On Stress: The Gory Details

Monday, February 16, 2015


   I think most of us can say similar things about our dear friend stress: we fear it, acknowledge it, try and deal with it and ultimately accept it as a daily companion, like a pesky shadow you just can't shake.

   Every step of our lives seems to come with admonishments to reduce and manage stress. I was particularly inundated with tales of medical students being consumed by stress, fables and urban legends about the first year student who finally lost it after an anatomy final and was never seen again. And of course it only gets worse when you become a resident: not only are you still responsible for a behemoth mountain of ever evolving information but now you have real live patients relying on your decisions and abilities. Adding a pregnancy (and subsequent newborn) to this mix may seem to some a wee bit reckless, nay, foolhardy?

   And yet.


   I am a true believer that work, money and those annoying details like crushing medical school debt are merely the means to a full life, NOT the focus of life. I acknowledge these details can be scary and deserve attention, but I also realize how easy it is to slip into what I call a problem focused life. I heard it a million times in medical school: 'Just three more years, then it gets better.' 'Just one more year then I'll be a resident and it'll be better.' Then residency came and I was probably more surprised than I had any right to be when I heard the very same sentiments from my fellow residents: 'Just three years of residency, then I'll be working and it'll be better.'

   One of the reasons I finally scrounged up the courage to change specialties mid residency was the simple fact that I really listened to the people I worked with and I realized one day that I was starting to tell myself the same things they were telling themselves: just a few more years, then I can be happy. No sir. Life doesn't work that way. Happiness and life happen now, not in five years. And if it's not, you better slow down and figure out why.


   Aside from the major life changes we may need to face, stress management is, in my humble pathologist's opinion, a micro activity. It is something that happens in the million teeny decisions we make every day that add up to a surprising artillery against the things that make our cortisol soar and our sleep restless. It's enjoying your breakfast quietly without checking your long suffering bank account. It's snugging up to your favorite work out DVD rather than stare at your computer and suffer through another five slides on the powerpoint that can wait until tomorrow. It's consciously dismissing that snarky comment your coworker winged at you and choosing to hug your spouse for an extra few minutes before you settle into the reassuring routine of making dinner.



    Back to my original question: adding a pregnancy and baby to the mix? For sure foolhardy! But life waits for no one and remember what I said about delicious, chubby, infant thigh rolls in my last post? At the end of the day most of the things we let stress us out are just gory little details. And details are never as beautiful as the big picture. Especially when there's a sweet smelling baby to be added to it.

   And for those moments that just get the best of you, I advise generous portions of this chocolate pudding. I blended it in the vitamix longer than the original recipe recommended and was rewarded with the most spectacular, airy yet dense love child of luscious pudding and ethereal mousse. Get on it.

Dark Chocolate Pudding
Serves 8. Or 6 in need of stress reduction.
Slightly modified from Melissa Clark  
  • 1 large egg, plus 2 yolks 
  • 6 ounces bittersweet chocolate (70% percent cacao, broken into pieces)
  • 2 tablespoons unsalted butter, cubed into several pieces
  • 1 teaspoon vanilla extract 
  • 2 ½ cups whole milk 
  • ½ cup heavy cream  (plus additional for serving)
  • cup plus 2 tablespoons firmly packed brown sugar 
  • 2 tablespoons unsweetened cocoa powder 
  • 2 tablespoons cornstarch 
  • ¼ teaspoon fine sea salt
  • Freshly whipped sweetened cream with a dash of vanilla extract, for serving
   Place the chocolate and butter in your blender. Set aside.
   In a small heat proof bowl, whisk together the egg and egg yolks. Set aside.
   In a heavy bottom sauce pan, whisk together the milk, heavy cream, brown sugar, cocoa powder, corn starch and salt. Bring to a slow simmer over medium heat, whisking the whole time. Simmer for 2 minutes (and no more). Remove from heat and slowly whisk some (about 1 1/2 cups) of the hot custard into your eggs until the eggs are heated up (this tempers the eggs and prevents them from scrambling when you add them into the rest of the custard). Scrape the tempered eggs into your sauce pan, whisking the whole time. Return to low heat and whisk until the pudding is quite thick and steaming. This should take only a minute or two. And do not stress if you see it getting a little grainy or curdled! The blender is to the rescue.
   Scrape all of the hot custard into your blender on top of the chocolate and butter. Turn blender on, bring it to high, and blend for a full 3 minutes. It will look a little frothy. Turn off blender and pour the custard into serving ramekins or cups of your choice. You can also pour into one big serving bowl but that's not nearly as fun or cute.
   Chill in the fridge, uncovered, for at least 4 hours before serving. If making a day ahead, cover with plastic wrap once fully chilled.
   Serve with generous dollops of sweetened whipped cream and a sigh of appreciation for life that includes this pudding/mousse love child.


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