That’s me sending up smoke signals.
I’m still here.
Just been a little busy…
There are said to be 4 stages of competency:
1. Unconscious incompetence – you don’t know that you don’t know
2. Conscious incompetence – you start to realize just how much you don’t know
3. Conscious competence – the light bulb has turned on…maybe you are actually starting to “know” things!
4. Unconscious competence – you open your mouth and some how the right words come out
I’m now 1 year and 3 months into my second year of residency (my “re-turn” year that is), and I’m still struggling to figure out where I fall in that scale.
I walk into the hospital every morning, we start rounds, and for about 5 minutes I feel like I’m at stage 3…then a patient (or patient’s family member) asks me a question, and suddenly I’m slammed back to reality – the reality that I’m still sitting at stage 2.
This is actually a huge improvement compared to where I was a little over a year ago. I’m finally starting to realize that I’ve spent the last 26+ years living at stage 1 (at least with regards to medical knowledge). But stage 1 is nice. Blissful ignorance!
I’m starting to realize just how dangerous the title of “doctor” can be. By wearing that title, it suggests that I can fix things (or at least have the knowledge to fix things). But what if I don’t? What if I am a doctor in name only? That’s what it feels like to be a resident. It feels like I’m walking around playing dress up. The white coat says my name, but do I really have the knowledge to wear it? Unfortunately, patients only see the white coat. They don’t see my sweaty palms when I walk into the OR, or see me frantically pouring out anatomy texts the night before. When I state my title, they assume I’m at stage 4 (or at the very least stage 3). Thankfully, I stand on the shoulders of those who are much further along in their competencies, and they’re willing to help me progress through the stages. This includes my fellow interns, juniors, seniors, fellows, attendings…the whole surgical heirarchy. I’m incredibly lucky to be in a training program that puts such emphasis on surgical education. Though I currently feel like I’m stuck at stage 2, I feel confident that I will be make the necessary progression through the remaining stages over the next 6+ years of training.
This recipe has little to do with that intro, except for acknowledging those in the years ahead of me. I’ve found an amazing group of friends and colleagues in my co-residents. We share more than our masocistic love of surgery…particularly when it comes to food.
Pho (Pronouced ph-uh, not with a long o) is one of my absolute favorite foods. It was introduced to me by my old roommate who’s mother would make large vats of the heavenly broth, freeze it, then deliver it to our Cleveland apartment. It’s the perfect comfort food. Only problem is it’s notorious for being an incredibly time consuming undertaking…one that the average resident doesn’t really have the free time to commit to. Or at least not if they try to take the traditional approach. Lucky for me, I have a co-resident who shares both my love for pho and my lack of free time…plus he has just about every cooking toy known to man. A while ago, the stars aligned and we had the same day off – the perfect opportunity to take a stab about pressure cooker pho.
- 2 1/2 lb beef shank
- 2 lb ox tail
- 1/2 lb tendon
- 2 yellow onions, cut in half
- Fresh ginger, about 4-5 inches, thickly sliced
- 12 stars of anis
- 2 tbs coriander
- 1 tsp peppercorn
- 3-4 sticks cinnamon
- 12 whole cloves
- 0.3 lb palm sugar (about 3 inches)
- 1/2 cup fish sauce (+/- a little more depending on your love of fish sauce)
- 1-2 lbs dried pho noodles (banh pho noodles)
- 1 lb raw round or sirloin steak, thinly sliced (easiest to slice if chilled in the freezer for 15 min before slicing)
- Garnishes – cilantro, basil, bean sprouts, thinly sliced sweet onions, jalapeños, lime wedges, hoisin sauce, sriracha…oh so much sriracha
- Begin by parboiling the bones – add beef shank, ox tail and tendon to a large pot and cover with cold water. Bring the pot to a boil and boil for 3-5 minutes (a foam will rise to the top of the water during this time). Drain the bones/meat and discard the water.
- In a large skillet, use a blow torch to char the beef shank, ox tail, tendon, onion and ginger. If you don’t have a blow torch lying around, alternatively, you can line a baking sheet with aluminum foil and broil the onions and ginger for 10-15 min until charred on all sides. The meat can be seared in a frying pan until brown.
- In a frying pan, toast the anis, coriander, peppercorn, cinnamon and cloves on low heat until fragrant (about 5 minutes).
- Place the bones/meat in a large pressure cooker. Add the onions, ginger, spices, and palm sugar. Cover the contents of the pressure cooker with water or up to the fill line (minimum of 4 quarts). Secure the top of the pressure cooker and cook under high pressure for 75 minutes (plus extra time to release the pressure). Be sure to read the instructions for your particular pressure cooker as this can vary depending on system.
- Once safe to open, strain the fat using a fine mesh, ladle, or a fat separator (this thing is awesome!!). Discard the onion, ginger and spices. Using two forks, shred the meat off the bones and set aside. You can keep or discard the tendon depending on whether or not you like it.
- Add the fish sauce to the strained broth. Taste and add additional if needed, then set aside.
- Prepare the rice noodles according to the package (or this way).
- Now the best part – assembly of the bowls. In a large empty bowl, add cooked rice noodles and raw, thinly sliced steak. Pour the just-simmering hot broth into the bowl. The broth will cook the meat. Add some of the shredded meat from step 5. Garnish with whatever you like. My personal favorites are – basil, bean sprouts, lime juice, jalapeño and sriracha.
This looks delicious! I’m so glad you’re back!
Damn delicious pho!!!!
lovin the way you describe the food within some surgeon recidency term, lol
my girlfriend is pediatric surgeon resident too, i just love the way ya\’ll talking how to gut a fish just like you\’re doing incision at the operation teather….
reading this blog encourage me to enter the oral-maxilofacial sugery recidency even more….