Goldring Center for Culinary Medicine, (December 2019), Cumulative Hours:19.75 [3.25 hours] Community Service, 9/30/19

Katie Pedroza the Chef leads the student chefs.

9/30/19 Community Service

Hours: +3.25 hours

Cumulative Hours:19.75
December Reflection

The fearless graduate students representing the Pharmacology Department performed community service at the Goldring Center for Culinary Medicine.  Registered Dietitian Kerri was more direct and delegated specific duties to the volunteers.   The team of volunteers washed dishes and cleaned to help support the community members.   The shelf had fresh basil leaves, which were made into fresh pesto and used to slather umami flavor into roasted eggplant sandwiches.  I washed the knives and many blenders. Cutting boards and dishes were picked up from various students’ stations while conducting multiple rounds around the kitchen.  

At the end of the evening, I swept the floors  and mopped half of the “green space” which make up the territory of the students’ cooking stations. Then, what everyone made was sampled. One brave colleague was a trooper and was a cooking partner and actually made Moroccan tofu.  The process involved squeezing out the excess water from the tofu, which resembles the consistency of  jello.  This healthy high-protein food is convenient and can be frozen. The price is low enough to accommodate patients who receive SNAP benefits.  In white American cuisine, tofu is constructed into a meat agonist, a protein option for vegetarians and the bourgeoisie consumers at Whole Paycheck; the oeuvre consists of scrambled tofu, tofu dogs, tofu turkey; tofu torture devices such as the tofu press are used. In Asian cuisine, chopped tofu is used almost like Southern dumplings or matzo balls to sop up rich, meaty stews. The tofu is the complement, or adjuvant, to meat.  The finished product could have been mistaken for tandoori with smoky flavors like that of cumin.  A second serving of couscous with raisins and pine nuts was consumed - a delicious juxtaposition of sweet and savory. There was extra chimichurri sauce consisting of cilantro, parsley  and garlic which went well on everything, prescribed to accompany the steak; like methotrexate, it had multiple applications. It was also used for an off-label usage to add a layer of umami flavor to the sweet and sour strawberry & feta cheese kale salad. The charred leeks tasted sweet like candy, surprising, given that the sharp leeks are usually used to accent savory dishes.  Goldring Center for Culinary Medicine continues to serve the community by teaching healthy and appetizing  dishes.  Cleaning and washing remains a chore, however.

The slogan of Goldring reads “Where Health Meets Food.” Directed by Dr. Timothy  Harlan, a physician and a chef,  Goldring serves to teach the community of simple recipes.  The trend of consuming processed and fast food has unwanted long-term consequences of increasing risks of chronic (and very expensive) diseases.   An unhealthy populace will create shared expenses that everyone will pay for in some way.  The preparation and planning of healthy foods is a challenge given the easy access to fast food and the postindustrial schedule of hectic work schedules. 

 Most patients do not spend their time in controlled inpatient settings and will need to take care of their nutrition.  As a state included in the Stroke Belt, the people of Louisiana are vulnerable to higher risks. The most recent health report reveals formidable statistics. A provider will have to address the acute and long-term outcomes on large and micro-scales: legislation to address environmental forces and social determinants and education and community organizations empowering members through education.  Enter Goldring Center for Culinary Medicine contributing the education of nutritional food preparation.  

Word Count:   500+ words

Photo Album link

Deliciously Denatured Glutamate

November Reflection: Orange Pumpkins & Chocolate Spiders - Community Service 9/28 Anna’s Place [6.25 hours]

Edible Art: Orange Pumpkins

November Reflection:  9/28 Anna’s Place 6.25 hours

Service Hours: 6.25

Cumulative Hours:  16.5 hours

Today was my return to Anna’s Place, the non-profit youth program affiliated with St. Anna’s Episcopal Church.  First, I assisted with the initial setup.  I cleaned the tables and then swept the floors.  I arranged the cups in numerical and color order.  Then, the kids arrived.  I took over the distribution of cereal bowls for the latecomers.  

I was officially assigned a group this time, the Green Group.  This group consists of S. the charismatic guy who will continue to serve as the witty commentator.  First session consisted of games.  

I was informed by Ms. T that that day was going to be low key and had fewer formal programmed events.  First session consisted of games.  Then, I participated in another art project consisted of chocolate donut spiders and mandarin orange pumpkins.  

 

I helped peel oranges for S.  “I want to sit next to her, “ he said.

He is kind and generous and offered the art supplies, chocolate donuts, pretzel sticks, M&Ms, and  celery.  He offered the celery.  I refused.  The kids pleaded to watch the movie Coraline. I nominated Ratatouille.

Then, the kids participated in their usual art class, which today consists of collages.  They glued pieces of colored paper.  A the drawing pro showed two drawings she completed.  

“C’mon, A” I said, “It’s Art class, your favorite,” I said, encouraging her to get in line to walk to Art class.  Conform.  

E.  was in my group.  He is so energetic, always beating on tables.  He cannot sit still for long periods of time.  Still, he was able to complete his collage.  I asked him to please stop tilting the tables.  For energetic E, every hard surface is an experimental drum that requires testing out the rhythm in his heart. 

The experience was helpful to a future provider dealing with young patients and families.  The female children demonstrated adult activities such as bullying and gossiping, which was not pleasant to observe. Female Passive-aggression starts young.  They gave each other mean looks and “she said …. To me.”  I didn’t want to depress them to let them know this will never end. It’s about being professional: there will always be mean people saying mean things about you.  But remember Eleanor Roosevelt’s adage, No one can or should make you feel inferior without your permission.  

Photo link

Word Count: 280+ words

November 2019: Cardiovascular + Professionalism

Cardiovascular Module

Dr. G returned for another retelling of an anecdote  of purchasing an autographed cookbook for his beloved spouse which ended with him threatening the chef who signed it, told during the P450 lecture from a prior module. He then confessed a personal account of patient non-compliance even as an educator of disregarding the doctor's advice on diet control.  Self control is dismissed when provided with the opportunity of an All you can eat/drink cheese and wine, guaranteeing the omniscience of statins.  

Narrowing on the organ of ANS,  the overview of heart diseases was covered.    There are multiple varieties Angina, Heart Failure, and Atrial Fib. There are multi strategies like rate control and rhythm control. 

Another interesting note was about diastolic heart failure, the problem with ventricular filling.  The diastole is important as Dr. Vivek Murthy, the former Surgeon General, stated as a metaphor in his speech at the University of Arizona.

Beta blockers, water pills, and Amlodipine were encountered previously while completing clinical pracuticim with a cardiologist. One patient was cautioned about the water content in fruits.  Dr. M. always commented about the ejection fraction as he looked over the ECG printout.  Heart failure was a common diagnosis.  

Professionalism.

Dr. K. addressed the students after the renal lecture.  He encouraged the students to not be discouraged.  “How do you deal with stress?” is one of the criteria of admission. What did you overcome?  

Did you have to work three jobs to support your family?  Did you take a three-hour bus ride because you needed that special chemistry class that worked with your work schedule?  

Despite the prestige and necessity of medicine, the profession is cursed with high rates of burnout and depression.  

Notable example of those who flourished under stress include the athlete Kobe Bryant.  He played with great finesse even though the tabloids already condemned him as a rapist.  When her husband’s infidelity became national news, Hillary Clinton still managed to get of bed and continue to work in advocacy for all her causes, including healthcare reform.  However, examples of those who did not survive the untruthful gossip of the masses include Marie Antoinette and Leo Frank, a Jew,  who was murdered by the masses based on a false accusation.  Those who are still quiet or too weird or misunderstood like Dr. Boltzmann will always be easy targets for the masses to scapegoat.  

People will challenge you and treat you with unkindness and gratuitous condemnation, as Dr. Randle Adair illustrated.  His expertise was belittled when he was labeled as a “not a real doctor” when he was still a titled Ph.D.  Dr. Adair shared his unconventional journey to medicine.  He was 45 years old when he matriculated.  

*

Word Count: 500+ words

Autonomic Nervous System ANS Module & Infectious Diseases Module - October 2019

Autonomic Nervous System ANS Module

Unlike the previous two modules, the first week of the ANS module did not commence with the naming of numerous drugs and their mechanisms of action.  Instead, it was a review of the nervous system physiology.  How does the body know how to osmoregulate for you, keep you beating, keep your heart breathing, without your conscious input?  ANS. 

I was surprised to learn that the receptors of cannabinoid metabolites inhibit appetite by inhibiting the GABA receptor.  Really?  But pop culture depicts that the usage of cannabis leads to the classic “munchies.” Is pop culture wrong ... again? Two types of receptors were discussed: one for the immune and one pertaining to the nervous system.  

  

He discussed the genius of Boltzmann who gave us another constant for students to memorize . 

“Looks like a genius,” he said, showing a bearded figure.  According to Dr. Li, Boltzmann had a unique personality like Isaac Newton, “he couldn’t take criticism.”

“You have to take criticism,” especially in science, he continued. You submit drafts of your research, a product of your blood, sweat, tears to a journal.  Then, you get the editorial criticism, “telling you how stupid you are.” 

“He suicide himself,” he said.  Boltzmann felt misunderstood.

---

Infectious Diseases Module

Reminded of the documentary Surviving R. Kelly, if  R. Kelly was your patient, do you what to e-prescribe for him?

Valacyclovir , of course, an improvement of Acyclovir, for his genital herpes. 

Given his habit of cigar smoking, and considering that tobacco is a known inhibitor of cytochrome P450 enzymes, his dose of Valacyclovir may have sub-therapeutic effects than the comparative doses given to his live-in girlfriends.  

Reading the syllabus, this module seemed simple.  But it’s not.  Within a short period of time, one has to memorize what seems like zillions of drugs and side effects.  I think all drugs will affect the liver with a large dosage, of course.  But you have to know more than that. Some affect graying of teeth and yellowing of eyes. 

Post Word Count: 300+

Goldring Center for Culinary Medicine 9/26/19 - October 2019

Goldring Center for Culinary Medicine

9/26/19

Hours: + 4 hours

Cumulative Hours: 10.25 hours

Community Service Activities 

  
The student chefs present their dishes at the end of the cooking session.  They describe the techniques and ingredients used.

Rite of Passage

          Finally, I arrived at the unofficial rite of passage held for the master’s students of the Tulane Pharmacology Department: the Goldring Center for Culinary Medicine. 

I heard about this opportunity at the Goldring Center for Culinary Medicine from reading the blogs from last year’s cohort members.  The organization teaches community members how to cook healthy meals. Most of us living in the post-industrial revolution have to resort to fast food, which has led to chronic diseases and high health insurance premiums. Cooking has become an exotic, vestigial tradition because of our hectic lives. Therefore, the Center addresses how affordable, healthy meals can be made even with our work and life schedules.   More healthy people are needed to reduce the cost of healthcare.   I participated in supporting the cooking classes held for community members.  I was supposed to perform regular kitchen rounds, pick up used utensils and drop them off at the dish washing station, and help with the washing and cleaning. Whenever there was a question about the recipe, I relayed the question to the Chef/Registered Dietitian to the specific station.

I was to support the cooking students’ activities.  I stood near their stations. Sometimes they asked me questions about the recipe.  I honestly didn’t know. I am not a culinary expert at all. 

“Am I supposed to chop this chicken before seasoning?”

I don’t know.  I went to the Chef.

Ms. J held up a piece of leftover celery, “Compost or Treasure?”

“Treasure,” I answered, feeling so proud to be useful. 

Compost or Treasure?

          I watched Station 7 make chicken salad sandwich.  The Station next to it made hummus sandwiches.  This station browned the chicken which added a nice umami flavor to the chicken.  The student added chopped almonds not to the green bean salad but to the chicken, so I had to look for more chopped almonds.  I searched in the pantry.  But I found nothing.  So I went to S, who is a student at the Tulane SOM, who told me that they were in the fridge. 

          At the end of the evening, the students presented their dishes, explaining the techniques and read out loud the ingredients.  The Chef explained how the mayo was reduced by using Greek yogurt.  This reminded me of a feature story of how a dietitian went to a pediatric patient’s home to teach the family how to cook Cuban food in a healthy way by substituting ground beef for ground turkey. 

          Goldring runs on a grassroots style.  No one will tell you what to do. You look around to make yourself to be useful. I swept the floors.  I wiped the counters. I took the dirty dishes to the dishwasher.  I would like to learn and observe how to make healthy versions of steamed vegetable buns or kimchi fried rice, because I long for the dishes of my hometown.  

I learned: 

Green beans are delicious.  Chicken salad with raisins and sliced green apples are delicious.  

The yogurt salad dressing was so good that I wanted to drink it. 

Entrance

Recipe

Student Cooking Station

Refreshing Tomato Zucchini Salad

Last Remaining Hummus Sandwich

Goldring Center for Culinary Medicine

9/26/19

Hours: + 4 hours

Cumulative Hours: 10.25 hours

Post Word Count: 500+ words

Anna's Place - September 2019 - [Hours: 6.25 hours 9/14/19 Saturday]

September Hours: 6.25 hours  

9/14/19  

Cumulative Hours: 6.25 hours

Anna's Place

Anna's Place is a social justice organization affiliated with St. Anna's Episcopal Church in New Orleans. All the clientele are black African American youth.  I had my chance to become Jean Piaget through observation. They children were grouped by age. The Yellow Group is the youngest. They have big puppy eyes and are eager to talk to strangers.  They are affectionate with camaraderie and hugs. This age group has yet to indicate to me how they pigeonhole me according to any racial schema.


In contrast, the Red Group:

“Where are you from?” one pre-teen fearlessly asked.

“I’m from…” I named a U.S. city.

“Oh,” she said, disappointed. I think she wanted to hear me say Vietnam or China, and an explanation as to why my skin color was so drastically different from hers. Through sight, perhaps she coded me as a foreigner.

For some white and black Americans, the racial schema codes Asian Americans as foreigners.  Asian Americans are Americans.  However, many white Americans refuse to accept those who look Asian American as genuine American, but code them as foreigners.  The term "American" is reserved for those who possess white skin and light colored eyes, the expression of the recessive phenotype.

Even though all the clientele were black, the volunteers were a diverse group and easy to tell apart just by using our racial schema. There were white individuals - guess which group they belonged to: volunteer or clientele?  There were many volunteers from Loyola, because in the late morning, some were standing around, eager to look for ways to be helpful.

I played four-in-a-row.  I lost twice.

“I won,” she said. She is A, a female between 9 and 13.

The game involved brain power.  The best strategy is to win in a zigzag pattern as opposed to arranging an orthogonal pattern.  Your opponent will view this and block your win. But a zig zag is much more difficult to catch and you can deceive your opponent if they are not careful.


I sat in the music class.  The Green Group were antsy when Mr. Leach tried to explain the lyrics of a song.  They were silly. But they enjoyed the name rhythm game, which involved clapping and snapping.  Even I made a mistake.  Mistakes always end with giggles.


The gardening class was fun.  The Yellow Group used rakes and other tools much bigger and taller than their small bodies.  They looked at worms and picked out plastic. The shovels were fought over.  They voted on which vegetables to grow. A. wanted to grow roses. But the gardening instructor explained that it’s not the season for roses.  Even better, we cannot eat them. Little V. wanted green beans, but it wasn’t the season, and she settled on peas and beets. I would have voted on kale.  When can I plant cilantro to put into pho noodle soups and tacos? I am getting homesick and I miss the food of home.

Gardening is one of the solutions from public health advocates given the food deserts of underserved communities.  Prevention of diabetes and other chronic diseases start early.

The business class was offered for the oldest group.  The instructor discussed the history of the Blockbuster and Netflix rivalry.  Now Blockbuster had just one store. Technology is a game changer.  Nokia v. iPhone. Guess who won? They drafted ideas for their business.  What was the problem? What was their solution?


Finally, I participated  in an art class. All the young students from the Yellow Group were placed in Arts because “It takes a certain skill set to do Dance or Drumming.” the coordinator explained to me.

Two older students from the Green group were also in art. Mr. Timothy with a sunshine smile and wavy white hair led the class.    One was very introverted. But A knows how to draw.

S. was very kind.  He was chastised during the music class. But in art, he was calmer.

“Do you want to paint,” he asked.

“Yeah,” I said.

He handed me a brush and a paper with an outline of three birds to color.

“You paint this one red and this one blue,” he instructed.

Cute V. was eager to show me her work-in-progress, a heart she painted in solid red.  She waved at me.


*

What is the point of community service?  To be connected to the less fortunate?

I tried to prepare for the long day with breakfast but it wasn’t enough because I was so starved by noon.  My liver was performing gluconeogenesis in high gear.

Thankfully, the Chef exhorted to Ms. Te’Ara, “the food’s going to get cold.”

Preach on, brother.

Lunch was red beans and rice.  So good. I was so hungry, I could not wait for a millisecond to put hot sauce on it like the kids.  I shoveled the tastiest rice and tastiest cajun links into my mouth. I knew I had to eat this every day. Never mind the arsenic in the rice and its inhibition of my pyruvate dehydrogenase complex....for now.  Let me enjoy the sweet dopamine release from the umami receptor stimulation.

A round trip Uber transportation cost a hefty $14.  Public transportation is practically non-existent here in downtown New Orleans. The bus spot is a spot with secondhand tobacco smoke, a Cytochrome P450 inducer.  No one should hang out there.

Hours: 6.25 hours  9/14/19 Saturday