What's a top toque like Alison Negrin doing in a hospital cafeteria?
Photograph by Akim Aginsky
Enjoy is not a word often associated with hospital food. Comparisons to what we once knew as airline food are much more frequent, as are vocal musings about how in the world a person can recover from an illness when the food is, well, sickening. Yet, through a process that sometimes has been like Alice Waters meets mystery meat, the food at John Muir Medical Center has hit a decidedly new level of popularity among patients.
David Loveall, a 55-year-old retired data analyst from Danville, is a bit of a hospital food expert, having lived through stays at a number of facilities. Unlike when he was hospitalized in San Francisco and had his family bring him meals from outside, he has nothing but praise for the food he was served at John Muir’s Walnut Creek campus. A seafood lover, he singles out the tilapia and “really delicious” grilled salmon he ate during a prolonged stay in John Muir’s physical rehab unit earlier this year. “They cook it just right,” chimes in his wife, Linda. Then there are great grains and lots of fruits and vegetables, the Lovealls say.
“I think the food helped me get well faster,” David says, echoing similar compliments from other patients.
No, this doesn’t sound anything like typical hospital fare—and it isn’t, thanks to chef Alison Negrin, a veteran of both Chez Panisse and Bridges. For the past six years, Negrin has worked hard to improve the food at John Muir’s campuses in Walnut Creek and Concord—a mission that hospital brass hired her to take on, but that has come with a tough set of challenges.
Negrin says that improving hospital food is some of the most exciting, satisfying work she has ever done. When she applied for the John Muir job, however, she surprised many in the food community. Why would a chef with white-tablecloth credentials venture into the sterile world of institutional food? The answer: Negrin, now in her mid-fifties, is no stranger to causes and has never shied away from challenges.
Studying at the California Culinary Academy in the late 1970s, the intense, five-foot-tall chef rebelled against what she considered a stodgy European approach. This led her to a coveted spot at Chez Panisse. The next rung on Negrin’s culinary ladder brought her to Contra Costa as opening chef of Danville’s immediately acclaimed Bridges.
All along, Negrin harbored an interest in food as a force for healing and positive social change. She left high-profile chef positions to teach kitchen skills to inner-city youths on Treasure Island and studied Chinese dietary traditions and Ayurveda, the 5,000-year-old Indian practice and philosophy of natural healing.
At John Muir, even though Negrin has had the support of the hospital’s board, she still had to make changes one step at a time.
For one thing, Negrin found that in a hospital, unlike in a restaurant, the chef cannot tweak recipes at will. Here, dietitians rule. They must assure that every patient’s special needs are met, which means that many familiar ingredients that add flavor, such as garlic, onions, cream, and salt, are restricted. At the same time, dietitians believe that patients like and need sauces and gravies. Yet, the water-based sauces they approved were about as appealing as baby food.
Negrin’s solution: a broth consisting of a reduction of wine and broth, seasoned with shallots, peppercorns, and bay leaves that are strained out before the infused liquid becomes the base for soups and sauces that—surprise!—have real flavor.
Besides tasting better, the meals contain ingredients that are grown and distributed in environmentally friendly ways. Negrin had her kitchens switch suppliers and replace fruits and vegetables with as many locally grown goods as possible. “In season, 90 percent of the produce we serve is grown within a 100-mile radius,” she says.
Negrin isn’t focused just on improving the quality of the 1,500 meals served to patients daily. She wants to educate and encourage hospital staff, visitors, and the general public to eat better, too.
The hospital cafeterias, or cafés, as the hospital likes to call them, now prominently feature farm-fresh salads on their menus, and the vending machines dispense baked chips, as well as fresh fruit, nuts, yogurt, and sandwiches on whole wheat bread.
Inspired by Kaiser Permanente’s sponsorship of nearly three dozen farmers markets in hospital parking lots, Negrin persuaded about 30 coworkers to subscribe to a CSA (Community Supported Agriculture) program in which farmers bring just-picked produce to the hospital for workers to take home. Negrin herself partakes of the weekly bounty, lugging home fruits and vegetables to her husband, Kevin Barnett, a public health executive, and their teenage son, David.
As a founding member of the Bay Area Hospital Leadership Team, made up of other progressive food professionals from organizations such as UC San Francisco and the Veterans Health Administration, Negrin encourages medical centers to embrace the value of stocking their kitchens with food grown and produced by local suppliers. “Hospitals are huge consumers,” says Negrin, with the enthusiasm of a reformer. “We can really affect change by purchasing sustainably grown food.”
Negrin also sought to give patients choice, the new buzzword among forward-looking hospital food professionals. She admits, for example, that not everybody loves the dense whole-grain baked goods she purchases from Vital Vittles, a Berkeley brand favored by natural food devotees. Therefore, white rolls and breads are still available to patients and in the café. “We offer enough choice to make almost everybody happy,” she says.
Negrin is the first to admit that there is still room for improvement. She is looking for ways for John Muir to buy more sustainably raised meat. Although the meat costs more, chefs can offset the added expense by downsizing meat servings and creating more vegetarian options.
For all her dedication to community health, Negrin is no zealot and doesn’t apologize for still serving burgers, fries, and sodas. People need familiar treats, she says. “Patients are away from home, sick, and under stress. … And who am I,” she asks, eyebrows arched, “to tell a physician who has just finished a four-hour surgery and wants nothing more than a cold Coke, ‘You can’t have that’?”
Overall, Negrin is pleased with her reforms to date. They jibe perfectly with what has been her mantra wherever she has cooked: “To serve food that is beautiful to look at, wonderful to taste, grown with care, and beneficial to eat.”
Better hospital food around the East Bay
Last year, Kaiser Permanente began using more fresh, locally grown produce and other ingredients in the 6,000 to 7,000 patient meals it serves daily throughout its Northern California facilities. The hospital cafeterias must adhere to a no–trans fat policy, and at least 50 percent of items stocked in vending machines must be “healthy picks.”
Since opening, San Ramon Regional Medical Center’s kitchen has employed restaurant chefs, made most meals from scratch, and continues to up its use of organic products and fresh produce.
ValleyCare Health System medical centers in Pleasanton and Livermore have done away with set menus and offer patients a choice of entrées, including grilled and roasted dishes, many made in-house with local, sustainable ingredients.
At its three Alta Bates Summit campuses in Berkeley and Oakland, Sutter Health hospitals have increased their use of fresh, seasonal ingredients in patient food and in cafeteria meals