Continuing with the topic of bad food, we move from Army food to Hospital food in
the latest installment of Sharon Farber's 'Medical Life' series. This article marks
the fifth year of this series, which began back when we lived in Tennessee. We
don't cross paths with her very often anymore, which made the meals we shared with
her in San Francisco high moments of our Worldcon trip.
 The worst food, even worse than army
food, can be found in hospitals.During my internship year I attended
the banquet at the World Fantasy Convention. I was given a salad with iceberg
lettuce that was neither wilted nor drowning in Thousand Island dressing; a piece
of meat that recognizably originated in a cow and might be chewed with ease;
vegetables boiled for less than an hour and devoid of salt and bacon. I dug in
with gusto. Then I looked up and noticed, to my embarrassment, that everyone else
at the table was picking at their food and wearing expressions of disgust. The
best meal I had eaten in the last four months was, for these writers and editors,
the worst.Not all hospital food is equivalent;
there is a hierarchy of dreadfulness. The cafeteria food at the University was
pretty similar to cafeteria food everywhere, though I must admit that in California
I was never offered sweet and sour turkey. Also, the food in St. Louis was an
uneasy mixture of Midwest bland (meat and potatoes, no flavor please) and Southern
cooking (fried, anything green boiled with bacon, and the weird bits of the
pig).The food in the employee cafe was
always less healthy and more attractive than the patient meals. Of course, there's
just something intrinsically unappealing about food on plastic TV dinner trays, and
much worse in hospitals than airplanes. Perhaps this is because on rounds one saw
the dregs of meals -- cold and clotted entrees, mixed together unappetizingly, or
spilled on gowns or vomited up on your shoes. Examining the patient, one regularly
finds bits of scrambled eggs trapped in bodily fluids or embedded in stool on the
sheets. Sometimes, one arrives while, during meals, when one is starving, the food
still smells good, and the patient is chewing open-mouthed and drooling.So when the nurse would call, "Hey
doc, the guy in 14 died and we've got an extra tray -- want it?" I would hastily
say, "No thanks."Instead, with missed meals, I might
raid the patient snack area. Smell (which is most of taste) is the intense
evocative sensation, heading right into your temporal lobe without detouring
through the diencephalon, making those memories more evocative than those of sight
or sound. Thus the taste of cranberry juice or graham crackers makes me immediately
nostalgic for sleepless, mealless nights at Barnes, and vanilla wafers remind me of
the shrieking babies in pediatrics.Some students stole cans of Ensure,
the high calorie milkshake-like food supplement. They claimed it was actually
pretty good, though since we frequently encountered it in vomitus and other toxic
spills, it was an acquired taste. The regular flavors were chocolate and vanilla,
though City Hospital seemed to have been given a bargain on the discounted flavors
-- and not even the most persuasive nurse could convince a starving patient to
drink a coffee or black walnut shake.When I was a student, another team
was investigating a young man whose urine was a frothy pure white; initially they
thought it an unusual form of pyuria (pus in the urine) but it eventually turned
out that he had a fistula allowing chyle (the fat content of digested food) to
enter the kidneys. Anyway, I recommended we name the condition 'Ensuria'. People
became quite angry with me. Not because of the bad pun, but because they could no
longer face a can of vanilla Ensure.The food in certain hospitals was so
bad that even patients who had been starving on the streets regularly refused to
eat. The green bologna at the VA was especially famous -- and if a veteran of the
army refused to eat something, you knew it was bad.At County Hospital, staff meals cost
a quarter, and we felt we were being ripped off. The cafeteria was not open nights;
midnight snacks were stored in a refrigerator. A hospital security guard stood
there to make sure you left your 25¢ meal ticket.
The food at City was the ultimate
in unappealing and inedible. Adding insult to injury, you had to work hard to
obtain it. The cafeteria was open only briefly for lunch. To get breakfast or
dinner, you had to call hours in advance and order the appropriate number of trays.
This meant waking at 5am (in the rare event you were asleep), but this bit of scut
work was never relegated to the students. They weren't considered responsible
enough for this most crucial act of the day.You couldn't get your breakfast
until 8am, which at other hospitals was rounding time. At City, we'd all sit and
watch the off call team eat; it was only polite. You'd order extra breakfasts for
anyone desperate, and save the doughnuts and cereal for emergencies. These went
into a drawer in the conference room, along with an illegal collection of feeding
tubes (which invariably went bad Friday at 4:35 when Central Supply closed for the
weekend), butterfly needles and small-gauge IVs (virtually unobtainable and very
necessary), and extra vacutainers and tournequits (brought down from the University
by each new team).A proper resident spent part of each
day scrounging for these bits of equipment, without which you could not keep
patients going, and which the hospital administration felt were unnecessary. For
instance, they gave us plenty of intravenous catheters -- yeah, two inch long
14-gauge, something you'd use to get a blood donation from a healthy muscular
football player, not something you'd dream of trying to insert in a frail, older
patient who'd been hospitalized two weeks and didn't have a good vein left. And
since we were technically no longer an ICU, despite having all these patients on
ventilators, our allotted blood gas kits lasted about a day and a half.Whenever the emergency room abused
me, I'd retaliate by sticking a couple of 20-gauges in my pocket. Then I'd return,
like some primitive hunter-gatherer, and hand out goodies to the interns. I left
City Hospital for my next rotation, at Childrens, where butterflies were ubiquitous
and all needles tiny. After a couple days there, I realized that I'd been
unconsciously filling my pockets with IV catheters.We lived in the fear that the
gynecology residents, with whom we shared our floor, might locate our precious
doughnut and needle stash. They would have no compunctions against ripping us off,
we knew -- we were the same folks, after all, who kept our lab such a mess that I
once looked through the microscope at a sample of spinal fluid and saw sperm.Hard as it was to obtain breakfast,
dinner was chancier. We were usually in the emergency room, and barely able to run
to the kitchen at the last minute -- only to find that the gynecology team had
stolen our trays.Even when the food was there, it was
mostly inedible -- I remember a long discussion as to whether bits of liquid cheese
on cubes of white bread was Welsh Rarebit or culinary desperation. We joked about
sending the occasional bits of meat to pathology for identification -- though we
were afraid that we might be returning them to their starting point.If you missed dinner, you were on
your own. The neighborhood was too dangerous for pizza delivery, and only a large
or foolhardy medical student would volunteer to run out for burgers. That left the
munchie machines, and in the rare event you had any change they were probably
empty.Late one night, I ventured into the
basement hunting for the mythical full munchie machines. Everything turned out to
be empty except the Coke machine, and while I was there a security guard wandered
by. She said, "I was just out on the street and heard screaming," and proceeded to
tell me a long and incomprehensible story, the gist of which (I think) was that
some girl was raping some boy in the bushes, which I found hard to believe as there
was very little greenery around the hospital. I make it a habit to be polite to
people who carry guns and tell weird stories, and I subsequently avoided that area
of the basement as much as possible.# # # #
The most disgusting hospital food
has to be the pureed glop for people with problems swallowing. You have to specify
pureed -- the soft diet may deliver bacon and white bread. I always feel
hypocritical when I stand above a tray with its little plastic rectangles of green
stuff, brown stuff, yellow stuff and gray stuff, and urge the patient to eat up.
If only the food wasn't so bright!One day at City Hospital, my chief
resident said, "There's a guy on the medicine floor who I think has bulbar
myasthenia. I'm due in clinic -- I want you to do a Tensilon test."Myasthenia is a disease where
antibodies attack the acetylcholine receptor, in essence blocking the muscle's 'on'
switch. In the Tensilon test, you inject something that increases the acetylcholine
available, and if the person really has myasthenia, he'll be much better until the
shot wears off, in about ten minutes. (Then you can treat with a long-acting pill
form of the medicine.)I read carefully how to do a Tensilon
test -- it was my first time -- then went upstairs. The patient was a tall, skinny
black man with droopy eyes and a voice so slurred that his speech was unintelligible.
He sat staring disconsolately at a tray of pastel purees.I introduced myself, and explained
that I was going to inject him with something that would make him better. Then I
picked up a needle full of saline -- the book recommended starting with a placebo,
because some people fake weakness and improvement. Of course, I later realized
that, when you have something objective like ptosis (droopy eyes) or dysarthria
(slurred speech) you don't need to bother with the placebo."This will make you feel a lot
better," I said encouragingly, and injected the saline. Not surprisingly, it
didn't. He looked angry, then began to mumble something I couldn't understand.I gave him the Tensilon next. He
was still mumbling, and suddenly his speech became clear. "...God damn idiot
doctors..."He stopped his diatribe, realizing
that his voice was back to normal. He flexed his arms. He stood. For the first
time in weeks, he was able to walk. He strode up and down the room, saying,
"Praise the Lord!"I felt like Oral Roberts.He walked back to the bed and looked
down at us. I thought he was going to thank us. Instead, he pointed to the tray of
puree."This is the worst food I have ever
seen in my life!" he began, and proceeded to tell us everything that was wrong with
the food, the nurses, the hospital... All the pent-up frustration that he'd been
unable to express emerged, with us as the target.We felt intense relief when, several
minutes later, the Tensilon wore off and his speech was once more low and
unintelligible.We wished him bon appetit, and got the
hell out of there, hoping the cafeteria was still open for lunch...  All illustrations by Teddy Harvia |
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