Holiday time - recipe!

It's too late for you to do this proper justice for Thanksgiving, but for [your December holiday of choice] it's going to be just perfect.

Spinach Madeleine

A Louisiana recipe made famous in River Road Recipes from the Junior League of Baton Rouge, LA. Adjusted according to my experience.

Step 1:
2 10-oz packages frozen spinach

Cook per package directions and squeeze as dry as possible by method of choice (mesh colander, cheesecloth). Retain spinach liquor. Set both aside.

Step 2:
4 T butter
1/8 C flour (2 T)
2 T chopped onions
1/2 C evaporated milk, room temperature.
1/2 C retained spinach liquor
1 tsp Worcestershire sauce

Step 3:
6 oz Velveeta Mexican Hot
1/2 tsp black pepper
3/4 tsp garlic salt
3/4 tsp celery salt

Melt the butter over low-med heat. Add flour and stir until smooth - do not brown this roux. Increase heat to medium and add onions. Cook, stirring constantly, until onions wilt to desired mushiness (my preference is ~10 minutes). Slowly stir in the evaporated milk, retained spinach liquor, and Worcestershire sauce bit by bit. Be sure to stir constantly to avoid lump formation.

Cook down until base is thick and consistent. This is of necessity a subjective decision, but here's my guideline. My spatula is ~2 1/2 inches wide, and a double recipe of this (which is what I always make) is about 1/3" deep in the pan I use. If I drag the spatula through the base broadside-on, it takes about 4 seconds to fill in the void created. Compare to reasonably thick cake batter. Remember: better too thick than too thin; you can always dilute it at the end (using some of the rest of the spinach liquor).

Cube 6 oz of Velveeta Mexican Hot (or Mild, if your taste buds aren't up to speed - it's not blistering, but I'm more accustomed to spicy foods than a lot of, say, Northeasterners) and add it, along with celery salt, black pepper, and garlic salt, to the pan. Stir constantly until smooth and fully melted. Remove from heat and fold in spinach.

You're done with the hard part now. It can be served as-is as a spinach dip; it may be placed in a casserole dish and topped with breadcrumbs, then toasted, as a main dish. Taste is noticeably improved if you let it sit for at least a day in the refrigerator before serving, as the flavors meld. N.B.: if you choose to let it sit, remember that some liquid will leach out of the spinach overnight. This is why it is so critical to eliminate fluid at the end of Step 2.

It freezes well, which makes it great for guests that just happen to stop by - in 20 minutes, you can heat it on the stovetop (microwaving probably works just as well, but my microwave tends to burn things).

Don't be afraid to tinker. Add more jalapenos if you want more kick; add a little fresh chopped garlic to the onions if you want a little more of that. The only crucial step in replicating the dish is to make sure you cook it down to the same consistency every time at the end of step 2 - you will be amazed how much its thickness just after the liquids have been added will vary.

Chef John Folse, from whose website I originally took the recipe, has a number of other suggestions. Check them out.

Late nights

11-7 am shift tonight, tomorrow night, and the next. It's not actually all that bad - but not many people are still coming in at 5 am. Those that are unfortunately tend toward the "really bad" end of the spectrum - we just had a guy come in with a gunshot to his back and no sensation or movement below his navel. I wasn't in the room to hear, but prior experience suggests that the nefarious Some Dude was responsible for this shooting. Mr. Dude is a criminal well known to emergency personnel around the country; he is known to commit multiple offenses in cities nationwide every night.

I'll never be famous

I don't blog enough.

The adventure continues

I just heard about someone they wanted to fly in for treatment here. Unfortunately, they died at the outside hospital before our helicopter got there. It was diabetic ketoacidosis (DKA), a nasty complication of type I diabetes (which has been known as juvenile-onset or insulin-dependent, though those have become less accurate as America fattens and plenty of teens get type II diabetes, and plenty of type II's need insulin for control).

For the medically aware: FSG 1890. Gap was 40. No word on pH.

For the laymen: a normal FSG (=finger-stick glucose) is around 100. With most diabetics, we aim to keep it at or below 150 (as a practical matter). "Bad" is around 180. "Really bad" is around 220. She was an order of magnitude out from normal. Gap (short for anion gap) is sodium - (chloride + bicarbonate), and should be <12. It reflects unmeasured negative ions in the blood, which mostly consist of proteins in normal people. In DKA, it's high because their blood is full of acids that are negatively charged at blood pH.

Anyway, a regular bout of DKA is FSG of 500 with a gap of maybe 20. (At least, that's the case here. YMMV.)