Comfort food

The Ceeb’s Sounds Like Canada radio show is running a series on hospital food this week. It’s sort of the “great equaliser” among patients – young or old, surgical or medical floor, private room or ward bed, everyone chows off the same menu. The usual culinary critique – they even managed to get a quip from the Minister of Health: “For every negative experience one patient has, there are ten who have been well looked after and whose biggest complaint seems to be hospital food.” And even Senator Pat Carney joined in, with her own first-hand insight. Great equalizer indeed, one of the negotiators of the North American Free Trade Agreement, of all people, sharing a meal (though not necessarily at the same table) with average Joe Canuck in hospital.

But like a lot of things about the health care system, the vast majority of people actually don’t have first-hand experience with it (fortunately for them), but everyone has an opinion. “Surgery wait times are too long.” (It might be a painful wait, but it doesn’t change the outcome – no one is dying earlier, or becoming permanently disabled, because they had to wait.) “There aren’t enough MRIs.” (There are literally only a dozen or so diagnoses where the MRI is essential – and a lot of those are neurology things we can’t do anything about anyway.) “What the f-, they airlifted me away for surgery and now they won’t fly me back!” (If it’s not medically-necessary, why should Medicare pay for it? You’re lucky you don’t get billed for Emerg and doctor visits that aren’t medically-necessary too.)

And of course, “Hospital food sucks!”

I’ve been asked before – no, doctors don’t prescribe what you get on your meal tray. We do specify, in general terms, what kind of foods you’re provided: “low salt diet” for heart patients, “diabetic diet” (sometimes with calories specified) for people with diabetes, “low protein diet” if your body can’t metabolise protein properly. Usually what you get with each of those isn’t far off from “normal food” – it’s the stuff you actually should already be eating at home, if you have an underlying medical problem.

Sometimes you end up with stuff that’s less familiar, like “clear fluids”, “full fluids” or “soft diet” if your bowels can’t tolerate solids yet. It’s basically what it sounds: things you can see through (like water or juice; Jello too), then things you can’t (like milk, pudding or broth), then soft semi-solid stuff (like oatmeal, mashed potatoes and veggie puree). You’ll also get restricted menus if you can’t chew or swallow totally normally – the traditional ice cream after you get your tonsils out, that sort of thing.

Patients’ meals actually are a good measure of how well they’re doing, and I think patients (and especially their families) can tell from what they get. It’s more accurate than the medical mumbo-jumbo jargon we can’t help but gloss over sometimes. It’s one thing to tell a patient You’re doing fine! and “reassure” the family Everything is going to be ok!; then the nurse comes in with a slurry paste of sugar and oil for “dinner” and then they really know how “fine” and “ok” they are. Conversely, when they finally graduate to, well, anything else (trust me, anything looks good after the sugar and oil “dinners”), that’s how they know all is right in the world (and their bowels) again.

Most hospitals can accommodate preferences like vegetarian, vegan; one nursing home I was at in Toronto had a whole floor of Jewish patients, and another of Chinese, so they always had kosher and Chinese menus for each (and you could switch around if you wanted to). For alcoholics likely to withdraw, we can even order a drink a day – just enough to keep you from getting shaky and seizing, but no more. And usually we want to get you eating (and BMing) normally as soon as you can, so if you wanted to bring in anything specific, just ask, and we’ll say if it’s safe or not.

I actually like to know what my patients are eating, and trying some if there’s an extra tray. Plus sometimes I’m too busy to actually leave the hospital and get something. Yes, some hospital food tastes like it was microwaved and shipped over from a factory kitchen across the province – because it has. If the cost savings of closing down the in-house kitchen to outsource meals means the difference between being able to provide medicines and surgeries, so be it… but it’s sad when things are so bad we can’t even give sick people a decent meal.

“Comfort food” – there’s a reason why good food is uplifting. Because, well, it’s good for you.

Apparently they wanted to axe the Masset Hospital kitchen and outsource it, either to the other hospital on the island, or to a factory kitchen on the mainland. Either way, it would’ve been a fragile setup, subject to the whim of the next windstorm or hurricane or earthquake threatening the island. Or a mechanic putting the wrong oil on the ferry, knocking out all shipping to the island for a week. Like this week.

Luckily they didn’t, because they have an amazing cook (she’s much too down-to-earth to stand being called “chef”) who uses the best local seafood and produce, right from the island. (At low tide, if there’s been a heavy northwest wind for long enough, followed by a southeast, fresh scallops wash up on the beach.) Plus she’s just too nice; like my Mum – asking if I’ve had enough, telling me there’s more soup on the stove and scones in the oven and worrying that I’ve lost weight – except white.

Grilled salmon, baked potato, steamed vegetables, with a brownie, Mandarin orange and a standard 250mL aliquot of 2% milk. This was one of my first hospital meals in Masset – and from then, I knew this rotation was going to be a treat.

Steak! In a hospital! Now that’s comfort food. With mushrooms and caramelised onions, mashed potatoes and steamed broccoli, corn in syrup and chocolate pudding. And a 120mL kids’ cup of apple juice – the first time I’ve had apple juice since elementary school.

Roast beef (slightly peppered and gravied), with mashed potato, carrot, squash (I think it’s squash anyway), fresh salad and blueberry cake, freshly-baked. They ran out of juice that day, so just a glass of water.

Steak – again!? Crazy! And mashed potato, peas, cauliflower, and – this was special – cheesecake from the hospital director’s husband, who is apparently a cheesecake master. That’s the cheesecake to prove it. Maybe that’s their way of saying “please stay and work here.” Small-town hospitals are notorious for tricks like that.

Christmas – steak! With mashed potato (I guess it’s a staple of hospital food everywhere), mixed vegetables, squash (I think – but scooped and strung out from the skin), salad, and lemon pudding with cinnamon and whipped cream. And just for Christmastime, festive cranberry juice instead of apple.

Actually, if I were a hospital Chief of Staff, I would prescribe cranberry juice with every meal – cut down on bladder infections, as generations of girls already know from their mums: drink cranberry juice! With so many inpatients with catheters (which are infection-prone), it would really help. (So would steak… yeah…)

Anyway, from the comments I get, hospital food (good or bad) ranks up there with post-op pain, uncomfortable beds, noisy wards and caring nurses as what people remember most about being a patient. Patients’ families also definitely take a critical eye on what their loved ones get. If I still had time, I would’ve done my residency research project on hospital food – menus, nutritional value, composition, variety, local vs outsourced, and of course, presentation and taste.

Volunteering myself to leave no tray unsampled – in the name of quality control and patient wellness, of course.