About Doc on the Run About Doc on the Run Active Duty Army Acute Care Surgeon. Nomad. Runner. Music aficionado. Culinary amateur. Intermediate-level technology nerd. Christian. Inquisitive life-long learner. My primary passion is surgery, and my life has been dedicated to becoming a trauma surgeon. After graduating high school at 17, I attended the University of Missouri, Kansas City, a six-year medical school. I was commissioned in the Army and completed 6 years of General Surgery residency in Augusta, Georgia. Board-certified in General Surgery. For 3 years, I was a staff General Surgeon in North Carolina and deployed to Iraq, Kuwait, Jordan, and Africa. Board-certified in Surgical Critical Care and completed a two-year AAST Acute Care Surgery fellowship in North Carolina. I spent two years in San Antonio, Texas, and then 1 year in South Korea, where I finished out my career on Active Duty. Photo courtesy of JW, 2013

Disclaimers for Vignettes Disclaimers This website is provided for educational and informational purposes only and although every effort has been made to present accurate information, this is not a substitute for professional advice. Always seek guidance from a qualified healthcare provider or physician for inquiries regarding medical conditions, treatments, or before embarking on any new healthcare regimen. Never disregard professional medical advice or delay in seeking it due to information found here. If you think you may have a medical emergency, call 911 or go to the nearest emergency room immediately. No physician-patient relationship is created by use of this website. The practice of medicine relies on using the best available evidence, but clinical scenarios often lack clear-cut answers. Every clinical situation is unique, and no single solution applies universally. Clinical guidelines attempt to provide recommendations that apply in most situations, but that are not one-size-fits-all solutions and they do not replace clinical judgment. The infinite variety of patient, disease, and environmental factors influencing clinical decision-making cannot be fully accounted for in medical literature. Therefore, any variance in the approach of physicians from what is presented here does not necessarily signify an error on their part. Some of the images on this website contain graphic content that may be disturbing or distressing to some audiences. Viewer discretion is advised. HIPPA- vignettes are presented to provide clinical education, with considerable care to prevent any patient from being identified. Protected health information and patient identifiers (name/ location/ date/ occupation/ contact information/ identifiable photos/ numerics such as SSN/MRN/insurance) have been withheld. Unique details have been removed from text and images. Details that don't impact the clinical case, such as age and gender, have been modified to obscure each patient's identity. Many stories are heavily modified to highlight the key learning points and some scenarios are complete fabrications. The scenarios span my entire 17 years of experience in the medical field, and they are seen on a routine basis in our field. I have not shared one-of-a-kind or sensational cases because the risk of disclosing identifiable details heavily outweighs any potential educational benefit. The views, opinions, and assertions expressed herein are those of the author and do not reflect the official policy or position of the Department of Defense. These scenarios are not designed to portray the comprehensive evaluation and management of acute care surgery patients. Many common steps are omitted, as the intent is to highlight unique learning points for different clinical scenarios. Trauma scenarios DO NOT teach all the basic principles of ATLS, so there is a minimal repetition of basic principles (primary and secondary survey). Any of the products found on this website are not specific endorsements. I do not receive any monetary compensation or non-monetary incentives for the sale of any items seen here.

Medical Literature Evidence-Based Medicine After you have established a firm foundation of the basics of your chosen specialty, you're ready to develop regular habits to stay up to date on the newest research. Evidence-based medicine is the basis of high-quality patient care, but it can seem overwhelming to try to keep up with the ever-growing body of research. There are countless journals, and it would be time-consuming to search them regularly. So how does one go about navigating the vast ocean of available data? Registering for email alerts is a simple way to get notified when there are new publications. With a quick skim through the article titles to see if anything is relevant, followed by a review of the abstract/ article itself, you can be on the cutting edge of the latest information in your field. Several require individual registration, but it's a very simple and quick process. Many journals require a subscription, often available through your medical school or hospital library. If you are military, you have access to AMEDD Virtual Library (abundant medical resource collection). Thankfully, three publishers (LWW Wolters Kluwer , Springer and Elsevier ) have centralized their journals, so you can quickly subscribe to several journals [these journals are designated by L, S or E]. Medicine and Critical Care Journal of the Ameri can Medical Association New England Journal of Medicine Intensive Care Medicine Critical Care Medicine (L) Current Opinions in Critical Care (L) Journal of Intensive Care (S) Critical Care (S) Journal of Critical Care (E) Critical Care Clinics (E) Surgery World Journal of Surgery World Journal of GI Surgery JAMA Surgery J Gastrointestinal Surg Advances in Surgery Annals of Surgery (L) Annals of Surgery Open (L) BMC Surgery (S) Surgery (E) American Journal of Surgery (E) Journal of the American College of Surgeons (E) Surgical Clinics of North America (E) Advances in Surgery (E) Trauma and Emergency Surgery European J Trauma and Emergency Surgery Trauma Surgery and Acute Care Open Journal of Trauma and Acute Care Surgery (L) World Journal of Emergency Surgery (S) World Neurosurgery (E) Other Specialities Journal of Neurotrauma World Journal of Cardiology JAMA Cardiology JAMA Neurology JAMA Network Open Anesthesia and Analgesia (L) Current Opinion in Anesthesiology (L) Current Opinion in Clinical Nutrition (L) Current Opinion in Infectious Diseases (L) Current Opinion in Neurology (L) Diseases of the Colon and Rectum (L) Journal of the American College of Cardiology (E)

< Back National Parks Yellowstone and Grand Tetons This is NOT by any means an all-inclusive list of things to see and places to stay. This is based on my personal itinerary. I arrived around noon on a Monday at the East Entrance to Yellowstone, and explored the eastern side of the Grand Loop that afternoon, and spent the night at Lake Lodge. Tuesday, I explored the southern side of the Lower Loop and the western side of the Grand Loop, and spent the night at Mammoth Hot Springs Cabin. Wednesday, I went horseback riding at Roosevelt Corrals, and then drove along the eastern side of the Grand Loop to the south entrance of the park and then onto Grand Tetons, spending the night at Colter Bay Village. Thursday, I spent the morning hiking around Jenny Lake, and then went whitewater rafting in the afternoon. Friday morning I departed (drove back up to the East Entrance of Yellowstone to head to Cody, Wyoming). Yellowstone Things to See *Artist Point- short walk from the parking lot, there is a lookout point with great views of the Lower Falls. Then there is a 2.7 mile hike along the “Grand Canyon of Yellowstone”. No guardrails/ fence along the route, with vertical sheer right off the trail. No narrow passings, so it’s safe as long as you are responsible. *Mud Volcano- short half mile loop, less steep to start at the southern trailhead (to the left when you are looking from the parking lot) and loop clockwise, lots of steps down at the end of the loop. *West Thumb Geyser Basin- boardwalk around multiple basins/ fumaroles. Lots of pretty colors. Right along the Yellowstone Lake. About ¾ mile walk, easy. *Old Faithful- I got here early in the morning, so parking was easy. Later, people are circling the lot. Lots of boardwalk to explore the different geysers. If you want to have a short moderately strenuous climb to the Old Faithful Viewing Area (Observation Point Trailhead)- if you face Old Faithful, walk to the right and you’ll get to the turnoff point to the Observation Point. Loops back down so you can walk amongst the geysers near Old Faithful. *Grand Prismatic Spring Overlook- this is how to see the Grand Prismatic from above. Started at Fairy Falls Trailhead parking lot, walked to overlook (maybe 1.5 miles, pretty flat, except for a brief uphill climb to the overlook), and then continued on to Fairy Falls trailhead. Also an easy flat walk, but it’s a couple miles out and back. The falls are beautiful. *Midway Geyser Basin- pretty short boardwalk loop (careful, narrow boardwalk by the Spring). You can see the Grand Prismatic Spring and Excelsior Geyser from ground level. *Lamar Valley- opportunities to view wildlife. Lodging Lake Lodge Cabins- very rustic/ simple. Just a bed, sink, shower, toilet. Mammoth Hot Springs Hotel and Cabin- slight step up from Lake Lodge. Links Yellowstone Lodging Reservations Yellowstone Park Maps Yellowstone Roads - detailed descriptions of the landmarks along each section of the roads through the Park. I used this after the trip when I forgot to note a location where I stopped to take pictures or take a hike. Best Trails in Yellowstone (AllTrails) - I got all the descriptions for the trails I planned to hike. Grand Tetons Things to See *Jenny Lake- the boat ferry takes you across the lake so you can avoid about 2-2.5 miles of walking (one-way). But you have to get there really early (like before they even open) or you’ll be waiting in line and it is probably faster to walk versus wait in line. Lots of different trail options (Inspiration Point- decent incline, Hidden Falls, etc). Lodging Colter Bay Village- slight step up from Mammoth Hot Springs. Within walking distance of two restaurants, the general store and Jackson Lake. Links Grand Teton Lodging Reservations Grand Teton Park Maps Grand Teton Roads - same as Yellowstone. Best Trails in Grand Teton (AllTrails) Maps and Guides National Park Maps National Parked National Park Service App You can download the NPS app (above)- when you open a specific park, there is an option to download for offline use. Highly recommend doing this for both parks. When you have your phone in airplane mode and you pull up the maps in the App, you can follow yourself very closely on each trail as you walk. Very very useful. Tidbits There are lots of road turnouts along the entire perimeter drive, as well as places to stop along the Yellowstone River, that aren’t labelled on the map. Military- if you show your active ID or your DD214, you get a free National Park pass. 10% military discount at park stores. There are maps at most of the large trailheads, they request a $1 donation or ask that you return the map when you finish. Things to bring (what I found helpful) Dry sack- the weather is unpredictable, so you might be out on a hike and get stuck in a downpour. Cooler- this is the one I got on Amazon, works very well. Amazon Link Bear Spray- rent it or buy it. There are a handful of pickup and dropoff locations (BearAware ). Previous Next

What is ACS? A day in the life of an Acute Care Surgeon. FAQs. ICU Rounds. Trauma Surgery. Acute Care Surgery What is Acute Care Surgery? Medicine, particularly surgery, has become increasingly specialized, with providers developing progressively narrower expertise. Previously, surgical critical care fellowship was the primary pathway for specialization in the management of critically ill and injured patients. Management of "sick" surgical patients, regardless of the underlying surgical etiology, requires flexibility in addition to width and breadth of knowledge to manage a wide spectrum of clinical challenges, including deranged physiology and complex surgical pathology. Balancing an acutely hemorrhaging patient, an elderly patient with severe poly-trauma, a ventilator-dependent patient with an acute abdomen...the list is endless. Acute Care Surgery (ACS) was brought about to ensure that there is access to a specialized physician that can manage a spectrum of critically ill patients, including trauma, emergency general surgery (EGS), and surgical rescue . Surgical rescue involves the management of procedural complications or clinical situations that require emergent surgical intervention: "airway emergency, hemorrhage, intestinal obstruction, perforated viscus, tube/line/device dysfunction, uncontrolled sepsis with a surgical etiology, visceral ischemia, and wound complication." Management can include the following interventions: "airway intervention, biliary repair/ reconstruction, bowel resection, hernia repair, hemorrhage control, source control of infection, surgeon-guided resuscitation, tube/line/device repair, and wound debridement."(1) Pillars of Acute Care Surgery 1. Kutcher ME et al. Surgical rescue: The next pillar of acute care surgery. J Trauma Acute Care Surg. 2017;82(2):280-286. 2. Kutcher M.E., Peitzman A.B. (2017) A History of Acute Care Surgery (Emergency Surgery). In: Di Saverio S., Catena F., Ansaloni L., Coccolini F., Velmahos G. (eds) Acute Care Surgery Handbook. Springer, Cham. Who Is Our Patient Population? Read More A Day in the Life of an Acute Care Surgeon Read More What happens during Surgical ICU (SICU) Rounds? Read More Who is on the Trauma Team? Read More What happens in the trauma bay? Read More The Trauma Bag Read More Frequently Asked Questions Read More Definitions Read More More Information on Acute Care Surgery Read More

Surgery trainee education. Trauma surgeon. Acute Care Surgery. Collaboration Interested in being a guest contributor? Any suggestions and contributions will be promptly reviewed and added to the appropriate page/ subpage. The contributor will be noted on the website- you can choose if you want your name or Twitter handle or whatever other identification you would like (or none at all if you would like to be anonymous). Content currently under development. Note- this list is NOT all-inclusive. Database of clinical vignettes in key topics of trauma, critical care and emergency general surgery. Focused on more complex scenarios (ie not run-of-the-mill appendicitis)! Please check out the vignettes I currently have to get an idea of what I’m trying to create- and reach out with any suggestions or cases. Literature reviews - deep dives, high-yield articles, etc Procedural or skill tutorials (pre-peritoneal packing, using the ultrasound in critical care, reading a chest x-ray). Each tutorial is followed by a list of primary sources, encouraging readers to pull information from multiple references. If there is any particular procedure or skill that you would like to create a tutorial for, or something that is currently on the website that you would like to enhance (for example, more advanced ultrasound techniques or ventilator settings), please feel free to reach out with suggestions! There is a wide array of other content that you can add to as well. Note templates Recommendations on networking opportunities Recommendations on social media accounts to follow Educational resources (textbooks, journal articles, training courses, web based open access medical education) Please send me an email (form at the bottom of the page) or contact me on Twitter @doc_on_the_run if you have any questions or want to submit something.

Critical Care Medicine. Trauma Surgery. Evidence-based medicine. Doc on the Run. Medical Literature. Welcome to Doc on the Run! A look into the life and mind of an Acute Care Surgeon Sharing the knowledge and wisdom gained after 38 years of life (and over 20 years in medicine). For those who want to learn about the specialty of Acute Care Surgery , you will find insight into the profession, both from personal experiences and citations from articles and websites. For those interested in the medical profession, particularly surgery, you will find career management tips , including networking and mentorship . For learners (students, residents, fellows), you will discover a wide array of educational resources, including recommended educational resources , tutorials on a multitude of topics, a collection of didactic lectures and quick reference guides , an ever-growing library of literature reviews , and clinical vignettes . For fellow Acute Care Surgeons, please consider collaborating and sharing your experience and wisdom with the next generation. For the bibliophiles, check out the constantly expanding list of book recommendations .

< Back Dogs #1 Supplies This is not professional/ medical advice. These are all based on my personal experience. I’m not a paid sponsor for any of these items. I have included reviews where appropriate. Treats and Edible Chew Items Bully Sticks- WOOF Bully Sticks Dog Treats, Made with Grass-Fed Beef Amazon Link Training treats- Pupford Freeze-Dried Training Treats Amazon Link Training treats- Pupford Soft and Chewy Training Treats Amazon Link Bison- Tilted Barn, Miniwags, Bison Recipe Chewy Link Chicken, Jones Natural Chews- Tender Taffy Soft Chicken Blend Jones Link Salmon and Sweet Potato- Trader Joe’s Ebay Link (picture—go in person!) Chicken- Trader Joe’s Jerky Sticks, Chicken Recipes Ebay Link (picture—go in person!) Pupsicles- WOOF Pupsicle Refill Pops Amazon Link Pupsicle Silicone Mold Amazon Link Lick Mats Amazon Link Notes: Pupsicles are advertised to last 20-40 minutes…my pup finishes them in about 5 minutes. So they aren’t a very cost-effective treat for her. But if your pup is a less aggressive licker, these refills, as well as a mold so you can prepare your own homemade pops, might be perfect for you! Lick mats have become very handy for grooming- I load them with wet dog food, freeze them and they last for a long grooming session. “Safe” Chew Items - made of edible material, although not specifically intended for consumption Sticks- Pupstages Dogwood Dog Chew Toy (Size Large) Amazon Link Sticks- Pupstages Dog Chew Toy (Natural and Hemp Flavors) (Medium) Amazon Link Nylon Chew Toys- Benebone Dog Chew Toy- puppy phase Amazon Link Ropes- Hemp Rope Dog Toys Amazon Link Meal Time Dry kibble, puppy food, Purina Pro Plan Chicken and Rice Amazon Link Dry kibble, adult food, Purina Pro Plan Chicken and Rice Amazon Link Wet food, puppy, Purina Pro Plan Chicken and Rice Amazon Link Wet food, adult, Purina Pro Plan Chicken and Rice Amazon Link Snuffle mat Amazon Link Slow feeder, West Paw Toppl toy Amazon Link Slow feeder, puzzle ball Amazon Link Dog food containers Amazon Link Notes: My pup uses her snuffle mat for almost every meal, occasionally uses the puzzle ball or other puzzles like toilet paper rolls. Similar to the lick mats, the West Paw Toppl toy can be filled with wet food and frozen. This will provide a long licking session. Crate Crate- MidWest Homes for Dogs Amazon Link Exercise pen (ex-pen)- MidWest Homes for Dogs Amazon Link Pet Camera, Remote Controlled Security Camera Amazon Link Notes: I used the exercise pen for the first few nights my pup was home with me, but she quickly learned how to climb over it (don’t ask…I have no clue). But then I used the panels fully extended to prevent her from accessing things in the house, such as the bookcase and TV stand, as she learned boundaries. Puppy Problem Solving Pet Odor Eliminator- Angry Orange Concentrate Amazon Link Vinegar and water (50/50 mix) in a squirt bottle Notes: Vinegar and water is a great natural option for cleaning puppy pee accidents on solid surfaces. I used Angry Orange for accidents on absorbable surfaces, like the rug or car seat. Training Treat pouch, Mighty Paw Amazon Link Treat pouch, Lanney Amazon Link Clicker Amazon Link Belt with bells for potty training Amazon Link Scent Training, Race&Herd Original Dog Scent Training Kit Amazon Link Notes: Both treat pouches have a main pouch and a front pouch (net pouch and zipper pocket), can either be worn over the shoulder/ across the chest or clipped around the waist like a fanny pack. Both have poop bag pouches. The Mighty Paw pouch has a magnetic opening, while the pouch has a drawstring opening. Travel Dog sling carrier Amazon Link Car seat Amazon Link Water bowl, collapsible, with carbiner for easy carrying Amazon Link Notes: I used the dog sling carrier during puppy socialization before my pup was fully vaccinated. Bath and grooming Hand-held shower head with 6 ft. hose Amazon Link Shampoo- Wahl USA Gentle Puppy Shampoo Amazon Link Detangling Spray- BioSilk for Dogs Amazon Link Slicker Brush- Coastal Dog Slicker Brush Amazon Link Grooming scissors and comb set Amazon Link Clippers- Andis, 2-speed, Corded Electric (with size 10 blade) Amazon Link Additional clipper blade, size 7 Amazon Link Additional clipper blade, size 3 ¾ Amazon Link Clipper comb guards Amazon Link Grooming Table- Yaheetech 46'' Pet Grooming Table, Weight Up to 265Lb Amazon Link Other Hygiene Toothpaste and toothbrush- Vet’s Best (peanut butter flavor) Amazon Link Nail clippers Amazon Link Styptic Powder- DOGSWELL Remedy Recovery Amazon Link Dog cleaning wipes (Arm and Hammer wet wipes) Amazon Link Eye wipes- Earth Rated Vet-Developed Dog Eye Wipes Amazon Link Eye comb (for eye boogers) Amazon Link Ear powder (for plucking ear hair)- Miracle Care Ear Powder Amazon Link Paw cleaning brush- shampoo with built-in silicone brush Amazon Link Paw cleaning cup with internal silicone bristles Amazon Link Notes: I do NOT endorse ear plucking. This is a discussion you should have with your veterinarian. However, if you do pluck, this stuff works really well. Apparel and Winter Gear Fleece Jacket, Gold Paw Series GoldPaw Link Winter Jacket, Plaid Amazon Link Winter Jacket, RuffWear Powder Hound Dog Jacket RuffWear Link Winter boots- Youly, The Adventurer, All-Weather boots PetCo Link Summer boots Amazon Link Paw Wax- Musher's Secret Amazon Link Post-spay body suit, BellyGuard surgery recovery suit Amazon Link Notes: Winter boots were an in-person purchase at PetCo, when we had a surprise snow storm and Amazon delivery wasn’t available. They fit really well, although the velcro isn’t very hearty- I’ve had to repair them by hand. Leashes, Collars and Tethers Collar, neoprene and nylon Amazon Link Collar, nylon, waterproof (doesn’t bleed color onto fur) Amazon Link Identification tag, silent, slide on collar Amazon Link Medium-length nylon leash, 15 ft- Hi Kiss Dog/Puppy Obedience Amazon Link Chew-Proof Tether, 6 foot Amazon Link Chew-Proof Tether, 50 foot Amazon Link Back-clip harness for car rides Amazon Link Notes: Bovie loves chewing leashes, and we went through several nylon leashes before I wised up and purchased chew-proof varieties, specifically for tethering in the house. For example, when she was a puppy, we trained her to stay on her place during mealtime, and she was tethered as a reminder. When we are outside eating or working, she has a 50 foot tether so she doesn’t take off down the hill or into a neighbors yard. I don’t keep her tethered for extended periods of time and she’s never unattended while tethered. Previous Next

< Back Dogs #2 Helpful Resources Calculate daily calories and water requirements for your dog based on weight, age, and whether they are neutered or intact Merck Vet Calculator Puppy Socialization .pdf Download PDF • 38KB Previous Next

Your Words Matter...And OCD isn't an Adjective "That's So Gay" Your Words Matter...And OCD isn't an Adjective "A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder." - DSM V (Diagnostic and Statistical Manual of Mental Disorders) Psychiatric disorders are a constellation of traits that impact a person's interaction with their environment. A formal diagnosis is based on a constellation of symptoms as well as an assessment of how functional the person is in their daily life. These disorders are outside the control of the individual, and they are pervasive in a way that interferes with daily life. We all have traits that could fit with a psychiatric diagnosis, but that doesn’t permit us to use the diagnosis as an adjective. We've all heard someone call themselves ADD because they're occasionally distracted or forgetful. People might call themselves or someone else OCD if they like a neat tidy environment. Bipolar is frequently used to describe (or insult) emotional people. What's the problem with using ADD as an explanation for occasional absent-mindedness, or calling someone bipolar because they are moody? Equating the presence of a trait of a disorder with an actual diagnosis minimizes the real struggle that many people experience every day. This is similar to using the words “retard/ retarded ” or “gay” to mean something is stupid or weird. In 2009, the Spread the Word: Inclusion campaign was created to eliminate the use of the “R-word”. In 2010, Rosa’s Law relabeled “mental retardation” to “intellectual disability”. The words “imbecile”, “idiot” and “moron” have also been relabeled as profound, severe, or moderate intellectual disability. The Stonewall Education Guides: Tackling Homophobic Language , which was published nearly 10 years ago (no date identified, but the document quoted literature published in 2012 describing “the previous 5 years”). They listed “that’s so gay” and “you’re so gay” as the two most commonly used homophobic phrases. They report that these phrases “are most often used to mean that something is bad or rubbish, with no conscious link to sexual orientation at all…a pupil might say ‘those trainers are so gay’ (to mean rubbish or uncool) or ‘stop being so gay’ (to mean stop being so annoying). Check out these PSAs discouraging people from using the phrase “that’s so gay”. "That's So Gay" Commercials Win Top Ad Council Award (starts at 1:16) Wanda Sykes Talks to Boys in a Diner Just like gay and retarded have been used out of their appropriate context to mean something is bad or stupid, here are some of the common traits that people mislabel as a "disorder" - OCD: excessive cleanliness, being overly tidy, “Type A” personality - ADHD: a tendency to make careless mistakes, forgetfulness, short attention span, easily distractable, tendency to interrupt conversations. - Depression: sadness, pessimistic, being an introvert - PTSD: bad memories associated with something trivial (the sound of a pager going off), bad dreams, fear of a particular event - Insomnia: occasional trouble initiating or maintaining sleep - Bipolar: moodiness, decreased need for sleep. - Anxiety: normal levels of anxious feelings It might not seem like a big deal- but try to imagine if you had a disorder that made normal interaction with your environment a struggle? Now imagine someone who can function normally but has a couple of “quirks” were to equate their experience with yours? You might feel that they are minimizing your disorder, invalidating your struggles- this might leave you feeling misunderstood and alone. Please think before you speak. Your words matter. Previous Next

< Back Sausage Tortellini and Brussels Sprouts Ingredients Sausage Tortellini 2 Tbsp olive oil 2 lbs sausage 2 cloves garlic, minced 1 c vegetable broth 2 c tomato sauce ½ c heavy cream 18 oz tortellini Salt & pepper Brussels Sprouts One package of Brussels Sprouts olive oil black pepper sea salt balsamic vinegar Instructions Sausage Tortellini Heat oil in a large skillet and cook sausage links about 5-7 minutes, until sausages are browned throughout. Add garlic and heat for 30 seconds. Remove sausages from skillet and slice into bite-size pieces. Return sausages to pan along with broth, tomato sauce, cream, and tortellini. Season with salt & pepper. Cover and simmer for 12 minutes. Brussels Sprouts Prepare sprouts by trimming the base and then cutting the sprouts in half or quarters, and then place them in a medium-sized bowl. Drizzle a small amount of olive oil and balsalmic vinegar, and then sprinkle black pepper and sea salt. Toss to coat the sprouts, let sit for at least 30 min. Roast at 400 for 20-30 min, toss halfway through. Sausages cooking Previous Tortellini in Sauce Brussels Sprouts Next

How to be a Terrible First Date Dating, Pt 2 How to be a Terrible First Date Recently, I was set up on a blind date. He seemed like a normal mature guy via text. Polite, intelligent responses, etc. We agreed to meet at a local bakery. My first clue should have been the fact that he didn't have the fortitude to message me first. I don't do a great job of taking my own advice…I had told myself I wouldn't message first, that he would have to be the guy and reach out first. Oops. When I showed up, he was sitting outside. I sat down and he asked if I wanted to order something. He told me they have great food and good coffee, to which I replied that I don't drink coffee. And the date careened downhill from there. His response? Not drinking coffee is a red flag that a woman isn't a good partner. Goes along with not liking chocolate. He declared that if something else goes wrong later in the relationship, you can look back and say yeah they told me there was something wrong from the beginning. Then he went off on a tangent about how people who don't eat the same kind of foods won't be compatible in relationships. For example a vegetarian and a vegan. More specifically, a really douchey vegetarian or vegan. I didn't know people still used that word…actually, I didn't know that it was ever used out loud as an adjective by a guy. He continued with other crazy comparisons. Like Jewish people who don't eat pork. Or cannibals. Or carnivores. Told me a story about having a friend who ate dogs. Some context for the dog-eating conversation-- there was an adorable medium-sized fluffy black and white dog sitting about 3 feet away from us. He and his owner are clearly within earshot. He continued…."do you see that dog right there, she (his friend from Asia) would think it would be OK to eat a dog." I didn't know what to say to that. All I could say at that point was that I could never eat that dog, that I couldn't even kill a dog! His monologue about eating continued with an explanation of why humans are the superior beings on the planet. The bottom line was that the thing that makes us the superior being is the fact that we can eat any other animal. It's not our intelligence (dolphins are more intelligent), it's not our technology, we aren't faster or braver. But we can eat any animal. And somehow he related this to the use of smartphones- using a smartphone doesn't make you smart. A stupid person can use a smartphone but still eat any animal. He then delved further into the world of food and eating with a rant about McDonald's. You’ve heard of McDonald's, right? Are you too good to eat at McDonald's? Have you heard of Jim Gaffigan? He does a skit about McDonald's. You ever run into someone at a McDonalds’s and they ask what you’re doing there...you just pretend you’re meeting a hooker. Him: McDonald’s fries are the best thing. Me: not if they’re cold. Him: Well you have to eat them within 5 minutes. After those five minutes, they’re no longer food. Me: But they aren’t always warm when you get them. Him: Then that’s your fault. If you don’t check and you drive away, it’s on you. You can’t blame anyone else. Me: But who wants to be the person who holds up the line in the drive-thru? Him: You have to be coordinated, pay, and inspect the fries all at the same time. And if they’re cold, you hand them back and say these are cold I need new fries. And everyone in that line behind you will understand that. If you drive away and the fries are cold, it's your fault. I tried to change the subject by commenting on the restaurant. Told him there was a place I previously lived that had similar food, but the décor on the inside was quirky. It was awesome because it was open 24/7. His response…there weren't other places open 24/7? IHOP? I asserted that there were not many places….maybe Huddle House. He said he's never been to a Huddle House. I said it's like a worse version of Waffle House. He said, have you ever been to a Waffle House? It's like a truck stop bathroom with a kitchen. I told him, yes, and that Huddle House must be an East Coast thing. He told me they don't have it up north, so I said Ok, maybe it’s a North Carolina thing. Why does everything have to be a disagreement??? Finally, after complaining about not wanting to give up the table he picked, he agreed that we should go in and order food. When we were in line to order, the conversation took on a slightly different tone. He proceeds to lecture me on the fact that making requests or asking questions regarding food at a restaurant is a personality flaw. He also told me that you need to try everything at least twice. Without even knowing me, he was insulting people who make requests at a restaurant. He made some mention of bacon, and I said I don't care for bacon, and asked whether not liking bacon is as bad as not liking coffee or chocolate? He said that's not a big deal in Texas, maybe in North Carolina or Georgia it would be (the last two places I've lived…again, he knows nothing about me). When I asked why I have to try something else two more times when I already know what I like (or don't like), he said, what if you get to be 80 years old, and your tastes have changed? He told me, just go with the flow….he said if he orders beans and they give him rice instead, he'll just eat the rice. Me: But what if you really want beans. Him: Just go with it, order the beans next time. Some people eat dirt and mud. Me: Just because there are people who have to eat dirt doesn't mean we just have to eat whatever is given to us. Him: Don't ask a lot of questions to someone who barely has a high school education. So basically…he doesn't have a spine to ask for what he wants when he eats out. Probably translates into other areas of his life where he isn't able to stand up for himself…just a guess. So now that he's already insulting people who have preferences about food, I had to tell him about a recent outing with work colleagues. We went to an outdoor American food place, and I wanted a plain burger. The only thing they had on the menu was a burger with brisket on top. So I asked my friends if that meant brisket sauce or actual brisket meat. Immediately, my date tells me I asked too many questions. I tried to play along, acquiescing that barbeque is a big deal in Texas. But then, I said I don't eat that much food at one time and I didn't want more meat on my burger. He told me not to complain, and just eat half and give it to a homeless person. He told a story about giving food to a homeless person once in Austin…the homeless person asked if it was gluten-free, and then when he said I'm not sure, and the homeless person said, ok, never mind. So a weird humble brag, talking bad about a homeless person while simultaneously telling me he is a generous person. So again, it was my turn to tell a story about myself to see how he'd insult me some more. Me: I went to a restaurant that I really liked back home and I like the green beans there. I went there one time and they didn't have green beans. Him: You can be sad about that but don't be whiny about it. The restaurant was relatively crowded, kinda looked more like a Saturday morning than a Thursday morning. He did that awkward thing where he says rude things out loud so everyone around us can hear him being insulting. Him: Why are there so many people here? It's a Thursday morning. These people should be at their jobs. Me: You do realize we are here, right? The menu advertised a breakfast sandwich…which I guess I was going to order but had to make sure not to ask questions or tell them what I want. In an attempt to make a sarcastic joke, he asked about whether the sandwich was gluten-free. And if the chickens were free-range. I made a joke and asked if the chickens were treated well and whether they were mocked as children. When we got back outside, he complains about the fact that the table he had been sitting at was taken. Then he walks around and complains that the rest of the tables are equally bad. Not so easy going now, eh?? We sat outside, and as we were waiting for our food, several birds were dive-bombing me, to which I responded like a normal person and ducked. He proceeded to chastise me for not standing up to the bird and not asserting my dominance. He told me it didn't bode well for my offspring that I couldn't stand up to a bird. Stated I would just let my children be pecked to death by birds. Said I'd be helpless, and hopeless for the rest of my life. Literally used those words. Not even implied, straight out said I was hopeless and helpless. Somehow we got on the conversation of working, basically said he only does his job to make money. I asked him if he enjoyed it or enjoyed helping people, and he said being a neurologist was the best he could come up with using the advantages he was born with. He said there was nothing better he could do to make money, to which I replied that he was choosing to limit himself. While we waited, he decided to give me a lesson on animals and nature. On nature shows, the lion is shown as the majestic king of the jungle, but they hide the fact that lions will eat their young. This part was much funnier in person because his tone of voice and storyline was so ridiculous. Like he was actually offended or thought it was a conspiracy that this wasn't shown on TV. He also gave a long monologue about how big birds eat other birds. Like helpless penguins. Birds try to eat their eggs. Sometimes the big bird will be looking down and the other bird knows it's about to get eaten. Other times, the other bird doesn't even know. It'll just be sitting there one moment, and the next moment, hey I'm being eaten. When I turned and spoke to one of the many dive-bombing birds, he proceeded to correct me about calling a bird the wrong gender. He stated that men are the brighter of the bird species because they have to attract the female bird. Told me about watching a show that talked about males of different species trying to attract females. Like fish get the rocks all together to show the girl fish that they can make a nice place, and then the girl fish comes over, so the male fish does a dance, and then if they get turned down by a female, they clean up the rocks and try again. Birds try to make the best nest to impress female birds. Then he told me that males are brighter than females, across all species. To which I disagreed, stating that I don't think men are more colorful than women. He corrected me, saying that’s why men wear ties…. Again, I told him I'm pretty sure females are more colorful. And he said, yea, women just like to shop. He also told me he could tell which was a female bird because they were the ones that ate everything. Yes, he said those words. Out loud. To a woman he'd never met. Throughout the date, he spent 97% of the date not talking about me or asking about me. I did proceed to tell him about the time I was attacked by dogs. And I told him it changed my life. He responded by asking (at least twice) what I did to the dogs to make them attack me. Seriously. Told him my story about the dogs. After I finished, he asked if I was bleeding. I recounted my story of going to the ER…to which he responded with…nothing. No sympathy. No nothing. Told him the rabies shot is really painful because they had to put it in my ankle. He said they probably did it wrong and it was his goal in life to never need a rabies shot. I then told him about how it changed the nature of my deployment…again, no questions about me. I told him it was odd to talk about birds eating each other on a first date. And I didn't know how he planned to get second dates after that conversation. He said he had watched a documentary with his niece and it was something he learned. Then he asked me what I learned. And then just stopped talking and went back to eating. Didn't even eat half my breakfast…so uncomfortable, and I wondered if he would tease me for eating all my food. By the way, he also sat with his feet on the chair next to me, legs straight. Back when we were in line ordering breakfast, I asked if he was cold, cause he had long pants, a sweater, and a long black wool coat. He said, no, he wore that so he wasn't cold… During breakfast, he told me because I had my arms folded that I was either cold or standoffish. Said that a few times over and over to me…and he even mocked me by folding his arms tightly across his chest and scowling. I then laid my hands on the table in front of me. He continued to mock me. Later, he noticed goosebumps and told me I was cold. And then told me because I wasn't furry (or hairy, I don't remember), goosebumps mean I'm cold. Later on, we took a walk along the river walk. It was mostly painfully awkward silence. But a few times, he did that weird thing talking out loud saying awkward things that other people can hear… There was a lady behind us with a stroller. He said, "I feel like we're being followed". Later, a yappy little dog barked at us, to which he said "no kill, no kill". The only interesting thing he talked about was racing cars. He mostly mumbled quietly, but I encouraged him to speak up and finally learned something interesting about him. He races cars- most recently a Ferrari, and he just bought a Lotus that he is getting ready for racing. He also used to race a Honda Accord. Reminds me of an ex-boyfriend who drove a Ford Taurus, but was convinced that just because he could hit the gas pedal hard, he was a race car driver… And then, just like that, mercifully, the torture was over. He walked us back to his car, pointed it out, and then walked away. Didn't ask where I parked or offer to walk me back. Again, all the little things can be written off as one-offs. Ok, fine, he didn't walk me to my car. Fine, he put his feet on the chair next to me. Yadda yadda yadda. But all together within like an hour? Come Previous Next