Sunday, September 21, 2014

Liberated by Repetition

Thomas Keller, the only American chef to have earned three Michelin stars at two restaurants, spoke to the Wall Street Journal about habits. He said that he was most comfortable in situations where repetition is the norm.

“In order to be great, you have to be consistent.” Habit doesn’t interfere with inspiration – it allows it to happen. At first, Keller needed to pay close attention to cleaning a salmon, but after a couple of years the task didn’t require so much concentration. The habit of always cleaning a salmon the same way allowed him the freedom to think about what he would do with the salmon after cleaning it.  “You become liberated by repetition.”

Set a routine to take medication the same way every day – it will free the mind to think of more interesting things than “did I take my pill?” Make the next blood pressure appointment when leaving the physician’s office – no need to worry about schedule conflicts and medication shortages. Prepare a brown-bag lunch the night before – the time saved by not looking for something to eat will free up time for a daily walk.

Monday, September 8, 2014

An Expensive Rash

An excellent treatment for early poison ivy is a topical steroid cream. Low dose steroids, such as over the counter strength creams, not only are not helpful but can lead to exacerbation of the condition.  The continued itching and subsequent scratching can lead to infection and patient frustration.

There are a couple of often used products that safe and effective. These creams have been around forever – so long that only the generic product is still available. Imagine my shock when a patient told me that a small tube was more than $400! My database lists the average cost to be $25. I immediately called the pharmacist who said that the patient actually got an insurance discount and the full retail price is nearly $600.

It turns out that the ever increasing cost of dermatologic medications is a huge problem. For a variety of reasons, the manufacturers are leaving the market, resulting in shortages and prices that escalate in the face of demand. Those patients lucky enough to have insurance have greater out of pocket expenses – but one case of poison ivy can put a big dent in the deductible.

Monday, September 1, 2014

Fresh Corn

One of my favorite summer foods is fresh corn on the cob. I always get two ears per person: in my opinion that’s one serving and if by chance one ear is not so good there will still be a delicious ear to eat.

The fresher the better and a farmers' market is the ideal place to buy. Not only is the corn fresh but also it’s an opportunity to support local agriculture. I never spoil the corn by partially peeling the husk. Keeping the corn tightly sealed in the husk will keep it fresh. Once the husk is opened the farmer can no longer sell the ear. Choosing a good ear is simple: go for fat, firm and heavy. The process of sugar converting to starch is exothermic so if the corn is cool there will be plenty of sugar in the kernels.

Don’t remove the husk until the water is boiling. Peel the ear and remove the strings. Put the ears into the boiling water, cover tightly and turn off the heat. The corn will be perfectly cooked in 5 minutes and can be left in the closed pot for as much as 30 minutes without overcooking.

Buy corn the same day you plan to eat it. And while at the farmers’ market buy other local produce. Ask what it tasty – there might be something new to try.

The Farmers' Market Trail has year-round activities.