Silversea Water Cooler: Welcome! Part Four

That Guiness looked mighty fine.....and it's only 6:30 am here.....!

Yum. Just YUM.

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Yum. Just YUM.

 

 

 

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England is just walking, er, running, all over Panama.

Dominating is the word!

What a game.

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Good Afternoon all .....

That was a lovely meal S!

Yesterday we had chicken in lime and stirfry and today was sousvide lamb shank with veggies.

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Jeff - Do you actually sous vide/water bath food at home? Personally I think this technique is a convenience tool for restaurant chefs, most of whom can't cook a proper piece of fish or meat. They just let the food sit in the water bath for hours on end, fish one out and brown it in a pan. I don't call that cooking. I first became aware of the technique at a highly regarded restaurant, Hambleton Hall, when my poulet de bresse had a rather weird, artificial texture. The waiter said it had been water bathed. I'll avoid it wherever I can. I guess cruise kitchens use it a lot.

Jeff - Do you actually sous vide/water bath food at home? Personally I think this technique is a convenience tool for restaurant chefs, most of whom can't cook a proper piece of fish or meat. They just let the food sit in the water bath for hours on end, fish one out and brown it in a pan. I don't call that cooking. I first became aware of the technique at a highly regarded restaurant, Hambleton Hall, when my poulet de bresse had a rather weird, artificial texture. The waiter said it had been water bathed. I'll avoid it wherever I can. I guess cruise kitchens use it a lot.

I use to and was an early (domestic) adopter and bought a decent "bath". However since then so many people offer excellent food I no longer bother. My rule is only take trouble where I can add some value. I also feel that sousvide is of limited value in a domestic kitchen and it is now in the larder with the vacuum machine and hasn't been used for a while. Frankly for the home cook, once the novelty has worn off, it is pretty much a complete waste of time and cash.

However your characterisation is the normal one. Firstly bad technique will produce a bad result and over-use inappropriately is equally bad.Over lengthy cooking produces a nasty overly soft texture to proteins. It is a myth that you can leave proteins in a bath for ever without killing it. It does one thing that cannot be done in any other way. It is the pasteurising issue of long-term low temperature cooking that makes what might otherwise have been unsafe, safe. Because food is made safe through the combination of time and temperature you can do things like cook chicken at a longer but much lower temperature so it is more flavourful and a temperature that would be unsafe if it were a shorter time. But in my case seeing chicken that colour does things with the brain and all my self-preservation instincts locks in and I do not get full enjoyment!

Also when it comes to beef for example you can get a degree of tenderness otherwise not possible although you would need to finish it off by caramelizing the surface ie "the mallard reaction". It is wonderful for rib-eye and some steak restaurants keep steaks in bulk to say 110 degrees and finish it to doneness on the griddle. Long time ago I noticed a picture by another poster of a steak on SS that seemed to have been sous vide as the colour was the same from edge to edge. A griddle wont do that. It is also good for fish, particularly salmon. However I really only cook fish one of two ways. It is either en papillote or dredged and deep fried.

It has two real distinct uses. It is a great industrial catering tool. It is great for producing soft textures and producing a very precise degree of doneness in proteins.

Good Afternoon all .....

 

That was a lovely meal S!

 

Yesterday we had chicken in lime and stirfry and today was sousvide lamb shank with veggies.

 

 

 

 

 

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Yo’re photos are making me hungry Jeff.

Just home after a 3 hour drive, with an empty fridge.

Do you do delivery?

Thanks all, for your lovely comments.

Love your funny Mysty.

Happy Sunday all.

Home delivery!?!

I'm not a bleedin' midwife! :D

Your Sunday Clarkson M!

A little gift I’d love to give the man who stole my TV: extreme police brutality

https://www.thetimes.co.uk/article/jeremy-clarkson-a-little-gift-id-love-to-give-the-man-who-stole-my-tv-extreme-police-brutality-nqhmxmtwh?shareToken=d7fe1314fb716c5b53035fb75ef6e0c8

.....and something else that may be of interest ....

Cheap, faulty and pumping death straight into the veins

https://www.thetimes.co.uk/article/cheap-faulty-and-pumping-death-straight-into-the-veins-hlb0xncw0?shareToken=15b4abc92485042107c53249190e5c0d

Thanks for remembering me J! That one was dark! He is obviously not a fan of the police service!

Good evening all from a beautiful sunny and glorious Wales,

Mysty I love the funny. One of those cats looks just like my big ginge.

Jeff, loving the look of those lamb shanks.

Chuckles at the Clarkson.

J...the second article link is horrifying! Any wonder why people are not keen to introduce medications into their lives? And hospitals do not seem to be very safe places!

Glad that Coolers enjoyed the cats! :)

J...the second article link is horrifying! Any wonder why people are not keen to introduce medications into their lives? And hospitals do not seem to be very safe places!

 

Glad that Coolers enjoyed the cats! :)

Hi M,

The core story concerns a doctor who appears to have “shortened the life” of at least 650 people. It is bewildering that so far although there has been shock but it has all been muted. She hasn‘t been charged and there has been a huge cover up. If this had been in a private hospital then it would be extremely noisy.

The NHS has a weird place in the British heart. It is enourmously wasteful and lots goes wrong but it is almost considerd worst to criticise the NHS than it is the Queen. If your memory is good you may recall an old boss of mine who I was fond of and abandoned me (Sir Len Peach) recently died who left us temporarily we thought but shortly after was Chief Exec of the NHS for a while and I wish I could report some of the stories he told. I think it is supposed to be the or one of the largest organisations in the world and he said it was almost completely ungovernable.

Norman Lamb who was the minister who halted the cover up and ensured an enquiry writes today ........

Never again must a patronising culture leave bereaved families disempowered and ignored

https://www.thetimes.co.uk/article/norman-lamb-never-again-must-a-patronising-culture-leave-bereaved-families-disempowered-and-ignored-jml5mczmw?shareToken=5465c142dc5d6f6530719866c7473149

Doctor gave fatal doses of painkiller

https://www.thetimes.co.uk/article/jane-barton-the-police-interview-dnrfr7r02?shareToken=5ab968ac5e5d4974d783881b81d463d5

Good evening all from a beautiful sunny and glorious Wales,

Mysty I love the funny. One of those cats looks just like my big ginge.

Jeff, loving the look of those lamb shanks.

Chuckles at the Clarkson.

Glad you enjoyed it Dave :)

J...we have experienced the same kind of problem here. A nurse in a senior care home was convicted of killing 8 seniors.

http://www.cbc.ca/radio/checkup/support-workers-doling-out-pills-in-nursing-homes-are-under-qualified-some-health-professionals-say-1.4719689

"Last year, Wettlaufer, a nurse, was convicted of killing eight senior citizens, and trying to kill or harm six others, while working in seniors' homes in southern Ontario between 2007 and 2016.

The public inquiry into those deaths has learned there were serious red flags raised about Wettlaufer, including a litany of medication errors she had committed. Yet she was allowed to continue nursing."

At least she was eventually caught and will be incarcerated. The other issue currently here is the abuse of seniors in long term care facilities by staff as well as by fellow "patients". Growing old is not for the faint at heart!

Home delivery!?!

 

I'm not a bleedin' midwife! :D

:')

Thanks for the Clarkson link, great read.

The second is shocking and disgraceful.

I went through an horrific experience last year. A very dear friend of mine was very poorly. She had been given only weeks to live. She was transferred from the hospital to a very well regarded local hospice and she was put immediately onto a “driver”. 24 hours later she was unconscious. 24 hours after that she was dead. I buzzed to go into the hospice. Eventually they let me in after 20 mins buzzing. I went to her room, she was stone cold with her mouth wide open. I couldn’t close her jaw or move her arms. I pressed the buzzer for the nurse. After sitting with my friend for 15 mins I went to find a nurse. They told me she was quite comfortable 1/2 an hour ago when they checked on her. She must have been dead for a good couple of hours considering the level of Riga mortis. Unfortunately the use of these drivers with life ending drugs is a very well kept secret and seems to be common practise.

Oh DW...what an awful experience! So sorry for your friend and for your, what must have been, traumatic time. When things happen behind a curtain of "don't tell" the effects are devastating.

It was M. Luckily I was able to shield her husband from the worst of it. I Went through it all with my Nan in 2003 and didn’t understand what they were doing at that time. This time I had an idea about what was going on but apparently she was unconscious because the ambulance journey from the hospital to the hospice had “tired her out”. It’s the best kept secret in medicine. The media are making a fuss about the quality of the drivers being unreliable but anyone that’s been there knows it’s the “cocktail’ of drugs injected that free up the beds much quicker.

Horrifying DW and depressing in the extreme! I would consider euthanasia rather than face the kind of treatment that seems to loom in our future. Canada has recently legalized it. There is something so dehumanizing in our treatment of older folk. A peaceful dignified death would be my preferred option. Sorry to be a downer here.

No probs mysty. I Also apologise if this is a bit downbeat. My experience is that it is actually euthanasia without having the legal complication of calling it that. The professionals seem to hide behind “keeping things pain free” despite people insisting that they have no pain before they take this route. It’s high time we had an adult debate in this country about end of life care rather than this dishonest pussyfooting, not properly explained to loved ones at such a difficult time because of the legal ramifications.

I agree DW! I think we are kinder to our pets than we are allowed to be with our loved ones. If the person is aware enough to make a choice for themselves I think that choice should be available. The medical community lying about using the option when the person is not aware enough to make the choice is unethical and hurtful. When the end is coming and there is no longer any hope and the person is suffering what is the benefit of "life-saving" measures?

So true m. It’s heartbreaking that politicians turn a blind eye to the practise so that they don’t have to face up to a difficult debate. We can only hope that this scandal gives them no choice. Seeing how the focus on the BBC has switched in the last 24hrs from life ending drugs to “faulty syringes that the NHS were warned about years ago” I douubt it.

This is why we have needed such a significant contribution from the Palliative Care teams.

Dave, what a horrible experience. Nobody should have to go through that.

M, it is hard to switch gears from saving a life, to counseling a patient to forgo said life-saving treatment. We have to do it frequently in the ICU and sometimes it's the move to the ICU and an up close and personal understanding of just what is involved in "life-saving treatment" that makes people suddenly decide that it's not for them. Other times we try and fail, then care can be withdrawn. One of my teachers told me that 50% or more of the deaths that take place in ICU are negotiated (that is, care is withdrawn or not escalated further in the setting of terminal disease).

But these conversations are hard! I've been having them with patients and families for 20+ years and although you get more experienced, they don't get any easier. That same teacher told me that if your hands don't get sweaty during these conversations, you're not really caring or invested in the process. True! And when something is that hard, isn't it just easier to "do everything" and let someone else do the heavy lifting?

I now teach my residents two things. One, there is always something that you "can" do for a patient, but any physician can do that. The excellent physician will take it a step further: figure out if you "should" do something. Principle two (related) is that you need to learn when to sit on your hands. When you are sitting on your hands, you can't use your hands to write ill-advised orders for ineffective medical care...

The issue with the principle of double effect (I think) is not explained very well in the article, and it is given a very negative slant which I don't think it deserves. The premise is that it is a greater good to palliate symptoms in a terminal patient who is suffering needlessly, even if the drug used for palliation may hasten death. It really only applies when the patient has decided not to pursue more aggressive therapy.

The converse is worth bringing up, in order to fully understand the principle: if you are terminal and suffering, is it ethical to withhold morphine because it may hasten your death? Would you really want that? Would your loved ones want that? Ethically it is a greater harm to not treat those symptoms. People don't die like they do in the movies. It's messy and painful. You don't really want to be aware, most of the time.

However, that has to be done with full disclosure. Slipping extra narcotics to a comatose patient to help them along faster is an ethical boundary which few of us would want to cross. I prefer palliative care to euthanasia, but I would have a hard time denying somebody that right. But if the perception is that a payor is condoning that behavior to save money or open up beds... Isn't that dangerously close to the "death panels" that we in the US were so scared about when we had the debate on universal health care?

We used those syringe pumps forever, but only for antibiotics or other stuff where it didn't matter if it went in a little slower or faster. Sensitive meds like narcotics are delivered by an infusion pump.

Enough medicalese. Time to make lunch for tomorrow and try to get some sleep.