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Saturday - May 18, 2013

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‘Nonstop parade’ taught Alexandra how to cook

It's not easy to stump executive chef Michael Harding. He and his staff at Children's Hospital in Lawrenceville prepare nearly 300 patient meals a day. His clientele, be they toddlers or teens, can be a finicky lot.

"A lot of times, they don't have the greatest appetite, being sick," Harding says. "We're big believers that kids eat with their eyes first, so you want it to look good."

Most hospitals have ditched the institutional stigma of their food for fresher, healthier fare. Harding and sous chef Anthony Mongell work with staff dietitians, who evaluate what each child is permitted to eat. They're ready to prepare anything from gluten-free breaded fish to sugar-free brownies or strawberry shortcake.

But sickness doesn't always respect the menu. Certain patients can present unique challenges.

"We call the chef in when we need the big guns, when we've got a problem that we can't solve on our own, when we need them to do something out of the box," says Ann Condon-Meyers, a clinical dietitian at Children's.

Recently, they had to figure out how to make a birthday cake for cancer patient Rylan Schmidt. Rylan, who was turning 3, had a severely restricted diet because he had undergone a bone-marrow transplant. Patients on a BMT -- bone-marrow transplant -- diet are forbidden to eat raw vegetables, fresh herbs or other uncooked food because of the risk of bacterial infection.

"Bone-marrow transplant patients are immuno-suppressed, so we have to open a new box or bag for the patient so they aren't getting something that had previously been opened for another patient," Harding says.

Harding and Mongell went shopping for ingredients in single-serve packages. They bought a new box of cake mix to reduce the risk of cross-contamination. They decorated the cake with a theme from Rylan's favorite movie.

"They got a couple of actual 'Cars' toys and put them on the cake as decorations," says Rylan's mother, Brandy Schmidt. "That made his day. He put his hands in the icing and grabbed the toys off the cake."

Another time, Harding and Mongell made a last-minute shopping trip to track down ingredients for nonfat macaroni and cheese. A small boy who had undergone surgery wanted mac and cheese for dinner, but he couldn't eat foods with fat. They made it with vegetable-based American cheese and no-fat, nondairy creamer.

"If they want it, I'll make it special for them and take it up to the room if it makes them happy," Harding says. "I would totally want someone to do this for my kids."

Mongell says he wants to create "food memories" for the kids, where they remember Children's Hospital as the place where they had, say, some awesome French toast.

"When a parent says, 'My kid ate for the first time in five days,' that really affects us in a positive way," Mongell says. "It means we're doing our job."

A good meal often is the highlight of a patient's day, says Lois Klinar, clinical-nutrition manager at Allegheny General Hospital on the North Side.

"It's all about control," she says "When you're in a hospital setting, you really can't control your medication or the tests the physicians have ordered, but we all have a relationship with food. The patient has the chance for real input at that point."

A chef might have to create a special meal for a cancer patient whose sense of taste has been dulled by chemotherapy. Sometimes, cultural considerations come into play.

"We've had patients who are Asian Indian," Klinar says. "We also may have patients who are vegans. All of those patients present a special set of challenges. If you also toss in their medical condition, that will often complicate things."

Alan Delrosso, operations manager and executive chef at Allegheny General, says he's made special trips to specialty grocery stores for patients.

"Sometimes, their dietary needs are a little special," he says. "Usually, one of the dietitians meets with the patients and talks to us. We do whatever we need to do."

Bob Fenoglietto of Lower Burrell was chef and manager at Allegheny Valley Hospital in Harrison Township for 30 years.

"That's one of the things I was really intrigued about, being a hospital chef," he says. "You had to be creative, using certain ingredients that weren't available to you. Something simple like an Alfredo sauce, for example. The classical recipe is calling for heavy cream and cheese and butter, but working in health care, you try to make foods as appetizing as you can, maybe using skim milk with a cornstarch base, using unsaturated fats and corn-oil margarine."

He uses tricks and techniques from his former hospital job while baking for clients at Fenoglietto's Wedding Cakes and Honeymoon Travel, the business he owns in Lower Burrell.

"There's so many people popping up that have celiac disease," he says. "We've been making gluten-free wedding cakes. Occasionally, we get people who can't have eggs. My hospital experience and career has bubbled over into the wedding-cake business."

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