PBS’s ‘This Emotional Life’: The Hospital Menu in the Modern Age

Thomas Edison wrote: “The doctor of the future will give no medicine but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease.”

Medical technology has made dramatic leaps in the past 150 years. From the invention of the X-ray and the introduction of vaccines to the mind-blowing capabilities of high-tech 64 slice CT scanners that allow physicians to view the inner workings of the human form, the ways in which we practice medicine today seem light years ahead of our predecessors. And yet, oddly, one aspect of the hospital stay has remained surprisingly constant — the menu.

Until recently, that is. Today’s hospitals are learning how important a tool the menu can be when it comes to promoting healing, increasing nutritional awareness and improving their patients’ emotional well-being. The twenty-first century has brought with it new ideas and sound philosophies relating to the bond between what we eat and how we feel, and nowhere is that link more dramatically felt than when one is forced to dine from a hospital bed. In the past the focus of hospital food was primarily somatic, although the lackluster fare did not always provide the much-needed healthy boost of vitamins and minerals. Today’s hospitals have come to recognize not only the value of well prepared, fresh food in bolstering the immune system, but the benefits choice can have on a patient’s psychological outlook during trying times. Food, it seems, is powerful medicine not only for the body, but also for the mind.

Since study after study continues to stress the influence proper nutrition has on rates of healing and overall health, many of today’s hospitals have begun to address the tired stereotype befitting Jell-O cubes and ice chips, striving instead to serve fare that is both varied and enjoyable. In doing so, both patients and hospitals benefit. By allowing patients to choose their meals, they are given a degree of control over their situations, albeit small, which can go a long way toward reducing the stress of waiting for test results, exams or procedures.

Over time, it has become clear that the old methods of serving patients are no longer a match for the needs of the modern hospital or those it serves. Since the average age of the hospital patient continues to rise as Baby Boomers find themselves entering their sixties and demanding a standard of quality that they have grown to expect, many hospital administrators have opted to outsource food services in an effort to provide patients with quality meals that are prepared without taxing the hospital infrastructure itself.

Today, nearly 20 percent of American hospitals employ food service outsourcing in one form or another, and the trend is on the rise. By doing so, hospitals are able to focus solely on the task of ministering to patients, freeing up staff members who once doubled as waiters and providing patients with food prepared by culinary experts who take pride in conjuring up a variety of nutritious dishes guaranteed to surprise if not delight the most curmudgeonly gourmand. This not only increases efficiency, it results in improved service, better food, greater selection and higher patient satisfaction. To keep up with the modern patient’s need to be pampered, many outsourcing companies have even begun to offer room service dining, which is in many ways similar to a hotel experience. When hungry, patients simply place an order with the kitchen, and their request is brought up in a timely fashion after having been vetted by the hospital dietitian. Food is freshly prepared and the menus are extensive.

Whether outsourced or not, many modern hospitals have committed to improving the quality and scope of their menus in an effort to capitalize on the link between healthy eating and psychological well-being. With greater variety comes better nutrition, as patients are not only eating healthier food free of excess sugars, starches and preservatives, they are eating more of it. The concept of food as preventive medicine has resulted in some leading hospitals offering primarily organic and chemical free food, including hormone free milk, antibiotic free chicken and beef and locally grown fruits and vegetables.

This stands as an excellent example of the way in which hospitals are beginning to regard education as a key factor in the continued health of their patients. Most American hospitals employ registered dietitians to ensure that patients eat healthy, well-balanced meals during their stay and receive the necessary education to continue such patterns at home. In this way, hospitals can do their part to proactively treat patients before they become sick as a result of obesity or lack of nutrition.

Understanding the full impact of a proper diet is no easy task for anyone, hospital patient or not. Modern times can often blur the lines between healthy or unhealthy, too thin or too heavy, without even addressing nutrition. Whether the focus is on obesity-associated morbidity or orthorexia nervosa (an antiphrastic oxymoron which is used to describe an unhealthy obsession with eating healthy), a hospital stay can help patients recalibrate their eating habits and promote greater combined mental and physical health in the future.

If you or a loved one find yourself in a hospital for any length of time, consider using your stay to familiarize yourself with the basics of nutritional healing and overall healthy eating. This will help you not only during your visit, but as you return to your regular lifestyle.

Get to Know Your Dietitian. Dietitians create menus that meet healthy eating guidelines set by the American Dietetic Association, as well as satisfying regional tastes (foods that are familiar to a large immigrant community, for example) and addressing specific patient related health needs such as those exhibited by diabetics, breast-feeding moms, wheat-allergy sufferers, etc. Your hospital dietitian will gladly provide advice and information on ways to improve your dining habits and cooking preparation, taking into account any health-related issues.

Shop Around. If you are not in the hospital as a result of an emergency situation, take a few minutes to find out what each of your neighboring hospitals have to offer in the way of dietary education, menu preparation, and room service dining. While medical expertise should always be the primary concern, you might be surprised at the quality of food service now being offered by medical centers in your area.

Use Your Down Time. While no one ever wants to be in a hospital, the periods of waiting between tests or while healing do provide many people with the opportunity to think about their health and reflect on ways to improve their quality of life once they are discharged. Ask questions and use the experts around you. By thinking long-term, you may be surprised to see just how easy it is to adopt healthier patterns once you are back to your normal routine.

By bringing the menu into the twenty-first century, today’s hospitals hope to educate their patients in the ways in which proper nutrition can bolster not only the body, but the mind and spirit as well. As always, the evolution of medicine continues to take its cue from Hippocrates, who must have thought holistically when he said, “Let food be thy medicine and medicine be thy food.”

This Emotional Life is a two-year campaign to foster awareness, connections and solutions around emotional wellness. Join our community at www.pbs.org/thisemotionallife.

PBS’s ‘This Emotional Life’: Rethinking ‘Medical Miracles’

Saint Augustine wrote: “Miracles are not contrary to nature, but only contrary to what we know about nature.”

A phenomena within health care, often applied when no rational scientific explanation can be given, preexists medicine itself. Be it via the Internet, urban legends or contemporary television and cinema, we have all marveled at the thought of the teen who lived 118 days without a heart, or the paraplegic man who was once again able to walk after being bitten by a brown recluse spider, or the window washer who fell 47 stories and awoke from his coma on Christmas Day. Sometimes, medical degree or no, the only way to explain the reasoning behind such patient outcomes is to use that often overburdened word — miracle.

From the outset, medicine and religion have been begrudgingly forced to spar in their attempts to provide relief. As the two have evolved, they have constantly found ways to overlap, each jockeying for position as the times around them changed. One point of mutual interest and competition has always dealt with diagnosis. For example, thanks to advances in modern medical technology, we now know Tourette’s Syndrome to be a rare neurological disorder. In its more aggressive stages, Tourette’s presents itself with facial tics and expressions, the perception of the eyes rolling upwards, and involuntary, often guttural sounds. Though contemporary physicians are capable of recognizing this disease for what it is, it is interesting to note that Tourette’s was once widely understood to be a form of demonic possession, and dealt with accordingly.

On the flip side, take the curious phenomenon of Lazarus Syndrome. Since 1982, there have been 25 documented cases of a deceased patient coming back to life without any medical intervention whatsoever, due to a spontaneous and unexplained restarting of the heart muscle after death. The name comes from the biblical tale of Lazarus, who was raised from the dead by Jesus after four days. Though medical science has put forth several possible theories for such an occurrence, it remains a widely debated mystery to this day, from both a scientific and religious standpoint.

Whether or not a patient believes in miracles, there can be no dispute that certain advances in medicine are nothing short of miraculous. In 1944, doctors performed heart surgery for the first time. In 1952, Jonas Salk took the first step toward eradicating the dreaded polio virus. Today, scientists can administer vaccines to cure many diseases, some even after infection. These same scientists believe they can also inject a patient with his or her own cells to help repair vital organs, thereby allowing the patient’s body to essentially heal itself without any outside, invasive intervention. More and more, the gulf between miracles and modern technologies continues to widen.

At their core, both medicine and religion seek to heal. To support this objective, modern medicine began to focus its attention on shortening the list of any diagnosis that could be classified as a “terminal illness” (an illness from which, despite treatment, death is certain). At the turn of the twentieth century, as patients began to realize that modern medicine was advancing quickly and achieving previously unheard of results, the role of medicine itself started to change. Patients began to expect not only treatment of symptoms, but cures. With this understanding came a new feature formerly the exclusive jurisdiction of religion, the possibility of hope.

To a certain degree, the medical miracles of yesterday have slowly become the miraculous advances of today. Many previously unexplained situations are now seen clearly from a scientific standpoint, a sure sign of progress. But to hospital patients and their loved ones who must face incurable disease, this temporal distinction weighs in as little more than semantics. Looking in from the outside, it appears that most families do not care whether comfort comes from a modern miracle or medical breakthrough, so long as it eases the pain.

No matter how far science advances, however, one should never discount religious faith within the medical arena. In fact, it is just such conviction that has always pointed the way to medical success. Study after study has shown that the act of having faith — be it in an afterlife, an all knowing creator, or a CT scanner — can have a dramatic effect on both the condition and quality of life during a loved one’s final days, for the patient and family alike. Modern medicine still has a long way to go in its quest to unravel definitively the mysteries of the human body, and when its efforts fail us, faith is the only remaining foundation.

Should you find yourself in the unenviable position of comforting a loved one when time is short, faith may prove to be your most powerful tool. In such times, communication and honesty are of utmost importance. Ask questions of the patient, and respect his or her needs and convictions. Some people insist upon continued care until the end, while others want only to be checked up on. Many want an ear that is willing to listen. Certain patients continually search for clinical trials or secret elixirs to keep their faith alive, while others take comfort in resigning themselves to what is to come. Respect the viewpoint of the patient and do your best not to superimpose your own desires or beliefs on top of theirs. Remember, this is their time, not yours.

As technology continues to discover new ways to push the limits of our understanding of the workings of the human body, faith in the unknown becomes ever more important, standing as a beacon to highlight the next step in a series of challenges. Not only must medicine and religion be allowed to coexist within a hospital, they must be able to complement one another. Most modern hospitals are big places. Surely there is room for both.

This Emotional Life is a two-year campaign to foster awareness, connections and solutions around emotional wellness. Join our community at www.pbs.org/thisemotionallife.