Except, I realized, that is what I had served these friends at my father’s seventieth birthday party. This would not do.

Time for a new plan. It should be yummy and interesting for people who know and care about food. It should be easy to get right, since this would be a dish I’d never made before. Most importantly it needed to be good after being transported and sitting around for a while, which is not easy for a fish.

I’d heard of ceviche, and even thought I might have had some at a tapas bar once. It might do. I looked it up in the Joy of Cooking (from which it was absent) and on the Internet (on which it is present in hundreds of disparate versions, often with specialized ingredients unavailable at short notice). I began to despair, but then realized that if the recipes were all so different that the details must not matter. Citrus juice was a constant, almost always lime, but the amount could vary between half a cup and 20 limes. Soaking time was even more broad, between ten minutes and twenty-four hours. Another constant was something bland or starchy, but this could be avocado, yucca, popcorn, potato or coconut. It should also have onions and a chili pepper preparation. And seafood.

This would definitely qualify for hard to get wrong and easy to transport. As far as pleasing those knowledgeable about food I would simply ask for suggestions for improvement which would supply conversation.

I was highly pleased with the results, as others declared themselves to be, which means that guests will almost certainly be offered a variation of Alison’s Fish Salad this summer. Recipe forthwith:

(for six)

1 kilo fish. I used tilefish because it was there, but anything fresh would probably do, including scallops and squid. (That’s 2 lbs for my American friends.)
5 limes
Ginger
Red peppercorns
Bell pepper, diced fine. I used an orange one.
100 g (4 oz for my american friends) cherry tomatoes, quartered. Italian tomatoes are often suggested.
1 small sweet potato, boiled and diced fine.
1 T cilantro, finely chopped.

Squeeze the limes into a glass bowl. Grate ginger into the lime juice and throw in a handful of red peppercorns. Skin the fish, slice into fine strips and stir into the lime juice. Let sit until shortly before you eat. Stir in the bell pepper, tomato and sweet potato. Transfer to a brightly-coloured serving dish. Sprinkle with cilantro.

Done.

Now is that yummy and easy or what?

I’m thankful to be here, with all of you. What more is there to say?

This is the rant on the original Medscape site, where you have to login to see it but it’s free and they don’t spam you or anything:

http://boards.medscape.com/forums?128@659.kq28abHJzWk@.2a0e4709!comment=1

For those who don’t want to login, I am taking the words at the bottom of the post literally and passing this essay on. I know you are mostly not healthcare providers, but much of it does apply to the rest of us anyway.

*** *** ***

This essay is, I would like to clarify, directed at healthcare providers, not patients. Healthcare providers have no excuse to avoid the flu vaccine: they have access to the world’s medical knowledge and should be able to rise above superstition and ignorance.  Yes, I too am a Dumb Ass, but for different reasons.

I give you, slightly rewritten for 2011, a Budget of Dumb Asses.

I wonder if you are one of those Dumb Asses who do not get the flu shot each year? Yes. Dumb Ass. Big D, big A. You may be allergic to the vaccine (most are not when tested), you may have had Guillain-Barre, in which case I will cut you some slack. But if you don’t have those conditions and you work in healthcare and you don’t get a vaccine for one of the following reasons, you are a Dumb Ass.

1. The vaccine gives me the flu. Dumb Ass. It is a killed vaccine. It cannot give you the influenza. It is impossible to get flu from the influenza vaccine.

2. I never get the flu, so I don’t need the vaccine. Irresponsible Dumb Ass. I have never had a head on collision, but I wear my seat belt. And you probably don’t use a condom either. So far you have been lucky, and you are a potential winner of a Darwin Award, although since you don’t use a condom, you are unfortunately still in the gene pool.

3. Only old people get the flu. Selfish Dumb Ass. Influenza can infect anyone, and the groups who are more likely to die of influenza are the very young, the pregnant, and the elderly. Often those most at risk for dying from influenza are those least able, due to age or underlying diseases, to respond to the vaccine. You can help prevent your old, sickly Grandmother or your newborn daughter from getting influenza by getting the vaccine, so you do not get flu and pass it one to her. Flu, by the way, is highly contagious, with 20% to 50% of contacts with an index case getting the flu.  However, Granny may be sitting on a fortune that will come to you, and killing her off with the flu is a great way to get her out of the way and never be caught.  That would make a good episode of CSI.

4. I can prevent influenza or treat it by taking echinacea, vitamin C, oscillococcinum or Airborne. Gullible Dumb Ass cubed then squared. None of these concoctions has any efficacy what so ever against influenza. And if you think oscillococcinum has any efficacy, I would like you to invest in a perpetual motion machine I have invented.  None of the above either prevent or treat influenza. And you can’t “boost” your immune system either. Anyone who suggests otherwise wants you money, not to improve your health.

5. Flu isn’t all that bad of a disease. Underestimating Dumb Ass. Part of the problem with the term flu is that it is used both as a generic term for damn near any viral illness with a fever and is also used for a severe viral pneumonia. Medical people are just as inaccurate about using the term as the general public. The influenza virus directly and indirectly kills 20,000 people  (depending on the circulating strain and year) and leads to the hospitalization of 200,000 in the US each year. Influenza is a nasty lung illness. And what is stomach ‘flu’? No such thing.

6. I am not at risk for flu. Denying Dumb Ass. If you breathe, you are risk for influenza. Here are the groups of people who should not get the flu vaccine (outside of people with severe adverse reactions to the vaccine): Former President Clinton, who evidently doesn’t inhale. Michele Bachmann. Wait, that’s the HPV vaccine.  And people who want to be safe from zombies. If you don’t get the vaccine you do not have to worry about the zombie apocalypse, because zombies eat brains.

7. The vaccine is worse than the disease. Dumb Ass AND a wimp. What a combination. Your mother must be proud. Unless you think a sore deltoid for a day is too high a price to pay to prevent two weeks of high fevers, severe muscles aches, and intractable cough.

8. I had the vaccine last year, so I do not need it this year. Uneducated Dumb Ass. Each year new strains of influenza circulate across the world. Last year’s vaccine at best provides only partial protection. Every year you need a new shot.

9. The vaccine costs too much. Cheap Dumb Ass. The vaccine costs less than a funeral, less than Tamiflu, and less than a week in the hospital.

10.  I received the vaccine and I got the flu anyway. Inexact Dumb Ass. The vaccine is not perfect and you may have indeed had the flu.  More likely you called one of the many respiratory viruses (viri?) people get each year the flu.  Remember there are hundreds of potential causes of a respiratory infection circulating, the vaccine only covers influenza, the virus most likely to kill you and yours.

11. I don’t believe in the flu vaccine. Superstitious, premodern, magical thinking Dumb Ass. What is there to believe in?  Belief is what you do when there is no data. Probably don’t believe in gravity or germ theory either. Everyone, I suppose, has to believe in something, and I believe I will have a beer.

12. I will wait until I have symptoms and stay home. Dangerous Dumb Ass.  Despite often coming to work ill, especially second year residents, about 1 in 5 cases of influenza are subclinical, hospitalized patients are more susceptible to acquiring influenza from HCW’s than the general population,  and 27% of nosocomial acquired H1N1 died. And you wil never realize that you were the one responsible for killing that patient by passing on the flu.

13. The flu vaccine is not safe and has not been evaluated for safety.  Computer illiterate Dumb Ass.  There are 1342 references on the PubMeds on safety of the flu vaccine, and the vaccine causes only short term, mild reactions.  All health care requires weighing the risks of an intervention against the benefits. For the flu vaccine all the data suggests huge benefit for negligible risk. And as a HCW, it could be argued that we have a moral responsibility to maximize the safety of our patients.

14. The government puts tracking nanobots in the vaccine as well as RFID chips as part of the mark of the beast, and the vaccine doesn’t work since it is part of a big government sponsored conspiracy to keep Americans ill, fill hospital beds, line the pockets of big pharma and inject the American sheeple with exotic new infections in an attempt to control population growth and help usher in a New World Order. Well, that excuse is at least reasonable. Paranoid Dumb Ass.

So get the vaccine.  And pass this essay on to someone else.  The life you may save may be your own. Or be a Dumb Ass.

And if you and yours are admitted to the hospital or visit a HCW during the flu season, ask if your provider has had the vaccine. If not, ask for a new provider.  Who wants their health care provided by a Dumb Ass?

*** *** ***
Dear All,

I arrived in Dhaka on August 22^nd. Beli and thirteen month old Isha arrived at my guest house two days later. Most of the following week was getting to know Isha and vice versa, and looking for a flat. Both endeavours were successful. Isha is a total delight and seems to think I’m okay. We celebrated Eid ul-Fitr together on the 31^st with Beli cooking in the guest house kitchen, then B&I returned to Jamulpur (eight hours by bus) to prepare for the shift to Dhaka. Beli has just called to say they are returning tomorrow. The household goods have already arrived. (See below.) If it sounds like we are in the process of forming a family unit, that’s what it feels like, too.

The flat is brand new, 1450 square feet, 7^th floor, tile floors throughout, three bathrooms and a servant’s bathroom and will be serviced by an elevator as soon as the electricity is fully installed. For now, it is like a mini Grouse Grind (Vancouver torture climb, for those not in the know), eight or ten times a day.

At 11:30 Sunday night, Beli’s brother-in-law, Abul Khair, phoned from the border of Lalmatia. Would I take a rickshaw to where he was waiting with the truck and lead them to my flat?

I found Abul Khair, the truck, and driver and we bumped our way back to the flat. Labourers arrived shortly after — contracted through tough negotiations earlier in the evening. The labourers carried the contents of the truck up seven flights of stairs, mostly on their heads. Chairs, tables, beds, china, pots and pans, fridge, and a huge steel box containing curtains, table mats, and a great deal of stuff yet to be uncovered — the contents of the house I had left nearly three years ago. When the truck was empty, Khair and I found a couple of mattresses and slept.

The next day was like opening a summer camp left mostly unattended for two or three years. After depositing the goods in her village eight hours north of Dhaka, Beli traveled her own small odyssey through a marriage, the birth of a baby, and divorce. The goods didn’t follow her through most of this but they did weather three monsoons. Everything in the steel box is pristine. A mahogany table, a glass-topped rattan table that I use as a desk, a bed, two comfortable rattan chairs, and six dining table chairs are very much fit for service. China doesn’t deteriorate and cook-ware has been in use since Beli returned to Jamalpur ten months ago.

Yesterday, the electrician from the guest house installed fans and lights, repaired the surge-protector for the fridge, then helped me buy and install a new ‘chula’ (two-burner cooker) and gas canister. Khair, who had had a hand in the packing and knew where most things were, did most of the unpacking — taking a break every once in a while to make the flat clean and tidy. This morning while I went out to buy take-out breakfast, Khair sorted out the curtains, which we put up after breakfast.

My office projects from the front of the flat, with four large windows on three sides allowing a nearly constant breeze and light and the reflection of cumulus clouds on my glass-topped desk. This afternoon a technician will install wireless throughout the house. Tomorrow I will probably go out and buy a printer; then CEP, South Asia branch, will be fully operational.

I will be returning to Ottawa towards the end of September, and then back to Dhaka for a month or so in January. Note that I now have room for guests (not luxury) in both cities and time to spend with them.

PICTURES: Each picture showcases a different dress. Each sewed by Alison. There are seven in all, and they all went to Jamalpur for the baby parade.

Love,
Pat

Picture me now, lying in my hammock as I copy out the recipe for what we ate from the New Recipes from Moosewood Restaurant cookbook. I would be happy to eat this every warm day all summer long.

Summer Sauce for Pasta
Serves 4

On those hot, lazy, sultry summer days, when, like a character in a Tennessee Williams play, you haven’t got the energy to do much more than lie around the house in an old tattered slip, try this quick, uncooked sauce. It’s fragrant, refreshing, and light.

6 ripe tomatoes, chopped
2 cups sliced mushrooms (8 ounces) [500 g]
6 to 8 ounces [200 g] mozzarella cheese, grated or cut into thin strips
1/2 cup chopped fresh basil
2 garlic cloves, minced
1/2 cup olive oil
1 teaspoon salt

1 pound [500 g] spaghetti or linguini

1/2 cup freshly grated Parmesan cheese (1 ounce) [30 g]

Mix all the sauce ingredients together and let sit at room temperature for an hour or so, for the flavors to mingle.

Cook and drain the pasta. While the pasta is piping hot, serve it in well-warmed bowls, topped with a ladleful of sauce and garnished with Parmesan cheese.

Of course I don’t make it exactly like that. I use fewer mushrooms, less olive oil, more garlic (which I crush instead of mincing) and I hate Parmesan so I use Romano instead. But you won’t make it exactly like that either.

Enjoy!

Biggest news since my last post: my mother died. She was 66. It was unexpected. She was less than 20 years older than me and I expected her to be active into her nineties, as her mother still is. I didn’t blog about that because her death affected so many people so intensely that I would have been blogging other people’s stories, not just mine. It didn’t feel right.

This is the picture I have on my work computer as wallpaper:
‘

You can still buy tea towels.

Also see:
Alston Adams on Facebook
Sending you good vibes, Alston on Facebook
alstonadams on Twitter

Alston on Alston
Here’s some cached text from youngadultcancer.ca. It’s Alston talking about going on the “July 11-23, 2009 – Owyhee River Kayaking Expedition, SE Oregon, USA” trip organized by YAC and the subject of the film Wrong Way to Hope.

Until May 1, 2007, I led a trite and meaningless existence. Just kidding. Until that date, life was pretty great in most ways. I had just started a new and interesting career in video games. And then…well, you know what happened then. The details: esophageal cancer. One of the worst ones, and unusual for someone that was only 32.

This is a bio, which normally means that it is very much of a compilation of who you are and what you’ve done. It’s part character sketch and part CV. But unlike many other major events in life such as marriage, first child, etc., this one tends to obliterate your life B.C. (before cancer). The effect of this is that UI and many others focus much less on the past and put more emphasis on the future, but especially the present. And that is why I am going to travel for 2 weeks on the Owyhee River with others like me.

This trip is an opportunity to make an impact in people’s live right now. Instantaneously. People around me are organizing themselves in order to realize something they believe in. I personally am reminded of my vitality and ability to contribute to something important to society. And it gets me out of the limbo of uncertainty that surrounds people my age hit with some serious disease.

I am a man, alive, relevant and vital. I am here, right now.

Three years ago he was diagnosed with esophageal cancer.

Two weeks ago we took him for a drive in the country. We thought that sitting in the car being driven around would be about all the activity he could handle, and as it turned out we had overestimated him.

His goal was to make it to his 36^th birthday, which would have been November 8^th.

He didn’t make it.

You know what they say about doing whatever it is now, not putting it off because there may never be a later? Yeah. What they say.

Carpe diem.