Thursday, November 19, 2009

Adding pomegranate molasses and sesame oil is not a revolution

I once wrote a story about the history of Caesar salad and I don't remember any of it. Something about Tijuana? I don't remember! Who was Caesar? Don't remember! All I remember is that the salad was initially intended to be eaten with the fingers. I think.

The Gourmet Today grilled Caesar salad involves briefly searing the croutons and the romaine. I had high hopes. Preamble to recipe: "Contrasting cool and warm, crunchy and soft, this Caesar is revolutionary yet familiar."

Not really. It was okay. I felt the lettuce was a tiny bit stewed. We ate it, but I would not grill another Caesar. This whole cookbook seems to be about making tiny, dubious changes to "familiar" dishes and passing them off as "revolutionary."
Another example: the seltzer waffles
Despite the "odd" addition of seltzer water, they are just waffles. Good waffles, but just waffles.

Meanwhile, I am beside myself with delight over the wonderful breast cancer screening news. If women under 50 don't get  mammograms or do breast self exams we will never find a questionable shadow or pea-sized lump and that means. . . fewer breast cancer diagnoses! Hurray! This is change I can believe in. I bet all those women in their 30s and 40s who have battled cancer are bumming right about now, realizing they could have skipped the early diagnosis, lumpectomy, radiation, chemo, nausea, rashes, and ugly hair loss and gone straight to hospice. 


  1. With you on the breast cancer, sister.
    I love the club soda waffles. I do think they are lighter (because really, shouldn't waffles be *even easier* to eat?!). But I haven't experimented much!

  2. I bet my friend whose mom just died of the breast cancer she got eight years ago when she was 46 is kicking herself for all that needless extra time she had with her mom! At least this new advice comes early enough to prevent Jenny from having a useless mammogram for a while longer.

  3. Simultaneous clever observations on food and health policy. Loving your blog more and more!

  4. Snark really isn't all that clever. This was a group of scientists looking at data and making a recommendation, not policy, and my understanding is that it relates to women without unusual risk factors. It does not suggest that women with risk factors, such as family history, much less symptoms forego screening or treatment. It is a discussion point--what if we could identify ways of identifying risks at a much younger age? What if there was a blood test that every woman could have at age 20 to determine genetic predisposition to breast cancer and if you test positive, you get a different level of screening than someone who doesn't? Maybe the current guidelines are the best and most effective way to protect women's health (Altough current guidelines would suggest that no one in their 30's should be screened either). But maybe not.

  5. Thank you Crabapple; I was beginning to think I was the only woman who agreed with the recommendations. I think that some people have just heard the "headline" part of it and are reacting viscerally, instead of really understanding what the recommendations are suggesting. I also think that most people in this country believe more screening to be better, and completely without harm or consequences, and that is not true.

  6. Crabapple -- But how would you even know if you have a symptom if you don't do breast exams? I don't get it. I'm eager to understand.
    Maybe the presentation in the newspapers has been inadequately nuanced, but "recommended standards" by a federally appointed task force sounds like more than a "discussion point" to a lay reader.

  7. The same way someone who has never had a mammogram (and that is a significant number of women in this country over and under the age of 50 and insured and uninsured) would find it--pain, discharge, a lump. The federal government is not saying you cannot touch your breasts. What they've said about breast self-exam doesn't make sense to me, but to wave off the discussion because it is too ridiculous as you did in your post today is wrong too. I've come to appreciate the thoughtfulness of your arguments. I just think you missed the boat today.

  8. Crabapple,

    Perhaps I was too flippant, but, to me, this is confusing news. Every woman I've known with breast cancer, both over and under fifty, started with a lump or a bad mammogram. I'm not a scientist or statistician, but this suggests to me that the crude tools we have -- self exams and mammograms -- are sometimes very useful. So the recommendation is, basically, to use them less and replace them with, for the moment, nothing? How does this not lead to fewer diagnoses of actual cancer? What am I missing?

    I can sort of understand the reasoning on mammograms, that they don't work well in younger breasts and they're not very precise, that rates of bc in youngish women are low (although there are plenty of anecdotes to rebut this: routine mammogram at 43, stage 3, etc.) but I'm totally puzzled by the recommendation against self exams. You're not supposed to actually look for a lump, just wait until you notice one by accident?

    This report -- or maybe just the way it's been presented - - doesn't make sense to me. I would really like it to. If you see a story that lays it out very clearly I would love to read it.

  9. Crabapple,

    "What ifs" don't do it for me! We do not have alternatives yet that are convincing and should use what we do have---which is women taking care of them selves as well as possible until convinced that there is a better way.

    I was told, after a mastectomy, that I did not need careful follow-up because my cancer was non-invasive DCIS and 99% of women have no reoccurrance. But there is always that 1%, and if the next thing you know is that you have metastatic stage four---well you sure are for any follow up, testing, screening that would have prevented such an outcome.

    Statistics may say the odds are in your favor, but if it's your life, relying on the odds does not seem all that smart. 1% risk sounds small, unless you are that 1%!

    As long as it is all only suggestions open for discussion, people can make their choice. But it must be a personal choice with full awareness of the real risk of a bad outcome.

  10. Oh, man, what a depressing post! Tipsy, you're so smart and savvy and such a reader -- and yet on the breast-cancer screening story you've fallen in with a reaction that is right out of the tea-bagger playbook. C'mon. Spend a little time to understand what a complex, difficult question this is, that, for instance, hard as it is to believe, early detection isn't necessarily the best thing. I've pasted a bunch of really long URLs below that you might want to check out. Meanwhile, as for self examination, the panel didn't say not to examine yourself; it said that teaching BSE has been shown to be completely and utterly ineffective in improving outcomes. It's a waste of time, money and energy. Damn. Don't we all agree we need to get smart about our health care?

  11. This article does a decent job.

    "For example, the relative survival benefit of 20 percent among women 40-74 who had mammograms in the Swedish trials translates to 511 women dead of breast cancer out of 130,000 who were screened for 15 years—a death rate of 0.4 percent.

    Among the comparison group of 117,000 Swedish women who did not have mammograms, the breast cancer death count was 585 women, or 0.5 percent. True, that’s a 20 percent relative benefit in favor of mammography. But 0.4 and 0.5 are very tiny numbers."

    (Note that was 40-*74*, not just 40-50.)

    It's been really badly handled by the media in general, who have done very crappy at explain the benefits/risk of almost every medical debate.

  12. Okay! Uncle! I will stick to baking and chickens in future!

    Pete: Maybe the report only said that "teaching" self exams is useless, but is that not because self exams themselves were deemed useless? The message in the media has been that breast self exams themselves do no good, lead to unnecessary biopsies without reducing cancer deaths. This strikes me as very close, if not tantamount, to a recommendation to skip them altogether. But I have not read your URLs yet.

    Melissa: That is a good piece.