week. You can read Gwyneth's post here: The French Pharmacy. Basically, what she says in the article, is that some of the highest quality beauty products she has ever found/used can be bought in regular run of the mill French pharmacies. In a nutshell, the pricey stuff we buy at Saks and Neiman Marcus here in America is probably equal in quality to the products that the French can buy at their equivalent of CVS. That pretty much solves the issue of why the French are so effortlessly beautiful and stylish.
     After my first year of medical school, well before I read this article, I took a trip with my friends to London and Paris. Because I am such a beauty product junkie, I actually loved walking into the French Pharmacies. They all have a luring green cross so they are easy to identify, even if you can't read/speak French. Go inside, and the only way to describe them is what I call a "cosmetic wonderland." Lucky French women. Additionally, they are run very differently than American pharmacies. If people in France are sick, they do not necessarily head straight to a doctor, but often go into a pharmacy, where the pharmacist is trained and licensed to treat minor aches and ailments. The problem for me, at the time, was that there were shelves and shelves of beautiful looking products, and my confused, English-speaking self, had no direction. I had no idea what to buy or where to begin. So I just kept walking in and out of the different stores, hoping that the next would provide me with more guidance. None of them did, because the key to shopping at the pharmacies was to know exactly what you were looking for. I got the distinct feeling that they did not love silly Americans standing and browsing for hours. So, you can imagine my excitement when I read Gwyneth's article, so of course, I had to try out the products she suggested.
      The only problem, was that many of the products she discusses are only sold in France. However, after a lot of research, I was able to find practically every product at a store in Chelsea called New London Pharmacy. Here is the link: New London Pharmacy. The great thing about this store is that you can order whatever you want online and they will ship the products to you if you do not live in NY. Additionally, since Gwyneth's article was published, New York pharmacies like Duane Reade have started carrying some of the brands she talks about like Klorane and Avenè. Lastly, if you are desperate to try some of these brands and really cannot find them, there are many sellers on Amazon and Ebay that carry them. Beware of big price mark-ups. The key here is that these are inexpensive, yet still great quality products. Below are my reviews on some of the products I have tried so far:


1.) Bioderma Crealine H2O- This is makeup remover and it is great. A few swipes and all of that heavy makeup that took you forever to put on is off in about 5 seconds flat. It is light-weight, non-greasy, and the best part is that it does not irritate my eyes as many other brands have in the past.

2.) Embryolisse Lait- Cremè Concentrè- This is a great moisturizer that can be worn under makeup and really works to give a dewy look. It is silky and very moisturizing but without the heaviness that comes with other super moisturizers. It absorbs very quickly. Many people with acne prone skin have said that it does not make them break out like other heavy moisturizers do.

3.) Avibon- This is a vitamin A cream and it is very interesting. All of the incredible retinols that you have been hearing about in magazines that are recommended by virtually every dermatologist are actually a form of vitamin A. It is said that they clear up skin and prevent and treat wrinkles. Most of them are very drying though. I am not sure about Avibon as a wrinkle reducer, but I do know that it made my skin very smooth and definitely helped reduce dark spots. The best part is, that it is actually hydrating, rather than drying like most vitamin A products. It smells like roses, but it is very greasy. If you are going to put it on your face before bed put a towel on your pillow or be prepared to deal with a mess when you wake up.

4.) Klorane Gentle Dry Shampoo with Oatmilk- This is one of my favorite products especially after I started washing my hair only every other day. I spray this onto my roots in the morning and wait for about 5 minutes while it soaks up oil from my roots. Then I brush it out and have clean feeling hair with lots of volume. There is no harsh smell or residue left behind. I would highly recommend it.

5.) Nuxe Huile Prodigieuse- This is a great body oil (that can technically also be used in your hair) that I put on after a shower. It is really moisturizing and has a really great smell. It sinks into your skin easily, so you don't spend all day or night feeling greasy after you put your clothes on.

Gwyneth was right (obviously) and I would highly recommend all of the products I have tried so far.

Thursday, February 14, 2013

Broiled Maple Balsamic Salmon

Ingredients
2 fillets of salmon (5 oz each)
1/4 cup soy sauce
1/4 cup balsamic vinegar
1/2 a lime
1/8 cup sugar free maple syrup (the 20 calorie per serving kind)
fresh ground pepper


Directions
1.) In a large bowl combine the soy sauce, the balsamic vinegar, the syrup, and pepper (the amount is up to you).
2.) Put the salmon in the bowl, and make sure it is covered in the marinade. Cover the bowl and refrigerate from anywhere from 4 hours to overnight.
3.) When ready to cook, remove the salmon from the marinade and put it on a baking sheet.
4.) Set broiler to medium high, and cook skin side up for 4-5 minutes. Flip it over and cook for another 4-5 minutes.
5.) Take it out of the oven and squeeze as much lime juice as you like on it.

Nutrition Information
Servings: 2
Serving Size: 1 fillet
Calories: 285
Fat: 15 grams (from good omega fatty acids)
Carbs: 0 grams
Protein: 28 grams


Tuesday, February 12, 2013

Ladybugs

      As I sit here contemplating my rank list, which is due next week, I find myself putting the programs in order of how friendly and inviting the people at the interview were as opposed to the location and prestige of the program. I have been advised that I am better off making an excel spreadsheet and using a point system rather than haphazardly placing these hospitals in order of how I feel at the current moment. However, given the fact that my rank list can determine the next 4 years of my life: my location, my happiness, and the kind of doctor I will become, I think that going with my gut is important. Anyone can pick the program with the most prestigious name, but if the residents are miserable, they will be less likely to go the extra mile during residency, and that will inevitably influence how they practice medicine in the future.
      On most of these interviews, I was thrilled at how nice the other applicants were. On many of them, I left feeling like I would be happy working with any of them for the next few years. There was only one interview where I met a girl I did not click with, despite the fact that we had just a 5 minute conversation. The reason for this, was that the girl was being competitive with me. While I tried to chat and be friendly, she behaved in a way that would make one think that I was the enemy, and that there was just one anesthesia spot in the program we were interviewing for (I think there were 10). I cannot understand why someone would behave like that, because you never know when you will meet people again- we could end up working together as residents or even attendings in a few years, so why be anything but friendly?
      I feel lucky enough to have made great friends in medical school, friends who not only wanted to do well themselves- but genuinely wanted to see their friends succeed as well. I could always count on them to help me out when I didn't understand something, and likewise, they knew I had no problem spending hours with them to explain topics that I had more clarity on. Apparently, and rather unfortunately, this atmosphere is not commonplace in most medical school communities. Medical school is supposed to be a cut-throat environment where everyone competes with each other for better grades and is willing to throw their "friends" under the bus if it means a higher grade for themselves. After all, one cannot just enter medical school and declare "I want to be a plastic surgeon." In order to become a plastic surgeon, they have to obtain the highest grades and board scores to even have a chance at getting a plastics residency, and the fewer people that have stellar grades, the fewer people they have to compete with for the limited plastic surgery spots available.
      I never realized how competitive people could be until I was on a rotation with several medical students from another school. Every single one of them were "gunners," which for those of you not in medicine is defined by urban dictionary as: "a person who will compromise his/her peer relationships and/or reputation among peers in order to obtain recognition and praise from his/her superiors." That definition seems about right in my opinion. I was quite spoiled before that rotation, because I was accustomed to my classmates and I working together to get things done and helping each other get through the day. To put it mildly, I was quite shocked at the behavior of the other students. I had never had anyone purposely try to make me look bad on a rotation. It was an unpleasant experience, and I truly believe that such behavior could very well be detrimental to patients. To me, it seemed like those students were so focused on outshining their peers, that the quality of their patient care had to suffer. There was even a hot minute where I felt myself gearing up to start behaving competitively to give them a taste of their own medicine. However, when I thought about it, I realized that that is not the type of person I am, and that I didn't want to behave that way. I was not going to let other people justify poor behavior on my behalf. If they were going to pour their souls into making me look bad, then let them. So, I just went about my business, did the best job I could, and figured it would catch up to them later somehow. I felt like the residents and/or attendings would eventually realize how they treated others, and it would come back to bite them, even if I wasn't around when it happened.
      When I hear or see people behaving this way, I am always reminded of a quote from the movie Ladybugs. Remember Ladybugs? It was that awesome 90's movie with Rodney Dangerfield and Jackée Harry about an all girls soccer team. They dressed a boy up as a girl so they could start winning because the coach would lose his corporate job if they didn't win. This was because the person who sponsored the team was very rich and his entire focus was on winning the game and being the best. His own daughter was on the team, but he did not want her to play because she was not very good. Of course this upset her, but he did not seem to care much about his daughter's feelings. He even threatened the coach (Rodney Dangerfield) when he put the daughter in the game anyway. To which the coach replied "What good is it being the best, if it brings out the worst in you?" It is one of my favorite quotes, and basically how I feel about cut-throat atmospheres where people try to get ahead at the expense of others. I do not think anyone, including the people behaving that way thrive in such environments. I know I certainly don't. Which Is why I would never intentionally put myself in a place like that because of a prestigious name. It is also the primary reason why I am going with my gut feeling when it comes to ranking residency programs.

Sunday, February 10, 2013

The Amateur Transplants

      I am done with all of my interviews!!! I cannot tell you how relieved I am that I will not have to put that suit on for another 4 years until I am ready for fellowship interviews (hopefully it still fits by then). I have been listening to people's advice along the "interview trail" as they call it, and I have heard many people say "if you really don't like a program, don't rank it." While I respect the advice of others who have been through this process before, I seriously cannot fathom why people say this. Not ranking a program which you have interviewed at is basically saying that you hated that program SO much, that you would rather risk going unmatched then go to that program. While there are definitely programs I would prefer to go to, I am going to rank all of my programs, because there is no program I hated enough to risk not becoming an anesthesiologist. I will just rank the ones I did not like as much at the bottom of the list. HOWEVER, I really hope I get one of my first 7 choices, and while my biggest concern is matching in general, I will be slightly upset if I drop below there on my rank list. It is like being served a chocolate blackout cake when you prefer vanilla on vanilla.......still delicious (you matched!) but you still prefer the other flavor.
      Anyway, if you know me you would know that I am obsessed with a singing group called the Amateur Transplants. They are a group of British doctors, who met in med school, who perform all sorts of hysterical medical parodies. They perform non-medical parody's as well, but you really have to have a certain sick sense of humor to appreciate them (which I do). One of the doctors is an anesthesiologist (or anesthetist as they call them in Britain), the other an obgyn. Here are some of my favorite (medical) videos of them. If you are anything like me, you will find yourself typing their names into youtube and spending the rest of the afternoon watching their videos.

(The Anesthetist's Hymn)

(The Drug Song)

(Final's Countdown)

(The Careless Surgeon)

These are some of my favorite's. Obviously, you will enjoy these particular videos more if you are in medical school or in the medical profession. I am obsessed!

Tuesday, February 5, 2013

Bathtub Gin NYC

     Last weekend, Matt, my friends, and I decided to try a new restaurant that I had heard about online. The restaurant is called Bathtub Gin, and it is located in Chelsea, but if you go there be prepared to get lost. In fact, I am really happy that our friends arrived there first and were able to figure things out, because Matt and I wandered up and down the block looking for the place for awhile. Who knows how long we would have been out there had we not received a text saying that we should come in through the coffee shop. As it turns out, Bathtub Gin is a speakeasy and I didn't even know it. Eventually, I did see a picture of the logo (a woman in a bathtub) under the sign for the coffee shop. It definitely did not jump out at you though.
      Anyway, when we finally got in, meaning the hostess in the coffee shop slid open a secretive back panel, it lead to a dimly lit restaurant which was decorated in a 1920's prohibition theme. We walked past the old-fashioned bar, and were seated at a table in the back next to a huge old-fashioned bathtub. It was so cute! The drinks were also great, fancy and made with syrups and fresh squeezed fruit juice, which went along with the 20's theme and decor. The bar area was so crowded we could barely walk through on the way in, but there was some breathing room in the back. Anyway, the food was also good even though the menu is not extensive. The food is of the tapas sharing variety and we ordered kobe beef sliders, eggplant flatbread, braised short rib sliders, and pulled pork tacos. However, the BEST thing we ordered were the s'mores at the end. They brought out a little toaster with a flame and sticks so we could actually roast the marshmallows ourselves (or set our marshmallow on fire, either one).


      By the end of the meal, I couldn't contain myself and asked the waitress if I could get in the tub. I had been eyeing it the entire meal, but didn't want to be presumptuous and get in, I am after all, a civilized human being. She said "people do it all the time, all day everyday, go ahead." So I jumped on in. I can check dancing in a copper bathtub in the middle of a restaurant off of my NYC bucket list. The waitress also informed us that there is a burlesque show there 2x a week on Wednesday's and Sunday's. I will definitely be going back one day to see that. I also missed the bathroom, which apparently had toilets with high tanks and pull chains. Definitely consistent with the theme, and definitely something that I need to go back to see. In summary, Bathtub Gin is a beautiful restaurant, has great food/drinks, and is so much fun. So if you like any of those things, especially fun, it is worth a trip downtown.

(My best friend Ellyn and I in the tub)


Saturday, February 2, 2013

Senioritis: Inflammation of the Senior

     Right now I am on a sub-I (short for sub-internship, meaning we should basically be functioning at the level of an intern and taking on the same responsibilities) in medicine, which is kind of a problem because I have no motivation. I am not sure what happened to me, I used to be (meaning up until December) a highly motivated, tenacious, eager to learn, enthusiastic medical student. When I was told to go home at the end of the day, I was always that girl that said "are you sure there is nothing else I can help you with," and would end up staying at the hospital until 8pm. Now, the second I am released I am like the Road Runner from Looney Tunes, you can only see the wind from my fast dash out of the hospital. Of course I still want the best for the patients I am assigned to follow, still write good notes, and always do what is asked of me at the hospital, but my heart is just not in it as it once was. I am not going home and doing additional research on their conditions, looking up experimental treatments, and basically going the extra mile. I am also not studying on a constant basis anymore. Yesterday the resident I was with asked me a question on Type 4 Renal Tubular Acidosis, and all I could come up with was "I SO knew this answer back when I took Step 2 in July." I didn't even care enough to be that embarrassed about it. I think part of the problem is that the sub-I is in medicine, which has probably been my least favorite rotation to date as all we seem to do (in my opinion) is call specialists, juggle medications, and round for about 5 hours every morning ( I have more of the surgical mentality of "lets fix things now!"). However, I also think I have what, in high school, used to be called senioritis.
     Back in high school, I was a big goody-goody, I took 5 or 6 AP classes my senior year, never skipped class, ALWAYS did my homework no matter what UNTIL.......I applied to my first choice college early decision and was accepted in December. From then on, I was like a different person. I had pulled more than a 180, it had to be closer to a 270, because I cared so little about school. For the first time ever I was not doing my homework, not studying for exams, and basically behaving like the antithesis of my former self. I still passed my classes and all that, but I remember, more than anything being scared that I would never revert back go my former self and that I would still be unmotivated once college started. It didn't happen that way, and once college started I did care about my grades and was able to sit down and do work, but I am definitely feeling the same way now.
      I am going to have BIG problems my intern year if I do not replace this lazy person I do not know with my former motivated self. My former self would definitely make a better doctor than this girl who has replaced her. Lets just hope that she can resurface in time for residency to begin, which thankfully, will be a good 3 months after I am done with my rotations. I have to believe that those 3 months will provide ample time to recover from the past 4 years before I begin. I think I am just burnt out from everything, including all of these residency interviews. If ALL of my med school friends didn't feel the same way, I would be extremely concerned. For now though, I am going to chalk it up to senioritis, which is clearly not just a high school thing. In fact, I think senioritis is a disease with a relapsing and remitting pattern (like Multiple Sclerosis), and tends to come back before the end of any major milestone. If only there were a cure.