When I arrive at 8:30 am, the team is already behind on their work having had to send the kids to the PICU. This is not how I wanted to start my first night of call for Heme-Onc. As we scramble to catch up and sign out, the time flies by.

At 5:00 pm, I finally get a chance to sit and think about lunch. It's been a busy day, but only it was a steady stream of work, nothing too overwhelming. The patients on the floor haven't been causing too much trouble, and there's only been one patient admitted; We'll call her Amy. Amy is 4, has a brain tumor and unfortunately the prognosis is grim. On a recent admission, just a few days before, her mom signed a DNR order. She comes in today unresponsive, but breathing from on outside hospital. When I see her she only responds a little when I rub her chest. It turns out that her sugars are high (>1000!). While she may not have much time left and she may be DNR, I think we can treat this and she could wake up. Mom repeats that just yesterday she had been walking and talking. I'm already worried.

It's 10:30 pm and we're finishing night rounds. We've checked on all the patients - 20 kids tucked and ready for bed. Just as we're finishing, we hear from one of the nurses that there is a patient in the ER likely to be an admission. As we're about to go the ER, Amy's nurse come up running out her room to ask if we can come check on her breathing. We had just seen her minutes before and she looked comfortable but breathing a little fast.

We enter the room and another nurse is suctioning her trach. Putting my stethoscope to her chest, I listen for breath sounds. Nothing. I move to the other side. Again nothing. I look up with fear at the nurses. I was just in here. She was breathing then. They continue to suction. Still nothing. No heart sounds either.

Mom is sleeping in the corner. We tell the nurses that we need to wake up mom. I continue to listen. I don't know how long it's been, but I feel like I've been listening to this silence forever. I can hear mom saying she was just walking and talking yesterday. She wasn't ready. How could she be? My senior looks at her watch. Amy is dead.

More nurses have come to help. They move with such a purposeful poise. They remove all the lines and plugs from Amy and clean her so that mom can hold her child one last time. Someone is covering the door so no one can look in. I'm standing on the side. Awkward just staring at mom searching for words. As she sits in the chair crying I try to think of something to say. Anything. Why have I gone blank? They even make us practice for this very moment in medical school. I thought I was ready. But I'm not.

I sit next to mom and place my hand on her shoulder. I opening my mouth just to close it again. She wants to be alone, so we all leave the room.

It's 11:30pm and now we have three patients in the ER. It's close to 4 am by the time I'm finished working to admit the new patients. By the time I back on the floor, I see they are cleaning Amy's room. I missed it all. Amy's mom has left with her family. I'm tired, but more than anything I feel defeated. I still don't know what to say, but I know I wanted to say something. But my chance is gone. I'm not sure what scares me more - that I won't know what to say again next time, or that I'm pretty much guaranteed a next time.

Since a large percentage of my dining out is actually comprised of Asian foods, it's ironic that back when I would actually formally review restaurant for fun, I never wrote a review for a Japanese restaurant. Even more surprising, when asked which Japanese restuarant in Chicago is my favorite I always have to stop and think about it. The answer really depends on what you're looking for in a Japanese food and what you're going to order. I mean, there are certainly standards of freshness, but I there are also just variations in taste expectation.

Here are three worth trying for different reasons:

Kaze
2032 W Roscoe St
Chicago, IL 60618
773.327.4860

Kaze may be my overall favorite of the bunch for it's creativity and quality. However, it is for that same reason that many may not enjoy it as much. For example, on this summer's omakase Chef's interplay of savory and sweet is very well done, but for those expecting a more traditional Japanese menu this may not be the best choice. While they can certainly handle more traditional items, it's just not worth the price.

The summer omakase:

Homemade tofu garnished with slivered almonds, mozzarella, boiled shrimp & black caviar paired with a tofu skin shooter in a soymilk & blue curacao liquor


Tuna Zuke Maki - Avocado & scallions wrapped inside out served with zuke tuna, cucumbers, wasabi mayo & tobiko

Awabi (Abalone topped with Kaze’s homemade sauce finished with yuzu & tempura flakes), Spicy Tako (A mixture of octopus, okra, fried garlic, tobiko & spicy mayo), White Tuna (East coast tuna topped with a bananawasabi puree), Katsuo (Bonito topped with a puree of garlic-infused enoki mushrooms & tomatoes garnished with pickled onions & fried garlic), Ika (Japanese baby squid topped with a spicy tobiko sauce)

Baked Whitefish - A crepe wrapped around slices of ankimo, minced shrimp & whitefish finished with Macku’s strawberry sauce served with a smoked salmon & cheese-filled dough







Mizu

315 W North Ave

Chicago, IL60610
312.951.8883

Yakitori is actually surprisingly hard to find in Chicago. But Mizu in old town has a nice selection of Yakitori (including gems like chicken skin and tongue) made fresh on the grill along with its sushi and ala cart menu. While not quite as good as pure yakitori restaurants in LA and NY, Mizu fills the much needed void in Chicago.

Chicken and Scallions








Squid, Chicken meatball

Sashimi

Chicken Skin









Chicken Wings







Ginza

19 E Ohio St
Chicago, IL 60611-2707
Phone: (312) 222-0600

Ginza, a small restaurant next to the ultra-shady Tokyo Hotel, is more of a tradition Japanese restaurant. The menu may not be flashy, but it full of value. Included on the menu are hard to find classics like Gold Don (uni, squid and ikura on rice).

Yi Jiang Nan just off Hollywood Rd. on Staunton St. tucked along more Western style restaurants in Hong Kong is a small restaurant for regional Chinese cuisine. One of their particular specialties is a fish soup which is a pure white. The soup is made simply with turnips a whole bony fish (very bony) and a drop of milk. It is simple, clean and delicious.

After I tasted the soup, I knew that I had to try to recreate it (with a few additions):

I started with the basic soup stock (turnips, ginger, whatever fish was fresh at the market). After straining the stock into another pot I added the milk and enoki mushrooms. The beech mushrooms were roasted in the oven and finished with a flame.

Gongnam Fish Soup with Enoki Mushrooms and Fire Roasted White Beech Mushrooms

It is a matter of preference but I generally do not like sitting at the sushi bar. I think it can be traced back to my distaste for being watched while I eat. But, there certain undeniable advantages to sitting at the bar; the obvious being that it is only at the bar where you can meet and actually converse with the person who is preparing your dinner.

JW's Sushi Bar
Pacific Place, 88 Queensway
Hong Kong SAR, China
+852 2841 3899

It was at the JW 's California Sushi Bar in the JW Marriott in Hong Kong, where I had the pleasure of sitting at the bar and meeting Toshitaka Kasseki. It is at this quiet section of the JW complex that Kasseki has been working for over ten years. I'm not sure this hotel restaurant qualifies as a hidden gem, but some of the food that Kasseki is preparing is certainly worth some more attention.

The omakase on this particular night was provocative, balanced and immense.

Octopus w/ Stewed Turnip
Seared Toro w/ Black Bean and Mustard Sauces
(a memorable savory creation - uber tasty)
Clam Medley
Grilled Hamachi
Sushi Course

Trio of Uni (US, Hokaido, Russian)

Mak's Noodles
Phone Number: +852 2854 3810
Address: 77 Wellington St, Central
Hong Kong

For a while now, whenever I would order wonton noodles, I would hear from Grace about this small noodle shop which she would often frequent in Hong Kong and how much better it was. And since I make it a point to try to eat everything that is ever mentioned to me with even just a smidgen of smug (either to prove they are wrong or provide myself with a good meal; win-win), I knew that we had to go while in HK.

The restaurant itself is small but clean. The noodles were pretty much as advertised; and I would have been more impressed if not for the portion size. Now I'm not asking for US sized uber portions, but at least something more than a small bowl which is barely enough to fill a toddler still in diapers. Surprisingly the best part of the meal may have been the tendons. The wontons were good, but probably not worth traveling across a sea. The tendons on the other hand were a soft and smooth savory delight, rarely available on this side of the pacific.

Wonton Noodles

Beef Noodle Soup

Wonton and Dumpling Noodle Combo

Marinated Stewed Beef Tendons

It is a peculiar (and egotistical) feeling to watch a movie and to think that it was in fact made specifically for you. It is a feeling that while one would think could be quite fulfilling, really is rather unsettling. I had something close to this feeling while watching the Will Ferrell film Stranger than Fiction. I'm not sure why it struck such a chord with me; perhaps it has something to do with the location of the film in an unnamed Chicago, or the strong thematic element of cookies. I have like many people thought, or perhaps hoped that my life was actually a story being written by some kind writer in a far off land. Hoping, of course, in the writers own love for his character. But inevitably it come back to the thought, who would want to read my story?
I think that the last few weeks are so may make some kind of story. If not fine literature, something good enough for the trashier sections of Walgreens' book rack. Somewhere within two graduations, two weddings, three receptions and the start of a new job in the span of a month you should think there should be something to say; if only I could remember any of it. Sadly, most of that story have gone the way of my brain cells during my hiatus, disappeared. Ironically, I think it was the hectic and story worthy schedule of things that made it to difficult to remember.

Luckily, In those precious few moments when I had a moment to breathe, I was afforded the opportunity to eat and enjoy. Which was particularly important being that I found myself in Hong Kong. Delicious.

Grace had lead us to New Cheung Hing, a classic Hong Kong establishment. Classic in the sense that this type of food is distinctly Hong Kong. A type of East West fusion cuisine before fusion was a culinary term.

Milk TeaRamen with Spam and Eggs

Rice Noodle with Preserved Mustard Greens and Pork Strips

Butter Toast

It's wedding week and I've been left home alone. Grace is off on her Las Vegas bachelorette party leaving me to fend off the wedding planning crisis alone. But nice things about having all this time is I've been having fun playing with the new kitchen tools (love them) that people are sending us.

The first super fun things to come was the waffle iron. First I had to figure out a waffle recipe since I am morally opposed to using a mix. Then I had to play with it a little until I figured out all the settings but after all that I made ---(cue any and all Donkey references) ---> WAFFLES!

Waffles with Whipped Cream and Blackberries
1.5 c flour
1.5 teaspoon baking powder
2 tablespoon sugar
1.5 c buttermilk
2 eggs
salt
vanilla
1/3 c oil

The waffles end a bit like cake and if with a touch more sugar they would taste a lot like "Gai Dan Zai." Grace liked them slightly less done, but I prefer them with a crispier exterior.

Today's super top secret wedding update includes the cake design (left) from 'the cake girls,' who incidently competed in a Food Network cake challenge to be aired this summer. My sources (them) tell me that they won.

The design is base on the synergistic elements of round and fat, two aesthetic themes which are close to both Grace and I. We tried sample of the cake a while back, but as far as the final cake flavor we went with something different, so I'm not sure exactly how it will turn out.

Back in Florida; which means it's time to grill. It's particularly fun to grill when I'm hanging with my parents because I'm the only one that will use the beautiful grill outside, and I always find something to grill. My favorite so far has been the awesome oyster bake we had. 50 oysters for $12 (I never thought eating that many oysters could be difficult, and it wasn't). Good times.

Since I'm not sticking around too long this time and I don't want a big clean up I thought it would be nice to do something clean and simple (nothing kills the desire to make chicken wings than the way it leaves the grill, my nice beautiful clean sparkly grill). So, steaks.

Flourless Chocolate Cloud Cake

12 ounces semisweet or bittersweet chocolate, chopped
12 tablespoons (1 1/2 sticks) unsalted butter
1/4 teaspoon fine salt
6 large eggs
3 egg whites, 1/4 teaspoon cream of tartar
1 1/2 cups granulated sugar Confectioners' sugar and/or cocoa powder, for dusting

Yesterday, we celebrated Anne's birthday, which is coming up this friday. As is the tradition for her birthday (done 3/4 times during medical school), the cake had to be personally made. Which is nice in theory (especially since usually there are 3 of us making the cake); but this year it fell onto me to make the cake. So I thought it would be a nice time to try out a flourless chocolate cake.

Question for Patient, Physician and Society

Q: Write about the challenges you face—as well as factors that help you—in maintaining empathy while practicing medicine. Give examples of patients or circumstances where you have found it particularly easy or difficult to maintain empathy.

A: When thinking about empathy, I decided to look it up in the dictionary just so I knew exactly what I was talking about. I don’t like thinking I know what I’m talking about, when in fact I don’t know what I’m talking about; you know? So I looked it up hoping that I would find some more information on empathy that might crystallize the question for me.

Dictionary.com Unabridged (v 1.1)
em·pa·thy (em-puh-thee) n.

1. the intellectual identification with or vicarious experiencing of the feelings, thoughts, or attitudes of another.

American Heritage Dictionary
em·pa·thy (ěm'pə-thē) n.

1. Identification with and understanding of another's situation, feelings, and motives. See Synonyms at pity.
   
2. The attribution of one's own feelings to an object.

Jackpot. I often put a lot of feelings into objects. My stuffed animal collection, which sits proudly on my bed slightly over flowing onto the self next it, is filled with my own feelings or at least something like them. Mr. Pickles, a small furry frog with a precocious bow tie, is especially filled with feelings. Whenever we talk to each other I find myself having to watch my words. Almost anything I say will send him into tears. He's such an emotional frog. But I supposed I can understand why. He lost his matching female frog (dressed in a fetching pink tutu) in the freak washer/dryer accident of 2002. It’s that kind of tragedy that anyone can understand. I can imagine myself losing my soulmate would be crushing. I think that’s what it boils down to. I can empathize with Mr. Pickles because I can see where he’s coming from. I can put myself in his place and at least attempt to identify with his situation. But Mrs. Pokey Bear, she’s just a diva.

Turns out the flower decision for the wedding was harder than originally anticitpated. Why? The two companies with contrasting styles with various pros and cons. Oh well. I guess we'll just have to use the dart board to decide. Sometimes the old ways are the best ways.

An arrangement from one of the flower firms. A small selection of satellite vessels surrounding the tall arrangement.

The time has come to toast our friends along,

With cheer and mirth we sing the Match Day song!

Lalalalalalalala~

It's match day today, and like all medical students all across the country, I learned my fate today. The day started at Gino's East. We all gathered at the third floor party room. The sealed envelopes were handed out along with poppers. Just before noon the countdown started and amongst a stream of confetti and poppers we opened our letters. I struggled with he envelope has I heard a steady stream of cheers behind me. But I was dazed. Even as I unfolded the papers, it seemed as if I were moving in slow motion. But finally I saw it, Children's Memorial Hospital. Here I come. Woot.

For anyone who's counting there is only one more week till match day and the beginning of my super senior slide. Yesterday, we had our monthly M4 class and cookie party, where we all get to bellyache together. It seems like I'm not alone in having these weird occult manifestations of tension. Sadly knowing that hasn't helped me.

So last night, more experiements.
Chicken Enchilada w/ Salsa Verde

In the interim I've been wasting away in the ER. It's not quite as intense as the show of the same name, but it is pretty fast paced (over 200 come through the emergency department a day). I've seen some interesting things; but nothing too crazy - some MVA, lots of chest pain and the occasional bulging rectal abscess.

Here's another wedding food preview; this time it is more of the sweet variety. Personally, I'm more of the savory sort (in both life and gustatory endeavors), but it's always nice to have a bit of sweetness. The pastry chef at Food for Thought created these three petite sweets for us to try - Lemon Beignet, Lavender Chocolate Cream Caramel Tart, Maple Macaroon. It's hard to decide about sweets, because there's always cake. Sweet, sweet cake.

Grace and I had a our tasting with Food for Thought yesterday. I highly recommend going to as many tasting as possible (especially with this company) if you're competing with an elephant on who can weigh more. We ended up trying 10 hors d'oevres, 2 first courses, 3 entrees, 3 petite sweets, 1 item from the special dessert station, and 2 late night snacks. The final line up for the reception is yet to be decided, but I thought I would preview some of the food that might be served. Here are the 3 entrees that we tried. At the reception we're going to only have one duo option that has elements of these three.

Thyme & Basil Roasted Halibut - Served w/ Israeli Couscous, Haricot Vert, Carmelized Vidalia Onions and Carmelized Black Mission Figs Served with Port and Plum Demi Glace

Peppercorn Crusted Kobe Striploin and Pan Seared Onaga - Truffled Pommed Puree, Baby Carrots, Oyster Mushrooms, Haricot Vert and Thyme Jus

Braised Beef Short Rib & Pan Seared Mahi Mahi - Slow Roasted Morel Mushrooms, Thyme Confit New Potatoes, Grilled Asparagus, Red Wine Jus

Just waiting in agony for Match Day. "Beware of the Ides of March" indeed. The only thing that seems to keep me from totally obsessing over where I'll be for residency seems to be cooking. Luckily, I've been able to experiment more and more since I started Dermatology. My sister recently bought me a few jars of caviar which have to been really fun to use.

Crab Salad on Endive with Beet Saffron Caviar, Grilled Onion & Pepper Quick Pickle Salad topped with a Fried Quail Egg

Poached Cod in a Shrimp Bisque with Stewed Vegetables Topped with Truffled Caviar

Grilled Beef Tenderloin, Sauteed Fennel with Panceta Gravy, Roasted Mushrooms, Balsamic Vinegar Reduction, Mint Chutney