Tuesday, December 11, 2018

Kitchen Adventures

Just unwrapped about a pound of gravlax that I had been turning end over end in a ceramic loaf pan morning and night under two heavy cans for four days.  Washed off the surface rub, tossed the dill into the garbage can and the loaf pan into the milchig tub for washing, then sliced off a chunk of the thicker end for myself.  Worth the effort.  Have to get more bagels.  Have cream cheese and some more dill. 

Next project, I think, Frog/Commissary Oatmeal Chocolate Chip Walnut Cookies.  Have not made these in years but they are the best, also a little effort but worth it.

Unfortunately, FoodTV has deteriorated from masters trying to elevate amateurs like me to a series of Iron Chef wannabe competitions.  I only watch Triple D nowadays, the original, not the component where one tries to outdo the other.  Cooking as it develops into my most enduring hobby does not have an opponent.  It has beneficiaries.  I learn patience, a little creativity as I modify the core recipes to adapt to kosher or to use up ingredients at hand or just to experiment.  Some of the effort, particularly complete dinners, requires planning.  And I get to see the result, both in the product produced and the delight of those who share the meal or goodies with me.  Competition detracts from this.

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Monday, December 10, 2018

Back to School

Across the USA there are branches of the Osher Lifelong Learning Institute, acronym OLLI.  University of Delaware has one, which my wife has attended since her retirement.  I've been there for some of their concerts, enthusiastic people, age distribution about what my shul has on shabbos morning.  While my mind was not exactly fallow early into my retirement, having read some books and written some essays, I should challenge it in a more formal way, so I will register for OLLI's coming semester.

The catalog appeared online this week.  I jotted down what interested me, then since each course meets only weekly, I made a time grid and transferred my selections to that.  It was my intent to enroll in three, spread over two days, though I might do four as there are two at different times that stand above the others and I do not want to make a special trip for one.  Applications next.  Some courses are limited in capacity, one requires pre-existing expertise for which I think I qualify, though the instructor may not.  Fill out the applications next week.

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Sunday, December 9, 2018

Road Trip

Despite being of age I missed out on much of what the 1970's offered its 20-somethings.  Not that there's anything amiss about studying chemistry in college, proceeding to medical school and residency, or getting married, the achievements that shaped me favorably forever.  But some experiences of the times did not happen and do not recapture easily.  Too little prosperity at the time, too much now, or at least too many obligations.

Image result for road tripIn that era, people used to go on wild spring breaks to Daytona Beach, but it would be unthinkable to spend my father's money that way.  My own kids mostly agree.  I could have done a medical school elective in Alaska or the Nebraska prairie but didn't, opting instead for six weeks of anesthesiology in Philadelphia on a grant that funded my fiance's engagement ring.  And people backpacked in European hostels, did a semester in Israel, or found somebody with a VW Bus redone with a psychedelic exterior to journey coast to coast via roads other than the Interstate.  I never did any of those things, not then, not now.  Made it to Israel as a tourist for my 25th anniversary and to Europe for my 40th, no serious money limitations but no extravagance either.  And the itinerary was a lot more secure and a lot less flexible than for my contemporaries to headed off to whatever they might find as 20-somethings.

One my home from Europe a few months back, the jet's entertainment module offered a feature on those 1970's travels that other people took.  As well as things turned out for me personally, missing out on that borders on a regret.  Now that I am retired, I theoretically could.  In fact, my father, a relative newlywed and newly retired person of about my age did exactly that, taking his time with my stepmother to traverse the country from Florida to Los Angeles over six weeks.  My own life still has fixed obligations, though.  A cat that needs care, but at least in theory could travel.  We take university courses.  My wife participates in musical activities.  Six weeks on the road cannot happen.  Ten days on the road, just myself if need be, could, limited by my own willingness to proceed.  But as a 60-something, and a highly accomplished one, my life has become a series of predetermined destinations to pursue, which no doubt accounts for what has been accomplished.  The GPS is set to take me someplace and I know when I have arrived.  Driving in a direction but without an end point to mark arrival doesn't really register in minds like mine. 

The video on the plane tempted me, though.  I should make an effort to see what roads are there without setting the GPS first.

Thursday, December 6, 2018

CME Inventory

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Pennsylvania medical licenses expire at the end of each even numbered year.  If you do not engage in heinous acts, most physicians just get processed through by some clerk near Harrisburg, the state capital, making sure that all the boxes are checked off and that the credit card payment goes through.  A sample gets audited, but that has never been me, not in Delaware, Massachusetts, or Pennsylvania where I have held licenses at one time or another.  Most of us are pretty good citizens and professionals that do not cause a lot of trouble. 

There are some very specific requirements above having a valid credit card and having the professional training that you claim.  The most intrusive is the Continuing Education standards, which are not difficult for us city folk, maybe a little harder for those taking care of people in rural Pennsylvania.  Every two years we need to show attendance at 100 hours of training, 40 of which need to be certified as Category I.  I just take the New England Journal article review courses, good for 50 credits per session.  Unlike showing up and sleeping through Grand Rounds, which most large institutions offer for free credit weekly or attending a national specialty meeting that would accrue 20 or so credits but at a high fee, the NEJM and most on-line courses care a little more about your learning something from the effort so they require a test of what was taught.  Not a big problem at all, and keeps me better engaged.  So I have my 100 credits, all Category 1.

As a practicing physician at the VA, I needed a license from any state, so I just continued my Massachusetts license.  The Board there can be a mixture of pompous and ornery.  They introduced a requirement in my early practice years that you needed 12 hours among the 100 related to risk management which could be defined rather broadly, but it was Category 1, the most difficult to acquire.  I did it, got a Delaware license, let the Massachusetts one lapse, and eventually took a position in Philadelphia for which I got a Pennsylvania license.  Initially they did not have this requirement, and I was in a training program which waives the CME anyway.  On returning to Delaware, I eventually let the Pennsylvania license expire, more for escalating costs than renewal requirements, but reactivated it when I started working in Philadelphia again, now with roughly the same 12 hour risk management requirement, though not limited to Category 1.  What qualifies has always been a little uncertain but as we get to the modern age of online learning, Medpage created a series of minicourses that would qualify for Type 1 credit, which I use to fill in the hours that my lecture attendance does not.

As of this morning I'm done.  5.25 hours on Medpage + 1.25 hours on Medscape where you can lose the credit since the questions seem harder and the articles more involved + six post-retirement Grand Rounds.  Let's see if I remember the subjects:

  1. Partnering with the VA for patient care.
  2. Documentation in patient encounters.
  3. Establishing a Medical Home
  4. Making hospital care more patient friendly
  5. Effects and policy challenges of Vaping
  6. Sickle Cell Diseases and Population Health Analysis
That's more than twelve.

Then we have a required course in Child Abuse Reporting Laws in both Pennsylvania and Delaware.  Since the laws differ, you have to take the three hours of online training separately in each state.  Then this cycle Pennsylvania added a 2 hour requirement for familiarity with the state's opioid prescribing laws.

All done.  Just need to figure out how to fill out the online form, provide payment, and I'm good to go for the last time unless I interrupt retirement by taking a job in Pennsylvania.

Wednesday, December 5, 2018

Money Saving Coupons

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One supermarket, Shop-Rite, made a key wise decision a number of years ago to set aside specialty kosher areas for bakery, meat and deli which essentially gave them exclusivity for us kosher consumers, with a little competition from Trader Joe's whose more limited inventory makes it attractive to empty nesters like myself who do not always benefit from a mega market.  Every Thursday the weekly circular arrives in the mail.  Coupons are noted.  Now that I am retired I can go any time, avoiding the Sunday crowds and likely to find significant clearances on an item or two of kosher meat, for which I should probably set a moratorium as my freezer needs some clever re-positioning to get the door closed tightly.

This week they had a particularly attractive array of coupons for things my doctor thinks I should avoid.  Bulk salmon just right for gravlax, though the price of a bunch of dill was exorbitant.  Can always use cream cheese for 99 cents.  Needed hanukkah candles as our big menorah that used shabbos candles snapped at its base.  Pepperidge Farm cookies, chocolate chips.  They require another $10 purchase, no problem with the kosher but dairy Manischewitz Hanukkah gingerbread house which was not so easy to find.  And we always need another package of paper towels and toilet paper.   Bargain on Morningstar Farms trayfe facsimiles and Manischewitz dry soup mix.  Now that I am home to make supper most days and like to make breakfast, brownies and latkes, eggs at a reduced price cannot be overlooked.  Before you know it, my cart was full, though the paper products took most of it, and my Visa chip debited about $130 from my account, and that's without buying any meat at all.

With the pantry, refrigerator, freezer and other flat kitchen surfaces now saturated, a game plan to eat all this stuff poses the next challenge.  Gravlax takes about 4 days to make and about 10 to eat.  The cream cheese will come in handy.  I've been baking a bit, which is why I needed some more eggs, and could bake some more.  Could make challah for shabbos, that uses up some eggs.  Don't know yet what to do with Morningstar Farms phony Pulled Pork, in part because I never made pulled pork and I don't know if the ersatz meat can be 1:1 substituted for the real thing.  And there is a Festival deadline for assembling that Hanukkah gingerbread house.

Tuesday, December 4, 2018

A Work Day

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Big task list.  There has always been a little tension on major projects like decluttering my study.  Is it better to do a half hour at a time over an extended time or allocate an entire day to just do that.  My inclination has always been to eat the elephant one bite at a time but there are reasons to question that.  My monthly writing assignment, for which I am paid, takes a few hours to research and write. I pick the topic in advance when I find something that looks interesting but the writing is done in one or two large blocks when it has my undivided attention.  On the flip side I keep up with dishwashing pretty much every day.  Grand fleishig dinners, like I had for Thanksgiving and my wife's birthday, generate a few racks worth of dishes.  I do one rack at a time, but multiple racks in one day and generally do not stop for a partial rack.  And there are the hybrids.  In school I kept up with my classwork each day but had marathon reviews the night or two before each exam.

So after maybe a week of mostly recreation from my trip to NYC, a day at the library, a day ill, and a weekend recovering, then birthday and Hanukkah and a return to SERMO, it's time to redirect to the work tasks.  Cleaning the house, writing an article I've been neglecting, making my two desks usable, dealing with a large dental bill that may be erroneous, major shopping with money saving coupons.  All do better with concentrated effort and defined completion points.  Unsure if I am up to the task.

Monday, December 3, 2018

Combining Festivals

Hanukkah has arrived, roughly its usual time on the American calendar, always its usual time on the Hebrew Calendar.  Opened our first of eight gifts, mine being an eyeglass holder to keep behind my bed to keep my glasses from falling behind the bed.  My wife, a cat aficionado, got a cat doll that can be warmed in the microwave and hugged.  We lit candles, greeted each other mostly electronically, took the Delaware Democrats to task in cyberspace for posting a shabbos menorah with seven branches instead of the traditional Hanukkiah with nine.  They updated their image. 

Hanukkah, while festive in its own right with its own special traditions and foods, does not always occur in isolation.  The movability of the Hebrew and American dates and Hebrew leap years comprising a full month every seven of nineteen years, sometimes the Hanukkah season changes.  It can rarely coincide with Thanksgiving, more frequently coincide one of the eight days with Christmas and nearly always merged into the Christmas season.  This year I got a special overlap, with my wife's birthday falling on the First Day, as mine sometimes does during Pesach.

Thanksgiving and birthdays derive from our public calendar, one a fixed date the other with a small amount of variability so this birthday and Thanksgiving are always not far from each other.  I have become the Grand Chef for both and seem to derive my own measure of pleasure from the menu planning to the execution to the cleanup.  Postponed the potato latkes until later in the Hanukkah festival, substituting as the starch shlishkas, a gnocchi-like pasta shaped as a nugget, one of the treats offered to me by my Hungarian maternal grandmother and now propagated, though via a yiddish cookbook recipe.  And we had roast duck, a very rare treat of limited availability.  Royal nuisance to make, again dependent on a classic preparation method from an encyclopedic cookbook, but worthy of a special occasion.  And an almond torte known as torta del re, this one from an Italian Kosher cookbook, another special occasion item, though with readily available ingredients and with modern cooking appliances not very difficult to make. 

So two occasions overlap, a birthday and Hanukkah, neither in competition with the other, unlike the secular festivals which sometimes do undermine each other.  All are special, even Christmas which was celebrated by my taking medical call each year as part of a specialty group and now going out for Chinese like the rest of the Jewish community that day.  We can now proceed with the rest of our Hanukkah for its own sake.

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