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Hospital and Institutional Foods


RJ Cooper
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Okay, so I'm coming down from my 7 day buzz, and was brought breakfast this morning. Hardboiled Egg, Cranberry-Corn Muffin, Oatmeal.

Pretty fucking simple right? No NO NOOOOOOO. I cannot believe a world class hospital would produce food thats so inexcusable and unpalatable. The hire these people with a title called "CHEF". Come on now. I may not be the brightest on my floor but with the high cost of healthcare your fucking kitchen should produce neutering palatable food so one can feel comfort and heal. Instead a quaff of something that relics the concrete bar floor at 7 am on the west side of Detroit.

So if I were to be chef for a day at JH (by the way world fucking class) here is my menu. Please interject.

stone ground oats, brown sugar, sorghum

broccoli quiche

greek yogurt and berries

1/2 c chicken broth

Does this sound complicated or simple? And what I am truly amazed about is that there are hotels the size of small towns that produce much better food at my guess a better food cost.

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Hey, RJ! Sounds like you are feeling feisty today. I'm guessing that means you're on the mend! BTW, I think you meant to write "nurturing" rather than "neutering." You made the same mistake in Siestema's chat today. I don't think you really think that food should "neuter" the ailing.

Just a thought: maybe hospital food is so bad that it encourages people to want to get out of there ASAP. If you were cooking there as you would wish to, I expect most folks would be eating much better food than they get at home and wouldn't be in such a hurry to go home.

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When I was working in hospitals in the 90's, a lot of private hospitals were using better food as a marketing tool--having vip suites with private chefs (I think Cedars-Sinai in L.A. might still do that) to attract upscale patients, or hiring companies like Marriott to take over their food service and improve the quality of the food. I'm not sure that it proved cost-effective enough to continue doing in many places, so back to the old cheap frozen swill, heated up by unskilled workers. In any case, a research institution like Johns Hopkins doesn't have to worry too much about competing with community hospitals for patients.

But if you think the Hopkins food is bad, I worked briefly at an East L.A. 7th Day Adventist hospital where, as in all Adventist hospitals, there was no meat or fish allowed. Just these foul-tasting "meat substitutes." The hospital cafeteria served hands down the worst food I've ever tried to eat. And even if the patients were not vegetarian, or had a need for quality high-protein diets, they were served things like "tuna" salad that smelled so vile a starving alley cat would avoid it. After the first day, I brought my lunch from home.

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RJ, you have my complete sympathy. I had a very complicated bypass procedure at JH in 2008, and spent nine days on the Bataan Death March diet in the CPCU. I finally determined that the bread and fruit salad were somewhat edible (not even the JH kitchen can screw up a grape), and survived on that although, it seemed, that if I hit the drug pump just before they served any meal, it was not as horrid as it looked-- everything tastes better with morphine.

The one saving grace during the nine days that I was there was when my wife drove over to Attman's and picked up a Pastrami on rye with mustard. This she reluctantly shared with me in a rare moment of pity (and, too, she was tired of listening to me complain). All went well until my blood pressure hit a new Hopkins record, and about ten residents surrounded me with lethal-looking instruments. Still, it was worth it.

If Dr. Shah is still the head of the unit, ask him to tell you some of his Woody Allen stories. It won't improve the cuisine, but it will give you hope that better days are ahead. Get well soon. Regards.

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So if I were to be chef for a day at JH (by the way world fucking class) here is my menu. Please interject.

Ok, I'll play devil's advocate here (having worked in the cardiology community for going on four years now):

stone ground oats, brown sugar, sorghum

What about people who can't handle extra sugar? Even stone-ground oats can jack up blood sugar in the wrong patient. (This would be the same problem with the alleged muffin and possibly-instant oatmeal they served you, though, for sure.)

broccoli quiche

Quiche usually uses heavy cream and/or a good amount of full-fat cheese -- which are not only often verboten for cardiac patients, but also can be tough to digest post-surgery (high-fat and rich foods often are). Broccoli is very low-GI but that also makes it tough to digest; I think hospitals often serve less fibrous veggies because of the digestion issues, although you note this is at 7 days post-op, which should be at a point that the digestion has returned to normal.

greek yogurt and berries

1/2 c chicken broth

No problem here as long as the yogurt isn't full-fat and the broth doesn't have lots of added salt (there goes that blood-pressure monitor)!

In all seriousness, I do think that hospitals should find the happy medium between food that patients can handle and food that actually tastes good and does nurture the body. I like RJ's title for this thread, because it highlights that this is a problem in many institutional dining settings, which would even include our schools -- a discussion handled here elsewhere in some depth, and of course something that RJ himself is passionate about as well.

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I spent six nights as an inmate of Washington Hospital Center a couple of years ago, and I challenge any hospital anywhere in the world to come up with worse food than they gave me. On the other hand, I also challenge any hospital anywhere in the world to come up with a better nursing staff than Washington Hospital Center's.

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I challenge any hospital anywhere in the world to come up with worse food than they gave me.

I have also spent time at WHC - and was on the low-iodine diet at the time. They knew that, as they had put me on that diet.

I was supposed to get food that was acceptable on the low-iodine diet. Not a single item I was served fit the diet. They couldn't bring me anything that did.

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Was Louise Mitchell the hospital administrator I heard interviewed on NPR about her pioneering efforts to increase the amount of fresh, local food served to patients in Maryland's hospitals? The initiative's called "Local Foods to Local Hospitals." A quick internet search suggests there are efforts to improve the quality of its preparation, too. Here's one example from MD Hospitals for a Healthy Environment: click. Perhaps chefs who do not work in hospitals might have insights to share.

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RJ, it is great to hear you are up and about!

I must note that you've hit a real nerve with me (!) since I spent two nights in Reston hospital in early December after having back surgery. The food was awful. It was terrible! But as an occasional glass half full kind of person, on the second day they told me that I should get out of bed and walk. Anywhere. It was exercise that I needed. Even if it was only a few feet.

I reached into my jeans and pulled out a few bills, put on a robe and 24 hours after spinal fusion surgery walked down the hall, found an elevator and when I got off of it, I hobbled another hundred yards. To a vending machine.

Never knew that Diet Coke, Twix and peanuts could taste so good.

Had dinner at the same vending machine, too.

...I must note that literally inedible food aside this was an extraordinary experience in a hospital that I feel truly fortunate to have stayed at. I also believe I found the best spine surgeon in the Mid Atlantic states for anyone who ever wants a recommendation. Thank you, Dr. Mazahery.

And, absolute best of luck, RJ. Look forward to seeing you back at Rogue 24!

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Does no one have family that brings them good food while in the hospital? When I had my daughters, i enjoyed not only delicious food, but served on lovely plates, etc, all brought in from outside. I know some people will be diet restricted, but anyone can steam/saute/grill some fish and vegetables for a loved one, can't they? I do not know RJ but he has an entire staff that cooks wonderful things and clearly has connections to at least one Baltimore restaurant, given his guest chef schedule. Maybe I am more fortunate in life than i think...

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I have also spent time at WHC - and was on the low-iodine diet at the time. They knew that, as they had put me on that diet.

I was supposed to get food that was acceptable on the low-iodine diet. Not a single item I was served fit the diet. They couldn't bring me anything that did.

Worst. Diet. Ever. And horrendous when put out by a hospital kitchen. When I was in isolation at Shady Grove Hospital, the low-iodine food was so bad that I actively dreaded mealtimes.

I don't remember the food when I had my kids, and I was in hospital for 4 days after each. I don't remember caring. Euphoria does a lot for one's appetite. :)

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When I had my kids many years ago, I remember them telling me as soon as I was up & walking around, I could be discharged, so I threw all my energy into that, out in 48 hours both times-I do remember my husband bringing me a Taco Bell bean burrito & I thought it was ambrosial. Unfortunately, I NEVER lose my appetite, last time I was briefly hospitalized, I was able to select menu choices while still groggy from anesthesia-I don't remember it being particularly good...

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I spent a few days at Holy Cross in the fall and was allowed to order every meal from a reasonable sized menu. I didn't have much of an appetite, and if I had to eat I wanted it to be bland, so I wasn't up in arms about the food. I had cornflakes and tea for breakfast (I travel to crappy places enough that I can tolerate Lipton) and vegetarian for every other meal--baked potato with sour cream that I'd mash up with a side of boiled broccoli, grilled cheese. I figured that if they were going to cook the food as badly as I thought they would, I might as well not make an animal die for it. And the pain medicine allowed me to transport myself back to my younger days when American cheese on white bread was yummy and a baked potato was a baked potato. The surprise on the menu was the "lemon sherbet." Served in one of those cardboard cups, it was actually more of a gelato, with a fantastic texture and a refreshing tang. I ended up ordering this at every meal, though the aforementioned pain meds have prevented me from remembering the brand name.

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Does no one have family that brings them good food while in the hospital?

I was at Mass General in Boston last Fall--went on my own and local relatives were travelling while I was there. But my SIL and BIL from NYC sent me a care package from Russ and Daughters with bagels, two kinds of smoked salmon, cream cheese and herring. I knew they had sent it, and I was concerned about it ever getting to me. The box actually found its way to me in that massive hospital complex, the contents still chilled from the cold packs. Luckily, there was a small fridge in my (private) room, and my stay there instantly became so much better. As I recall, I had mostly subsisted on tuna salad sandwiches up until that point, which actually weren't that bad. Everything about the care I received there made it the best of several hospital experiences I've had as a patient, and the many hospitals I have worked in as a social worker, closely monitoring the experience of the patients to whom I was assigned.
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