Hospital Food

This piece was written for my book, Kitchen Party, but somehow, in the transferring of 47 essays and images to the final manuscript, it got lost. I remembered/discovered it this past weekend and was very disappointed, because not only was it written specifically for the book, it is one of my favourite pieces. So I’m sharing it here instead. If you like it, please check out my book over at Stained Pages Press, which is full of similar pieces.

Donuts. Muffins. Trays upon trays of little bowls of pudding; today it’s vanilla. Pan after pan of brownies and carrot cake, both options on the regular menu for tomorrow. And, can it be? A three-layer birthday cake decorated with frosting roses and swags. “Happy Birthday Andrea”. I don’t know who Andrea is but she must be someone special to warrant a huge cake like that in a place like this.

So cold. I can’t stop shivering. The sleeves on my uniform are short, if someone doesn’t show up soon, I’m going to freeze to death. They’ll find me in the morning, asleep in a corner, discarded muffin wrappers around me, jam from the donuts in splurts down the front of my apron, my exposed skin slathered with the butter-cream from Andrea’s cake as an extra layer of insulation against the cold.

What time does the morning shift start anyway?

**

The night I got locked in the pastry fridge at the Victoria General Hospital might well go down in history as the most willpower I have ever exerted at one time. The thought that you’ve got ten hours ahead of you locked in a fridge is bad enough, but to spend that time surrounded by cakes and cookies and pastries is enough to make the brain snap.

Fortunately, before I could help myself to the masterpiece that was Andrea’s birthday cake, my shift supervisor realized that I had not clocked out and came to find me.

I had been by myself in the massive hospital kitchen, having come after dinner service was over to grab a pudding for a diabetic patient only to discover that the walk-in that housed the puddings and pastries didn’t have a safety latch on the inside. I pounded on the locked door. I screamed to be let out. And then I resigned myself to my fate. I would have to eat the cakes to stay alive.

I spent a little under a year, from the fall of 1986 to the summer of 1987, as a dietary aide at the Victoria General Hospital in Halifax (or the VG, as it was known). Hired by my mother’s best friend in an act of complete and utter nepotism, I joined a team of unionized workers whose job it was to deliver meals to patients.

The job required little skill, and demanded only that we be presentable, polite and physically fit enough to walk for a few hours and to carry a tray a few steps from a cart in the hallway to the patient’s bedside. We did no cooking, although some of us did work in the kitchen, situated along the constantly moving conveyor belt, adding dishes, cutlery and food items to the nine hundred or so trays that were prepared for patient meals three times a day.

Back in those days, hospital food was actually cooked in the hospital, and while no one would ever consider it gourmet fare, what we served actually wasn’t terrible. It was bland, and not especially exciting, but it was the 80s, and Halifax was, at that time, pretty conservative when it came to gastronomy. Memorable dishes included chicken a la King, fish and chips, a very nicely grilled pork chop, and a pretty decent spaghetti Bolognese. Breakfast included French toast, poached eggs, and some serious oatmeal.

There were the requisite containers of concentrated juice, bowls of jello, and an assortment of other mediocre starters and side dishes, but the cooked food, at every meal, was passably decent. Certainly, to the untrained palates of the mostly teenaged work force hired to deliver the things, an extra tray, meant for a patient who had been moved, or sent home or, yes, passed away, was a thing to be fought over.

On nights when we served anything with French fries, the nurses and ward clerks would watch us hauling the tray-laden carts down the hallways and would immediately come and claim the trays intended for patients who were gone. We would always insist that if the patient wasn’t there, the food had to go back down to the kitchen, which was the rule, but the nurses outranked us, and we’d watch them scurry off with the tray to a back room where they’d scarf down the fries and cookies we had all hoped would be our reward once we got the empty cart to the servery.

The tray itself was a two-piece plastic, foam-injected monstrosity, the bottom shaped with different compartments for various dishes and food items while the lid sat on top and fit the shape of the bottom so the trays could be stacked eight or ten units high on the transport cart without the need for shelves. Intended to keep the food hot, it had the unfortunate disadvantage of making the food that should have been served cold (juice, milk, salad) warm and unappetizing.

Down in the kitchen, the belt was run by a dynamo (some might say maniac) named Shirley. Dietary aides working the belt were each responsible for adding one item to the tray and would consult the order slip as the tray rolled by. Shirley, at the end of the belt, would check each slip to ensure the contents were accurate, and then the lid would be added and the tray would be placed on the cart. But Shirley was fast, so much so that our teams of four people on the floor often had to split up and deliver a whole wing alone because the carts would arrive faster than we could distribute them.

Distribution was as easy as checking the room number on the slip, then, in the case of a shared room, finding the right patient. The hard part was often finding a place to put the tray – ideally the patient would be ready for us and have their table cleared off. Barring that we could set the tray on the bed or a chair, but never, ever, on the floor. We also were not supposed to touch the patients in any way. If they needed anything, we were to tell a nurse. This was sometimes easier said than done, especially on French fry night when it was hard to even find a nurse on the floor, but also because sick people can get awfully demanding and cranky and sometimes didn’t understand that we weren’t medical staff.

Collecting the empty trays was when the real stress began. We needed to move just as quickly to collect the dirty dishes and trays as we had delivered them – at this point the staff in the kitchen were waiting for us – but the shape of the lids meant that everything had to be in the right spot on the tray or it wouldn’t close properly. Anyone who has ever been a server knows what a mess people can make of their plates. Imagine that with the inclusion of lots of extraneous crap – band aids, tissue, once on the ob/gyn ward a co-worker was handed a tray that had a used maxi-pad atop the dirty plate – and having to fit it all into some sort of shape puzzle.

From there the carts of trays were taken to a servery on each floor, and sent down to the kitchen, one by one, via a dumbwaiter-type contraption. Known as “the chute”, this process struck fear into the heart of many a newbie, since there were no actual shelves to put the trays on, just a row of rungs on each side, both of which were constantly moving downwards, and which didn’t always line up perfectly. The aide then took one tray, held it underneath with one hand while balancing/guiding it with the other, lifted it to roughly eye level, and slid it onto a pair of moving rungs, hoping to hell that the tray made contact on both sides so the rungs would carry it downwards to the waiting kitchen staff.

If the aide was unsteady, and tipped the tray in any direction, the whole thing, lid, bottom, dishes, cutlery and uneaten food, would start to spin and would drop down to the tray below it. Sometimes it would just sit there and those rungs would show up in the kitchen with two trays, albeit messy. But more often than not, a dropped tray would create a domino effect, causing each tray below it in the chute to also fall.

This would inevitably jam the chute, and would mean that we’d take the carts full of dirty trays down the way they came up, via elevator. But in the kitchen, it meant that anyone standing at the entrance to the chute had to dive for cover as fifteen or twenty trays, and their contents, came clattering down and spewing out into the dish room in a melee of flying forks, broken plates and splashes of juice. Breaking the chute might mean an early night for the floor staff, but they cursed us in the kitchen whenever it happened.

Over the course of my year at the VG, I managed to drop most of my baby fat and develop muscles I had never used in a school gym class. Each 3-hour shift was about ninety percent walking and lifting. For the first time in my eighteen years, I had noticeable biceps, and from my first day, barely able to carry one awkward tray with two hands, I progressed to carrying a stack of three, with one hand, at shoulder level, like a cocktail waitress.

At each meal, two aides were assigned the “early” shift. This actually meant not only coming in a half hour early, but also staying late, to sort and deliver snacks to patients with special diets. We’d use a smaller, room-service style cart, and offered things like pudding, cookies and cheese and crackers. Most of these items were pre-packaged, or we’d dole out cookies into snack bags, and were ripe for pilfering. We always put a few extra cookies on our carts “just in case” and those inevitably made their way into our pockets as we left for the night. It was one of those late shifts where I found myself locked in the pastry fridge, at which point, a couple of stolen Peek Freans really didn’t hold a candle to the black forest cake I was contemplating having for dinner if I couldn’t get out.

When I say that we weren’t allowed to touch the patients, that’s not exactly true. Many patients, especially the older ones, scared and desperate for human contact, often wanted to shake or hold a hand. The day I came to work with an asymmetrical haircut in which half of my head was shaved down to a teddybear-like velvet, every little old lady in one ward had to touch it and coo over it. My supervisor was concerned that the older patients would be offended by my new ‘do, but the older ladies, remembering their own experiences bobbing their hair in the 20s, adored it and thought it was fab.

My other favourite group of patients were up on the cancer ward. In 1986, hospitals didn’t really know what to do with the HIV/AIDS patients. The disease was still rare in the Halifax gay community, and the VG, at that time, had about five or six AIDS patients, housed on the ward with the cancer patients. Many of the other dietary aides, despite being provided with information about the disease, began refusing to serve patients on that floor. No amount of arguing could convince them that they were more of a risk to the patients than the patients were to them.

Over time, that 8th floor ward became mine. If I was on duty, I would deliver and pick up trays there, regardless of how the shifts were broken down. When I moved to an apartment a couple of blocks away from the hospital, I’d often be called in (at full pay) just to deliver to that ward, because the people working that shift all refused to walk into a room with someone with AIDS.

I was happy to do it. Both the AIDS patients and the cancer patients were there long term, so they were happy to see familiar faces who greeted them kindly and stopped to talk to them for a bit, or took a moment to tidy up a table for them. They had all figured out what was going on with the other aides refusing to serve their floor, and more than once, a crying relative took me aside to thank me for doing my job and showing their son or brother or uncle some compassion.

Of course, in 1986/87, there was no treatment for AIDS – the drug cocktails that allow those with HIV to live normal lives didn’t exist – and we all knew that those guys were never going home. Watching them slowly deteriorate, listening to their breathing get coarser from day to day as the inevitable pneumonia filled their lungs, was devastating. I had more than a few crying jags on the 8th floor, hidden behind my cart stacked with insulated trays, as I arrived with dinner for one of my favourite patients only to find their room empty, the bed stripped, their personal items gone. And while I walked in on a few dead bodies during that year, the empty beds, the sweet boys gone too soon, caused me much more heartache.

During the 1990s, hospitals began scrapping their on-site kitchens. Outsourcing unionized jobs to low-bid catering companies meant plenty of money saved, even if the food the patients received, food that was supposed to help them grow strong and get better, went steadily downhill in quality. Hospital cafeterias too, were replaced by food courts serving junk food, ostensibly because staff and visitors wanted food they recognized and liked, even if it was tasteless and lacking in nutrition.

It took twenty years for hospitals and governments to see the light, but in the past few years, hospitals the world over have started to move back to preparing food on-site. And they’re not just reheating pre-cooked frozen food, but are creating really interesting, nutritious and palatable meals from fresh ingredients that cater to the wants and needs of patients. It should never have gotten to this point, of course, but it’s exciting to see the innovative changes being made. I bet it’s also exciting to pull the cover off a tray of food and have it look, smell and taste delicious.

That the arrival of the dietary aide with dinner now brings a smile to a face instead of the fear of impending doom (and fish sticks) is heartening. It’s not always an easy job, and dealing with people who are sick or in pain can be very stressful. But knowing that you’re bringing them something good to eat, whether it helps them to heal or simply makes them momentarily happy, is worth a lot.

I’ve had lots of different jobs in my life, but in many ways, my very first job, those days walking the hospital corridors, brightening the days of people by bringing them French fries or a bag of cookies, was probably my most rewarding. I’m not much of a people person, but that year I felt very connected to the people around me. I felt like I was part of something bigger, even if my specific task was fairly menial. It certainly ensured that I’d never take hospital food for granted.