Heart of a Lion, Hands of a Woman: What Women Neurosurgeons Do
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Friday, July 30, 2010

Taste of Summer

I found this recipe for the perfect quick pickling sauce and wanted to share it! The result is close to the taste of those great veggies you get in  good Thai restaurant.   It is a perfect way to use those extra cucumbers, carrots, onions (and probably zucchini!) that are coming into season. Use the final product alone, as garnish for meat/fish, as a component in a complex salad...the uses are endless.  I like using any leftovers on my lunch sandwhich-YUM!  I usually double or triple the recipe because it is so easy and then I have a ready supply on hand.

Pickling Juice

1 cup water
1/2 cup rice vinegar
1/2 cup plus 2 tablespoons sugar
2 tablespoons Kosher salt
1 whole clove
1 teaspoon mustard seeds
1 teaspoon black peppercorns
1 teaspoon fresh ginger
1/2 jalapeno pepper, seeded and chopped (any hot pepper will do, more or less to taste)

Combine all the ingredients and simmer for 5 minutes or until the salt and sugar dissolved.  Cool, strain and store until ready to use.

To Pickle:
Slice a red onion (thin)
Warm 1/2 cup pickling juice (in pot or microwave).
Add onion and steep for 30 minutes (more is fine).
Strain and reserve liquid for reuse (I find it is good for 2-3 times then I discard).

Monday, July 26, 2010

Journey Back-Poland 2 (Krakow)

Stara synagogue
Jewish Cemetery Krakow
Krakow is a city rich in history with an impressive castle, a magnificent and imposing central square, and one of the oldest universities in Europe (counting Copernicus and Pope John Paul II as graduates).  A thriving Jewish community emerged though they were "relocated" to Kazimierz by King Kazimierz the Great in 1335.  Here they lived, worked and played until the death knoll tolled in 1939 with the Nazi invasion of Poland.   The first full day of our "Roots Adventure" would explore   a critical slice of the history of Krakow by tracing Jewish life there-from economic and intellectual pinnacle to ghetto to deportation and then on to Auschwitz-Birkenau.
Today, one can still visit more than 7 surviving synagogues within a few city blocks. The Stara (old) synagogue has been lovingly restored and now serves as a museum.  Most evocative for me was the cemetery-which sustained extensive damage at the hands of the Nazis but now has a serenity that pays tribute to the contribution of Jews to Poland and Krakow.  In addition, pieces of damaged and desecrated tombstones found throughout Krakow (the Nazis classically used them to build roads) have been fashioned into an evocative memorial.
Krakow's "Wailing Wall"
Kazimierz has now become one of the most fashionable districts of Krakow and side by side with Jewish historical sites are cafes, art galleries, restaurants and expensive apartments.  I also learned of a fascinating connection to NYC through General Kosciuszko-who fought in the Revolutionary War (for which he is honored by a bridge between Queens and Brooklyn) and then exported those radical ideas to his homeland to foster an uprising against both Russia and Prussia.  
Memorial at Plaszow Concentration Camp
We then followed the plight of the Jews across the Vistula River to Podgorze, the site of the ghetto.  Here I heard the inspiring tale of a pharmacist (non-Jewish) who refused to move his store after the Jewish resettlement and then served as a conduit for black market supplies, secret meetings of the Jews and escape! (The Pharmacy under the Eagle)  This was the first of many heroic stories we would hear of "ordinary" individuals who would try and save people from the Holocaust.  The main square of the ghetto is now marked by a striking sculpture of empty chairs which contrasts strikingly with the frenetic traffic of a thriving Krakow whizzing by.  Other than this memorial, the ghetto has otherwise been erased by modern Krakow with just two small remnants of the ghetto wall still standing (most who survived life in Krakow's ghetto were deported  east to Belzec).  The final stop in our exploration of Jewish life in Krakow the Plaszow Concentration/Labor camp.  This small but deadly camp was located adjacent to the ghetto and run by a brutal, sadistic commander.  As the Soviet's approached near the end of the war, the camp was abandoned and the remaining prisoners marched to Auschwitz.  Today, the site is a designated park inhabited only by trees, wildlife and a striking sculpture that looks away from Krakow toward Auschwitz-Birkenau. 
In just 4 hours, I had followed a history that spanned hundreds of years.  We all study the Holocaust but somehow, tracing the history of this long-standing, thriving Jewish community (65,000 pre-war) to complete decimation gave me greater insight and of course, great sadness.
But our day was barely half over-now we departed for Auschwitz-Birkenau...

Friday, July 23, 2010

7 Post Challenge

If I have a blogger hero it has to be Suture for a Living-she single handedly inspired me to pursue my own blog, to understand how to make it work for me, and her blogs are always interesting, informative, well written and linked to others who help make the medial blogosphere worth being a part of.  As usual, she led me to the 7 Post Challenge which I just couldn't resist.
Polish Kebab Anyone???

  1. My first post now seems like such a novice effort.
  2. The post I enjoyed writing the most allowed me to combine man aspects of storytelling that I most like and tries to demonstrate how I as a woman/person/mother/neurosurgeon deals with the variety of patients I encounter every day.
  3. A post which had great discussion...well I have to say I haven't been the most popular but writing about medical malpractice seems to generate the most notice.
  4. You can always visit TBTAM for a wonderful mix of food, travel, musings or Toni Brayer, MD for insightful medical thinking.
  5. Obviously none of my blogs have been life-changing-but that isn't why I am blogging so I would offer up Exercising Your Brain and Rage Against Golf as ones I think would be helpful if more people read them.
  6. Titles? Perhaps I should spend more time thinking about them, I am usually most concerned with getting my thoughts down but I did have fun writing Pop, pop, fizz, fizz when Congress was failing miserably in addressing the Medicare cuts.
  7. I wish more had read my blog about JAMA review of Heart of a Lion, Hands of a Woman: What Women Neurosurgeons Do because I am so proud of this book and wish the blog would encourage more people to buy it and discover the amazing talent of this group of women neurosurgeons.

Monday, July 19, 2010

A Story I Have to Tell

Fernando Botero's: After Velazquez
On the intake sheet it only said "second opinion" so I had no idea when i walked into the examination room and was greeted by my patient and her mother.  She was a lovely young woman complaining of more than 10 years of back pain with debilitating progression.  This woman was also coping with psychotic schizophrenia (on three controlling medications) and suffering from morbid obesity (5'4" an 310 lbs).  Her exam showed no significant neurological impairment.  However, her MRI revealed a large ruptured disc and also the ravages of degeneration from the extra stress of her body habitus.
I began my usual explanation about ruptured discs and treatment options but had to conclude by informing her I would not consider surgery for a number of reasons all related to her obesity (the high rate of surgical complications, the likelihood of significant residual pain related to the widespread deterioration of her spine, her inability to exercise and adequately mobilize after surgery just a few of many).  I went on guardedly to make sure she understood that it wasn't that I didn't want to help her or that I was prejudiced about her weight and then moved on to my recommendation that she strongly consider surgical treatment for her obesity. I finished, so I thought, on a positive note saying that with the rapid weight loss one could expect, we might be able to consider surgical treatment for her back in less than a year.
I stopped talking after inviting any questions and there was absolute silence.  It took great restraint to let her speak next-the pause was so prolonged.  Her mother took my cue and also waited.
"It won't work," she finally blurted out,"I am a compulsive eater and so I know I will fail any surgical intervention because I don't have any control." Gratefully, her mother took up the conversation with her own story of surgical weight loss and subsequent reversal of the ravages of uncontrolled diabetes.  My patient responded again with a plaintive, "Won't work, I am psychologically impaired and I like to eat too much."
I smiled, it was time for me to end my silence. Gently I offered that many of US were compulsive eaters who loved to eat and that her weight issues were separate fro her other problems.  I realized that she had always linked the two and knew (rightly) that she would never conquer her mental illness, only keep it controlled (mostly with strong medications) for periods of time.  Thus she had come to think of her eating has a fait accompli, too.
I doubt I will see her in my operating room any time soon but I knew by her and her mother's beaming smiles that I had offered them something even better-perhaps a fresh start.  And they had given me something-the intangible gift of a patient helping you to understand something about the world and yourself that otherwise would have remained elusive.

Friday, July 16, 2010

No Hair Shave

I used to love the feel
The straight blade gently caressing
Strands falling away
Skin baby soft
A perfect palette to start
Wrapped tightly in white when done

No more
No more

Now I do parts and braids
Tediously planning the cut
And then the surgery done
More work to restore clean and tangle-free
Smiles reflected in the mirror
Change is good.

Monday, July 12, 2010

Journey Back-Poland 1

MarianPlatz, Munich
After four rainy, cold days of a professional meeting in Munich, I piled my mother and our luggage into a rental card and headed north and east towards my family roots in Poland.  For many years, I had shared with my mother an exploration of our family roots-searching out clues to their lives, digging to find more remote relatives, and to solidifying our family tree as far back as possible.  For me, part of this journey of discovery was the desire to "walk in their footsteps" and as such had looked for an opportunity for my mother and I to find time to spend in Germany and Poland.  Finally that time had come.
Krakow Streets
So we sped north on the marvelous Autobahn passing rapidly from Bavaria into the heart of what was East Germany though nothing about the road or the cities/villages betrayed significant evidence of this recent history. Another welcome surprise was the easy transition from Germany to Poland-both are now members of the EU so there was really no border patrol-just a short stretch of highway that narrowed to 1 lane with a 30 miles/kilometer speed restriction (all the police I saw were busier drinking coffee than watching the passing traffic).  The clear benefit of EU membership was in clear evidence as the excellent highway continued through the western entrance to southern Poland. Slowly the flatlands gave way to rolling hills as we neared our first destination, Krakow.  Despite imposing (and traffic stopping) roadworks on the periphery of the city and the challenges of navigating the narrow, confusing medieval streets of the city center, we parked the car right in front of our hotel right on schedule. After a full day of driving, we were more than ready to check in and then stretch our legs, explore the streets of Krakow and find some authentic Polish vodka and grub. This we did, ultimately relaxing to a flight of Polish vodkas (who knew?) with amazingly tasty food with direct views of the impressive central square.
Night in Krakow's Central Square
Next up: Jewish Life in Krakow and Auschwitz/Birkenau.

Wednesday, July 7, 2010

Rage Against Golf

This is not a knock on Tiger Woods, nor a complaint about being an "orphan" to a husband addicted.  This is not even a rail against the environmental impact of creating and maintaining all those acres of pristine fairways and greens.  No this is frustration at the continual role that golf plays in the "business of medicine".  Each year I am confounded by the obligatory (or many) GOLF TOURNAMENT BENEFITS when many of my male colleagues take the day or afternoon off to drink, socialize, and hit a little white ball toward a small hole with a flag. This week I was further assaulted by a hospital trustee who will host about 15 males (mostly surgeons) at a very expensive/prestigious local golf course along with the requisite luncheon before and cokctails after.  Again, these partners will take much of the day "off" but it will count toward work.
Now I fully realize that many women also love the game of golf (though they are rarely fully included in the activities described) and that I am fully free to take an afternoon off if I choose BUT...it is not the same and we all know it.  Penciling in a Benefit Golf Game into one's schedule rings completely different than-taking 1/2 day off for R and R!!!
So here is my call to ACTION:
Would some hospital administrator, hospital Board Member or Trustee step forward and offer at least some equivalent non-traditional alternative the Boys on the Links???  Here are a few suggestions:
Spa for a Cause (half day full spa treatment in exchange for a defined contribution to the cause)
Art Day (some activity for profit, education or just fun that revolves around painting, photography, dance, music, etc.) 
Wellness Rewards (yoga, Tai Chi, massage, stress reduction, cooking instruction for fun or profit)
I know thee is someone out there listening...

Saturday, July 3, 2010

Coming Soon

Been traveling and teaching for two weeks then the requisite hell week catching up on return but have some wonderful things to share and know that life has begun to return to a "normal" rhythm so the blogs will soon flow again.  Look for:
Travels with Mom I: Roots in Polish villages
Travels with Mom II: A Sobering Visit to Auschwitz-Birkenau
Return of the children: It's summer and the kids are back in town
Worldwide medical community: the beauty of coming together

MarianPlatz, Munich June 2010