REDEFINE THE DIET RULES IN THE HOSPITALS

 

Do the hospitals need a dietician to advise what food is best for the patients? Or Should the dieticians’ role be restricted as what not to eat in view of Indian patients’ craze for ghar-ka-khana (home-made food)?

 

Although I argue with my wife about the food and food preparation, I must admit that I eat the healthy food at home. And this realization is not as of now. But, food as a subject came in to sharp focus when I had to eat food in the hospital for just seven days during my ‘Bilateral total knee joint surgery” at the Delhi’s super-specialty hospital last week (Jan 11-17).

In the past, I often glanced over the columns of dieticians advising people what is to eat for healthy living. But, more often, I just ignored the advices therein. My refrain: You cannot always live life by them. I have also read miracles occurring to some obese or thin people shaping their body through diet control and exercise, but did not believe in them.

So let me get back to diet in the hospital. As per rules, the patients need to eat the food provided in the hospital. The first three days that include two-post operation) were uneventful for me. The diet consisted of morning hopeless coffee and two biscuits by 7 am, followed by breakfast of cereals (dalia-what germs or cornflakes non-fortified with dry fruits), fruit mix, tea/coffee. Dishes like poha (pressed roasted rice flakes) etc were poorly fortified with tomato, beans, carrot and capsicum without garnish of coriander. South Indian dish like Idli (fermented rice steamed) with veggie stew were in bad shape and served cold. Often milk was admixtured with water served hot or not so hot. The lunch was served often at fag end of 1-2 pm range. It was late for me. It consisted of dal (either mung (green gram), arhar (red gram) or probably mix of seed pulses), one vegetable (often paneer (Indian cottage cheese), spinach or malai (creamy milk) paneer or veggies like carrot, spinach), rice, salad (4-5 slices cucumber, a slice of lime), three small chapatis/roties (Indian flat bread) laced with ghee (clarified butter) and sweets like seviya (semolina), custard for namesake. Evening coffee/tea was served at 5 pm and then dinner at 8-9 pm. The dinner was more or less repetition of lunch. In view of reports of avian flu these days, all non-veg products like chicken or eggs were banned. Fish was not talked about. Looking at the food plate,  this plate (thali) will be fine for any one.

From day one, dieticians will come and enquire about the food that I ate and will let me know what will be served later for dinner or breakfast next day, as they planned food for me in their charts. There was not much of green veggies despite that winter season is the best for vegetables. They are in plenty and reasonably priced. I suspect that food admin department of the hospital often ignored procurement of vegetables like beans, broccoli, green peas etc. as they are costly and others like methi (fenugreek), palak, coriander, suwa etc that needs careful segregation and cutting.

I am not aware of hierarchy of dieticians, but one or two will knock at least once or twice to enquire. And conversation will run a same pattern.

Dietician: Hello Sir, how are you? how was the diet?

Me: I am fine, Food is fine.

Dietician: If you need anything, please let us know. Okay, bye…..

After a while, I broke this pattern by telling young dieticians, that rather than generic questions, they should prepare the checklist about responses and eat the food themselves to know the quality. Both dieticians told that they did not eat it. Later, one said that someone else sample food by tasting. I did not meet this someone. I am sure that no patient will argue with the dietician, in view of his conditions and questions being verbose.

After two days, and with some effects of treatments, I felt quite unenthusiastic about food. My wife got me apples, guava and banana that gave me some relief.

While I had to eat hospital food, my wife who served to be an attendant for me, ate home-made food as our family friend insisted on bringing daily home-made food that included her breakfast and lunch. Of course, it was not allowed initially, but stealthily, and later, with physicians’ help, it was in our room.

The home-made food turned out to be great, as she shared it with me. It was tasty, wholesome, and satisfying. Later, she shared more of my hospital food and found some dishes like those of paneer stale and wondered as to how I was eating hospital diet. And to remind you, my wife is not food adventurist like me, grounded in the simplicity of food with moderate dose of spices.

Drawing upon her experience of looking after her father in the another super-speciality hospital in Nagpur, our family friend personally visited us, 3-4 times as is a custom here, and told us of an incidence in the past, that her father was almost on death bed, as the doctors struggled to cure him using lot of medicines for the ailments that they were not sure of. With humble background of living simply as naturally as possible, her father believed that nature cures. And so is the family value that our family friend inherited. As she saw deteriorating condition of her father, and poor diet that did not enthuse her father to eat, she felt the time to revolt against the medical advice. Disregarding dieticians’ advice, she fed her father with home-made food that he was used to. And, that sets in motion a signalling of good intake, personal care and more natural treatment. Eventually, her father became medically fit to be discharged. Proudly, she says that my father is still with us.

This sets in an aspect that is often overlooked; the emotional bonding that home-made food creates for healthy living. The specific needs like those of spices, balance of various ingredients, relative quantities of dal, veggies, milk products and salads, frequencies of intake are dictated by likings and dis-likings of persons that define the personality. And this has been built over time. The hospitalization means breakup in this bondage especially for patients who are old and with moderate style of living. Of course, I am aware of faddists that believe that emotions are transferred from the person who prepare food to the food itself and carried forward to one who eats. This is another area, telepathy, which for the moment I may not talk about in view of lack of evidence. But believers of this kind are in plenty.

Back to my experience, the question of dieticians’ role in personalizing dietary needs of patients and ability of the hospital administration to provide it assumes a larger role, Until then, there will be many who believe in home-made food that cures and cares.

PS: green chilies are not provided, nor is their presence or of red chilli or its preparation in food items perceptible in the food. Chillies are integral part of Indian diet. I wonder as to why this cold-shoulder treatment is given in hospital diets? Bland diet affects bowl movement adversely as I found out. Interestingly, medicines for bowl movements are allowed, but not chillies have health benefits including bowl movements as I realised during stay. Here are only two web-links for information. https://www.lybrate.com/topic/green-chilli-benefits-and-side-effects; https://www.webmd.com/diet/health-benefits-chili-peppers#1