Banana bread

Every Christmas, I made banana bread. Not just one or two loaves, but more like a half dozen. I wish I was kidding, but I'm not. I guess the banana bread that I make is rather good and it's in high demand - and turns out, so is the recipe!

So, here is a much-coveted banana bread recipe. Follow it right and you will end up with sweet, non-dense banana bread that is great hot out of the oven with a side of vanilla bean ice cream or toasted in the morning as a breakfast treat.

Warning: it's not good for you. Yeah, it contains bananas but that's about as nutritious as you're going to get with this bread.

Banana bread

Makes 1 loaf

Preheat oven to 325 degrees

Prep time: 15 minutes

Cook time: 1 hour

Ingredients:

• 3-4 very ripe bananas (key is very ripe - it's just not the same unless they're ready to be thrown out)
• 1 cup granulated sugar
• 1 stick butter, room temperature
• 2 eggs, room temperature
• 1 1/4 cup unbleached, all-purpose flour (if you have bleached, you can work with it - but buy unbleached next time!)
• 2 tsps baking soda
• 1 tsp salt
• 1 tbsp vanilla extract
• Optional: 1 cupe walnut chunks

Directions:

1. Mash up bananas and walnuts (if you have them) in one bowl. Place aside.
2. Cream butter and sugar together with a hand mixer, or a whisk if you have strong arm muscles and determination. The key to this step is to make sure that the butter is truly room temperature. No cheating allowed here (putting a stick of butter in the microwave for a few seconds is not the same as leaving it out for the day - trust me, I've tried).
3. Add eggs, one at a time. Beat the mixture after each egg to fully incorporate it.
   
4. Add bananas and walnuts, if you have them.
   
5. Add all dry ingredients (flour, salt, baking soda, vanilla extract) to bowl. Using a spatula or large fork, mix all ingredients thoroughly, but minimally. The secret is to mix as little as possible but to mix all the ingredients together.
6. Pour into a buttered loaf pan (my trick to do the buttering is to take the paper from the stick of butter and just invert it, spread it all over - kill to birds with one stone and you don't waste food!).
   
7. Bake for one hour at 325 degrees. Remember to rotate your loaf pan halfway in between if you have a shoddy oven like me that doesn't heat evenly. Check on it about 50 minutes in, put in a toothpick, if it comes out clean, it's done.

Now, I don't bake and cooking is my real joy (I even got the Joy of Cooking day by day calendar this year to perk me up), but this is my one baking joy. I perfected this bread in a way that it's almost like cooking to me, as I don't even have a written copy of the recipe and I "measure" rather inaccurately and it still turns out perfectly. It took many attempts to get a banana bread that tastes good but does not require the accuracy most baking calls for. So, you may call this a baking recipe for a cook.

White Christmas

I finally made it up to Seattle last week for a white Christmas! I was so delighted and got to spend some good quality time with my family up there... which makes me happy and allows me to keep on chugging along with intern year.



Some great pictures from the trip (more pictures can be found here):

Evolution, Schmevolution

My dear friend Eric is now wheeling and dealing amongst the big fish and has gone out and published his own book, and gotten a superb article (and even more superb pictures) in Sierra magazine! 

And to imagine, at one point in high school, I used to "edit" his work - ah, the good ole days.

Argh!

It's funny how I cannot stay awake while studying, despite the fact that I, a) slept 10 hours last night, b) just had a cup of caramel macchiato (albeit decaf), and c) the Christmas music is playing right by my head. 

Did I mention how depressed I am that I'm still in California?  I want to go sledding!! 

Vacation! Well, not really.

Today is the first official day of my vacation, but what have I done?  I've managed to lose my crochet needle - and hence cannot work on some Christmas gifts.  I am sitting at the local starbucks, studying (or trying to at least - it's hard when David Bowie is singing Little Drummer Boy so loud your ears ache), and overall, not doing a thing.  Oh yeah, don't try calling Alaska Airlines to try and rebook my ticket - it's been busy since yesterday.  And when I get through, all is says is, "Sorry, due to the extreme weather, we cannot help you at this time."  Duh. Like I needed a phone message to tell me that.
 
Oh well, what a start to the vacation.  So, I'm spending $300 to fly to Seattle for what will now be a 3 day vacation (nevermind that I'm paying for half of my brother's ticket).  I'm so sad.  Especially now that they are emailing me wonderful pictures and stories of sledding in the backyard.  Did I mention how much I love sledding? 

Stranded

It all started with am 11am flight to Seattle. Then it got delayed an hour. Then two. Then three. Then, put on hold. Finally, it was cancelled.

I am so so so sad.

Fatigued, exhausted, worn out

There are many ways to put it, but that's what I've been since starting residency.  Would I be less so if my hours were better?  If I had a 5 hour nap overnight while on call?  If I was guaranteed one day off every week?  If I could not be on call more than once every three days?  It's hard to tell, but it will be interesting to find out. 

Soon enough, we will all find out if the new resident work hour recommendations made by the Institute of Medicine are put into effect. 

On my toes

My last call night, I realized how important it is to be on my toes, even at 4am.  I did a c-section at 4am and it went fine, except for some excess bleeding secondary to uterine atony.  We had controlled the bleeding, but she had lost a good amount of blood during the operation.  As I was in the recovery room, dictating the case, the nurse called me over. 

Nurse: "Her blood pressure has dropped."
Me: "How low is it?"
Nurse: "Right now, it's 70/40."
Me:  [Right now, I'm thinking, "Crap!"] "Ok, bolus 1 liter normal saline, get another large bore IV, draw labs, and let me examine her." 
[I then proceed to see if she's bleeding and get a fist-sized clot out, but otherwise it's ok.] 
"Ok, let me get the attending."

Yeah, that's me on my toes.  They may be short little toes and it may have been 5am, but yeah, I did things right.  Of course, that was my first time where a patient needed my immediate attention.  And I was alone, at least in the room.  It was scary, exhilarating, and pretty awesome all at the same time.  In the end, it helped me have faith in my own abilities and, yeah, I really am a doctor. 

Duh

This article just came out in the New England Journal of Medicine and it states the obvious - that medical students are graduating from medical school with a mountain of debt.  Upon looking at that mountain of debt, some people who went to medical school to work in primary care or in underserved areas may be swayed to choose more lucrative careers. 

In short, I am one of those quarter of people who graduate from medical school with more than $200,000 in debt.  Yes, you read that right, $200,000.  I think it's a touchy subject because a lot of people don't like talking about money, especially debt money.  However, I think that it's important to consider.  That's enough money to buy a house.  That's enough money to start a small business.  With the interest and eventual pay back, I will have paid back nearly half a million dollars.  Half a million dollars.  Sometimes it's unbelievable to myself.  Sometimes I stop looking at the monthly interest statements that come to my mailbox, in hopes that maybe all of that debt will go away. 

With the mountains and mountains of debt that I have, I am definitely not one of those doctors that laments the "pitiful" income that doctors make.  I think we forget that, even as a resident, I get paid more than the average American.  Granted, I have gone through much more school and training than the average American, but that doesn't make me more privy to a decent income than the next person.  More often than not, I find myself grateful that I can make a more than comfortable income doing something that I love doing. 

I was also fortunate enough to have fallen in love with a medical specialty that pays more than the average primary care income.  With my debt, I am looking at monthly payments of $5,000, or annual payments of $60,000.  If I went into internal medicine or family medicine, that would be more than half of my take home income.  That's downright crazy.  There have to be better ways of going about doing this.  I understand that debt is something that is inevitable, but when is too much too much? 

R&R

It's vacation time!!! 

Nights like these

Last night, I did a c-section where the lady lost almost two liters of blood (maybe due to the fact that she had been in labor for two days, or the fact that her baby was 9 pounds plus, or maybe due to the fact she had an infection, or due to the fact that I have bad luck) and needed a transfusion. 

The board (what we call the list of patients on Labor and Delivery at any point in time) was packed full and every patient was complicated - with diabetes, drug use, placental abruption, placental previa (where the placenta covers the cervix), pre-term labor, etc etc.  Lots of fun stuff to be had. 

Unfortunately, with all the excitement, I get no sleep and I only racked up two deliveries (including the c-section).  Oh, to top it off, as I'm rounding this morning, I slip and fall flat on my butt and bang my knee against the ground.  Just what I needed. 

Er, I just want to curl up into a ball. 

Aches of all sorts

(Image courtesy of Wikipedia)

Two quotes from an article I'm reading right now:

"Sensible sun exposure can provide an adequate amount of vitamin D3, which is stored in body fat and released during the winter, when vitamin D3 cannot be produced. Exposure of arms and legs for 5 to 30 minutes (depending on time of day, season, latitude, and skin pigmentation) between the hours of 10 a.m. and 3 p.m. twice a week is often adequate."

and

"32% of healthy students, physicians, and residents at a Boston hospital were found to be vitamin D–deficient, despite drinking a glass of milk and taking a multivitamin daily and eating salmon at least once a week."

Now, I'm convinced that my joint pain is secondary to rickets. I'm getting rickets. Or maybe it's just that I'm getting older. Either way, it's no fun.

Somewhere, someone is thinking...

to ban shoes from all press briefing rooms. 

And in that same room, someone is pulling their hair out.

Just one of those days

I love it when it rains but then the sun comes out. It's just absolutely beautiful. Just a nice thought on a post-call day.

Farmer's Markets

I love going to farmer's markets, which is a natural extension of my love for fresh, delicious food. One of my favorites in the south bay thus far is the Campbell's Farmer's Market. It's close to my house, open year round (on Sundays), and has a good variety of farm fresh produce, meats, crafts, and ready made food. On my most recent excursions, I have gotten way too many pomegranates, orchids, and a yummy tamale.
They also have live music, which lends nicely to the atmosphere.

A time for firsts

The first Vietnamese-American Congressperson was elected recently. How cool is that? Well, not too cool that it's taken this long, but pretty cool that this happened - and in the South.

This still leaves room for the First Vietnamese-American woman in the House of Representatives, or better yet, the First Vietnamese-American in the Senate. Let the plotting begin.

Intern life

A sliver of my schedule for the last few days:

• Work 6am-6pm Monday - Friday
• Work Thursday night until Friday morning at 9am
• Sleep from 11am Friday to 6pm Friday
• Awake from 6pm to 10pm Friday
• Sleep 11pm Friday to 6am Saturday
• Work 6am Saturday to 9am Sunday
• Sleep from 10am Sunday to 6pm Sunday
• Awake from 6pm Sunday to 10pm Sunday
• Work again 6am Monday
• etc, etc

So, for the last 5 days, I have only been "awake" and not at work for less than 10 hours.  10 hours.  To life a normal life.  And I looked at my schedule for this month.  I get a whopping one day off in nearly 3 weeks - until my vacation!  I cannot express how excited I am for vacation.  Why did I wait 6 months to take vacation my intern year?  Am I crazy?  If I wasn't before, I certainly am now.