Gourmet food in the hospital bed
A liver pâté sandwich is not just a liver pâté sandwich*,
at least not at Herlev Hospital in Denmark. A liver pâté
sandwich here is served with pickled sago cooked in
beetroot juice, so they make a garnish like small red
pearls on top. At Herlev Hospital, patients eat gourmet
cuisine with touches from the Nordic kitchen.
*What is a liver pâté sandwich? A liver pâté sandwich is a traditional Danish open sandwich, which consists of liver pâté on rye bread. Liver pâté is a Danish lunch classic. Danes eat approximately 14,000 tonnes of liver pâté every year, and this spreadable topping is eaten by all Danes, regardless of income or education.
“Why shouldn’t they have the best food?” asks the chef at the hospital, Michael Allerup Nielsen, as it is no more expensive to make that sort of food than it is to buy finished
and semi-finished products. And at the end of the day, when Michael A. Nielsen does
the accounts, it is a profit in job satisfaction, quality and satisfied patients that he enters
in the books.
FROM FROZEN TO FRESH INGREDIENTS
“The tool our staff used to use most was a hobby knife or a pair of scissors to open the bags of frozen vegetables,” he says. An observation that says something about the common quality of the food, and which was instrumental in the Nordic food concept being realised in 2012 in the large hospital kitchen in Herlev.
“I thought that we’re so well known around the world for Danish gastronomy and talented chefs that why shouldn’t we also serve a good meal, made from quality ingredients, when we’re dealing with public food,” he says.
With the help of his colleague Christian Bitz, Research Director of Nutrition at Herlev Hospital, thoughts were transformed into action. The intent was to raise the quality of the food, give it more flavour and use fresher ingredients, which led to contacting a Michelin-starred chef at noma.
OFF WITH THE CHEFS’ HAT AND ON WITH THE HAIR NET
On the quayside in Havnegade in Copenhagen, the 65-metre long oval Art Deco building in mint green steals the street scene. Studio is on the first floor and the owner is gourmet chef Torsten Vildgaard. He was the one who responded to the request from Herlev Hospital nearly five years ago. He had just taken the plunge from noma and was in the process of setting up a consulting company - in collaboration with his colleague Søren Westh. “I thought the idea was incredibly interesting. It made so much sense, even though it was very much in contrast to a Michelin service and the world’s best restaurant (i.e. noma), to suddenly stand there with a hair net on and make hospital food for 1,000 covers a day,” he says. But both he and his partner jumped at the offer to help create a revolution in the hospital kitchen. They came from the Mecca of the Nordic kitchen with the mindset that comes with it, which was to be rolled out to patients. To begin with they observed the existing kitchen. They figured out that with few things they could raise the quality: “They had a salmon sandwich on the menu all the year round, and then there was asparagus on top all year round. But of course, there isn’t fresh asparagus all year and it was also seriously expensive to make. We said, ‘Well, we’ll have smoked salmon on once in a while,’ and the garnish could, for example, be apple or horseradish, rather than tinned asparagus.” Instead, the two chefs wanted to work with the seasons:
“We would follow the four seasons and buy fresh ingredients. For example, buy a large batch of apples when they were in season. Ingredients are at their best and cheapest when in season,” Torsten Vildgaard explains about the changes that have paid off in terms of both taste and budget.
BUTTER, CREAM AND RECOGNISABILITY
Even though the two gourmet chefs had free rein and good conditions to do the job, there would still be liver pâté as well as egg sandwiches on a daily basis: “So we invented 14 types of egg sandwiches, 7 for even weeks and 7 for odd weeks. The sandwiches repeated every 3 months, and then we changed the whole menu,” says Torsten Vildgaard, adding: “There are of course many elderly patients admitted to the hospital, so we wanted to give them something recognisable and at the same time something to look forward to.”
Back at Herlev Hospital in a small office hidden away behind the big echoing kitchens, where the kitchen staff are full of vim and vigour in white coats with blue and green hairnets, Senior Dietitian Tina Munk takes a seat next to Michael A. Nielsen. The two are working closely on the overall plan for the food served each morning for approximately 1,300 patients. Today there is a butcher, a produce section and a bakery at the hospital. The food is made from scratch and 80% is organic and without food colouring. The wildest thing, according to Michael A. Nielsen, is the nitrites that have to go into the rolled seasoned meat (i.e. a traditional Danish lunch meat), because patients simply won’t eat it the slightly greyer version without them. It should be pink, just like they know it and recognisability is an important criterion, even though the kitchen is set up for a broad selection in taste and appearance: “We’re not talking about gastronomy, because patients want something recognisable when they’re sick. It’s good everyday food,” says Michael A. Nielsen, and it is food with both butter and cream.
“The typical patient isn’t well and doesn’t eat much during their hospitalisation, so it doesn’t matter about the extra calories you get, and it may well be that you’re overweight, but we don’t recommend people losing weight when they’re sick. That can be done at home, when you’re healthy, so it makes perfect sense to have some tasty food when you’re here,” says Tina Munk from a nutritional perspective.
And if the patient has a vitamin deficiency, a vitamin pill is given with a meal. Conversely, as part of her PhD in clinical nutrition, she has helped develop another concept, Herlev’s Splendours (Herlevs Herligheder), which are small protein-enriched dishes for patients without much appetite, a concept that runs in parallel with the Nordic kitchen. The homemade food also has the advantage that chefs can make special considerations for certain patient groups. Tina Munk says that when taking heart and kidney patients into account, as little salt as possible is added to the food, contrary to what the industry is doing in the food they make.
HOMEMADE YIELDS PROFESSIONAL PRIDE
Herlev Hospital has taken on the task and in this context it becomes clear how organic homemade food in hospitals can be financially worthwhile: “We’re not trying to make money, we don’t pay rent, electricity, water and heating in the same way here, so we’ve been able to make this radical change. When we bought the pre-chopped vegetables, we paid for rent, wages and machines out in the industry. Some of that money we’ve been able to convert to employing more staff in the kitchen,” says Michael A. Nielsen. Because opting out of pre-made mayonnaise in a bucket and smoked ham pumped full of brine requires more hands. “When we make smoked ham here, we get the joint without the rind, cure it ourselves and smoke it ourselves. The product is much better and a slice of smoked ham looks like a loin when we make it, so that way we greatly improve the meat products,” he says. And in the same breath he talks about how he finds that the level of professionalism amongst the staff has gone up. Tina Munk confirms this viewpoint:
“The fact that you don’t have to cut a bag open, but are allowed to use your craft, the craft that you’ve been trained in, helps you feel good about going to work, and I believe this is a hugely important part of this concept.”
When Torsten Vildgaard took over the kitchen, that was precisely what he had in focus, including a realisation of his own position towards new players on the field: He rolled up here as a Michelin chef and had to learn from a hospital kitchen, and even though he felt a little resistance in the very beginning, it did not take long before the levels of enthusiasm
increased among the staff. He particularly remembers a female member of staff who ran through the large kitchen with a spoon in one hand and shouted ”Torsten, come and taste this.“ She had succeeded in making a big bowl of mayonnaise. “One way or another, it’s magical to find out you can do it yourself. Then it becomes second nature and you become more proficient and begin to optimise,” he says.
Professionalism is broadly represented in the kitchen today. Butchers, bakers, chefs and assistants are employed to make the food, and the development chef, who took over from Torsten Vildgaard and Søren Westh, has room to experiment:
“We’re trying to work vegetables into our desserts and today our development chef presented a buttermilk mousse to me with sugar-pickled carrots with a sea buckthorn jelly. And I said “Ooh! Do we dare?” – do we dare put carrots in a dessert, do we dare to introduce patients to what could be a slight transgression, because it’s not what patients normally eat?” says Michael A. Nielsen, and the response from the chef was “Yes, we dare.”
FOOD IS QUALITY OF LIFE
Not only does homemade food make good sense, it also brings professional pride with room to develop. Not for the sake of developing, but for the sake of taste. For the sake of looks. All of these for those who ultimately have to eat the food. “You should bear in mind that food is one of the only ways you can relate to a patient at a hospital. A great many things are going on that we don’t have control over. For many people meals are also something that divides up the day up when they’re hospitalised. It’s one of the things patients can look forward to in a hospital, where there aren’t a lot of pleasures other than the food,” says Tina Munk.
And precisely where it’s about creating a little bit of joy for the patients, is what’s close to home for Torsten Vildgaard. His own parents were part of a study group that were attached to the project with the protein-enriched food at Herlev Hospital. They both had cancer. “My parents were very weak. They lived in Tingbjerg, so it wasn’t very far from Herlev. Once a week, I had a weekly menu driven out to them in a taxi and the food was stored in the fridge.
That way they got something decent to eat, because they didn’t have the strength to cook themselves. I could see it lifted their spirits and was a huge help for them, and they could focus on taking care of themselves.
Every day they had a starter, a main dish and a dessert, and they ate and were excited about it,” says Torsten Vildgaard. They both died last year, after having been sick for many years. “It was hard for me as the eldest child, as I also had my own life with two children. I couldn’t come and cook for them every day. In a way, I could help them a bit this way by making it easier for them, and there are many others who also
deserve it,” he says. The food gave Torsten’s parents quality of life, and the intent is the
same for patients at Herlev Hospital.
YOU GET WHAT YOU WISH FOR
The future at Herlev Hospital has started. Both in terms of wishful thinking and development in practice. A sensory garden for patients is just around the corner in the truest sense of the word, in connection with a new hospital construction. Michael A. Nielsen wanted to build a herb garden on the roof, which came to be solar cells instead. “We want to be self-sufficient, so we can tell our story to the patient with food,” he says, and admits that it sounds a bit idyllic. It is the idea of being close to both the food and the patient that appeals to him, and
Tina Munk adds: “One thing is that down here in the kitchen we have devised a great concept with amazing ingredients, but if it’s served without thoughtfulness, then all the food can look boring and you may lose your appetite, so the kitchen has introduced meal hosts in some departments.”
The goal is to get many more hosts out with a sense of serving an aesthetic plate. Today a printed picture of the finished portioned food goes around with the buffets for the staff who have to serve the patients. And there is a goal of making the menu electronic, to achieve a gold medal in organics, which requires 10-12% more organic use and also more beautiful surroundings to eat your food in.
In the slightly more luxurious interiors in Torsten Vildgaard’s Michelin star restaurant, it sounds as if the gourmet chef is not quite finished with cooking food that makes sense – in a slightly grander sense. He thinks about the public food in Denmark, amongst other things, out in nursing homes, it is not nice words that go along with the food. “I wish I could do more, but I’m tied up at a restaurant and I also have a family,” he says about how he spends his time. But he also says it can annoy him that he has to completely let go of the kitchen in Herlev.
The project was very close to him in many ways: “I would love to do a collaboration again. A collaboration that didn’t necessarily cost money, but because I have a desire to do it. Now I have a restaurant and maybe some of the staff at Herlev might want to come in and get some tools and work with me for a few hours, a day or two or a week.”
Nobody knows the future. Right now there is a new climate at Herlev Hospital, which also recently merged with Gentofte Hospital. New hospital buildings shoot up from the ground next to the existing ones, a sensory garden will waft scents around the outdoor areas and organics has seriously taken root in the kitchen. Whether or not the wind will blow towards yet another trend-setting collaboration between the gourmet chef and Herlev Hospital, time will tell.
Published by HOUNÖ
Text: Journalist Lousin Hartmann
Photography: Rasmus Bluhme, Moment Studio and Signe Birck
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