There’s no one moment I remember distinctly when I realized my love for cooking. Cooking has been part of me for as long as I can remember: recipes have long since been abandoned for the spontaneity of Thursday night creations. Tuesdays have become an excuse to make cookies.
For my family, like for many, the kitchen was the center of our house. Maybe my love of cooking came early, sitting on the floor in my parent’s apartment banging spoons to pots, maybe later playing with the scraps of Christmas cookie dough or eventually when I was set loose on my own to stir risotto in endless circles or curl my fingers under while I chopped onions into long, thin strips. It’s a running joke among my friends that I should have gone to culinary school instead of medical school.
Earlier this week, I escaped early from the hospital and stood in my kitchen to make tacos and beans and calabacitas. I filled plates with warm corn tortillas and fat slices of avocado and broke down bell peppers into fine pieces. Somewhere in the middle, as I flicked pans and shredded cabbage, I thought about Joe.
Joe’s hospital stay had been endless — his hospital room looked more like a hotel room at this point. He had an esophageal perforation that was taking weeks to resolve and until it did, he’d been completely unable to eat. He was on TPN (total parenteral nutrition, basically food via IV) to keep him alive, but imagine how close that would feel to starving, weeks without the simple satisfaction of a meal. I thought about that morning when they finally allowed him some green Jell-O and pink pudding. I thought about how he had reacted as though this meal was a miracle.
When I asked him how the food was after all that waiting, he just shrugged, “You’d think after six weeks without real food they could manage to give me something a little bit better, healthier, you know? But this will have to do.”
The hospital is full of trays of what may be the most depressing food of all time. Piles of eggs that come from a carton instead of the inside of an eggshell; stacks of sad, flavorless white bread; lettuce that might have been green once but has long since turned pale; anemic oranges; bruised bananas; and slices of some processed cheese product that bears more resemblance to the plastic it came wrapped in than the cheese it’s supposed to be. Hospital food is unappetizing and tasteless, and it’s often not even healthy.
When studying 14 California children’s hospitals, researchers from UCLA found that only 7 percent of all meals served in those hospitals were healthy. A whopping 7 percent! Yet, as was reported in JAMA in 2013, we know that dietary risk is the number one risk factor associated with death and disability in this country. Yes, an unhealthy diet has outstripped tobacco as the risky behavior most likely to kill you.
So why are hospitals contributing to the problem? First, we have failed to properly train our future doctors on nutrition at all. We spend very little time on nutrition in medical schools. Less than half of all medical schools in the country receive the required 25 hours of nutritional education recommended by the National Academy of Science. By improving the diets of patients in the hospital, we might teach them how to improve their diets once they leave.
In 2012, the Institute of Medicine recommended that health care professionals need to act as “role models for patients and provide leadership for obesity prevention efforts in their community by advocating for institutional, community and state-level strategies that can improve physical activity and nutrition resources for their patients and communities.” As medical professionals we must remember that we do not live in isolation, the decisions we make, the example we set does not only affect patients in the hospital but also stand as models for the community. Maybe changing the way we look at food in the hospital could be the first step toward creating lasting change in a country that seems to be completely at a loss for how to create healthy, sustainable eating habits. When we know that healthful options can save lives and unhealthful ones put them at risk, why must we insist on handing patients the guns? Patients with diabetes are given pancakes for breakfast, and those with heart failure still enjoy greasy pieces of bacon alongside their white toast. We hand them the weapons that have contributed to their admission in the first place.
We have seen it before and know that hospital policy can inform greater change in the community. Hospitals were one of the first places to ban smoking. As obesity and its complications have quickly outstripped lung cancer as the leading cause of death in this country, why not take steps to curb its effects? Food is a part of our consciousness, a part of our lives but now we have the power to make food part of the solution. Perhaps after patients leave the hospital they will return to fast food diets, but why miss out on the opportunity to teach? Instead of making hospital food the punch line to a thousand TV jokes, we could turn it into another way to improve patient wellness.
My mother always told me, “that an ounce of prevention is worth a pound of cure.” I see nowhere this is more true than in the world of food.