It’s not very common for me to hear things out of the mouths of our patients that I have not heard before—I have heard most things many, many times. For example: “exercise (insert dance, soccer, cheer, ballet, etc) is my only social life, I don’t have any friends without it,” or “school is the most important thing to me. I can’t get behind because of treatment,” or “I don’t care abut how much weight I gain, as long as it’s muscle,” or “I don’t tolerate milk products, fatty foods, wheat (gluten)…..”. And so on.
But this weekend I heard a request I had not heard before, and I almost laughed out loud because, in a way, it was so…endearing. The child was young, very young. Sitting bold upright in the hospital bed, emaciated face, small shoulders and thin hands, trying to wrench some control from a situation where they felt themselves disenfranchised of all control, looking at the menu, out it came: “Can I speak to the chef, please?”
Solemnly, the patient added: “I do all my own cooking. I eat no milk products and very little gluten. I love vegetables and apples. I drink a lot of water.”
“Why?” I asked, knowing that, in fact, the water drinking was so excessive that we had needed to take steps to assure blood sodium was not so low as to induce seizures. That’s right, seizures!
“Because drinking lots of water is good for you. I read that on the Web. Everywhere”.
Further perusal of the menu: “And I don’t eat mayonnaise either. I hate oily food.”
“I see,” I said. “But one of the reasons you have become so ill is because, although you feel you ate ‘a lot’, it was almost entirely devoid of fat.”
“No. No. I eat fat. I eat avocados. One for dinner every night.”
Looking into that sweet, anxious, cachectic face and thinking about many others I had listened to, I asked myself: since when do such young children obsess about the exact ingredients to their meals and food? When did it become commonplace to know how many grams of fat something contains, or the meaning of ‘trans-fat’? When did ‘glycemic index’, or ‘genetically modified grains’ enter the lexicon of childhood?
This particular child came from a delightful family, with concerned, appropriate parents, but parents who, like the rest of us, have lost some control of their child’s universe of information. The Web now defines and populates this universe. Both encyclopedia and trusted older friend with advice, the Web offers our children a diet of real and pseudo facts about anything they care to know. And increasingly, our children reflect what has happened to all of us: we talk continuously about food but we spend less time than ever in the kitchen.
Maybe it is we who should speak to the chef?
