Friday, December 30, 2011

Variety Friday: Japanese Hospital Food

Before I entered the hospital on December 20, one of my friends remarked that she believed that Japanese hospital food was better than American hospital food. I can't make such a comparison because my only experience with American hospital food was when I was 12 and had a tonsillectomy. Like many kids who were going to have their tonsils out, I was promised ice cream to soothe my sore throat and given a liquid diet consisting of broth, non-citrus juice, and gelatin. My disappointment was rivaled only by my pre-teen outrage.

The one thing about being in a hospital that I was sort of, kind of, well, just a little happy about was the opportunity to sample the food. I didn't know exactly what to expect, but I did know that the food would be vegetarian as that is what the hospital promises. Though Japanese cuisine lends itself well to dishes which do not include animal products, vegetarianism in this country is rather rare. I've never met a Japanese vegetarian, though I have taught a woman who is a chef at a vegetarian restaurant. She told me she was transitioning back to meat because she wanted to diversify her experience base and work for restaurants which served meat. She wasn't terribly committed to eschewing animal flesh, and most of the Japanese folks to whom I mention the notion of giving up things like beef and pork say they simply like these things too much. At any rate, with soybeans, tofu, and eggs being a big part of the traditional Japanese diet, I was curious to see what the hospital came up with in line with the "lacto-ovo vegetarian" food. 

The first day after surgery, I was given an all liquid diet. Though I was hardly thrilled with this because I didn't eat anything for more than an entire day, it did provide the chance to sample what the Japanese offer when someone is operating under dietary restrictions. Besides, this was something I could compare to what I had in the U.S., though I was a lot less sanguine at the prospect when I was a kid and denied my ice cream.

Note that you can click any picture and a much bigger one will load. This isn't because I think more detail was necessary, but because these are sized for my Facebook pages and I'm too lazy to make smaller versions for this blog post.

My liquid diet breakfast:

The tiny container in the upper left is a small quantity of melon gelatin. It tasted fine, but I'm not a big fan of melon-flavored things. The yellow cup to the right of it is decaf coffee. I was allowed a packet of sugar to add to it, but no milk. The coffee was extremely weak and lukewarm. The black bowl had extremely weak broth, likely vegetable based, but the flavor was so lacking in potency that I could barely taste much. It would have been greatly aided by salt, but it seems they preferred to give me my salt via I.V. at this point as I remained hooked up to bag after bag of saline during the day after surgery. The most interesting item was the clear stuff with the spoon in it. When I first removed the top from the covered bowl, I thought it was a bowl of hot water. It turned out to be something my diet card called "kuzuyu", or a kudzu-flour thickened soup. It was lightly sweet, and didn't taste bad, but actually lacked any strong flavor. It was a bit hard to eat it all because the sweetness tended to get stronger, but I was starving and put it all away. According to on-line sources, this is a hot winter drink in Japan. 

My liquid diet lunch:

Lunch was a little more fleshed out as it included a box of acerola juice fortified with iron and calcium. This time, I got a tiny quantity of strawberry gelatin instead of melon and miso soup instead of largely tasteless broth. Both of these were improvements, especially the miso soup. They gave me barley tea with lunch, but somehow thought it wasn't good with breakfast, oddly. The breakfast diet card included it, but it was whited out on the paper (diet cards are the slips of paper on the tray detailing the contents). The pink packet behind the gelatin is pickled plum sauce and there was also a tiny packet of salt. I guess this was stuff to be added to the bowl of white stuff in the forefront. This was "rice water" (omoyu), and that's what it really tasted like. It really did taste like slightly thickened water that had been siphoned off of washed rice. This reminded me of when I was a kid and made "glue" out of flour and water. I think this is what it would have tasted like. Even with the plum sauce and salt, it was pretty hopeless, but I drank it anyway because a starving women will take whatever she is offered. 

My liquid diet dinner:

My final liquid meal was one I greeted with extreme disappointment. Other than the pineapple carrot juice, it was all re-runs and the worst ones from lunch and breakfast at that. That's the rice-glue water, melon gelatin, pickled plum sauce, tasteless broth, and barley tea. I would have rather had the sweet stuff and some miso soup again, not to mention strawberry gelatin. It seems the repertoire for the liquid diet options in my hospital were extremely limited. 

I'd have to say that I can't imagine that American liquid diets are any better or worse than this. I think at the very least, they would give people black tea (without milk) as an option there. By the end of this first day, I was dying for some tea, as I'm a tea fanatic and drink at least 4 cups a day, usually more. Though I like barley tea just fine, one little half mug of it in a lukewarm state twice wasn't doing enough for my tea desires. 

Unsurprisingly, I was now looking forward to the solid food portion with exceptional gusto. Though I sneaked in a late night snack of some strawberry cookie bars I'd brought from home, I was hungry for "real food". The doctor mentioned that it'd be bread for breakfast, and that was just fine by me. 

First solid breakfast:

The green box is soy milk, which I rather like, but rarely buy for myself because it contains more fat than low-fat dairy milk. Of course, that's a banana, albeit not a super ripe one. It was also clearly refrigerated and I'm not really a fan of cold bananas, but starving people can't complain. The greyish stuff in the cup is potage soup. It was creamy, hearty, and had a good balance of onion, potato and milk as well as salt and garlic. I don't know if it was real or instant, but it was damn tasty. The little container in the upper right is a warm salad with what I guess is vegetarian salami and what I think was lettuce or cabbage (can't remember). The salad was very flavorful and delicious. The bread was fresh and tasted like it was recently baked. I twas also slightly warm. The packet of jam in the upper left is apple and I spread it on the bigger roll, which was white bread. The small one was whole grain and I dunked it in the soup. This was really a tasty meal. 

Solid lunch:

Lunch was the biggest meal that I received there, and was impressively tasty and diverse. The stuff with the green peas on top that looks like curry is hayashi rice, a sort of stew with a demi-glace sauce that is usually made with beef. Obviously, there was no beef in this. It was packed full of onions, carrots and what seemed to be grilled mushrooms with slightly blackened edges. There was a lot of heft to it and it was savory without being too salty and richly flavorful without being heavy. I'd like to have the recipe for it because it was a feat doing this as all vegetarian and making it so delicious. The salad was baby spinach greens with toasted slivered almonds. The salad itself was great, but was served with a packet of lackluster "French" dressing which did little to enhance it. The drink is a yogurt drink which was pretty much the usual tasty mixture of yogurty sourness and sugary sweetness that such drinks offer. It was yummy as well, but all of these types of things are. The finish was a small container of flan, which was sweet, creamy and had a nice burnt caramel sauce on the bottom. There was also a half mug of barley tea which really did not do the rest of the meal justice as a pairing. 

Solid dinner:

I'm not sure if dinner was intentionally lighter than lunch, but the portions of food were definitely on the slighter side. That was okay, because the truth is that the hospital meals I got two days after surgery were bigger than anything I make for myself at home. The item on the left is a warm cabbage salad with bits of carrot seasoned with sesame. It tasted great, but gave me horrific gastrointestinal distress all night. At every meal prior to this dinner, the nurses queried me about having gas and stuck some device on my stomach to test for difficulties and I was worried they'd find out this one had done a number on me and fret over it (possibly delay my release, heaven knows!), but they'd given up on monitoring my digestion after lunch. 

The rice is what passed for brown rice in Japan and nothing more. It's served with a fish-stock based soup that includes konnyauku (a flavorless, gelatin-like substance with little black specks on it), daikon (Japanese radish) and carrot. I believed it was meant to be a vegetarian take on tonjiru, a popular pork-based soup, but I could be wrong. This might simply be a standard non-miso type of soup. The stuff in the upper right is fried tofu with a savory and sweet sauce topped with a broccoli sprig. This was also pretty tasty and even a non-tofu lover like me found it pleasant. Finally, I was given a small carton of tomato juice and more barley tea. 

Second solid breakfast (last hospital meal):

Breakfast is actually my favorite meal and what I had at the hospital was no exception. One thing I loved about it was that they always included soup with the first meal of the day. It's something I'd like to do at home, but just don't have the time to make it. The combination of food at meals was inspiring, and I actually have added in some of the common elements in my own breakfasts since the hospital stay (including a little salad sometimes). This final meal was a piece of what I'm certain was Roman Meal whole wheat bread (the only sort of whole wheat bread you can cheaply and commonly get in Japan, though it is more of a bastard whole grain than the real deal as it's very white-bread-like), a packet of strawberry jam, a piece of "pocket cheese" (in the foil wrapper), a carton of whole milk, fresh pineapple pieces, and vegetarian minestrone soup. The soup was delicious with that familiar flavor of minestrone without the familiar oil floating around in it. The pineapple was six shades of awesome as it was clearly not from a can and sliced off a sweet, ripe fruit very recently. 

One thought I had as I consumed these meals is that there must be an immense competition for hospitals among food manufacturers. I never thought much about companies like Yakult (famous maker of yogurt drinks) and Kagome. They must sell huge numbers of packaged drinks to hospitals to serve to patients. In fact, I'd be shocked if they weren't better customers than the consumer market since the supply need would be quite steady. 

Since I never had any solid meals in an American hospital, I can't say if this was better or worse. However, my sister tells me that, during my mother's hospital stay, she was served things like canned fruit rather than fresh and that things were very overcooked. I do think that it's more likely in the U.S. that canned food would be used. However, I cannot stress enough that the food I ate was just what was on offer at my particular hospital. It could be different in various other hospitals. Mine was a smallish place, which may factor into how much care they take with meals. I cannot know. 

Overall, I thought the food was fresh, tasty and well-prepared. I was also impressed by the care given to the nutritional balance that was achieved. Of course, one would expect a hospital to be careful about such things, but I think they really did a great job. If this were a restaurant, I would feel okay, but not thrilled because I'd likely be paying more at a restaurant. However, if it were a school cafeteria, I'd be quite pleased to receive such dishes and if I could buy this food for cheap at a restaurant, I'd go there very often. 

If you've had experiences with hospital food in Japan or your home country, I'd absolutely love to hear what it was like to provide points of comparison to what I had. I know most of my readers are young and probably haven't been in hospitals, however, so I won't expect to hear too much.

Thanks for reading, and I'll be returning to usual form next week. An extra thanks for my readers' patience with all of my hospital talk on both blogs. It's just something that I had to get out of my system. 


Japan-Australia said...

I have to admit I struggled with the food in Japanese hospitals because it was pretty much the same for breakfast, lunch and dinner and not a lot of variety. I guess a month in Hospital will do that to you. Can't compare it to hospitals in Australia because I've been lucky enough not to have an extended stay so far - touch wood.

Japan Australia

Marvo said...

This (and your posts on your other blog) were quite fascinating. I've never been admitted to a hospital, but I have been to an emergency room twice. I have seen meals my father had after heart surgeries, but the only thing I remember about them is the Jello.

R said...

Wait... how is gelatin vegetarian? Or was it a gelatin substitute?

Orchid64 said...

Japan-Australia: Do you remember what the food was? I'm curious if it was different from what I had.

Marvo: I'm guessing based on the food you sample that you were there to have your stomach pumped? ;-) Seriously, I hope it wasn't anything too terrible!

R: Japanese gelatin is made with agar agar, a seaweed derivative. I've had people argue this with me before, saying that it's not actually "gelatin", but that is what the Japanese call it both in it's unflavored form and on my diet card (it's says in "gelatin" in katakana). It's different from the stuff made from animal products mainly in that it doesn't have to be kept cold to remain firm and is slightly softer. It's pretty much the same though it is vegetarian.

Thanks to all for commenting!

Afoofoo said...

The soups look really good, and the meals seem really well-balanced! I'm kind of excited to try Japanese hospital food now, haha. I'm glad your surgery was successful! Do take care.

As you have guessed, I am young and the only surgery I've had was for appendicitis. I did get hospital food, but wasn't allowed to eat it as it consisted of chicken curry (a must in Pakistan :'D) rice and custard. My relatives ate it while I had chocolate, cereal, and broth my mother brought. I wonder why they sent that meal in the first place if I couldn't eat it, hmm...

Jessi P. said...

generally hospital food in the u.s. ranges from disgusting to awesome. unfortunately they provide only an extremely limited number of vegetarian dishes, so as a veggie myself, you get awful tired of the same 3 or 4 dishes you can stand to consume, especially if, like i have, you are spending months at a time there. fruit there generally sucks, and the vegetables aren't any better. that said, there is something weirdly awesome about getting to order as many ketchup packets as you want!

peg said...

Wow, these meals look delicious.

I'm a nurse in a hospital in the US, and when I was in college I worked as a "diet tech" at a large research hospital. The common clear liquid diet here (which you were on - the natural progression after surgery is clear liquid - full liquid - regular diet; since you ate all of your clear liquids without gi problems your nurses probably skipped right to a regular diet) includes beef/chicken/veggie broth, jello, italian ice, and clear fruit juice. It's the same for breakfast, lunch, and dinner.

Obviously all hospital food varies wildly from place to place. It's true that the same food distributors that service restaurants also supply hospital kitchens.

Orchid64 said...

Afoofoo: It does seem strange that the meal they gave you was one which you could not eat, though as a great fan of curry, it sounded good!

xoryxx: I'm guessing (but don't have enough experience to know) that this hospital has a pretty good range of vegetarian dishes since that's all they serve. Years ago when I went there for gall bladder surgery, all I recall was that they gave me brown rice and an apple with salt on it. This time, I wanted to remember. ;-)

peg: The nurses actually were not the ones in charge of my diet. That was solely in the doctor's hands. I don't know if that's a difference between Japan and the U.S. or just the hospital I went to, but he had determined exactly what would happen from the moment I had surgery (he informed me of all of this beforehand). It was contingent on my not having problems, of course, but he had already decided - no food at all (day of surgery), liquid diet (day after), then solid (two days after). The nurses just followed orders.

Thanks to everyone for commenting. I really appreciate it! Happy New Year!

totoro said...

I moved your attitude toward adversity. Not only sick in surgical operation but also here in Japan, unknown situation, you tries to find the meaning of this experience! I would like to follow your attitude toward whatever may happen to me, I would like to find the meaning of its experience. I deeply touched and like this site more. Please take a rest and write Japanese thing from another point of view.

Bamboocopter said...

Your Day 1 fares are so sad-looking! Glad to see the improvement on the succeeding days'. Hope you're feeling better. :)

Orchid64 said...

Thank you, totoro, and Ce! I really appreciate the kind words and that you both took the time to read and write!

Happy new year to both of you!

Yvette said...

I enjoy reading your blogs and liked the little deviation from the norm that you took to share your hospital experience :-) My mom had quite a few hospital visits throughout her life and we always joked that she was always visiting the hospital just for the food, lol. As far as I know she mostly visited hospitals in Canada (where we live), but I bet she would have enjoyed some of the meals that you had during your hospital stay. Some of them really did look tasty, especially when you're so hungry, lol!

cohenster said...

I already commented on the other thread, but I'll comment here too! I would have enjoyed Japanese hospital food I think. I am 20 but have found myself in hospital a lot this year. I get the impression that the food I had in hospital is about as good as it gets in the UK. The food was important at this hospital because many patients had stays lasting over a week and/or repeated stays (like myself). I got a menu card every day and could choose what I wanted to eat off a list of 3 or 4 main meals including veggie options and pudding. There was also a "call order" menu with sandwiches, soup, cereal, fortified name it. You could order off that if you didn't like your meal options and also at pretty much any time of day or night. This was helpful for me as I was often on steroids and got the midnight munchies! In typical British manner we also got offered tea about 6 times a day and usually a big jug of water. When I had my operation, I started off just having tiny amounts of water off a damp sponge, then sips through a straw, then on day 4 I had clear soup and ribena, and day 5 I had a milkshake. It was a bit of a revelation the first time I had a tiny portion of mashed potato! Overall I feel very lucky I went to such a good hospital in terms of the food! Again, thanks for this awesome blog :)

Pratyeka said...

I was going to ask about the "gelatin" - of course, here in the west, gelatin means specifically the meat-based product so it's useful to know that agar-agar can be called "gelatin" in Japan. I'm curious about the Hayashi rice - demi-glace is typically a meat-based sauce, any idea how they got around it? I've never had hayashi rice because of this very reason, I'd love a vegetarian version. I've been reading these and your "1000 things" posts for a while now and I really appreciate all the great information and opinions you've shared.

Sophia Lee said...

Wow this is fascinating. I've only been to U.S. hospitals and hated the food there. I've never seen such an interesting...liquid diet before. I must say though that the curry looks delicious!

I hope you're doing well. I was quite alarmed at first to read that you were hospitalized. Wish you all the best!

Orchid64 said...

cohenster: Your experience sounds downright luxurious! I can't imagine being given a choice (and tea 6 times a day is right up my alley!). And I know how hard it is to be on steroids. I had Bell's Palsy quite some time ago and was on them and it was horrible. It messes with your body something fierce on multiple levels!

Pratyeka: I wish I knew how they made the hayashi rice without beef and kept it so tasty. Unfortunately, I couldn't guess at how they made it aside from the fact that they seem to have used a tomato based, vegetable stock and some grilled vegetables. I want that recipe! Chances are, however, that I'm not going to get it.

I'm not a vegetarian, but I do enjoy vegetarian dishes. In fact, I'm a falafel addict at present and could easily see myself becoming a vegetarian if I just decided to give up chicken (which is the only meat I eat 99% of the time).

Burp and Slurp: Thank you for the good wishes! I didn't expect to be in the hospital at the end of the year either. It all happened a bit fast once I found out I had the tumor (fell together in about 6 weeks).

Thanks to everyone for commenting and reading!

Annushka said...

I was in a Japanese hospital for a week about two years ago (St. Luke's, what what!)

I'm a vegetarian and I was in for a kidney complaint, and they stuffed me!!! Five-course meals (although they generally did mess up the "no fish" part of being vegetarian) and if I didn't finish my whole bowl of rice every time, they'd scold me about it.

It's the only time I've had a hospital stay, so I can't make much of a comparison, but I wasn't a huge fan of the food and I HATE having people ask me about poo! :O

jill said...

glad to hear you're feeling better! I only recently discovered your blog and I am having a great time digging through your archives. We have a small Asian grocer here in my sleepy Canadian town, but I am jealous of all the interesting things you get to try!

Orchid64 said...

Annushka: I've love a 5 course meal after 36 hours with no food at all! Alas, I was eating those liquids! Thanks for commenting!

Jill: Thank you for your comment and for reading! I wonder what it would be like to do this blog from home where my access would be limited!

Anonymous said...

I've been reading through your 1000ThingsAboutJapan blog which I think I found after initially finding this blog... And now I've been randomly reading both.

That said, I work in a hospital and although I've never been admitted to one, I've seen the food.

My mom actually LOVES hospital food, surprisingly, and would frequent the hospital I was born in (different from where I work) just to get a meal in the cafeteria. Sometimes I think the cafeteria serves different food than patients get but at that hospital it was all pretty bland so I think patients ate that too.

I've been to other hospital cafeterias where the food is actually much more mainstream - you might find it in a cheap restaurant. But I think the patient meals are always pretty bland and judging from what I've seen go to people's rooms - I'd guess I'm on the money.

Anyway, your meals sounded pretty simple but far more interesting than many meals I've seen offered to patients. The fresh factor is surprising. It's all canned over here.

Do you know if they had a cafeteria and if so, would visitors have had some of the same food you did?

Love your blog(s) by the way. My friend moved from NZ to Japan and since, I've become intrigued to learn more about what she is experiencing.

Orchid64 said...

Anonymouslyyours: Thanks for reading my blogs and for taking the time for commenting!

Your question about what guest could eat at the cafeteria is a good one. There was a small cafeteria on the top floor of the hospital, but I never saw it when it was open. My guess would be that they would be served exactly what I was as there did not appear to be separate cooking facilities. The hospital really was quite small and the cafeteria was pretty much cheap tables and chairs set up in a large space to give family a place to hang out. It wasn't a sophisticated place at all (but quite serviceable).

I'm actually a little surprised at the food quality in the U.S. and just how much of what I have been served at restaurants which clearly has come out of a can, a frozen bag, or as a reheated entree. I wasn't excited about coming back to the U.S. for the food, except for access to turkey breast, which I love, but it has been beneath my not incredibly high expectations.

My sense is that people don't cook anymore and tastes have developed along the lines of prepared and processed food as a result. I couldn't get my father-in-law to try my homemade pancakes because they weren't made with a processed mix (like Krusteaz or Bisquick). When I offered them to him, he said, "how did you make them?" When I said, "with flour, butter, milk, egg, etc." He said, "oh," and "no thanks". Frankly, people are surprised that I can and do, you know, cook my own food for the most part.

So, if average people don't cook for themselves, it's no shock to me that hospitals get most of their food from cans!