I must have heard the first cough, because I vaguely remember it. It was the last one, though, that woke me fully. The deep, wet cough — a cough that seemed too loud to have come from my little boy — was followed by a sharp intake of breath. The inhalation was more of a wheeze than a soft breath, as if my son was struggling to pull air into his lungs through a straw. Fully awake now, I held my breath and went perfectly still, waiting to hear the sound of Oliver exhaling.

One second passed. Then two. And three. And still, there was silence.

Finally, he exhaled, quietly and slowly. After another small cough, one appropriate for his size, his breathing settled into a steady pattern. He was asleep and unaware.

I continued to listen, eyes open and staring upward in the dark, but not seeing anything. My body was filled with adrenaline, every nerve on edge. As the minutes passed, my panic subsided, my own breathing calmed, and my heart slowed, resuming its regular pace. As my son’s sleep noises returned to normal, my eyes finally closed. His rest and comfort assured, I was able to return to sleep.

Motherhood, I thought as I drifted off. This is what it’s all about.

This morning, I was up before the rest of my family, before the sun had risen fully. I sat at the desk in my darkened office, writing, taking advantage of those few moments of morning silence before I had to leave for work. After a while, my daughter tiptoed into the room with Oliver following a couple of steps behind.

I hugged them both, their arms squeezing me tight in response. I felt grateful.

In the meantime, while not writing my book, I managed to write a piece on my other blog, a blog post that I’d been thinking of writing for a while. As usual, I found inspiration in a patient. This is not uncommon when you love this job, love these patients, as much as I do.

That site has been floundering, sustaining itself on one or  two posts per month. When the feeling strikes, though, the words flow. That post was one of those times.

Another day, while procrastinating on some other work-related projects, I wrote an essay over a few hours. I wrote. I edited. I wrote some more, edited some more. After the morning of writing, I submitted it here, one of the major medical journals in my field. They have a great section – Art of Oncology – that lets physician scientists shed the cloak of stuffy scientific writing while exploring the humanistic side of our profession. In other words, that section is totally made for me.

My essay was accepted 13 days after I submitted it.

To say that I am thrilled would be an understatement.

And I baked a cake with my kids. It was heaven.

My daughter and I read the recipe together, a recipe I had written and typed up. We gathered the ingredients, and she measured each one, carefully and with trembling hands. She’s as much of a perfectionist as I am. My son buttered and floured the parchment-lined cake pans. They watched the mixer as it beat the batter, eyes fixed on the spinning beater, as if they were watching magic happening. And they were, I guess. I poured the batter for them, and we slid the cakes into the oven to finish.

Later, after the cake was cooled and frosted, we shared a piece together. Nestled between the white cake layers was a strawberry filling made from this homemade strawberry jam, and I added a touch of the jam to the frosting as well. Each bite smacked of the sun-soaked fields those berries came from.

Baking this cake with my children? That was the icing on my week.

White Cake with Strawberry Filling and Strawberry Vanilla Buttercream Frosting

Yield: 10-12 servings

A beautiful dessert to serve for a birthday or Mother's Day, this cake doesn't disappoint. I like to use plenty of frosting, so this recipe has enough to completely cover the cake plus some. If you're not a big frosting fan, you can halve the frosting recipe.

Ingredients:

For Cake:

3 cups (11.25 ounces; 315 grams) cake flour
2 teaspoons baking powder
1 teaspoon coarse salt
1-1/2 cups (12 ounces; 3 sticks) unsalted butter, room temperature
2 cups (14 ounces; 392 grams) granulated sugar, divided
1/2 teaspoon vanilla extract
Zest of one lemon
1 cup milk, room temperature
7 large egg whites, room temperature

For Frosting:

1/4 cup strawberry jam, divided
4-1/2 sticks unsalted butter, softened
4-1/2 cups confectioners' sugar
1/8 teaspoon coarse salt
4 tablespoons heavy cream
2 teaspoons vanilla extract

Directions:

To Prepare Cake:

1. Preheat oven to 350 degrees. Butter two 9-inch round cake pans, line the bottom of each pan with a round of parchment paper, then butter the parchment. Lightly dust the cake pans with flour, shaking out excess. Set aside.

2. In a medium bowl, whisk together the cake flour, baking powder, and salt; set aside. Using a stand mixer fitted with the paddle, and scraping down sides of bowl as needed, beat butter and 1-3/4 cup sugar about 3 to 4 minutes, until pale and fluffy. Beat in vanilla extract and lemon zest. With mixer on low speed, add the flour and milk in an alternating fashion (starting and ending with flour), and beat until just combined. Transfer mixture to a large bowl.

3. In a clean bowl and using the stand mixer fitted with the whisk attachment, beat egg whites on low until foamy. With mixer running, gradually add in the remaining 1/4 cup sugar. Beat on high speed until glossy, stiff peaks form, about 4 minutes, taking care not to overbeat. Fold 1/3 of the egg white mixture into the flour/butter mixture, incorporating the egg whites completely. Repeat this two more times until all of the egg white mixture has been folded into the cake batter completely.

4. Divide batter between the two prepared cake pans, smoothing batter, then bake for 30-35 minutes, until a tester inserted into the center of each comes out dry. Cool on a rack for about 20 minutes, then invert, peel off parchment, and re-invert cakes so they cool completely with the top facing upward. When completely cool, frost as below, and refrigerate until ready to serve.

To Prepare Frosting and Filling:

1. Strain 2 tablespoons of strawberry jam, using the back of a spoon to force the liquid from the jam, and reserve liquid. Solids can be discarded.

2. For frosting: In the bowl of a stand mixer, beat the butter on medium-high speed until smooth, about 60 seconds. Reduce speed to medium low and slowly add confectioners' sugar. Beat until smooth, about 3 to 5 minutes. Meanwhile, in a small bowl, stir together salt, cream, and vanilla; stir until salt is dissolved. Add cream mixture and reserved strawberry jam juice to butter mixture. Increase mixer speed to medium-high, and beat until the frosting is light and fluffy, about 5 minutes.

3. For filling: In a small bowl, combine the remaining 2 tablespoons of strawberry jam with 3/4 cup of the frosting. Stir until well blended.

Note: Frosting can be made ahead, up to 2 days, and refrigerated in a tightly covered container. Bring to room temperature when ready to use, and beat on medium-low in the stand mixer for 3 to 5 minutes until light and fluffy.

Assembling the Cake:

To frost cakes, place 1 layer on a cake plate. With an offset spatula, spread top with the strawberry filling. Place the second cake layer on top, making sure it is centered, and refrigerate for 30 minutes to allow the filling to set. Remove cake from refrigerator and spread frosting evenly over top and sides of cake. You will have frosting left over.

After taking my daughter to gymnastics that afternoon, we stopped by the farmers market to browse the selection. It’s a small market, with only ten or so booths set up in the peak months, now through the summer. In the winter months, there might be just a couple of farmers selling their produce. On Monday, though, there were some good things available. Several farmers had fresh tomatoes, greens of some sort or another, lots of zucchini and yellow crookneck squash, and cucumbers. A couple of booths had pints of fresh plump blueberries, and many of those pints were filled with berries almost the size of a dime. One local goat farmer had raw goat’s milk, goat’s milk ricotta, and fresh eggs.

As we were leaving, arms loaded with bags of summer squash and blueberries and a token batch of goat’s milk ricotta, Maddie dragged me over to a table filled with jam jars of all sizes. The jam maker was a tall Australian man wearing a cowboy hat. His accent was lovely. He wasn’t so bad looking, either.

I explained to the jam maker that I had just made a batch of strawberry jam, just two days before. And no, I really didn’t need any jam, but his certainly looked good. He asked my daughter if she’d like a taste. This was a sneaky move, of course. What eight-year old turns down free samples of sweet jam and apple butter? Not mine.

While winning over my daughter, one lick at a time, the jam maker told me about the flavors he’d created and about his upcoming ideas for new batches. Before I knew it, the Australian had won me over. His passion for jam-making and combining new flavors, his sweetness to my child, and yes, his accent — all of this resulted in me coming home with $10 less in my pocket and two jars of jam we didn’t need.

So, about that jam I made. The Australian’s strawberry jam was good, but mine takes the cake.

After going strawberry picking with the kids on Saturday, we had an abundance of strawberries. Seven pounds of strawberries, in fact. Making preserves of some type seemed the only rational thing to do with that many berries. Other than eating them by the handful, that is.

Jennie is always a reliable recipe source – not to mention friend – and she didn’t fail me here. I used her strawberry jam recipe as a model, mostly because I loved her idea of using the microwave to cut the preparation time. Genius, I tell you. I can hardly wait until her cookbook comes out.

Strawberry Jam with Balsamic and Black Pepper

Yield: approx 3 cups

Cook Time: 8 minutes

This recipe is adapted from Jennifer Perillo's Strawberry Jam recipe. I used regular pectin since that's what I had on hand, and I added some balsamic vinegar and black pepper.

Strawberries plus balsamic vinegar plus black pepper might just well be the new bacon.

Ingredients:

2 quarts strawberries (approximately 8 cups), washed and hulled
3/4 cup sugar
2 teaspoons aged balsamic vinegar
4 grinds fresh black pepper
2 teaspoons pectin

Directions:

In a large glass microwave-safe bowl, mash strawberries using a potato masher or fork to desired consistency. Microwave on high in the microwave, covered, until strawberries are almost boiling, about 5 minutes.

In the meantime, whisk together sugar and pectin. Stir sugar and pectin mixture into berries. Add balsamic vinegar and black pepper, stir to combine. Cook on high for 3 more minutes, taking care to cover the bowl well with a paper towel (very important!), until thick and bubbly.

Transfer to a container, let cool, and refrigerate for up to 3 weeks.

My work-life balance has been wonky lately. When my mind drifts in the evening, I find myself thinking about work projects or emotionally-difficult patient encounters. My sleep has been disrupted with dreams of work, dreams filled with patients and their diagnoses. I’m certain my children are sensing my preoccupation, at least in some subconscious way. My five-year old has been especially clingy, refusing to sleep in his room, and Madeline is more on-edge and sensitive than usual.

Last night, after a particularly dramatic melt-down with no apparent cause, Madeline hugged me tightly, her face still wet with tears. ”Can we bake something this weekend, Mommy?” she asked. “Can we bake a cake together?”

Creating balance between work-life and home-life is a daunting task. When I juggle my important roles — wife, mother, doctor, employee, daughter, sister, friend — it’s a struggle to keep from dropping one of those balls, much less all of them.

The motivating factor that helps me keep those balls in the air? Guilt.

As much as I hate that feeling of guilt, it’s the third hand — and fourth and fifth hands — in my daily juggling act.

This blueberry buttermilk tart was an effort to overcome my guilt last weekend after spending Friday and Saturday  away from my family for a work meeting and to speak at a conference. We had one remaining bag of frozen blueberries from our blueberry picking excursion last summer. The bag held two cups of plump berries, not enough for a pie, but just the right amount for this tart. I battled with the sticky dough for the crust, throwing out one batch entirely after it misbehaved. I finally used Dorie Greenspan’s tart crust method, and it came out wonderfully.

And this weekend? I predict another round of guilt-induced baking.

Blueberry Buttermilk Tart

While you can use a pre-made dough for this crust, I recommend making your own. The baked crust has a texture like shortbread - sandy and almost-but-not-quite crumbly. The method for the crust comes from Dorie Greenspan. Rather than risk the irritation that comes from watching the dough tear and stick as you try to roll it, just use this method. It works.

Ingredients:

For the tart shell:

1-1/2 cups all-purpose flour
1/4 cup granulated sugar
1/4 teaspoon kosher salt
1 stick (1/2 cup) plus 1 tablespoon cold or frozen unsalted butter, cut into bits
1 large egg yolk, beaten with 1 tablespoon ice water

For the filling:

1 cup buttermilk
3 large egg yolks
1/2 cup granulated sugar
1/2 teaspoon nutmeg
1 tablespoon fresh lemon juice
1/2 stick (1/4 cup) unsalted butter, melted and cooled
1-1/2 teaspoon vanilla
1/2 teaspoon kosher salt
2 tablespoons minute tapioca
2 cups fresh blueberries, picked-over and rinsed

Directions:

Prepare the tart shell:

In the bowl of a food processor, pulse together the flour, sugar, and salt a couple of times until combined. Add in the cold bits of butter and pulse until the mixture resembles coarse meal. Add in the beaten egg yolk and process for long, 10-second, pulses until the dough starts to come together in clumps. The sound the food processor makes as it works the dough right before the clumps form will change, so listen closely. Pour out the dough onto a work surface, and knead it a couple of times, just to incorporate any loose bits that try to escape.

Press the dough into the bottom and sides of a non-stick, 10-inch, fluted tart pan with removable bottom. Chill the shell in the freezer for at least 30 minutes.

Preheat the oven to 375 degrees. Butter the shiny side of a sheet of aluminum foil and place the buttered side down tightly over the tart shell. Bake for 25 minutes, then remove the foil. Press down any puffed up areas of crust with the back of a spoon. Bake for another 5 to 10 minutes, or until the crust is a light golden color. Cool the shell in the pan, on a cooling rack.

Prepare the filling and tart:

Preheat oven to 350 degrees.

In a blender or food processor, combine the buttermilk, egg yolks, granulated sugar, lemon juice, nutmeg, vanilla, salt, and tapioca. Blend until the mixture is smooth. Spread the blueberries over the cooled tart shell, and pour the buttermilk mixture over the blueberries. Bake for 30 to 35 minutes, or until the filling is just set.

The tart crust and method come are adapted from Dorie Greenspan's recipe in Baking: From My Home to Yours. The filling is slightly adapted from a recipe in Gourmet, July 1990.