Focaccia as Motor End Plate

So surgery was a bit like going to a rave sober. It was hard not to feed off the high of the surgeons so in love with the OR and with operating. The climate buzzed ecstatic. I came out of the operating room each day singing and still throwing punches, bouncing on my toes, chanting about the secret of the Fox. I barely slept, but I barely could sleep—so thoroughly jazzed.

Now I’m on neurology, and each day I feel like I’m going into the intense atmosphere of Chess Tournament National Finals. My glasses are taped. What move are you going to do next, Lyle? Do left right confusion! No, do naming. Better yet, test stereognosis. Do a Romberg’s! So many possible moves. So many eponymous places a lesion could be–only one right answer.

I made this focaccia bread last week in Florida, at a time when I was contemplating pitting edema. But now I’m thinking about neuromuscular junctions and how this bread resembles a motor end plate. With cheese.

Focaccia as Motor End Plate

Adapted from The Village Baker

1 cup sourdough starter

6 cups organic, unbleached white (or all-purpose) flour

2 cups water

1 teaspoon malt extract or 1/2 teaspoon honey

4 teaspoons fine sea salt

1 1/2 tablespoons olive oil

Warm 1 cup of the water. Mix in the sourdough starter. Dissolve the honey or malt extract in the diluted sourdough mixture.

Place half of the rest of the flour and half of the salt in a food processor and pulse to mix (or just knead by hand—I always do.) Add the sourdough and malt extract mixture. Pulse the processor to combine the ingredients, then slowly add half of the remaining water through the feed tube while the processor is running. Process the mixture for between 30 seconds and one minute. The dough should be wet and sticky. In the last 10 seconds of processing, pour half of the olive oil through the feed tube.

Empty the dough into a large bowl and combine the remainder of the ingredients in the food processor to make a dough in the same way.

Combine both batches in the bowl by mixing them together with a wooden spoon or plastic dough scraper.

Let the dough rise, covered, in a warm place for 1 hour. 

While the dough is rising, combine the olive oil, salt, chopped garlic, and sage leaves.

2 cups extra virgin olive oil

2 teaspoon salt

8 cloves garlic, chopped

24 whole leaves fresh sage

Place equal amounts in 2 medium-sized bowls and set them aside.

Turn out the risen dough onto a well-floured worktable and divide the dough in half. The pieces will be wet and sticky, but use a little extra flour and round them up into tight balls. Place each piece in a separate bowl. Roll the dough balls around in the oil mixture and set them aside, still in the oil, to rise for between 3 and 4 hours. The dough will have almost tripled in size and be very soft and airy.

Remove the balls of dough from the oil and transfer them onto large cookie sheets that have a rim at least 1/2 inch high. With the palms of the hands and with your fingers open wide, spread the dough out to about 12 inches by 18 inches, and about 3/8 inch thick. The dough may spring back. If so, let it relax for a few minutes, then repeat the stretching process. Pour the remaining oil, along with the sage, garlic, and salt over the top of the dough. I put both of the batches on the same baking sheet because I was short on time, that is why they are so tall!

Set the focacce aside, covered, to rise for 1 hour. When they have risen, poke the dough with the fingertips several times. 

As you poke in tedium, talk yourself through how a neuron depolarizes and releases neurotransmitters at the axon terminal. Imagine your finger is the axon, the dough is the motor end plate of the receiving muscle fiber.

Bake in a 400 degree oven for between 15 and 17 minutes, or until they are golden brown.

You could take little roasted garlic pieces and try to fit them into the receptor sites on the focaccia bread and quiz yourself on neurotransmitter pharmacology if you too are a medical student. I wouldn’t tell anyone. Serve to over-exhausted general surgery residents for an act of good karma.

As featured with my favorite Sourdough community: http://sourdoughsurprises.blogspot.com/