Spiced Chickpea, Sausage and Greens Stew

And goodbye to all that (my boobs)

Hi, friends. I hope you’re all well. Today we’re going to talk about the best soup to make in terrible rainy weather, and also preventative mastectomies! Right this way.

What’s for Dinner?

This soup is, honestly, everything a soup should be. It is nourishing, warming and delicious. It tastes great the day it’s made, even better the following days, and freezes well. I made it to (emotionally) prep myself for an upcoming surgery, but I highly recommend it for just about any occasion in which you need nourishment.

We’re going to get right to it today, but first a couple of ingredient notes:

Harissa: This comes in so many varieties, and all will work in this recipe. Some lean towards tomato and cumin, others are very spicy, or tart, or salty. Give yours a taste. Mine came from Sahadi’s and is very hot, very pickle-y, very salty. If yours tastes more mild and tomatoey to you, feel free to add a little more than I called for below. Taste the soup before serving, too, and you can add more on top, if you like, as you see above.

Labneh: The luscious white swoop you see on top of the soup is labneh. It’s a very thick, very rich strained Middle Eastern yogurt. But that description really doesn’t do it justice: It’s closer to sour cream in richness, but so much more flavorful, with a hefty silkiness. If you can find it, do yourself a favor and put it on top of this soup. (And/or just drizzle it with olive oil and salt and eat with flatbread.) If you can’t find it, don’t worry: You can use yogurt instead, or even strain your yogurt in a fine-mesh strainer first, to approximate labneh texture.

Merguez: This is a very delicious spiced sausage often made from lamb, but I used one made with chicken. Mine was a raw sausage, which I prefer for something like this. But so many of the sausages at the grocery store are pre-cooked and that’s fine. If you can’t find merguez use a hearty sausage that you know you like, with preference for a raw one if you can find it—even hot Italian would be pretty great.

Did Mira eat this? Mira ate this! But I did have to remove the carrots for her. But the fact that she ate something with so many “wet greens” (her term for…cooked greens) was very exciting.

Spiced Chickpea, Sausage and Greens Stew

Serves: 6

1/4 cup olive oil
1 red or yellow onion, chopped
Kosher salt
5 garlic cloves, smashed and chopped
2 carrots, peeled and sliced
1 pound merguez sausage, preferably raw, sliced into bite-sized coins (or any other sausage you like!)
3 tablespoons harissa, plus more to taste
2 tablespoons tomato paste
6 cups chicken broth or bean cooking liquid, or a combo
2 (15.5-ounce) cans chickpeas, drained, or 3 cups cooked chickpeas
1 large bunch collard greens or kale, stemmed and chopped (or one 10-ounce bag frozen kale or collards)
Black pepper
Labneh or yogurt, for topping

1. In a large soup pot or Dutch oven, warm the olive oil over medium-high heat. Add the onion and a big pinch of salt, and cook, stirring occasionally, until translucent, about 5 minutes. Add the garlic and carrots, a bit more salt, and cook until fragrant, 1 minute. Add the sausage and cook, stirring, until it’s sizzling and firmed, about 3 minutes. Add the harissa and tomato paste, and stir well to combine and toast for 30 seconds or so.

2. Add the broth and bring to a brisk simmer, scraping the bottom of the pan to bring up any browned bits. If your broth is unsalted, add 2 very large pinches of salt. If it is low salt, add one large pinch. If it is fully salted add a small pinch.

3. Add the chickpeas and collards. Season with a generous amount of black pepper. Simmer the soup on low for at least 20 minutes, until the carrots are tender, and up to 1 hour, depending on your schedule and how tender you like your greens. Taste and add more salt, pepper and/or harissa if necessary. Top with labneh or yogurt.
   

Opinion Soup

Goodbye To All That (my boobs)

One of my earliest memories of my mother’s body is her scar: At some point it must have been purplish, but I remember it whitish-pink, running jagged down the right side of her flat chest. She’d had a single mastectomy after a diagnosis of metastatic breast cancer when she was around 40 and I was 5, in 1985. They’d given her an implant reconstruction, but it ruptured and so finally she just went flat on one side. Her other breast was small and it was hard to tell, with clothes on, that she had only one. 

I don’t know all the details of the time when she was first diagnosed, because I was so young. But I know that when she first found the lump, the doctor said it was nothing. By the time she got it properly checked and biopsied, it had spread to her lymph nodes. She told me she prayed that she could live until I was 16—and then, after going into remission, her cancer returned when I was 16. This time it was on her bone, a spot on her sternum. She had a small blue-green dot tattoo there, for the radiation. Later it spread to her vertebrae, spots growing up and down her spine, that I imagined like lichen. It made it painful to walk. She was genuinely excited when she figured out that walking on her tiptoes made the pain more bearable. Then it was in her liver. She just wanted to go back to work, to her job as a children’s librarian. She died when she was 56. 

I can’t come up with much feeling for my own breasts except weariness. And they’re coming off tomorrow—as prevention, I do not have cancer—so I’m trying to find the right way to say goodbye to them. We have certainly been together for a long time. They came too early and too large. How odd it must have been for my mother to see such a different body on her daughter than the one she had. I would have preferred to have her slim hips and flat chest, the way she could move around the world without drawing much attention, whereas I felt I was conspicuous, galumphing. Nearly any shirt at all made me look like I was trying to be sexy, when I was really just existing.

I understand that breasts are beautiful in any shape and size, and they can feed babies, which is also beautiful, but to me they have always felt at worst like ticking time bombs, or at best like something heavy to lug around. My daughter came so prematurely that we were unable to breastfeed, and so instead I pumped breast milk for a year, resulting in ropy pale scar tissue around my nipples. I was grateful I was able to do it, happy my daughter got breast milk because that’s what I wanted, but it was not a positive experience. 

I always thought of what it would feel like to be rid of them, but I made the decision to have a mastectomy after I was diagnosed with lobular carcinoma in situ—an alarmingly named not-quite-cancer that nevertheless increases my risk of actual-cancer quite substantially. That, combined with a very strong family history (my mother’s sister also had it and survived), extremely dense breast tissue (a more minor risk factor) and five biopsies for suspicious masses that turned out to be benign but felt like they took years off my life nonetheless, and I was done. I don’t want to live with this level of risk if it’s something I can avoid. I don’t want my daughter to know the fear that I lived with.

Here’s the amazing part: All of this was my choice, and all of it (minus our out-of-pocket maximum, which, ugh) will be covered by insurance. I had three choices, to be exact: Intensive screening, tamoxifen (an estrogen blocker that would halve my risk), or mastectomy, which virtually (~95%) eliminates the risk. It wasn’t easy to make the choice, but I am so grateful that I had choices where my mother had none. 

All of this is because of the Affordable Care ActWomen's Health and Cancer Rights Act (WHCRA) of 1998, which mandated that reconstruction after mastectomy be covered. Additionally, the Affordable Care Act (AKA Obamacare) strengthened those protections and made it illegal for insurers to deny coverage based on a “preexisting condition.” Now that I know I have such a high risk of breast cancer, and especially with the LCIS diagnosis, it’s possible that, before the ACA, if I had opted to keep my breasts and then got cancer, it wouldn’t be covered. My mother, in fact, went without insurance for a while: She was a substitute teacher and a waitress at a restaurant, and she could not purchase health insurance—no one would sell it to her because of her cancer. And even once she got it through her employer, getting her care covered was like running a gauntlet.

What would her outcome have been, if, if: If her doctor had listened to her when she first found the lump, if she never had to skip care because she had no insurance? 

So here I am, with all these choices, thanks to government regulations and my husband’s excellent health insurance, which buys us entry to Memorial Sloan Kettering—and that is a whole different world, let me tell you. My breast surgeon tells me he’s doing the surgery to spare me from getting cancer, not to save my life. He feels confident that if I get cancer, they’ll be able to treat it. I understand that’s based in evidence, and that he’s telling me the truth as best he knows it, but on some level, I can never believe him. I know too much about uncertainty, about the limits of prognostication, about how someone has to be the one percent. To me, breast cancer is the monster that stole my mother, who wanted so badly to live. And I can’t undo any of that. But I can do this.

Sometimes I’m overwhelmed by the luck I have, the life I lead now: My husband, my daughter, our cozy home, our pets. Neighbors who stop to chat; a career I struggle to make a living at but deeply love. Health insurance. Choices. What tremendous luck to have my cousin and aunt, my mother’s sister, flying in all the way from Kansas City to be with me. Mira’s best friend’s family, who welcome Mira to sleepover on a school night, so Amol can stay with me. A wonderful neighbor-friend who brought me boob-themed socks and is happy to walk the dog. Friends who send texts and care packages, friends and loved ones who send good thoughts. Health insurance. Choices.

Not everyone has all these choices, all this luck. Everyone should. I know my act of taking control is limited: I could still get another cancer, or get hit by a car, or have a stroke. Something’s going to kill me someday! But I have a chance to get off this ride. I can opt out, at least, of this one thing. No more mammograms, ultrasounds, MRIs. No more needles in the boob. It’s been hard for me to imagine growing old. My mother died at 56, my father at 65. How can I grow older than they ever were?

But this is my stab at optimism: I’m having my breasts removed as a way of imagining having the great good luck of getting old.

See you next week, on the other side, friends!

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