Sunday, January 30, 2011

UP TO THE PRECIPICE


Gloria Eleanor Clemente


Gloria was a strong woman.  Except for one serious hospitalization I never remember her ever being sick.  If she was ever sick she certainly never let it stop her.  Hardy stock those Clemente women.  Enviable for their strength, determination and longevity.  Gloria was my mother's next younger sister and would be 89 years old now.  

Sometimes strength can also be translated as stubborn.  Stubborn can masquerade fear.  Fear can hide embarrassment.  Nine years ago Gloria began to have some "female" problems.  After doing her best to hide her discomfort she finally confided in my sister who urged her to see a gynecologist.  After much persuading from the family, Gloria went to the doctor.  

The doctor immediately referred her to a specialist for what turned out to be cancer of the vulva.  The specialist performed quite radical surgery during which Gloria encountered some surgery-related problems.  After a very difficult recovery period she was doing remarkably well.  At her six month check-up the doctor was very pleased.

By the time the one year check-up rolled around Gloria had once again been hiding additional symptoms.  The doctor made the pronouncement that the cancer had returned.  If an original diagnosis of cancer is bad, reoccurrence is much worse.  

By this time early signs of dementia had been surfacing.  Signs easily recognizable to a nephew who had been taking care of his mother with Alzheimer's disease for a dozen or so years at that point.  The dementia combined with the problematic previous surgery ruled out another surgery.  My sister and I were in agreement with the surgeon.  We agreed to a consult regarding radiation therapy.  We also agreed that we would not tell Gloria the extent of her condition because of the dementia. These are very difficult but pragmatic decisions caregivers are faced with.  I decided it was more humane not to keep her completely informed.



The visit to the radio oncologist was devastating.  The doctor examined Gloria and then made an excuse to speak with my sister and me alone.  She said the treatment would be excruciating.  It would require weeks of  burning treatment with frequent hospital stays.  I asked the prognosis and the doctor said she thought Gloria would have four to six months with the treatment.  "With the treatment"!  My sister and I were stunned.  I looked at Patricia who was now in tears and then asked the doctor to please give us the information for Hospice.  There was no way we would put my aunt through torture for such little gain.

The doctor was lovely.  She said she was hoping we would choose Hospice and promptly contacted them for us.  We agreed that we would tell Gloria that her discomfort was part of the healing process, knowing that she would never be able to get thought the months ahead of her if she didn't have hope.  We knew what we were in for.

Within the week the Hospice representative was in my kitchen getting things started.  That was the first night I slept in a while because I knew I wouldn't have to face this tragedy alone in my home.  Now I had Gloria on Hospice and my mother with her advanced dementia.  I had been thrust into running a de facto nursing facility.

Hospice was miraculous.  There were people to take care of Gloria.  Supplies would magically appear at my front door.  There were numbers to call if [when] I was feeling overwhelmed.  Hospice looks after the whole family.

Overwhelmed happened.  Even the strongest of caregivers is mortal.  Between the stress of both patients, the parade of strangers through my home and seeing Gloria in ever-failing health, I ended up with pneumonia.  It wasn't horrible but it was a warning for me to take care of myself.  That is a caution to all caregivers:  TAKE CARE OF YOURSELF!    It's akin to the instructions on an airplane that "in case of loss of cabin pressure ...put the mask on yourself first and then help others".

Ultimately the excruciating pain exacerbated Gloria's dementia. My wish had been to make it through the holiday season which was about three months after the onset of Hospice.  We made it gingerly though Christmas but on New Year's Eve morning I was awakened at 7 to Gloria hollering.  She had gotten dressed and made it downstairs, which was miraculous, and was in full psychotic break.  She was no longer in pain but had been transported, in her mind, back 40 years.  She was calling for my father to take her to work.  My father had been deceased for 30 years at this point.

I called Hospice and ultimately made the decision for Gloria to go to their cancer wing at a local hospital that they served.  There were more ups and downs but I was able to rest knowing that she was being well taken care of.  I knew that I was no longer able to provide the comfort and care that was required to make her final time comfortable.

Seven years ago this week I got the 5 o'clock in the morning call, in the middle of a blizzard, telling me that Gloria had passed away.  The pain and suffering were over.  None of our lives would ever be quite the same again.  

Pushed to my limits I was forced to learn so much from this experience.  An experience that no one wants to  face but so many of us do.  I found strength and compassion that I never knew I had.  I learned more about caregiving and Hospice and bureaucracy  than any post-graduate degree could ever offer.  An education I never wanted.

Never feel that you have to face these challenges alone.  For end of life, Hospice is there to ease the burden and the trauma.  At other, less serious, times there is Visiting Nurse.  Consult your physicians.  Turn to your clergy.  Utilize the help that is out there for you.  It's never going to be easy but at least it becomes more bearable.  


Friday, January 21, 2011

FOODIE FRIDAY RECIPE - PIZZA

PIZZA!
The word alone makes most people smile.  That perfect combination of home made bread, tomato, cheese opens the door to an endless variety of personalization choices.  For me, the basic combination is all I need but once in a while I splurge with some fresh asparagus or leftover meatballs or shrimp.  

There are few aromas that can compete with that of pizza baking in your oven.  The rich cheeses, the aromatic basil and the slight acidity of the tomato all get your memories flowing and your mouth watering.

I am going to give you the basics, including the dough recipe.  I promise not to frown if you choose to use a fresh pizza dough from your grocer's refrigerator or from your local bakery.  They are fairly readily available and perfectly acceptable.  Please do not used one of those pre-formed packaged pizza / focaccia shells sitting on the shelf next to the white bread.


I do not usually advocate single-use or specialty gadgets but one item that I suggest you add to your collection of  baking sheets and pans is an aluminum pizza screen.  They are reasonably priced and help produce a wonderfully crisp crust.


Ingredients:

[for the dough]

1 package active dry yeast
1.5 cups room temperature water
3.5 cups all purpose or bread flour
1 tablespoon salt
1 tablespoon olive oil



[for the topping]

2 cups shredded cheese [I like the mozzarella/provolone mix]
1/3 cup grated Romano or Parmesan cheese
6-10 fresh basil leaves
2 teaspoons dried oregano
1 teaspoon salt
1/2 teaspoon ground black pepper
1 tablespoon olive oil
1 cup tomato puree
1 small clove garlic, minced


Method:
[for the dough]
Combine the dry ingredients in the bowl of your stand mixer or in a large bowl if you are going to kneed by hand.  Stir to mix well.  Add the oil and all but 2 tablespoons of the water. Mix with the dough hook for 5 minutes. If the dough seems dry then add the rest of the water. Let rest for 5 minutes and kneed for another 10 minutes.  Transfer the dough to an oiled bowl, cover with plastic wrap and let rise for an hour.

[for the sauce]
For pizza it is best to use a raw "sauce".  Please don't use a pre-made sauce!  Blend the tomato puree, garlic, oregano, salt and pepper.  

Assemblage:

When the dough has risen for an hour, turn it out onto a floured surface.  I like to use a silpat mat for this but you can work directly on your counter top.  

Preheat oven to 425*

Rub some flour on your hands and begin to stretch the dough with your hands.  At this point you can cheat and use a floured rolling pin to flatten and continue to stretch the dough until it is quite thin but not torn.  This dough generally makes a 16" crust.  Feel free to leave the dough in a free-form shape if you are unable to get it into the traditional round.  I like the rustic look and then you can be sure your guests will know it is handmade!


Place the dough on the pizza screen or baking sheet and very lightly cover with the sauce.  The sauce should barely cover as illustrated in the photo above.  If you use more sauce than that the pizza will be soggy.

Sprinkle the grated Romano over the sauce. Now arrange the fresh basil leaves over the pie.  Cover with the shredded cheeses and sprinkle with the remaining olive oil.  





Bake on middle rack for 20 minutes or until golden and bubbly.




Serve piping hot from the oven.  You can also cut into bite-sized pieces and serve as an hors d'oeuvre.

Friday, January 14, 2011

FOODIE FRIDAY RECIPE - OVEN "FRIED" CAULIFLOWER

Crispy breaded cauliflower baked in the oven is a wonderfully delicious, simpler and healthy alternative to the fried cauliflower I grew up eating [and loving].  I made this tonight as a side dish to our Friday night family dinner and we could have easily made this the centerpiece of the meal.  Crispy on the outside and creamy and sweet on the inside you're going to want to try this recipe / method with all of your favorite veggies.

"cauliflower is nothing but cabbage with a college education"
mark twain

Ingredients:

1 head fresh cauliflower
2 eggs
1 cup plain bread crumbs
1 cup all purpose white flour
1/3 cup milk
3 tablespoons grated Romano or Parmesan cheese
salt
fresh ground black pepper
1 tablespoon dried parsley flakes
1 tablespoon olive oil
non-stick cooking spray


Method:
Remove any leaves from the head of cauliflower and pare the florets.  Begin by turning the head on its face so the stem is facing up.  With a paring knife, remove the large center core and discard.  Remove the florets by hand in chunks as pictured above.

Rinse the florets in cold water and then place in a pot with enough water to barely cover.  Add 1 teaspoon salt and bring to a boil.  Lower to a simmer and cook for about 5 minutes until barely fork tender.  Immediately drain and run under cold water until cooled.  Place in a colander and set aside.

Preheat your oven to 425*.
Cover a baking sheet with foil and spray with non-stick cooking spray.

Now set up for the traditional 3 bowl dredging:


Bowl 1:  flour, 1 teaspoon salt, 1/2 teaspoon pepper.

Bowl 2:  eggs, milk, 1 teaspoon salt, 1/2 teaspoon pepper, parsley, cheese.
[beat these together as for scrambled eggs]

Bowl 3:  bread crumbs, 1/2 teaspoon salt, 1/4 teaspoon pepper.

One at a time dip a piece of cauliflower into flour, then egg wash, then roll in bread crumbs and then place on baking sheet.

When all the vegetable is coated and on the baking sheet, drizzle with the olive oil and put into the center of your pre-heated oven.


Bake for about 35 minutes until golden brown.

I prefer to serve these just the way they come out of the oven but you can certainly serve with your favorite marinara sauce or an aioli for dipping.