Executive chef Paul Meola suggests a few options on his weekly lunch menu in the cafeteria at St. Luke's Hospital in Easton: vegetarian fried rice, hot pot soup, and lasagna.
Even better: All the squash, broccoli, peppers, chard, and kale the chef roasts and sautes for these dishes comes from a new organic farm on five of the hospital's 500 acres.
"This is brand new for all of us. It's really thrilling," says Meola, 61, who is poised to roll out fresh zucchini pancakes and tomato jam, too.
The three-year-old Easton hospital, known as the Anderson Campus of the nonprofit St. Luke's University Health Network, is the first in Pennsylvania to start its own farm on the premises.
"The time has come for stuff like this, and you can do it anywhere, the limiting factor being land," says Edward Nawrocki, president of the Anderson Campus, who expects the farm to break even in three years.
On campuses large and small, hospitals are finding ways to transform their historically bland, unhealthy, institutional food into the kind of delicious, nutritious, and locally sourced offerings that have captivated American gastronomes for years now.
And then there's this, which relates not just to patients and visitors, but also to staff, the primary consumers of hospital meals:
"Most of our medical expenditures have something to do with diet-related disease, so if we're going to get a handle on this, we need to . . . create a healthier group of people," says Emma Sirois of the Healthy Food in Health Care initiative, part of Health Care Without Harm, which works with hospitals on environmental health issues.
Hospitals are building hydroponic greenhouses and planting large gardens - at least one on a rooftop - to grow produce for meals, in-house farmer's markets, and Community Supported Agriculture programs.
Those without the land or desire to grow buy directly from local farmers or indirectly through so-called food hubs. Common Market in Philadelphia, for example, picks up fresh produce and other products from 75 small farms and processors within 200 miles of the city and delivers it to large institutions, including 13 hospitals in the Philadelphia region.
"Our hospital work has grown by leaps and bounds this year," says Haile Johnston, Common Market cofounder.
The nation's first hospital-farm partnership is believed to date to 2010 at St. Joseph Mercy Health System in Ann Arbor, Mich., followed in 2012 by Cancer Treatment Centers of America's Western Regional Medical Center in Goodyear, Ariz., which just added 66 acres to the original 25.
CTCA's Nicole McTheny says such partnerships make sense, especially for cancer patients.
"You hear story after story of patients struggling with eating when they go through cancer treatment," she says.
St. Luke's provided $147,000 in start-up money and pledges continued support for the Easton farm, which is managed by Rodale Institute, the organic powerhouse in Kutztown.
"It's not complicated. It takes a little initiative, some seed money, and a partner who knows how to do it," Nawrocki says.
It also takes a farmer.
Lynn Trizna, 26, is a West Chester native who has worked on farms since her freshman year at the University of Pittsburgh. St. Luke's pays her $40,000 a year with benefits and health insurance, a decent package for a young farmer and evidence of a desire to "create the perception of farmers as professionals," says Mark Smallwood, Rodale executive director.
Trizna and three parttime farmers fertilize with compost and compost tea, a nutrient-rich liquid. They hand-pick Japanese beetles off the plants and rely on beneficial parasitic wasps and ladybugs to keep other bad guys in check.
Trizna has a walk-in cooler, washing station, hoop house for seedlings, tractors, riding mower, and refrigerated cargo van for deliveries. An irrigation system is planned.
Healthy soil is the key to growing successful organic crops, which at the moment include greens, squash, peppers, beets, potatoes, tomatoes, and basil.
Trizna sends out a weekly order form, then delivers the goods to Chef Meola, an employee of Sodexo, the hospital's food vendor, and two other hospitals in St. Luke's network.
In the first month, 600 pounds of produce were delivered, a number expected to climb to 44,000 in a year. Eventually, the network's three other hospitals will be looped in.
Smallwood wants to add 15 acres and more farmers and adapt his business model to other institutions. "Invest in farming and it will pay for itself," he says.
St. Luke's nurse Barbara DiMarcantonio describes the new organic strategy as "what needs to be done.
"If you feed people well, people will feel better," she says, "and if nothing else, it gets the conversation going."
For Chef Meola, who, short of lettuce one day recently, harvested 40 heads of romaine himself, hallway conversations often begin with someone asking, "What's fresh today?"
Soon, the answer will be tomatoes, tomatoes, and more tomatoes. Trizna has intensively planted five rows of the summer's most popular crop.
Each row is 540 feet long.
Makes 5 servings
10 small whole yellow crookneck squash
2 whole medium sweet onions, sliced into rings
2 whole medium sweet red or green peppers, stem and seeds removed, then sliced (optional)
1/4 cup pickling or canning salt
21/4 cups granulated sugar
21/4 cups white or apple cider vinegar
2 teaspoons celery seeds
2 teaspoons mustard seeds
1 teaspoon turmeric
5 one-pint canning jars with lids and rings (you may need a sixth)
1. Wash squash but do not peel them. Cut squash, onions, and sweet pepper into thin slices and place in a bowl. Add 1/4 cup salt, then cover with cold water and ice. Let the mixture stand for one hour, using additional ice to keep it cool, or refrigerate. Keeping the vegetables cool is important as it will crisp them up. After one hour, drain well. (Do not rinse!)
2. Combine sugar, vinegar, celery seeds, mustard seeds, and turmeric in a large pot. Bring to boil and boil for three minutes, stirring occasionally.
3. Add drained squash mixture. Bring to boil and simmer for three minutes.
4. While the mixture is cooking, sterilize the jars and heat the lids and rings according to standard canning practices. The lids and rings should be placed in near-boiling water to heat. This recipe calls for five pint jars but may require more or fewer depending on your exact measurements of squash and other vegetables.
5. Fill sterilized pint jars with pickle mixture and cover with vinegar mixture. Wipe top of jars well and seal with hot lids and rings. Process according to standard recognized safe canning practices (for example, process in a water bath for 10 minutes). An exceptional website for canning technique is pickyourown.org, choose the "All About Canning" post.
Makes 8 to 12 servings
For the cake:
2 medium beets, unpeeled but trimmed of their greens
1 teaspoon vegetable oil
6 ounces (3/4 cup) unsalted butter, softened, plus more for greasing the pans
1 cup packed brown sugar
3/4 cup granulated sugar
2 large eggs
1 teaspoon pure vanilla extract
2 cups all-purpose flour, plus more for dusting the pans
2/3 cup unsweetened natural cocoa powder
1 teaspoon baking soda
1/2 teaspoon baking powder
1 teaspoon salt
11/4 cups buttermilk
For the frosting:
8 ounces (1 brick) cream cheese, softened
1 cup (2 sticks) unsalted butter, softened
2 tablespoons finely grated beets, mashed with a fork
4 to 5 cups powdered sugar, sifted
1 teaspoon pure vanilla extract or scrapings of one vanilla bean pod
1 to 2 teaspoons milk, depending on desired consistency
1/2 teaspoon fresh lemon juice
Pinch of salt
1. Place a rack in the center and upper third of the oven. Preheat oven to 375 degrees.
2. Thoroughly wash beets under running water, and trim their leaves, leaving about 1/2 inch of stem. Place clean beets in a piece of foil. Drizzle with just a bit of vegetable oil. Seal up foil. Place on a baking sheet in the oven. Roast until beets are tender when pierced with a knife, about 1 hour.
3. Remove the beets from the oven. Open the foil and allow beets to cool completely. Beets will be easy to peel (just use a paring knife) once completely cooled.
4. Using a box grater, grate the peeled beets on the finest grating plane. Measure 3/4 cup for the cake and 2 tablespoons for the frosting. Set aside.
5. Reduce the oven temperature to 350 degrees F. Use butter to grease two 8- or 9-inch round baking pans. Trace two pieces of parchment paper the same size as the bottom of the cake pan; cut out and place inside pans. Butter the paper. Dust the pans with flour. Set pans aside.
6. With an electric stand mixer fitted with a paddle attachment, cream together butter and sugars on medium speed until pale and fluffy, 3 to 5 minutes. Beat in eggs, one at a time, for one minute after each addition. Stop the mixer and scrape down the sides of the bowl as necessary. Once eggs are incorporated, beat in beets and vanilla extract until thoroughly combined.
7. In a medium bowl, whisk together flour, cocoa powder, baking soda, baking powder, and salt.
Add half the dry ingredients to the butter and egg mixture. Beating on low speed, slowly add the buttermilk. Once just incorporated, add the other half of the dry ingredients. Beat on medium speed until just incorporated. Do not overmix. Bowl can be removed from the mixer and mixture folded with a spatula to finish incorporating ingredients. Cake batter will be on the thick side, not pourable.
8. Divide the batter between the two prepared cake pans. Bake for 23 to 25 minutes (for a 9-inch pan) or 30 to 32 minutes (for an 8-inch pan). Cakes are done when a skewer inserted in the center comes out clean. Remove from the oven and allow to rest for 10 minutes. Invert cakes onto a rack to cool completely before frosting and assembling.
To make the frosting:
9. In the bowl of an electric stand mixer fitted with a paddle attachment, beat cream cheese for 30 seconds, until pliable and smooth. Add butter and beat for another 30 seconds, until well combined. Stop mixer and scrape down the bowl as necessary. Beat in beets. Add the powdered sugar, vanilla extract, milk, lemon juice, and salt. Beat on medium speed until smooth and silky. Refrigerate the frosting for 30 minutes before frosting the cooled cakes.
10. To assemble, place one layer of cake on a cake stand or cake plate. Top with a generous amount of pink frosting. Spread evenly. Place the other layer on top of the frosting. Top with frosting. Work frosting onto the sides. You will have frosting left over. Refrigerate for an hour before serving to make the cake easier to slice. Cake will last, well wrapped in the refrigerator, for up to 4 days.
from Fine Cooking, November 2001
Per serving (based on 12): 674 calories; 7 grams protein; 87 grams carbohydrates; 66 grams sugar; 36 grams fat; 124 milligrams cholesterol; 622 milligrams sodium; 3 grams dietary fiber.
Makes about 11/2 cupsEndTextStartText
2 pounds unripe tomatoes (about 6 medium, the greener the better)
2 tablespoons minced fresh ginger
1 teaspoon mustard seeds
1 teaspoon cumin seeds
1 teaspoon ground coriander
3/4 teaspoon salt
1/4 cup cider vinegar
1/4 cup brown sugar
1/4 cup granulated sugar
2 tablespoons minced garlic
Cayenne to tasteEndTextStartText
1. Dice the tomatoes and place in a medium-sized saucepan with all the remaining ingredients except the garlic and cayenne.
2. Bring to a boil, lower the heat, and simmer uncovered for 45 minutes, or until everything is well mingled and very soft.
3. Add the garlic during the last 5 or 10 minutes of cooking. Cool to room temperature, then add cayenne to taste. Taste to see if more salt is needed.
4. Transfer to a jar with a tight-fitting lid and refrigerate until cold.
Per tablespoon: 24 calories; trace protein; 6 grams carbohydrates; 5 grams sugar; trace fat; no cholesterol; 76milligrams sodium; trace dietary fiber.