Barn-Burner Chili from VEGAN FOR THE HOLIDAYS & Book Review

 

The Holiday season is a special time for gathering with family & friends, and don't forget all the yummy comfort foods. The wonderful traditions that we grew up with and now share with our own families make our lives more beautiful and enjoyable. Food is always a great way to bring everyone together. I love creating and trying new recipes, and the Holidays are a good time to do this. Vegan cooking expert Zel Allen demonstrates in her book, Vegan for the Holidays, that plant-based foods are as delicious, innovative and elegant as their hallowed meat-based counterparts.  You all know I am a big supporter of whole, plant-based foods and my biggest goal is to make it taste delicious and familiar as the memories you grew up with.  I have enjoyed making a lot of the recipes in Zel's book.  They are simple, pure,  and healthful!  I love the quote by Zel from page 3:

"As I sit down to plan my own family holiday dinners, I feel grateful for the rich bounty sown and harvested by our American farmers, who have enabled us to celebrate with an abundance of fresh foods.  And it gives me deep pleasure to invite you to join me in the kitchen throughout the season, as together we participate in fun celebrations and conclude each event with a darned good meal.  And now, let's bring on the holiday feasts."
You can find Zel at either of her websites:
Vegetarians in Paradise or Zel's Vegan NutGourmet.

The recipe I decided to share with you all came from Chapter 5:  Happy New Year Soup and Chili Bash
I made the fabulous Barn-Burner Chili.  You will absolutely love this yummy chili. It is so packed with flavor, I didn't need to add anything to it. It is hot, hearty, and full of spices that will warm you up during the cold months ahead.
Check out Little House of Veggie's with another wonderful recipe from Zel's book - Sweet Potato Soup.

Printable Recipe 

Serves 6-8
2 onions, chopped
2 green bell peppers, chopped
1 red bell pepper, chopped
1 large crown broccoli, coarsely chopped
1 large carrot, chopped
5 cloves garlic, coarsely chopped
2 3/4 cups water
1 tablespoon balsamic vinegar
1 tablespoon tamari
3 cups bite-sized chunks scrubbed white or red potatoes
3 1/2 cups cooked dried kidney beans, or 2 (15-ounce) cans kidney beans, undrained
1 1/2 cups cooked dried pinto beans, or 1 (15-ounce) can pinto beans, drained
1 1/2 cups cooked dried black beans, drained, or 1 (15-ounce) can black beans, drained
2 (6-ounce) cans unsalted tomato paste
1 large tomato, chopped
2-4 tablespoons maple syrup
2 tablespoons chili powder
1 tablespoon plus 1 teaspoon ground cumin
1 tablespoon red wine vinegar (I used Apple Cider Vinegar)
2 1/2 teaspoons liquid smoke (I didn't have this, so I left it out)
1 1/2 teaspoons salt
1 to 2 teaspoons freshly squeezed lemon juice
1/4 to 1/2 teaspoon cayenne
1/4 teaspoon ground pepper
2 dashes hot sauce (optional)

Toppings

1 (15-ounce) can corn kernels, drained (I used frozen)
1 sweet onion, chopped
1 (8-ounce) can black olives, drained and choped
2 cups shredded vegan cheddar cheese (I didn't use any cheese)

1.) Combine the onions, bell peppers, broccoli, carrot, garlic, and 1/2 cup of the water in a large, deep skillet.  Cook and stir the vegetables over medium-high heat for 5 to 7 minutes, or until the vegetables are softened and all the water has evaporated. Add 1 or more tablespoons of water as needed to prevent burning.

2.)Add the balsamic vinegar and tamari, stir well, and transfer the vegetables to a slow cooker.

3.)  Put the potatoes and enough water to cover in a 2-quart sauce pan.  Cover and bring to a boil over high heat.  Decrease the heat to medium-high or medium and simmer for 5 to 7 minutes, or until the potatoes are just fork tender.

4.) Using a slotted spoon, transfer the potatoes to the slow cooker and add the remaining  2 1/4 cups water, all of the beans, tomato paste, tomato, maple syrup, chili powder cumin, vinegar, liquid smoke, salt, lemon juice, cayenne, pepper, and optional hot sauce.  Mix well to distribute the ingredients evenly.  Cover and cook on low for 6 to 8 hours.

5.)  Adjust the seasonings, and spoon the chili into serving bowls.  Serve the toppings in separate bowls on the table or near the slow cooker and make the meal a self-serve chili-and-toppings bar.

Malignant: Medical Ethicists Confront Cancer

I've just read Malignant: Medical Ethicists Confront Cancer, edited by Rebecca Dresser. Seven ethicists who have either had cancer themselves (5) or cared for a spouse with cancer (2), or both (1), write about their experience and discuss what that experience might mean for ethics and clinical care. It's a very approachable book. I think most readers of this blog would find it powerful.

Here are some of the main lessons I gleaned from the book:

1. Not surprisingly, direct experience deepens our understanding of the issues we teach about in the classroom and write about on blogs and in print. The deepening isn't conceptual knowledge. It's more that the experience acts as a filter, indicating what's truly important in what we've thought and where we've been naive or callous. In my ethics seminar section at Harvard Medical School we regularly work with cases. I've taken to "becoming" the patient in the case, and interacting with the class in that role. I've found that taking on the persona of the patient - even when that persona is very different, as when I play a teen age female - the role comes alive for me in feelings and perceptions. I become a better teacher for it. If the students learn half as much as I do from those exchanges, the class is a success.
2. Norman Fost describes a remarkable experience. Being worked up for what seemed clearly to be a recurrent kidney stone the resident evaluating him ordered a CT scan. Fost explained to the resident why he thought the scan was (a) medically not called for and therefore (b) an wasteful expenditure. But he didn't refuse it. The scan confirmed what he knew - he had yet another kidney stone. But it also showed a mass, which on further exploration turned out to be an early, and apparently curable, kidney cancer. Kidney cancers are often found too late for cure. Fost believes the CT scan may have saved his life. But he holds to the view that it was wrong to order it and that it reflects an overly interventionist, inadequately cost attentive, US medical culture.
3. Rebecca Dresser and Dan Brock write about decisions they made that in retrospect (a) went against their values and (b) about which they wish their physicians had discussed/argued with them. Dresser's example is especially telling. She refused a feeding tube and was close to death when a nurse talked her into changing her mind. Dresser and Brock speculate that physicians may have learned the lesson of respecting patients' decisions too well! Rather than challenging bad decisions - decisions that to against the patient's values, they too readily acquiesced. In terms of "Four Models of the Physician-Patient Relationship," a valuable paper  by Linda and Zeke Emanuel from twenty years ago, their physicians applied the "informative" model - provided information and then, in effect, followed the patient's "orders," when the reflective give-and-take of the "deliberative" model would have been more useful.
4. Arthur Frank sees cancer support groups as potentially hugely valuable for patients, but he warns that these groups and what he calls the "survivorship industry" can thrust identities that don't fit onto patients. His comments helped me understand something I observed several times in my clinical practice. Patients who had experienced a loss, and who by all appearances were going through painful, but "healthy" grief, were frightened by the fact that they weren't crying more. They had imbibed the view that "proper" grief involved lots of tears and feared that they were full of unshed tears that would act like a poison. Explaining that there wasn't a single "correct" way to experience grief reassured them.
5. Finally, and with most personal impact for me, John Robertson and Leon Kass write in painfully raw terms about accompanying their wives on their journeys with ovarian cancer. Robertson's wife Carlota Smith died. Kass's wife has experienced recurrences, but is still in treatment. I hope that if my wife encounters a similar experience I will respond with the commitment, care, and courage that Robertson and Kass displayed.

There's lots more than I've written about to glean from this moving book!

Allowing import of needed drugs from Canada

Last year I wrote about a well-intended FDA policy about colchicine, a drug used since ancient times for gout, and now for other serious conditions, such as Familial Mediterranean Fever. As an ancient treatment widely used prior to formation of the FDA, colchicine did not require FDA approval as a new drug. Then in 2009, the FDA granted approval to URL Pharma for Colcrys, its version of colchicine, based on randomized controlled trials the company conducted. Because colchicine had never been subjected to the FDA approval process, Colcrys was, in a technical sense, a "new" drug approved for a "new" indication - treatment of gout and FMF - despite the centuries of prior use, and by regulation was entitled to market exclusivity. In 2010 the FDA ordered all other manufacturers to cease production and marketing of their versions of colchicine.

Unfortunately, Colcrys is not effective for some patients with Familial Mediterranean Fever. To maintain their health these patients need the generic form, which must be imported from abroad. A friend recently told me about the new roadblock a family member is encountering. Here's the letter that went to the patient's senators:

I am writing with regards to the recently passed Food and Drug Administration Safety and Innovation Act (S. 3187). The bill includes a provision (Section 708) that may prevent me from being able to import my prescription from Canada, which I depend on for my health and quality of life.

This legislation authorizes the seizure and destruction of safe prescription drug imports valued under $2500. I have a prescription for generic colchicine for a rare genetic disease which I have, Familial Mediterranean Fever. When I tried the US brand of colchicine, Colcrys, I experienced extreme side effects and a relapse of symptoms, resulting in a month of illness, including an overnight stay in the hospital with high fevers and dehydration. Through this experience, my doctor and I discovered that it is essential that I be able to access an alternative brand of colchicine. Due to an FDA ruling, all brands of colchicine except Colcrys were taken off the US market several years ago. I now depend on my prescription from Canada for my health and well being.

When I am able to take colchicine imported from Canada, I have no symptoms and live a normal, healthy life. Without access to this medication, I will experience fever episodes lasting from several days to a month, pain, and inability to eat. It will compromise my ability to finish graduate school, where I am currently working on a challenging program. It will put me at risk of future complications from my genetic disorder.

I am extremely concerned that when Section 708 of Act 3187 is implemented, I will lose access to my direly needed medication. Please let me know what you plan to do to change Act 3187 to allow me to continue my life. Thank you for your time and consideration.

I don't fault the FDA's intentions. But in a country of 300 million people, it will be the rare policy that applies to all in a fair manner. Justice requires a robust exception process in situations like the dilemma of FMF patients who require the generic drug.

The patient did her part in putting the issue onto the public table. Now it's up to the FDA to respond.