PROVIDENCE — Before every new rotation in medical school, Clinton Piper would give himself a crash course in the new topic. He’d read for days, downloading whatever he could find, and he’d prepare himself mentally to feel like an idiot again.
So it didn’t seem odd to him to download an e-book on knife skills, cook some recipes from his iPad, and a few days later find himself in an industrial kitchen learning to sear sea bass and pickle vegetables. “It was an awesome opportunity to get tossed into it,” says Piper, a medical student at Tulane University in New Orleans, who just finished a monthlong rotation at Johnson & Wales University, learning about nutrition from inside a kitchen.
The collaboration between the two schools, which began in the fall, is intended to increase the nutrition literacy of med students and the medical literacy of chefs-in-training. A Johnson & Wales student took a turn in the “culinary medicine” program at Tulane, while Piper and two fellow students were in Providence.
Piper, of Tyler, Texas, who says he could do little in the kitchen besides “find my way around a peanut butter sandwich” before the program, thinks medical schools need to do more than teach students how to treat illness. Students should also be taught how to head off disease with lifestyle changes such as healthier eating, he says.
Chefs also need to take a more active role in the war against obesity, said Karl Guggenmos, dean of culinary education at Johnson & Wales. “We provide pleasure — that’s all we’ve been concerned with,” he says. “But we didn’t realize the damage that we cause. It’s time for us to wake up and take simple steps that will have a big effect on the future.”
Restaurant food will always include sugar and salt, he says, but chefs at establishments from high-end to home-style can cut back on ingredients they know cause harm in large quantities. Guggenmos says chefs have to be clever about how they make their food healthier. Touting its healthfulness may turn off customers.
Instead, he suggests “simple, subtle change in ingredients that customers will not notice,” such as changing plate and portion sizes, and seasoning with spices rather than salt. “That’s where the art and craft come through, without the customer really knowing that these changes are taking place.”
Even at Johnson & Wales, though, not every student learns about healthy cooking. “That’s not a skill the industry is looking for,” says Chef Todd Seyfarth, who teaches nutrition courses attended by some of the medical students. The school is adding short food science and nutrition components to its classes, starting next year, and Guggenmos envisions more improvements soon. “Culinary medicine will be a mainstay of our curriculum,” he predicts, “and in 20 years will be as common as teaching new stocks and sauces.”
For their part, the medical students who just finished their Johnson & Wales rotation say they are surprised at the many parallels between cooking and medicine. The kitchen, according to Gary Kao, feels a lot like an operating room. There’s a structure, a hierarchy. You can’t be afraid to ask for help. “You can’t expect someone to stand there and spoon-feed you,” says Kao, originally of Cupertino, Calif.
And doctors also need to learn the art of subtly helping to make the world healthier. “Just because we prescribe it doesn’t mean people will take it,” Kao says. “It comes down to what’s practical, what’s effective.”
Their patients in New Orleans often have multiple health problems compounded by the lifestyle challenges that can come with a life of poverty. “So much of the population has no idea how to prepare [healthy] food,” says Neha Solanki, of Jackson, Miss., who, as a future internist, will play a bigger role in her patients’ lifestyle changes than will Kao or Piper, both of whom plan to become anesthesiologists. “You can’t blame them.”
But the stakes are high, says Solanki, who will soon start a residency program at the University of Massachusetts Medical School in Worcester. “If they’re healthy, they’ll be less violent, more likely to go to school, so it’s really a much deeper issue than just food.” Solanki was struck by how cooking foods differently — steaming instead of boiling green beans, for instance — can make them more nutritious. That’s something she’d like to pass on to her future patients.
Solanki, Kao, and Piper say they also learned new respect for the skill and effort involved in cooking. In one assignment, Kao and Piper had to cook a meal that met strict nutritional guidelines: 50 percent carbohydrates, 20 percent protein, 30 percent fat, no more than 600 calories total. When Kao combined Chilean sea bass with forbidden rice, though, he had to do some “creative rearranging” to get the numbers to work out. He ended up cooking the fish in parchment, so he wouldn’t have to add more than a drizzle of oil, and added lemon juice and a blend of fresh herbs to give it flavor without too many calories or fat.
That puzzle-solving process is very much like what they have to go through with patients when prescribing medication, the students say. If a patient has drug allergies or a bad kidney or is obese, they might need a different medication or a different dose than someone else.
Of course, the Tulane students also enjoyed themselves at Johnson & Wales. How could they not, with free, fabulous food around nearly every corner?
“I’m going to go back [to New Orleans] and be very hard to please,” Kao says.