Wednesday, March 19, 2014

Booted by Western Medicine All the Way to China






I have decided to make a serious exploration of a medical system that does not include in its focus an over-reliance on available medical testing equipment, a protocol developed by insurance companies, and a strong affinity for doing whatever invasive thing will cover one's arse for liability purposes.











So, friends, I haven't brought this up before but it's time.  Thanks to a series of unfortunate medical care experiences, I've decided to...um... yes...well... I'm having trouble getting it out of my mouth.

This is why I haven't brought it up before... it's a difficult thing to admit.  I have no idea what you will think of me.  But now that I'm further along in my nascent exploration, I'm going to take the plunge and bring you into my thinking process.

But maybe I get ahead of myself.  Maybe this would be easier to tell you if I contextualize my decision with a couple of stories.  Be forewarned that there is female parts talk in this story.  If that's problematic for you, this is where you exit.


BACKGROUND:  Once upon a time, I had a cyst removed.  When the surgeon went in, she found that the cyst had grown into my right ovary.  An otherwise perfectly good ovary was playing hostess to a cyst and causing me pain.  So, along with the cyst, out came the ovary.  Now, what comes next is going to be over-simplified both because that is how it was explained to me and because it doesn't make a hill of beans' worth of difference at this point to clarify the nuances.  A drop in estrogen triggers another hormone (name forgotten) that is supposed to rekindle estrogen production.  However, if that doesn't happen, that other hormone just keeps trying until... bad things happen.  One of those bad things is a decline of the function of the thyroid.  You see, all these hormones operate as a system.  Thyroid and female hormones and adrenal gland, etc, etc.  I got progressively tireder until I couldn't keep my eyes open from about 3 pm in the afternoon until about 6 pm.  I was worthless.  I was a danger to myself in a car.  If I had to work or go to a meeting, I had to pump myself up on so much caffeine just to stay awake that I couldn't sleep at night, which created further complications.   And yes, I've since been told that I should have been given a hormone supplement to ease the abrupt drop off but let's let that go.  It didn't happen and here we are.

Story No. 1:  Dr. A has an excellent reputation.  In fact, I was referred to her by a friend I trust implicitly to know good doctors from bad.  My first meeting with her goes well.  She takes a bunch of blood work and returns a verdict of guilty thyroid, along with some other hormone imbalance stuff.  I am getting to that age, and all.  She prescribes a thyroid supplement and compounded hormones.  The thing is, prescribing hormones is a fine art.  Our bodies make them, and so there is no "one dose."   You wait awhile, retake the blood work, and see how you feel.  It's a process and something of a fine art.  So, over the next year, I have my blood drawn about six more times.  I submit to assorted other tests.  Things still aren't well adjusted.  But on top of all that, after the first visit, I never see my doctor again.  She is always on vacation or at a conference or anywhere but in her office.  And every time I show up, I see a different nurse practitioner.  I don't know if it's a turn-over problem or she just employs a lot of different people.  At any rate, of all the things that can go wrong when the doctor is not overseeing her own patients, here is my favorite thing:  One day, following one of these blood draws, I get an urgent phone call from one of the nurse practitioners that I must come in immediately for an adrenal treatment of some sort.  I am startled and say so, because as far as I know, I have no adrenal implications.  This was just a routine follow-up blood draw and shouldn't turn up something brand new.  She insists.  I refuse.  She says it is urgent.  I doubt aloud whether she is looking at my chart or someone else's.  I ask for the doctor to review the test results.  She tells me the doctor is on an island somewhere sipping an umbrella'd beverage.  She says my treatment won't wait.  I make her call the doctor, wherever she is.  It turns out that the blood work belonged to someone else, and my blood work is lost.  One wonders whether the patient who needed the urgent adrenal treatment ever got it.  One wonders what would have happened to me had I been a more mousy, less assertive patient and quietly succumbed to the test.  In the course of a year, I have visited the practice nearly a dozen times and seen the doctor once.  Given the craziness of the U.S. medical payment system, one does not wonder why the doctor put the nurse practitioners in charge.  It's easier to make the practice pay (and more fun too) if you let the lower-paid nurses do all the doctoring. 

Story No. 2:  In my search for a replacement for Dr. A I consult my pharmacist because I need a doc who will prescribe compounded hormones.  My pharmacist refers me to Dr. B.  As I am still a student, I begin a dance with the folks at the university's Student Health Center to get around the insurance company requirement that I make an actual visit to the Health Center (in another state) for the referral.  By the time I get in to see Dr. B, I am out of thyroid medication.  I've brought all my charts with me, and the doctor looks at my hormone levels and freaks out.  Yes, I mean that.  Her bedside manner included forcefully projected anxiety and if I was more easily frightened, well... let's just not go there.  Apparently, under the watch of Dr. A's nurse practitioners, my assorted female hormone levels had escalated into a danger zone.  Or perhaps it's just a difference in opinion, but I'll never know because there's no way to facilitate a conversation between Dr. A and Dr. B.  At any rate, Dr. B tells me to get off everything, wait six weeks and then return to her office for another blood draw. Six weeks and ten days later (after the blood draw), I am called in to see... you guessed it... a nurse practitioner.   By this time I am feeling pretty crappy again.  However, the nurse practitioner informs me that their office will  prescribe the compounded hormones but not the thyroid medication.  She wants me to see an endocrinologist for that.  Surprised, I explain that all these hormones - female and thyroid - work together and can't be treated independently of one-another.  She declines anyway.  I try another tact, tell her I'm having a very difficult time working and ask for just one 30 day supply of my thyroid supplement while I go through the Student Health Center dance again to get a referral to an endocrinologist.  "No."  I ask to speak to the doctor herself.  She trots back somewhere but comes back to tell me the answer is still "No."  I plead with her for compassion.  I can barely function, I have to work, and they are leaving me without treatment.  She is really getting irritated by my advocacy in favor of myself.  I ask to see the office manager.  The office manager also tells me "no" and asks me whether I will willingly leave the office or wish to be escorted out.  I am an uncooperative patient and have been booted from the practice!  

Story No. 3:  I am exhausted and ill, but through sympathetic friends I find Dr. C.  She is an internist and will treat everything.  She is lovely, gives me a prescription for thyroid, and we begin the process, once again, of finding the right balance of hormones.  At some point over the next year, I begin vaginal bleeding.  I make an appointment, but the doctor's schedule is packed and I have to see... the nurse practitioner.  I should tell you that I have friends who are excellent nurse practitioners and this one might be too, except perhaps she spooks too easily.  I come in for my appointment.  She looks at my chart, we talk, and we agree it is highly likely to be a problem with my hormones which we are still in the process of fine-tuning.  However, to be on the safe side, she asks that I get a trans-vaginal ultra sound.  I do both things.  The ultra-sound results come in two days before the hormone panel and the same nurse practitioner calls to tell me that the ultra-sound is clean - but I must go see an oncologist pronto. Now I don't know about you, but there is some cognitive dissonance for me when I hear "the ultra-sound is clean" and "you need to see an oncologist."  I asked if there was something she wasn't telling me.  Although she says "no," I manage to ferret from her that the radiologist who read the ultra-sound made a notation on my chart to the effect of "Can't find the problem.  Next stop, oncologist for a tissue biopsy."  However, the radiologist did not have the benefit of my entire chart. She did not know that we had a theory based on the entirety of my situation, or that I am in the middle of balancing hormones.  She did not know a crucial hormone panel would be back in two days.  All she knew was that I was bleeding and she couldn't find it.  I suggest to the nurse practitioner that we wait the two days (did I mention it's only two more days?) until the hormone panel comes back before I go through a painful, expensive, invasive procedure.  "No."  "Why not?  What am I missing?"  She won't say but keeps urging me to see the oncologist now.  At this point I may have asked her whether the urgency has to do with covering her office's arse because of the radiologist's notation, and of course, she denied that.  We are going around in circles and I am tense because either there's something she's not telling me, or it's a total CYA move, and either way, I need to know the truth.  So I beg for any valid reason why, given that we DO believe it's probably hormones and I have a nice, CLEAN ultra-sound, we shouldn't wait TWO DAYS for the HORMONE PANEL TO COME BACK.  Now you need to know that those capital letters represent my raising my voice at Dr. C's nurse practitioner, behavior for which I later had to answer to Dr. C and for which I apologized to the nurse practitioner.  Note: Neither the nurse practitioner nor Dr. C apologized to me for scaring the bee-jeezus out of me in hopes of covering their...  In the end, I simply refused to make the appointment with the oncologist and told the nurse practitioner to make a note in the file that the patient willfully refused to see the oncologist before the hormone panel came back.  Oh, and yes, it was hormones.  Adjusted.  Bleeding stopped.  End of story.  Except...

Story No. 4 is just beginning.  I'm still at Dr. C's office - thankfully they did not give me the boot and I continue to appreciate Dr. C - and I'm not going to bore you with the whole story, except to say that another nurse practitioner in Dr. C's office has recently recommended me to yet another (in my mind) premature invasive procedure for what appears to be a pretty minor gynecological issue.  I might even need it, for all I know, but I can tick off very clear reasons why it is not the next logical step in diagnosis.  It is a bitch to be an educated, self-advocating patient, and despite everything you read about being a participant in your own care, in my experience medical practitioners don't prefer that kind of participation.  I think they simply mean you to participate by actually doing what you're asked to do - whatever that is.  And so I've decided I need to consider other pathways.

So just to ease your minds, I've made an appointment with the gynecologist who delivered my daughters a million years ago and even her nurse practitioner will probably have seen more problems like my current problem than the internist's nurse practitioner.

But I have also decided to make a serious exploration of a medical system that does not include in its focus an over-reliance on available medical testing equipment, a protocol developed by insurance companies, and a strong affinity for doing whatever invasive thing will cover one's arse for liability purposes.  Now please don't get me wrong.  I think that medical professionals are pretty much forced into this system and it's become a way of life.  It's become the American medical experience.  But statistics tell us there are something like unnecessary 130 tests and procedures that are routinely used, to the tune of $6.8 billion a year.  Notice, they haven't even tried to measure it in terms of patient anxiety costs.  Sisters and brothers, I am tired, tired, tired of being part of that routine.

Now, with all that build up, maybe what I'm about to share will make some sense.  The alternative medical tradition does not try to pinpoint a primary underlying cause for a symptom,but rather looks at symptoms in the totality of the person's life, physical, emotional, psychological, environmental.  Here is an example of what I am talking about:  The alternative medical tradition understands that a peptic ulcer may arise from one of six unhealthy situations, and if the ulcer is treated with a common western treatment for ulcers, but the actual underlying situation is left diagnosed and untreated, the problem will simply re-manifest one way or another.  Here is a description of the alternative medical system I have decided to explore:

"The...physician...directs his or her attention to the complete physiological and psychological individual.  All relevant information, including the symptom as well as the patient's other general characteristics are gathered and woven together until it forms ...a 'pattern of disharmony.' The pattern of disharmony describes a situation of 'imbalance' in the patient's body....Diagnostic technique does not turn up a specific disease entity or a precise cause but renders [a] workable description of a whole person.  The question of cause and effect is always secondary to the overall pattern...The...method is based on the idea that no single part can be understood except in its relation to the whole. A symptom, therefore, is not traced back to a cause, but is looked at as part of a totality.  If a person has a complaint or symptom, [the methodology] wants to know how the symptom fits into the patient's entire being and behavior.  Illness is situated in the context of a person's life and biography. Understanding that overall pattern, with the symptom as part of it, is the challenge..."

That paragraph should ring true with anyone familiar with systems theory.  It comes from a book by Ted Kaptchuk, "The Web that has no Weaver: Understanding Chinese Medicine," considered to be the best entree into traditional Chinese medicine for the westerner.  What resonates for me about Chinese medicine is its focus on the whole person.  Although Dr. Marcus Wellby used to take an approach similar to the one outlined above, today's doctors are pushed more and more away from using their experience and instinct alongside science, limited by insurance companies to a strict scientific approach.  Compare the concepts above to the primary methodology of western medicine, which Dr. Kaptchuk explains,

"...is primarily concerned with isolable disease categories or agents of disease, which it zeroes in on, isolates and tries to change, control or destroy.  An ontologically circumscribed entity is the privileged ideal of the system.  The western physician starts with a symptom, then searches for the underlying mechanism - a precise cause for a specific disease.  The disease may affect various parts of the body, but it is a relatively well-defined, self-contained phenomenon.  Precise diagnosis frames an exact, quantifiable description of a narrow area.  The physician's logic is analytic - cutting through the accumulation of bodily phenomena like a surgeon's scalpel to isolate one single entity or cause."

In other words, practitioners of Chinese medicine don't try to isolate the thing gone wrong inside the body.  They look instead to the person - to the whole person, in context of her life and environment. While the modern Chinese physician doesn't ignore the modern tools available for diagnosis and treatment, she would never have had to rely solely on a blood test to diagnose a patient's adrenal failure and consequently, would have recognized the incompatibility of the blood result with the rest of the patient's circumstance.  She would never have kicked a patient out of her office because she was not allowed by her insurance carrier to treat the whole patient.  She would never have seen one notation by a radiologist who has not visited with the patient to be a definitive determinant of next treatment steps.

And so... down this path I go.  Anyone want to come with me?  

Sunday, September 29, 2013

Shhh.... Meatless Meatloaf

This year, my resolution is to live more intentionally.  I do some cool things - at any rate I think they're cool things - but they are wasted for posterity because I don't record them.  For example, I don't write about the amazing things that sometimes happen in my classrooms that  my students are doing.  And closer to home, I often make delicious, healthy foods that will never be made again because I don't bother hanging onto the recipe.  Or if I created the dish, I don't bother writing it down.

Now, on the one hand, no biggy because I can create a new dish every single day if I want to.  On the other hand, what a shame, right?  Because if it's really good, why not allow myself the pleasure of enjoying it again?

One of the things I wrestle with - I've wrestled with this for years - is our reliance on meat.  Part of my new commitment to intentionality is to be more intentional about meat eating.  The ramifications of eating meat bothers me on multiple levels - the cruel way most of our agricultural industry treats the animals that become our food, and the amount of land we use to feed animals that could otherwise be used to reduce human hunger.  Unfortunately, there's a bigger profit in beef than in beans, but that's a topic for another day.

I am also aware that our health is better when we include more non-meat fiber, protein and vegetables in our diet.   I'm not planning to become vegetarian, but when I cook for others, I too often find myself falling back on the dinner plate formula I learned growing up in Kansas - meat, potato, vegetable, dessert.  Oh, and a hunk of garlic bread if we were lucky. Well, there are very few white potatoes in my life anymore - although  I consider truffled garlic fries a birthday cake substitute.  And I eat bread only "out" and then only those loaves I consider irresistible. At home, my dinner plate often excludes what used to be called "a starch," the role on the plate represented by the potato or pasta - "bad' carbs.  But it doesn't often enough include the healthy replacement, "a fiber."  Fiber, good for us in so many ways, often contains enough protein to let us leave meat off the plate.  A reduction in meat is good for me and good for society in several ways:

Reducing meat purchases reduces food costs, leaving me with extra money to pay the higher cost of buying meat from compassionate farmers when I do buy meat.  I can't even write about what happens to many of the animals abused by industrial food production facilities without my stomach turning, but the Grace Communications Foundation website covers it thoroughly enough, and everyone ought to take the time to read about it at least once.1  Unfortunately, meat raised in kinder (and more sustainable) ways costs quite a bit more than facility-raised critters, but if you reduce your meat costs by eating less of it, you can shift those savings to paying the up-charge. Sources for compassionately raised meat can be found at CertifiedHumane.comAmericanHumane.orgAnimalWelfareApproved.org and compassionate-carnivores.org.

If you happen to keep kosher, like I do, it's going to be more difficult.  I've found three companies, Wise Organic Pastures, Kol Foods, and Grow and Behold.  Unfortunately, they're all on the east coast, making shipping prohibitive if you live anywhere west of the Mississippi, although Kol Foods and Grow and Behold have buying clubs in some cities.  Two other Colorado based companies and a Texas company stopped offering kosher grass fed meats within a few years of their launch dates.  Costco and Trader Joe's carry free range organic kosher chicken from Empire.  Trader Joe's carries kosher meats, but as far as I can tell, besides the Empire offerings, none of it comes from compassionate producers.  Otherwise, I suggest Googling "free range kosher meat" and see what's available.

If everyone would reduce meat consumption even by a little, some of the land used to raise feed could be converted to raise crops for humanity, and more people would get fed.  According to a Stanford study, over two-thirds of the world's agricultural land is given over to raising crops to feed livestock, compared to only about eight percent used to feed humans directly.  I find that unbelievable.  And as the economies grow in third world countries, these numbers are only expected to get more extreme.  The industry is taking over forests and grasslands, changing ecosystems forever and using our already insufficient supplies of fresh water.2  Why, in 2012, a Business Insider article reported that within the last decade, over 495 million acres were sold or leased to foreign governments for the purpose of accessing land for agricultural, forestry and natural resource extraction purposes.3

And of course, we are healthier when our ratio of vegetables, legumes and fruits is higher than our meat consumption.  I say "of course," but maybe that's not so obvious.  I have no intention of getting into it with the Paleo crowd and say, "God bless them," but we are not the same creatures we were in caveman times.  The level and type of activity we needed to eat to support, and the length of our lives were different then, and medical science still insists that too much meat leads to heart problems.  Conversely, adding vegetables, especially those cruciferous veggies like cauliflower, broccoli and the like, have the opposite effect.4

Ok, the "why" discussion can give way to the recipe.  What, you may ask, prompted me to go all "eat less meat" on you?  Well, today's recipe is a meatless substitute for one of America's favorite meat dishes, meatloaf.  Just try it.  I predict you'll like it.

Shhh.....Meatless Meatloaf

As often happens, my inspiration for this meatloaf came from a lot of online sources.  I saw some amazing versions that include walnuts, but I got in the habit of eliminating all nuts but almonds from my cooking about 30 years ago, because my oldest daughter turned up allergic.  So many kids have nut allergies.  I noted what I liked, but moved on to lentil loaves.  I liked the idea of a hearty lentil meat replacement, but most of the lentil loaves mixed lentils with rice.  I've more or less given up on rice, because its glycemic index number is higher than I prefer, even though it's not a simple carb.  So, in the end I decided to mix chana dahl - looks and tastes like a lentil but is actually from the chick pea family and has more protein than lentils, and mix them with quinoa.  As an Indian food staple, it's readily available at your local Indian market or online.  I worked to get the same meaty, tomato-y taste we're all used to from a good, old-fashioned meatloaf, and I think I succeeded - but would love to hear about your modifications.

Ingredients

Loaf
1.5 c quinoa
2    c chana dahl
7    c vegetable broth - I used "No Beef" bullion
1/2 tsp thyme
1/2 tsp oregano
1/2 tsp sage
1    tbsp worcestershire sauce (vegetarian or not)
1    tsp soy sauce
1    tbsp olive or other oil
1    yellow onion diced
1/2 c shredded carrots
3    cloves garlic, minced (I was out so I used garlic flakes, which I didn't bother to measure)
Salt & Pepper to taste

Glaze
1 small can of organic tomato paste
1    tbsp worcestershire sauce (vegetarian or not)
2    tbsp coconut palm sugar.
1/2 tsp mustard (I used dijon because it was handy but I think anything will do)
1/4 tsp hot sauce of choice, amount adjusted to personal taste
1 tbsp roughly of water, to get the whole thing to the right consistency to spread on top of the loaf

Soak the quinoa and chana dahl briefly to dislodge any particles of dirt or tiny stones, and, using a strainer, pour off the rinse water - I used it to water plants - and put the quinoa and dahl into a pot.  Add the broth and spices and bring to a low boil.  As the proteins in the dahl break down, a white foam will well up in your pot, similar to simmering meat for broth.  Skim it.  Turn the heat to low and simmer for approximately an hour minutes, stirring occasionally until the water has been absorbed, the dahl mixture is creamy but not wet, and there is no broth left in the pot when you stir it.  If you feel the dahl is drying out before it reaches this stage, feel free to add up to more broth or some water.  When finished, taste it to see if it needs salt and pepper.  This will depend in large part on the bullion or broth you used.


While you wait, saute the onions and carrots until the onions are translucent.  About now, it's probably time to preheat the oven to 350 degrees.


To make the glaze, mix all the ingredients but the water together in a 3 or 4 cup measuring cup, or a wide mouth bowl.  Then slowly add a bit of water, stir until well mixed, and continue to add more until you get a consistency that would be easy to spread but unlikely to drip.  That's your glaze.

When the dahl and quinoa are ready, mix them into the onions and carrots, add the worcestershire and soy sauces and stir until everything is well mixed.  Use a bit of oil to lightly grease the surface of a loaf pan, and turn the mixture into the pan.  As you can see, I chose to use an 8 x 8 pan instead of a loaf pan, but you can do it either way.  At this point, assess your dahl mixture.  It should be dry enough to support the glaze on top, but if it's not, you can glaze the loaf midway through baking.


Bake for 1 hour, or until it just begins to pull away from the sides of the pan.  Let it sit for about 10 to 15 minutes to cool sufficiently to cut before serving.  Serves 6.

Issue
The first time I made this, I took the advice of those who said that if you cook dahl without a pressure cooker, add more water.  So I added an extra cup, and then it took about 2 hours to evaporate all the water out of the dahl.  The second time, I used a cup less liquid and found that the mixture stuck to the bottom of the pan and I needed to add more water.  In neither case did it impact the flavor, but too-wet dahl mixture did not bake up as firmly as I would have liked it to.  Just be aware.

Alternatives
American vs. Asian loaf:  I have to say that using these particular spices with dahl felt awkward, as I usually think of dahl as carrying asian flavors, but if you want it to taste like meat loaf, go with my combo.  If you want something more exotic, feel free play around with cumin, dried chili pepper, masala and other spices.  If you do, you probably ought to use a half teaspoon of finely grated ginger and something slightly fruity - jam or chutney - in place of the worcestershire and mustard in the glaze.  If you use ginger, remember that fresh ginger has a pretty strong bite, and reduce the hot sauce accordingly.

Sweetener:  Coconut palm sugar is slightly less sweet than table sugar, lower glycemic and lower calorie, and has a natural vanilla taste.  You might prefer maple syrup, brown or plain cane sugar, or a zero calorie sugar alternative.  If you substitute, start with a tablespoon (or an equivalent for the zero calorie substitutes), and adjust upward till you get a sweetness you like.

Hot Sauce: I used Nando's Peri Peri Sauce, medium, courtesy of my friend Kate, who brought it back from South Africa.  I put my pinky in the jar and tasted it first.  Whoa. Hot. Not Medium.  I don't even know if you can get this in the states.  Chipotle would be good, or Sriracha sauce.  Or anything, really.  Adjust to personal strength.

Lemon Juice:  If you don't have any, sub in balsamic or another vinegar.


1. http://www.sustainabletable.org/274/animal-welfare

2. Brooks, C. (2011?). Consequences of increased global meat consumption on the global environment -- trade in virtual water, energy & nutrients. In W. I. f. t. Environment (Ed.). Stanford, CA: Stanford University.

3. Khetani, S. (2012). These 14 Countries Are Buying Incredible Amounts Of Foreign Land In Deals You Never Hear About. Business Insider.

4.  Pan, A., PhD, Sun, Q., Md, ScD, Bernstein, A. M., . . . et al. (2012). Red meat consumption and mortality: Results from 2 prospective cohort studies. Archives of Internal Medicine, 172(7), 555-563. doi: 10.1001/archinternmed.2011.2287.

Thursday, May 2, 2013

First Harvest: Roasted Eggplant, Squash & Tomato Salad

It's only May 2nd, and yet I harvested two beautiful Japanese eggplants from my garden.  This particular plant sprouted of its own volition from last year's harvest, and so it's light years ahead of the plants I put in a few weeks ago.  Herbs also lasted through the winter, or popped through as soon as it warmed up, so I plucked some sage too.

Never having been a patient woman, I hit Google immediately in search of recipes.  I found several that appealed to me, both for the idea of them, but also because I mostly had the ingredients at hand.

In the end, though, the assorted ingredients in my refrigerator suggested their own outcome.  Yellow squash, mushrooms, onions, arugula, tomatoes.  Roasting appealed to me because grilling or frying eggplant is a mess - a delicious mess and I do it sometimes, but not today.  Very simple - and - it got the thumbs up from Tony, especially the 'shrooms.


Roasted Eggplant, Squash & Tomato Salad

2 Japanese or one "regular" eggplant
1 yellow summer squash
1 medium onion, any color
8oz tub of fresh mushrooms - I prefer crimini
6 cloves of garlic
6 small or Roma tomatoes, or maybe 3 times that many cherry tomatoes
Handful of fresh torn or teaspoon of dried sage
1 Tbsp olive oil
1 tsp garlic powder (optional)
                                          salt and pepper mill pepper to taste

1/4 c of pine nuts
2 c arugula
3 oz soft goat cheese

Preheat the oven to 450 degrees.

Slice the eggplant and the squash into medallions about half an inch thick.  Cut the onion into 6 to 8 wedges.  Slice the 'shrooms in half.  Get the garlic cloves out of their skins.  Throw all these veggies except the tomatoes because they're probably too fragile into a bowl and toss until coated with the olive oil, the salt and pepper and the sage. If you're a garlic hound, add the garlic powder.  Cut the tomatoes in half, unless they're big ones, and in that case, cut them into very thick slices.

Find a 9 x 13 glass baking dish, dump in all the coated vegetable pieces and spread them out across the dish.  Add the tomatoes in a bit more carefully.  Roast the vegetables for 20 to 25 minutes, depending on your oven.  Slightly under-cooked is far better than over-cooking them.  The high heat will continue to work through the flesh even after you pull the veggies out of the oven.

On salad plates, spread some arugula.  Scoop some of the veggie medley on top of the arugula, crumble goat cheese liberally, and then scatter a few pine nuts for show.  Voila!  Serves two as a main course, with left-overs, or five or six as a side dish.

Tuesday, April 9, 2013

Damn, that's Good! Wild Rice & Mushroom Soup

Occasionally I strike out.  I made something the other night that Tony so over-salted.  I got the message.

Tonight, on the other hand, home run.

Wow. What's with all these sports metaphors? That's so not me.

Anyway, back to my home run.  Or really, back as far as Passover.  I got this idea that I would make some mushroom matzah kugel for Seder.  So I bought a couple of trays of crimini mushrooms.  But my friend Sharon offered to bring this winner of a sweet potato dish, and I realized I could drop back one dish.  I'm an ambitious hostess, but I know a gift when I see one.  At that last moment, having one less thing to prepare is a blessing.  Thank you, Sharon!

Passover was a bit ago already, but I still have a couple of gallons of turkey broth, and two packages of mushrooms.  Perfect storm for Wild Rice & Mushroom Soup.  This is the easiest soup ever, hearty and delicious.  And demonstrates the value of having frozen broth on hand.  If you don't have broth, click this sentence for my fast and easy Vegetable Bin Broth recipe.

Wild Rice & Onion Mushroom Soup

2 tbsp olive oil
2 onions, sliced thin
1 container of mushrooms (about 8 oz), sliced
8 cups or so of turkey, chicken, beef or vegetable broth
1/2 cup of uncooked wild rice (or, use quinoa, barley, beans or lentils)
Salt and pepper to taste

Heat two tablespoons of olive oil in a large, deep saute pan.  Add sliced onions to hot oil, and turn the heat down to medium low.  Push the onions around so they all get coated in oil, and then stir occasionally.  Saute until onions become translucent, and then caramelize.  To caramelize the onions, you simply cook them over medium to low heat long enough for them to brown, stirring occasionally so they don't stick and burn.  If they seem to be sticking, just turn the heat down and stir more frequently.  This process takes about thirty minutes.  If you want a fuller explanation about caramelizing onions with lots of pictures, click this sentence to be whisked to one of my favorite recipe blogs, Simply Recipes.

Once the onions are how you like them - or if you've never done this before, a warm brown color, push the onions to the side of the pan to make room for the sliced mushrooms. Toss them in, and push them around every few minutes, for about ten minutes, until they are well sauteed, but still firm.  Set the onions and mushrooms aside.

You can see carrots in my soup.  These were already in the
turkey broth, but aren't necessary.
In a pot, pour the broth and add the wild rice.  Heat to barely boiling, then lower the heat and simmer gently for thirty minutes, until the rice is al dente.  If you're using something other than wild rice, adjust the time accordingly.  Lentils, for example, usually take longer than 30 minutes.  

When the rice is ready to eat, simply stir in the onions and mushrooms, and let them heat in the broth for a couple of minutes.  Salt and pepper to taste.  Ready to serve.

Before we say goodbye so you can go make this simple and beautiful soup, I feel the need to make mention of my suggested substitutes for wild rice.  Not everybody has wild rice in the house all the time.  You could, I suppose, substitute regular white rice for this dish.  It's not as hearty and the flavor is different, but it would work pretty well.  You could substitute pasta.  Almost everyone has regular rice and some sort of pasta sitting around the cupboard.  But I specifically did not recommend those things because they are high on the glycemic index, and low on nutritional value.

They are the comfort foods of your childhood, but if you don't give them up or at least reduce their incidence in your diet significantly, they will be the bain of your old age.

But don't take my word for it.  If you don't understand glycemic index, read what Harvard says about it by clicking this sentence.  To see Harvard's food chart listing glycemic index of 100 foods, click this sentence.

Was that easy or what?

Vegetable Bin Broth


Fridge clean-out day.  I didn't plan it that way, but when I opened the bin this morning, so many melancholy veggies looked up at me with those big, sad eyes.  I knew it would be Vegetable Bin Broth day.  Vegetable Bin Broth is the perfect antidote for pouting veggies.  Almost anything that is so far gone you wouldn't buy it from the market, but not actually rotten can be put into the pot to create a delicious, healthy soup base.  Use it now, or freeze it for later.  

Here's the recipe.  Don't despair that my measurements are not exact.  You really can't do any harm here as long as you have adequate water in the pot with the veggies.  Quantities depend on how many veggies you're trying to get rid of, and how big a pot you're using.  And you will notice I don't have you remove skins or leaves.  These add flavor, color and nutrition, and you'll strain them out later.  If you don't have a regular strainer, use your spaghetti strainer!

Vegetable Bin Broth

Nice to Have Ingredients:


You can make a nice soup with only the following ingredients.  But even if you don't have all of these, you can just use whatever you have.  Really!

An onion or two, quartered.  Don't even bother to remove the skin
Two or three cloves of garlic.  Leave their skins on too.
A couple of carrots cut into pieces


Pepper corns
A bit of salt
A couple of bay leaves or a sprout of thyme or parsley 


Optional ingredients

Whatever uncooked, limp but un-dead vegetables in your fridge. Celery, root vegetables, peppers, past-prime (but never sour tasting) tomatoes, parsley or other herbs, broccoli, brussel  sprouts, squash, mushrooms.  Anything, really.  The only vegetables I strongly advise against are cucumber and particularly starchy vegetables like potatoes.  Trim off bad spots and stems, but use the leafy tops.


This soup is perfect for vegetarians and vegans, but if you are a meat-eater and want to  toss in a couple of chicken quarters or beef bones, feel free.  But don't feel you have to.  A purely vegetable stock is a lighter concoction with a more delicate flavor, and you'll find lots of uses for it.   Some of my favorites:  as a base for Asian soup recipes, a flavorful broth for steaming or poaching fish, or a substitute for water when simmering rice, lentils or beans.   

Preparation

Toss whatever you've got into your pot, and add water to just cover the vegetables.  Now however high the water comes in the pot, add more water till it's double.  Bring to a boil and then quickly reduce the heat and simmer until the onions are translucent and the carrots have exchanged their vibrant orange for a muted rust color.  The process could take anywhere between twenty minutes and an hour, depending on how much stuff you've got in your pot.  


By the way, if you get involved in something else and forget your soup, and when you return, there's hardly any soup in the pot, do not despair.  Unless you've let it go so long that the veggies are scorched and stuck to the bottom of the pot, just add water back to reconstitute the very concentrated broth that's left.  It will be fine.  If it is scorched, you'll have to toss.  Scorched veggies leave an acrid taste in the broth.  Yuck.  If you're like me, and prone to time lapses where you look up at the clock and entire half days have gone by, consider setting a timer that goes off loudly.

To know when you're done, use your eyes.  When the colors are dull, the broth is ready.  Don't worry about how your veggies look - you're not serving them.  You're getting rid of those veggie carcasses as soon as they transfer their healthy goodness into the pot.  If they're still bright and colorful, then their value is still in the vegetable and not yet in your broth.  


Once your broth is ready for you, use a strainer placed over another pot to separate the vegetables from the broth.  Let the broth cool and refrigerate it.  Reheat your broth for soup tonight, adding some cut up veggies, rice, or lentils before serving, or you can freeze it for later use.  

I don't want to guilt you, but consider tossing your spent veggies into a composter.  They are still good for enriching your garden soil.  I seriously recommend clicking here to see this little composter guy.  It fits right under your counter so you don't have to run your scraps outside.  It is air tight, surprisingly doesn't smell at all, and turns out some really great compost, as well as compost "tea" for your house plants.  By the way, compost tea needs to be seriously diluted before using.

Once you've gotten into the habit of creating delicious stock from your vegetable bin, you will swear off bullion cubes forever.

Bon appetite!




Monday, April 8, 2013

Garlic & Kale Smashed Cauliflower

Can I write about food here?

I'm on a self-imposed diet.  I'm trying to keep my youthful figure, even though I'm upwards of that half-century mark where everything heads south, best intentions notwithstanding.  So, I've become a low carb, low glycemic kind of gal.  I also avoid fried foods, but more because frying tends to destroy perfectly good vegetables than that it's bad for me.  I know it's bad for me, but the best food in the universe is a french fry, and really crispy onion rings are right behind.  And a few other things, but I won't go on.  I occasionally do indulge.

Mostly I'm good.

I've noticed that when I don't record my recipes, I can't remember how I made something.  This has been vexing for baked goods, because, while I can pretty much improv anything else, I'm not much of a baker.  Tony likes his sweets, though, so it's worse than a shame when, after spending ages trying to force almond flour and sweetener substitutes into ice creams, cookies, brownies and bars that pass the Tony taste test, I can't remember how I made them.  From now on I record.

Today I'm not baking.  Today I am missing mashed potatoes.  I thought I would try to replace it with smashed cauliflower.  I read half a dozen recipes, and then created my own.  Here goes.  Maybe I'll remember to take a picture and post it here before I eat it.  Maybe not.

Garlic & Kale Smashed Cauliflower

Ingredients

One head of cauliflower, cut into large florets
Enough vegetable broth to cover cauliflower in a pot
Olive oil
3 cloves of garlic, chopped into smallish pieces
Two cups of kale, cut or torn into medium size pieces
One cup of basil, torn into medium pieces
1/4  cup grated parmesian cheese (optional)

Put the cauliflower and the broth into a pot big enough to hold them with room.  I actually made a vegetable-based broth because I only had left over Turkey broth in the house, and meat and cheese do not co-mingle in my kitchen.  I also think the gamier flavor of meat broth would overpower the basil flavor, but I'm not sure about that.  If you try it, let us know.

Making a vegetable broth, by the way, is an easy way to get rid of vegetables that are limping along in your refrigerator wondering if you even remember they're there.  If you already have broth, that's great.  But if not,  click here to check my fast and easy recipe for Vegetable Bin Broth.

So, where were we?

Oh, yes, the cauliflower is now in a pot, with broth to cover.  Bring to a boil on medium high heat, then reduce heat to low and simmer.  While you are waiting for the cauliflower, rinse and chop your garlic, kale and basil, if you haven't already.

After 10 minutes, the cauliflower should be done enough to move a fork through the vegetable easily. It's best not to overcook it, to preserve nutrients, flavor and texture.   Use a strainer to catch the cauliflower, pour off the broth, let it cool, and refrigerate it for another use.

Put the cauliflower back into that pot or a smaller one, and mash it with a potato masher, mixing in a tablespoon of good olive oil, and salt and pepper to taste.  Put the cauliflower aside.

In another pan, heat a tablespoon of olive oil, and add the chopped garlic.  Stir over medium heat until the creamy shade of the garlic begins to darken to a beige color.  You'll want to watch carefully, because garlic goes from beige to burnt fast.  Burnt garlic gives your oil - and hence your dish - an acrid flavor, forcing you to pitch the oil and start over.

When the garlic is ready, add the kale and stir.  It will begin to wilt within a couple of minutes. If you hear sizzling or cackling, add a bit more oil and reduce the heat.  As soon as the kale starts to wilt, toss in the basil. Stir for another moment, until the basil starts to wilt  too, and then remove the pan from the heat.  If you're ready to eat, move on to the next step.  If not, let it cool, and refrigerate the greens and cauliflower in separate containers until you are ready to eat.

When you are ready to serve, reheat the cauliflower if necessary, stirring in a few tablespoons of the left-over broth. Stir in the greens. If you want cheese, stir that in too.  When the cheese "disappears" into the dish, it's melted and you're ready to serve.  Serves four.