The Zen of Food in Hospice

MaryEllen Kirkpatrick is a professional chef, but she doesn't create signature meals at a four-star restaurant or sling hash at a neighborhood diner. Instead, she nurtures people who are dying. She cooks for the residents of Zen Hospice Project's Guest House in San Francisco.

The Guest House serves its residents with a Buddhist philosophy that MaryEllen embraces as she creates meals for people in their last months of life. At the end of life, appetite may decline and the senses of taste and smell may change as a result of medical treatments, but food often remains important. MaryEllen works with each resident to provide exactly what they need to feed his or her body and spirit, whether that is a memory of a favorite regional dish, a nourishing comfort food, or just a nod toward normalcy.

We asked MaryEllen to share a few stories of meals she's prepared for residents of the Guest House, as well as a favorite recipe that comforts her as well as the residents.

Sharing a Bond Through Food Memories

"We had one resident whose family origins were Russian, originally, and we had another resident in the house who was, I think, Ukrainian at the same time. They were at opposite ends of the house. The Russian woman had lived all over the world since she had left Russia. She was very fluent in English, very engaging. She would talk to you, and she was a very good cook. She had a lot of stories to share about food.

"And the woman at the opposite end of the room didn't speak any English at all, and she had mechanical issues as far as chewing and swallowing. But she had a similar background in what she would have eaten because they were from similar areas. And so in talking to the one resident who we had conversations with, she would tell us about food that she had eaten, and food that she had loved, and food that she had missed. And then we would go down in the kitchen and try and create these things. And she would always include, 'And I'll bet this other woman would really enjoy that, too.'

"So we would cook for both of them, sometimes very differently because we would find ways to make the food that we were creating with that profile of taste in a way that someone who didn't have the ability to chew could enjoy. That became a really wonderful thing, and so every once in a while when both of these women would come down to the garden and sit, they would talk together because they shared a language about food and what we were preparing. And then we would get feedback, 'No, this is supposed to be done like this. This is supposed to taste like this.'

"It was a wonderful engagement because we got to know both women, we got to serve both women. They got to comfort each other in their own ways as well while they were both in the house."

Cooking for a Former Chef

"Another resident is Luca, who worked as a chef. He is a wonderful man, and he is so grateful, and his whole life has been in food. He loves everything, and I find this is true of most people who are chefs. It doesn't limit your palate. You like everything, and so he's willing to try. He wants to enjoy. Cooking for him, he doesn't often tell me exactly what he would like.

"He doesn't ask me for specifics, and when I ask him, 'What would you like to have?' he's like, 'Oh, whatever is going to be fine.' And then he says, 'I wish I could come down and cook with you.' His knives are down in our kitchen there, in a knife roll that's up on a shelf. So he's in the kitchen with us at the same time in that way. He appreciates every aspect of what we bring up. He looks at the food, he can smell the food when it's downstairs and being prepared, and then he looks at it when it comes up.


Related: What Really Matters at the End of Life?


"He considers it as your offering, and he considers it also as something that he would have made. And he is always so appreciative of what you've made. He's a wonderful person to cook for. He loves pasta so I make a lot of pasta for him. Creamy things. He loves crunchy things, he loves everything. He's a joy to cook for.

"I think sometimes it makes him sad. A volunteer told me that he had commented the other day that, 'Oh, if it weren't for the stairs, I could just come down and help you cook.' Because as soon as he sees the food, he wants to be able to offer, too. He wants to be able to give back, and he wants to be able to offer things in ways that he has in the past; to cook for people and to offer that."

A Representation of What Food Means

"There's another woman that we had who was eating when she came in. Some people come into the house, and they're able to eat everything, and then some people can't. As her disease progressed, she stopped wanting to eat, but she always wanted a tray.
"So I would make her a tiny portion because a lot of food at that point is off-putting – you see this big pile of food. But she always wanted a tray, even if she didn't necessarily intend to eat it. She wanted a tray for what it was to her, and so we would make a little soft-boiled egg on an egg cup or a piece of toast with jam, and just arrange it in a way so that it was beautiful. It was a tiny representation of what food meant to her.

"She couldn't speak a whole lot, but she would always say, 'Thank you. That was perfect.' And it would come back down and it would have a spoon in it, but it wouldn't have been eaten. I think that, to me, illustrates that food is really so much more than food. It's a way in, it's a trigger. It's like a catalyst for a memory."

MaryEllen's favorite comfort food

"My favorite comfort food is chicken with fine herbs. I make it at the (Guest House) relatively frequently because I find it's comforting for a lot of people.

"You take some chicken, either a chicken breast with no bones or a chicken thigh and leg with the skin on, and you dredge that in flour. And then you sauté that in a pan with a little butter and a little olive oil, and then you add some onions and you float that in white wine and chicken stock together, and sometimes mushrooms, but usually just onions or leeks. You put the white wine and the chicken stock in that, and then you put the pan in the oven, and then you just let it cook. You turn it over so the skin is facing up, and it's like halfway up on the meat. The skin side is up so it stays crispy and a bit rosy.

"Then when the chicken is cooked, you take the chicken out of the pan and you thicken that liquid. A little corn starch and water slurry just to thicken it, or you could use a little bit of roux or just whatever you like to thicken things with. And then a good handful of four different herbs together – I use parsley and chervil, tarragon and thyme, all minced up. It's fresh, and you add it right at the end. Then you put the chicken back in, and that's chicken with fine herbs. It's a simple dish, but it's very satisfying."

Chicken with Fine Herbs

Ingredients:

1 chicken half breast, boneless with skin on

salt to taste

pepper to taste

sweet paprika to taste

flour as needed to dredge

butter as needed

olive oil as needed

1/2 small onion sliced fine (about 1/4 cup)

2 fl oz white wine

2 fl oz rich chicken stock

1 fl oz heavy cream

1 teaspoons minced fresh herbs- parsley, tarragon, chervil, thyme (dry herbs will not do in this recipe)  

 

Season flour with salt, pepper and paprika.  

Dredge the chicken half breast in the flour mixture.

Melt butter and olive oil in a heavy, oven safe pan on medium heat.  

Place chicken in the pan, skin side down.  

Add the onions and cook to soften.

When the chicken skin is browned and crispy, flip it over.

Add the wine and chicken stock, and place the pan in the oven (325 degrees) to finish cooking.  Add additional stock and wine as needed, adjust seasoning with salt and pepper.

When the chicken is cooked through, put the pan back on medium heat on the stove and add the cream.   Cook the cream down and just before serving add the minced fresh herbs.  

NOTES:

The amount of stock and wine you use really depends on the size pan you are using.  You want the liquid to come halfway up the sides of the chicken.  

The rich stock that you use will contribute significantly to the flavor of the dish.  Here at the Guest House we make a very rich long simmered stock from chicken bones, aromatic vegetables, herbs and spices, and then we use it in many dishes.