Andrea Reusing: Cooking in the Moment

I picked up Cooking in the Moment for two reasons.  First, it fit the seasonal theme of my last post. Second, Reusing is posed on the back with a wool scarf and a black and white rooster under her arm.  I admit it, I have thing for women who know how to accessorize with poultry.  The photographer may have overdone the backwoodsy feel of the book: farmers in overalls, coolers in the trunk of a station wagon, a family cracking crabs at a table sawn out of a tree-trunk. I like the picture of a contraption for catching fruit flies and the jar of fat labeled “Not for Human Consumption,” but all this overlooks the eclecticism of Reusing’s recipes. She’s not another down-home cook like Paula Deen, running out into the field to slather butter on the tender shoots of corn as they first break from the soil. Reusing is from Manhattan originally; she grew up eating in China-town; her North Carolina restaurant is pan-asian, and her cookbook is global.

If you want authentic Southern, go with the Lee Bros.  If you want farm, go with River Cottage. Cooking in the Moment is more about doing simple–and sometimes clever–things with fresh ingredients. And drinks.  I guess that’s the third reason I bought the book. “The Homeward Angel,” reads like a biography. Named after the NC cemetery angel that inspired Thomas Wolfe–“Look homeward angel now, and melt with ruth”–it’s really just a Manhattan in disguise: 2 ounces rye whiskey, 1/2 ounce sweet vermouth, 1/4 ounce orange bitters,  two pickled sour cherries and a splash of the brine.  Can a manhattan be authentically North Carolina?  Who cares. Maraschino cherries are usually what keeps me away from manhattans, including the island. And sour cherries, who knew?  We’re fortunate enough to get good sour cherries as far north as Philadelphia, but only for a couple of weeks out of the year.  Reusing also has a wicked cherry relish–one sliced red onion, sixteen pitted cherries, and two tablespoons of red wine vinegar–that goes with just about anything pork or poultry.  She uses the leftover stones to flavor panna cotta. Doesn’t that sound like someone who knows how to make the best of the most local, most ephemeral of ingredients?

I like that local and fresh isn’t equated with regional or parochial.  There may be southern twang to the ingredients, but if she uses okra, it’s fried with Indian spices.  If she’s pickling, it’s just as likely to be pumpkin with with thai chiles as it is green tomatoes. If she can’t find ingredients nearby, she actively encourages local farmers to grow them.  So there’s recipes for flash-fried shishito peppers alongside more conventional recipes for grilled broccoli with garlic and anchovies.

That said, it’s difficult to sustain simple, whimsical, and worldly all at the same time.   The results are uneven. One week you may get a salad made with watercress with a fried egg and black sesame sauce, and another week you might get a perfectly ordinary recipe for fried chicken. Okay, I get it, it’s North Carolina.  She has to include fried chicken. But is chicken seasonal?  Hers aren’t even local;  she fed-exes hers from Kansas. Don’t get me wrong.  I like fried chicken in all its varieties, but there are so many other recipes out there, it’s hard to contribute something new.  William Styron devoted a whole essay  to Southern Fried chicken.  How do you compete with that?  Apparently with, 1) heat oil, 2) add chicken.

The timeline is the most frustrating constraint. I like the idea of a cookbook where recipes are organized not just by seasons or months, but by weeks; I’m just not sure it works. The so-called “seasons” of foods vary considerably in their peaks and duration. It doesn’t follow the rhythm of a metronome. Cooking in the Moment is slender too, so you may have only two recipes for any one time of year.   I like to stick with a cookbook, immerse myself in it for a few weeks or months, and move on, so this was painful. I bought the book in “Early April,” so I had to choose from cooking trout in a skillet or making bacon and eggs in a paper bag over a campfire.  It was raining, so I couldn’t exactly go and dig a fire pit in the backyard.  I picked up some of the early season trout fillets at the Ardmore’s farmers market, dusted them with cornmeal, and cooked them in a skillet.  It was the best store-bought trout I’ve ever made, but I still felt like I was missing something because I wasn’t in a tent in the Poconos. In the meantime, I was aching for “broiled ripe figs with warm ricotta and honey,” but I had to wait until September.  I’ll probably also have to move, preferably to  because figs are never local here.

Bottom line,  it serves as a good model for how to think about food and place, but don’t try and follow it lock-step.  I’ll probably never be true locavore, because I can’t give up Spanish vinegar, tropical fruits, or for that matter citrus.  If Pennsylvanians went truly loco, they’d probably all get scurvy. But I know to look for apples during apple season.  If there’s one thing the Northeast does well it’s grow apples,  pick apples, store apples, distill apples, and contemplate apples.  “My long two-pointed ladder’s sticking through a tree / Toward heaven still”.  You’ll never see a Robert Frost poem about okra.

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Seasonal I: Local Flavors

Several months ago, I vowed to eat more foods in their prime.  I will eat more from our garden. I will seek out the best of  farmers’ markets. I will search for fruit and vegetables most in season and most recently picked.

Since then, the woodchucks ate all our zucchini, the squirrels made off with our tomatoes, and rabbits have gradually nibbled away at all the rest. “Nothing like gardening to turn mild, pacific folk into ravening, blood-lusting murders,” my colleague insists, but Ann, God love her, continues to approach pest control organically. She constructs magical wards from dog hair, garlic pellets, and even coyote urine.  Sadly, our suburban squirrels have never seen a coyote before, so they don’t seem put out by it. They continue to roll the still green tomatoes across the yard where they can eat them in peace.  I even found a half-eaten one on the picnic table. Are they borrowing our lawn furniture as well?

“At least the woodchuck is keeping its distance,” Ann said.

“So are the neighbor kids,” I add. And it’s true.  Last year they continually leapt over the chain-link fence, looking to play catch on a wider expanse of green.  Now they just pace back and forth on their lot, looking feral.

I’ve also been somewhat frustrated with the range of cookbooks that genuinely help me with my newfound quest.  Publishers, it seems, have discovered that people like farmers’ markets. They know we read Michael Pollan and we’re willing to pay 40 or 50$ for a book that will bolster our belief that locally sourced, organic vegetables are noble.  Ann, who grew up on a farm in Northeast Pennsylvania, insists that this is just called “food,” but I remind her that when she was growing up, her organic sweet potatoes came with marshmallows.  Today’s organic and locally sourced food is not about picking your dinner up off the ground or out of a spiral-bound junior-league cookbook. Locally sourced food is sophisticated, elegant, and politically subversive.  It does not come with marshmallows.

But here’s the problem.  As much as one may want to get behind simple, local and seasonal aesthetic of someone like Alice Waters, it seems that it’s actually difficult to capture that effectively in a cookbook.   I remember the disappointment I felt the first time I looked at a Chez Panisse cookbook.  Really?  This is what the fuss is all about?  Chez Panisse’s reputation was built on the quality of its ingredients and the skills of its chefs. Without these, the cookbooks were simply spartan recipes for Caprese salads.

More recent cookbooks have tried to address this trend.  They’re as much about procuring ingredients as they are about preparing them.  The more a writer gets into talking about local sources and markets, however, the more one realizes that his or her locale isn’t mine or yours.  I’m also somewhat impatient with cookbooks that are organized by season.  It’s hard to accept that during the summer, I’m can only use summer recipes, or when I have a summer like this one, the cucumber recipes. Meanwhile there are all these pages of sour cherries, fiddle-head ferns, blood oranges and quinces that are either out of place or out of time.

The first book to wrestle with these issues seriously, I think, was Deborah Madison’s Local Flavors: Cooking and Eating for America’s Farmers’ Markets.  This book was useful several years ago when Ann and I joined our first CSA, the Red Hills Farms west of Philadelphia.  Like most new CSA members we had questions like, “Is Kohlrabi food?” and “No seriously, do people actually eat this?”  There is a whole range of alternate dimension vegetables, like garlic scapes.  They grow exactly as plants shouldn’t, in stiff curling stalks like crazy straws; if left to their own devices they will flower in a colorful globe.  Yes, they are part of the garlic plant that everyone loves, but we don’t see them in grocery stores any more than we tend to see heads on chickens.  Scapes are too mild to use as an aromatic and too tough to sprinkle on as an afterthought, like chopped scallions. So what do you do with them?  You look in a book like Local Flavors.

And you don’t find them.

Don’t get me wrong.  Madison gets most of it right. Kohlrabi is there, along with fiddle-head ferns, quinces and blood oranges.  But there’s no scapes, and this bothered me because that’s what I needed, a quick DYI reference for dealing with scapes.  Instead, I’m leafing through alluring pictures of citrus that only grow in Southern climates.

Madison’s admits to spending most of her time in Santa Fe markets, so perhaps that’s part of the problem.  But she says she’s writing a book for all America’s Farmers’ Markets.  Is that even possible?  Is it desirable? If one could cover all that territory, wouldn’t the book end up focusing on the most common things in markets — which would miss the point — or it would have to become encyclopedic — which also would seem to miss the point.  There are actually more recipes for Kohlrabi in her previous, utilitarian opus, Vegetarian Cooking for Everyone, but it’s about as much fun to read as a phone book.  That sense of place, that sense of cooking in the moment that I’m looking for, isn’t here either.

I have a growing suspicion that blogs may actually be better for this kind of thing than cookbooks.  Local blogs can tip me off to when the sour cherries hit the market and explain what to do with them. But this is a cookbook blog, so I have to give books the benefit of the doubt.  Over the last two months, I have  experimented with the newest crop of books with mixed results.  I worked my way through the in-season part of Andrea Reusing’s Cooking in the Moment, which emphasizes not only cooking by seasons, but by the month and even week. I worked my way through Nigel Slater’s Tender, with its ultra-local emphasis on terraforming urban backyards. I also tried to overcome my prejudice against Chez Panisse style cookbooks and bought David Tanis’s A Platter of Figs, and The Heart of the Artichoke.   I’ll break these reviews into separate posts to make them easier to digest, but to ease the suspense a little, I’ll tell you advance.  None of them say anything about garlic scapes.

Nor do they have recipes for woodchucks.

Better III: The Opposite of Everything

(This is the third section of a three part essay) Part I Part II / Part III

In April I swallowed a camera.  This was a first for me.  I’ve eaten strands of pollen, jellyfish, and sliced tongue, but never a camera. Once, I tried to eat a drinking glass, but I was four then.  I know better now.  Certain things are not food.  So I was naturally suspicious when the doctor asked me to swallow a plastic capsule about the size of a .38 round.  The clear bubble-shaped window in the front reminded me of the submarine from the Fantastic Voyage.  The doctor assured me that the miniaturization process that shrunk the camera would not wear off in transit.

The doctor wasn’t sure the capsule endoscopy would reveal anything, but this was the only test left.  That’s a bad sign, right?  The last test. If they didn’t find anything, I’d be a medical mystery, a helpless case, or someone who was just ‘making it up’.  But I’m a diagnostic junkie, so I couldn’t pass up the opportunity to have 10,000+ photos taken of my insides.  I couldn’t pass it up. I couldn’t leave just one option unexplored.

“It might get stuck,” the doctor said.  “One percent of patients need to have the camera removed surgically.”  This risk was greater for me, because I was diabetic and presumed to have gastroparesis, a slow stomach. There was talk about taking Reglan to speed up my stomach, but he decided against it because of the potential side-effects, which include irreversible neurological damage.

This turned out to be wise.  He called me the next day, his usual nonplussed self.  “Not much to report,” he said.  Deep sigh.  He focused on the positives. The ulcers had cleared up.  Everything else looked clear and healthy.  “Oh,” he added as if it were an afterthought. “There was one surprise.  The camera went through your stomach in about three minutes.”

“Is that normal?”

Food is supposed to stay in your stomach for two to four hours. That is if you have a normal stomach. As the doctor switched from talking about  gastroparesis to tachygastria, a slow stomach to a fast one, I had to do a double take. How is this not new information?  How is this not the opposite of everything?  The doctor explained, somewhat sheepishly, that people can have both conditions. Basically, the stomach is controlled by pacemaker tissue, much like the heart.  If the contractions in my stomach are too fast, the stomach can’t keep up, so it may skip a beat, slow, or stop temporarily.  But he’s less concerned with whether my stomach is going fast or slow.  He’s more concerned about the symptoms,  and the fact that he still can’t explain the underlying cause.

I thought on this for a while.    No.  It still seemed significant. Through all my diets and diagnoses, gastroparesis was a constant, and the treatment was eat less fat, smaller servings, and more fiber.  For the last eight months, I spent forty-five minutes every morning stirring a pot of steel-cut oats.  I’m not a morning person.  I don’t deal well with the world until I eat or drink coffee, but there I was abstaining from both, stirring my oats and thinking good healthy thoughts.  I not only endured this ascetic ritual, I came to embrace it as a righteous cause.  I was doing what’s good for me, and steel-cut oats are so rustic, so earthy, so utterly devoid of earthly pleasures, that I can easily imagine monks in sackcloth eating it during prayer.  Please God, I would whisper to the pot.  Please Jesus or Allah or Buddha or that bearded guy from Hogwarts. Please accept this offering of my time and trouble and make my stomach better.

But God didn’t want me to eat oatmeal.

He wanted me to eat French toast.

Preferably made from brioche or challah.

To be fair, the doctor didn’t tell me to eat French toast.  He told me to separate eating and drinking, because even a sip of water could trigger the contractions.  But the additional fat from egg-based breads, milk and butter in French toast does seem to help slow things down further.  A little Cointreau or Grand Marnier probably doesn’t hurt either.  Alcohol is notorious for slowing digestion.  I also stopped taking Protonix.  All of these seem to have had a salutary effect.

Don’t get me wrong.  I stand by my last post.  The extended pleasures of food are more important than immediate gratification.  Growing your own food, gathering it, cooking it, sharing it with others gives you reason to eat in spite of suffering.  But you know what else is good?  Less suffering. Less suffering and more French toast.

I still don’t like the word better.  When people ask, “You’re better now, right?” I say yes, but it catches in my throat.  I have to explain.  The heart of my stomach still runs too fast.  It still flutters like a wounded bird.  It’s not better.  I’m just not provoking it anymore.  I’m feeding it what it wants.  I eat more and hurt less.   Maybe that is better . . . I roll the word over my tongue and try to get used to it.  It feels right in my mouth.  Just not in yours.

After several weeks of the French Toast Diet, I decided to really test out my new stomach.  It was May fifth, which Ann insists on calling “Cinco de Ted,” because it was the day I woke up in hospital.  It’s also my parents anniversary, so we’ve often spent that day eating out; now we just have a new reason to continue that trend.  For our first Cinco de Ted, we decided to go to the newest addition in Jose Garces’s empire, JG Domestic.  It’s probably not his best restaurant, but I find its awkwardness endearing.  It tries to combine the idea of local, American food with small-plate, tapas style eating.  Since when have American’s been into small plates?  Or for that matter, since when has a clientele of mostly suits and ties wanted to unwind by throwing back drinks and sharing miniature fondue pots with their almost exclusively male co-workers?   But I like to think Garces, with his regularly rotating menu, might eventually find a way to make it work.  The restaurant has many charms, not the least of which is a tasting menu chock-full of foods that I have been avoiding for the last two years.  I started with an “Adirondack,” a bourbon drink flavored with rosemary agave and mezcal and let it settle in before tackling the meal.  You have to pace yourself with Garces meals.  They start quietly with a few snacks and a salad that should only be picked at tentatively.  They’re good, but unexceptional.  From the Peekytoe crab croquettes onward, the meal seems to get increasingly rich and decadent.

Hickory smoked pecans with maple and bacon; house charcuterie and cheeses; seasonal salad with local mixed greens, seasonal baby vegetables, and citrus vinaigrette; peekytoe crab croquettes with avocado and pumpkin seed; wood oven flatbread with black trumpet mushroom, truffles, shaved cheddar and farm egg yolk; baby artichokes with potato dumpling, black truffle, smoked ricotta; Creekstone natural adobo rubbed rib eye with refried rancho Gordo cranberry beans and Vidalia onion rings; Barnegat light day boat scallops with cauliflower, black truffle, and kumquat; Bourbon beignets with bourbon vanilla mousseline, and Marker’s Mark butterscotch; Richter Farms rhubarb-swirl ice cream & jam with crème fraiche parfait and pickled rhubarb.

Sure, I felt full about a quarter of the way through, and I had to forgo the final bit of gelee served at the end, a dark reminder of Mr. Creosote and his wafer-thin mint. My stomach sounded like a garbage disposal, and I wanted to throw up for at least two hours.  But you know what?  So did everyone else.  That’s what’s important, isn’t it?  Feeling better and eating better is good for the everyday, but it’s nice to know that once in a while, if the occasion demands it, I can still compete in a no-holds-barred bacchanal dedicated to the pleasures of excess.

Speaking of Garces, Marisa McClellan won the Latin Evolution giveaway. She’s been giving away stuff on Food in Jars for years, so it’s nice that she gets to win something too.  Check her site out if you’re interested in all things preserved.

Coming soon:  Seasonal Cookbooks

Better II: The Pleasures of Eating

(This is the second section of a three part essay) Part I / Part II / Part III

By winter, my obsessions with eating were starting to get the best of me.  Eating healthily isn’t usually a problem for me. Cooking is always about making do with what’s available. If it’s December, you don’t spend your time dreaming of asparagus; you think of new things that you can do with Kobacha or with beets and bulgar wheat. If your doctor tells you to cut back on sugar, or fat, or sodium, than that further limits you, but limits can be generative, like the edges of a poem.  They push you to be creative.

At least that’s what I’ve always told myself.  This winter, my usual platitudes failed me.  I simply didn’t know where the limits were.  I didn’t know what I could or could not eat. I’d go through long periods of resignation.  Then I’d get some new lead, advice from a friend, a medical journal, and I’d be convinced that a cure was just around the corner. Fructose malabsorption—Eureka! I’d read labels and frenziedly try to extract every last bit of fructose from my diet.  This is a dangerous path. Fructose is in everything.  You start with high fructose corn syrup and fruit, but by the end you’re finding it hidden in wheat, brown rice, ginger or dill.

Even when I was tested I had doubts. I spent several hours in a hospital, blowing up balloons, until they called to tell me that this was a dead end too.  But could I trust them?  The balloon test has only 60% accuracy.  I might as well have flipped a coin.

I tried diets for things no one suggested.  I ate steel-cut oat for breakfast thinking the fiber might help.  I cut back on wheat-gluten thinking I might have celiac.  I thought I might have illnesses that I didn’t even have the symptoms for. Why not?  When I thought I had an earache, it turned out to be meningitis.  When I thought I was having back pains in college, it turned out to be pneumonia.  A nurse actually diagnosed me with heartburn and sent me home with Tums; the next day I was coughing up blood.  It’s all about deferred pain, right?  My nerves must be wired wrong.  My stomach pains have nothing to do with my stomach.  Maybe it’s bunions.

Not surprisingly, all this gradually chipped away at my appetite.  The only time I felt at my best was when I was fasting for a test.  Did I even like food anymore?  Did I still like to cook?

By March it was clear how far down the rabbit hole I had gone.  I thought of food almost entirely in terms of what I shouldn’t eat, rather than what I should.  I read labels for saturated fats, wheat-glutens, and sugars.  I was thinking only in terms of consequences, never in terms of the pleasures of anticipation, the sizzle of the pan, the curves of a pepper, the smell of fried ginger.

Spring Risotto with Asparagus and Peas (Fields of Greens Cookbook)

As the first asparagus or field peas showed up at the farmer’s market, I tried to elevate my spirits.  Maybe I couldn’t fix what was broken, but I could eat to make the rest of me happy.  I could try to eat in the moment, rather than thinking about what I might feel like an hour  later. I could for my overall health and well-being, rather than the health of my stomach.  I turned to simple foods, focusing on what was local and seasonal. I went with Ann to Pete’s Produce in West Chester to pick out vegetables for the garden.  Ann was willing to forgo planting flowers this year, so we could devote most of our four beds to heirloom tomatoes, zucchinis, peppers, cucumbers and a miniature forest worth of herbs.

That said, eating simply did not come easy for me.  For the last decade, my guiding principle has been, “That’s delicious! How can I make it more complicated?”  Cooking is an art.  It’s about transforming raw ingredients into something else—a gift for our appetites, a meal for family or friends, a visceral part of our culture and identity.  As such, it takes a little effort, skill, and creativity. Pulling greens and eating them with olive oil and vinegar isn’t cooking; it’s grazing.  Adding Roquefort or truffle oil to your salad is just a snootier form of grazing.  I still don’t understand why David Chang got into so much trouble for his condemnation of post-Chez Panisse restaurants in California.  “Fuckin’ every restaurant in San Francisco is just serving figs on a plate.  Do something with your food.”  Wasn’t he just saying what everyone else was thinking?

Yet here I was, eating simple, natural, earthy things that would make Wendell Berry wax poetic. I didn’t dig around in the dirt much myself.  For the most part I sat at the kitchen table, sipped tea and watched Ann work with her trowel through the sunroom windows.  But sometimes, I put on slippers and pad around in the backyard, pretending that I’m attending to the garden’s progress. I admired the bell peppers, which really did look like bells on the vine. I watched the great leafy squash and the creeping cucumbers with their star-shaped flowers. I planned for their future with cookbooks such as Nigel Slater’s Tender, Andrea Reusnig’s Eating in the Moment, and yes, even David Tanis’s A Platter of Figs.

Perhaps we invested so much in the garden this year because vegetables were the only thing that didn’t remind us of the big bad.  We only planted a few tomatoes the year before, and they withered and died.  So while pollen, humidity, and rising temperatures reminded me of rehab, the garden just seemed healthy.  Azaleas creeped me out a little.  All that color, all at once. But cucumbers were just cucumbers.  Voracious climbers. They had tendrils reaching out in all directions. All you had to do was put a stake in the ground and they’d find it, coil around, and hold tight.

Growing stuff, it turns out is doing something with your food.  It takes time, technique, and a little creativity. If Ann and I are standing over squash blossoms, thinking about whether we should fry them, make soup out of them now or wait until all the zucchini fully developed, then we were involved with those zucchini in ways we wouldn’t be otherwise. When the woodchuck nibbled on them, I didn’t even think.  I just grabbed one of Ann’s shoes by the door, ran out and winged it at the chubby demon as he shawshanked his way under the fence. Why?  I was never fond of zucchini.  Many of our zucchini have gone straight from our crisper to the compost heap. But I would defend these with every one of Ann’s shoes if I had to. And Ann owns a lot of shoes.

zucchini blossoms

I find a partial answer in Wendell Berry’s essay, “The Pleasures of Eating.”  I used to feel as indifferent to Berry as I did to zucchini.  Most of what he says is right, I’m sure, but the delivery was always a little bland.  Even when he writes about pleasure, he sermonizes, devoting the bulk of his essay to the sins of industry and consumerism. But pleasure appears eventually:

The pleasure of eating should be an extensive pleasure, not that of the mere gourmet. People who know the garden in which their vegetables have grown and know that the garden is healthy and remember the beauty of the growing plants, perhaps in the dewy first light of morning when gardens are at their best. Such a memory involves itself with the food and is one of the pleasures of eating. The knowledge of the good health of the garden relieves and frees and comforts the eater.

I cling to this passage now.  I’ve always thought of eating locally only in terms of the quality of the food, and not the quality of the locale.  I know that tomatoes picked from the backyard taste better than ones from the store. Michael Pollan tells us why:  store-bought tomatoes often travel long distances; they are picked before their time, and ripened with ethylene gas.  This means the natural sugars in the tomatoes were never allowed to develop properly. But this is still about the way that tomatoes taste, not the associations that go with them. These are the concerns of a gourmet, and these are the pleasures of eating that are most easily worn down by a sour stomach. The “extensive” pleasures of eating, however, are all about process. They intimately coil around the communal spaces of a garden, a market, a kitchen, a dining room. They are about being part of something larger than oneself, and this is what keeps me cooking, keeps me eating, even if it hurts.

So the first thing I do in the morning is walk into the sunroom and see the tomatoes peeking out over the windowsill. I’ve watched those tomatoes grow from tender little plants to bushy, leafy things barely contained by their cages. They will taste better because I know the effort that’s been put into them, and because it was Ann’s efforts.  They’ll taste better because when the green globes finally mature, we get to decide who to share them with and how.  We’ll get to decide whether we eat them right off the vine, whether we slow roast them overnight, or whether we blanch, seed, dice, and otherwise torture them into a Heston Blumenthal Bolognese.  And they will be glorious.

Unless the f*cking woodchucks get them first.

(To Be Continued)


Better

(This is the first section of a three part essay) Part I / Part II / Part III

This time last year, I was making my first forays out of the house.  Even under “home care,” I took a daily constitutional, a walk to the curb or to the corner.  Ann or a PT supervised while I hobbled on my cane.  Spring turned into summer while I was in hospital, so everything looked sharp and bright.  This was the best part of recovery. Each day, I walked a little farther than the day before.  Progress could be measured in feet and yards.

Better is a bit of word magic that summons up positive thinking.  When I was still in the hospital, no one talked about normal. They talked about better. From the moment I woke up, they had me pushing my legs against the end of the bed to avoid blood clots and breathing into an “incentive spirometer” to help increase lung capacity. They had me doing exercises in bed, against a wall, with a walker, with a cane; they gave me a home therapist, individual sessions with an out-patient therapist, and a Pilates class where little old ladies with hip replacements outperformed me on every sidekick and stomach crunch.  They estimated that it would be a year before I really would be able to assess the damages, and it’s hard to spend all that time thinking that you’re doing all this work just to get back to may-or-may-not-be-normal. So you focus on better.

Better is whistling past the graveyard. I was actually excited by surgery.  Doctors said the gallbladder was probably just a casualty of septic shock, but they acknowledged that the “pre-gangrenous” nub of an organ, might have contributed to my current problems, and the stomach issues before it.   Long before the big bad, there was the little bad—stomach pain that lead to a string of hospitalizations.  After the third incident, they ran a string of tests but they were inclusive.  The best diagnosis that I could get was ulcers combined with diabetic gastroparesis.   That never sat well with me. I’ve been a type I diabetic for most of my life, so I would understand if I developed some form of neuropathy.  But this is supposed to start at the periphery.  Why would it skip the hands and feet and go straight for my stomach? A swollen gallbladder on the other hand, made sense.  It was a simple, concrete, diagnosis.  It was a ring of bright pebbles around it on the X-ray. So cut it out.  Take it away.  I’ll be better.  Better than I was before.

“You’re not supposed to be happy that they found something,” the doctor insisted.  I knew it was a long shot, but I figured I wouldn’t have to cope with the disappointment for a month or even a year, and I’d be in a much better position to cope with it then.

The day I left hospital, I threw up breakfast along with my Percocet.  I had a tummy pillow which I was supposed to clutch whenever I felt like I was going to sneeze;  it helped support my stomach and the incisions. I clutched it in the car all the way home.  We were terrified but it was really the best choice.  I’d have more control over what I ate. The only real dietary restriction I had been given was to avoid fats, but the gallbladder was really only one issue.  I was eating for recovery.  All those changes in your endocrine system and metabolism are a lot like grief.  You want to eat little or not at all.   So I turned mostly to congee.   The last time I had been a lively and energetic eater was in China.

Ann was teaching a course abroad through Saint Joseph’s University, and I tagged along.  Even then I was nervous about my stomach, and worried about how it would hold up.

When traveling, I have an almost uncontrollable desire to eat my way through every town and city, and our hosts eagerly fed that desire. We dined around large tables as our hosts gorged us on plant pollen, 1000-year old eggs, chickens with their heads and feet still on them, and enough baijiu to fell a water buffalo. We were told it was impolite not to drink when anyone made a toast, and that it was impolite not to make toasts. If you’re seated at a table for twenty-four that takes its toll.  After we had already drunk to our hosts, to international relations, to education, I once found myself toasting the free-range chickens, pecking the ground outside the window. But for all that, I never felt sick.

So I returned to life with Chinese food in general and congee in particular.  Congee, also known as Jook or Zhou is basically just boiled rice.  It sounds like the blandest most impoverished food in the world, but like Risotto—every grandmother seems to have their own recipe.  The simplest, used for medicinal purposes is just a few grains of rice boiled in water, but the actual quantity of rice used, how soupy it is, or how well cooked the rice is varies tremendously.  Congee actually served for meals is often garnished with peanuts, scallions, and ginger, along with any form of meat or vegetable.  The first congee I ever had was at the Congee Noodle House  in Vancouver, and it was served with Ostrich, so it goes without saying: congee is more flexible than most American comfort foods like chicken-noodle soup. It’s varied enough to merit its own cookbook, The Book of Jook: Chinese Medicinal Porridges.  It’s fed to children with sick stomachs, and equally important, it’s eaten during times of grief.  In Joan Didion’s The Year of Magical Thinking, congee is all she can eat after the death of her husband. In Nicole Moyes The Last Chinese Chef, the protagonist eats congee with a family grieving for the loss of an esteemed elder cook.

She mixed her congee with her spoon and tasted it.   Oh, so good.  She shivered.  The salty and piquant flavors against the delicate fragrance of rice, the crispy fish against the tofu and the soft gruel. Sheer goodness.  She caught Sam’s eye and said one word, “Wonderful.”

The uncles agreed. “I would come back from the dead for this,” said Jiang. “What is that poem? The one that calls back the soul to the table?”

“Oh! From the Zhou Dynasty,” said Tan.

To their surprise, it was Liang Yeh who started to intone, in English.

“O Soul, come back!! Why should you go far away?

All kinds of good foods are ready:

Rice, broom-corn, early wheat, mixed with yellow millet –

Ribs of the fatted ox, tender and succulent;

Sour and bitter blended in the soup of Wu.

O soul, come back and do not be afraid.”

Okay, so “ribs of fatted ox” wasn’t exactly on my diet, but I’m fond of ginger in all it’s varieties, shredded, pickled, or fried.  As I recouped, I graduated to roast chicken and salmon. As long as Ann did all the crouching, pulling pots out for under the counter or vegetables from the crisper, I was okay.  I could slice thin bits of salmon and pour the congee over it to cook.

As my tastes grew more adventurous, Ann supplemented meals by picking up an order of xialongbao from Sang-kee Bistro in Wynnewood. These soup dumplings were one of the highlights of our China trip. They’re like traditional steamed dumplings, only they’re filled with broth as well as the obligatory ball of pork and chicken.


Soup dumplings are tricky to make yourself, and they are emphatically not the kind of thing you should learn to cook from a book.  But since I never found anyone in Xi’an to teach me, and since I had a lot of free time on my hands, I turned to  Brian Yarvin’s, A World of Dumplings.  This probably isn’t the most authentic source, but it taught me the two key things I needed to know. 1) Do not, under any circumstances, use store-bought wrappers.  Home made ones are far more pliable, far easier to seal than store bought wrappers, and that’s important if you’re going to be filling them with soup.  Besides, the dough is fun to work with.  You start with a simple mixture of flour and water that you endlessly stretch by hand. You form a ring of dough, and you gradually pull it through your hands like prayer beads. The loop of dough gets longer and longer, until it brushes the floor, at which point, for sanitary reasons, you stop and section the dough for rolling. 2)  You do not actually wrap soup in your dumplings.  I feel like a magician revealing a secret here.  You probably think that for centuries, Chinese chefs have been deftly injecting soup directly into premade dumplings with diminutive turkey basters. I hate to dispel that fantasy. But the trick is simple.  They use a stock that is so rich in collagen that it is solid at room temperature. It’s like jello and only melts into soup when the dumplings are steamed.

I was happy enough with the results, but Yarvin’s recipe convinced me that Xiaolongbao was best left up to the professionals.  It’s just too much work.  I could even put up with Sang-Kee’s vaguely obscene translation “steamed juicy buns,” if it meant not having to spend a whole afternoon rolling out dough.  That said, cooking was clearly a uniquely pleasurable form of occupational therapy.  If my home OT had taught me to make Xialongbao rather than giving me remedial lessons on buttoning my shirt, I probably wouldn’t have kicked her out the door.

My stomach and mood did not recover as deftly as the rest of me.  Long after my daily constitutional reached the grocery store and back, my stomach started to kick.  At first, I was just one of the 40% of patients that brochures say will have difficulty with digestion for up to a month or six weeks after surgery.  My doctor was not at all surprised that my adjustment might be slower than that due to my diabetes and everything else I had been through. He was more concerned with the rolling headaches and monitoring my Warfarin dosages.  But my stomach didn’t get better.  It got worse. It vibrated with a low voltage current, like a car battery was clipped to either end.  Whenever I ate, it fibrillated. Mornings were the worst. Breakfast led to cramps and other unmentionables. For at least a few hours out of each day, I felt clammy and depleted, as if I had motion sickness.

By the fall, I returned to my GI.  His first thought was that my gastroparesis had deteriorated.  This was unacceptable.  I had worked hard to get him to concede that I might not have gastroparesis at all. My stomach problems were supposed to disappear along with my gallbladder into a jar of formaldehyde somewhere, right?  So why was he insisting on this diagnosis now? I accepted diagnosis number two: bile salts.    Gallbladders don’t do very much. They moderate the flow of bile into the digestive tract, which aids in digesting fats.  Without it, bile keeps on flowing but haphazardly.  A small percentage of patients have ongoing problems with excess bile and bile salts after their surgery. That seemed appropriate somehow. I’m bile-impaired.  Doctors from Hippocrates through the middle ages associated an excess of yellow bile with sleeplessness and irritability.  Even today, “biliousness,” refers less to projectile vomiting than to those who are petty, snappish, ill-humored, or given to grumbling.  Now that I think about it, I’ve probably been bile-impaired since the age of four.  Can I get a disability card for that?  It would probably come in handy at work.

The problem is permanent, but easily treatable. All you need is a daily packet of orange resin, called Cholestyramine.  It looks and even tastes a little like Tang.  Sadly, that loose association with astronauts was the treatments only positive result. After a few weeks, I was back to square one. I supplemented my Protonix with new medications, started to eat steel-cut oats for breakfast, and things just seemed to get worse. Ann bought me a Vitamix for Christmas, hoping that if I couldn’t eat raw vegetables, at least I might be able to drink them. I was ecstatic to have a shiny new toy, but my first vibrantly green smoothie made me sick for days. I almost sent it right back to the store, but that was too much to bear.

I avoided milk for several weeks, then wheat-gluten, then fructose.  Each time I tried a new diet, I felt certain I was on to something. But a few days would pass, and the engine in my stomach would slip out of gear and grind.

Better is a lie.  We want to tell stories that lead from cause to effect, from conflict to resolution.  This is what makes stories coherent.  This is what makes us coherent.  I want to say that illness is an “out there,” kind of problem, and I want to tell a story about how I solve that problem.  By this reasoning, becoming better and becoming a better person were one and the same thing.  But chronic pain doesn’t submit easily to our expectations for narrative form.  There’s no beginning, middle and end, no peak action, no resolution. It’s about as likely to make a good story as watching waves break on the Jersey shore.

(To be continued).

Jose Garces Giveaway: Get a Free Copy of Latin Evolution.

The Garces giveaway is officially over.  Congratulations to Marisa McClellan of Food in Jars.

Guajillo sauce ingredients

A year ago, I promised I’d cook dishes from Jose Garces’s Latin Evolution, and a year ago I did.  Most of this was written in April of 2010, just before the big bad.  The above flower of guajillo sauce ingredients sits in a blender I no longer use; the camera has been replaced; the store I bought the chiles from no longer carries them. But thanks to my long hiatus and some over-zealous gifting, I now have two copies of Latin Evolution, one to give away to a lucky reader.  If you’re interested, post a response below with a link or address for your favorite Latin recipe.

As noted in my first Garces post, the term “Latin” covers many different culinary traditions, as does the aptly titled Latin Evolution.  It’s not what you’d call authentically Spanish, but a celebration of Latin influences across the globe, principally from Spain, South America and Mexico.  It’s pretty much just like Garces himself.  He may be steeped in the Ecuadorian traditions of his family, and he may have trained with a few Spanish chefs, but he’s also just a guy from Chicago, and to my mind at least, his recipes have more in common with Charlie Trotter than they do with Simon and Inez Ortega.  This is a good thing if you’re eating out, but it’s going to be tough on the interests of the home cook.

Sadly, the contemporary American side of the cookbook means that it has may of the traits I tend to avoid.

  • Architectural” elements. Garces likes to stack food on top of other food.  Recipes are composed out of a lot of little recipes.  Expect to use a lot of those little post-it flag bookmarks.
  • Lots of directions, no reflection.  I’ve made this point many times before.  I’ll follow any instructions, as long as the explanation is sufficient.  You want me to brunoise a shallot while wearing a PVC bondage hood?  Fine, but you damn well better explain how this improves the soup.
  • Foam or Air. I don’t mind foam in my cappuccino, but when foam or air appear in a compound noun, you know it’s time to run.  Foam and air are invariably terms for innovative ways to put bubbles where bubbles don’t belong. Think “lemon air” or “beet juice foam”.

As I struggled through a couple of dishes, however, I realize these concerns don’t really run deep. Yes, in the interest of full disclosure, the cookbook is difficult.  It’s probably best suited for professionals and diehard fans who want to gain a better appreciation of their favorite chefs and restaurants.  Working through recipes helps you to understand the processes and ingredients that go into “restaurant food,” even if it is impractical to make at home.

That said, Garces’s team seems to have worked hard to keep the recipes just this side of possible for home cooking. Yes, Garces uses food additives like soy lecithin, xanthum gum, and agar powder, but only rarely, and I was pleased to find that these ingredients are all baking supplies, available through companies like Bob’s Red Mill.  You don’t need an expensive Ferran Adria chemistry kit to make lemon foam. As such, Latin Evolution saves you the pain and disappointment that comes from someone like Michel Richard, who wanted me to spend more than three hundred dollars on flexipan molds just so I could make faux hard boiled eggs, or that Momofuku-r David Chang, who tantalized me for pages with stories of Frankenmeats before I realized that transglutaminase meat glue (TMG) costs about a hundred dollars a bag.

While the recipes were possible, they certainly stretched the limits of my kitchen and my abilities.

Roast chicken breast with poblano cornbread, charred pineapple and red chile sauce.

Jose Garces cornbread, grilled pineapple, and red chile

Let’s face it, if you work your way through these recipes, you want bragging rights.  So I knew that if I was going to cook out of Latin Evolution, I was going to need discerning dinner guests. Jason and Dee went with us on out first visit to Amada, so I knew they would understand what I was shooting for and why.  I mean, really, who wouldn’t want to be able to recreate some of that?

I let them choose which recipe I should make, because they’re the only people I know who have more dietary restrictions than me. This means we eat a lot of chicken, but when it comes down to it, chickens are surprisingly versatile creatures.  They can be made to do all sorts of tasty things and this recipe was no exception.

Garces assures us that the recipe takes its influences from all over Mexico, from the Yucatan flavors of achiote, orange and garlic, to the “chile spiced cornbread” whose inspiration he attributes to “Zarella Martinez”.  But I think anyone reading the title will know that this familiar gestalt of chicken, cornbread, and chile is probably a tip of the hat to North-of-the-Border Latin. Hell, it may even be North-of-the-Canadian-Border Latin, because I always assume the quantity of sugar in cornbread is directly proportional to how far you travel away from the Mexican border.

The “chile” is a paste made out of guajillos. This is time consuming, but I felt like I was up to the task because I’ve always been a fan of Rick Bayless’s early cookbooks. Bayless calls guajillos his “workhorse” chiles, and speaks of them with considerably more poetry than Garces:

“A puree of roasted, rehydrated guajillo sings with a chorus of bright flavors that combine spiciness, tanginess (like cranberry), a slight smokiness and the warm flavor of ripe, juicy sweet tomato; the flavors go on and on. The puree is a deep, rich, red-orange—the color of good tomato paste”.

I prefer Rick Bayless when it comes to making chile pastes. Even his most uncompromising books, Authentic Mexican and Rick Bayless’s Mexican Kitchen, are still more practical than Garces. Both are big on roasting every ingredient, but Bayless uses a cast-iron pan for just about everything.  Garces on the other hand wants you to deep fry the peppers individually. He wants the garlic to be roasted in the oven, with tomatoes, and he calls for the onion to be cooked on a grill.  After it’s all pureed it goes back into the skillet for frying, which, oh wait, hasn’t actually been used yet. There’s no denying that it makes for an amazing rich, red sauce, but in the end, it’s all going to be used for painting a decorative circle on your plate.  How many dishes do I have to clean now, just get this little undercoat of guajillo?

The second “level” of the dish surprised me. The cornbread called for unusual ingredients in unusual quantities: 1 cup of butter + ½ pound of sugar + 4 eggs + 2 cups rice flour.  Who makes cornbread without any cornmeal?  Who weighs the sugar but doesn’t weigh the flour?  Most importantly, who uses that much sugar? Southern cooks sneer at sugar in cornbread in any quantities, protesting that it is an unwelcome Yankee encroachment on their sovereign cuisine.  I had to imagine that Mexico felt similarly—but since neither Rick Bayless nor Diana Kennedy even mention cornbread in their cookbooks, I’m guessing that they are richly and deservedly indifferent.

I double-checked the Garces recipe on-line against other recipes.  I was disturbed to find that “Zarella” is really “Zarela” with one L, a Mexican born cook who currently works in New York.  Her cornbread recipe was quite similar to Garces’s right down to the poblanos, rice flour, and fresh corn, but she only calls for two tablespoons of sugar. On the other hand, I found another Garces recipe on-line for 3 chile cornbread, which called for 8 oz of butter and 8 oz of sugar.  The ratios were the same, so I decided he must really mean it. Yes, it was a much lighter and much sweeter cornbread than I’m accustomed to, but the rice-flour confection, studded with poblanos and fresh-cut corn, ended up tasting surprisingly like, well, cornbread. Served by itself, I would prefer less sugar, but in the end, I think this was deliberate because the sweetness helped as a contrast to the earthy guajillo sauce and the sour-edge of the chicken and grilled pineapple to come.

Jose garces cornbread

The cornbread is the pedestal to show off the achiote marinated chicken. The dish seems to play on our expectations here, because the color of the marinade for the chicken is very similar to the chile paste but with nothing else in common. Achiote comes in bricks, and its primary ingredient is annatto, the seeds of the achiote trees, also called “lipstick trees”.  Annatto has a very mild peppery flavor, but it’s mostly used for the color.  Achiote gets most of its flavor from the orange juice added in making the bricks. Garces ups the acidity with freshly squeezed naval orange.  So the end result is tangy rather than hot.

Garces call for “4 (6 ounce) skin-on chicken breasts”.  This gave me pause, because it was clear from the weight and the quick pan frying of the breasts that they should be deboned. But have you ever noticed that you can’t BUY deboned chicken breasts with the skin still on them?  It didn’t actually instruct readers to debone the chicken, but I decided it was better safe than sorry, and the results were good, perhaps even a revelation. The breasts are just quickly seared in the pan, and the marinade helped to make a well-marked skin. How is it that I never thought of using chicken breasts this way?  Ann said it was the best, most tender chicken breast she’d ever had.

With all this there’s also a side of roasted pineapple.  It’s the simplest part of the dish, and the one I’m most likely to combine with other dishes. All you do is mark the pineapple on a hot grill—about a minute for each side. Chop the pineapple in ½ inch chunks, add olive oil, shallot, and cilantro. Aside from the tenderness of the chicken, it was the only part of the dish to get singled out for comment from my guests. Dee: “I just have to say . . . pineapple and cilantro?  Yum.”

Sous-vide truffled chicken with fried eggs, rosemary fingerling potatoes, and truffled chicken jus.

Garces Sous-Vide Chicken

Given the range of recipes in Latin Evolution, I wanted to try at least one other recipe before passing judgment. The recipe appealed to me because it basically followed the spirit of Sous-vide cooking without actually requiring a cryovac or an immersion circulator. Sous-vide is French for “causes food poisoning” and it sometimes compared to boil-in-a-bag, but I find this can be a bit confusing because it doesn’t really get at why people are so interested in risking life and limb to produce good food.  If you make boil-in-a-bag rice, you’re not cooking; you’re just warming up precooked food at a high temperature. In Sous-vide you’re actually cooking the food, and you’re doing so by choosing the target temperature that you want, usually one which is well below the simmering point, so the temperature needs to be carefully monitored. In Garces’s recipe, you seal boneless chicken breasts in plastic with cream, and then cook them in a water bath at 155 degrees.  That’s a low temperature for chicken, but you’re cooking it for two hours, so the chicken is not only reaching that temperature all the way through, but hanging there for a while.  This does apparently, guarantee the death of microbes, but only just barely.

Why do you do this?  Sealing the meat in means that it will cook only in its own juice, or in this case, cream.  Cooking at 155 is important, because as soon as you hit 158, proteins start to contract, and juices get squeezed out.  Really, I think no one should recommend Sous-vide cooking at home under any circumstances.  Even if you have a Foodsaver device for sealing food into packets, and a candy thermometer to measure the temperature, you’re still taking chances.  And when someone like me discovers that his Foodsaver machine is broken, and decides to continue on with the cooking anyway, that’s just stupid. I ended up using a standard zip lock bag, which I dangled in the water with twine and an alligator clip to keep the mouth of the bag just out of the water. This had the added advantage of keeping the bag off the bottom of the pot, so I could regulate the temperature a little more evenly.

The downside of course is that the meat doesn’t brown, but it’s easy enough to remedy that after the fact.  Since you dutifully leave the skin on, and the chicken has absorbed some of that cream, a few moments in the pan makes for an amazing sear. The final product was tender and very, very rich.

Otherwise, the recipe is fairly conventional, but it is layered much like the last dish. You start with a Jus on the plate, then the fingerling potatoes, and then the chicken.  It’s all topped off with an egg yolk.  It’s just a regular fried egg, though most of the white is cut off with a three-inch ring mold, or, if you’re me, a slender water glass.  The dish as a whole still seemed to be missing something on the vegetable front, so I threw in some broiled white asparagus on the side.

Even with the extra improvising, I was pleased with the end results.  I always worry that recipes like this will require inordinate time and effort and still leave me with something that looks like Juan Miro threw up on a plate.  But the dishes came through as advertised. Admittedly, I will probably not make these dishes again.  I may only harvest ideas like the grilled pineapple or those tidy egg yolks for other applications, but going through the recipes was worth it. What I hope to get out of a cookbook like this is simply a better sense of how a chef’s mind works and a greater appreciation for the foods I can order in their restaurants, even if, in the end, I feel like the restaurant is where they should stay.  Most of what Garces does well is not about the parts, but about the whole palette he comes up with—and nowhere is that more evident than in the tasting menus at Amada or Tinto.  Imagine, if you have to do all this just to make chicken, what would it be like to put together twelve dishes for a tasting menu?  To cook for a full house?

While fandom requires that I own an autographed copy of Latin Evolution, however, I do not need two. So I’m more than happy to give one away.  I’ll choose randomly among people who respond to my questions in last week’s post or this one. For this post, interested readers should include a link to their favorite Latin recipe on-line.  For last week, interested readers should name their favorite examples of food writing.  I’ll announce the final winner in the next post.

Rabbit Redux: Paula Wolfert’s Stew and a Trip to the ICU

It has been almost a year since my last blog entry.  Due to some magic that I don’t fully understand, this blog now has three times more traffic than it did when I posted regularly.  Most of this readership comes from search engines, so I know I don’t owe anyone an explanation for my absence, but I thought I’d offer one anyway.  Think of it as a little public service announcement for those who might run into similar problems.  You know what I’m talking about, those NBC commercials where d-list actors try to teach you something in thirty seconds? Bullies are bad.  The environment is good.  A rainbow spreads out across the screen while dulcet tones signal that the network has reached a satori of self-satisfaction.  “The More you Know . . .”    The more you know . . . what?  In all honesty, I don’t know how this information will be useful to you, but it makes me feel better in posting it.  If nothing else, maybe I can quell a few rumors. Since my return to life, to work, and to the internet, I’ve heard people say they thought I had an aneurism, or I went into a diabetic coma, or I ate tainted rabbit.  Granted, I started the last rumor myself, but that’s just all the more reason why I should set the record straight.  It wasn’t the rabbit.  It wasn’t our lop-eared friends, who make excellent pets and pair well with Chianti.  It was the bacteria Pasteurella Multocida, which somehow made it into my blood stream and into my brain.

You see, when I went offline in April, I almost went off-line for good. One morning I checked into the hospital with nothing but a mild ear infection; I was given antibiotics and sent home.  That evening, I knew something was wrong.  My wife, Ann was out of town, so I called a friend to take me to the ER, where I went into an unresponsive seizure in the waiting room. My right eardrum burst. A spinal tap came back positive for bacterial meningitis.  I was put on a respirator and given a PICC line. Over the course of the next thirty-six hours, bacteria spread to my circulatory system, and I went into septic shock. My whole body swelled to twice its normal size. A nurse had to administer eyedrops regularly because my eyes were swollen open. My blood pressure crashed. I was on the brink of organ failure.  Just as my family was wending their way here—from Bermuda, from San Francisco, from Seattle—at the news that I might not make it through the day, the ICU finally started to turn things around. “That’s the closest I ever want to be to seeing a dead thirty-nine year old,” said one of the nurses.  Even as they identified the bacteria, put me on the right intravenous antibiotics, and pushed the infection back, I still didn’t wake up. My family plied with music, read to me, and tried to stir me back to consciousness.  Jamie and Ann played RockBand tracks for me on their iPods.  They read Greg Rucka to me.  They read Philip Larkin. Ann whispered in my ear.  “It’s Jose Garces!  He’s come to sign your copy of Latin Evolution!” I say nothing.

I woke up about the time they were going to have to put me on a feeding tube.  They don’t know why, but I’d like to think I came back because I was finally hungry enough to do so.  While people were still trying to figure out if I was of sound mind, I was visited by a speech therapist, tasked with administering the “swallow test”.  I tried water, graham cracker, and a little bread.

“What do you think?” she asked, as I chewed deliberately, exaggerating every motion.

“It’s awful!” I said, surprised at how small and thin my own voice was.

“You’re having trouble swallowing?”

“No.  The bread is awful.  . .  It tastes like paste.”

I hadn’t had shelf-bought white bread in almost a decade.  I felt bad about being snobbish, but even the man who delivered my next meal, did a double-take after unveiled it.  “Pureed country bread and sausage?” he said. “What? Did you fail the taste test too?”

Meningitis is a bit like pneumonia in that any bacteria, and even many viruses can cause it.  Not all meningitis is caused by meningococcus, anymore than all pneumonia is caused by pneumonococcus.  (In fact, pneumonoccocus is one of the more common bacteria that cause meningitis).  Any bacteria or virus that gets past the blood brain barrier and infects the meninges, the insulative membrane which protects your brain and central nervous system, becomes meningitis.  Meningococcus is particularly nasty, because it’s contagious, but none, not even the relatively mild viral infections are a walk in the park.  My infection, not contagious, was caused by Pasteurella Multocida.  This is commonly found in the mouths of dogs, cats, and rabbits, but has no business being in the spinal fluid of human beings.  The doctors were suspicious that my two perfectly healthy, orange cats, Leon and Diego had somehow punctured me.  Like all good television doctors they did a thorough search of my body, checking above my hairline and between my toes. The found no signs of an infected bite or scratch. My family and I, like all good educated people, weren’t happy with this kind of ambiguity, so we turned to the internet.

What’s the first thing you find when you google Pasteurella?  Rabbits.

The word ‘Pasteurella’ strikes fear into the hearts of many bunny lovers. It conjures up images of nasty abscesses, of sticky noses, of sick sad bunnies.

So I quickly hatched my own theory about how I contracted meningitis.

It was the rabbit stew.

Specifically, it was Paula Wolfert’sRabbit Stew with Preserved Pear and Ginger“. Paula Wolfert’s The Cooking of Southwest France is one of the best French cookbooks I know, for people who want to spend more time on a dish than Julia Child, and yet, not put truffles in everything like Thomas Keller.  She may even have been first recommendation for a French cookbook, if it hadn’t been for the little fact that she had tried to kill me.

Or maybe the H-mart tried to kill me. See, I don’t usually go around cooking rabbits. Like most Americans, I think they’re cute and more importantly, expensive. When they’re in the produce section at a Korean supermarket, however, they are neither cute nor expensive. They look like alien embryos and they cost only slightly more than “Old Black Chicken”.

Or maybe it was my fault.  My kitchen is never quite as clean as Alton Brown’s.

I try to be clean.  I know all about cross-contamination.  But when you’re making stew, you have to get a bit messy.  You have to cut pieces across the bone with a cleaver, rather than at the joint.  That way the marrow can simmer into the dish.

I explained all this to my ID doctor at the time.  He listened patiently to my rabbit theory along with my detailed instructions on how to make a proper stew.  I explained not only about the marrow but about the collagen and how it breaks down to help thicken the sauce. The doctor showed genuine interest in my theory, but acted like he had never met someone who cooked rabbit before, or for that matter stew. “So  . . . this rabbit . . . How did I put this . . . You didn’t serve it raw, right?”

No, goddamn it.  It’s stew.  You cook it forever, and it’s glorious.

People humored me after that.  Several people asked me about the rabbit and where it came from, and they recommended against my eating rabbit in the future. But I’m pretty sure they were only humoring me.  ICU doctors and nurses probably know that patients who have been under Propofal for six days are going to say all sorts of nonsense.  I imagine this usually works quite well, but in this case I had my family and the internet at my disposal, so even before I had learned to type again, I was on-line and spreading Facebook rumors about Paula Wolfert and her rabbits.

Three days later I would be equally convinced that a vicious cult was kidnapping all the patients from the ICU in order to “re-educate” them in the ways of the Lord before sending them to the great beyond.  My clinical acumen, then, was understandably a bit off.  My neurologist called it, “a little ICU disorientation,” not wanting to upset me. The nurse used the more clinical term, “ICU psychosis,” when talking to Ann, though was surprisingly cavalier about the whole thing.  In retrospect, I realize this is because approximately one third of all ICU patients may suffer from some level of ICU psychosis; it’s a result of trauma, medication, and the unfamiliar environment. It usually only lasts a few hours or a few days, and almost always clears up when the patient is moved from the ICU back to a regular hospital room.  Ann however, didn’t learn this, and so spent the next two days believing that I was out of my gourd for good. To her credit, she adapted quickly to this new information.  In spite of my continual queries about how she got past the security checkpoint at the elevator, she decided she wasn’t going to lock me up somewhere like a Charlotte Bronte character.  As long as I could still cook and play piano, it wouldn’t matter if I occasionally thought men in robes were hunting me.  We would endure, even find a way to enjoy our lives.

The hallucinations worsened because I was on morphine. Remember when I mentioned organ failure?  Well, the good news is all I lost was my gallbladder.  It took three or four days for my body to telegraph this news to the world, because I was eating so little and was on so many antibiotics.

“How bad is your pain on a scale of one to ten?”

“According to yesterday’s scale or today’s?”

“Is it a dull pain or a sharp pain”

“The pain is dense, like clay”

” You’ve been reading too much Emily Dickenson. Is it a dull pain or a sharp pain?”

“Yes.”

It was hard to concentrate during the questions.  The hospital was sponsoring a competition in the ICU where doctors and nurses were supposed to work collaboratively to make parade floats representing common diseases.  The one right outside my door was making a parade float of a drowned girl who had a clock for a face, and I was really having a hard time figuring out what disease she represented.

“Does it hurt when I put pressure on it or when I let it go?”

“Yes”.

It was two days later before they actually removed the gall bladder, but my sanity was restored before then. As advertised, when I was moved from the ICU, my “little ICU disorientation” subsided.  It was like water draining from a drowned village.  Everything was sodden, but ordinary, even tedious.  I thought the pain in my gut had subsided, except that every so often another doctor would come by and insist on poking at it, like a schoolyard bully flicking some bookish kid behind the ear. Sure, I curled up in a little ball, but otherwise I felt fine.  Even when I went in for the HIDA scan, and they had to perform it twice, only to tell me that they couldn’t find my gallbladder, I thought that was good news.  I mean, if my gallbladder was all swollen up, it should be easy to find, right?  Apparently that just means there’s no blood supply getting to it.  The surgeon who removed it said it was almost gangrenous.

In the end, I recovered much more quickly than expected. For a long time, people kept telling me how lucky I was, and for a long time I hated those people. According to most of the medical research I have done, there have only been thirty or so recorded cases of Pasteurella meningitis in English medical records in the last century.  How could I be lucky?  But illness and recovery is about contradictions. The worse the illness, the luckier you are to live through it. I was lucky because if I had arrived at the hospital any later, I would’ve died.  According to the admitting doctor in the ER, I also would’ve died if I was a half hour earlier; he said he would have just drained my ear and sent me home.  I was lucky because they were able to diagnose the problem and respond to it in spite of its rapid escalation.  I’m lucky because I hear fine out of my right ear in spite of the ruptured eardrum. I’m lucky because I didn’t have to go to rehab, as expected; after nineteen days in hospital I was released directly to home care. I was lucky to have my family there and adequate health insurance and people at work who covered for my classes. I was lucky I had adequate insurance.  Did I say that already?  Very well. I was lucky I had adequate insurance. One day in the ICU costs $3,000 and that’s not including the tests and consultations.  That’s pretty much just the rent.

I have also come to peace with rabbits.  I haven’t eaten rabbit since the illness, but now that I am lucid, I know Paula Wolfert wasn’t trying to kill me, and I encourage you to try the recipe which can be found here.  Since my time in hospital, I did a fair amount of research, and I have found no evidence that anyone has ever gotten Pasteurella meningitis from eating a rabbit.

This may be of some comfort to people who like rabbit, but is probably of little comfort to people who own cats.  The vast majority of people who had Pasteurella meningitis handled animals. Only ten percent of cases were people actually bitten, but the vast majority of meningitis victims had handled pets.  It seems likely that the contagion is passed through saliva, a “lick is as bad as a bite,” as one source says. But don’t get all freaked out because your cat or dog licks your kid’s face in the morning.  It’s still far, far, more likely that they’ll die tripping over their pet than from contracting meningitis. Thirty cases, right?  Think about that.  According to Atul Gawande, there are roughly a thousand cases of flesh eating bacteria in U.S. hospitals every year.  So if you want to be a full-blown bacteriophobe, you have bigger things to worry about, like dirt.

I guess that makes this a pretty useless PSA. Well, you might still contract all the other varieties of meningitis, particularly viral meningitis.  Since my illness at least six people I know have come forward as having had meningitis or knowing people who have had it. One can recover from viral meningitis without medical care, but I wouldn’t recommend it.  You can’t tell what kind it is unless you’re admitted to a hospital, and all reports suggest that even viral meningitis hurts like a motherf*****.    If your case is bacterial, immediate hospital care is necessary or death is inevitable. Basically, if you have the telltale signs of a spiking fever, headache, and most importantly a stiff neck, get yourself straight to the hospital. True, I didn’t have any of those symptoms, but I’ve been told that’s what I should say if I want to make myself useful.

And oh yeah, wash your hands frequently if you own cats. Chances are your cat won’t give you meningitis, but you never know what you might give your cat.

So there you go.  The More You Know. . .

 

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