Thursday, September 10, 2009

What Do I Say...

WARNING: The first of this post is a run-down of an on-call day in the NICU...if you just want the cookie, PLEASE scroll down to just above the first picture! :-) It's a great cookie!

I guess I'm liking the NICU thus far. I really like my babies, though some of them have decided that it's cool to just hang out and let us pump formula in the instead of sucking the bottle. We'll just have to teach them. I was on call Tuesday night and it was busy to say the least! Between 6:30 and 8:30 we had three deliveries to attend. Then from 10 until about 2:30 we were dealing with a baby who was crumping (basically trying to die). We sat there and watched while her heart rate dropped into the 40's and, at times, even to virtually zero. Somehow, she kept returning to a rhythm. By about an hour to two hours in to working with her, we knew she was dying but "stable" for the night. So, we went to bed...for 15 minutes when we were paged to another two deliveries...then returned to bed for 30 minutes when we were paged to a delivery only find that the baby was already in the NICU...strange! Got that baby situated and we were paged to ANOTHER delivery...where I successfully intubated the baby!!!!!! I was so excited. That's where my call went really bad. I was on rounds and the nurse came to tell us that the baby we worked on for so long had no heartbeat...and my attending decided that it was a good idea for me (after virtually no sleep) to pronounce her. Um....let's just say my emotions were running on high (or low). I had to compose myself before I gave a time of death, then had to compose myself before returning to round...and on and on. Let's just say I had several moment of tears and basically broke down in my car on the way home. I think, though, that it's a good thing that this happened. It helped me see that, even though in the heat of the moment, in the stress of trying to figure out what's going on you almost HAVE to detach so that you can get things done, I am still human and really do care about my patients. That sweet thing was so small and her Mama didn't get to take her home. I cannot imagine.

After all that, it was a good thing I had one solitary cookie left over from call! Yep...I'm continuing the tradition of making treats for call. This time, I purchased a bag of toffee and went in search of a cookie recipe, and, boy did I find a good one! This is, once again, from Anna. The recipe is actually from Reynolds wrap. I changed it a bit for what I had on hand. Although Anna calls them capuccino cookies, I honestly couldn't taste the coffee. That did NOT detract from the cookie itself, though. My fellow on call residents thoroughly enjoyed them...M even told me that I had to quit bringing such good things on call because he had already eaten around 7 cookies. :-) Even my attending had a couple...of course, he never got away from the NICU, so they served as his supper. Anyway, I highly recommend these...and I'm not even a huge chocolate fan! Chocolate Toffee Almond Cookies

2 1/2

cups flour


cup cocoa


teaspoon baking soda


teaspoon salt


cup (2 sticks) butter, softened - I used 1 stick plus 3 Tablespoons and they were still quite moist and delicious!


cup packed brown sugar


cup granulated sugar


tablespoons instant coffee


tablespoon milk




teaspoons vanilla extract


package (8 oz.) toffee bits, divided I didn't use the full package...probably have 1/2 cup left


cup semi-sweet chocolate chunks I used about 2/3 cups white chips and 1/3 plus a little more of semi-sweet chips


cup sliced almonds, toasted I used pecans

PREHEAT oven to 350°F. Combine flour, cocoa, baking soda and salt in a bowl (or just wait and do my quick combine on top of the butter sugar mixture!)

BEAT butter, brown sugar and granulated sugar together in a large bowl, on medium speed of an electric mixer, until light and fluffy. Dissolve instant coffee in milk. Beat in coffee mixture, eggs and vanilla until well blended.

ADD flour mixture gradually to creamed mixture; beat on low speed just until blended. Reserve 3/4 cup toffee bits; stir remaining toffee bits into dough. Drop by heaping tablespoons about 2-inches apart onto parchment-lined cookie sheets. Combine chocolate chunks, almonds and reserved toffee bits (or white chocolate chips, pecans, and toffee!; set aside.

BAKE 4 minutes (cookies will still be wet on top.) Remove from oven; press cookie flat with the back of the measuring spoon. Sprinkle 1/2 heaping tablespoon almond-toffee mixture onto each cookie. Using the back of the measuring spoon again, lightly press topping into dough to form a larger round cookie.

CONTINUING BAKING 8 to 9 minutes longer or until cookies are set. Do not over bake. Slide parchment with cookies onto a wire rack to cool. This suggests using parchment paper...I didn't have any, so didn't use. IF you don't use it, be sure to remove the cookies after about 4 minutes of cooling or they will be VERY hard to remove from the pan!


Katrina said...

Oh my goodness, what a day!!! I don't know how you do it (all doctors). And a great big thank you from me for all you do!

Cookies! Also one of my FAVES--Anna's Cookie Madness! ;)

Red Dirt Mummy said...

Gosh, I don't blame you for breaking down and having a good cry. Lots of hugs.

PS: The cookies look GREAT!

sarah (SHU) said...

okay, i'm WAY jealous of your intubations! as for the supersick baby that is sad but definitely a reality in the NICU. it is still heartbreaking to pronounce anyone!

on a lighter note, have you seen this video: NICU cribs? if not, you need to!

The Cookbook Junkie said...

I could never do that job myself but I'm glad there are those of you out there that can. I will be thinking about this for a long time and I wasn't even there.

Megan said...

So sorry about your rough night of call. Russ was in the delivery room when his resident delivered a still born baby last year. Very devastating for all doctors involved. In fact, everyone involved went home that night. Cookies make everything a little better! :)

Megan said...

I made these cookies today - they were fantastic! As a former NICU mom myself, I know how much the families there appreciate what you do. Thanks for the great recipe!

Unknown said...

Katrina - The only way I do it is with strength from God! This is where He wants me, so....And isn't Anna's site the best. Always find something good there.

RDM - Thanks! A good cry help and, thankfully, my mom was coming through town that day, so I got a hug as well!

Sarah - :-) And, yes, I LOVE NICU cribs...we're quoting it all the time!

Paula - Yeah, it's one of those things that just kind of sticks with out.

Megan - Yeah, I had one of those experiences as well that night...SO very sad! You should make these cookies for tailgating one week!

Megan(2) - I am so glad that you liked them! It's so much fun to find a new and good recipe. Stopped by your blog and your (former) NICU babe is just precious! That's why we keep doing what we do!

Abby said...

I can't believe you find the time and energy to bake with all you do at work. Amazing.

I could never work in the NICU. You're right; unimaginable.

B Nettles said...

Oh, Claire,
I cry with you. And I rejoice with you (the intubation).

I have ALWAYS been proud of you.

Peabody said...

Oh I am such a sucker for toffee, these sound all sorts of wonderful.

Hang in there with the sadness, I would cry to. Then again, I cried when my mixer broke. ;)