Today marks the final week of my fourth year psychiatry rotation – 1/4 of the way towards those looming end of year exams (which I would far prefer to avoid by burying myself in baking, thanks). Though I can’t say it imbued me with a strong desire to become a psychiatrist, it was far more useful than I could have imagined beforehand – and whether a medical student is fixed on becoming a surgeon or a general practitioner, it seems like an essential field to at least scratch the surface of. Because we are not treating diseases, or symptoms. We treat people, often at some of the hardest points in their lives. And that includes the context in which they arrive into a doctor’s care: their state of mind, their family and friends, and all of their past experiences that led them to this point. It all feeds into the success (or failure) of treatment.
Psychiatry is one of the only specialties in which a patient’s background is fully explored – for example, the history taking of a patient presenting with suicidal ideation and depression will be completely different to a patient presenting with a broken hip. However, that older woman currently living in her home who tripped on the edge of a rug and broke her hip still has other needs beyond the orthopaedic treatment, such as grief over the loss of physical health and the ability to look after herself, or anxiety over future falls, or conflict between family members caused by this hospitalisation. Or the difficult patient who causes conflict between staff members, or the woman presenting with chronic pain, or the man who goes into delirium tremens due to alcohol withdrawal after a few days on the ward. Some level of awareness and understanding of psychiatry, however small, is worthwhile.
However, this knowledge of the symptoms of mental illness or empathy towards it in others does not seem to be protective in doctors themselves. Another issue publicised recently is the spate of suicides and high rates of depression and anxiety in medical students and junior doctors, much better spoken about here in the Guardian. It’s a complex minefield, mental illness, and I feel like I’ve only glimpsed a fraction of it. The only way forward, like for anything holding stigma and causing isolation, seems to be in that combination of public education, awareness & activism, policy and simply talking. It can’t be a behind-closed-doors issue.
Anyway. To the recipe.
You may have noticed these brown butter, miso & walnut dark chocolate blondies pop up on my instagram story way back in January. I hadn’t forgotten – I’ve just been preoccupied by capitalising on the cheap plums, peaches and berries flooding our shelves (my favourite time of year to bake). Stone fruit is now disappearing and the humid fog starting to lift, revealing crisp autumn mornings and golden leaves – the kind of days that justify turning the oven on and filling the house with the scent of browned butter and toasted walnuts. For those who don’t know, blondies are essentially a cookie in brownie form. You do lose the crisp cookie edges, but gain the maximum amount of thick, gooey, slightly chewy centre – plus there’s no need to roll out cookies or refrigerate a fussy dough.
Don’t be scared off by the white miso – it is the mildest form of miso (as compared to red miso, for example) and adds a slight salty, unami note to the blondie. (If you’re a miso-in-baking lover like me, you might also want to check out these miso caramel apple tarts.) The browned butter and sugar give an almost caramel decadence, with pockets of gooey dark chocolate throughout. And it’s a stir and bake deal – no mixer required. Just make sure you cool the brown butter enough that you don’t accidentally melt your chocolate. Enjoy!
- 170g butter
- 1½ cups brown sugar (280g)
- 3 tablespoons white miso paste
- 2 eggs
- 2 teaspoons vanilla paste
- 1½ cups flour (200g)
- 1 teaspoon baking powder
- 1 cup dark chocolate, roughly chopped (180g)
- 1 cup walnuts, toasted and roughly chopped
- Preheat oven to 180°C. Grease and line a 20cm square tin .
- Toast the walnuts by spreading out in a single layer on a baking tray and toasting for 5-8 minutes or until fragrant and starting to brown. Set aside to cool, then roughly chop.
- To brown the butter, melt the butter in a small pot - ideally in a pot with a light coloured bottom so you can see the colour of the butter. Swirl the pan occasionally to keep ti cooking evenly. The butter will start to foam and change colour from yellow to a toasty brown - the milk solids will cook faster and start to settle to the bottom. Once it is starting to brown and smell nutty, transfer the brown butter to a bowl to cool (you can pop it in the fridge or freezer to do this faster).
- Once cool, whisk in the brown sugar, then the miso, eggs and vanilla essence.
- Fold in the flour and baking powder until only a few bits of white streaks remain, then gently fold in the dark chocolate and walnuts.
- Bake at 180° until golden, 30-35 minutes. The skewer test won’t work as it always comes out clean unless you hit chocolate, so look for a just crisp top that is starting to crack. It will firm up more as it cools.
- Leave to cool, then cut into squares. It also freezes well.