When Being Broken Means Becoming Better

Jul 6, 2021 by

17 years ago on July 1, 2004, I put on my first long white coat, clipped a bulky black pager to its left front pocket and snapped a picture of myself standing before a full-length mirror.  

It was my first official day as a doctor.  

I started intern year of residency at Westchester Medical Center equipped with two black pens, three pocket-size “quick reference guides” and giant grey PalmPilot to look up every medication I was now legally allowed to prescribe. I had a naïve belief that four years of undergrad and four years of medical school had properly prepared me for this day, the day I would start changing the world, one patient at a time.  

I was so wrong.  

The next three years gutted me of everything I thought I knew, and then proceeded to shatter my very sense of self into a million worthless pieces.  

The days were long, the night shifts were longer, and whoever thought the 80-hour work week was doable had clearly never done one, much less three consecutive years of them.  

It seemed as if every day was a loss, and only seldom was there a win. The harder I worked, the more I failed.   

There was a limit to how many times I could say “I am sorry, there was nothing more we could do,” before I began to ask myself “is this really the place I am supposed to be?”  

I had lost hope in hope.  

But then slowly (so very slowly) residency stopped breaking me, and it was then I began building this doctor that I have become.   

And so what have I become? To start, I am a doctor who works tirelessly, I am a doctor who acquires wisdom, and perhaps, most important of all, I am a doctor who is (once again) filled with hope for every patient- regardless of circumstances, regardless of diagnosis and regardless of their often times terminal condition.  

And in the 14 years since completing residency I of course have been shattered again and again. Those first 6 months of 2020 alone left me in terrified pieces as I continued to care for patients- my most pervasive thought being “if I die now, my daughter Heather will never remember my face.”    

But now, instead of rebuilding the parts of me which were destroyed, I hand those fragments over to my patients and say “here, this is me, this is the part of me that cares for you. Carry it and know that in this, you are not alone.”  

I don’t know everything, and I know I never will, but I know that I am a very good doctor. 

To all of those who have entrusted themselves to my care… thank you, it has truly been an honor.  

And today, July 1, 2021, I can say with all confidence that I do change our world every single day, one patient at a time.  

Sarah Mildred Gamble, DO, is a Board-Certified Internal Medicine physician. In 2010 she founded Greenwich Pure Medical, LLC, a concierge medical practice in Greenwich, Connecticut. For the past 7 years, she has been consistently recognized as a Castle Connolly Top Doctor in the New York Metro Area and as a Top Doctor In Concierge Medicine Across America. Her clinical interests and expertise focus on personalized primary medical and primary preventative care. She enjoys gardening (for which she has little skill), gluten-free baking (frequently lacking in taste) and trying to keep up with her 4-year-old daughter (which has proven to be quite difficult at the age of 45). Her website is www.GreenwichPureMedical.com and she can be followed on Instagram @greenwichpuremedical  

Thank You,  

Sarah Mildred Gamble, DO 
Board Certified Internal Medicine Physician 

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Healthy Meal Prep

Mar 25, 2017 by

Meal Prep: A Helpful Healthy Eating Strategy

Chopped vegetables on a cutting board for meal preparation, including acorn squash, Brussels sprouts, carrots, and kale, as well as white beans and dried farro.

Who hasn’t left work late with a growling stomach but little energy to shop and cook? A busy schedule is one of the top reasons why people choose quick takeout meals, which are often calorie-laden and a contributor to expanding waistlines. [1-3]

Now, imagine a different scenario where within a few minutes of walking through the door you have a delicious home-cooked dinner, and perhaps even lunch packed-up for the next day. Amidst hectic weekday schedules, meal prep or meal planning is a great tool to help keep us on a healthy eating track. Although any type of meal prep requires planning, there is no one correct method, as it can differ based on food preferences, cooking ability, schedules, and personal goals. Here are some examples:

  • If you now eat fast food or takeout several nights of the week, your goal may be to choose a specific day of the week to create a food shopping list and hit the grocery store.
  • If you already food shop once a week and have basic cooking skills, your goal may be to choose one day a week to do most of the cooking, or try a new recipe.
  • If you already cook some weekday meals for your family, you might decide to create a schedule so that you are not deciding last minute what to make and to ensure you have the needed ingredients on hand.

Some benefits of meal prep:

  • Can help save money
  • Can ultimately save time
  • Can help with weight control, as you decide the ingredients and portions served
  • Can contribute to an overall more nutritionally balanced diet
  • Can reduce stress as you avoid last minute decisions about what to eat, or rushed preparation

Prepping for Meal Prep

  • Discuss with your family what types of foods and favorite meals they like to eat.
  • Start a monthly calendar or spreadsheet to record your meal ideas, favorite recipe sites, and food shopping lists.
  • Collect healthy recipes. Clip recipes from print magazines and newspapers and save in a binder, or copy links of recipes onto an online spreadsheet.
  • Consider specific meals or foods for different days of the week. Remember Wednesday as Prince Spaghetti Day? Some families enjoy the consistency of knowing what to expect, and it can help to ease your meal planning. Examples are Meatless Mondays, Whole Grain Wednesdays, Stir-Fry Fridays, etc.
  • Start small: Aim to create enough dinners for 2-3 days of the week.

Getting Started

  1. Choose a specific day of the week to: 1) plan the menu, whether week by week or for the whole month, and write out your grocery list 2) food shop, 3) do meal prep, or most of your cooking. Some of these days may overlap if you choose, but breaking up these tasks may help keep meal planning manageable.
  2. As you find favorite ‘prep-able’ meals, or your menus become more familiar and consistent, watch for sales and coupons to stock up on frequently used shelf-stable ingredients like pasta, rice, and other whole grains, lentils, beans (canned or dried), jarred sauces, healthy oils, and spices.
  3. On your meal prep day, focus first on foods that take the longest to cook: proteins like chicken and fish; whole grains like brown rice, quinoa, and farro; dried beans and legumes; and, roasted vegetables.
  4. Also consider preparing staple foods that everyone in the family enjoys and which you can easily add to a weekday meal or grab for a snack: washed greens for a salad, hardboiled eggs, a bowl of chopped fruit, cooked beans.
  5. If you prefer not to pre-cook proteins, consider marinating poultry, fish, or even tofu on your prep day so that you can quickly pop them into the oven or stir-fry later in the week.
  6. Multi-task! While foods are baking or bubbling on the stovetop, chop vegetables and fresh fruit, or wash and dry salad greens for later in the week.
  7. When you cook a recipe, make extra portions for another day or two of meals, or to freeze for a different week. Be sure to date and label what goes in the freezer so you know what you have on hand.
  8. For lunches, get a head-start and use individual meal containers. Divide cooked food into the containers on prep day.

Storage

Meal prep can save time and money if you are preparing just enough for what is needed the following week. Refrigeration and freezing are an important step to successful meal planning. However, forgotten food such as produce hiding in a drawer or a stew stored on a back shelf in an opaque container for too long can spoil and lead to food waste. Label all prepped items with a date so that you can track when to use them by. Rotate stored items so that the oldest foods/meals are kept up front. Store highly perishable items like greens, herbs, and chopped fruits front-and-center at eye-level so you remember to use them.

When it comes to freezing, some foods work better than others. Cooked meals tend to freeze well in airtight containers. Foods with high moisture content, such as salad greens, tomatoes, or watermelon, are not recommended as they tend to become mushy when frozen and thawed. Blanching vegetables for a few minutes before freezing can help. However, if the texture of a frozen food becomes undesirable after thawing, they might still be used in cooked recipes such as soups and stews.

The following are recommended times for various cooked foods that offer the best flavors, maximum nutrients, and food safety.

Refrigeration at 40°F or lower
1-2 days: Cooked ground poultry or ground beef
3-4 days: Cooked whole meats, fish and poultry; soups and stews
5 days: Cooked beans; hummus
1 week: Hard boiled eggs; chopped vegetables if stored in air-tight container
2 weeks: Soft cheese, opened
5-6 weeks: Hard cheese, opened

Freezing at 0°F or lower
2-3 months: Soups and stews; cooked beans
3-6 months: Cooked or ground meat and poultry
6-8 months: Berries and chopped fruit (banana, apples, pears, plums, mango) stored in a freezer bag
8-12 months: Vegetables, if blanched first for about 3-5 minutes (depending on the vegetable)

Ready to get started? Below are some recipes that lend well to bigger batches—and don’t forget that the Healthy Eating Plate can serve as a helpful menu planning guide. Happy prepping!


References

  1. Fryar CD, Ervin RB. Caloric intake from fast food among adults: United States, 2007–2010. NCHS data brief, no 114. Hyattsville, MD: National Center for Health Statistics. 2013.
  2. Lachat C, Nago E, Verstraeten R, Roberfroid D, Van Camp J, Kolsteren P. Eating out of home and its association with dietary intake: a systematic review of the evidence. Obes Rev. 2012 Apr;13(4):329-46.
  3. Nago ES, Lachat CK, Dossa RA, Kolsteren PW. Association of out-of-home eating with anthropometric changes: a systematic review of prospective studies. Crit Rev Food Sci Nutr. 2014;54(9):1103-16.

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How Concierge Medicine Saved My Life

Mar 20, 2017 by

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Harvard University Researchers Find a Link…

Apr 22, 2015 by

zeusd1-KIMR-2695821… Between High Pesticide Residues and Male Reproductive Health!

Another compelling reason to choose organically-grown produce.  There’s a link between consuming fruits and vegetables with higher levels of pesticide residues and low sperm count, lower ejaculate volume and lower percentage of normal sperm.  Click here to read about this new study conducted by the researchers at the Harvard University School of Public Health.

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21 days of Blog/Facebook/Twitter Updates: Day 3

Jan 3, 2015 by

DAY 3:  Gaining Weight
gain-weight-2

What Causes Weight Gain?  It’s more than what you eat!
1. Diet: The quantity and quality of food in your diet.
2. Genes: Some people are genetically predisposed to gain weight more easily than others. 3. Physical inactivity: Exercising is a key element of weight control.
4. Sleep: In general, adults who get too little sleep tend to weigh more than those who get enough sleep.
As we age, increased weight gain also increases the chances of developing heart disease, stroke, diabetes, high blood pressure and certain types of cancer.

Because most adults between the ages of 18 and 49 gain 1-2 pounds each year, stopping and preventing weight gain should be a priority.

Move more. Eat less. Get a good night’s rest!

Click here to read more about this from The Harvard School of Public Health

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21 days of Blog/Facebook/Twitter updates – Day 2

Jan 2, 2015 by

DAY 2:  Health Concerns with Eggs

There are many reasons to reduce or even eliminate eggs from your diet.  Recent studies suggest that egg consumption can cause cardiovascular disease, diabetes , and colon cancer.
The research is startling:

  • If you consume seven or more eggs per week, you increase your risk of developing cardiovascular disease by 19%; for diabetics that risk jumps to 83%.SadEgg
  • Consume seven or more eggs per week and your risk of becoming a diabetic is increased by 68%!
  • People who consume even just 1.5 eggs per week have nearly five times the risk for developing colon cancer, compared with those who consume less than 11 eggs per year.
  • Even egg whites count.  Since most Americans include far more protein than necessary in their diets, adding a highly concentrated source such as egg whites can increase your risk for kidney disease, kidney stones, and certain types of cancer.

Click here to read more about this from the Physicians Committee For Responsible Medicine.

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21 days of BLOG Updates! Day 1

Jan 1, 2015 by

Happy New Year!

DAY 1:  Red and Processed Meat Products: No Safe Amount

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Americans love meat.

More than 50% the meat we consume is RED Meat, while 25% of the meat consumed is PROCESSED Meats. Processed meat (including bacon, deli, sausage and hot dogs) is meat that has been preserved with additives or manipulated to its alter color, taste, and durability.

There is strong evidence that consumption of both red meat and processed meat products can lead to increased risk for many diseases, including high blood pressure, obesity, cardiovascular disease, diabetes, and cancer.  For instance:

  • Processed meat products are high in sodium which can lead to high blood pressure.  High blood pressure is a leading cause of kidney failure, heart failure, heart attacks, and strokes.
  • These meats are high in saturated fat, which can lead to obesity and cardiovascular disease.  Cardiovascular disease remains the number one killer of Americans.
  • The high saturated fat in red and processed meat products causes fat buildup in cells which can lead to the development of diabetes.
  • Both red and processed meat products contain high levels of N-nitroso compounds which are associated with an increased risk of cancers of the pancreas, stomach, bladder and colon.

In order to PREVENT these diseases, AVOID  red and processed meat!

Choosing to replace just one serving of red or processed meats a day with nuts or legumes can decrease your risk for developing these diseases by 10-19%!

Click here to read more about this from the Physicians Committee For Responsible Medicine.

 

 

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For Preventive Care, Primary Care Physicians Are A Women’s Best Bet

Sep 30, 2014 by

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A new study conducted by the Centers for Disease Control and Prevention in Atlanta, GA found that women who see a PRIMARY CARE PHYSICIAN (internist, general practitioner, family practitioner) for their yearly checkups receive a wider range of preventative health services than those who only see their OB/GYN.

To put it simply…

Women of reproductive age who see only an OB/GYN for care may not be receiving the full spectrum of recommended health screenings and preventative counseling.  Don’t miss out on a yearly check-up for: hearing loss, vision changes, immunization boosters, colon and skin cancer, cholesterol elevations, thyroid dysfunction, pre-diabetes or even diabetes.  Plus, OB/GYNs don’t usually spend up to 50% of your visit counseling for proper diet, increasing physical exercise, seatbelt and helmet use, tobacco and alcohol cessation, depression and anxiety screening as well as intensive obesity prevention.

So ladies, in addition to your yearly appointment with your OB/GYN, make an appointment with a PRIMARY CARE PHYSICIAN to get on track with lifelong illness prevention through yearly wellness examinations and education.

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