Aga Aga Algorithms

A lot of medicine is governed by algorithms: diagnosis pathways, management algorithms, treatment guidelines, etc. They help provide a framework to guide clinical decision making and uphold a standard of care for all our patients. While their utility cannot be argued against, the individual patient or disease condition may or may not respond accordingly to whatever treatment is initiated. It is in these variations that I find the most excitement and intellectual stimulation.

That same kind of stimulation that draws me to cooking. I fully admit that I when I cook, I rarely follow specific recipes. I hardly ever measure anything. I get an overall gestalt for a dish and improvise from there. From the times I’ve cooked with my mom, I’ve learned to stop asking how much of something gets added because the answer tends to be “as much as you need.” This method seems like a far cry from most Western-style cooking where everything is carefully measured out. I feel like this video of Gordon Ramsay’s introduction to the concept of “aga aga” in Malaysia highlights that point.

“Aga aga” described as “up to you” or “any amount” might seem daunting at first but is a lot of fun. When Sarah and I were at Johnson and Wales for culinary school, we found ourselves constantly tasting and seasoning dishes as we went. I feel like cooking this way really helps develop an understanding for spices, flavors, and ingredients. So for this next recipe, I’m not providing any measurement because curry tends to change in India from region to region, street to street, and household to household. Aga aga to your heart’s delight and find the variation that works for you.

Tikka Masala

img_0336Ingredients:

  • Chicken thighs* (optional)
  • Onion
  • Ginger
  • Garlic
  • Cardamom
  • Coriander
  • Tumeric
  • Cumin
  • Cayenne
  • Plain yogurt
  • Tomato puree (start with canned tomatoes and run them in the food processor)
  • Butter/ghee
  • Heavy cream
  • Salt
  • Lemon

If using chicken, combine cardamom, coriander, tumeric, cumin, salt, and a little bit of cayenne with the juice of half a lemon and some plain yogurt. Mix it well in a bowl and marinate your chicken thighs in the mixture and let sit in the refrigerator for 2-3 hours. Run your ginger, garlic, and onion in a food processor until you get to the consistency you want. In a large pan with a lid, add butter and turn to high heat. Take your marinated chicken thighs and sear them in the butter until they have a nice golden brown coating and set aside. Add a bit more butter and cardamom, coriander, tumeric, cumin and toast the spices for a few minutes before adding in the onion, ginger, and garlic mixture.Your kitchen should be smelling exquisite by this point. Saute the onion, ginger, and garlic with the spices until nicely caramelized and stir in the tomato puree, making sure you incorporate all the aromatics nicely. Add the chicken thighs to the pan and put the lid on. Let simmer at medium-low heat for 30-45 minutes.Stir in a bit of heavy cream to achieve the final classic orange color of the tikka masala. Serve on basmati rice and garnish with some chopped cilantro.

D

*Your other option is to skip the chicken completely and add chickpeas instead (no need to marinate) if you want to keep it vegetarian-friendly.

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Permission granted

When you work 6 day weeks and 14 hour days, time off is precious. Unfortunately, that one day off a week often gets gobbled up by laundry, grocery shopping, cleaning, studying and other random chores. We try to do at least one fun thing on each day that we both have off, but sometimes it feels a like a race to pack everything in. Because of this, when we do get a rare two day weekend off together or, in the case of this special week, an un-precedented three days, it feels like a magnified expanse of time. This weekend has already felt like a little mini-vacation, and we’re only two days deep! If I ever bail out and return to the corporate world, I’m willing myself to hang on to this feeling – this heightened enjoyment of free time.

The other effect of all of this work is that I feel especially entitled to little bits of self-indulgence. Bar of dark chocolate from the Whole Foods checkout line? You deserve it! Adorable little plant at the farmers market?  You totally earned it! Painfully expensive cocktail at a DC bar with coworkers? Whatever… you need to make friends!  $15 to spend 75 minutes petting cats at a cat cafe because you just wasted a precious vacation day taking a board exam? Shit, man…. This time though, I think we really did earn it, as early September marked 6 months of marriage (woo!), surviving the first three months of residency (whew!), and finishing day one of the aforementioned last non-surgical board exam (don’t get me started…). And celebrate we have! On Thursday night we hit up Tail Up Goat – a DC joint recently named to Bon Appetit’s top 50 new restaurants – and ordered everything, including a loaf of bread to go. Friday, we trekked out to a farm in Maryland and went apple picking for the first time this fall, collecting a haul of JonaGolds, GrannySmiths, and Honeycrisps. Once we got home, I promptly turned four of those apples into an apple cake, which we then ate for dinner (yay adulthood!).

I originally found this recipe in the archives of the Wednesday Chef, where Luisa praised it for at last liberating apples from cinnamon. I, of course, dumped that cinnamon right back in, and added some ground cardamom and ginger for good measure. I made a few other swaps along the way and it made the kitchen smell like magic. Of course, I think it would make the kitchen smell like magic no matter what you do to it – I think the smell of apples baking is simply one of those sorts of magical smells. Whatever your interpretation, it’s a wonderful way to bring a bit of fall into your kitchen even if you, like us, are just pretending as the weather hasn’t really cooperated yet.

Apple Cake

  • 3/4 cup all-purpose flour
  • 3/4 teaspoon baking powder
  • Pinch of salt
  • 4 large apples (if you can, choose 4 different kinds)
  • 2 large eggs
  • 3/4 cup turbinado sugar
  • 1 t cinnamon
  • 1/2 t ground cardamom
  • 1/2 t ground ginger
  • 2 tablespoons cream, or milk
  • 1/2 teaspoon pure vanilla extract
  • 8 tablespoons (1 stick/4 ounces) unsalted butter, melted and browned, then cooled

Pre-heat oven to 350 °.

Mix together the dry ingredients in a medium-sized bowl. In a separate bowl, whisk together eggs, vanilla, cream, and vanilla until well incorporated. Add egg mixture and cooled brown butter to dry ingredients, stir until combined. Peel and core apples and slice them into thin slices. Stir gently into batter, taking care not to mangle apple pieces.

Butter and flour an 8″ round pie tin, or line with parchment paper. Pour the batter in. Bake at 350º for 45 minutes, or until a toothpick inserted in the center comes out clean.

Note: the original recipe tells you to stir a tablespoonful of rum or brandy into the batter and I think that would be a wonderful addition, we simply didn’t have any on hand.

S

 

Plum tuckered out

Sarah and I have talked a lot about getting a dog at some point. But not just a dog, a big dog. The bigger the better. We’re talking St. Bernard, mastiff, Bernese mountain, Newfoundland…any dog that outweighs Sarah by at least 50 pounds. Too bad our schedules are not too conducive for taking care of it, and there’s the added issue of Sarah being allergic.

Thinking back to the past few weeks in the hospital, I can’t help but feel somewhat canine. Outside of the obvious cliche “working like a dog,” there’s a few other things. My pager is my dog whistle. When it goes off, I come loping. If it’s a long way to go, there may be some panting upon arrival. When I get home, there’s nothing I like better than curling up next to Sarah. She pets my head most nights, and I drool a little (or a lot) on the pillow. But overall, I’m still a happy big dog.

Poached Plums in Spiced Red Wine

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Ingredients

  • Plums                                 6, halved and pitted
  • Red wine                           1.5 cup
  • Cinnamon stick               1, broken in half
  • Cloves                                 2, whole
  • Star anise                           3-4
  • Maple syrup                      2 T
  • Greek yogurt
  • Mint

Add red wine and maple syrup to a small saucepan and bring to a low simmer while gently stirring for 5 minutes. Add cinnamon stick, cloves, star anise to mixture and continue to let simmer for an additional 10-15 minutes. Add plum halves with sliced surface facing down and let simmer for another 10-15 minutes. The skin of the plum will start to peel away by itself as the flesh soaks up the liquid. Remove the plums from the liquid and remove the peels (they should come off easily). Allow your liquid to reduce more on the stove until it begins to have a syrupy consistency. Plate your plums with a dollop of plain Greek yogurt and top it off with some mint leaves. Drizzle your reduction over and serve.

D

I (Th)Ink I Can

Some days just flow. One task transitions effortlessly into another, checking off boxes on the to do list one after another. Patients are happy. They are going home. The entire team just feels like we’re working like a well-oiled machine. Those days are easy, and time seems to fly by. Then there are other days that tend to be a bit more trying. Sometimes it feels like I’m chipping away at one Sisyphean task after another and there are always fires to be put out at the most inopportune times. In these times, I’m supremely thankful for the support of my co-residents, attending physicians, the nurses. But  I want to acknowledge our medical students.

I’m in pediatrics so I have to bring up one of my favorite children’s books, The Little Engine That Could. Too often, I hear students introduce themselves as “just a medical student.” I find this notion to be preposterous and always think back to that tale of that little blue engine puffing and chugging over the hill. There are definitely days where it feels like my med students carry me over the hump of the day so we all make it to the other side. I’m always impressed by your curiosity and thoughtful questions. Thanks for all your hard work.You guys make this 21 day work week much more pleasurable.

Catalan Calamar

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Yet another one of those simple, fast, and delicious recipes inspired by our Barcelona trip. It truly does not require anything more than squid, olive oil, salt, and parsley. The fresher the squid, the better the flavor.

Ingredients

  • Squid                          3, cleaned and cut into rings
  • Olive oil                     1/2 T
  • Parsley                       Chopped
  • Salt                              To taste

Heat oil in a pan at high heat. Once oil is hot, add squid. Saute for only about 1 minute. Squid cooks very fast and if you leave it in too long, the texture turns into rubber. Remove squid from pan and add salt. Garnish with chopped parsley. Serve with a small drizzle of olive oil.

Chug chug. Puff puff.

D

 

A Spanish Reprieve

It’s been a bit over a week since I started my inpatient hospital rotation. The days are much longer, and the pace is much faster. Juggling 20+ patients of varying medical complexity on some afternoons and weekends is definitely a sink or swim experience. It’s easy to feel bogged down after a while, but fortunately Sarah and I have been pre-preparing a lot of ingredients for our weekly meals (many of the recipes we have posted) so that we can throw something together in 15-20 minutes on most nights when we return home. Within the seemingly unending hustle and bustle of the day, it’s always nice to be able to enjoy dinner together for 10-15 minutes before we’re busy studying for our next set of board exams or looking over our patient lists and to do’s for the next day.

Sarah’s parents gifted me the Flavor Bible for my last birthday. The first page has the formula, “Flavor=Taste+Mouthfeel+Aroma+The X Factor.” The X Factor is described as the emotional, mental, and even spiritual aspects of a meal. It’s the reason why there will never be a chef in the world who can match up to your mother, father, grandmother, or grandfather’s recipe. It’s the reason why even the simplest meal allows us to take a quick breath and disconnect temporarily from the pace of life.

We will always remember our time in Barcelona with fondness where we found ourselves frequenting the local corner bistro on many nights and hanging out with the locals. We liked to sit at the bar, gesticulating and speaking in a mixture of broken Catalan and Spanish with the waiter as we sipped on cava or vin de la casa while munching away on plates of tapas. There’s nothing that says tapas like pebrotes, patatas bravas, and pan con tomate.

Pebrotes

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Best enjoyed with a cold class of cava or Spanish sparking wine

Ingredients:

  • Padron peppers                                                1lb, whole
  • Oil                                                                         1.5 T
  • Salt                                                                       To taste

Toss your peppers in a large bowl with the oil until they are nice and coated. Stick them on a sheet pan in a single layer into the oven on broil. They take 10 minutes or so to get a nice color and char to them. Remove the peppers from the oven and sprinkle on the salt while they are still hot (use coarse sea salt if feeling fancy).

The experience in eating these is a little bit of Russian roulette. Most of the peppers are not spicy, but every once in a while you may find one that packs a punch which just adds to the experience (I’ve been lucky thus far). Enjoy at your own risk!

D