I've Moved!

So, I'm not web savvy enough to figure out how to automatically redirect everyone to my new blogsite. I moved to wordpress because it seems to work better for me. And then my husband put a new domain name in my stocking for my, and then gave it to me early!! So I'm now at:

http://www.homemakermd.com/

Come over for a visit!
Oh, and the comments actually work there!

The ultimate career

"The homemaker has the ultimate career. All other careers exist for one purpose only - and that is to support the ultimate career. "


— C.S. Lewis

Thou Fount

Come, Thou Fount of every blessing, Tune my heart to sing Thy grace;
Streams of mercy, never ceasing, Call for songs of loudest praise.
Teach me some melodious sonnet, Sung by flaming tongues above.
Praise the mount! I'm fixed upon it, Mount of Thy redeeming love.


Here I raise my Ebenezer; Hither by Thy help I'm come;
And I hope, by thy good pleasure, Safely to arrive at home.
Prone to wonder, Lord, I feel it, Prone to leave the God I love;
Here's my heart, O take and seal it, Seal it for Thy courts above.


Jesus sought me when a stranger, Wandering from the fold of God;
He to rescue me from danger, Interposed His precious blood;
Prone to wonder, Lord, I feel it, Prone to leave the God I love;
Here's my heart, O take and seal it, Seal it for Thy courts above.


O to grace how great a debter, Daily I'm constrained to be!
Let Thy goodness, life a fetter, Bind my wandering heart to Thee.
Prone to wander, Lord, I feel it, Prone to leave the God I love;
Here's my heart, O take and seal it, Seal it for Thy courts above.

Shadowlands

So far the weekend is off to a good start. Currently my husband is sorting out his garlic bulbs on the coffee table in preparation for planting them later (he's got quite the green thumb), and I'm trying not to watch the news, which I'm currently overloaded on.

Last night we had our community group (a bunch of medical residents and students and friends) over for a movie night. Usually we meet on Sunday nights and I make a huge dinner over which we discuss the mornings sermon and sunday school lesson. The church we attend is quite large (so different from the small churches my husband and I grew up in) and we need these smaller groups within it to foster true community and accountabilty.

So back to last night. We chose to watch the movie Shadowlands. Anthony Hopkins as C.S. Lewis and the story of his marriage to Joy. I've watched the movie countless times, and even saw the play on stage in London last Febuary...and I love it. To counter the guys hestitation in watching a movie certain to invoke tears from all females in attendance, my husband suggested that they all bring pipes (despite the fact he's an oncologist?) and take a smoke on the porch afterwards in honor of ol' Jack.

Highlights from the movie are some of the words from Lewis' writings. I'll say that you can feel the awkwardness between Lewis and Joy at early points in the movie. Anyway some of the favorites:

"The pain now is part of the happiness then." -stated by cancer ridden Joy, as they sheltered in a barn in the golden valley during a rain.

"Pain is God's megaphone to rouse a deaf world." -said by Jack (what Lewis went by since he hated his first name Clive) during several lecture he gave during the movie.

I loved the shots of Oxford. My husband and I went there while in England as well, and even tracked down the Eagle and Child pub where Lewis met with The Inklings, the little literary club he developed with friends like Tolkein. It was funny to walk through the pub to the back room. People were enjoying it with friends as a normal night at any English pub, and I wondered if they knew the conversations that had been carried on in that back room decades ago, and how far the ensuing stories and ideas now reached.

So anyway, that was our friday night. Also making friday day great was the fact that I finished the first draft of a large writing project I've been working on. More on that later. So other than my baby girl falling and scraping up her little cheek this morning, the rest of the weekend looks promising. See that photo at the top of this post? That's from Magnolia Gardens, one of the oldest gardens in the country. I live about 5 minutes from it and several other equally stunning southern plantations. Being a local and a member of the Artist's Guild here (I paint a lot) I have access to all these great places that make me feel like I'm either walking through time or Narnia or something like that. So perhaps later this weekend we'll do a little exploring...

Book Review: Finding Purpose Beyond Our Pain

Finding Purpose Beyond Our Pain: Uncover the Hidden Potential in Life’s Most Common Struggles


By Paul Meier, MD and David L. Henderson, MD

This book is written by two Christian psychiatrists who are also on faculty at Dallas Theological Seminary, and throughout the book they draw on their experiences in biblical counseling and psychiatry to discuss the pain we all experience throughout life, digging for deeper meaning by looking for God’s purpose in it. They divide the book into seven sections about seven general types of pain, each with four chapters followed by discussion and application points. The sections are as follows: Injustice, Rejection, Loneliness, Loss, Discipline, Failure, and Death.

It is rare to find psychiatrists who are Christians, so to have this book from two of them is indeed something to appreciate. Their writing is clear and the examples they include drawn from their life as well as the people in scripture are compelling. I enjoyed their use of allegory in explaining some of the spiritual and emotional principles. For example, in the section on rejection they discuss people who tend to become too transparent early in relationship as being well-diggers, and people who remain guarded and superficial in relationship as building walls. They then applied biblical truth to these issues. I would recommend this book to people who are having a hard time understanding God’s purpose in the hardships they face, as well as anyone in a “ministry” position such as a bible study leader, pastor, missionary, as well as Christian doctors…really anyone who counsels people biblically and struggles with wanting to do it well.

The Cranberry Challenge: Part 3...Cranberry Scones

I think this is my favorite cranberry recipe in this use-three-pounds-of-cranberries-while-they-are-fresh challenge. Scones are so great. They are comforting like my favorite southern breakfast food, buttermilk biscuits. But they are just a little more civilized and fancy. Scones bring back memories of my 29th birthday, when my husband and I were in London. He suprised me with high tea at the Ritz in the famous Palm Room. It was unreal--a once in a lifetime thing for a girl from the most rebellious state in the colonies (SC!). There were silver tea services and tiny tea sandwhiches which kept multiplying. The best birthday present: I found out that very morning I was pregnant with our first child, but had to give up caffeine all at once, meaning the withdrawal from my 6-cuppa day fix was just starting to kick in by the time I ordered my chamomille...But those scones...unreal and oh so london.

I think the key in making successful scones is using very cold butter. I've tried other versions of scones in the past without paying attention to the temperature of the butter, which turned out to be a terrible mistake, resulting in scones which were really more like slightly-less-sweet cookies. In any case, I found this scone recipe here. I changed it up a little, of course. Pecans are always my go-to nut in these recipes so I used those instead of walnuts. They turned out great. Of course I was glad I could enjoy them with coffee again, though the little cuddly toddler snuggling next to me made those caffeineless months well worth it!!

Helping Africa

This morning, for several reasons, I was thinking about Africa. Perusing photos from a recent medical missions trip some friends of mine made, memories of my times on the contitent broke over me like waves. I almost smelled the wild sage as our jeep drove across parts of the Vendi region of South Africa, and remember the face of hospitality in a tiny hut on the shores of Lake Victoria.

Then I happened across Justin Taylor's blog and read some thoughts about why aid to africa isn't working, and it got me thinking.

I’ve gone to Africa with a stethascope and bags of medicine enough times to know that the current strategy of putting bandaids on a gaping wound isn’t going to cut it.

The thing about it is that whether you are there or here, the need is ever present. There it is in the form babies dying in front of me with cerebral malaria and adults thin as rails from aids. Here it is in the long, drawn out nightmare that is alzheimer’s and the painfully extended deaths we elicit in our hospitals while flogging our dying with tubing and painful procedures.

The thing about approaching all this as Christ would is we fight agaist it as hard as we can because He called us to, and we do it in his name, offering cups of water as we are equipped. But the thing about it is still the crux of the gospel itself: all our striving will never be enough. The day we think we can solve it ourselves is the day that we stop relying on Him to be glorified in the midst of all the mess we make with the gifts He’s given, despite ourselves.

So we lift up our heads in the midst of all the muck of the decay and pain around us, fixing our eyes on the prize set before us, on the face of the One who has called us to fight the good fight and finish this race.

A Caramel Cake Tutorial

I have been trying to perfect this recipe for years, and think I am about as close as I'll ever be. The thing about caramel cake is that it's kind of like any other skill--the more often you do it, the better you'll be at it.

The first time I tried to make it I was in medical school, when a really cute medical student {who happens to now be my husband} said it was his favorite kind of cake. It was coming up on his birthday, and we were dating at the time, so I decided it was high time to try my hand at it. The caramel cake that is famous in his hometown is an ELEVEN LAYER concoction that rivals the best desserts in all of Charleston {even the famous peninsula grill coconut cake}! I was determined to learn to make it myself, but of course the recipe was a secret! So I searched and experimented, and finally {years later} have perfected something people rave about. Mind you there were a lot of bumps in the road. Most vividly I remember that first attempt, in my tiny studio apartment kitchen back in med school. I had about six square feet of room and about one square foot of counter space to work with...but the real problem was that I tried to make that icing with no electic mixer- just my hands! For most cakes that would be feasible but not for this one--I beat that icing till my arms were about to fall off and still couldn't get it right! I still remember the way the icing just ran all over the place, pouring out from between the cake layers and gettin' everything it touched sticky. No I know that if I'd just beated it long enough it'd turned out OK. It was just one of many cooking embarrassments for me, but my sweet husband enjoyed every bite, runny icing and all, which is I guess why I keep on being adventurous and reaching above my skill level in cooking {despite almost certain failures along the way}!! All that aside, I'm going to share all I've learned through all those mistakes how to make a Caramel Cake to die for....

These directions are for a six layer cake, but you can increase the quantities for more layers! Also I'd like to say that this recipe was adapted from Joy of Cooking, however they don't include any of what I think are the important details or photos, which is probably why I messed it up so much before!

Tools you need:
Cake Pans {I use 3 round 9" pans to cut into 6 layers}
Candy Thermometer {it's best if you find one that can measure the temp in the center of your pan, not the edge--more on that later}
Electric Mixer {stand is easier but you could do it with a handheld too, if you have strong arms}
Medium Sauce Pan {If this is your first time you may want to use a pot that's not your favorite...I'll explain later}



Ingredients for the Caramel Icing:
Brown Sugar {I use light brown}  3 cups
Heavy Cream  1.5 cups
Butter 3 tablespoons
Vanilla Extract  1.5 teaspoons

Step 1: Bake the cake. Notice I'm not including a cake recipe here...that's because this cake is all about the caramel icing and all about as many thin layers as you can make so you can have as much icing on there as you can! The cake is secondary, so keep it simple. I usually use a boxes of yellow cake mix, mixed according to directions on the box, and add an extra egg to make it stiff so thin layers hold together better. So you can do this too, or use your favorite cake recipe and be sure you make it a firm enough cake {add another egg if you need to}. Once I mix up the batter, I put equal amounts in each of my 3 buttered round cake pans and bake them, then let them cool, and turn them out of the pans. This can be done the day before the icing if you want.

Step 2: Be sure your candy thermometer fits properly in your saucepan. By this I mean, clip it on the pan and be sure you can adjust it so it doesn't quite hit the bottom of the pan but almost does (like 1/4") from the base. And it's important that the thermometer is measuring the temperature toward the center of the pan and not just the very edge. Otherwise it won't read accurately! Trust me, I've learned this the hard way and ended up with a pan of solid hardened caramel before (which wasn't friendly to my cast-iron Le Cruset's enamel when getting it out!). Thus my warning to use a cheap saucepan for this!

Step 3: Begin the Icing. Put the Heavy Cream and the Brown Sugar in a medium sized saucepan on the stove. If this is your first time you may want to use a pot that's not your favorite (I'll explain later). Mix it until it's well dissolved, over medium heat.

Step 4: Turn the heat to Medium-High, and put the candy thermometer in place as described in Step 2 above. Allow it to cook on the stove without stirring it, until the temperature reaches 238 degrees Fanenheit.  This will be the part where you are tempted to leave the stove for a while while you wait for it to get hot enough. DON'T DO IT!

{Last time I drifted over to my laptop to check my email and when I checked again, the temp had already hit 250 and the icing was ruined! In the case you do ruin a batch in this way, the think to do is to pour it out of the pan immediately into/onto something heatproof and lined with wax paper. Allow it to cool there instead of in your pan. Then boil some water in the pan to help get it cleaned out. If you leave the overheated icing in the pan to cool you will have a much harder time getting it out later!!!}

Keep a close eye on your pan of hot caramel and when it gets close to 238 degrees, be ready to pull it off the hot stove right away! For some reason it like to hover around 230 for a long time to lull you, and then it races up so quickly you can easily miss the moment. Anyway, when it does hit 238 degrees Farenheit, pull the pan off the stove right away and place it on a trivet. Be sure you don't have kids in the kitchen during all this (easier said than done, I know!). Leave the thermometer in place.

Step 5: Cut the butter into a few slices and just kind of lay them on the top of the hot caramel.

Step 6: Allow the saucepan of hot caramel to cool without touching or stirring it, until it reaches 110 degrees Farenheit. This will take anywhere from 30 minutes to an hour.

Step 7: While it is cooling I start to prepare my cake by slicing it from three round layers into six round layers. This can be done a number of ways, as I've seen desribed in various cookbooks. But for these, layers, since they are so thin, I use the Dental Floss Method. First, I use a long serrated bread knife to cut a groove all the way around the edge of each cake. Then I wrapp a piece of {waxed and preferably plain rather than mint flavored} dental floss all the way around in the groove, crossing the two ends together in the front. Then I slowly tighten the dental floss, allowing it to cut into the center of the cake and producing two layers from one! {no one mentioned a mint flavor in this particular cake, so if you that's all you have, go for it!}

Step 8: When the caramel is cooled to 110 degrees, pour it into a bowl and beat it with your electric mixer until it becomes cool, thick, and creamy. It will take a while! You will know it is done when the color has lightened, and it's no longer runny at all. If it gets too stiff you can add in tiny amounts of cream. You want it to be spreadable and hold it's shape.

Step 9: Frost it up!! Save the prettiest layer for the top of the cake. Spread the frosting between each layer, alternating frosting with cake layer until you have them all stacked up. Then frost the top and outside! You can do this a day or two ahead and it will still be great when you cut it up and serve it. It tastes great with vanilla ice cream. Also you can try different cake flavors with it as you gain confidence. I did a banana last time and may try a spice cake next time. My husband still thinks a plain yellow cake is best though.

Let me know if you try this and leave a comment with any changes/problems you run across, so I can improve this little lesson if needed! Have fun!

Biblical thoughts from a former feminist

When I have to do something manual around the house that doesn't require my brain, I often like to listen to things that I can think about, like a sermon or a talk. Today I ran across these talks given by Carolyn McCulley at a conference at Northridge Baptist Church. I've popped over to her blog a couple times and enjoyed what I read. Also I'm really looking forward to reading her book soon as well (Radical Womanhood). She talks about the home as not simply a place with four walls, going beyond that to being about the relationships and spirit of hospitality fostered there rather than the idea of simply making a house pretty. She challenges the philosophy of feminism and identifies ways it has sublty snuck into our thinking, even as Christians.

I loved her talk on "The Mommy Wars," and totally identified with what she was talking about in regards to people looking at the stay-at-home-mom as "someone who used to be a fully functional adult." That seems to be the look I get when people realize I used to be a doctor. So many people (including us homemakers) look at the repetitive tasks like the diapers and the laundry as drudery and then misinterpret the task we have in building our homes as menial, mindless, and dull. But every job has it's repetitive parts. When I was a working in the hospital, it took the form of writing note after note after note, not to mention the repeated rectal exams and pap smears on clinic patients. And you think diapers and burp cloths are gross?

I highly recommend Carolyn's talks and look forward to getting a copy of her book in my hands.

Warm November Days

Our weekend was full of fresh roma tomatoes from our backyard (check out my windowseal), a beautiful six-layer caramel cake I whipped up (tutorial to follow later this week) for my mom's birthday, and a trip down the coast to the island where my parents live to deliver said cake and stay for a visit! The drive back took us on a detour through the beautiful town of Beaufort, SC, where we poked around in antique shops, gauked at some historic homes, gazed out over the golden bay, and satisfied our sweet tooth at the Chocolate Tree.

Other than that, if you happened by my page this weekend you may have seen any one of a number of new templates I tried out for my blog here. I'm new to this whole blogging thing, as you've probably figured out, and hunted everywhere online for a great, three column format I could use. I finally found this simple, three column minina which I've adopted, and quickly set in one of my favorite shades of blue. It's close to the Tiffany's blue, but maybe a little more muted. But I guess it could look different on your monitor. Our master bedroom is painted in a similar shade, which oozes serenity and calm. It reminds me of when I look out over the Cooper River from Waterfront park in downtown Charleston on a cool spring day like the one when my husband proposed so many years ago!

Later this week at Homemaker, MD, I'll be posting the above mentioned caramel cake tutorial (this is the real deal people), write a little bit about a questionable procedure called "palliative sedation" and the ethics surrounding it, do a little show and tell involving some of my home decor, and explain why on earth a homemaker like me is so interested in thinking through Christian bioethics--and why I actually think it is part of building up my home and family. I'll also be tweaking my site a little bit here and there, playing with fonts and stuff. I don't know code and don't really want to learn, but I do want to spruce things up a little. Let me know what you think and if you have any advice for me in this area!

Book Review: "Life, Liberty, and the Defense of Dignity" by Leon R. Kass, MD

This was a heavy and rich work. I found Dr. Kass to have a profoundly well-thought out explanation of his philosophical perspectives in many areas of bioethics. One complaint I had overall, however, was the tedious nature of his writing, and sometimes I wished he had more specific examples or practical applications for the points he was making. Granted, I agree with him that the defense of dignity is a hard thing, seeing as it is a value he describes as a “soft”, even “symbolic” (p15).

One strength of his writing for the Christian bioethicist is that the defense that he makes for human dignity is frequently made through moral reasoning rather than from Biblical sources, which makes for usefulness in conversation with those who have no belief in divine inspiration of Scripture. Also I appreciated the challenge he makes to Christian bioethicists who becomes “just like everybody else” in their discussion of the issues. (p61)

From his discussion in “The Meaning of Life-in the Laboratory,” I appreciated his pointing out the new beginning that occurs in fertilization, which is entirely different from the separate sperm and egg, that there is a new individual after fertilization is complete. I found his comparison of the in vitro blastocyst with the aborted fetuses (p89), to be painfully obvious—of course a live blastocyst is more viable than a dead fetus! Also I would have liked more elaboration on his mention that the thin-edge-of-the-wedge argument as being faulty or weak (p104). I also liked his approach in regard to legislation, that “not every folly can or should be legislated against.” It seems like there are areas of biotechnology that shouldn’t be funded by taxpayers but also can’t be legislated against (for instance because some would be impossible to regulate), though certainly experimentation on human embryos and human cloning are not among those areas. He provided very clear reasons to object to federal funding of embryonic stem cell research, in response to each of the major arguments in favor of it. He made the excellent point that funding should first go to preventing the causes of infertility (i.e. blocked oviducts from STDs) rather than to expensive high-tech/low-yeild treatments (IVF) (pg 111). Also I believe this is the only place I’ve read that stated that actual cost of funding all these IVF treatments if the government were to pick up the tab, and it is sobering. He ends this chapter with a candid summary of how difficult this discussion has been to him, and I appreciated and felt his honesty.

In his section on genetic technology, he discussed the concerns of having too much knowledge of our own genome and genetic disposition, and it’s dangers. I hadn’t considered this aspect of the matter, but rather had thought only of privacy issues. But the idea of people living life with the knowledge of their genetic future (dementia, etc.) is concerning.

While reading the chapter on cloning, it struck me several times how much has developed even in the seven years since Kass wrote this volume. This was in my opinion one of his best chapters, and the basis of his arguments against cloning was strong. Toward the end of the chapter he pointed out that scientists whose names we don’t know and in places we don’t know are currently working behind closed doors and in secrecy to clone humans. This is a chilling but certainly valid concern. Equally chilling was the discussion on the next chapter on maintain perfusion and respiration mechanically in the newly dead in order to maintain an organ supply.

One of the strengths of Kass’ writing is the candid way in which he admits his personal difficulty with some of the arguments he makes, yet his honestly only serves to strengthen his perspective. For instance, on page 210, he points out his “weakening on the subject of euthanasia is precisely this: I would confess a strong temptation to remove myself from life to spare my children the anguish of years of attending my demented self and the horrible likelihood that they will come, hatefully to themselves, to resent my continued existence.” He notes these reasons might lead him to think he might have a duty to die, but argues against this thought in that “What principle of family life am I enacting and endorsing with my ‘altruistic suicide’?” and also points to another article for further discussion of this concern (210). Later he has a very balanced view as he states he “defends the practice of allowing to die while opposing the practice of deliberately killing.” (p227)

One argument that did appear weak which he used in regard to several issues was that deep within us we find the idea of certain things (i.e. cloning) repugnant, and that this feeling should be taken into consideration and even have possible moral value. This seems a stretch; since there are a lot of things which we may find repugnant but certainly have no moral opposition to.

Overall this is a book I will frequently refer to as I work through these issues, and the insight and candor with which Dr. Kass examined the issues is a rich resource to any who would read it.

On the fear of death and the failure of technology

From Life, Liberty and the Defense of Dignity, by Leon Kass, MD:

The greater our medical successes, the more unacceptable is failure and the more intolerable and fightening is death. True, many causes of death have been vanquished, but the fear of death has not abated, and may, indeed, have gotten worse. Nor as we have saved ourselves from the rapidly fatal illnesses, we now die slowly, painfully and in degradation--with cancer, AIDS or Alzheimer's disease. In our effort to control and rationalize death and dying, we have medicalized and institutionalized so much of the end of life as to produce what amounts to living death for thousands of people. Moreover, for these reasons we now face growing pressures for the legalization of euthanasia, which will complete the irony by casting the doctor, preserver of life, into the role of dispenser of death. We seem to be in the biomedical equivalent of a spiraling arms race with ourselves, creating technologies that heal only to cripple or crush, requiring us to respond either by seeking more technologies that heal or by electing a technological escape from life altogether.

Tylenol and Vaccines

It seems like a lot of moms I know routinely give their kids tylenol either before or after their childhood vaccine shots, to make the experience a little less painful and keep fevers down. I've even heard of some pediatricians that in the past have told moms to give it. (Though my pediatrician never recommended it, I never heard any reasons not to use it). We'd been giving it to our daughter around shot time.

Well, recently a couple studies came out that reveal that tylenol decreases the response of vaccines by decreasing the antibody response, and the antibodies are why you want the vaccines--they are the how you end up being protected from viruses. After seeing what these studies show, I won't be using tylenol for my daughter's shots again! Here are the details, printed in the Lancet, arriving in my email from my journal watch service:

Prophylactic Acetaminophen Reduces Immunogenicity of Childhood Vaccines

        Children given acetaminophen with vaccinations have lower rates of fever in response, but the vaccinations produce a lower immunogenicity, reports a Lancet study.
Researchers, including some from the sponsoring vaccine manufacturer, followed over 400 infants receiving primary and booster immunizations. Half received acetaminophen via suppository in three doses over the first 24 hours after vaccination, and half received no prophylaxis.
        The percentage of children with a temperature of 38 degrees C or higher was significantly lower in the acetaminophen group by some 40% to 50% both at primary and booster immunizations. However, vaccine immunogenicity was lower in the acetaminophen group — significantly so for some antigens, e.g., all 10 pneumococcal serotypes after the primary immunization. The authors hypothesize that the effect could result from acetaminophen's preventing inflammation.
         Over 95% of all children had seroprotective antibody levels, but researchers argue that antipyretics "should ... no longer be routinely recommended" with vaccination. Editorialists agree, calling the case "compelling."

Acetaminophen After Vaccination Reduces Antibody Response

      Prophylactic doses of acetaminophen given after vaccination reduce fever but blunt antibody response to multiple antigens.
      Fever is common after vaccination, leading some to recommend prophylactic antipyretics. But do such agents affect vaccine immune response? In an industry-supported study, investigators randomized healthy infants in the Czech Republic to receive vaccines alone or followed by three doses of acetaminophen (suppositories) over 24 hours. They assessed febrile response and antibody response to vaccine antigens after primary and booster doses.
      The infants received 10-valent pneumococcal nontypeable Haemophilus influenzae conjugate vaccine coadministered with diphtheria–tetanus–acellular pertussis, hepatitis B, H. influenzae type B, oral rotavirus, and inactivated poliovirus types 1, 2, and 3 vaccines. Primary vaccine doses were administered at ages 3–5 months; booster doses at ages 12–15 months. Infants remained in the same group for primary and booster doses; however, based on initial results, the study was amended before completion, and not all acetaminophen-group infants received acetaminophen after booster immunization.
Fever >39.5°C was uncommon after primary vaccination in both groups (3/233 [1%] with no acetaminophen; 1/226 [<1%] with prophylactic acetaminophen). However, fever 38°C was significantly more common in the no-acetaminophen group than in the acetaminophen group (66% vs. 42%). Acetaminophen recipients showed significantly reduced antibody response to 10 pneumococcal conjugate vaccine serotypes and multiple other antigens. Children with and without fever in the acetaminophen group showed similar diminution of antibody response.
      Comment: The authors conclude that acetaminophen should not be given prophylactically as a routine practice with vaccination. Whether the same effect would occur with other commonly used agents, such as ibuprofen, is unknown but should be studied. The authors postulate that acetaminophen may interfere with interactions among dendritic, B, and T cells by reducing the local inflammatory response. Editorialists note the need to also assess whether antipyretics increase the proportion of vaccine nonresponders and reduce population protection.

No more prophylactic tylenol for our baby! At a later date I'll post about why we are not concerned about vaccinations and autism, and why kids should get vaccinated.

The Cranberry Challenge, Part 2

This is my second post in a series of cranberry recipes, which I've embarked upon after aquiring a three pound bag of the sour little red berries. This time I used a cookie recipe for the cranberries. The only downside to it was that I had to cut all the cranberries I used in half, which was a long and tedious procedure. I guess I could have thrown them in the food processor, but even the briefest little swirl in there would have left something too mushy. Later, when the chopping was almost done, I remembered seeing someone on the cooking channel illustrate how to cut a bunch of grapes in half. They used two round plastic lids that are about the same size, putting a layer of grapes in one round lid up to the edges, then placing the other lid on top, and then just running a big knife between the two lids while holding the grapes steady between them. I really wish i'd remembered that beforehand, because it would have been much faster...

Anyway, the recipe was for Cranberry Pumpkin Cookies, which felt very appropriate to the season, and the recipe was here. I changed it up a little (as always), by using pecans instead of walnuts (this is the south), and also added mini semi-sweet chocolate chips. Actually I made a few before adding in the nuts or chocolate (so the baby could try them--she can't eat nuts quite yet), and then a few with nuts but no chocolate, and then the rest with chocolate. I'll just say that hands down, everyone most loved the ones with all the stuff in them. I tripled the batch, so have a ton in the freezer. It's a good recipe I'd use again, making a not overly sweet cookie that is quite moist!

A side note: I did use one of my cans of pumpkin filling, which I'm now grateful I stockpiled last year, given this year's shortage! Usually I have it for the family pumpkin bread recipe, passed down from my Mamaw. I'll share that recipe sometime soon, too, if I can find some more pumpkin...

As far as the cranberries, looking at my bag of them it looks like I still have a pound and a half left!

The Cranberry Challenge, Part 1

It's well into fall now, and I live in a part of the country where we are still wearing flip-flops and even shorts. The magnolias, live oaks and palmettos don't change color with the seasons, so I've got to find other ways to feel like it's really fall, which is one of my favorite seasons. October is maybe my favorite month of the year, and it is the month of cranberries! (And also the month I got married four wonderful years ago and also had my beautiful daughter one year ago!) SO, there is always celebrating to do in October. Now that November is here I really need to get on with feeling fall-ish, and in that spirit aquired a THREE pound bag of fresh cranberries. (I live practically across the street from Costco, what can I say?) Sure, I could freeze some. But right now they are fresh, and apparently can last for 2-3 weeks in the fridge. Plus its so special to have fresh cranberries--the checkout lady at Costco told me they sell out very quickly every year.

So I decided to challenge myself to cook them all in various ways over the next couple of weeks. So here goes....

Tonight's dinner recipe was Spiced Pork Tenderloin With Fresh Cranberry and Orange Glaze, which I found here. I changed things up in the recipe a bit. I am a notorious pot-saver when it comes to cooking (which stinks when I try Julia Child's techniques), so I just threw all the stuff the recipe calls to be cooked separately on the stovetop into the same pot as the pork, and it came out great! I loved it--the tang of the cranberries and the moistness of the pork. My husband loved it too, though he mentioned he's not a huge fan of cranberries...

Brain stimulation among other things...

Yesterday I was reminded of this crazy job I had once when I was in medical school. I worked at a place called the Brain Stimulation Laboratory, which was located (of course) a Psychiatry Hospital. I did this for almost a year, some while taking med school classes. It was a strange place. There was the mad scientist/inventor/manic doctor who ran the place. He was rumored to only sleep a few hours each night and had a CV that weighed about 10 pounds because he had so many publications and inventions. I had a desk in a room with two other scientists–one was a Israeli-Russian guy, Jewish, who happened to hate working with the other one–a Japanese women. They were in cubicles on opposite sides of the room, as far as they could be from each other, and the fighting exchanges between them were outrageously entertaining. My desk was of course located in the cubicle between the two, where I spent most of my time trying not to laugh when they lapsed into their forgein tongues to mutter curses at each other. Fortunately I was out of the room and down the hall in the lab most of the time.

We were working on something that the defense department was funding–an investigation into whether we could create a “thinking cap” to keep fighter pilots from falling asleep when sleep-deprived. I was just doing my part in the war on terror, ya’ll. What it involved: getting volunteers to sign up to be sleep-deprived for several nights a week (they were monitored in a wing of the hospital where I can only image the poor nurse poking them to keep them awake all night), and then instructed to fly a flight simulator program for most of the next day. While they were “flying” I directed either real or placebo magnetic stimulation (TMS) to a specific part of their brain. (We had previously used a fMRI to locate the area we’d target in each indivual). Lest you think that a magnet can’t stimulate the human brain, think again! For part of the set up of the procedure, I moved the magnet over the motor cortex until the subject’s thumb twitched involuntarily with each pulse of the magnet. Needless to say, we were not successful in creating a “thinking cap.” But the data we gathered revealed a whole lot of other stuff in sleep deprivation research, and people are still anazyling what we gathered and writing about it in professional journals!

Why this is sorta cool: scientists have to add me as an author any time they use the data I collected in their studies! So that means there are all sorts of studies that I get my name on without having to do any more research than I did that year in med school. Cool deal, right? I guess it works out well if you are building up your CV for all the hoops you have to jump through in academic medicine. So to all my med student friends: try to get in on the data collection or benchwork level whenever you can, since it’s higher yield in terms of the number of times you get your name put on stuff. Just part of the game, ya’ll.

So anyway, yesterday I got an email with another manuscript to review and sign off on that’s going to print. And I hardly lifted a finger!

Book Review: "The Contraception Guidebook: Options, Risks, and Answers for Christian Couples"

By William R. Cutrer, MD and Sandra L Glahn, Th.D.

This book was primarily written to discuss the specific ethical concerns Christians might have as they consider different birth control methods, written by an OB-Gyn/Theologian and a patient/theologian.

From the beginning of this book to its end, I was impressed with the humble attitude with which the authors approached these sensitive and controversial issues. Time and time again they acknowledged different perspectives in the Christian community with grace.

The chapter on “The Why of Sex” did a great job at succinctly summing up the viewpoints from two primary schools of thought that exist within the Christian community. The possibility that marriage’s (and thus intimacy’s) primary purpose being procreation is an idea commonly surfacing among Christians. Concerns I have heard from Christians are appropriately out of a humble desire to obey God fully, and the out of fear that treating intimacy in marriage as something that can be separated (by any method of birth control) from the possibility of procreation that would be in rebellion to His plan. I felt that this chapter made several good and helpful points concerning this matter, including the following:

-There are entire seasons in married life (after menopause, during pregnancy, etc) where married people are intimate despite the absence of potential for procreation

-The entire book of Song of Solomon is about the marriage relationship yet does not mention children.

-The very design of the human body also points toward purposes beyond procreation, and specific examples are given

In the beginning of part two, the authors detail methods of more “natural” birth control. I was impressed with his mention of newer and more sophisticated methods used by couples in tracking ovulation, specifically the use of urinary hormone monitoring at home. After recently hearing questions from several people about these methods, I did an extensive search of the medical literature regarding this practice in particular. Specifically it seemed that the ability to predict ovulation by hormonal changes several days prior would make it much more reliable than simple calendar-based plans. I found very little research had been done using home urinary hormone monitoring other than at Marquette University, and was impressed that he was aware of their technique (using the Clearblue fertility monitor) , though I would have liked to see a website for it listed in the back for readers to learn more, given the reliability of the method.

Another strength in this book is the straightforward and clear way in which he describes the female hormonal loops and their feedback. I wish I had read this back in medical school before getting into the more complicated texts. This is a useful section for laypeople, and necessary before they enter the section on specific types of hormonal contraception.

The chapter “Do Birth Control Pills Cause Abortion” was perhaps one of the most helpful parts of the book. I have talked to many women who have concerns about this issue, and rightly so. The authors again wisely handles this section with the grace to allow readers to make their own informed decision regarding it, yet without compromising concerning the sanctity of the life of an embryo. He described all angles of the issue in an easy to understand way, which I believe laypeople would be able to follow easily. The section of the chapter called “Is Any Risk Acceptable” did a good job of putting the concerns in perspective. That we do not routinely sequester pregnant woman from the risks of being out in public where they would possibly contract an illness which would cause fetal death, for example, is a good example of a risk routinely taken in pregnancy, as small as it is. That the best pro-life scientists differ in their views on how to use the information since we don’t exactly know the risk helps me personally dispense grace to Christians who evaluate the information and come to different conclusions.

He also discussed balancing intent with the weight of knowledge. Using the example of a person backing their car up without looking yet not intending to kill a neighbor was poignant. I think of previous generations that didn’t have the same kind of access we have now to information. With the internet and thus latest research being so readily available, we have an obligation as Christians to keep up to date with the latest findings in this area, and I appreciated him reminding his readers to keep up as new info comes out. I truly hope that more research is done in the near future that can provide us with the needed clarity to make better decisions about it.

He continues in his book to cover the other hormonal methods of birth control helpfully and then to discuss the surgical options for more permanent sterilization. From my knowledge of these techniques and procedures, he summed up the information and concerns for each technique quite well.

I found the chapter “The Future of Contraception” to be quite interesting. I had no idea some of these ideas were in the pipeline.

Part Three covered the biblical view of family and its purposes. He again addressed these issues with grace and biblical insight. The idea of having a huge family being something of an idol in some Christian circles was an interesting point. I have occasionally noted the unsaid implication that somehow the large family is more obedient. He discussed this in the context of Gen 1:28. I do wish, however, he’d spoken into the concept of evangelism as a way to obey God in this.

All in all, this was an incredibly well written guide for the Christian family, which I would recommend to friends, family, and patients.

Freedom through Homemaking

I recently ran across a reference to this essay by G.K. Chesterton on Domesticiy, and simply had to post one of my favorite parts here:

She should have not one trade but twenty hobbies; she, unlike the man, may develop all her second bests. This is what has been really aimed at from the first in what is called the seclusion, or even the oppression, of women. Women were not kept at home in order to keep them narrow; on the contrary, they were kept at home in order to keep them broad. The world outside the home was one mass of narrowness, a maze of cramped paths, a madhouse of monomaniacs. It was only by partly limiting and protecting the woman that she was enabled to play at five or six professions and so come almost as near to God as the child when he plays at a hundred trades. But the woman's professions, unlike the child's, were all truly and almost terribly fruitful;

This sentiment rings so true with me! Sure, I enjoyed becoming a specialist and being able to develop a sense of expertise in the field of adult medicine. But now that I've been a homemaker for a little while, I'm really coming to realize how beautiful the spectrum of what I can do here is. I can nurture my "twenty hobbies" without feeling the need to become an "expert" or professional in each of them. For instance, I can play the violin for my daughter as she pounds on the piano next to me, and do it well--even play in friends' weddings, without making it the only thing I do all day every day. I can create complex recipes from my Julia Child cookbook to suprise my husband and broaden my cooking skills without having to enter a competition or write a cookbook. I can advise family and friends in medical issues, checking the latest evidence, without the confines of hanging a shingle. I can paint a landscape inspired by the waves of the ocean or the vast marshes to brighten a corner of our home, and develop my skills as a painter, without setting up shop in a gallery downtown. I can do all of these things without having to compete in the marketplace to become the very best at any of them, and find fulfillment in the way in which I can glorify God in them, without turning them into my vocation! This is a taste of freedom, not the imprisonment modern feminists would call homemaking.

In Edith Schaeffer's book, The Hidden Art of Homemaking, she touched on this philosophy a bit as well. I read it late last year and it inspired me with the affirmation that I can use even my weakest gifts to create beauty in ways that edify. But lately I think I'm really beginning to look at this new vocation of mine as the canvas upon which I can paint with each of my hobbies and talents in ways that will build up my home and bring glory to God. The bredth of unique challenges faced in my daily calling brings opportunity for growth in so many areas.

Just some quick thoughts...
Now on to develope my handyman skills in fixing my dryer!

On Devouring Books

I can't really describe how much I enjoy reading. Maybe that's why I don't remember a time I was ever bored. I mean, there is always something to read or something to think about. So today I added the area on the blog where I list what I'm currently reading, with the intention of briefly reviewing them as I go along. I can't possibly imagine catching up with reviews of all the books I've previously read in the past few decades, but over time I'll post a list of my all-time favorites on here.

Generally I read any number of books at the same time, opening up one or the other depending on what mood I'm in. So perhaps I'm inquisitive one day and want to read ethics or philosophy. Or perhaps I'm on the beach and want to read a novel. (Don't scoff fiction--you can actually learn things through reading fiction, and there can be redemptive qualities in many narratives, i.e. there is fiction that edifies). Frequently, as my husband can attest, the pile on my bedside table grows until it collapses onto the floor without warning (even in the middle of the night when my pillow bumps it in my sleep, taking my thick eyeglasses with it!) Hopefully I notice the glasses before I trample them in the morning in a sleeply haze.

So a current problem in our home is the fact that we have run out of bookshelves for all of the books! Our daughter has her own little bookshelf which is short where she can reach it, and she just seems to be getting more interested in me reading her books about the alphabet and numbers, so we have it well stocked for her to get to at her leisure. And we have filled the bookshelves in our study to the brim, with the unsightly placement of books in every crevice including lodged sideways and on top of the once neatly arranged line-up. When we moved into this house I arranged all the books topically, so all the medical ones had a place, all the Bible commentaries had another place, all the biographies another. And my husband's WWII books had their own entire bookcase. In addition to these crowded crevices there are now stacks of books in the corner of the study. I've neatened them as best I can so that the titles are visible and accessible, but still. And next to them are the growing stack of hematology and oncology journals that my husband reads. I still stifle a laugh that one journal is simply called "Blood."
We also have several stacks in our bedroom. I'll admit sometimes I read in a bubblebath (only once did I drop a library book in --a collection of short stories by Brett Lott that was excellent. Don't worry I replaced it at the church libary with a new one and they even offered me the now-dried-wrinkled one to keep. ). So anyway, there is a stack by the bathtub as well. Downstairs in the family room I've tried to stash books we are currently reading here and there. There isn't room for a bookshelve in that room so I've found some places to line a few titles up between bookends out of reach of the baby and without making the room look cluttered--like on top of the upright piano and at one end of the mantle. In the kitchen the cookbooks (which I also like to simply sit and read at times) are in one of the cabinets, taking up precious space that pots and pans would probably prefer to occupy.

So, needless to say, I've got to find more shelves, and recently undertook a hunt for affordable glass-fronted bookcases. I really hate books getting dusty (especially given how how it makes my eyes water and sneezing to occur when I pull them out), so I've been poking around antique stores with my eyes open lately.

This blog

I'm starting this blog to share my thoughts and experience as a homemaker with whoever would like to follow along. And yes, I have an MD. That's another story, a long one, which I'll tell you later. But suffice it to say that gives me a unique perspective on being a full-time homemaker. I call myself a homemaker rather than just a "stay-at-home-mom" because I feel that it better describes the entirety of what I do everyday. I am making a home, a refuge, an escape, a learning center, a safe haven, and it not just for my daughter--it's for my husband too! Calling myself a "stay-at-home-mom", though there is certainly nothing wrong with the description, just doesn't include the fact that caring for my husband is my calling, too!

I love what I do everyday, more than I loved even when I was practicing medicine, and I enjoyed that, too. Perhaps one day I will return to medicine. Probably I will in some way. But for now I'm in a season of life where I believe this is exactly what I am called to do.

So if you'd like to hear my opinions (they are like armpits, everyone has them!), advice (but consult your own doctor and don't take what I say in place of that), experiences, and thoughts, then follow along.