Saturday, October 25, 2008

Chocolate Chip Cookies from the Island of Reil

When I'm on call, I get intense food cravings. They are especially intense when I'm up way past my bedtime.

I'm pretty sure I'm not alone in this. A lot of my friends say they graze a lot while on call. I try not to graze, and I try to keep guilt-free snacks around like fruit and yogurt, but when I don't graze and don't have a stash nearby, I daydream. And as the topics of conversation among fellow-employees might suggest, we all tend to daydream about food.

I should know better, because I always find food pictures on her blog enticing, but the other night at 3 in the morning after placing an epidural and while waiting for the next expected one (which I knew would be called for in a matter of minutes), I stopped by my friend Anali's blog, and BOOM - I got a sudden, enormous, overwhelming craving for chocolate chip cookies.

The next epidural happened to be one of those nightmare ones you wish you could just pass along to someone else. First I had to remind the patient to please remove a body piercing - which never makes patients happy, so already you're starting off on a negative note. After that, it took a few tries, but at last I had the epidural needle inserted a full 9 cm - its entire length - and only then did I have even a HOPE of being in the right space (average length to "the right space" is 3.5 - 5cm). That alone should have put a stop to my cookie craving, but alas, it didn't. In fact, it came back with a vengeance once the epidural was in and the patient was dozing off, comfortable at last. I went out to the front desk and remembered: COOKIES.

I wanted cookies. Not just any ordinary, store-bought, nothing-to-write-home-about cookies. I wanted artisan-quality, fresh-from the oven, soft-in-the-center but crisp-at-the-edges chocolate chunk cookies. Like the ones that used to be sold at David's Cookies stores in New York, where the head-spinning aroma would just waft down the street in tendrils that wrapped around you and lured you to the storefront. The online variety are no match for what the boutiques once baked and served.

According to neuroscience, the insula, a.k.a. the insular cortex / lobus insularis / Island of Reil, is to blame. It's a portion of the brain that lies tucked away in an area called the lateral sulcus on each side. It plays a role in body representation, pain experience, subjective emotional experience (especially of fear, anger, sadness, happiness, and disgust), empathy, and hunger. The right insula enlarges in people who meditate. There it is again: a physiologic locus that can be related to the overlap of spiritual, pleasure-oriented, and emotional experiences.

Perhaps when we practice professions that require active empathy at all times, tend to leave us with rushed meal breaks if any, and arouse our limbic structures through stressful responsibilities, long hours on our feet, and lack of sleep, our insulae go into hyper-drive. "Give me cookies!" they cry. (Or, for some, cigarettes, or shish kabobs, or beers, or video games.) Luckily, that night it was late enough (or, by then, early enough?) that my desire for sleep won out.

I am currently on call almost every other night. Today I gave in. I took advantage of a rare afternoon at home and made chocolate chip cookies. Not as good as David's - but mm, mm good anyhow. The kids and the Hunk seemed happy. (And yes, I let them eat some of the cookie dough.)

Back to yogurt, berries, and tuna tomorrow...when I am on call AGAIN.

T.'s Chocolate Chunk Cookies
1 c (2 sticks) butter
1 c dark brown sugar, packed 
2/3 c white sugar
2 eggs
4 tsp. vanilla extract
1/2 tsp salt
1 tsp baking soda
2 1/2 c organic all-purpose flour
2 c semisweet chocolate chunks

Mix together the way you usually make your cookies, drop by spoonfuls onto an ungreased cookie sheet, and bake at 350 degrees for 10-15 minutes, depending on your oven, desired brown-ness, etc. Makes about 40 depending on how much cookie dough you end up eating... :)


Dragonfly said...

Jolly island of Reil. What is it with islands? Reil, Langerhans, then other islands where you can get fantastic food from...Japan, Cuba, Jamaica, Malta, Cyprus, Sri Lanka just to name a few.

Lisa Johnson said...

I think we're in a vicious (or should I say a delicious?) circle here. After reading your post, I made more cookies!!! I'm going to post the recipe today. ; )

Anonymous said...

I totally understand your craving for food-on call circle!
because I suffer from the same disease! I usually can control myself until the 18th hour, after which the disaster begins...
and I don't want to start talking about the mental justifications I give myself at these moments!
greetings from Portugal, where (unfortunately) the island seems to be equally active!
ps: 9cm?! ;)

T. said...

Dragonfly - then there's all the foramina - Foramen of Monroe, Foramen of Luschka, Foramen of Winslow, Foramen of Magendie...

Anali - our recipes have pretty much the same proportions of lipid-based goop / brown sugar / white sugar / flour / bakind soda / salt! :)

Catarinolas - NINE. WHOLE. CENTIMETERS. But thankfully, an unequivocal loss of resistance at that point, resulting in a reliable epidural!

Anonymous said...

I just made sugar cookies. Now I need chocolate chip cookies. And I'm humming C is for Cookie...

Seriously. Thanks.

PS. Don't forget Foramen Ovale. That one cost me a trip to the cath lab for a cute little umbrella device. I'd have rather gone to one of those Islands for a drink with a cute little umbrella stuck in a pineapple!!