Tinypliny's Journal

02/13/2009 04:36 #47740

Don't lose your comments. Ever.
Category: e:strip

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02/10/2009 19:55 #47705

How many of you believe that...
Category: opinion

cancer has not been "cured" because researchers and clinicians are just making too much money out of it to destroy what is virtually a cash-cow?

Today morning, at a discussion seminar, I had this very disturbing thought that definitely made me question whether I was right in choosing to do what I do. I know we really are not close to a "cure" for cancer. But WHY are we so hesitant to restructure our healthcare system and do even little things that will certainly make a difference in cancer incidence and outcomes?

Every cancer centre in this country depends on its patients to run. That is a fact. But in running health care as a business are we getting away from the basic motivation behind healthcare - to eliminate disease? There is so much drive to carry out all kinds of complicated research, but what are we doing about what research has already shown us? Is it so tough to step away from what has become a blind chase for more and more patients or publications and see whether we have achieved anything tangible in the last so many decades?? Is translational research just another over-hyped myth? No one wants to talk about what we can possibly do to IMPLEMENT our findings and translate them into healthcare policy. Instead, everyone wants to talk about precision of measurement in research and methods to recruit even more patients to clinics and research studies.

Recruitment to studies has steadily become more and more difficult. Has any of us wondered why? Is it just because people have caller-IDs on their phones and won't answer random surveys? Perhaps. But I am not sure that this is the sole reason. It could be because we have become so research-oriented that we don't care what the deliverable outcomes of our research are, any more. We are just interested in a job called "research". What does this "research" mean? Many of us would struggle to answer that question - regardless of how many "public health significance" abstracts we might write.

I am feeling so bitter and cynical today. I am sorry. :( I might probably not agree with all I said here in my happier research moments. Research is exciting to me - not just because I think its cool but because I feel like I am working towards something that will help my former patients and more importantly, future research beneficiaries. Its a personal cause to me. Thus, it feels awful that I really might not achieve the end-result I dream about all the time because there will be no one in the end, who really cares about what my research might mean to healthcare policy but only look at how much grant money I might bring in with my research or how many publications I can stack up. :/

tinypliny - 02/13/09 04:44
(e:dcoffee): That's a great idea. In a way, it does work. For eg. government hospitals in India make no money and the salaries of the staff are paid by the government, the healthcare is always free. There is also a dangerous downside to such a scenario - stagnation and lack of motivation to improve healthcare practices.

I don't know what is worse - greedily squeezing your patients for all they are worth, or let apathy shroud your practice and be uninterested in any research for progress. It's a delicate balance that is often tilted in favour of the worse outcomes. One has to wonder about the people actually serving in healthcare in this day and age - are they really committed to the essence of healthcare at all?

libertad - 02/11/09 13:44
I'm glad there are at least some people still left in your field that care. That makes it even more important that you stick with it!

dcoffee - 02/11/09 12:52
I have one bit of advice for you. Don't let your energy go to waste. We need people like you, and we need you to fulfill your potential.

you said "Research is exciting to me - not just because I think its cool but because I feel like I am working towards something that will help my former patients and more importantly, future research beneficiaries. Its a personal cause to me." that says to me, that you don't need a profit motivation, you're doing valuable work that gives your life meaning. Your curiosity and your desire to help drives you.

I don't think health institutions should be motivated by profit at all.

Here's a radically practical idea. Make health institutions non-profit. Insurance companies, hospitals, clinics, etc. Like Catholic Health systems, everyone gets paid a good wage, but you don't have shareholders whose only goal is more profit.

Profit motivation creates waste. It's more profitable for a research institution to do 3 separate studies on the same topic. Then conclude that more study is needed. But what if the goal is purely to help people instead of profit (off their misery).

It's not just a problem of hospitals though, I can think of other occupations that are worse. Move the conversation where you are.

tinypliny - 02/10/09 22:02
We were talking about models of socio-economic status today. Sigh. Isn't it enough to know that lower SES is a major impediment to follow-up care and compliance to treatment??! And don't we know this already? Would people who are struggling to keep their jobs want to miss their workdays to take a kid to hospital for follow-up when their kid is apparently doing well after a childhood cancer related surgery?

Obviously, we feel the need to conduct research and blow money to verify with numerous models and redundant studies, if this is really true instead of changing policy to alleviate this problem. We have to wake up at some point and realize that health behaviour is not as flexible as health infrastructure. It IS VERY hard to change what people do and have been doing for centuries! Preaching and reproach will only get you so far.

Social engineering often gets a bad reputation but changing health infrastructure and health administration is a form of social engineering WE NEED if we want even a small chance of making a dent in cancer as a scourge. The other facet of social engineering - health behaviour change is limited by how much influence we have over the population as whole - which is not really that much!

I know I am part of this evil academia, and very deeply so. I have been in it ever since I can remember. I am just saying that it starting to look like having tangible goals is not enough anymore. Because apparently, that doesn't get you anywhere near the influence you will need to have, to push for real world changes. Unless you are willing to alienate a ton of researchers and speak out in favour of policy change, and risk getting viewed as a lunatic who is preaching advocacy because you are too married to your ideas (which may or may not be the case).

Heh. But really thinking through all this convinces me that its time to develop an even tougher skin (I think I have a warted skin already so this can't be that hard, can it?!) and think about even more devious strategies to get what I want. Thanks, (e:heidi). :)

I agree that, on paper, having clear goals seems like it will do the trick and I want to believe in it heart and soul. But on days like these, when I see priorities among my own peers and community completely at loggerheads with I want to believe, it gets somewhat tough to hold on and smile.

heidi - 02/10/09 21:30
This is one of the reasons I got out of academia - there is so little focus on what to do with the research, how it fits into an agenda for social change. I remember sitting in a grad class in stratification and being extremely frustrated with the professor. He was very excited about his latest piece of research and the infinitesimal change in the methodology that made it different than the last piece of research. Yes, accurately describing wage differences by gender is important, but can be adequately accomplished at a couple levels of less detail. He never addressed what he was going to DO about the problem.

The way you described your goals to me, (e:tinypliny), it seems like you want to solve a very specific problem and see real world changes because it. I doubt you'll get hemmed in by that kind of narrow focus.

(And I agree, the sickness-centric model of US health care is very problematic.)

02/08/2009 12:34 #47679

Semolina Upma
Category: eating in

Another day, another meal! Feel free to stop me when this gets kind of toxic. Hee Hee. :p

I used the Greek Semolina I bought at the Indian Store. It is awesome! I am SO GLAD I didn't get the conventional Indian brand!

Ding Ding...Recipe time!!

1. Bring water to a boil with a nice scoop of red chillie powder and turmeric powder. Add semolina and cook around 2-3 minutes. Turn off heat.

2. Take half-a tablespoon of peanut oil in a pan and heat till the oil is flowy. Add a pinch of each (see pictures in the post below)
- Black mustard seeds,
- Urad dal (white split lentils)
- Channe ki dal (split yellow lentils)
- Dried red chillies.
- Cumin

3. When the mustard seeds start to pop, add
- tablespoon of chopped ginger root
- Chopped green chillies (thai/indian/jalapenos) to taste
- Chopped Karuvepelai ("Curry" leaves)
Stir them around till karuvepelai becomes really fragrant!

4. Add a dash of Asafoetida powder to the above and stir

5. Add chopped red onions - saute till translucent.

6. Add chopped green bell peppers - saute a bit. Add salt to taste

7. Add cooked semolina and stir to coat the veggies on the semolina.

8. Enjoy with a cup of Mango tea!

I used to have Semia Upma for breakfast on so many Sundays, growing up - that it's as much of a Sunday morning ritual as church is to some of you. Probably a lot more "sinful". Hehe. :)

jenks - 02/08/09 13:34
Tiny i seriously want to hire you as my personal chef. Everything looks/sounds so delicious.... and from nice healthy ingredients. yum! I am jealous! (and starving!)

02/07/2009 17:40 #47671

Keerai Molaguttal
Category: eating in

Since (e:heidi) requested more food posts, here is one! :)

Keerai Molaguttal is an uber traditional dish from the Palakaddu district of Kerala. Its not so much Tamilian as it is Malayali. You won't see this in ANY Indian restaurant - north or south, even if they are in India. It's very unglamorous and very practical but worth dying for. Some days, I just crave it so much I can even smell its fragrance before I start cooking. Its got this addictive potential. Some people hate it and some like me, just can't live without it.

Its not spicy or hot, so strong hot south Indian lemon pickles (that I bought yesterday) go wonderfully well with it. Its comfort food taken to the Malayali extreme. :)

The really simple recipe:

1. Cook rice in the rice cooker - Any rice will do, but Basmati is awesome. Don't smash the rice.

2. Wash and chop a good amount of spinach - blend the spinach in the blender to a smooth paste, add generous water to make it a smooth flowing paste but don't make it too watery.

3. Cook orange lentils (masoor dal) or toor dal

in the rice cooker. Toor dal needs around 5-6 hours of pre-soaking if you are not using a pressure cooker. Masoor doesn't need any and is readily cooked. The objective is to cook the lentils really well so that you can smash them to a paste with a ladle.

4. In a wide-bottomed pan, take a teaspoon (or 1.5 tsp) of peanut oil, heat the oil till it flows freely. Add a pinch of black mustard seeds,

, a pinch of urad dal (while lentils), pinch of channe ki dal (split yellow lentils), whole black peppercorns and several dried red chillies.

5. When the mustard seeds just start to pop, invert the whole blended spinach paste into the pan and stir well. Add a pinch of turmeric powder and a pinch of red chillie powder.

6. Fresh-grind around 2 tablespoons of cumin in a mortar and pestle and add to the spinach. Next, add around 4 tablespoons of coconut powder or coconut shreds to the spinach.

7. When the spinach paste starts bubbling a bit (around 2 minutes) add the cooked lentils (masoor or toor) and some more water to take it a to a hearty thick soupy consistency.

8. Bring to a rolling boil. Turn off heat. Its VERY important not to overcook the spinach. Unlike North Indians who murder their spinach in that insane dish called palak paneer, South Indians value the art of just-enough cooking to preserve that fresh awesome taste of veggies. If your keerai molaguttal has turned a dark green tinted with yellow (the colour of palak paneer, btw), you have got it all wrong. It needs to be a bright dark green and when you taste it, the raw spinach smell is gone but the fresh spinach fragrance remains accented by the coconut, cumin, lentils and red-chllies.

9. Serve over cooked rice.

10. Garnish with a nice big scoop of south Indian lemon pickle!

PS: Keerai: Spinach in Tamil. Molaguttal: I really don't know what this means. Molagu means peppercorns. I guess it could mean seasoned with peppercorns. Its a word that is neither Tamil nor Malayalam but somewhere in between - very typical of the border-district of Palakkadu.

dcoffee - 02/08/09 17:15
oh boy. I have to try this. I usually invent recipes based on what's lying around. This looks tasty!

james - 02/08/09 17:09
ya, I was also out of cumin.... BUT! it was delicious. I licked my bowl.

And if their is an Indian cooking party I would be giddy, GIDDY to be invited.

heidi - 02/08/09 14:58
Yea! Indian cooking party @ (e:heidi)'s apartment!

tinypliny - 02/08/09 12:39
The not-so-ideal but closer substitute for mustard seeds are cumin seeds - especially for this particular dish.

tinypliny - 02/08/09 12:37
YIKES! You did WHAT?! The "Mustard" paste and mustard seeds are like several solar systems apart. LOL. You know what, I am planning to get together with (e:heidi) to cook some south Indian food as soon as my grant craziness simmers off a bit, maybe you and (e:jim) should come along!

james - 02/08/09 12:29
Well, I only had green French lentils instead of the festive blend you listed. I didn't have any mustard seed so I just gave a squirt of mustard into the oil while I toasted the other spices. Also, I did not have any lemon pickle. Which I am now fiending for.

tinypliny - 02/08/09 12:20
Just curious... What substitutions did you make?! :)

There is a golden ditch-rule of south-Indian cooking that I didn't talk about - go north-Indian. If things don't go as planned and things are off-colour, take some peanut oil, add a generous heap of garam-masala in the oil and fry a nice juicy tomato in it till its almost pureed. Invert this on your off-the-mark effort. You will like the outcome whatever the disaster (short of charring). ;) Add some salt.

I think I typed this recipe for the life-saver garam-masala earlier. Here it is again.

Dry toast:
5 parts coriander seeds
2 parts cumin seeds
2 parts cloves
2 parts whole black peppers
Dry red chillies to taste (A LOT! :)
in a cast iron skillet till the coriander seeds are a lightish brown and aromatic. DO NOT CHAR.

Pour everything in a blender. Add
1 part dried mango powder (Amchur)
3/4 part cardamom pods (shelled)
Dash of cinnamon.

Grind to a fine-coarse powder. Store in the fridge to retain freshness (around 6 months).

james - 02/08/09 11:53
I tried making this today for lunch. Of course, I didn't have a few ingredients so I had to make substitutions. It is pretty yummy but I will make it better next time. Thanks for the post.

tinypliny - 02/08/09 09:13
Unfortunately not :(.

But hey, it *really* easy to make! Try it out! :)

heidi - 02/08/09 02:11
mmmmmmmmmm.... got any leftovers?

jacob - 02/07/09 21:39
You and the amazing food porn!

02/07/2009 08:38 #47665

30 items or more - February 2009
Category: grocery

All the reasonably priced orange-bags at Wegmans had greenish fungus on them so I didn't get them. I got these instead:

1. Milk - Fat-free 2 Gallons - $3.98 (1 Gallon @ $1.99)

(This is almost the first time in two years I have seen a gallon milk below $2.00).

2. Milk - 2% - 1/2 Gallon - $1.49

Coffee becomes so much more tastier with 2% milk!

3. Vanilla low-fat yoghurt - $1.99

4. Wegmans Wheat Pita Bread - $1.79

(The pitas are so much more tastier and cheaper at Guercio's. Why Oh Why do they close at 6.00 PM!?! :/)

5. Wegmans Lite Wheat Bread - $2.49 It is lite, it feels rite.

6. Wegmans Firm Organic Tofu - $1.99

(Used to be $1.29 when I first moved to Rochester)

7. Wegmans 1 Pound Sweet Cream Butter - $1.50

(Okay! I caved in. I am going to try baking some cookies with this evil addictive and gorgeously delicious substance. But mainly, I am going to have it on crisp toast.)

8. Dole Mixed Frozen Fruit - $8.59

Interestingly, they changed the fruit mix to strawberries, peaches, mangoes (yes! mangoes) and pineapple. I was not a big fan of the melons so I am pretty excited. :)

9. Edys's real fruit bars - 12 bars - $2.99

(Small pieces of heaven if you can pretend that its summer.)

10. Cheez its! - $$1.50

11. Natural Gruyere Swiss Cheese. - $4.95

I felt like I needed an indulgence. This is it! :)

12. Grapefruit 5lb - $2.99

13. Macintosh Apples 5lb - $4.75.

I am stuck with these for yet another week. Depression. I miss my Granny Smiths. But I refuse to pay $0.79 per smallish Granny Smith! That is atrocious.

14. Red Potatoes - $1.12 (1.13lb @ $0.99/lb)

15. Green Seedless Grapes - $4.95 (@ $1.29/lb)

16. Bananas - $1.88 (3.84lb @ 0.49/lb)

Total: $48.95

I also went to the Super Bazaar because I desperately needed a fix of Indian Snackies!

17. Gujarati Fulvadi - $1.99

18. Bhavnagri Gathiya - $1.99

19. Bikaneri Bhujia - 2 X $1.99 = $3.98

20. Gujarati Tam Tam - $1.99

21. Rice Khichia - $1.99

Like papads, but 1000x cooler and tastier.

22. Semolina - $1.49

I am intrigued by the one's I bought. They are from Greece. I can't wait to make the traditional upma with the Greek version...

23. Tata Tetley Elaichi Chai - $0.49

24. Mother's South Indian Style Pickle - $1.99

25. Roma Tomatoes - $4.15 (4.19lb @0.99/lb)

26. Indian Green Chillies - $0.99

27. Thai Green Chillies - $0.99

28. Karuvepelai ("Curry" leaves) - $0.99

29. Coriander - 2 Bunches - $1.00

30. Tender Okra - $1.46 (0.77lb @1.89/lb)

31. Bottle Gourd - $4.40 (2.95lb @ 1.49/lb)

32. Fresh Ginger Root - $0.98 (0.66lb @ $1.49/lb)

33. Super Long Indian String Beans - $3.70 (1.86lb @ $1.99/lb)

I LOVE these! They are very costly outside of ethnic stores. I think they come from the Caribbean.

Total: $34.57

Grand Total - $83.52

tinypliny - 02/08/09 09:14
I know! Those melons kind of stuck out like a sore... melon!

heidi - 02/07/09 16:41
I would love to see your meals! Please, more posts!

james - 02/07/09 14:02
OMG! I am so excited they took the melon out. I used to get the mixed frozen fruit and the tropical frozen fruit to mix them, picking out the melon (I would eat the melon and just be very unexcited with it).

tinypliny - 02/07/09 12:12
You know, if they were in downtown, I would probably shop there all the time. I run into many Indians in the one class I take on South Campus and they ALL shop at that store everyday. Its like shops back home. You never stock up, you shop daily and know the shopkeepers on a personal basis.

I miss such shops. I hate that the groceries are so far away and so impersonal. :(

tinypliny - 02/07/09 12:07
I forgot one more thing that went into that stuffing - chopped red onions!! They make all the difference.

And yes! They drop me back. Its pretty generous of them but I guess that's how they compete with the other stores around. With newer ethnic stores coming up in that area, I think they have people without cars as a kind of "captive customers". I could easily take a bus from the metro station and back (as I used to earlier) but that takes a lot of time. I don't really want to be captive but its convenient. If you go there regularly, you can actually have them pick you up and drop you as well.

I don't go there often though. Maybe once a month or once in two months. Apart from their fresh produce and Indian-cooking-specific stuff, things are on the expensive end. I guess they have to make up some way for all that expensive driving around.

libertad - 02/07/09 11:49
Sounds yummy! I can't believe they pick you up! Do they drop you back off at the metro?

tinypliny - 02/07/09 09:41
Hahaha.. Yes, I love drinking milk. I add it to the numerous cups of tea I drink. They help keep me cramp-free with the calcium and I get my VitD! Super Bazaar is on the corner of Sheridan and Bailey (3218 Sheridan Dr Amherst, NY 14226 (716) 835-4770) Here's a map -> :::link:::

It's great for groceries. They have very high turnover and things are mostly fresh. They are probably the only shop to have fresh tender okra around. I usually take the metro to the south campus and call them to pick me up from the metro station. They don't mind because I usually buy a ton of stuff. :)

There are so many ways to stuff pitas! I think I will do a post on that. Yesterday, I had a mixed greens-garbanzo-hummus pita dinner. For this you take mixed greens, cooked garbanzo beans, a generous dollop of garlic/roasted pepper hummus, 1/2 teaspoon balsamic vinegar and a generous scoop of Bhujia (a lentil based noodle-like snack), toss them all together till everything is evenly coated. Toast the pita and stuff it all in! :)

libertad - 02/07/09 09:25
I love peaking at your groceries! Two and a half gallons of milk?! Where is the Super Bazaar? Do they actually sell fresh okra? What do you stuff your pitas with?