McClendon's Select

Cancer Treatment Centers of America  – Part Three: The Kitchen

On my second visit out to the Cancer Treatment Centers of America (CTCA) I had a chance to meet with Executive Chef Frank Caputo.  Since our relationship began with CTCA I have heard from Bob time and again about Chef Caputo.  He and Bob hit it off immediately.  When I met Frank I knew why instantly.  Chef Caputo is not only as fanatic about organic produce as Bob, but they also share that same unstoppable work ethic, attention to detail, palette for quality, and sincere love and compassion for the people they serve.   Those traits in a chef make for excellent dining in any restaurant, but when you health is on the line, having Chef Caputo in the kitchen is like having a prizefighter in your corner.

The CTCA wasn’t an obvious choice for Chef Caputo.  As a graduate of the Culinary Institute of America, Chef Caputo had built a career heading up the kitchens of upscale restaurants and country clubs along the East Coast.  Cooking wasn’t just a passion it was in his DNA.  He grew up working in his family’s Italian restaurant outside of Pittsburgh.  His Italian roots had long held a close relationship between the chef and the farmer.  He had learned early the value of always knowing where his food came from and who grew it.  When he went to the Culinary Institute of America he wanted to master the classic French techniques to go along with his old school Italian cooking, and he wanted to work for a chef that really knew how to cook.  It was at the Culinary Institute of America that Chef Caputo met his mentor and closest friend, Chef Jack Shoop, the same man who would introduce him to the CTCA years later.

In his years since graduating from the Culinary Institute of America, Chef Caputo spent his time and talents perfecting the art of haute cuisine and enjoyed working along side his mentor Chef Shoop many times.  He credits Chef Shoop with expanding his culinary education and continuing to lead and inspire him in the kitchen.  When the idea of opening the kitchen and dining room for the CTCA in Goodyear was first introduced to him by his friend, Chef Caputo balked.  Chef Shoop was heading the kitchen for the CTCA in Philadelphia and felt like it would be a good move for Chef Caputo as well.  But for Chef Caputo moving from fine dining to a hospital kitchen felt like a step backwards, or maybe like one off a cliff.  After years of perfecting his talent, this was not in his game plan.  He had cooked for world leaders, celebrities and athletes that were name brands, and he was building a name for himself in the culinary world.  A hospital kitchen seemed like the antithesis to everything he had done.  But the thought wouldn’t go away, and during a time of real personal reflection, he decided that he needed a change and wanted to focus on doing things for others.  When he shifted his thinking outwardly, the CTCA became the natural choice.  This kitchen was not about him, his ideas, recipes, or talent; it was about serving others.  Meals at the Cancer Treatment Centers of America have the power to change lives, in hearing Chef Caputo talk, it sounds like they changed his as well.  He came out to the CTCA in Goodyear to open the kitchen and get them started and has been with them ever since.  He says he can’t imagine being anywhere else.

From the moment Chef Caputo arrived at the CTCA, his focus was completely on creating meals that had as many cancer-fighting properties as possible, while maintaining the quality and flavor that he had built a career on.  Just as Sharon Day, the CTCA’s Director of Nutrition, Chef Caputo’s goal is to introduce as much variety and quantity of fresh, organic fruits and vegetables into every dish served to patients.

McClendon’s Select organic produce is used every possible way in the CTCA kitchen from the freshly juiced drinks and smoothies in the café to adding vegetable purees to dishes as a substitute for other ingredients.  They are found on every plate.  Chef Caputo wants those antioxidants and nutrients available to patients as much as possible, and in whatever flavor, form or recipe that will appeal to them the most.  On an average week, Chef Caputo makes about 35 gallons of vegetable stock from scratch.  In fact, his kitchen makes everything from scratch, so he may control the quality and purity of the ingredients as much as possible.  (I even spied ketchup made from scratch in the refrigerated walk-in.)  I didn’t see anything that came in a can, but instead the kitchen shelves were filled with organic beans, rice, and grains of every variety.  The meats, dairy, including cheeses, and even the coffee are all 100% organic.  Chef Caputo has even gone as far as to find organic spices and sesame seeds to use.  He is a fanatic for detail.  Cornstarch or tapioca is used as a substitute for flour; fruit juices are used to substitute wine in recipes; salt and fats are cut out.  He admitted that it was hard getting away from using flour, but he did it and doesn’t look back. He wants everything that goes into the food served at CTCA to be working for the patient in their cancer fight.

Do not be fooled into thinking that this is just hospital food with organic ingredients. Chef Caputo is creating the classic French dishes that he has done throughout his career, along with reinventing the Italian dishes he grew up on.  But his culinary education has expanded now to look critically at the nutritional value of his food, as well as the flavors.  He wants his food to be on the same level and standard as everything else at the CTCA, meaning exemplary.  I can personally attest that when walking into the kitchen the smell wafting through made my mouth water.  Marsha and I both wanted to pull up a chair and have a bowl of whatever was cooking.  That was not a reaction I thought I would ever have in a hospital kitchen.  He has elevated hospital dining to such a point that dignitaries are once again coming to Chef Caputo’s dining room.  He even recently cooked for one of the presidential candidates.  But for the chef, it is all about the cancer patients now.  They are the ones that Chef Caputo is honored to serve, and he speaks of them with reverence.

Chef Caputo regularly works fourteen-hour days in the kitchen, but he will tell you that the most important part of his day is during the dining hours.  He spends mealtime in the dining room so he can get to know the patients, their families and caretakers personally.  He asks each of them what do they need from him.  He sits and talks with the patients to find out what flavors they like, what dishes they make at home, and what would provide them comfort during a time when they need it the most. Often times Chef Caputo will bring patients back into the kitchen to give them a tour.  He gives them recipes, teaches cooking techniques, does demonstration classes, and offers nutritional advice.  But this isn’t just about food.  He asks about their diagnosis and treatment plan and what issues are they having as a result. He wants to know their story and how he can help.  And his help comes in many different forms, far beyond the kitchen.

One patient he met had been diagnosed with throat cancer and had been told to visit an oral surgeon to have his teeth removed, as they would likely be lost as a result of radiation anyway.  For someone who loved food and eating, this advice was as shocking as the diagnosis.  The patient rejected that advice, and instead came to the CTCA for treatment.  He wanted to maintain his dignity.  He had once been a big man with a big appetite for food and for life, but when Chef Caputo met him, he was emaciated.  His throat was raw from his treatments leaving him unable and unwilling to eat.  Dietitians were encouraging him to put on weight so that he would have the strength to continue his fight, but he was rejecting the suggestion of a feeding tube.  That seemed again like a humiliation that he couldn’t face. Chef Caputo sat with him and asked what he could do.  What did he eat before his diagnosis?  What flavors did he crave?

Chef Caputo then went to the kitchen and fixed this patient five different meals, each pureed versions of food this man had once enjoyed.  When he went back to check in on the patient to see if any of these dishes might encourage him to eat once again, he was surprised to see that the patient had finished all of them.  He hadn’t just finished his meal, but for the first time since his treatments had begun, he had enjoyed food once again.  It was a step forward that gave him strength well beyond the physical to continue his battle.  This, Chef Caputo told me, is why he can’t imagine being in any other kitchen.  This particular patient has now been in remission for over two years, with his appetite back and his dignity intact.  

This was just one patient of the Chef Caputo, I could tell that he has many more similar stories of patients who need his help just as they need their doctors’.  When he speaks of the patients, he talks of them like they are his own.  He says that he wants his patients to feel spoiled, like they are at a country club with their every need met.  He wanted this dining room to have an open arm feeling and it does.  This is a calm, healing place where patients can relax and forget for a moment why they are there.  They don’t have to worry about what they are eating, how it was made, and if it will work with the advice given by their doctors, because Chef Caputo has already done that for them.  He keeps in touch with many of the patients he meets, checking in on them when they are back home, sending recipes, good wishes and encouragement.  He told me that his dining room is filled with a lot of laughter and smiles and said that many have told him that they miss his kitchen.

Imagine that – missing a hospital kitchen.

Having seen it for myself, I completely understand.

Cancer Treatment Centers of America
at Western Regional Medical Center
14200 W. Fillmore Street
Goodyear, Arizona  85338
623.207.3000
www.cancercenter.com

Cancer Treatment Centers of America – Part Two: The Nutrition

Since we began supplying organic produce to the Cancer Treatment Centers of America (CTCA) in Goodyear, everything that Bob had described in his visits and meetings there painted the picture of a world-class run operation. Their goal of putting the patients first had created an environment as un-hospital-like as possible while offering care that far surpasses what other cancer treatment facilities are doing. With an organization so driven and professionally run, it came as no surprise that the people I met while I was there were warm, professional and incredibly knowledgeable. They were all individuals you would want on your side when you are in the fight of your life.

Sharon Day is the Director of Nutrition for the Goodyear CTCA. Her role at the CTCA is to not only oversee all of the dieticians working with patients, but to work closely with the chef in their dining room to make sure that all of the meals served to patients work with their individual dietary needs. This seems like an obvious thing to do; however, having seen the meals served in hospitals, it is very clear that this is not the norm.

As dieticians, their first goal is to prevent or reverse malnutrition that can result from cancer treatment. Their next goal is to be a resource to patients to educate about foods that have cancer fighting potential and to help them make gradual changes in their diet and habits for long-term success.

When patients come to CTCA after receiving a cancer diagnosis, they meet with a dietician on their first day and continue to throughout their treatment. Dieticians work with each patient individually to assess their current diet, the type of cancer they are dealing with, the effects of the treatment they will be receiving, how to help patients make the diet changes they need to assist in their healing, and to give them the information and tools to continue this course when they return home.

These individual dietary plans outline the foods they should focus on for their healing.  While they may differ from patient to patient, they all focus on increasing the quantity and variety of organic fruits and vegetables.  Depending on the course of treatment, some patients face loss of appetite that can lead to malnutrition. Other patients may need to make adjustments to their daily meals to change their protein intake, sodium levels or to avoid food allergens. Each patient and diagnosis is different, and dieticians work with the individual and their clinicians to assess their specific needs so that their diet can work in tandem with their treatment.

To help patients successfully make these changes, Sharon also works closely with Executive Chef Frank Caputo at CTCA. Together they are creating a database of every meal prepared and served at the CTCA and analyzing the nutritional value for each meal. This is time-consuming and monumental, when you think of the size and scope of a kitchen serving an entire hospital, but it has proved to be invaluable to patient care. In effect, they are creating a nutritional label similar to one you would find on any food label at a grocery store. But these labels they are creating are not for packaged foods, but for meals prepared fresh and made from scratch daily in their kitchen.  They are analyzing every ingredient to fully evaluate the complete meal served to a patient.  Patients are also educated on how to properly read nutritional labels, so that they are making the best choices.  Each patient room at the CTCA is outfitted with televisions that have the meal selections on them for patients to access and request.  Only the meals that fit within a patient’s dietary plan are displayed, eliminating the temptation for selections that would work against their diets, and allowing patients to see the host of options that fit their goals.  Having seen the kitchen and what the types of dishes that Executive Chef Caputo creates, these are meals that can stand the scrutiny of restaurant critics.  The food created here is intended to meet all of patients medical needs, while also satisfying their basic need to enjoy the meal before them.  This may be a hospital, but they are not serving ‘hospital food’.

Through the process of analyzing the nutritional content of their meals, Sharon is able to collaborate with Chef Caputo to adjust how meals are prepared to reduce the fat, sodium or sugar in a recipe. Both know that meals that do not appeal to a patient won’t be eaten, so recipes are adjusted with both the nutrition and the flavor in mind.  Having a chef and dietician work together to meet these goals is yet another distinction that sets the CTCA apart. Sharon attributes Chef Caputo’s ability to show patients that good nutrition can come without sacrificing flavor as being huge in helping patients overcome some of the mental barriers to changing dietary habits.

But it is not just identifying what is in the meals at CTCA that helps in a patient’s treatment. One of their greatest resources as dieticians, Sharon told me, was in educating patients on foods that have cancer-fighting potential. First and foremost, they want to increase the fruits, vegetables and whole grains in a patient’s diet. They explain the benefits of foods high in Omega 3s that have anti-inflammatory properties that can help fight cancer, versus those high in Omega 6s, often found in processed foods, which create inflammation. It is through understanding food on a scientific level, that patients are able to see the direct correlation between nutrition and its impact on health.

Dieticians develop relationships with patients to take that education and help them learn how to put that knowledge into practice. They take patients to grocery stores and teach them how to shop for the food; they explain how to create meals with the proper portion size and calorie count for the diets. They also advice patients on what to look for when they dine out and try to help them avoid some of the marketing pitfalls that can be detrimental to their diet.  They also involve the hospital’s kitchen staff to offer culinary demonstrations and cooking classes, and send patients recipes that will appeal to their palettes.  They remain in constant contact with their patients, whether they are at the hospital or back at home, to continue offering advice, information and most of all, encouragement.

As it relates to us, patients are also educated on the difference between organic and conventionally-grown produce, and they are given the names of local organic farmers and farmers’ markets in their area. Organic fruits and vegetables are an essential part of every patient’s dietary plan, both for their current treatment and for future prevention.  According to cancer studies, Sharon told me that 30 to 40% of cancer diagnoses are attributed to diet and lifestyle. In her role, she wants patients to have the most nutritious options while they are receiving treatments at CTCA, and to have the most information as possible to take home with them to continue their healing.

Food is absolutely key to the treatment of cancer, and at the Cancer Treatment Centers of America organic produce is at the heart of their dietary recommendations to patients.

Cancer Treatment Centers of America
at Western Regional Medical Center
14200 W. Fillmore Street
Goodyear, Arizona  85338
623.207.3000
www.cancercenter.com