kidzdoc's No Fluff Zone, Act 3

Currently reading:

    

Madame Verona Comes Down the Hill by Dimitri Verlhurst
Chloroform: The Quest for Oblivion by Linda Stratmann
Evicted: Poverty and Profit in the American City by Matthew Desmond
Samarkand and Other Markets I Have Known by Wole Soyinka

Completed books: (TBR = book acquired prior to 1/1/16)

January:
1. Nutshell by Ian McEwan
2. A Question of Power by Bessie Head TBR
3. The Assault by Harry Mulisch

Books acquired and purchased:

January:
1. The Lives of Things by José Saramago (1 January, Verso e-book ($1))
2. Syria Burning: A Short History of a Catastrophe by Charles Glass (1 January, Verso e-book ($1))
3. Human Acts by Han Kang (12 January, LT Early Reviewers ARC)

Classic 20th Century Novels from the African Diaspora

Betsey Brown by Ntozake Shange
Blind Man with a Pistol by Chester Himes
The Emigrants by George Lamming
The Famished Road by Ben Okri
If Beale Street Could Talk by James Baldwin
Invisible Man by Ralph Ellison (re-read)
The Marrow of Tradition by Charles W. Chesnutt
Maps by Nuruddin Farah
Moses, Man of the Mountain by Zora Neale Hurston
Native Son by Richard Wright
Petals of Blood by Ngũgĩ wa Thiong'o
A Question of Power by Bessie Head
Sozaboy by Ken Saro-Wiwa
Texaco by Patrick Chamoiseau

Notable 21st Century Literature from the African Diaspora

Abyssinian Chronicles by Moses Isegawa
Blackass by A. Igoni Barrett
Black Deutschland by Darryl Pinckney
The Book of Memory by Petina Gappah
Claire of the Sea Light by Edwidge Danticat
That Deadman Dance by Kim Scott
The Drift Latitudes by Jamal Mahjoub
Fifteen Dogs by André Alexis
Foreign Gods, Inc. by Okey Ndibe
Ghana Must Go by Taiye Selasi
The Good Lord Bird by James McBride
Half of a Yellow Sun by Chimamanda Ngozi Adichie
Juice! by Ishmael Reed
Ladivine by Marie NDiaye
Nervous Conditions by Tsitsi Dangarembga
Pym by Mat Johnson
Someone Knows My Name by Lawrence Hill
The Turner House by Angela Flournoy
The Underground Railroad by Colson Whitehead
Wading Home: A Novel of New Orleans by Rosalyn Story
Welcome to Braggsville by T. Geronimo Johnson
Zone One by Colson Whitehead

Nonfiction from the African Diaspora

Between the World and Me by Ta-Nehisi Coates
Beyond Black and White: From Civil Rights to Barack Obama by Manning Marable
Black in Latin America by Henry Louis Gates, Jr.
Changing My Mind: Occasional Essays by Zadie Smith
Darkwater: Voices from Within the Veil by W.E.B. Du Bois
Democracy in Black: How Race Still Enslaves the American Soul by Eddie S. Glaude, Jr.
Going to Meet the Man by James Baldwin
If They Come in the Morning … : Voices of Resistance, edited by Angela Y. Davis
In My Father's House: Africa in the Philosophy of Culture by K. Anthony Appiah
Known and Strange Things: Essays by Teju Cole
Letter to Jimmy by Alain Mabanckou
The Lights of Pointe-Noire by Alain Mabanckou
The New Jim Crow: Mass Incarceration in the Age of Colorblindness by Michelle Alexander
More Than Just Race: Being Black and Poor in the Inner City by William Julius Wilson
A Power Stronger Than Itself: The AACM and American Experimental Music by George E. Lewis
Respect Yourself: Stax Records and the Soul Explosion by Robert Gordon
Stamped from the Beginning: The Definitive History of Racist Ideas in America by Ibram X. Kendi
Tradition and the Black Atlantic: Critical Theory in the African Diaspora by Henry Louis Gates, Jr.
The Wretched of the Earth by Frantz Fanon

Autobiographies, Biographies and Memoirs from the African Diaspora

Aké: The Years of Childhood by Wole Soyinka
The Audacity of Hope by Barack Obama
Black Boy by Richard Wright
Dreams from My Father by Barack Obama
Frantz Fanon: A Biography by David Macey
I Never Had it Made by Jackie Robinson
The Last Holiday: A Memoir by Gil Scott-Heron
Long Walk to Freedom by Nelson Mandela
Mingus Speaks by John F. Goodman
Street Poison: The Biography of Iceberg Slim by Justin Gifford
Sweet Thunder: The Life and Times of Sugar Ray Robinson by Wil Haygood
Zenzele: A Letter for My Daughter by J. Nozipo Maraire

2017 Booker Prize longlist: TBD

2017 Man Booker International Prize longlist: TBA 3/17/14

2016 Booker Prize longlist:

Paul Beatty, The Sellout
J.M. Coetzee, The Schooldays of Jesus
A.L. Kennedy, Serious Sweet
Deborah Levy, Hot Milk
Graeme Macrae Burnet, His Bloody Project
Ian McGuire, The North Water
David Means, Hystopia
Wyl Menmuir, The Many
Ottessa Moshfegh, Eileen
Virginia Reeves, Work Like Any Other
Elizabeth Strout, My Name Is Lucy Barton
David Szalay, All That Man Is
Madeleine Thien, Do Not Say We Have Nothing

2016 Man Booker International Prize longlist:



José Eduardo Agualusa (Angola), A General Theory of Oblivion, translated by Daniel Hahn
Elena Ferrante (Italy), The Story of the Lost Child, translated by Ann Goldstein
Han Kang (South Korea), The Vegetarian, translated by Deborah Smith
Maylis de Kerangal (France) The Heart: A Novel, translated by Jessica Moore
Eka Kurniawan (Indonesia), Man Tiger, translated by Labodalih Sembiring
Yan Lianke (China), The Four Books, translated by Carlos Rojas
Fiston Mwanza Mujila (Democratic Republic of Congo/Austria), Tram 83, translated by Roland Glasser
Raduan Nassar (Brazil), A Cup of Rage, translated by Stefan Tobler
Marie NDiaye (France), Ladivine, translated by Jordan Stump
Kenzaburō Ōe (Japan), Death by Water, translated by Deborah Boliver Boehm
Aki Ollikainen (Finland), White Hunger, translated by Emily Jeremiah & Fleur Jeremiah
Orhan Pamuk (Turkey), A Strangeness in My Mind, translated by Ekin Oklap
Robert Seethaler (Austria), A Whole Life, translated by Charlotte Collins

Iberian Literature and Nonfiction

A Bad End by Fernando Royuela
The Calligraphy of Dreams by Juan Marsé
Catalonia: A Cultural History by Michael Eaude
The Dolls' Room by Llorenç Villalonga
Fado Alexandrino by António Lobo Antunes
The Gray Notebook by Josep Pla
The History of Catalonia by F. Xavier Hernàndez
The Inquisitors' Manual by António Lobo Antunes
Life Embitters by Josep Pla
Monastery by Eduardo Halfon
Obabakoak by Bernardo Atxaga
Paris by Marcos Giralt Torrente
Private Life by Josep Maria de Sagarra
The Selected Stories of Mercé Rodoreda
The New Spaniards by John Hooper
Things Look Different in the Light by Medardo Fraile
The Yellow Rain by Julio Llamazares

Medicine, Illness and Public Health

AIDS at 30: A History by Victoria A. Harden
An Anatomy of Addiction: Sigmund Freud, William Halsted, and the Miracle Drug Cocaine by Howard Markel
Asleep: The Forgotten Epidemic That Remains One of Medicine's Greatest Mysteries by Molly Caldwell Crosby
Bedlam: London and Its Mad by Katharine Arnold
Death in a Small Package: A Short History of Anthrax by Susan D. Jones
Hope in Hell: Inside the World of Doctors Without Borders by Dan Bortolotti
Jonas Salk: A Life by Charlotte DeCroes Jacobs
The Killer of Little Shepherds: A True Crime Story and the Birth of Forensic Science by Douglas Starr
The Last Asylum: A Memoir of Madness in Our Times by Barbara Taylor
Madhouse: A Tragic Tale of Megalomania and Modern Medicine by Andrew Scull
Madmen: A Social History of Madhouses, Mad-Doctors & Lunatics by Roy Porter
The Man Who Closed the Asylums: Franco Basaglia and the Revolution in Mental Health Care by John Foot
Mania: A Short History of Bipolar Disorder by David Healy
Missing Microbes: How the Overuse of Antibiotics is Fueling Our Modern Plagues by Martin J. Blaser, MD
The Price of Silence: A Mom's Perspective on Mental Illness by Liza Long
Proper Doctoring: A Book for Patients and Their Doctors by David Mendel
States of Mind: Experiences at the Edge of Consciousness by Wellcome Collection

The Rise of Populism and Related Current Affairs

The Unwinding: An Inner History of the New America by George Packer
Strangers in Their Own Land: Anger and Mourning on the American Right by Arlie Russell Hochschild
Hillbilly Elegy: A Memoir of a Family and Culture in Crisis by J.D. Vance
Listen, Liberal: Or, Whatever Happened to the Party of the People? by Thomas Frank
The Populist Explosion: How the Great Recession Transformed American and European Politics by John B. Judis
White Trash: The 400-Year Untold History of Class in America by Nancy Isenberg

Reading Globally

Quarter 1: Works by writers from the Benelux countries



The Assault by Harry Mulisch
The Darkroom of Damocles by Willem Frederik Hermans
Madame Verona Comes Down the Hill by Dimitri Verhulst
Rituals by Cees Nooteboom
Roads to Santiago by Cees Nooteboom
Three Bedrooms in Manhattan by Georges Simenon

Quarter 2: Travel writing by non-European and non-North American authors



The European Tribe by Caryl Phillips
Looking for Transwonderland: Travels in Nigeria by Noo Saro-Wiwa
One Day I Will Write About This Place: A Memoir by Binyavanga Wainaina

Quarter 3: Works by writers who write in what are considered minority languages within their own country

Quarter 4: Writers from the Scandinavian countries and associated territories

Voices of Color/Social Justice

Al' America: Travels Through America's Arab and Islamic Roots by Jonathan Curiel
Chavs: The Demonization of the Working Class by Owen Jones
A Crime So Monstrous: Face-to-Face with Modern-Day Slavery by E. Benjamin Skinner
Criminal of Poverty: Growing Up Homeless in America by Tiny, aka Lisa Gray-Garcia
To Die in Mexico: Dispatches from Inside the Drug War by John Gibler
Dying to Live: A Story of U.S. Immigration in an Age of Global Apartheid by Joseph Nevins
The Ethics of Identity by Kwame Anthony Appiah
Ethnicities: Children of Immigrants in America, edited by Rubén G. Rumbaut and Alejandro Portes
Evicted: Poverty and Profit in the American City by Matthew Desmond
For the Muslims: Islamophobia in France by Edwy Plenel
The Good Immigrant, edited by Nikesh Shukla
A History of Violence: Living and Dying in Central America by Óscar Martínez
The Honor Code: How Moral Revolutions Happen by Kwame Anthony Appiah
How Does it Feel to Be a Problem?: Being Young and Arab in America by Moustafa Bayoumi
Howard Zinn on Race by Howard Zinn
Latino Americans: The 500-Year Legacy That Shaped a Nation by Ray Suarez
Latino Immigrants and the Transformation of the U.S. South by Mary E. Odem
Men Explain Things to Me by Rebecca Solnit
The Mosaic of Islam: A Conversation with Perry Anderson by Suleiman Mourad
The Muslims Are Coming!: Islamophobia, Extremism, and the Domestic War on Terror by Arun Kundnani
The Other Slavery: The Uncovered Story of Indian Enslavement in America by Andrés Reséndez
A People's History of the United States by Howard Zinn
Rebel Music: Race, Empire, and the New Muslim Youth Culture by Hisham D. Aidi
Serve the People: Making Asian America in the Long Sixties by Karen L. Ishizuka
Trans: A Memoir by Juliet Jacques
Violent Borders: Refugees and the Right to Move by Reece Jones
We Are All Moors: Ending Centuries of Crusades Against Muslims and Other Minorities by Anouar Majid
We Are the Ones We Have Been Waiting For: Inner Light in a Time of Darkness by Alice Walker
We Should All Be Feminists by Chimamanda Ngozi Adichie
What Everyone Needs to Know About Islam by John L. Esposito
Who Are We: And Should It Matter in the Twenty-First Century? by Gary Younge

2017 Wellcome Book Prize longlist: TBA 1/30/17

2016 Wellcome Book Prize shortlist:



Playthings by Alex Pheby
It's All in Your Head by Suzanne O'Sullivan
The Last Act of Love by Cathy Rentzenbrink
Neurotribes by Steve Silberman
Signs for Lost Children by Sarah Moss
The Outrun by Amy Liptrot

2015 Wellcome Book Prize shortlist:



The Iceberg by Marion Coutts
Do No Harm by Henry Marsh
Bodies of Light by Sarah Moss
The Incredible Unlikeliness of Being by Alice Roberts
My Age of Anxiety by Scott Stossel
All My Puny Sorrows by Miriam Toews

Planned books to read in January:

The Assault by Harry Mulisch
Chloroform: The Quest for Oblivion by Linda Stratmann
Democracy in Black: How Race Still Enslaves the American Soul by Eddie S. Glaude, Jr.
Evicted: Poverty and Profit in the American City by Matthew Desmond
Madame Verona Comes Down the Hill by Dimitri Verhulst
The Mortifications by Derek Palacio (LT Early Reviewers book)
My Struggle: Book Three by Karl Ove Knausgaard
Nutshell by Ian McEwan
A Question of Power by Bessie Head

Ooo, first through the door. Nothing erudite to say though. Waving...

Actually, very relevant MLKjr quote.

I like your topper, Darryl.

Happy new one!

Happy new thread. Excellent topper...

Happy new thread, Darryl, perfect thread topper.

>12 Caroline_McElwee:, >13 katiekrug:, >14 jessibud2:, >15 FAMeulstee: Welcome to Caroline, Katie, Shelley and Anita! Please make yourselves at home.

*searches for Jim*

Happy new thread! Hope you like the Cholula! I came across a new food place - not really a restaurant since you stand in line to order. They serve Mediterranean based salad or grain bowl, you pick your own veggies and protein and sauces. Anyway, they had something called harissa I'd never head of before. Turns out it's pepper paste from Tunisia that was outstanding. Apparently one can get it by the jar at international markets, so I'm off on a hunt for it soon.

Happy new thread, Darryl!

Happy new thread!

>17 drneutron: Thanks, Jim. What took you so long?

I see that my local Kroger stocks Cholula hot sauce. I plan to go there early tomorrow morning after my shift ends, and I'll pick up a bottle while I'm there.

The food establishment you describe sounds a bit familiar to Marrakesh Mediterranean Market in Ponce City Market in Midtown Atlanta, except that Marrakesh offers entrées and salads to which you can add mezzes or other sides.

I've heard of harissa, but I don't think I've ever had it. There is an international market just outside of Atlanta, the Buford Highway Farmers' Market, that I intend to go to soon, and I'll look for this pepper paste when I go there.

>18 scaifea: Thanks, Amber!

>19 ChelleBearss: Thanks, Chelle!

Another batch of the lamb, mushroom, pasta dish was made here. Are used canned tomatoes and homemade frozen tomato sauce which had no seasoning added. I think i'd modify the seasonings a bit but will add it to the recipe file. Thanks for sharing.

Happy new thread, Darryl. I like your topper.

Just marking my spot, Darryl. Great King quote! A colleague and I were conversing last week about great orators ... King was certainly one of the best.

>20 kidzdoc: I was standing on >17 drneutron:'s tail.

>20 kidzdoc: A few restaurants near me serve eggs in harissa sauce at brunch -shakshuka. Yum.

Book #2: A Question of Power by Bessie Head

  

My rating:

"We have a full docket on you. You must be very careful. Your mother was insane. If you're not careful you'll get insane just like your mother. Your mother was a white woman. They had to lock her up, as she was having a child by the stable boy, who was a native."

Bessie Head (1937-1986) was born in Pietermaritzburg, South Africa, the product of a relationship between a wealthy white woman and an unknown black man, who was believed to be a farm hand on the family ranch where her mother, Bessie Amelia ("Toby") Emery, lived. Toby was committed to a local mental hospital after her parents learned of her pregnancy, which was taboo in that segregated country. She gave birth to Bessie in this hospital, and as she was deemed to be too mentally ill to raise the child Bessie was sent to live with a white family, who subsequently disowned her after they discovered that she was a "Coloured" (mixed race) girl. Her mother committed suicide after Bessie was taken away from her, so she was placed in a foster care with a black family until she was 13, and then sent to live in a mission orphanage in Durban.

After she earned a teaching certificate she left the orphanage and taught briefly in Durban before she moved to Johannesburg to become a journalist. Her career was marred by racism and sexism, as she was the only female journalist for the publication she worked for. However, her career allowed her to meet members of the Pan Africanist Congress in the early 1960s, who sought the removal of the apartheid system in South Africa and a return to self government by black Africans. She was introduced to her future husband, Harold Head, an anti-apartheid activist, who she married in 1961 and subsequently divorced three years later. She joined the Pan Africanist Congress, and her activities led to her arrest and imprisonment. She sought asylum and left South Africa for neighboring Botswana with her son in 1964. She was accepted as an alien refugee there, on the condition that she would never attempt to return to her home country.

Bessie Head taught and became an agricultural worker in Botswana, but was very lonely and was ostracized in her new surroundings, which led to a nervous breakdown and hospitalization in a mental health facility. She began to write after her release from hospital and slowly gained recognition for her short stories and novels, which allowed her to escape crushing poverty that resulted from her loss of work. Just as she was becoming an acclaimed writer she contracted hepatitis, which led to her premature death at the age of 48.

A Question of Power, which was published in 1973, is a semi-autobiographical novel whose protagonist, Elizabeth, is a mixed race South African who fled to the Botswanan village of Motabeng, where she became a schoolteacher. Elizabeth, like her creator, struggled to fit into Botswanan society, and slowly descended into madness. The narrative features her unusual relationship with two mysterious men, who may or may not be real, and her hallucinatory fantasies are interspersed with her brief lucid periods. The novel can also be viewed as a metaphor for the disturbed state of apartheid South Africa, as well as the effects that this system had on its Black and Coloured residents.

A Question of Power was a disturbing and difficult book to read, as I had a hard time following Elizabeth's schizophrenic thoughts. It is a powerful and inspired work of literature, though, and I do intend to read more of Bessie Head's books, particularly her autobiography A Woman Alone, in the near future.

>17 drneutron: & >20 kidzdoc: Harissa is lovely. There is a harissa paste here that the boyfriend uses it sometimes when marinading or rubbing meat, or in with roast vegetables like onions, peppers, aubergine etc.

On questions from your last thread:

No, I don't believe there is a website specifically for US/UK food conversions but there should be! I generally just ask google and the information is usually around, or I ask the boyfriend who lived in SC for six months or so, so knows a little about these things.

Passata is definitely supposed to be a deeper, more tomatoey flavour but the brand of passata and chopped tomatoes we'd bought have been really disappointing both times we've used them, so we'll look for a new brand and try a couple.

And yes, you can eat kale raw. I'm not a fan as I don't like the texture of it, but our guinea-pigs love it. We buy at least one 500g bag of a kale a week for them, often more, and it vanishes. Usefully it's often in the 'reduced' section of the supermarket because it's expiring that day, but of course the animals don't mind. When we went shopping on Saturday, the 500g bag of kale was on sale anyway (£2 down to £1) but a bag in the reduced section was 25p. We also got 2 packages of baby chinese greens, one for the guinea-pigs and one for us, both reduced to 20p each. Bargains were had - or they would have been if we hadn't then bought excessive amounts of meat, cheese and wine!

Here is a picture of the Slap Yo Mama spices:



We use it or the Tony Chachere's on a lot of things, but especially for The Big Sandwich: We mix together equal parts of mayo and spicy mustard with a healthy addition of the creole spices. Spread generously over a split loaf of Italian bread. Layer sliced meats (ham, salami, turkey are our go to, but you can use anything), provolone cheese and very thinly sliced (we use a mandolin slicer) layers of tomato, green pepper and onion. Wrap in foil and cook at 350 for about an hour.

Cut into slices, this is a big hit for football watching parties, tailgates, etc. I firmly believe the Tony Chacheres makes the sandwich.

Book #3: The Assault by Harry Mulisch



My rating:

This brilliant novel opens in the Dutch city of Haarlem in early 1945, during the Hongerwinter, the famine that afflicted millions of residents of the German-occupied western portion of the Netherlands due to a blockage of food and fuel by the Nazis. Anton Steenwijk, a 12 year old boy, and his parents and older brother were spending a quiet evening at home, huddled around a lantern to keep warm and trying to keep hunger out of their minds. Their peace was broken by the sound of nearby gunshots, and when they looked outside they noticed the body of a man lying in front of their next door neighbors' house. Those neighbors then moved the body to the front of the Steenwijk's house, and they saw that the dead man was the local Inspector of Police, a notorious collaborator who was reviled and feared for his cruelty towards his fellow citizens. The family panicked, and after German soldiers arrive the Steenwijks are falsely accused of the murder. Anton is separated from the rest of his family, taken briefly to a local prison for the night, and later he learns of their fate.

Anton is sent to live with his well to do uncle and aunt in Amsterdam, where he studies and establishes himself in a notable profession. He is haunted by the events of that fateful evening, and although his future is a bright one with a beautiful young wife and child his view is to the past, as he desires to learn what happened to his parents and brother, and to find out more about the events that led up to the Inspector's shooting. He eventually meets key people who were involved with or were observers of the episode, and those encounters, along with fragments of his memory that he is able to uncover, permit him to piece together the full story of that night in Haarlem.

The Assault is a powerful and unforgettable novel about memory, responsibiiity, and one's past history and how it affects, and sometimes mars, the future, which is relevant not only to survivors of war and personal strife, but to anyone who has experienced a difficult or eventful past life. The book was the source of a movie of the same name, which won won the 1986 Academy Award for Best Foreign Language Film, and the Golden Globe Award for Best Foreign Language Film that same year. Harry Mulisch is considered to be one of the Great Three Dutch postwar writers, along with Willem Frederik Hermans and Gerard Reve, and this outstanding novel makes it easy to see why this is the case.

>28 michigantrumpet: Oh, that sounds great! *scribbles down instructions*

>29 kidzdoc: Great review, Darryl. My library has an audio copy. Will take it when I'm there the next time.
Happy new thread.

>29 kidzdoc: I should have read this last year, moving it up the tbr pile. Great review.

I use harissa quite often in my cooking now that it's more readily available here. I've ended up getting it online in a bulk pack as I use it so often that the little gourmet containers from the supermarket just don't work for me. My son really loves Ethiopian chili powder, he sprinkles it on almost all his food. We can only get it from an Ethiopian restaurant and go there every few months to have a meal and buy the spice.

So....how does one put those little red check marks on their list?

>29 kidzdoc: Outstanding review, Darryl, it is a very good book.

Of the Great Three, I think Mulisch was the best storyteller.

Fabulous review of The Assault, Darryl. And a movie, to follow up with. Sounds like one for the list.

Sometimes you can find Harissa at places like World Market, etc., but it is almost always available at Trader Joe's, Fresh Market/Whole Markets, and I have even found it in my local Publix. I find I have to be careful using it, as some people don't like it. But then some people don't like Tabasco or any kind of spicy sauce.

It's interesting the different degrees of 'heat' that people from different countries think acceptable in their food. In the U.K. spicy food is very common indeed and most people will tolerate a certain level of spiciness. I remember though when we went to Malaysia we spent an afternoon on a trip with some people from Croatia, who were struggling hugely with the food, as Croatian cooking just doesn't contain spice. Whereas we didn't find it a problem at all!

>21 Helenoel: You're welcome, Helenoel; I'm glad that you also enjoyed the lamb & mushroom pasta.

>22 RebaRelishesReading: Thanks, Reba.

>23 lit_chick: Thanks, Nancy; Yes, MLK was one of the greatest orators of all time. It was a pleasure to listen to excerpts from some of his most famous and lesser known speeches on NPR (National Public Radio) when I drove to the hospital not long ago.

Happy New Thread, Darryl! Great MLK quote up top.

Two excellent reviews, too, of the Bessie Head book and The Assault. Thumbs from me for both. I'd never heard of The Assault before; I'm adding it to my WL.

>24 Morphidae: Jim has a tail?!

>25 ffortsa: I had my first shakshuka when Paul Harris from Club Read and I went to Café Also in London two or three years ago; that's the restaurant that Paul Cranswick, Hani, Joe, Debbi, Caroline, Bianca, Claire, I and at least one or two others met this past September. It was delightful, and the meals I've had there subsequently have all been outstanding. I think I can claim it as my favorite London restaurant.

>27 lunacat: I clearly need to get harissa. One of my partners that is working with me tonight is from Ghana, so I'll ask her if she knows where to buy it, although I'm all but certain that the Buford Highway Farmers' Market east of Atlanta will sell it.

Did your boyfriend live in South Carolina for six months, Jenny?

I'm not certain that passata is sold routinely here. My local Kroger doesn't sell it, and my nearby Publix has a product with "passata" in the name, but it doesn't look to be what I saw online.

Hmm...we seem to have established that guinea pigs like raw kale, but what about humans? ;-)

>28 michigantrumpet: The Big Sandwich sounds great, Marianne! I'll definitely keep that in mind for future consumption. Is it larger than a Dagwood sandwich?



>30 drneutron: I agree, Jim. That's a keeper, and possibly a sandwich to be made on Super Bowl Sunday.

>31 Ameise1: Thanks, Barbara. Anita, Paul and I all gave The Assault 4-1/2 stars or higher within the past two days, so I hope that others decide to read it as well.

>32 avatiakh: Thanks, Kerry. I'll have to see if others besides the three of us have read or are planning to read The Assault for this quarter's Reading Globally challenge.

I'm glad to hear that you're also a fan of harissa. I'll definitely buy and try it soon. I checked Publix's web site, but it doesn't carry it; I would have been surprised if it did, even though that supermarket carries a wide selection of items. Hmm...what about Whole Foods? Checking...ah! It looks as though it might. I'll go there this week or next and check.

>33 tangledthread: Here's the GIF I use:

http://bouncetime.co.uk/index_files/checkmark.gif

I use an img width of 15.

>34 FAMeulstee: Thanks, Anita. I'll look at your review shortly, and hopefully catch up with everyone else's threads tonight.

I use a slightly more delicate Rose Harrisa.

>35 lit_chick: Thanks, Nancy. Anita and, I believe, Paul have also reviewed it either yesterday or today.

I'm eager to see the movie version of The Assault, especially since it won multiple film awards.

>36 benitastrnad: Thanks, Benita. I'll have to check to see if Trader Joe's sells it as well. The closest one to me is in the plaza on Monroe Drive, close to 9th Street in Midtown, which is a short distance from the southeastern edge of Piedmont Park and is across from the stadium next to Henry Grady High School, roughly a mile from where I live. Whole Foods is not much further, in the shopping center off of Ponce de Leon across from what is now Ponce City Market.

>37 SandDune: There are also significant regional differences in the US, Rhian. People from Louisiana and Texas are far more used to spicy foods than those from the Midwest are, in general. There are also regional specialties that would either be unheard of elsewhere, or if they were served in a restaurant you would be loathe to try them. Cheese steaks are generally terrible outside of Philadelphia; gumbo, jambalaya and étouffée probably should not be ordered outside of south Louisiana; and deep dish pizza is best made in Chicagoland.

This is the kind of passata we have (though not this brand):



Yeah, he lived in South Carolina when he was 21/22 for about six months I think, with his girlfriend at the time who was/is American. So he has a slight idea about US food but not for a while.

I wouldn't eat raw kale, but then again I wouldn't eat it cooked either except in soups etc!

>39 jnwelch: Thanks, Joe! I'm long overdue a visit to the café, and I see that you've opened a new branch of it. See you soon.

I would definitely add The Assault to your wish list. It's less than 190 pages in length, and even though I bought my copy in the Netherlands my edition was published in the US, so you should be able to find it without much difficulty. I'm not sure about A Question of Power, though.

>43 Caroline_McElwee: Interesting; I would probably prefer a spicier harissa, but I'll look for rose harissa as well.

>45 lunacat: Thanks for posting the photo of passata, Jenny. I'll look for it when I go to the supermarket early tomorrow after tonight's shift ends.

I haven't visited Charleston, SC yet, but I hope to do so in the spring.

>40 kidzdoc: Yes. Jim has a tail. But we aren't supposed to talk about it. Oops. You notice he didn't even react to my post?

>44 kidzdoc: In the Midwest, ketchup is considered spicy. And there are certain dishes you can't even FIND outside their region, like grits outside the South. I went without grits for decades in the Midwest until I could find a decent replacement I could make at home. But forget getting it in a restaurant. In the South, it's more like, "What type of breakfast do you want with your grits?"

>48 Morphidae: Ha! I'll have to look at Jim's Facebook page, to see if there are any photos of his tail.

In the Midwest, ketchup is considered spicy.

Yikes. Seriously?! Based on friends and coworkers of mine who grew up there, I believe you, though.

Grits should only be ordered in restaurants outside of the South with extreme caution. My mother is originally from Alabama, and she and my father both cook grits in the old fashioned Southern style, using a double boiler on low medium heat, so I've been spoiled on what they are supposed to taste like. I'll order them in Atlanta, but I would be loathe to do so in the Northeast or, especially, the Midwest, save for Chicago, as it experienced a large influx of black Southerners from Mississippi and elsewhere during The Great Migration.

Grits, made well, are fabulous. I haven't made shrimp cheese grits in the longest time, and I adore fish and grits, which my mother often made when we went fishing on Long Island or at the Jersey Shore.

Grits are much more commonly found outside the South now but usually on lunch or dinner menus in some form of shrimp and grits or similar-type dish. My local diner has decent grits at breakfast, too.

>17 drneutron:, >20 kidzdoc: I've purchased harissa from igourmet.com. It's good! I purchased it to make a Moroccan stew.

There was a lovely recipe for shakshuka in the NYT a few months ago; I'm sure you can search for it online.

>47 kidzdoc: Charleston is probably my favorite city. I hope you enjoy your visit there.

I must comment on the half & half from your previous thread. This morning I discovered my milk was out of date, so I used half and half on my cereal. Probably not the healthiest thing in the world, but it was good.

>49 kidzdoc: I have my mom's old double boiler for grits and other fun things. Unfortunately, it doesn't work with my ceramic top stove because of the materials from which it was made. I really wish I had a gas one since there is a gas line to the house. Maybe when this one wears out! Instant grits are "of the devil." Slow-cooked is the only way to go. At least there are other ways to create your own double boiler!

Happy new thread, Darryl.

Never had grits but am of course quite willing to try. Grit is something we put on the roads in England to keep them from being too slippery.

>48 Morphidae: Ketchup is considered spicy?!

Darryl, question. Are the 3 John Lewis books all graphic novels or just the last one? I would love to get my hands on them and will see if my library has or can get them. But it would be good to know if all three are the same format. I will admit that until I started hearing the warbling here on LT about them, I was not familiar with his name. The more I am learning though, the more he sounds like someone I want to know more about.

Happy new thread! The John Lewis books are sold out around here after Trump's comments

Great review of The Assault. I'll put it on my wish-list. I can't say I've eaten grits at all and I don't think I'd be keen on them. When I was quite young, we used to have oatmeal mixed with Red River Cereal, https://en.wikipedia.org/wiki/Red_River_Cereal, cooked on top of a double boiler. You would then add brown sugar and / or milk, whatever suited you. My great aunt cooked it every morning, but once we moved away with my mom and dad at the helm, we just had cold cereal every morning. But I have fond memories of porridge. I'm not sure I can speak to Canada's food differences. I confess I am not much of a foodie. Here in Vancouver you can find every kind of cuisine, and what is really popular seems to be sushi and a large variety of Chinese/ Vietnamese / Korean foods etc, but I'm not much for them. Raw fish? No thanks.

Just caught up on the last thread and this one ... wondering if you have posted that etouffee recipe somewhere? I would love to get my husband to make that.

Happy New Thread, Darryl! Great topper quote. The Good doctor is Red-Hot! 50 unread posts on the last thread. 57 here. Wow! Nailin' it!

It looks like I better request The Assault. You and Paul have been raving about it. Sounds great.

I hope you are enjoying Evicted.

>49 kidzdoc: >53 PaulCranswick: Said mostly in jest as a lot of Midwestern food is non-spicy meat and potatoes, casserole, or other "homestyle" type meals. Something you'd get in the 1950s. Which I, personally, am fine with. It also depends on your age. You start getting folks in the 30's and 40's, especially the 20s and the cuisine changes noticeably. Still not terribly spicy but they do get more adventurous.

***

I'm a butter and salt on my grits gal. On a rare occasion, I'll have cheese. I've never had shrimp though I'd be willing to try. Fish? Nopenopenope. Sugar and milk? Oh, he** no. Grits are a savory not a sweet. Blech,

>50 katiekrug: I agree with you, Katie. I have had good grits in at least two restaurants in Manhattan, Acme on Great Jones Street in Greenwich Village near NYU's main campus, which I don't think is there any more (checking...it is still there, but it seems to be under new management, and the menu is completely different from before), and the Upper West Side restaurant where we had an LT meet up several years ago...Peter's Pickles, I think? Checking...Jacob's Pickles, on Amsterdam Avenue between 84th & 85th Streets. I can't remember if I had grits when I went to Noho Star with Judy & Jim, but I'd be willing to try grits from there.

>51 Cariola: Thanks, Deborah; I hadn't heard of igourmet.com before. I'll keep them in mind if I can't find any spices locally, but in a city as large and diverse as Atlanta I should be able to find nearly everything in or just outside of town.

Last year, or possibly the year before I made a dish that was simiar to shakshuka, using a recipe from the NYT. Let's see...I found it. It was Indian-Spiced Tomato and Egg Casserole, which is, I think, a Persian variation of shakshuka. I liked it, and I should make it again soon.

>52 thornton37814: That's good to hear, Lori. Many of my friends here are also very fond of Charleston, and I'm probably one of the few people I know who hasn't gone there yet.

I no longer drink cereal with milk, but I think half & half would be fine as a milk substitute in a pinch.

My parents recently both a ceramic top stove, and they are in the process of giving me most of their old pots and pans, since they can no longer use them on that stove. Hopefully later this year I can spend two weeks with them, and drive to Philadelphia instead of flying as I usually do, and now that I have an SUV I have plenty of room to bring things back to Atlanta.

Instant grits are an abomination. They are almost as bad as Miracle Whip or Velveeta cheese.

>53 PaulCranswick: Thanks, Paul. We need to get you and Hani to New Orleans, to try the amazing cuisine there; I'm sure we would have no problem finding grits, preferably served with alligator tail, per Hani's request.

Sadly I think Morphy is right in her comment about Midwesterners finding ketchup spicy. I doubt that would be the case in any other part of the US!

>54 jessibud2: To my knowledge all three books in John Lewis's March series are all graphic novels. I've only read the first one, though.

>55 The_Hibernator: Thanks, Rachel! I wouldn't be surprised if his books are unavailable locally here as well, at least Intown.

>42 kidzdoc: kidzdoc Thanks for the gif.
We had the lamb & mushroom pasta tonight...it was delicious and perfect for tonight with an ice storm brewing outside. And it looked just like the recipe photo!

>56 vancouverdeb: Thanks, Deborah. I hope that The Assault does receive a wide readership here, as it certainly deserves it.

Given your current and past comments about your tastes in food I probably wouldn't recommend grits to you, although I wouldn't be completely surprised if you liked them. I will eat raw or cured fish with pleasure, particularly as sushi or ceviche, and smoked salmon, sturgeon and sable are unquestionably the Food of the Gods.

>57 ursula: I think I posted the crawfish étouffée in The Kitchen in 2015 when I first made it, Ursula. Let's see...yes, I did (http://www.librarything.com/topic/185043#5064247):

Crawfish étouffée (makes 6 to 8 servings)

Ingredients:

6 tablespoons butter
2 medium onions, chopped
2 garlic cloves, minced
1 medium green bell pepper, chopped
3 rib celery, chopped
1 pound peeled crawfish tails
1 (10 3/4-ounce) can cream of shrimp
1/2 cup water
½ to 3/4 cup dry white wine
Salt, cayenne and hot sauce to taste
Minced green onions for garnish
Add Tony Chachere’s Creole Seasoning to taste

Instructions:

In a heavy pot, melt the butter and sauté the onions, garlic, bell peppers, and celery until wilted.

Add the crawfish tails and cook for 10 minutes.

Add the soup, water, and wine and stir. Simmer for 30 minutes.

Add the seasonings and simmer another 10 minutes, add the green onions and serve over steamed rice.

Note: If you have extra serve it over baked fish.

I like this recipe after one day. Cook it and refrigerate for one day.
__________________________

I noted at the time that it made a blonde roux instead of a brown one, which I was more used to. I still enjoyed it, though. IIRC Jane (@janemarieprice) may have also posted her recipe in Club Read after I made it. I'll look for it shortly.

Well, while we are talking shellfish, we had Six Ingredient Steamed Mussels last night and it was really good:
http://www.food.com/recipe/easy-6-ingredient-steamed-mussels-in-beer-444441

accompanied by baked parmesan fennel bulbs...yum!

So I have a tail, eh? Mrsdrneutron claims I have a bit of devil in me... :)

>65 drneutron: See! See! Horns AND tail!

Yes, I just got a ceramic top stove and have to get some new pots and pans-but I discovered that using my new pan -my omelette was amazing-thin and slid out of the pan like the cooking shows! Who knew?

Happy new thread, Darryl!

Great food conversation. I love spicy food but, unfortunately, it doesn't like me. :(

>60 kidzdoc: - I really want to go to Jacob's Pickles. Hoping to get there soon!

>61 kidzdoc: - Thanks Darryl. I will see if I can find them here.

>63 kidzdoc: Thanks so much!

>58 msf59: Thanks, Mark. It been hard to keep up with my own thread, nonetheless any of the other popular ones, like yours.

Anita also raved about The Assault, along with Paul and I. They both gave it 4½ stars, but I thought it was worthy of a full 5 stars. The edition that Paul and I both read was published by Pantheon in the US, so it shouldn't be too difficult to find here.

I need to get back to Evicted, but I am enjoying it so far. I'll finish one of my TBR books on the history of medicine, Chloroform: The Quest for Oblivion, and then get back to Desmond's book.

Oops. I have another admission in the ER. Back later...

I just don't like spicy food. Nor do I like any type of mint. It's not the taste but rather I don't like the burning sensation in my mouth. If it fades within a second or two or if it is VERY VERY mild, I can deal with it as long as I have some milk. For instance, we put three to four shakes of cayenne into a large batch of goulash (10 - 12 servings).

Darryl--Happy MLK Day!! Tonight my daughter is making sushi using her Sushi Bullet. I cannot wait! Congrats on the new thread.

Hi Darryl and I will echo Kim's wishes for a happy MLK Day (although it is just about over by now).

I had brought home a copy of The Assault sometime last year but sent it back to the library unread. Your excellent review has me adding it to my list of seven books I get to buy later this month for my Thingaversary (which is really just a silly excuse to do what we would have done anyway, which is Buy. Books.).

I will be traveling to Tampa on Wednesday for a tightly-scheduled professional institute. I will have some free time on Saturday afternoon and I hope to find a local indie bookstore and go say hello to the Gulf. I grew up in Florida, near the Atlantic coast and I have wonderful memories of time spent on the gulf coast. I may have to splurge on some local shrimp.

Have a great week!

>59 Morphidae: I think I could tolerate traditional Midwestern fare for a week or so, but after that I'd have to make or find something else to eat. Jersey City, my home town, is probably one of the most diverse cities in the US, due to its proximity to NYC and to Ellis Island, where millions of immigrants landed on their arrival in the United States. Ellis Island is far closer to Jersey City than it is to Manhattan, as is the Statue of Liberty, and there is a bridge that connects Ellis Island to Jersey City. I just checked, and found out that Jersey City is the second most diverse city in the US, after Gaithersburg, Maryland, a suburb of Washington, DC, and a few spots higher than NYC. I was exposed to all sorts of cuisines when I lived there, particularly German, Irish, Italian, Dominican, Puerto Rican, Filipino, Indian, Jewish, Chinese and Jamaican. Many of my friends growing up were second or third generation immigrants, and there were often grandparents from the old country who spoke English as a second language if at all. The Lutheran church I attended as a child had an equal mixture of Germans and African Americans initially, before the Germans eventually began to move to the suburbs in the early 1970s (we did as well, after my father's department was transferred from Brooklyn to suburban Philadelphia). So, my taste in food is quite broad, and I'll eat, and enjoy, practically anything that is cooked well (except for horrific packaged foods like Kraft Macaroni & Cheese, canned chili (Beef-a-Roni, etc.), Hamburger Helper, plasticized cheeses like Velveeta, frozen pizzas and bagels, and the like).

Yes to butter and salt on grits. Yes to cheese. A big yes to shrimp. I adore fish & grits (and don't expect everyone else to), but the usual way I have my father's grits are with a lightly fried egg on top, cut into pieces and mixed into the grits (yumtastic!). Sugar and milk on grits is an inhuman atrocity, and anyone who eats their grits that way should be tarred, feathered, drawn and quartered, then banned from LibraryThing permanently.

And, to reemphasize the previous point, instant grits should only be eaten as a last resort before fatal starvation (and preferably without my knowledge, even if you are starving).

>62 tangledthread: You're welcome for the GIF, tangledthread. I'm glad that you also liked the lamb & mushroom pasta!

>64 tangledthread: Yum...I love steamed mussels! Thanks for posting the link to the recipe.

>65 drneutron:, >66 Morphidae: Ha! The rumor has been confirmed.

>67 torontoc: My silky omelet slid out of the pan just as it did in the Jamie Oliver video as well. It helps that I had essentially the exact same no stick frying pan, made by the same company as the one he uses. I use the heck out of them, and other than some slight peeling around the edges of some of the pots (which you can see in the photo I took of the Zuppa Toscana I made yesterday) they are as good as new.

>68 tymfos: Thanks, Terri! I love spicy food, although I don't like adding chili sauce just to make it hot; it has to add flavor to the dish.

>69 katiekrug: Sounds good, Katie. We liked what we had there, and we had a very good turnout for Sunday lunch at Jacob's Pickles. Oh...I forgot to mention that I made the mistake of ordering several types of pickles from there, thinking that I was getting one pickle of each type. As it turned out I was given four or five large jars of six or more pickles. Instead of asking for one jar I left with all of them, and lugged them back on the NJ Transit train back to Trenton, as I was staying with my parents in Langhorne, PA (about six miles away from Trenton station). I don't know what happened to the pickles, as we didn't eat any when I was there, but I suspect that my parents gave them away or discarded them. Stupid me.

Woo! My shift is almost over. It's been a busy one, but hopefully tonight (Tuesday) won't be as bad when I return in a little over 16 hours (it's nearly 12:50 am now).

>70 jessibud2: You're welcome, Shelley. Good luck on finding John Lewis's books in Toronto.

>71 ursula: You're welcome, Ursula. Do let me know how your husband's version of crawfish étouffée turns out.

>73 Morphidae: Nope. I can see that we were not separated at birth, Morphy. I love spicy food, and food with multiple spices like Mediterranean and Indian cuisine. I love mint as well.

we put three to four shakes of cayenne into a large batch of goulash (10 - 12 servings)

Don't you mean three or four fistfuls?

>74 Berly: Thanks, Kim! I'd love to see a photo of your daughter's sushi.

>75 EBT1002: Thanks, Ellen. Yep, it's nearly 1 am here, so MLK Jr Day ended a little less than an hour ago.

I hope that you do read The Assault, especially since Paul, Anita and I thought so highly of it.

Have a safe trip to Tampa on Wednesday. The weather here is supposed to be nice that day, but starting on Thursday we're in for at least three days' worth of rain. Tampa looks as though it will stay dry until Saturday, but hopefully the rain will hold off and not affect your trip there.

I'm caught up, I think, and it's 12:57, so I'm ready to blow this joint. Peace out, y'all.

I would struggle without any spicy food. My normal grocery shop will usually include fresh chillies, fresh ginger and replacements for any of the thirty or so spices that we would keep as standard. The local supermarkets all have a very good stock of spices, so something like harrissa is readily available.

>79 SandDune: I agree with you completely, Rhian; I would be lost if I didn't have the ability to readily obtain garlic, ginger, cumin, tumeric, cayenne pepper, jalapeño and habañero peppers, etc.

I stopped by Kroger supermarket on the way home from the hospital, and bought a bottle of Cholula Chili Lime Mexican hot sauce, along with the half & half I need to make Emeril Lagasse's macaroni and four cheeses! recipe. (Emeril Lagasse is a well known New Orleans chef.) I'll go to bed shortly, as it's just past 2:30 am here, and if I wake up early enough I may make this recipe later toda, although I suspect that I'll wait until my string of second (swing) shifts ends early Friday morning.

I didn't see harissa at Kroger, but I didn't expect to. I'll look for it at Whole Foods or Trader Joe's this weekend.

What on earth is hamburger helper? A product for helping you make your own hamburgers? I don't understand!

Spices are essential in every kitchen. Back to the cilantro/coriander conversation - I love it, and we just sowed a whole load of seeds in a pot in the kitchen ready for homegrown herbs whenever we need them.

I always get hungry visiting you, Darryl. Happy new one!

Morning, Darryl!
Those last two books read sounds fascinating - adding them to the wishlist.
And you mentioned listening to bits MLK's speeches; a couple of years ago I checked out an audio'book' from the library that was a collection of his recorded speeches, and it was powerful, indeed. The man knew how to use a tricolon crescendo.

>76 kidzdoc: I kind of feel like the midwest is getting a bad rap for food here. Having grown up in the rural midwest, the super bland cuisine discussed vanished in the late 80's. If someone came to visit in the Twin Cities, I am not sure where I would take them for old school midwestern casseroles and the like. Minnesota has been racking up James Beard awards at a prodigious rate. I can't even say that I have been to all of the restaurants although I have visited a few. Ethnic cuisine is readily available. Minnesota has some of the largest populations of West Africans and Southeast Asians in the U.S. Finding their food is not a struggle. Even the suburbs have halal markets and restaurants.

Even back in my hometown the food options have gotten much better. Minnesota has had an explosion of brew pubs providing good food and beer over at least the last five years. There are a few of the old cafes that still exist in the small towns that might serve the kind of casserole being discussed but you would need to go looking for it. In my opinion, you are much more likely to find a good microbrewery or a good coffee shop than a place selling basic meat and potatoes dishes.

Howdy Darryl!

>44 kidzdoc: We have some amazing gumbo, jambalaya and étouffée etc...here in Houston. The best boudin I ever had was from the Golden Triangle (Beaumont, Port Arthur and Orange). Of course we have a large influx of people from Louisiana always in this area so it is very easy to get really authentic style food.

One of our former ER patient liaisons used to bring gumbo from her mama all the time. So very good!

>29 kidzdoc: added to the wishlist

>84 Oberon: on the other hand, you can go to the Upper Peninsula of Michigan ang get "midwestern cuisine "

>81 lunacat: Hamburger Helper is a line of products sold by Betty Crocker that contains uncooked pasta and powdered spices. You cook ground beef yourself, then cook the pasta and add it and the spices to the beef to make a meal. I don't see why you couldn't buy your own pasta and use spices from your pantry and fresh ingredients (onion, garlic, etc.) to achieve a much tastier, and cheaper, result.

I agree; spices are essential in every kitchen. However, I find that my parents often don't have ingredients that I routinely use, particularly cumin and turmeric, and I often have to purchase fresh onions, garlic and cilantro when I cook there, as they are more likely to use onion powder and garlic powder, which I haven't used in a recipe in a very long thyme.

Well done on growing your own cilantro!

>82 DianaNL: Thanks, Diana! There's plenty of food here if you would like some.

>83 scaifea: Hi, Amber! A Question of Power was a struggle, but it's a powerful and important novel, and I may give it another go in the future. The Assault is brilliant, and I would recommend it to everyone.

I had hoped to read or listen to some of MLK, Jr's speeches last night at work, but we were all too busy seeing one kid in the ER after the next. Hopefully we'll be less busy tonight, as Mondays are traditionally one of our busiest days for hospital admissions.

>84 Oberon: Thanks for setting us straight, Erik. I meant to say that I would have made exceptions for Chicago and, to a lesser extent, Madison, where I've had some very good food lately, and I would assume that MSP also has excellent cuisine, due to its diverse population. I was thinking mainly of smaller towns and rural areas with very few nonwhite residents, where I would assume (perhaps wrongly) that ethnic foods mainly consist of the fare sold by Taco Bell and Pizza Hut.

>85 luvamystery65: Hi, Roberta! Although I've only visited Houston once, I wouldn't be the least bit surprised that you could easily find good Cajun and Creole food there, given your proximity to Louisiana, and I'm sure the same could be said for Mexican and Vietnamese food, along with cuisine from nearly all other ethnic groups.

>86 The_Hibernator: Heh. I'll take a pass on going to the UP of Michigan, thankyouverymuch.

>87 kidzdoc: - which I haven't used in a recipe in a very long thyme.

Was that pun intentional, oh punny one? ;-)

>76 kidzdoc: It's not really all that bad in the Twin Cities, for instance. You can find all sorts of ethnic fare. I'm thinking more of the non-urban areas and homes of the 50+ crowd. For instance, there is nary a spice in my in-laws home nor when I was involved with the Gillespie Center (for seniors.) I'd have lunch there and the cook was always talking about how he couldn't have anything spicy.

... (except for horrific packaged foods like Kraft Macaroni & Cheese, canned chili (Beef-a-Roni, etc.), Hamburger Helper, plasticized cheeses like Velveeta...

We'll just move along here...

*mutters, "At least I didn't get banned."*

>77 kidzdoc: The rumor has been confirmed.

Was there every any doubt?

>78 kidzdoc: Don't you mean three or four fistfuls?

Sure, by Barbie dolls.

>84 Oberon: Since we haven't been out to eat in years, I'll bow to your expertise.

>88 kidzdoc: Fair enough. There are certainly plenty of small, rural towns with little more than Taco Bell (or Taco John's!) and Pizza Hut. As a former Pizza Hut employee, I can vouch for how sad this can be.

>89 jessibud2: Yes, Shelley, that pun was entirely intentional!

>90 Morphidae: It's not really all that bad in the Twin Cities, for instance. You can find all sorts of ethnic fare. I'm thinking more of the non-urban areas and homes of the 50+ crowd.

Right, Morphy. That's what I was thinking as well. I have no doubt that there are plenty of great restaurants in MSP and the nearest suburbs, but the exurbs and rural areas, especially those with older, stable and less diverse populations would be the ones that would have the most bland and, to me, uninteresting food.

However, to be completely fair, that would be the case in most regions of the US, and probably in other countries as well. My parents live 10-15 minutes by car from the Philadelphia city line, and 25 minutes away from Center City (downtown), in a large suburb with plenty of malls, shops and restaurants in close proximity. However, it's overwhelmingly (over 90%) white and has a large working class, blue collar population, and the food choices available there are very dismal. Other than the excellent Indian restaurant in the next town their best food options are the local pizza place, which makes great Philly cheesesteaks, strombolis, subs and pizzas that compare well with the best Italian restaurants in the city, Boston Market, Chick-Fil-A and Chipotle. Practically every national chain restaurant is within a 10 minute drive, but we never go to the ones other than those I just listed. For good food we have to go to the city, or drive to Trenton, NJ (which has some good Italian restaurants) or, better yet, Princeton, which fortunately are both within 15-20 minutes by car.

*mutters, "At least I didn't get banned."*

*adds Morphy to "watch closely" list*

Sure, by Barbie dolls.

LOL!

>91 Oberon: Right, Erik. If my parents' town didn't have Amato's, the Italian restaurant that makes outstanding pizzas and Philly cheesesteaks, their best option may be Pizza Hut as well. *shudders*

ETA: The same can be said for smaller towns in north Georgia as well, based on conversations I've had with parents from those areas over the years.

I live in an exurb and our choices are a "family restaurant," i.e. bland food, a pizza/pasta sports bar, a drive in (not open in winter months, but OMG the best fried chicken, again nothing spicy or ethnic), and a tiny drive-thru Mexican joint. Never tried it, heard it's good. Within a couple minutes there is also a tiny "BBQ" steakhouse (10 tables? Steaks are good. Way too expensive.) and another sports bar but just with cheeseburgers and such. Oh, and a burger joint called Culvers. (A step up from other burger chains.)

So, yeah, nothing ethnic except the Mexican drive-thru. I've looked at the menu and it seems pretty true to its roots. But I didn't call the pizza/pasta sports bar Italian on purpose.

There's Domino's, of course, and another place that delivers pizza, but I don't consider them to be restaurants.

Oops! Forgot the two "Chinese" restaurants.

None of these except the BBQ would I consider to be "nice" restaurants. And even that one is iffy. For those you'd have to drive at least 20 minutes away to a boutique city on the lake. (And the prices go up correspondingly.)

>87 kidzdoc: Re: Hamburger Helper : "I don't see why you couldn't buy your own pasta and use spices from your pantry and fresh ingredients (onion, garlic, etc.) to achieve a much tastier, and cheaper, result."

This is definitely true if you have the financial resources to afford various bottles of spices and several types of grains and pasta. But for people on very limited budgets, if a recipe takes three different spices (very few spices, indeed) at $3-$4 dollars a bottle, what do you not buy instead of the spices? For $1 - $1.50 a box you could buy three boxes of Helper featuring three different starches (rice, noodles, orzo) and the spices for three different cuisines (say Mexican, Chinese, Italian) for what one bottle of spice costs.

Granted, you can accumulate spices when there's a bit of give in the budget, but if you have $20 to feed yourself and others for a week, it's a hard thing to do.

Our food bank likes getting these boxed meals for that reason - and also that they take little skill or equipment to cook them.

I think they're also pretty popular with 'starving' students.

Although our local food bank doesn't specifically ask for donations of spices, because they'd rather have food to hand out to hungry people, they seem to be happy when I drop off a bag of edibles with a jar or two of spice in the mix.

>87 kidzdoc: and cheaper, result." I get Hamburger Helper from the food shelf for free. Before I used the food shelf, I almost never used Hamburger Helper.

>94 streamsong: I look at some of these recipes I'd love to do online and I just shake my head and move on. I don't have the 12 to 24 ingredients they require.* I don't have wine or sherry or six to eight spices or 1 TBSP of sour cream or 1/2 cup ricotta cheese (what do I do with the rest?), etc. because we can't afford it and you can't get them at the food shelf.

*Nor the time and energy. Any idea how tiring it is to be this poor? We just found out that I'm getting a whole $3 more a month on Social Security. So what did the county do? Took $3 off our food stamps. Bleh.

The midwest has a great diversity of food. The same as would be found in New York City. The reason is that most of the small towns out in the midwest have a predominate ethnic background because the place was settled by people of those ethnic backgrounds. For instance, in my home county in Kansas, there are Swedes, Norwegians, German Lutherans, Czechs, and Danes all in the same county. Baking contests always feature Swedish Tea Rings going head-to-head with Kolaches. Then there are those wonderful coffee cakes from the Germans. And don't get me started on the homemade kraut and sausages and of course the Lutefisk and ostakaka and lefse.

Personally I find nothing wrong with a good tatter tot casserole. It is hot filling, and has protein and vegetables. I think that midwestern casseroles are a very creative food designed to provide the maximum in nutrition with a minimum of effort in the making. I believe that food is bland due to many of the things that Streamsong mentioned in her post (#94) and the fact that people tend to not be adventurous when it comes to their food. People don't like things to taste strange and spices are one of those things that people find strange. I don't usually make Hamburger Helper, but those packets of spices (mostly salt, but still...) leave me with no waste. Plus, using this kind of food results in less storage space needed in a kitchen. The farther away from a grocery store a person is, the more likely they are to have things like Hamburger Helper on their shelves. It makes economic sense and is practical.

I wasn't quite getting the Hamburger Helper at all (I obviously missed Darryl's original explanation), so I looked it up on Google, and I'd got completely the wrong idea of what sort of things it was. I was picturing some sort of things that helped you 'make' hamburgers, but I couldn't see why this would be a very convenient product as hamburgers would usually come ready made. And I didn't see what rice or pasta had got to do with it at all!

I see you're reading Madame Verona. I really loved that book.

>97 SandDune: I think the word "hamburger" threw you, Rhian, because of a difference in US vs UK English usage. Hamburger Helper became "a thing" in the 1970s. At that time it was common to refer to ground beef as "hamburger," even if it was not formed into a patty. I haven't heard the word used that way lately. But I believe in your part of the world there are "beef burgers" and "mince." And on that basis I can see why you formed a very different mental picture!

>88 kidzdoc: Heh. I'll take a pass on going to the UP of Michigan, thankyouverymuch.

Yes. *sigh*

>97 SandDune: I've never seen the point of purchasing Hamburger Helper when it's much cheaper to purchase the pasta and other stuff yourself.

>101 thornton37814: Hamburger Helper: 1.75 (can find even cheaper on sale, sometimes for 1.00 to 1.25)

2 cups of milk: .45
Elbow macaroni: 1.00 (if on sale)
1 cup cheddar cheese: 1.00 (if on sale) (now over price of Hamburger Helper)

The next four items we would have to buy. We don't have them in stock. We have Garlic Powder and Onion Salt. I'd love to use garlic but we can't.

Cornstarch
Paprika
Onion Powder
Garlic

We have:

Salt
Sugar

We get them from the food shelf. As we do with the milk and pasta. And the Hamburger Helper. And usually the ground beef, too. The only thing we always have to buy is the cheddar and only on sale.

So unless your groceries are a heck of a lot cheaper. I don't know how you are making it less expensively.

Enjoying the food chatter on your thread, Darryl. I may be kicked off your thread for my admissions. Gasp! My kids loved Hamburger Helper when they were around 8 - 18 and they were such fussy eaters it was something I could cook that they would eat. Personally I did not enjoy it, and neither did my husband - too salty, a pile of " crap" but it is tough when you have picky eaters and my kids would have starved rather than eat something that they did not like. I recall our eldest and my husband getting into a standoff when Daniel - our eldest and most picky eater, would not eat his supper if it was not to his taste. He was a small guy, in the 10th weight percentile at the age of 3 and 4 and never got above the 30 % percentile. My husband tried putting his uneaten dinner and serving it to him for breakfast, but Daniel would just say no to the food. After about 3 or 4 days of that, I told my husband - he has to eat and we will have to make concessions to what he likes to eat.

Our eldest was the fussiest eater. Even in his teens I'd make home made lasagna and I'd mince the onion into such tiny pieces , but even so he'd object to that. Kidz! I was accustomed to fussy eaters from my family of origin - one of my brothers refused to eat spaghetti if it had sauce on it - he would only eat the pasta, not the sauce etc etc, and my mom and dad just rolled their eyes and my mom made a lot mixed up dinners for a family of 7. The fussy brother is still very fussy, but he did end up at 6 ft 4 and 180 lbs, so I figure my mom and dad did right by him. Now he has 4 fussy kids of his own ( ages 15 - 6 ) and I'm sure they are giving their parents ( his wife is a pediatric hospitalist like you ) a run for their money :)

My daughter in law as I have mentioned is from Hong Kong and when she asked me some years ago, "what is typical Canadian food" I was lost for an answer. It really depends on your family of origin - I had a good friend who's family was Lebanese , another friend who was Mennonite , and we had neighbours who were Jewish , and every family had it's own kind of food. That said, I imagine my family ate more of the typical "British fare" . Roast beef, chicken, potatoes, canned peas, canned corn, canned beans in tomato sauce etc.( and a lot of ground beef / Kraft dinner etc. As time went by we did adapt new foods into our diet . Back in the 1960's and early 1970's, fresh veggies and fruit weren't as easy to get as they are now. We always had oranges and apples, raw carrots, lettuce, tomatoes, but it was later in my teens more fresh veggies and fruit was available.

Warning: The Ranting Pediatrician is IN. Feel free to ignore the following message.

Arrgghhh. Yesterday's swing shift was busy and benign, and it wasn't bad at all. Tonight's shift, however, was even busier, and extraordinarily painful, due to incompetent doctors, annoying nurses, and several overly dramatic mothers. I'm now back at home, and consuming a large adult beverage (tequila with orange juice) to take away the pain of this evening.

Fortunately my greatest source of satisfaction came from the most irritating situation. I saw a little boy in the ER who had been having moderate to severe abdominal pain for the past eight days, who was being admitted for managment of "constipation" after two prior visits to the ER and two visits to see his pediatrician in the past week for severe abdominal pain. He contined to have severe abdominal pain that would cause him to scream and cry in pain all night for the past two nights, and today he developed a fever and a bright red rash behind his ears, on his buttocks and on his lower legs. He was seen by his pediatrician again on Tuesday, who checked his urine, and noticed that it contained small amounts of blood and protein, so he referred him back to our ER for further evaluation. The clueless ER doctor that saw him, who isn't one of my favorites, ordered numerous studies on him, but failed to interpret them correctly or notice the telltale rash that he had. When I was called to see him the ER doctor said that she wanted him to be admitted for management of "constipation" and abdomnal pain, which I thought was a bit strange, as he had been having severe abdominal pain for eight days despite having large bowel movements this holiday weekend and havng several episodes of diarrhea today. It's hard to claim that a child is constipated if he is having lots of diarrhea, and constipation does not cause fever and a rash!!! I reviewed the labs and radiographic studies that Dr Dumbass had ordered, and noticed that his CT scan of his abdomen was abnormal (which she didn't tell me about), and that his inflammatory markers were elevated (ditto). I realized that the story that the ER doctor told me made no sense at all, so I decided that I needed to start from scratch to find out what was really going on. I spent nearly an hour with the family in the ER, to the chagrin of the annoying and stupid young ER nurses, who couldn't understand why I was spending so much time speaking with the parents of a toddler who was "constipated", and after a thorough history, which provides the correct diagnosis 85% of the time if the clinician takes the time to listen to the patient or parent, I realized that the wee one's problem was not "constipation", as the three ER physicians had said, but was almost certainly a far more serious inflammatory condition, Henoch-Schonlein purpura (HSP). My physical examination showed that he had the classic rash of HSP, although it was early in the process, and I told them that I thought that this was their son's problem, not just "constipation" as the three ER doctors who saw him before I did thought. They were greatly relieved to finally receive a diagnosis and a treatment plan, as they were worried sick about their little guy, and I left the room the mother gave me a long hug and sobbed in my arms for a few seconds, and her husband shook my hand with tears in his eyes. I had to chastize the highly annoying young nurse outside the room, who was irritated with me for spending so much time in the child's room when there were patients in the waiting room who had been there for up to two hours waiting to be seen, and kept knocking on the door to see if I was finished yet. After I barked at her and put her in her place she left us alone, although I doubt that I'll be getting a Christmas card from her in December. Fortunately the clueless ER doctor had left the hospital, so I didn't get a chance to fuss at her for being sloppy and incompetent in figuring out what was truly wrong with thet poor little guy, who had been suffering for over a week because the three ER doctors who saw him weren't smart or patient enough to ask the right questions to figure out what was really wrong with hiim.

Oof. I fell asleep two hours ago, after I finished the rant while I sat in my glider. I think I'll go to bed now...

>104 kidzdoc: Doctors like you are heroes, Darryl, to put in the time and effort to make a correct diagnosis when the details you've been given don't add up, at a time when you're busy and under pressure to move on to the next patient. It does seem weird that a kid with diarrhoea would receive a diagnosis of constipation. Well done for sticking to your guns and uncovering the real problem. And feel free to rant - you've more than earned the right!

I'm enjoying all the food talk, and the discussion of how differently people cook as a result of so many different factors. Like Morphy, I get turned off by recipes with lots of small amounts of many ingredients, although that is as much due to laziness on my part as to economics (although that does play a part). And yes, it is sad but true that very often buying a commercially-made product is cheaper than making something yourself. I was going to make my own tomato and marscapone pasta sauce until I realised that the marscapone alone cost more than a ready-made jar! I'm sure home-made would taste better but it just didn't seem like the best use of my time and money.

I hope the rest of your work week is less stressful than your last shifts, and that the adult drink and the nap leave you refreshed.

That's not a great ratio, three out of four fail to diagnose that kid Darryl, especially with such clear evidence that constipation wasn't the issue. Is HSP an unusual problem? Glad you were able to help the little guy.

I imagine despite knowing that accurate diagnosis increases to 85% if people listen, it's common for Docs and nurses to get swept into the frenzy of thinking there isn't time, which to those of us outside the situation doesn't make sense. Looks like some folk at the hospital need a skills top-up about listening!

Hope you got a good nights kip.

I can relate to the rant a bit. My primary job for Solar Probe is to make sure the spacecraft performs as required. When there's a problem, so many times I see people jumping to incorrect conclusions about causes because there's such schedule pressure to fix the thing and get moving again. I've had to rein in folks so many times.

>104 kidzdoc: sorry you had a frustrating shift but you should be proud of yourself for taking the time to help that little kid! I've been in hospitals where the staff are in a rush and seem to be too busy to really care and I've been in them with staff that take the extra time and show they care even when they have a much work as the first group! As a parent it's nice to know that there are some people out there that truly want to help and make a difference!

>104 kidzdoc: Good save, Doc! Wow - the difference that one caring person can make.

>102 Morphidae: Thanks for speaking up, Morphy. I first became aware of this problem a couple years ago when many of the food bloggers were taking a month long challenge to live on dishes solely created with the amount of money that they would be eligible for using food stamps. Beth from Budget Bytes participated the first year using the challenge rules that she had to assume that she had *nothing* in her cupboards - meaning no spices etc. The next year she did it again, but decided she could use spices and other odds and end from her cupboard. She said with all her skill and experience, she couldn't create tasty dishes without "cheating" a bit.

Your first hand experiences are very valuable! We all need to hear this!

>104 kidzdoc: No problems with the ranting pediatrician at all, Darryl.
You did a great job after some others failed befor you. I am happy for the boy and his parents and proud of you!

I hope you got the sleep you needed.

>95 Morphidae: We have been on a very tight budget for years, Morphy, so we know how hard it is.
We were lucky to get out of that 8 years ago...

Great review of The Assault! The public library has a copy of the book and the movie, so maybe I'll read the book and then watch the movie!

The only time I ever ate Hamburger Helper was during the month that my mother went to New Zealand with my grandmother while my dad was home with my brother and me. Hamburger Helper was his go-to meal while he was doing the cooking. Fortunately we had several dinner invitations from neighbors while my mother was away. It gave us a little variety in our diet!

I hope your next shift is better than your last one. I'm glad you were able to diagnose the little fellow correctly, and I'm sorry that he had to suffer longer than he should have.

Sorry for that half asleep, half crazed early morning rant! Yikes...my high school teacher would have had a field day correcting the numerous grammatical errors in that message.

Good news: The little guy, according to the nursing documentation, had a good night. He was in severe pain (8/10 severity) during the late evening for 1-2 hours after I saw him, but after he received a dose of morphine just before 11 pm he slept comfortably the rest of the night, and hasn't needed any pain medication since then. Morphine only lasts for 2-4 hours, so I would conclude that the medication I gave him to treat HSP started to work, as I expected it would. I'll be very curious to see if my partner, the only person remaining in my group who has been in practice longer than I have, agrees with my diagnosis and treatment plan. I'll check on him when I return to the hospital this afternoon.

I did get one part of the story wrong. The CT scan that was done last night was normal, as the ER physician said. It was the abdominal ultrasound that was done four days previously, during his first visit to the ER, that was abnormal and not consistent with constipation. He didn't have the telltale rash at that time, as that started two days ago, but he certainly had it last night. The ER physician from last night also saw the rash, which was admittedly a subtle one, but she didn't make much of it. It's entirely possible that the rash became more prominent between the time she saw him and the time I did, but the location of it on his, buttocks, lower legs and especially the back of his ears is highly suggestive of HSP.

I'm very disappointed in this ER doctor, who I haven't worked with much even though she's been on staff for at least two years, and I'll add her to my "Do Not Trust" list. All of us make mistakes, and I've made my fair share, and to her credit she and her colleagues that saw him previously did do a good job in ordering diagnostic tests that allowed me to think outside of the "constipation" box that they had placed him in. Ultimately, though, none of those tests were essential for me to make my diagnosis; what was required was a "good set of ears", which one of my professors in medical school taught us was a physician's most valuable tool. Listening to the parents, who were great historians, and asking proper questions made me think of HSP, and my examination of his rash confirmed my suspicion. The thousands of dollars spent on labs and radiographic studies during those three ER visits, including the abnormal abdominal ultrasound, were far less helpful, and, arguably, not necessary.

Health care providers in the US, IMO, spend far too much money ordering tests, and not enough time sitting down, listening to patients and their families, and using the valuable organ between their ears to make diagnoses. There are certainly times when tests and consultations are needed, which applies to the boy with the bizarre ulcerated skin rash that I saw earlier in the evening (none of us had ever seen a rash like that before), but that is far less common, and it's very possible that my senior partner (who we say trained under Hippocrates) may see this rash today and exclaim, "Oh! I know what this is."

>104 kidzdoc: >105 Sakerfalcon: Agreed. You are a hero. How in the world can you diagnose someone with constipation when they have diarrhea? Impaction maybe. (Been there, done that.) But constipation?

And then the nurses. Dear lord.

>113 kidzdoc: - Ultimately, though, none of those tests were essential for me to make my diagnosis; what was required was a "good set of ears", which one of my professors in medical school taught us was a physician's most valuable tool.

Darryl, that wise approach reminds me of what Abraham Verghese wrote in one of the books of his I read, when he was learning his craft as a doctor. I can't remember which book it was, perhaps, My Own Country but I really remember that as a stand-out bit of wisdom. Or it might have been Atul Gawande in one of his books (he wrote Being Mortal. I sometimes mix the two up in my mind because I read quite a bit of both doctors around the same time. In any case, what you did was so intuitive and so right, and thank goodness. Good on you.

>93 Morphidae: The description of the restaurant options in your town is probably also true for thousands of similar places throughout the US, Morphy. Given their preponderance I'm not sure that I consider Chinese, Greek, Italian and Mexican cuisine to be "ethnic", at least not in comparison to Brasilian, Jamaican, Indian, Ethiopian, Turkish, Vietnamese and other foods that are far less common outside of major metropolitan areas in the US.

I would also imagine that the "Chinese" and Mexican restaurants serve fare that is not completely authentic, but modified for the tastes of Americans who haven't been to those countries or are used to authentic Chinese or Mexican cuisine. Several of my closest friends from medical school are Chinese, and most of them emigrated from mainland China or Taiwan as young children. They have taken me to restaurants, particularly in the San Francisco Bay Area, where there were no or very few non-Chinese diners, and I've had some fabulous dishes that they say cannot be translated into English or obtained in restaurants that cater to a sizable non-Chinese population.

>94 streamsong: Thanks to you and Morphy for setting us straight, Janet! I'm all but 100% certain that I've never ordered or made Hamburger Helper, and I wrongheadedly assumed that the cost of each box would be less than the cost of its components (not thinking of the cost of a bottle of a spice, but how much the portion of the spice used in the recipe would be). I also hadn't considered that buying a full arsenal of spices would be very pricey when you don't have them to begin with. I did assume that the cost of, say, 4 oz of store brand macaroni would cost less than the 4 oz of macaroni in Hamburger Helper and similar products would, which is why I surmised that it would be more cost effective to buy the ingredients separately rather than in a boxed product. Wrong!

I've gotten out of the habit of it, but when I was in medical school and residency on very tight budgets I would always buy the local paper(s) on Sunday, mainly for the coupons and store ads, and stock up on sale items to save money. I don't use coupons much anymore (although I should get back to doing so), but I will go through nearly every aisle when I go to Publix on Sunday mornings, look for the weekly BOGO (Buy One Get One (Free)) sales, and stock up on items I use frequently, such as chicken and vegetable broth, beans, canned tomato products, and rice. I was able to make the Mediterranean lamb & mushroom pasta the weekend before last because I already had sufficient ingredients that I bought during BOGO sales at Publix. It helps that those sale items are strategically located in special display cases and the ones at the end of each aisle.

On Sundays after church my parents would almost always visit my aunt & uncle who were both related to my parents (my uncle was one of my father's older brothers, and my aunt is my mother's oldest sister) and lived on the other side of Jersey City. My aunt & uncle would have four or five newspapers delivered to their home, and my father would pick up at least three or four of those same papers, from North Jersey and from NYC. They would go through the papers, pick out coupons and relative advertisements, and go grocery shopping later that afternoon before dinner. This little bookworm would read the papers, especially The New York Times, and I followed that same habit during medical school and residency. My father continues that practice, as he buys the local suburban and city papers and does weekly shopping based on what's on sale at different supermarkets and stores.

Excellent rant Darryl. I hope the young lad is OK and that you are able to have a word with the ER doctor at some point, gently (or not so gently) pointing out how you made your diagnosis and the things to look out for. Including the idea that if he's having diarrhea.........well, it seems unlikely that the diagnosis is constipation with nothing else going on. I believe (correct me if I'm wrong) that diarrhea and constipation can occur simultaneously, or at least feel as if they are, in cases of IBS, in which case shouldn't the doctor have been investigating further anyway?

I'm glad you've been able to figure out what is going on with him anyway, and hopefully he'll have a recovery with no complications.

>102 Morphidae: Very good point. When we used to do health clinics and teach heart healthy diet or diabetic teaching one of the biggest complaints was that it is expensive to eat healthy, and honestly, I could never argue that point. The same argument can be made for cooking fresh healthy meals.

>109 streamsong: Was this also when Gwynth Paltrow did this? I remember her doing something like this and she was criticized for keeping to the budget using fresh foods and vegetables that are often not available in the inner city and when they are, the cost is higher.

>104 kidzdoc: >113 kidzdoc: Your experience makes me want to read What Patients Say, What Doctors Hear even more! I'm glad you take the time with your patients. I used a concierge medicine doctor for my mom the last 3 years of her life. It was very expensive but I needed someone to listen to us and help me navigate her very difficult health problems. I know two of our physicians that are routinely criticized for coming late to the hospital to discharge patients but I also know that they take time with each and every one of those patients in the hospital and at their clinic. They truly care about their patients. One now uses a hospitalist group, the other still rounds himself. Both are excellent clinicians.

>95 Morphidae: Thanks for that valuable lesson, Morphy; I apologize for being so thoughtless. Shame on the county for taking away three dollars' worth of your food stamps!

>96 benitastrnad: The midwest has a great diversity of food. The same as would be found in New York City.

Uhh...I don't think I can agree with this statement! Although your comments suggest that there are variety of cuisines from central and western Europe in midwestern towns, I would be shocked if there were also restaurants that serve Afghani, Indian, Jamaican, Peruvian, Thai, Moroccan or Ethiopian cuisine, as you would find throughout Manhattan, Brooklyn and Queens, or for that matter Chicago or even Madison (I've been to excellent Afghani and Indian restaurants there). On the flip side, though, I suspect you would have a harder time finding restaurants in NYC that served the European fare that you mentioned, so I'll grant you that point. I'd be willing to bet a week's salary that there isn't a single Afghani or North African restaurant in the suburban county my parents live in.

The farther away from a grocery store a person is, the more likely they are to have things like Hamburger Helper on their shelves. It makes economic sense and is practical.

Yes...that makes perfect sense to me, and that's a great point that this city boy didn't consider. I'll readily admit to being spoiled and narrow minded in my own way, and this comment is helpful in reducing the blind spot I have about life outside of major metropolitan areas.

I wonder if many people in exurbs and small towns who don't have supermarkets nearby use Amazon or similar services, both to purchase non-perishable items and to save money. I have purchased some spices online from Amazon after I noticed that it was considerably cheaper to do so than to go to a local spice store. I think I did that last year when I bought...let's see...za'atar, a Palestinian spice blend, when I was making something for my parents. I could have driven to Penzey's in Princeton or Center City Philadelphia to get it, but that would have taken nearly an hour and cost nearly twice as much.

>97 SandDune: Ha! I'm sure that some of our food discussions must be bewildering to my friends who live outside of North America, Rhian. Are there products similar to Hamburger Helper in the UK?

>98 TadAD: I haven't started Madame Verona yet, Tad, but I plan to do so later this week, for the Reading Globally Benelux literature challenge. I think that Anita and Monica recommended it to me as an excellent Belgian novel, so I'm glad to hear that you were also fond of it.

>99 lauralkeet: Ah. That makes sense, Laura. I think I now fully understand Rhian's point.

>100 ursula: Sorry, Ursula. I'd say it's far more likely that I'll visit Hong Kong or Cape Town before I travel to the UP of Michigan.

>120 kidzdoc: There are stir in sauces for various types of pasta, but I can't think of one that has everything in a box like that. We would always at least buy the pasta as dry pasta, then a ready-made sauce, and the beef mince or anything else you wanted to add.

I suppose a pasta bake might be the closest thing, but even they would be separate servings of sauce and pasta.

There is this:



which just requires assembling, plus the meat and cheese added, but it is far far more expensive than the individual components would be.

Or something like this:



but that is generally designed to just add water or milk and microwave.

>101 thornton37814: I've never seen the point of purchasing Hamburger Helper when it's much cheaper to purchase the pasta and other stuff yourself.

That was my assumption as well, Lori! However, Janet and Morphy have set us straight on that point.

>102 Morphidae: So unless your groceries are a heck of a lot cheaper I don't know how you are making it less expensively.

Excellent breakdown of those costs, Morphy. I have no reason to think that groceries in Atlanta are less expensive than those sold in exurban Minnesota; if anything I would suspect the opposite to be true.

>103 vancouverdeb: Good point, Deborah. Hamburger Helper, Kraft Macaroni & Cheese and other ready made or premade products like Beef-a-Roni were very popular in the 1970s, and plenty of kids in the neighborhoods I live in preferred to eat them. My mother was trained as a hospital dietician and worked as a nutritionist, and she frowned on the amount of salt and unnatural ingredients in these products; as a result we never had them as kids. (Wasn't there also a product that allowed you to make cornbread stuffing, using that term very loosely?) Instant foods were also very popular, particularly grits, oatmeal and Ramen noodle soup. My partner who I share a cubicle with used to have instant oatmeal on cold mornings for breakfast, but I think I've given her so much (good natured) grief about it that she no longer does so (or maybe she doesn't make it when I'm around).

>120 kidzdoc: Oh no, the *sigh* was because I'm stuck in this food wasteland for the time being. I wouldn't expect anyone to come here. It is a million miles from anywhere.

Edited to add:

I wonder if many people in exurbs and small towns who don't have supermarkets nearby use Amazon or similar services, both to purchase non-perishable items and to save money. I have purchased some spices online from Amazon after I noticed that it was considerably cheaper to do so than to go to a local spice store.

We buy a decent amount of things from Amazon, and we've also started using Thrive to order a lot of the ingredients we can't get around here. We are just in the free trial at the moment, and it does require a membership fee after that. However, they also give away an account to someone who needs it for every one that someone buys, so I think we're going to go ahead and continue with them for the time we're here. (Also, there's no such thing as a "local spice store" within ...? 200 miles? of here, just for reference of what it's like when you are nowhere near anything that can be called a city. Although - there is a bulk store in Canada that sells stuff like that. So if you have transportation, bridge fare both ways and a passport, you could get that stuff closer to home.)

It's distressing to hear about so many medical professionals not being competent but I'm so glad you were there for the little fellow. Hope he gets well soon.

I remember it now...it was Stove Top Stuffing, which is sold by Kraft:



I tried it once (hopefully not twice) many years ago, and it was all I could do to keep from gagging when I tried to swallow it. You can't make proper stuffing in five minutes!!! (Apologies to Stove Top Stuffing aficionados.)

>105 Sakerfalcon: Thanks, Claire. I suspect that the ER physician didn't take the time to ask the little guy's parents about his stool caliber, which had become diarrheal that day (he had 4-5 episodes of it by the time I saw him last night). I also suspect that she had her mind made up that he was constipated, based on the studies that were done during his previous two visits, and she didn't take the time to consider other possibilities for his severe abdominal pain.

I get turned off by recipes with lots of small amounts of many ingredients

I think I'm just the opposite! I like recipes that include a variety of different flavors, such as Emeril Lagasse's slow cooker chili that I made for Christmas Day lunch with the PCA 3 nurses, which contained semisweet dark chocolate, cinnamon, dark Mexican beer, masa harina and at least a dozen other ingredients.

I'm getting sleepy again, and since I only had five hours of sleep last night I think I'll take a nap, and hopefully return here this afternoon or evening.

>119 kidzdoc: It's okay. It's rather like (but nowhere near the degree) of race privilege - it's class privilege. For instance, ten years ago, I would blow three dollars off as nothing. To me now, it could be several meals worth of meat or pasta or sauce. It could mean do I get fruit this week or not? People who are middle class and higher, simply don't think of these things (for the most part.)

Other examples: If I drive to this grocery store that is farther away, will the money I save cover the cost of gas? Is it worth spending the extra money to buy fruit at store A which tastes better and I will be more likely to eat or do I take the risk of it not tasting as good but spend less money at store B? Do I take a chance on this generic canned (sauce/veggie/bean) that I got from the food shelf and chance it ruining a dish or do I buy something I'm more familiar with?

I've noticed that we eat a lot less fruits and vegetables in the last couple of years. In the last month, I think I've had two servings of fruit. Part of that is winter. But part of it is that fruits and vegetables come last in our food budget. Protein, dairy, and carbs come first. The food shelf has very little in the way of fresh produce though when it does, we grab it up. For instance, we had chef salad last night with the bag of lettuce we got.

They do have canned fruit but ugh, I can hardly stand the taste of it. Most of it is the light syrup type with sugar substitutes. Yuck. Plus sugar substitutes make my daily headaches worse. Usually they are light enough I forget them until someone asks if I have a headache. "Oh, yeah. I do." (I've simply become accustomed to them after two years.) But some things, like sugar substitutes, can make them painful enough they come up into my awareness.

>119 kidzdoc: Darryl, this reminds me of another reason you should visit Toronto: I've found that the food offerings there are actually much better than in Manhattan, in terms of having all sorts of varied food all around (and at more reasonable prices!). In NYC it often seemed necessary to spend an hour on the subway travelling to the outer boroughs, while in Toronto you can get good and varied food everywhere.

>123 kidzdoc: My mother was also the hospital's dietitian. Even if Hamburger Helper is cheaper, I'd rather have fresh milk and cheese rather than powdered varieties, so I think I'll continue to make stroganoff or other meat/noodle dishes from scratch. I agree most store mixes use too much salt. I know it's to give some of the stuff a longer shelf life, but it's more salt than we need.

>126 kidzdoc: oh no, not proper stuffing if it's made in 5 minutes. Don't go there.

>119 kidzdoc: Columbus, OH, in the good old Midwest, has Indian, Thai, Ethiopian , Moroccan, Korean, Turkish, Vietnamese, Tibetan, Japanese, Brazilian, Somali, Kenyan, Guatemalan, and Greek restaurants, to name a handful.

Just sayin'...

PS: I LOVE Stove Top. But you're not shocked at that admission.

>128 _Zoe_: - I second that. Absolutely everywhere. You don't even have to go to specialty shops for international foods any more. Most supermarkets have whole aisles devoted to such staples

>131 scaifea: Ha! I am heartened by the love for Stove Top Amber. I love the stuff too and am mocked for it by my wife. It is a staple when dad cooks.

*fist bumps Amber and Erik*

While homemade is best, I kind of like Stove Top, as long as it's not soggy.

>129 thornton37814: - I think everyone would prefer fresh milk and cheese over powdered but the point that not everyone has access or can afford them is important.

Let's see, what else can I comment on?

My husband is a devotee of Penzey's which had a store not far from our house in Dallas. I could never fathom how he spent so much money there, but I do think their spices are better than most of the brands found in a regular market.

I love harissa.

Interestingly, if I compare, say a 5-mile radius from our house in Texas to a 5-mile radius from where we live now in suburban New Jersey, there was actually more cuisinal (not a word but you know what I mean) diversity in the former. At least this particular suburb seems to survive on Italian. Excellent Italian, of course, but wow. Obviously, if I compared city to city, NYC would leave Dallas in the dust -- though I will say Dallas has developed a pretty excellent food scene over the past decade or so...

I think it's getting harder and harder to make regional generalizations about food and cuisines because of the spread of populations, mass communication (I'm thinking of things like Food Network which can encourage people to try a new recipe or taste a new flavor), the availability of new and different foods and foodstuffs, etc.

Another vote for Stove Top Stuffing! Preferably Cornbread.

(You know Darryl's going to kick us all out of here.)

*fist bumps Morphy, too*

Okay, here is one of my top picks for prepared food. No preservatives. Chicken with no antibiotics, hormones and veggie fed. Just microwave and eat!

>137 Berly: Yeah, but how much does it cost? (Looks yummy.)

>104 kidzdoc: Oh, that makes me very angry because it reminds me of a situation I had with my daughter when she was 12. She complained for two days about severe abdominal pain. Initially, I thought it was probably cramps as she had just started her first menstrual period. By the second day, she was in so much pain that she was walking stooped over and crying, so I took her to the U-Michigan hospital ER. The first person who saw her was an intern who said he thought it was appendicitis. They took an xray and saw nothing unusual, but she had a fever and an elevated white blood cell count, so they admitted her. The following day, they decided that it was constipation and gave her an enema. She was screaming in pain when they did it, and the nurse told her to stop being a big baby. When that didn't resolve the problem and her fever went up to 104, they did an ultrasound and found that her appendix had ruptured and encapsulated. It was in an unusual position and hadn't shown up on the xray. We were just lucky that it had encapsulated. They put her on antibiotics for about a month before admitting her for surgery to remove the appendix. We were told that she would probably have difficulty if she ever wanted to get pregnant because of scarring of the fallopian tubes. (She's an adult now, never married, so this didn't become an issue, but still . . . )

I'm so glad for that little boy and his parents that you were there for them and cared enough to take the time to find out what was really wrong instead of jumping to the easiest conclusion.

>138 Morphidae: I couldn't find my latest receipt. I will try to report back next time I go.

We don't have Afgani, Ethopian, Brazilian, or North African. That is mostly because people of those ethnic backgrounds have chosen to not settle in the Great Fly-over Country. But we do have many other ethnic kinds of foods.

I was in Scottsbluff, Nebraska this last year and the most popular restaurant in that town is a Chinese place. The people who own it immigrated from Taiwan and ended up in the panhandle of Nebraska. In Ogelalla, Nebraska, the Chinese restaurant there celebrated its 30th anniversary. My first exposure to pho was in the Vietnamese restaurants in Garden City, Kansas. There are several Indian restaurants advertised along Interstate 80 between Kearney and Sidney, Nebraska. The most popular restaurant in Kearney, Nebraska has a wine list that placed it in the top 50 restaurants in the U. S. for wine coverage back in the early 2000's. I purchased my copy of Plenty by Yotam Ottolenghi in a coffee shop in Belleville, Kansas. Omaha, Nebraska is home to a large Italian population and the good neighborhood Italian bistro's abound in that city.

There aren't as many restaurants with fine food (European Cuisine) or expensive ethnic food in the Fly-Over country, because people don't have the income to pay $50.00 per meal, but the plain down-home street food from Guatemala, Singapore, Taipei, and Mumbai is welcome in those places. Just don't charge more than $10 to $12 dollars per plate.

>140 Berly: Oh, please don't go to that much work.

>106 Caroline_McElwee: My senior partner saw the boy with abdominal pain, and she agreed with my diagnosis of HSP. He is still having intermittent abdominal pain, although it isn't as severe as it was previously. HSP would be an unusual condition for the average primary care pediatrician to see, especially before the telltale rash develops, although I probably see two or three kids with it every year, so I've had roughly 40-50 kids with HSP that I've seen in nearly 20 years of working as a pediatric resident (1997-2000) and a pediatric hospitalist (2000-2017). It's on my mental list of possibilities for kids who have severe abdominal pain, and IIRC the first kid I saw with it as an intern had such bad abdominal pain that he underwent an exploratory laparotomy for suspected appendicitis. His appendix was normal, but the surgeon saw that his intestines were inflamed and had petechiae, localized blood spots, and so the diagnosis of HSP was made not by the pediatrician, but by the surgeon in the OR!

The patient I saw last night also had petechiae, although they were very small and scattered, similar to the ones in this photo:



I only saw one classic petechia on his left lower leg, but that was all I needed to see, in combination with the history provided by the parents. The following photo is a more typical presentation of HSP, with a mixture of petechiae and purpura, the large purple areas:



Every pediatrician or ER doctor who sees kids and possesses two functioning brain cells would recognize that the kid in the second photo likely has HSP, but the petechia I saw similar to the one in the first photo probably didn't appear until yesterday evening. I pointed it out to his parents, and IIRC they had not seen that one.

Looks like some folk at the hospital need a skills top-up about listening!

I think that could be said about a lot of physicians, and I would include myself in that category, as all of us could stand to be better listeners. I've already been recommending the book I read and reviewed late last year, What Patients Say, What Doctors Hear to my colleagues and the trainees (medical students and residents) that were on the team last week.

>107 drneutron: Right, Jim. The busier the ER gets the sloppier some of the weaker doctors become, and for the ones on my "Do Not Trust" list I have to ask them a lot more questions to be sure that the patient they want to admit to me has been thoroughly worked me and managed properly there, and is stable for transfer to the PCAs (patient care areas). Last night was very busy, as there was a two hour wait time for kids to be placed into a room and seen. That put more pressure on the ER staff, and when they want to get kids moved out of rooms they don't spend as much time with the patients that are there as they should. My focus is not on those kids in the waiting area, but the ones that I'm admitting to hospital. If it's a simple and straightforward diagnosis I think I'm nearly as fast as anyone in getting the essential information in the shortest period of time, especially if I have multiple kids to see in the ED simultaneously, but if the story is complicated or unclear I want to be sure that I get it right the first time.

>108 ChelleBearss: Right, Chelle. As I mentioned above I've been on the other side of the bed in the ER of my local hospital five times, and I appreciate the excellent care and concern that I received there, and after I was admitted three of those times. My first ER visit and hospitalization came when I was an intern, when I developed vomiting and severe abdominal pain, which I thought was due to food poisoning. The ER doctor that saw me was a middle aged woman, who listened to my story but clearly wasn't convinced that food poisoning was my problem. She examined me thoroughly, and when she pressed over McBurney's point, where pain from appendicitis is best appreciated, I demonstrated what we jokingly call the "chandelier sign": the patient jumps off the bed in excruciating pain, hits the chandelier, and comes back down. We looked at each other, and knowing that I was a pediatric intern, she knew that I didn't need to be told what my problem was. She said, "You know what this is. I'll call the surgeon."



What I also remember is that I vomited after she examined my abdomen and was in significant pain. She helped me to a sitting position in the bed, held the emesis bag, and placed a gentle hand on my shoulder while I vomited and dry heaved for a minute or two. That simple touch meant a lot, especially after I knew that I was going to need surgery for acute appendicitis, and it made me feel that I was in good hands. I try to do the same thing to patients and, when it's appropriate, to parents and other family members.

I firmly believe that essentially all the physicians and nurses I work with want the best care for the patients they see, including the ER physician from last night. However, all of us, particularly the ER staff, are under a great deal of pressure to get kids in and out of there as quickly as possible, and that pressure can at times lead to inadequate and insufficiently thoughtful care.

>109 streamsong: Thanks, Janet. Untreated HSP can lead to serious complications, so early diagnosis and prompt treatment is essential to a good outcome. Hopefully he'll do well.

I'm grateful to you and Morphy for "schooling" the rest of us about the cost of food! We take care of a number of kids whose families are struggling to make ends meet, and I'll keep your and Morphy's comments in mind when I counsel them on proper diets for their children and families. I do know that the south side of Atlanta (south of Interstate 20, the east-west superhighway that cuts through downtown) is much more poorly served by full service supermarkets than the north side, where most of us live and work, is. There is a very telling map of the location of Publix supermarkets in the immediate metro area; let me see if I can pull it up...no, I don't seem to be able to. However, I was able to count roughly 20 Publix supermarkets within the interstate that rings the city and immediate metro area north of I-20 (corresponding roughly from 9 to 3 on a clock, and none south of I-20 (from 3 to 9 on the clock). The same holds true for Kroger, the other major supermarket chain here. Food options for people in south Atlanta are far more limited than they are for us on the north side of town, and the wealthy northern suburbs, and I would assume that items are more closely on the south side as well. Fortunately there is a local black owned chain of supermarkets (Wayfield) that serve south Atlanta, but there are far fewer of them than there are of either Publix or Kroger stores in north Atlanta, and I would guess that the selections are nowhere near as good. I should visit the Wayfield supermarket near the airport one day to see what the difference is, not for myself, but for the families who live nearby.

>110 FAMeulstee: Thanks, Anita. I could definitely use more sleep, but I'm not exhausted or sleep deprived yet.

>111 FAMeulstee: I lived on a relatively tight budget for seven years when I was a medical student and a pediatric resident, but I'm sure that it wasn't anywhere near as tight as the ones that you and Morphy were on.

>112 cbl_tn: Thanks, Carrie. The Assault is an outstanding book, and hopefully the glowing comments from Anita, Paul and I will gain it, and its author, wider readership.

This night is already much better than last night was. I've only had one admission in the first three hours, and not a single nurse call yet...although my partner who was on long call and about to leave just told me about a patient who is on her way from an outside hospital.

>144 kidzdoc: If they have access to computers, have them check out the following:

https://www.thebalance.com/the-cheapest-fruits-and-vegetables-month-by-month-138...
http://www.frugalvillage.com/forums/blogs/c-rol/5379-cheapest-fruits-vegetables-...

(Or just Google "fruit vegetables cheap by month".)

I rely on sites like these to figure out the cheapest fruits and vegetables by month. Not only cheapest, but they taste better in season. For instance, grapes always taste best in October.

Also, see if there are farmer's markets in the area. Sometimes you can get produce cheaper there. It depends on if they are run by big companies/cooperatives or by smaller farms.

>114 Morphidae: How in the world can you diagnose someone with constipation when they have diarrhea? Impaction maybe.

Right. There is a condition called encopresis, in which liquid stool can leak around a large hard stool mass in the colon and pass through a distended and relatively insensate rectum that has been massively stretched by that stool ball. However, this boy was having sizable amounts of diarrhea that had some formed elements, and since he was only mildly constipated per the abdominal X-ray that was performed on Monday that wouldn't have been consistent with constipation. I'm left to conclude that the ER physician who saw him last night did not take a thorough or even a decent history or do a good exam; otherwise I think she would have made the correct diagnosis.

And then the nurses. Dear lord.

Most of the nurses at Children's are outstanding. However, the system has hired a bunch of new graduates, who are very young and not as well trained clinically as the ones in previous generations. Some of them have chips on their shoulders, and treat the consulting doctors, and the families, with very little respect. I refuse to take any bad behavior from or be intimidated by these little brats, most of whom were barely out of pull ups when I first started working here and definitely when I started my residency 20 years ago. I'm sure that I hurt that nurse's feelings last night, but she'll get over it and hopefully treat staff and families decently from now on.

>115 jessibud2: Thanks, Shelley. I read and greatly enjoyed My Own Country and Being Mortal, and I would count Abraham Verghese and Atul Gawande amongst my greatest teachers as well.

>117 lunacat: Thanks, Jenny. That ER doctor isn't working tonight, or at least she isn't there at the moment. I probably won't talk to her about the kid, unless she comes up to me and asks about him. Hopefully she has checked or will check in on him using our electronic health record system, and realize that she misdiagnosed him. Fortunately no harm came to him as a result.

I have IBS (irritable bowel syndrome), and when I have flare ups I can have explosive diarrhea. I think you can have episodes of constipation as well with it. I do have significant pain prior to passing stool, but it goes away quickly and doesn't last for hours or days as this poor little guy had, though. Gastrointestinal infections can cause abdominal cramping, but generally not to that degree, and he is young to have inflammatory bowel disease (ulcerative colitis or Crohn's disease), although that would still be a possibility. There is a condition called mesenteric adenitis, in which the lymph nodes with the mesentery, a structure that lines the abdominal cavity, can become tender and inflamed, causing abdominal pain. It usually doesn't cause that much pain, though. Appendicitis is one of the leading causes of severe abdominal pain in children, even as young as him, but the CT scan and abdominal ultrasound that were performed showed no evidence of this. It was interesting that last night's CT scan also didn't show bowel wall thickening, as I would have expected given the amount of pain he was experiencing, and especially because his abdominal ultrasound done six days ago did show that finding.

ETA: Intestinal obstruction, a blockage in the small or large intestine, could present wth severe abdominal pain and profuse vomiting. However, since the intestines are blocked, stool doesn't pass through the rectum and out from the anus, so the fact that he was having diarrhea doesn't fit with this diagnosis. There are other far less common causes of severe abdominal pain, but a good history, physical exam, and, if needed radiographic or laboratory studies would point toward one of those diagnoses.

The geographical distribution of food markets, grocery stores that carry real food, based on demographics of the population kind of blow my mind. We see the same thing in Seattle, where poorer families (and let's face it, more people of color) live often have to travel a significantly greater distance to access fresh fruits and veggies. Some of the Asian markets help with this, but it's still discouraging to see. We live in a sort of boundary neighborhood -- to the north of us is increasingly affluent and to the south of us is increasingly poor -- and it's a study in privilege to drive in either direction.

Have a sweet Thursday, Darryl!

We have a fairly new Dollar General less than a mile from my house. I'm surprised by how much I've shopped there since it's been open. I'm about 5 miles from the closest grocery store, so if I run out of something while I'm cooking dinner that used to mean at least a 1/2 hour round trip. Now I can get most staples at Dollar General, and it's often less expensive than the grocery stores. Bread, milk, eggs, butter, cheese, rice, cereal, canned vegetables and fruit, basic spices and condiments, flour and other baking supplies, coffee, tea. No fresh produce, though. :-( It's close enough to walk, although I haven't done that because I can't take Adrian with me. It's not pet friendly.

The appendix talk reminds me of going to the ER with my father when he had his appendix out. He'd had a biopsy for temporal arteritis exactly a week earlier and he was supposed to see the surgeon that afternoon for a follow-up appointment. He did see the surgeon, but in the ER instead of the office. The ER doctor was going to do some kind of scan, but the surgeon sent him straight to the ER since he would have done exploratory surgery if the test was negative. It seemed like a waste of time and money if he was going to have surgery either way.

The next day, someone from anesthesiology came to my dad's room for a follow up assessment. The way the room was oriented, my father's scar from the temporal artery biopsy was visible from the side of the bed facing the door. The anesthesiologist, who apparently wasn't the one who had been in the OR, asked what he was there for. When my dad said he'd had an appendectomy, the man had a horrified expression on his face. We realized he was looking at the still fairly fresh scar on my dad's head and thinking someone had made a big mistake! We reassured him that the scar he could see was from last week's surgery.

>118 luvamystery65: Now that you mention it I have heard the same thing said about the cost of eating healthy meals, although I didn't think about it when I wrote my post.

I would recommend What Patients Say, What Doctors Hear to everyone, and I'll probably re-read it later this year.

My senior partner and I probably spend more time with our patients and families than anyone else in our group, and because of that our customer service ratings are amongst the highest of any of the physicians in my group. Parents of hospitalized patients receive surveys about their experiences, good and bad, about two weeks after their children have been discharged, and are encouraged to complete and return them. They are tracked throughout the system, particularly at the highest level. We also have "Catch Me at My Best" cards in patients' rooms, and parents are encouraged to fill them out to recognize a Children's employee who parents "catch going the extra mile." I received this card from a mother earlier this month, which is sitting on my desk:

"I could not have had a better Dr. over my son's care. Thank you for listening & taking care of everything."

>121 lunacat: It looks as though what you in the UK call mince we would call ground beef or ground chuck. However, I would imagine that you could readily get lamb or beef mince; I can get ground lamb at Publix in addition to ground beef, but as

>122 lunacat: Hmm. I haven't seen anything like that pasta bake or instant pasta dish that you described; microwavable pasta does not sound appealing! Have any North Americans heard of products like these?

>124 ursula: I wouldn't expect anyone to come here. It is a million miles from anywhere.

You're in Sault Ste. Marie, Michigan, right? Let's see...oh! You're close to...uh...never mind.

there's no such thing as a "local spice store" within ...? 200 miles?

Yikes. There is a spice shop in my old neighborhood (Virginia-Highland), which is 10 minutes from where I live, and a Penzey's Spice Shop in Sandy Springs, where I work, which is also 10 minutes away. There are numerous shops and farmers' markets that also sell spices within 30 minutes of where I live as well. Yep, I'm spoiled all right.

>125 RebaRelishesReading: Thanks, Reba. Let's see...I'm in the hospital and I'm covering him and the other 70+ patients that are currently on our service. He's still having episodes of pain, but he seems to be doing well tonight.

>127 Morphidae: It's rather like (but nowhere near the degree) of race privilege - it's class privilege.

I don't know this for certain, but I suspect that class privilege can be as bad as race privilege, at least in some cases.

Thanks for breaking it down for us, Morphy. I and I'm sure everyone else hopes that you and your husband's situation improves soon.

>128 _Zoe_: That's good to know, Zoë. Toronto is at the top of the list of new places I want to visit in North America, but I think the timing won't work out this year. Do keep me in mind if there are any LT meet ups there, as I would like to go if the timing is right.

>129 thornton37814: I'd rather have fresh milk and cheese rather than powdered varieties

I imagine that everyone would agree with that statement, provided that they could afford those ingredients. Thanks again to Janet and Morphy for opening my eyes about this.

>130 Caroline_McElwee: not proper stuffing if it's made in 5 minutes. Don't go there.

I won't, Caroline!

>150 kidzdoc: Well, we're never going to get pulled over for driving while poor...

And with any luck we'll have his SS hearing this summer and he'll be on disability with back payments. We'll lose a bunch of supports but we're hoping it will be enough per month to make it easier on us.

Great stuff here Darryl.

Food - As an Englishman constantly derided by those terrible Frenchies on account of our apparently lousy food, I can appreciate and sympathise with Erik and the allegedly bland Mid Western Fayre. I happen to like English food and we have some great dishes but of course it is nowhere as pretentious as the stuff over the channel. I am sure that the Mid West has its culinary moments. Hani and I would surely love the cuisine in New Orleans as we are used to some spicy-ness in our dishes here.

Medical information and your diagnoses are fascinating mate as always and a reason that many of us would quietly consider you something of a hero.

>131 scaifea: I'm not surprised that Columbus, OH would have a variety of ethnic restaurants, Amber. The same is true for Madison, and I would imagine that many of the cities where Big Ten schools are located would have similarly diverse fare. Is that also true for Bloomington? (You went to IU as well, right?) Columbus is also a major city in its own right, from what I understand, so even more reason for it to have diverse cuisine. Wow...I had no idea that it was the 15th largest city in the US! Atlanta, with a 2015 population of 463,878, is only 39th, although metro Atlanta (5,710,795 residents) is considerably larger than metro Columbus (2,424,831).

I LOVE Stove Top. But you're not shocked at that admission.



Me, shocked? Not at all.

>132 jessibud2: You don't even have to go to specialty shops for international foods any more. Most supermarkets have whole aisles devoted to such staples.

Publix, my local supermarket, does have most of a side of one aisle that is dedicated to international foods and spices. I can find most things I need there, or at Kroger, the other supermarket, but za'atar and harissa are two spices that they don't carry.

>133 Oberon: I am heartened by the love for Stove Top Amber. I love the stuff too and am mocked for it by my wife. It is a staple when dad cooks.

>134 katiekrug: I kind of like Stove Top, as long as it's not soggy.

>135 Morphidae: Another vote for Stove Top Stuffing! Preferably Cornbread.

Oh, I've been pulled over for driving while poor. All you need is a crappy car, expired registration, and god forbid, two car seats in the back.

Then what you get is threats about how your car could be towed (he has no intention of doing this, he just wants to let you know he holds that sort of power over you) and questions like "how many kids do you have, anyway?"

>153 kidzdoc: Yeah, Columbus is kind of a big deal. It also has (or had, when I lived there) the largest LGTB population in the midwest. It's a very cool place. Bloomington, IN does have some diverse restaurants (they have what was the first Tibetan restaurant in the country, and it's run by the nephews of the Dalai Lama (and the food there is AMAZING)), but it's nowhere near as large as Columbus (it's a pretty small town, really).

Thank you Heather and Darryl! I'm going to try the jambalaya recipe this week. My guys are going to love this!

More non-soggy Stove Top love here!

>139 Cariola: I was a bit older, but had a similar situation. A year post college- my roommate had a digestive "flu" so I did not worry when I had similar symptoms and pain. When I finally went to the college infirmary (in the 1970's they let alums come if they did not have another doc.) without any bloodwork, diagnosis was an ovarian cyst ( I guess because I was female and 22?) appointment made for gynecologist- three weeks later gyne could not do internal exam because too painful,. so scheduled me for non-emergency surgery. Found no cyst, but an encapsulated retrocaecal burst appendix. five weeks from initial pain to surgery. Three weeks in hospital with IV antibiotics. But I'm here.
Sorry to hijack Darryl's thread, but your daughter is the first other person I know of with similar.

Great list for Medicine, Illness and Public Health passed it on to my daughter going into this field.

Hiya, Darryl.

Wow, that city to metro area ratio for Atlanta surprised the heck out of me. 463,000+ to 5.7 million+?! I'm going to have to think about that one. For us, it's about 2.8 million/8.9 million.

Hey, when you have a minute or two, would you mind pm-ing me with a couple of tips for New Orleans? We're going for a week next month. I know you love it there.

Oof. I'm feeling the effect of working three busy nights this morning. I was going to catch up on threads, but I would be better off catching up on sleep. I'll check back in later today.

Hope you are having a delightful nap.

OK, I'll fess up. My favorite stuffing is made by sautéing onions, garlic, carrots and celery then adding browned sweet Italian sausage and a box of Stove Top Chicken stuffing mix moistened with chicken broth. That goes into the oven until it's brown and slightly crusty on top. Love it!!

A graduate student here at UA did a similar study on grocery stores in Tuscaloosa. He found that for people living in certain parts of town it was almost impossible to find fresh apples. There was only one convenience store in the West side of town that had apples. There are no grocery stores in that part of town. Buying those apples was cost prohibitive making the purchase of fresh fruits very hard to do.

And then we wonder why people have poor diets.

There is one small Winn Dixie store that serves the west side of town. The Publix are only in the affluent areas of town.

>157 Helenoel: That does sound like pretty much the same scenario. I'm glad it didn't take three weeks for them to diagnose my daughter; it was about five days. Massive antibiotics and no gym class for about a month before the surgery. She was able to come home after a few days in hospital.

I'm thankful that this is my last night shift of the week. I'm exhausted, still groggy and sleepy despite sleeping well this morning and afternoon, and I'm looking forward to a quiet weekend mostly spent at home. I do have to study for the upcoming PALS (Pediatric Advanced Life Support) course I have to take next Thursday, and since I'm working Monday through Wednesday I'll need the weekend to re-read the 250 page manual and take the Pre-Test. (Can I count this book toward my 75 Books reading total?)

I hit the ground running tonight, but we're experiencing a lull at the moment. There are 74 patients in the ER at the moment, so I have no doubt that I'll have to put my skates back on and start doing more admissions soon. I'll catch up here as best I can in the meantime.

>134 katiekrug: I've only been to Penzey's once, when I stayed with Caroline outside of Boston in 2015 and went there with her and Edd. There is one near the hospital I work at, as I mentioned, but I usually only drive to work when I have to work nights, weekends and holidays, and the hospital is 11 miles north from where I live, so I probably won't go there anytime soon.

Yep. I just got a call from the ED. Back later...

There are now 89 kids in the ED. Fortunately they can only hurt me for a little more than four more hours.

Back to >134 katiekrug: I'm not the least bit surprised that there is a greater diversity in cuisine in Dallas than suburban New Jersey, or suburban anywhere for that matter.

I think it's getting harder and harder to make regional generalizations about food and cuisines

Agreed, certainly when it comes to larger metropolitan areas. Those foods (e.g., Philly cheese steaks, New Orleasns jambalaya, Chicago deep dish pizza, New York reuben sandwiches) can often be found in other major cities, but the quality of them is often only fair, at best. I've only had two Philly cheese steaks here in 20 years, including a place that specializes in them that is close to where I live, but I found them to be massively disappointing each time.

>137 Berly: That Simple Truth stuffed chicken breast looks good! I think at least one member of our front office staff frequently has something similar to that on a regular basis. I may have mentioned last year that I tried two Indian frozen meals from Trader Joe's, upon the recommendation of a colleague, and I thought that they were both good. The quality of frozen food has improved dramatically since they first became available in the 1980s, once microwaves became a common household item.

>138 Morphidae: Good point, Morphy!

>139 Cariola: I think I remember you sharing that awful story about your daughter with me in the past, Deborah.

My little guy is still having significant abdominal pain and is worse today than yesterday, unfortunately. His rash has progressed, so the diagnosis of HSP is still accurate.

>141 benitastrnad: I've found that most authentic ethnic restaurants, and not the fancier fusion ones, are very affordable, especially if they cater heavily to members of their own community. There are dozens, if not hundreds, of such restaurants along Buford Highway just east of Atlanta, where you can get massive amounts of very tasty food for surprisingly low prices, and less than you would pay at a corresponding American restaurant.

This also holds true for restaurants in San Francisco's Chinatown, and in the Asian neighborhoods in the Fog Belt close to the Bay. One of my favorite places to eat specialized in juk, also known as congee, a rice porridge. It served a fabulous fresh seafood congee which cost $5-6 and was very filling. There is a great noodle house close to...a well known plaza whose name I can't recall. Several years ago I had lunch there, and for less than $1 I got a noodle bowl and a plate of three or four dumplings. I remember feeling odd leaving a 25 cent tip, even though it was close to a 30% tip! My favorite dumpling house, Kingdom of Dumplings, is located on Taraval Avenue in Parkside, a tiny neighborhood place that makes dumplings to order. You can get enough dumplings to feed two people (or one very hungry pediatrician) and a large cup of soy milk for less than $20.

Sigh. Another admission...

>166 kidzdoc: We prefer to spend no more than $3 (on average) on meat per dinner. I expect that chicken dish to be at least $5 - $6, if not more.

Aaaaand, I went looking to see how much they cost and it doesn't matter. The closest store that has them is 150 miles away!

>167 kidzdoc: Embarcadero?

>145 Morphidae: Thanks for those very useful links, Morphy! I'll save them for future reference.

That's a great idea to think about farmers' markets or cooperatives for less costly produce.

In the past I have recommended to families that they buy the Sunday Atlanta Journal-Constitution, for the coupons and the ads. The AJC came up with what I thought was an excellent idea several years ago: you can purchase the early Sunday edition, which is sold on Saturday, combined with the Sunday morning paper, for slightly more than the cost of either paper alone. That way you get twice the coupons, and the AJC can presumably claim a higher circulation. Win/win.

>147 EBT1002: The geographical distribution of food markets, grocery stores that carry real food, based on demographics of the population kind of blow my mind.

I assumed that this same phenomenon wasn't limited to Atlanta, so I'm not surprised to hear that, Ellen. All eight Whole Foods Markets are north of I-20, but as I look I do see that there are several Kroger supermarkets in predominantly black neighborhoods and cities south of I-20. I doubt that other stores like Trader Joe's and Target, and better "fast food" restaurants like Moe's (a Deep South Tex-Mex chain), Einstein Bros., Boston Market and Panera Bread would be found in south metro, other than the airport and the nicer areas.

However, I would suspect that the same also applies to the poorer, predominantly white towns throughout the state, particularly in north Georgia once you get outside of the middle and upper middle class cities. My hospital is located in a wealthy suburb of Atlanta (so much so that I can't afford to buy a typical house here!), with a major shopping mall and hundreds of other stores not far from here, and it's not uncommon that middle class families from the north Georgia mountains will actually go shopping if their child is in the hospital, as they don't have the same variety of stores there and often come to the city or the well to do northern suburbs to purchase items that they can't get locally.

There was an interesting story from WABE, our local NPR station, which looked at the income of people who lived around the different metro stations on the Red Line, which starts at North Springs, an upper middle class suburb, then proceeds southward through the heart of the city and ends at the Airport. The difference in average income once you head south from Five Points, the station in the heart of the city, is stark. The story received a lot of coverage in the media here, and few people were surprised that there was a significant difference in income, but many were surprised at how large the difference was.

http://youarehere.cc/j/subway/atlanta.html

"According to WABE: “Along MARTA’s Red Line, which runs north-south through the city, median household incomes range from $19,447 at West End Station to $104,518 at Buckhead Station.” Those two stations are 9 miles apart from each other.

"To compare two stations that are closer together, consider that Ashby Station in west Atlanta has an average median household income of $21,895. Take a 9 minute train ride to the east (4 miles away) to the Inman Park-Ryenoldstown Station and that median is $61,221."

What's also interesting about Atlanta is that the street names often change when you cross from the north of town to the south. Blacks have traditionally lived to the south and whites to the north, and at least prior to segregation whites here did not want to live on streets with the same name as the ones that blacks lived on. The neighborhoods correspondingly change as well. For example, when I drive from home to go to my local barbershop, which is directly across the street from Ebenezer Baptist Church, where "Daddy" King and his son Martin preached, the street I turn onto is called Charles Allen Drive, which ends at Piedmont Park, the park close to my home.

Another admission. To be continued...

>169 kidzdoc: I find it cheaper in my area to look at the store coupons online then pick them up in the store to cut them out. I tend to find that newspaper coupons are manufacturer coupons which are for mostly new processed food which companies are trying to market, beauty items, pet food, and the like. Plus, of course, the store coupons which I can find online/in store.

Minnesota is very, very white. We're 85% white. The non-whites tend to congregate in the Twin Cites, but even there - Minneapolis, for instance, is 65% white. I don't believe we have the problem with the geographical distribution of food markets. Or at least not near as much. The segregated areas simply aren't large enough.

>166 kidzdoc: 89 kids in the ED? Holy cowza what's going on? Epidemic or bus crash?

Sending hugs and good wishes!

I think I've done my last admission: six in seven hours. It's 12:43 am, and with 17 minutes left in this shift, and 20 hospital admissions this week, I'm ready to take a break for a few days.

Back to >147 EBT1002: As I was saying, Charles Allen Drive, the street I take to go to my local barbershop on Auburn Avenue, is eight blocks long, with lovely but not opulent homes, trees on either side of the streets and in the central median, and an almost entirely white population. Once you cross Ponce de Leon Avenue the name of the street changes to Parkway Drive. The next block contains several older apartment buildings, with an entirely African-American population, and it's common to see young men hanging out on the streets (to be honest I like to get through that block as quickly as possible). The next quarter mile features single homes that aren't as nice as the ones on Charles Allen Drive, but definitely nicer than the apartment buildings on the one sketchy block. Atlanta Medical Center, a large complex, borders the next block, and one you cross Highland Avenue you encounter new apartment buildings and condominiums on the right, which have a diverse mixture of residents, who look to be mostly young professionals, and after another couple of blocks you see the new Ebenezer Baptist Church on the right, the old Ebenezer Baptist on the other side of Auburn Avenue, and the plaza where my barbershop is located is on the right.

That sketchy block is now prime territory, as it's very accessible to public transportation on Ponce de Leon and North Avenues, and it's very close to Ponce City Market. I anticipate that the owners of those apartment buildings will soon convert them into condominiums, or tear them down and put up newer (and more expensive) housing. That's happening in a number of the older and less appealing neighborhoods in this city, particularly those in Midtown and NE Atlanta. Those areas will become less diverse (although there are a decent number of professional African Americans like myself who live in Midtown), and those poorer residents will be forced to move elsewhere, probably south of the downtown area.

It's 12:58 am, so I'll print my signout, talk to my partner who's working tonight, and I am outta here!

I've always had a bit of trouble accepting the scorn that some of my doctor friends feel for ER doctors, psychiatrists, and family medicine doctors. (In fact, when I was dating a guy in family medicine, one of my neurologist friends said that he probably only went into family medicine because he couldn't get a residency elsewhere...no one purposely goes into family medicine.) But after reading that rant I understand why ER doctors would be scorned. Not that I think they deserve scorn as a habit. But that's just horrible medical practice!

ETA: It turned out that my neurologist friend was right about the guy I was dating, but it still miffed me.

Today is the day that many of us have been dreading. I can't do anything to reverse the event, but I can try to inject some wry humor to keep from being completely morose. So, in that spirit, I just posted the following on my Facebook page:

I understand that donald j. trump has chosen a song by Frank Sinatra to be played during his inauguration dance. For the first (and possibly last) time he has made a decision that I completely agree with.

Send In the Clowns

Don't bother. They're here.

>148 cbl_tn: Thanks for mentioning Dollar General, Carrie. The closest one is nearly 5 miles from home, so I won't go there regularly, but I'll probably visit that store the next time I go to Barnes & Noble...although I won't go there very often, since there is now an independent bookstore in Ponce City Market, which is considerably closer to me.

Great story about your father's surgery! I would have paid to see the look on that anesthesiologist's face.

>151 Morphidae: I hope that your husband's Social Security hearing this summer turns out favorably, Morphy.

>152 PaulCranswick: Thanks, Paul. English food gets a bad name, as far as I'm concerned. I've had some superb traditional English meals, most notably at The Clink Restaurant within HMP Brixton with Margaret in September, and I love the sandwiches at Roast to Go in Borough Market, the fish & chips at North Sea Fish Restaurant in Bloomsbury and Sussex Fish Bar near Paddington Station, and the fare at several pubs in Cambridge when I've shared dinner and drinks with Fliss and Rachael. Oh, I shouldn't forget the great food at 10 Greek Street in Soho. As I tell my Atlanta friends I could more easily name my favorite 10 restaurants in London than my top 10 ones here.

I appreciate the compliment, but I certainly don't think of myself as a hero. All of us have jobs and responsibilities, and I try to do my best, with God's help and only by the grace of God. I'm far from the smartest doctor at Children's, but I try to compensate for my shortcomings by working hard, listening, and caring.

>154 ursula: I can absolutely see that happening, Ursula. Driving while poor may not be as potentially deadly a "crime" as driving while black, but it's still onerous, I would think.

>155 scaifea: I've never been to Columbus, or Bloomington, but both sound appealing based on your comments, Amber. I'd love to try that Tibetan restaurant!

>156 Carmenere: Sounds good, Lynda. Please let us know how you like the jambalaya.

*ignores additional positive comment about Stove Top Stuffing*

>157 Helenoel: Yikes. That's an awful story, Helenoel, and I'm sorry that you had to go through that. Acute appendicitis is (or should be) an easy diagnosis to make if it presents in a typical manner, as mine did, but it can be far more tricky if it doesn't (not that I'm making any excuses for the physician who misdiagnosed you). The appendix is seated much deeper in the abdomen in some people, making it more difficult to locate on imaging studies (CT or ultrasound), and rarely it's located in the left lower quadrant of the abdomen instead of the right lower quadrant if a person's intestines rotated the opposite way of normal during fetal development. I know that our surgeons routinely see kids with ruptured appendices, but, from what I can tell, our ER doctors do an outstanding job of diagnosing acute appendicitis promptly and correctly. It's a very common condition in my hospital, and I'm sure that it's very unusual that at least one kid isn't getting an appendectomy on a particular day.

Thanks for sharing your story with us. You didn't hijack my thread at all!

>158 Cmatha: I'm glad that you liked that list, Cmatha. If you'd like I can post a list of my favorite books in that category.

>159 jnwelch: Hi, Joe! That ratio of Intown Atlantans to those who live in the suburbs and nearby exurbs has been true for decades, and certainly during the nearly 20 years I've lived here. What has changed in the past two decades is that the longstanding decline in the city's population has reversed, as people, especially young professionals, no longer wish to live in the suburbs and make long commutes, and would rather take advantage of the cultural amenities within a major city. Fortunately Atlanta is responding to that demand, particularly by opening superb new restaurants and creating new shopping venues like Ponce City Market and numerous other ones that weren't here in 1997.

I'd be happy to send you a PM with my favorite NOLA restaurants and sites. I'll do that sometime this weekend, probably tomorrow if not today.

>161 Morphidae: I did sleep well yesterday afternoon, Morphy, but getting up at 3 pm was utter torture. I had to talk myself out of calling out sick, as I wanted nothing more than to be able to go back to sleep. However, I knew that it would probably be deeply unfair and unduly burdensome to my partners that were working with me last night, all of whom I respect and adore, and that did turn out to be the case. I was a bit groggy at first, but once I had dinner and a mug of coffee and the admissions started flowing our way my juices began to flow and I got into a very efficient pace. Sarah, the neurohospitalist that worked last night, remarked "Wow, you're fast!" when I completed one simple admission, including admission orders, my H&P (history & physical exam note) and billing in less than half an hour. I know that she appreciated my hard work, and that was all the thanks I needed on what was a tough night for all of us.

>162 RebaRelishesReading: My favorite stuffing is made by sautéing onions, garlic, carrots and celery then adding browned sweet Italian sausage

Yes! That sounds perfect.

and a box of Stove Top Chicken stuffing mix moistened with chicken broth

>163 benitastrnad: Right, Benita. I'm sure the same could be said for many sizable cities and towns throughout the US, and probably for most developed countries as well. I'd be curious to hear from our British friends, but I would think that there aren't any Waitrose supermarkets or Whole Foods Markets in poorer areas of London or the southeast of England, and very few if any in the Midlands or the north of England.

I don't think we have any Winn-Dixie supermarkets in metro Atlanta. Let's see...that's right. There are only a handful in Georgia, and from what I can tell they are limited to metro Columbus and metro Valdosta.

My only criticism of Publix is that they are limited to more affluent areas, at least in Atlanta. I'm fiercely loyal to them, though, so I'll continue to go there preferentially.

>164 Cariola: Five days isn't as bad as three weeks, but that is still an unduly long hospital stay for appendicitis, Deborah.

>168 Morphidae: We prefer to spend no more than $3 (on average) on meat per dinner. I expect that chicken dish to be at least $5 - $6, if not more.

I would agree with you completely, Morphy. Perhaps you could find them on sale, but higher end products like that one (which is organic) rarely do, at least in my experience.

Embarcadero?

No; it's Portsmouth Square. Now that I'm at home I can refer to my old and still very valuable Access San Francisco guidebook. The noodle house I was thinking of is Hon's Wun Tun House, on Kearny Street a block away from Portsmouth Square, and Hing Lung Chinese Cuisine, which was on Broadway between Stockton and Columbus, is the place that specialized in juk:

Fans converge here mainly for the juk (a thick rice porridge offered 17 ways). The house special stirs a delicate blend of shellfish and fish into the thick, steaming mixture. Other juk dishes include pork liver with sliced pork, fresh clams with abalone, which has a clean, fresh flavor, and pork-blood curd, with musty nuances.

I can vouch for the first three juk mentioned in that paragraph. They were delicious, and very cheap. Customers were seated elbow to elbow on long tables, and the restaurant was invariably full. Often times I would be the only non-Chinese person there, and usually one of the managers would have to take my order, as most of the waitresses spoke no English. Can you say authentic?

ETA: Here's a photo of Portsmouth Square, which is probably the largest public open space for the Chinese community in Chinatown:

>170 Morphidae: I agree with your general assessment of newspaper coupons, Morphy. Now that I'm making practically all of my meals from scratch I don't use those coupons often, which is why I've gotten out of the habit of buying the Sunday Atlanta Journal-Constitution. The BOGO sales at Publix are far more valuable and relevant to me.

Minnesota is very, very white.

I think the same could be said about most of the Midwest, or for that matter most of the interior of the country outside of the Deep South and the Southwest, save for isolated pockets mainly in large cities.

I don't believe we have the problem with the geographical distribution of food markets. Or at least not near as much. The segregated areas simply aren't large enough.

That makes sense.

>171 streamsong: 89 kids in the ED? Holy cowza what's going on?

Let me see if I can remember the diagnoses of the kids I saw last night: a three day old baby with jaundice and fever, a very unusual combination; a young boy (6 yo?) with pneumonia and status asthmaticus; a similarly aged boy who fell from a chair while wrestling with his brother and hit his head, then proceeded to fall and hit his head again while he was sitting in a chair (the story that his mother gave was a bit suspect, so we're investigating it more thoroughly while we watch the kid, who wasn't acting normally last night); a 3 week old baby with recurrent jerking movements of his right leg suspicious for seizures; a toddler with bronchiolitis and hypoxemia; umm...I think the last one was a "hot baby", a neonate (baby of 0-28 days) with fever, but that could have been from the night before last. Sarah, the neurohospitalist who worked alongside me last night, told me that she already had six admissions to the Neurology service between 6 pm to 12 am, which is an unusually high number. We're all normally far less busy in January and February than we are in November and December, but that hasn't been the case this year.

>173 The_Hibernator: I've always had a bit of trouble accepting the scorn that some of my doctor friends feel for ER doctors, psychiatrists, and family medicine doctors.

ER doctors get a lot of grief and are under a lot of pressure, due to expectant parents, high volumes of patients who must be seen quickly, and push back and grumpy attitudes from busy, tired and overworked hospitalists (*raises hand*) and other subspecialists, especially if the latter are awakened in the middle of the night. Someone, I think one of the third year pediatric residents from Emory, mentioned to me recently that she planned to go into emergency medicine, and that she was prepared to be "one of the least liked doctors in the hospital."

The majority of the ER doctors I work with are excellent, and several are good friends, most notably my neighbor Lily, who I think I've mentioned previously. I have great relationships with them, even on the worst of nights, but the mediocre and less competent ones drive me, and my partners, out of our minds on a regular basis.

We highly value our psychiatry colleagues (who share an office space with us), both the physicians and the nurse practitioners, and I'm very close to all of them, particularly Erin, the nurse practitioner who I met, along with her youngest daughter, in Paris for dinner this past September.

We always have family practice residents from Atlanta Medical Center and Gwinnett Medical Center on the teaching service, so we interact with them regularly. I would argue that they have to be some of the brightest of physicians, as they have to know far more medicine (e.g., pediatrics, adult medicine, OB-GYN, and, in some cases, surgery) that those of us who specialize in one field do. One of my dearest friends from medical school is a family practitioner in her home town of Bradford, PA; we met for dinner when she was in town for an AMA House of Delegates conference, and I was very impressed by her knowledge and poise, and I felt like a slacker in comparison. Family practitioners definitely get a bad and very undeserved rap, particularly by specialists who would be lost if they were in their shoes.

I'm caught up for the moment here. I'm quite sleepy, but I think I'll fight through it and start cooking, so that I don't waste this day. I'll try to catch up with everyone else's threads later today or tomorrow.

I have been listening to the discussions about the cost of food and the problems of inexpensive fresh veg and fruit seems to be universal.
For anyone who is looking to start/organize/fund a good community group that addresses part of this problem- take a look at the group
The Stop ( in Toronto. ON)

>177 kidzdoc: Thanks, Darryl. Oh, I'm glad young professionals are moving back into Atlanta, and the city is responding. I love cities, and that sounds healthy.

We, like you, have been dreading this day. We're staying off Facebook for the day, but we've been told to be sure to visit the Onion website, as it's supposed to be very good today. I'll be doing that soon.

Thanks re NOLA. I'll look forward to it.

>179 kidzdoc: I would think that there aren't any Waitrose supermarkets or Whole Foods Markets in poorer areas of London or the SouthEast of England Not Waitrose shops no, but virtually all towns will have one of the big supermarkets which may not stock so much of the higher end items (depending on area) but will certainly have a good stock of fruit and vegetables. Then there are a lot of cheaper supermarkets such as Lidl and Aldi which also do a good range of fresh produce. I'm thinking of where my mother lives in South Wales, which is definitely less prosperous than the South-East of England: she only has a smaller Co-op supermarket but there are also two greengrocers and a butchers and various other smaller shops. The poorer parts of London that I've been too frequently have ethnic shops and markets which provide a variety of produce.

The worst places to get fresh food would be on one of the large council estates that are on the outskirts of poorer towns, with transport to the shops (as well as general poverty) being the problem. And then also very rural areas if you had no car and were dependent on very intermittent bus services. But I do find it difficult to imagine places where you couldn't even buy apples, even if they were more expensive that at the bid supermarkets.

>179 kidzdoc: Four days of my daughter's initial hospitalization were before they finally diagnosed her ruptured appendix. When she went back for the surgery, I believe she was only in for two days.

I'm wearing all black today. I am in mourning for my country.

>184 Cariola: - I mentioned earlier in the day on another thread (Mark's, Joe's?, can't remember), that there have been other times in my life when, as my own personal protest for very bad political outcomes or events, I have chosen to wear red and black: red for rage and black for mourning. I don't do crowds well and I am not a loud person but in my own way, I feel it makes a statement. I am not even American but I did it today, too, in solidarity. If it were up to me, flags would be at half mast, too, but I believe there is *official* protocol that would likely prevent this...

The Asparagus Bacon Quiche is now cooking in the oven, and it should be ready within the hour, in time for dinner. If I'm not out of gas after dinner I'll make Emeril Lagasse's Macaroni with 4 Cheeses!, otherwise I'll do so tomorrow. I figured that making quiche is the ultimate pinko libtard response to trump's inauguration today. I'll post a photo and the recipe once it's done.

>181 torontoc: the problems of inexpensive fresh veg and fruit seems to be universal

I suspected that this was the case, Cyrel, although I didn't give it much thought until the past week. This discussion has been an eye opening one for me, and it directly ties in my desire to get my head out of the sand and learn more about how people who are different from me live.

>182 jnwelch: Right, Joe. Atlanta has become an increasingly desirable place to live, because of the relatively low cost of living compared to other major US cities, particularly NYC and San Francisco, the excellent colleges and universities here, particularly Emory, Georgia Tech, Morehouse and Spelman, the number of Fortune 500 and other large companies that have offices here, the nice neighborhoods Intown (despite what the Tweeter-in-Chief claimed last week), and the increasing cultural amenities and excellent restaurants that have become much more prevalent in the past 5-10 years.

Now that I've sat down after preparing the quiche I'm feeling bushed, so I suspect that I'll post those NOLA links to your profile page (and cook the mac & cheese) tomorrow.

>186 kidzdoc: Makes sense, Darryl. It makes me think of Pittsburgh, too. The difference in the cost of living between Seattle, where he was, and Pittsburgh, where he is now, blew the mind of son Jesse.

>183 SandDune: That's good to hear, Rhian. We have Aldi stores in the US, including at least three in metro Atlanta (the closest one to me is about 5 miles away), and Lidl plans to open stores in Georgia in 2018.

>184 Cariola: I'm mostly hiding my head in the sand today, Deborah. I refuse to read the newspaper, listen to the radio, or watch television.

>185 jessibud2: I've read and responded to Facebook posts by Fliss and Rachael today, who are both bemoaning the inauguration even though they both live in Cambridge, UK. Ilana has been posting regularly about her disbelief and despondency about the election result and inauguration since November, as well.

I wouldn't be surprised if some of the residents in my very liberal and diverse neighborhood are flying their US flags at half mast. I'll go out tomorrow or Sunday and look for them.

>187 jnwelch: Right, Joe. Pittsburgh, IMO, is very underrated as a place to study and live. It has fabulous neighborhoods, plenty of parks, more cultural amenities than you would think, good sports teams, and excellent universities, especially Pitt and CMU. Best of all, I'm sure that it's vastly more affordable to live there than places like Seattle.

>189 kidzdoc: Totally agree. Pittsburgh was a great place to go to college and live.....even though it's been quite awhile since I did that.

>189 kidzdoc:, >190 tangledthread: Yeah, but you gotta learn to say "yinz". Don't know if I can get rid of the "y'all"... :D

I finished making the Asparagus Bacon Quiche about three hours ago, and had a slice of it for dinner:



Ingredients:
1 store bought prepared pie crust*
8 ounces sliced mushrooms
1 tablespoon oil
1/2 pound asparagus cut into 2-inch pieces
6 large eggs
3/4 cup heavy cream
4 green onions, sliced
1 roasted red pepper, sliced
1 1/2 cup white cheese, shredded (jack and muenster)
6 strips of smoky bacon, cooked and cut into bite size pieces
salt and pepper

Instructions:
1. Preheat oven to 375 degrees.
2. Spray a removable bottom 9.5-inch tart pan with non stick cooking spray.
3. In a medium skillet saute mushrooms with oil until golden.
4. Set aside to cool.
5. Fill a medium saucepan with enough water to cover the asparagus.
6. Bring water to a boil; add asparagus and boil 1 minute.
7. Drain immediately and set aside to cool.
8. Roll out the prepared pie crust, press into the sides of the tart pan.
9. In a large bowl lightly beat the eggs, add the cream and stir together.
10. Add the onions, red pepper, shredded cheese, cooled mushrooms, cooled asparagus and bacon.
11. Salt and pepper to taste.
12. Gently fold all ingredients together and pour into prepared tart pan.
13. Set pan on a cookie sheet, bake 50 minutes or until a knife inserted into the center comes out clean.
14. Cool in the pan 15 minutes before removing the tart pan sides.
____________________________________
* I used the recipe for oat crust found in the Caramelized Onion, Mixed Mushroom and Gruyere Quiche recipe that I'm very fond of.

I cooked the quiche for an additional 10 minutes, as the center was still very wet, possibly because I used a bit more cheese and asparagus than the recipe called for. As a result, the top of the quiche is a bit browner than it ideally should be. It still tasted good and not burnt, though, and it is very filling. I can't really taste the bacon in this recipe, and I would say that it isn't essential, so this could be easily converted into a vegetarian recipe. I had never roasted peppers before, but I found a good online source (http://toriavey.com/how-to/2010/02/roasted-bell-peppers/) that gave me good instructions on how to do so. I love this quiche, and this recipe will be added to my list of favorites.

I decided to fight through my sleepiness and make the macaroni & cheese. It's cooking in the oven now, and it should be ready in a few minutes...ha! My timer just went off.

Here's my version of Emeril Lagasse's Macaroni with 4 Cheeses! recipe:





Ingredients:

4 tablespoons butter, plus 2 tablespoons, plus 1 tablespoon
4 tablespoons flour
2 cups half and half
3/4 teaspoon salt
1/4 teaspoon ground white pepper
1/4 teaspoon Emeril's Red Hot Sauce
8 1/2 ounces grated Parmigiano-Reggiano, or other good-quality parmesan cheese (about 2 cups)
1 pound elbow macaroni
1/2 teaspoon minced garlic
4 ounces grated cheddar cheese
4 ounces grated fontina cheese
4 ounces grated gruyere cheese
1/4 cup fresh bread crumbs
1/2 teaspoon Essence or Creole Seasoning

Instructions:

In a heavy, medium saucepan melt 4 tablespoons of the butter over low heat. Add the flour and stir to combine. Cook, stirring constantly, for 3 minutes. Increase the heat to medium and whisk in the half and half little by little. Cook until thickened, about 4 to 5 minutes, stirring frequently. Remove from the heat, season with the salt, pepper, hot sauce and 4 ounces of the grated parmesan. Stir until cheese is melted and sauce is smooth. Cover and set aside.

Preheat the oven to 350 degrees F.

Fill a large pot with water and bring to a boil over high heat. Add salt to taste and, while stirring, add the macaroni. Return to a boil, reduce the heat to a low boil and cook for about 5 minutes, or until macaroni is very al dente (slightly undercooked). Drain in a colander and return the macaroni to the pot. Add 2 tablespoons of the butter and the garlic and stir to combine. Add the bechamel sauce and stir until well combined. Set aside.

Using the remaining tablespoon of butter, grease a 3-quart baking dish or casserole and set aside.

In a large bowl combine 4 ounces of the remaining parmesan cheese, cheddar, fontina and gruyere cheeses. Toss to combine.

Place one-third of the macaroni in the bottom of the prepared baking dish. Top with one-third of the mixed cheeses. Top with another third of the macaroni and another third of the cheese mixture. Repeat with the remaining macaroni and cheese mixture. In a small bowl combine the bread crumbs, remaining 1/2 ounce of grated parmesan, and the Essence and toss to combine.
Sprinkle this over the top of the macaroni and cheese.

Bake for 40 to 45 minutes, or until the macaroni and cheese is bubbly and hot and the top is golden brown. Remove from the oven and allow to sit for 5 minutes before serving.
______________________________________

I substituted pecorino romano for Parmigiano-Reggiano, and used Tabasco sauce with habañero peppers and Tony Chachere's Creole seasoning; otherwise I followed the recipe to the letter. This produced a very thick and cheesy mac & cheese, which I prefer infinitely over runny or watery recipes. The bread crumb topping was perfect, and the spices give it a proper New Orleans flavor. My father's amazing mac & cheese recipe remains my all time favorite, but this outstanding one falls right behind it.

I left "yinz" behind a long time ago (been in SE Mi for almost 40 years).

PS: Had some yummy scallops w/ sugar snap peas from this NYT recipe tonight:
http://cooking.nytimes.com/recipes/9636-sea-scallops-with-sugar-snap-peas

but we required some red pepper flakes to zing it up a little bit. (What is all this talk about midwestern bland food?)

That quiche looks good enough that I want to pick up my computer and take a bite of it, Darryl! The Mac N' 4 looks scrumptious, too : ).

Happy weekend, Darryl.

>174 kidzdoc: smiling. I'm glad to say that the BBC have not gone overboard on coverage here. 'Every breath he takes' is not on the menu, in the way it was for Obama, who withdrew from the stage with the dignity we have come to expect from him. He will be missed, but I'm looking forward to what he does next, and his writing. I'm suspecting climate change may be a focus.

Quiche looks amazing Darryl. I had a good week of homemade soups at work, will try something chicken based this week I think.

>197 Caroline_McElwee: - I too, am looking forward to some writing from Obama. I have read his 3 previous books and I hope he has already started on a fourth!

Note to self: Do not stop over here, if you are hungry.

Happy Saturday, Darryl! Love all the foodie stuff. I am not a fancy cook but I do like to eat.

I started Just Mercy. Have you read this one? It looks like it is going to be another very important read.

Good Saturday morning/afternoon, everyone. It isn't a happy day, of course, after donald trump took the oath of office and became our new President. Several of my LT and non-LT friends and colleagues will participate in Women's Marches in Atlanta, Chicago, Washington, and even London (give 'em hell, Rachael!). Unfortunately the weather will not be good for marches and other outdoor activities this weekend in Atlanta, with strong and possibly severe thunderstorms forecast for today and tomorrow, along with a chance of high winds, damaging hail, and isolated tornadoes both days. It's very dark outside, a huge swath of moderate to heavy rain is on the way, and I heard a rumble of thunder in the distance a few minutes ago. I hope and pray that the marchers in Atlanta and elsewhere make their voices heard, and arrive back home safely.

I'll almost certainly stay inside all day today, as I need to study for Thursday's PALS (Pediatric Advanced Life Support) renewal class today and tomorrow. Being PALS certified is a requirement for my job, and since my current 2 year certification expires at the end of this month not passing this course is not an option, although I've passed it every time I've taken it since 1997. It's not a given, though, and anyone who doesn't study for the class is probably in deep trouble. I'll probably go to Publix as usual on Sunday, and cook one or two dishes, as I'm working six out of seven days next week; my "off day" is the date of the PALS renewal class, which usually lasts at least six hours. So, I'll need to stock up on food, and I'll probably make an entirely or mostly vegetable soup, possibly something new.

First, though, I'll catch up on threads.

>190 tangledthread: Where did you live in Pittsburgh, tangledthread? I lived all four years in the same apartment building in Shadyside, on Ellsworth Avenue between Negley Avenue and Summerlea Street. It was a great location, as the 71C bus stopped at the corner of Ellsworth & Summerlea, which dropped me off on Fifth Avenue in front of what was then Children's Hospital of Pittsburgh, and the Pitt Shadyside shuttle stopped on the corner of Negley & Ellsworth, so I didn't have to drive to campus. I loved that peaceful neighborhood, and the neighbors who lived in my building were very friendly, particularly an older Jewish couple who sat on their patio near the building's entrance and often invited me to join them for dinner after I arrived home. They were quite old then, and I'm sure that they have both passed on.

>191 drneutron: Ha! I could never say yinz, as I had been saying y'all or, far less commonly, youse my whole life. Maybe Myron Cope, the late long time radio and television voice of the Stillers Steelers, has some instructional videos that teach new residents how to speak Pittsburghese. What a character he was!

Good morning, Darryl. I just heard something on the news that caught my ear. One woman who is going to one of the marches, just said this: "I have to accept that trump is my president but he needs to understand that I am not the enemy, I am his BOSS." I thought that was excellent. Not that he will *hear* it, but others will and hopefully, be empowered by it. Sadly, so many of my American friends and family are really scared and worried, particularly about health care. Sadly, those idiots who voted for him will have to learn the hard way just what a liar he is. And how dangerous. I hear he has already pretty much rewritten the White House website, removing all references to many important issues (climate change, LGBTQ, for example). I guess telling them "be careful what you wish for" is probably too late now... :-(

Morning, Darryl! Good luck studying this weekend!

>194 tangledthread: Mmm...I love scallops! I'll have to look for some and give that recipe a try.

>195 lit_chick: Ha! Thanks, Nancy. The mac & cheese is deceptively runny looking; I took those photos just after it finished cooking, but after it cooled down it was much thicker, just the way I like it. I'm curious to taste it and the mac & cheese this afternoon, as I suspect both will taste even better after a night in the refrigerator.

>196 Ameise1: Happy weekend to you too, Barbara.

>197 Caroline_McElwee: I'm sure many of us will also be curious to see what Barack Obama and his family have planned in the near future. I imagine it's commonly known that they have purchased a house in Washington, and will live there until their youngest daughter graduates from high school.

>198 charl08: Thanks, Charlotte; I was pleased with the way it, and the macaroni & cheese, turned out. I'll make soup tomorrow as well, although I haven't decided what type(s) yet.

>199 jessibud2: Barack Obama has written three books? Checking...oh, that's right, I had forgotten about Of Thee I Sing.

>205 kidzdoc: Whatever he does Darryl, I am sure that he will have more well wishers than he could ever imagine. I cannot remember anyone leaving high office with such overwhelming good will for him/her than for Mr. Obama. It will be interesting to see what both he and Michelle do. She could be a dark horse for future high office, I think.

>200 msf59: Hi, Mark! Do you cook at all? What's your specialty dish?

I haven't read or heard much about Just Mercy. I just read a synopsis of it, and it sounds very interesting. I look forward to your thoughts about it.

>202 jessibud2: That's a great quote by one of the marchers, Shelley. trump must understand that he is the president of all the citizens of this country, not just the minority who put him into office. His approval rating prior to the inauguration was as low as 37%, roughly half of what Barack Obama's was at this time eight years ago, and that was the lowest pre-inauguration rating for an incoming POTUS in history. Unfortunately he labeled the poll as fake, and he continues to act like a petulant child whenever he is challenged or criticized.

I am very afraid for those people who stand to lose their health care, particularly the children who we see. The nominee for Secretary of Health & Human Services, Dr. Tom Price, is the US Representative for Georgia's 6th congressional district, which includes Sandy Springs, where my hospital is located, and most of the wealthiest suburbs north of the city. He is an orthopaedic surgeon, and was formerly the chief of Orthopaedic Surgery at Grady Memorial Hospital, Atlanta's large public hospital, before he was elected to Congress. That would seem promising, but he is a far right conservative who is opposed to public health programs like Medicare, Medicaid (which provides free insurance for children of poor families), and the states' Children's Health Insurance Programs (which provides low cost coverage for children of low income families). Cuts or alterations to Medicaid or Peach State, Georgia's CHIP, would be devastating for many of the kids we care for, as over half of the ones we treat are covered under one of those two programs. We shall see, but I'm scared as well.

>203 scaifea: Happy weekend to you, Amber! I didn't sleep well, so I'll take a nap after lunch before I start reading the PALS manual, which could put the worst insomniac on the planet in slumberland in short order.

>206 PaulCranswick: Right, Paul. Barack Obama and his family will be sorely missed as occupants of the White House, particularly in comparison to its new residents. I'm sure that trump has noticed the difference between the reception the Obamas received in comparison to his, and I would imagine that he is offended by it. The crowds at yesterday's inauguration were relatively sparse compared to the ones from eight years ago, and I'm sure that trump noticed this as well.

There has been a groundswell of support for Michelle Obama to seek higher office. It will be interesting to see what she decides to do once the Obamas settle into their new home in Washington.

>208 kidzdoc: I like that as a put down Darryl. donald trump uncapitalised until he does something to earn his way out of lower case.

>209 PaulCranswick: Exactly, Paul. I also liked this week's cover of The New Yorker, with its portrayal of trump as a petulant child:

That's a great cover! lol!

Someone on one of my other book sites posted this pic and it just begs a caption contest, don't you think? ;-)

https://pbs.twimg.com/media/C2qnqB5WIAEZVd3.jpg

>211 jessibud2: 'I think I've got constipation, do you have any laxitives darling?'

>211 jessibud2: Yikes. That photo does need a caption. I could also see someone pasting trump's head on the body of a pouting toddler in a high chair. He got what he wanted, as he is the new POTUS, so why is he in such a bad mood?

If I'm being fair I thought that Melania's outfit was fantastic.

>212 Caroline_McElwee: There aren't laxatives strong enough to clean trump out. He's been anally retentive since he was a child.

>214 kidzdoc: - LOL

Melania: You idiot, I told you, I am NOT moving to this city, to this house. I want to go home!

trump: Shut up. I don't want to be here either but all those stupid people who believed all my crap and lies, they made this happen. It's their fault. I'm thinking, thinking. There will be a way out. I will find it. I will make our exit great .....

>215 jessibud2: LOL!

Yesterday was a difficult day. There are supposed to be HUGE crowds in Boston for the Women's March today. So many friends are participating in DC, here and elsewhere. It's truly heartening to see Democracy in action. That more people are willing to stand up, be counted and speak against hurtful or hateful policies than those who came to the Inauguration (or parade) is a wondrous thing. No greater love of country than to speak truth to power.

Wishing you a wonderful weekend.

>217 michigantrumpet: I understand that the crowd for the Women's March in Washington will be considerably larger than the one for the inauguration, which will send a powerful message to the country and the world, although I'm sure that it won't positively affect trump one bit. I'm enjoying the photos posted on Facebook of LT friends and others who are participating in Women's Marches today; I hope that Rachael (@FlossieT) posts photos from the London march as well.

>213 kidzdoc: I saw a clip of them dancing together and they are certainly a sharp contrast to the Obamas. They seemed very awkward and distant from one another, and her subservience leaves a very bitter taste in the mouth. You couldn't pay me enough money to marry him, though I suppose it would seem preferable to a standard life in Slovenia (I'll take the Slovenian life please).

>217 michigantrumpet: - My friend who lives outside Boston (in Worcester) is marching today in Boston. I also have friends marching in Florida

>218 kidzdoc: It seems Trump does *occasionally* bow to public outcry. The First Lady's bio on the WH web site HAD contained a shameless plug for her jewelry line, sold on QVC. Received a TON of negative press, in addition to being pretty unethical). By the end of the day, the reference was removed.

Sometimes, it seems as if they push to see if there is any pushback.

>220 jessibud2: I don't think I have many women friends here in MA who aren't attending the March. If I weren't coming off a 2.5 week bout of the LT lurgy, I would definitely be there with them. I'll just have to content myself with following on FB and Twitter.

Good for your friends. If you ever come to visit the Worcester crew, please stop by for a Boston area Meet Up!

>219 lunacat: I just watched a brief clip of the inaugural dance. Yikes...if he was any more stiff he would have shattered into pieces.

Melania and donald are an odd couple, to say the least. What in the world attracts him to her, other than his money and massive ego?

>220 jessibud2: Excellent. One of my favorite nurses from Children's drove from Atlanta to Washington with nine friends and will participate in today's Women's March there. I'm all but certain that someone from Children's will participate in the March here, althugh the weather will probably keep the participation relatively low.

>221 michigantrumpet: Seriously?! That's shameful and very unethical.

>210 kidzdoc:

The caption is his two minders talking:

"How the jaysus are we going to keep feeding 1,461 days worth of dimes into this toy?"

>221 michigantrumpet: - Wish I had been on LT a few years ago. I visited my friend in Worcester 3 years ago, when a local friend and I did a road trip to Boston, and also, a year before that when we did a road trip to the Maine coast. This summer, she is coming to visit me in Toronto. If you are ever up this way, let us know!! We've had 2 LT meetups here so far over the last few years, when Zoe comes home to visit

I just had a small slice of quiche and a portion of the mac & cheese for lunch. This not very good photo, which I took just after I reheated the mac & cheese in my toaster oven, shows its thickened consistency:



I hate watery and runny mac & cheese, and the dense consistency of the one from this recipe is very similar to the one my father makes.

>223 PaulCranswick: Ha! Given trump's deep unpopularity I suspect that the Secret Service agents in charge of protecting him will be busier than any in our history. Mind you I don't want any harm to come to him, or any man or woman.

>224 jessibud2: I'd love to go to an LT meet up in Toronto, especially if Zoë is there. Please keep me in the loop when y'all plan to have them in the future.

>192 kidzdoc: That quiche looks really good, Darryl.

I have been watching the Women's March on C-SPAN; they are covering it in its entirety. The last estimate I heard was half a million attendees. I am sure that Trump's tweet will write them all off as "sore losers." I was quite dismayed this morning to turn on CNN and MSNBC and see not the march but Trump at the National Cathedral pretending that he believes in a God other than himself.

>202 jessibud2: I like that quote, but I have no doubt that Trump thinks he was elected emperor, and he will do whatever he pleases. His cabinet nominees, his first priorities, and his remarks yesterday have shown that he has no interest whatsoever in uniting Americans or listening to other points of view. Its clear that he intends to keep building divisiveness; his inaugural speech was an intentional slam at everything Obama has done and stands for. The key, I think, is to keep putting pressure on our members of Congress. They are the ones who will have to listen if they expect to get reelected. Otherwise, it will be the special interest groups and radical conservatives that will prevail, setting progress back 60 years.

I was appalled to hear Trump say that he plans to parade military power in the streets of and skies above our major cities, like they do in Russia and North Korea. I want to live in a peaceful nation, not one that feels the need to threaten other countries and our own citizens.

>213 kidzdoc: Bill Maher said that Melania's blue outfit was made for head transportation . . .

>222 kidzdoc: So did he dance with Caitlin Jenner as predicted? (I doubt it!)

Did anyone else see his tweet (I doubt any of you pay attention to his feed but I do, because I feel like being aware of the crap he spouts is vaguely important) in which he couldn't spell honoured. I know the US and the UK spell it differently so in the US it would be honored, but this was 'honered'. It's been changed now, but I spat my drink out laughing, and then sobered up quickly at the thought this is the 'leader of the free world'. So I went and looked at pictures of intelligent, well informed and strong willed people marching and protesting today, which made me feel slightly better about the world.

>226 Cariola: - You are right, of course, about trump not listening, not hearing, and certainly not caring about anything anyone says, unless it is in support of HIM. But it's still important for those excellent quotes, wise words and strong, sensible feelings to be put out there and heard by others. Contrary to what he believes, he is NOT the only person in the world. On some level, someone in his circle of trolls will have to get up the guts to tell him he is making a mess. I think today's marches all over the world were an important show of solidarity among the sane and level-headed. But I think it's also important for Americans especially, to keep the message alive and current. He may be thinking (if he is thinking at all, that is), that if he just bides his time, it will all blow over and the women will go back to their kitchens but as we all know, he is a dimwit and has no idea what solidarity really means.

A little late commenting on the ER talk, but I'm glad you were able to diagnose the little boy and how sad that the family had to come multiple times before a diagnosis :(

As a kid getting stitches and a broken arm, I managed a few ER trips myself. The only one I remember with any clarity was for appendicitis: I was convinced it's what I had and my mom had to be talked into going to the hospital. I woke up with pain on my right side, and it started higher so she thought it was gas. I also had nausea and couldn't keep anything down (which was helpful when it turned out I needed emergency surgery). This was a Saturday. That night, I went to bed and the pain had lessened. I woke up early in the morning with pain increased and lower on my side. Mom called the doctor to essentially ask "How can I tell the difference between appendicitis and gas?" and was basically told "You can't. Get her in to the hospital." So the day after I first had pain, away we went. At the time, there was a small hospital right in town so we went there first. They saw my arm in a cast and immediately assumed it was my arm. Nope, that's already in a cast.

So they went through all the tests, my white blood cell count was at 35,000, and after confirming appendicitis they sent me to the hospital in the nearest city that had a pediatric surgeon since they didn't. So 2nd ER of the day, and the receptionist looks at me, asks if it's my arm... and then tells me mother, "If it was appendicitis, she'd look a lot worse that this." They also didn't believe that the first hospital had the blood tests right (now that I've read your story, though, I could totally see how this would be the case) and did everything over again. At this point, I had rebounding pain (they could press on the left side of my abdomen, let go and I had *shooting* horrible pain on my right side). My mom is of course panicked now and I was fairly calm when they brought in a resident to he could basically see what all my symptoms looked like, I guess? I was ten, so the details are fuzzy here. Anyway, I was able to get into surgery and I remember one nurse in particular being fabulous about helping me get out of bed to use the bathroom in the nights after. I haven't had a huge medical emergency since, knock on wood.

I hope you're able to get a couple of good days of rest in, Darryl. The quiche looks fantastic.

>201 kidzdoc: Clyde Street which is a one way street, one block long between Fifth Ave. & Ellsworth. It was a great location because I could walk almost everywhere from Pitt campus to Shadyside.

And being a one way street it was pretty quiet.

I just looked and Carnegie Mellon U has purchased the building that I lived in.

I'm not talking about politics. It stresses me out beyond belief. Instead...

>192 kidzdoc: 'SHROOMS!

>225 kidzdoc: Macaroni & Cheese! Yum!

ETA:
>180 kidzdoc: Never EVER Google "Hot Baby." I'm just sayin'.

>208 kidzdoc: The crowds at yesterday's inauguration were relatively sparse compared to the ones from eight years ago, and I'm sure that trump noticed this as well. Our news reported that Trump said that it was misreported that the attendance was low at his inauguration.

Happy Sunday, everyone! As usual I went to Publix and bought a bagel sandwich and bagels for the week at Einstein Bros next door. Continuing with my love for the New Orleans chef Emeril Lagasse I bought ingredients to make his Homemade Chicken and Vegetable Soup, which I'll get started on very shortly.



I'll resume studying the PALS Manual this afternoon, after I finish making soup.

Happy Sunday! As ever, your thread makes me hungry - that soup looks brilliant.

Good luck with your exam Darryl.

>226 Cariola: Thanks, Deborah. I had a slice of it for lunch yesterday, and I liked it even better than I did on Friday.

I'm boycotting all television and news coverage this weekend, but I did read the article about trump's and his press secretary's response to the inaguration coverage and his dismissal of the extent of the crowd. Sean Spicer, the spokesman for trump's Ministry of Truth, falsely claimed that the press was lying about the photos that were posted on Twitter and elsewhere, and claimed that trump had drawn "the largest audience to ever witness an inauguration," with an estimated 1-1.5 million people in attendance. That far fetched claim prompted this brilliant response during last night's National Hockey League game at the American Airlines Center in Dallas, which seats roughly 19,000 fans:



I agree, we will have to maintain pressure on our elected officials to keep trump from turning back the clock 100 years or more.

That Bill Maher quote you mentioned went over my head. Did he really say that he was going to dance with Caitlin Jenner?!

>227 lunacat: I haven't signed up for trump's tweets, but I have been looking at his Twitter feed more often, so maybe I should. He'll probably claim me as one of his supporters, though.

>228 jessibud2: Right, Shelley. Some in his inner circle or family will have to rein him in on a regular basis to keep him, and this country, from going off the rails. Melania, his wife, doesn't seem to possess the backbone necessary o do so, and I suspect the same is true for his adult children and son-in-law.

Darryl, exciting news from my semi-rural outpost: my supermarket had ground lamb yesterday!! I snapped it up and put it in my freezer to make the pasta dish later, probably next weekend.

>236 kidzdoc: - Sigh... I suspect that if only 3 people had shown up for the inauguration, he still would have somehow claimed that it was 3 million. Just pray that he doesn't learn how to use photoshop. Can you even do photoshop on twitter?

As for the *reigning in*, I am afraid that is just wishful thinking on my part. I don't think there is a human alive who can succeed at that task. And didn't I hear that they took away his twitter account again?

I usually listen to our own CBC morning radio show on Sunday mornings because it's really good but this morning, I decided to turn on the tv to watch CBS Sunday Morning (I think it's CBS). I was curious to see if they talked about the marches. However, I tuned in a bit late so if they addressed it at all, I missed it. However, I did catch Ben Stein. Sheesh. The man is a jerk. First of all, how can someone with such poor diction even be allowed on tv? He mumbles and swallows his words to the point of being practically unintelligible. But, more than that, I felt he was insulting the intelligence of viewers by praising trump's phony baloney *embracing* the Obamas and Clintons at the inauguration as *civility. The word *civility* doesn't belong in the same room, let alone the same sentence as *trump*. He is as delusional as everyone else who voted for trump. May he deserve what he gets.

And on the very anniversary date of Roe. vs Wade, I heard on our news that trump is set to repeal reproductive rights today, or something like that. Shame, shame, shame. I can't think of enough bad things I wish on this man. Not proud to say this but there it is. I am evil.

>236 kidzdoc: I'm not one of his followers so I don't add to his 'twitter popularity' but I like to know what the enemy is saying. I think it's important to stay informed in order to fight back. Plus you get the added bonus of laughing A LOT when he makes a simple spelling mistake or says something utterly idiotic and then needs to backtrack or edit it.

>229 bell7: Yikes. That's some story about your case of acute appendicitis, Mary. I imagine your mother still feels guilty about blowing off your symptoms! Your elevated WBC count is certainly consistent with a significant bacterial infection. 35,000 is quite high, but certainly not unheard of. The rebound tenderness and referred RLQ (right lower quadrant) abdominal pain you described is consistent with a "surgical belly", and in an otherwise healthy 10 year old girl acute appendicitis would be at the top of everyone's list of likely diagnoses.

When I developed acute appendicitis I thought I had food poisoning, and since it was very early Sunday morning at the time I thought I needed emergency assessment I foolishly drove myself to the ED at Piedmont Hospital. Emory University Hospital would have been slightly closer, but I didn't want to be seen by any medical students or interns, even though I was a pediatric intern myself, as I knew that I would have to undergo multiple physical examinations. The drive to the hospital was torturous, as every time I hit a bump, no matter how small, I felt as if someone was stabbing my abdomen with a sharp knife. Years later I read a journal article in which the authors conducted a study of patients presenting to the ED with abdominal pain. The most reliable predictor of whether a patient had a surgical abdomen or not, prior to conducting a physical exam and performing laboratory or radiologic studies, was if the person had moderate or severe abdominal pain while passing over bumps en route to the hospital!

The quiche looks and tastes great, espcially on the day after I made it. It's a very dense quiche, so I'll get at 6-8 servings out of it. I've had two slices of it, and nearly 3/4 of it remains.

>230 tangledthread: Clyde Street sounded familiar to me, so I looked for it on Google Maps, and saw that it is very close to Neville Street. IIRC the 71C bus turns onto Ellsworth from Neville, so it would have passed by Clyde Street to the right.

Clyde Street looks to be close to CMU, so I'm not that surprised that the university decided to buy the building you lived in.

>231 Morphidae: Naturally I did Google "hot baby", Morphy. I wish I hadn't, especially on a Sunday!

>240 kidzdoc: Yep. The building was all studio apartments. We had a cozy little community of students and elderly people....way back in the '70's.

Since I am a knitter, I want to point something out to this group. All of those pink hats that were walking around yesterday.....they were all hand made by people, mostly in the US.

Those red hats you've been seeing? Outsourced.

Something to think about....

PS: spending today reading Notorious RGB:The Life and Times of Ruth Bader Ginsburg

(I don't know why that book is so hard to link to on LT)

May she live and be healthy these next 4 years!

>241 tangledthread: - Thanks! I was wondering about the pink hats!

>232 Familyhistorian: Right, Meg. The front page of today's NYT features an article about the false statements made by trump and Sean Spicer, his press secretary, about the media's coverage of Friday's inauguration:

With False Claims, Trump Attacks Media on Turnout and Intelligence Rift

>234 pokarekareana: Happy Sunday, Jen! I'll get started on the soup as soon as I catch up here. I'll make some modifications to the recipe, as I didn't want to go through the effort of deboning a chicken, and it allows you to choose which vegetables you want in it. I bought zucchini, an eggplant and a butternut squash, but unfortunately Publix was out of fresh and frozen okra, which would have been great in this soup. I do have frozen corn, though, and I'll add some if I don't have enough zucchini, eggplant and squash to make five cups.

>235 Caroline_McElwee: Thanks, Caroline. Fortunately the exam isn't until the end of the course on Thursday.

>237 lauralkeet: Excellent, Laura! I look forward to hearing your thoughts about the Mediterranean lamb & mushroom pasta after you make it.

>238 jessibud2: I'm certain that you could insert photoshopped photos into a Twitter post, Shelley. I had read somewhere that one of trump's web page featured a background photo of the large inauguration crowd, but it was actually the crowd for Obama's inauguration, not his. I can't confirm the accuracy of that story, though.

>239 lunacat: True, Jenny. As the saying goes, keep your friends close, and your enemies closer.

>241 tangledthread: Yep. The residents of my apartment building were a mixture of graduate students, young professionals and retired couples. The retired couple next door to me on my floor wasn't very friendly, but I was good friends with the young schoolteacher who lived across from me, and to the building's manager and his son.

Great point about the homemade pink pussy hats and the outsourced red MAGA ones! I hadn't seen anyone else mention that before.

>242 tangledthread: Yes yes YES!!! May Justice Ginsburg remain in good health, at least for the next four years.

>243 pokarekareana: I'll have to go back to the photos my dear friend Rachael (@FlossieT, who hasn't been active in LT for several years) took when she attended the Women's March in London yesterday. She wore black cat ears, but I can't remember if I saw anyone sporting pink hats.

I'm off to make soup. I'll return here after it's finished, start a new thread (my fourth, and it's still January?!), and post a photo of the soup and the recipe there.

>243 pokarekareana: LA Times article on the subject:

http://www.latimes.com/politics/la-pol-ca-pink-hats-womens-march-20170115-story....

>244 kidzdoc: According to Kellyanne Conway, those are not false statements, they're "alternative facts."

>245 kidzdoc: - Bwahahaha! He used a pic of Obama's inauguration? That's rich! Of course he did. Melania took Michelle's speech, trump took Obama's turnout photos. Where would he be, without Obama.... I wonder what's next

*rolls eyes* ;-p

>236 kidzdoc: That is hilarious, Darryl! I'd read the same about Trump's dismissal of the numbers in attendance at the inauguration.

>240 kidzdoc: Does anyone listen to me? NoooOooOoOOOooooo...

;)

Did you see this, Darryl: http://www.newyorker.com/humor/borowitz-report/disturbed-man-gets-past-white-hou... Borowitz Newsletter (1)&CNDID=46582228&spMailingID=10277636&spUserID=MTcxNjg3MDg4NDAwS0&spJobID=1081814311&spReportId=MTA4MTgxNDMxMQS2

Thank goodness for satire. It's what keeps us sane!

I didn't watch the inauguration speech, but the sound byte I heard "an education system flush with cash, but which leaves our young and beautiful students deprived of all knowledge;" made me sick. He obviously needs to go on DonorsChoose.org and see teachers begging for pencils and books for their kids. Vouchers won't solve the problem of little funding for schools in poor areas.

>247 tangledthread: Thanks for posting that great article, tangledthread!

>248 ursula: Yikes. This is definitely sounding Orwellian.

>249 jessibud2: One can only wonder in amazement and horror at the clown show that is currently playing in Washington.

>250 lit_chick: That was a very bold statement, especially in a city that is traditionally very conservative compared to most major metropolitan areas n the US.

>251 Morphidae: Hmm. Did someone say something? *adjusts hearing aid*

>252 jessibud2: That is fabulous! I love Andy Borowitz's posts.

>253 streamsong: An education system flush with cash?! I'm sure that Becca, Debbi & Joe's daughter, would choke on whatever she was drinking or eating if she saw that comment, as would any other teacher in this country. trump is an unhinged idiot.

The "soup" is done, and I'll mention it in my new thread.

>236 kidzdoc: Bill Maher said that Melania's blue outfit was made for head transportation . . . I think what he meant was that it looked like a Star Trek outfit, or something out of Sci Fi. "Beam up my head, Scottie."

Love the NHL response! This morning on one of the news talk shows, a Russian emigré journalist (I think her name was Masha Glessner) commented on the press secretary's insistence that the numbers at the inauguration were misreported, as well as Trump calling out CNN's Jim Acosta as "fake news" at his press conference and refusing to take his questions, plus what I noted above about the major networks focusing on Trump sitting in the National Cathedral while 275,000 marchers descended on Washington. She said that this is exactly what Putin does: makes sure his photo is on the front page and that he is the lead story every day, even if he really isn't doing anything (fishing, horseback riding, etc.); controls the media by shutting down questions and ejecting reporters that he doesn't like; accusing the media of lying and setting up his own outlets as the "real" news. The consensus of the analysts was: 1) The media should stop posting Trump's photo and every move unless he is truly doing something newsworthy; and 2) stop attending press briefings if they aren't going to be allowed to ask tough questions and are given nothing but lies, inaccuracies, and exaggerations; 3) rely on their own investigative sources for real news. I think they may be right.

>238 jessibud2: Someone wrote in an excellent article I read the other day (analyzing Trump's personality for the umpteenth time) that the only people he ever listens to are Ivanka and Jared Kirschner.

You are right: I have heard others say that Trump's inaugural speech was "gracious" and "conciliatory." They must have heard a different speech than the one I heard, which was insulting to Obama, hostile towards anyone who did not support him, antagonistic towards the rest of the world, and embarrassing in (wrongly) describing the current state of our nation.

Darryl, I am extremely limiting my facebook time. It was heartening yesterday to see all the photos and signs from people who attended the Women's March. But then I ran into a "friend's" rant about how it was nothing but an anti-Trump rally for losers and how women have all the rights they need so there was no point holding a march aside from embarrassing Trump. The march was about so much more than "women's rights," if you are narrowly defining them as the right to vote and reproductive rights (which are, as noted above, under attack). This woman is in the military, where equal pay may not be an option. But the marchers and speakers were also voicing concerns for children and families: whether their children will have clean air to breath and clean water to drink and decent health insurance if they don't, whether the new immigration laws will break up families, if gay families or Muslim families will be targeted by new laws, etc. I wish I could have been there.

>238 jessibud2: I also have bad wishes for Trump that I'm rather ashamed to admit . . . but with his many evils, especially his desire to ramp up nuclear proliferation and his statement that if we have nuclear weapons, we shouldn't hesitate to use them, I feel that I am justified.

>244 kidzdoc: Speaking of Kellyann Conway, did you all see her absurd Inauguration Day outfit? She looked like a refugee from a high school marching band . . . and (for real!) the brass buttons on her outfit were angry pussy head!

>256 Cariola: - Paul Hunter, a respected CBC news reporter has been reporting from Washington for years. On one of the newscasts I heard this afternoon, he was mentioning how, on trump's first full day and first news conference, the focus was on the *numbers* in the crowds. How he and Spicer seemed obsessed with the numbers. Hunter actually said "Who cares?! Why is this so important that it would be the first thing they talk about in their first news conference". Indeed...

My words, not Hunter's, here but it sounds to me like a pissing match of 12-years olds. Size matters, my numbers are bigger than yours, etc, etc.

Good grief...

And the tv news showed the clip of Kellyanne Conway discussing *alternate facts*, (known to most of the sane world as *lies*) ;-p