In the emergency room, it’s not all that often that you connect, truly, more deeply with your patients. I’m not saying that in a numb or unemotional way, but it’s generally the nature of the beast. There is simply a lack of time and a fervor trembling through the vein of organized chaos. ER is messy, dirty, always germy. It’s sad and sick and bloody. And yesterday was Valentines Day. This is my bloody valentine, 2021*. Parental supervision required.
The night before, it all started. She was an 80 year old lung cancer patient, (let’s call her) Sylvia. She was my patient.
Sylvia arrived by ambulance, short of breath, with 02 saturations in the 70’s on arrival. She does not wear oxygen. She does not smoke. She lives alone, happily.
Sylvia has a vibrant spirit. She is pale, sunken. She looks frail, saddened. But she talks to me like we’re old friends. The feeling is mutual.
Her daughter, (let’s call her Laurie) is here. Her heart was in it. She is lovely, not overbearing. She asks appropriate questions. Understands. Or asks again until she understands. And I’m happy to elaborate.
Sylvia is cold. No, she is hot. I touch her back. Dripping. Not febrile? I obtain a rectal temp. Nope, wrong. Febrile.
She laughs at my ill timed jokes. She appreciates sentiment. She tells me about her life, in it, teaching me about life. Losing the love of her life, broke her heart. Teaching her grandchildren about art was her daily motivation.
I like her face. It’s pale, I note again. But it’s a nice face. I think she loved well. I know by our short interaction she is loved.
I have to run. There is a code down the hall. The patch comes through. Ruptured esophageal varices. So I run. “I will be back, Sylvia.”
The code blue, the man, blue, in his early 60’s is dead (or albeit) dead on arrival. Blood gushing from his cracked, open grimace. Crumbs caked in every crevasse of his skeletor-like body. “Crunch” the ribs go, as CPR ensues. Choked, spewing, with every compression, more blood violently volcanoing into the air. They are all covered.
I get back to Sylvia as soon as I can. Laurie tells me she felt a ‘hot flash’ come over her and she was shaking. She looks worried. I order a repeat EKG. Sinus tach, no arrhythmia. Her heart was beating. Labs back; septic, but fighting.
It’s time to go home now. I don’t often say goodbye to patients.
I enter her room, and end up talking with them for another 20 minutes. In that time she laughs the laugh of a vibrant young woman.
Laughter, I’ve come to find, is the best medicine.
Sylvia and I hold cold hands and I massage her weathered knuckles.
I clock out late. I’ll get in trouble, tomorrow.
Tomorrow was Valentines Day.
The day after, back to work.
A man walks into the ER. I’m the triage nurse out front that day.
“How can I help you sir?”
“Hello, I’m here to pick up some belongings from Sylvia, who was admitted to the acute care unit.”
“My Sylvia?” I wonder.
I look up her admission room, 506. Wait..
Pause. Dry Swallow. Deep, deep breath.
Does he know? I inquire..
“Sir, are you here to go see Sylvia?”
He looks at me with sorrowed eyes above his white paper mask.
“My mother died yesterday.”
“I took care of your mother two days ago…”
He approached me kindly, and without warning, he hugged me. Thanked me for my kindness. He said “her heart just wasn’t in it”.
Hug your loved ones often. Stop procrastinating. Eat delicious food.
1 tart feeds you and another ‘beeting’ heart; Takes 50 min.
Ingredients for Leek & Potato Tart with Beet Soaked Apples
- 1 rolled out sheet of puff pastry dough, poked many times with a fork
- 1 small gold potato, peeled and cut paper thin (use a mandolin if you can)
- 1 baby leek, outer skins removed, cut into small rounds and washed well (mostly white and some light green parts)
- 2 tbsp tarragon pistou (recipe below)or your favorite pesto
- 1 cup freshly shredded comté cheese
- 1/2 cup full fat, freshly shredded mozzarella
- 3 small beets, roasted and juiced (see note below)^
- 1 honey crisp apple, peeled and cut into cubes
- Juice of 2 oranges
- Olive oil, salt and pepper
- Extra basil and tarragon for garnish
Ingredients and Method for Tarragon Pistou
- 1 handful basil, stems and leaves
- 4-5 sprigs tarragon leaves
- 1/2 cup good olive oil
- Zest and juice of 1 lemon
- 3 oz fresh parmesan cheese
- 1 clove garlic
- Salt & pepper
In a small food processor add the basil, tarragon, lemon, and olive oil. Blend until the consistency of pesto, without chunks.
Add cheese, pepper and garlic. Blend again.
Taste and add desired amount of salt (if you’re me, its a hefty pinch). Blend again and refrigerate immediately, if making ahead of time. **This will last in the fridge for 5 days.
Method for Tart
Add the juiced beets, orange juice and apples into a small sauce pot and cook for 15 min on medium low and then turn to low for another 15 min.
Meanwhile, preheat oven to 400F.
Brush the puff pastry with about 1 tbsp of the pistou and add a sprinkle of salt to the dough.
Layer the comté cheese on the pistou.
Place the potatoes in a single layer on the comté and then add the leeks and top with mozzarella. Curl in the edges of the dough around all the ingredients so they are tucked in. Brush the edges with more of the pistou.
Bake for 15 minutes. Remove carefully from oven and pop any big bubbles the puff pastry may have made.
Top with sweet apples and more tarragon if desired.
Laughter is the best medicine. Here are some other bests:)
- Best in winter OR summer – Gewürztraminer and Saffron Drowned Risotto
- Best anytime your going bananas – Coconut Banana Bread French Toast
- Best anytime you want to eat anything at all, ever – Sesame, Garlic Broccoli Grilled Cheese
- Best anytime you wanna sink your teeth in, chin dribblin’ – THE Fried Chicken Biscuit Sandwich with Heirloom Slaw
- Best anytime you are challenged to a duel – Truffle Mac & Cheese with Mascarpone and Roasted Garlic
- Best anytime your feeling saucy or needing sauce or at brunch – Rosé Mimosa with Lemon & Bourbon
*Recipe updated April 2023.
^Note on juicing beets: There are plenty of ways to do this, but here is how I did it this time…
Peel the beets first and cut off ends. Wrap them in foil with a small drizzle of olive oil and roast for 45 min. Once cool enough to touch, press the beets through a mesh sieve reserving the beautiful juice on the other end. So simple and colorful! (You could also throw them in your juicer or muddle them and then strain the juice that way:)
