There is a tribe to which all of us will belong, if only for a moment. Our time as a member can be a brief flash or last an eternity. It is the tribe of the dying, it welcomes us into its ranks regardless of how we find our way there.
Food takes on special meaning when considered in the company of death. The last meal offered to condemned prisoners is of mythic significance. We seem to think a persons last meal choice will give us a glimpse into the depths of their being in a way that nothing else can. Food is so profound in so many ways, what better comment on a life than the menu of our last meal?
Those suffering from terminal illness face the promise of a final meal every day. This gives a whole new meaning to Slow Food. Every bite can be a farewell to the living – that can be heaven or hell.
My Uncle Jude suffered the terrible wasting death of A.I.D.S. before medicines to control H.I.V. had been developed. Over several years his body lost its ability to draw nourishment from food. Its strange how some diseases cut us off from life by changing our relationship to food. It even became painful for him to swallow, due to some of the opportunistic illnesses that were a part of AIDS back then.
Jude was lovingly cared for by his housemate and protégé in leather, Jerry. Young enough to be Jude’s son, Jerry’s family had rejected him because of his homosexuality. Jude took Jerry under his wing, shepherding him through the wild and exciting nightlife on San Francisco’s South of Market club scene. They made up their own tribe in the midst of a world they felt had rejected them.
The first time I cooked with Jude I learned how to make his pot brownies. Like patients undergoing chemotherapy, people with A.I.D.S suffer from lack of appetite and chronic pain. Marijuana can be a great way to increase appetite, decrease pain and ease anxiety. Making pot brownies has a wonderful alchemical twist. Heat up your oil or butter to just below its burning point. This varies from butter to oils, keep the butter pretty cool. Toss the pot in and stir it around. Let it heat up. Just as the green leaves are crisping and the oil is about to burn, take your pan off the burner and let it cool. Now you have a medicinal pot tincture to add to your food!
Jude’s pot came from a personal garden on the roof of his Victorian home. He was a transplant from the East Coast, bringing his passion for early American antiques with him. His home was transplanted as well, from one side of San Francisco to the South of Market area after it had been devastated by the fire that followed the Great Quake of 1906. Its white picket fence spoke of Cape Cod, a place I visited him and his family during my childhood. Many of his meals reflected the same Irish American East Coast taste, corned beef and cabbage, a good steak and a giant baked potato.
I visited him throughout his illness as care giving support for Jerry, occasionally taking in his Meals on Wheels lunches. Developed to ensure home bound seniors got at least one decent hot meal a day, they also served some of those suffering during the height of the AIDS crisis in the city. The meals were small and Jude could only finish a portion, but the generosity of the gift banished the darkness from his home for a while. It was as if they placed a daily benediction on his doorstep. Though he might never know the people who delivered this invaluable gift, they were hailed as saints whenever they knocked.
I shared Jude’s last meal with him, it came several years after his initial diagnosis. Jerry called me a few days before Thanksgiving. “He’s getting close. He wants you to come up for Thanksgiving dinner. It would mean a lot to him.” Jude was not really able to eat at that point, he was little more than a skeleton, barely able to talk. Jerry cooked a beautiful, traditional Thanksgiving meal with stuffing, potatoes, gravy and cranberry sauce to garnish a large turkey.
I slid paper clip sized slivers of turkey between his thin dry lips – he eventually tasted everything on the plate. I don’t think he was able to swallow any of it. I had never been so intimate with a relative before. He shared with me his last sacrament, a farewell to family and life. He knew this was the last meal he’d eat in his beloved home. A few days later we moved him to a Bay Area Hospice. He died peacefully with Jerry holding his hand during his first night there.
I worked as a Hospice caregiver and nurses aid for a few years after that. Food never failed to become a sacrament to the bed ridden. When I cooked something from scratch for those I cared for it was always received with extraordinary delight. I remember one client in particular – Thelma. After breaking her leg a year before she decided not to get out of bed again. Bed ridden for so long she sealed her own fate: it was slowly killing her.
Thelma was not a nice person. She resisted all efforts of the nurses to help her get well and out of bed, acting like a stubborn two year old whenever they came by, cursing them to their faces or back with extraordinary venom. An avowed racist she spent many an hour trying to turn me into an anti-Semite. “Oh yes I love the new aid you sent over. He’s much better than that Spanish woman you saddled me with. He’s not a Jew is he? Oh Irish, I suppose that’s OK.”
She took to me as if the agency had sent her Richard Gere fresh off the set from “American Gigolo.” At first I thought I could leverage her affection to get her out of bed and into a wheel chair. This did in fact work for a week. She managed not to call the nurse who helped me operate the small winch we used to get her into a wheel chair “F-ing Jew” for at least a day or two.
The body was not made to lay horizontally for months on end, our hearts lose the ability to feed our brains enough oxygen to keep us conscious when we suddenly become upright again. The price of verticality was too much for her, leaving her faint and exhausted. She started up on her Hitler lectures again, playing coy games to get me to pay more attention to her. The most annoying was hiding her seizure medication in the some pretty unpleasant places (lets just leave it to your imagination). Ultimately she settled back into life from bed, romancing me and practicing the art of hate on her nurses.
When you perform home health care work for the seriously or terminally ill the food is often tasteless. Sticking with the industrial mindset of “one size fits all” and “everything must be sterilized” the meal choices often consist of highly processed frozen food. I doubt any condemned prisoner ever asked for “Healthy Choices Lemon Pepper Fish” as a last meal. Who wants the taste of dry cardboard in their mouth as they die?
Many of us know our taste buds can be heightened when we’re sick. Laying in our beds the slightest smell can either delight or make our stomach do back-flips. Perhaps this is where the tradition of bedside flowers came from – smells to mask the odors that accompany illness and anything else too strong for the patient. A Master Sommelier once told me it was easier to pass a blind tasting wine test when he was hung over. Imagine how aware of flavors we can become when every moment life is being stripped away from us.
Cooking for the terminally ill requires less flavoring than more, and the freshest possible ingredients. A rich smell can quickly turn an already queasy stomach completely upside-down while flat and lifeless food is only a harbinger of doom. Processed food packed with salt and chemical flavoring shouldn’t really be seen as valid food to feed the ill or dying. After all, how many meals does this person really have left to eat? Vital ingredients and subtle flavors are required to either nourish health or support our final moments in this world.
One night I decided to cook Thelma one of her favorite foods – sweet potato pie. I had never made one before, but I was sure I didn’t want to use all of the sugar and margarine she was suggesting. I just used a combination of baked sweet potatoes and yams with a little cinnamon and nutmeg thrown into a blender and then a crust. That was it. Though Thelma was as much a vegan as a T-Rex, she loved the pie. It was perhaps the first serving she’d finished in many months. She even had seconds.
Cooking for her was a lesson in the tribe of the dying. When we are ill or dying nothing separates us from each other, not even hatred that has caused untold suffering for thousands of years. The meals we eat at the table of the dying are the last thing to really connect us to our body and the pleasures and pains of this world. They are inevitably transcendent.
These meals should reflect the sacredness of life and the bounty that brought us as far as it did. The best food to eat there is the simplest, closest to its fundamental ingredients. This way the food can work its magic, dissolving resistance and opening us to what needs to unfold.
I was honored to feed Jude his last meal as a sacred family duty. He was as vulnerable as a child as I guided crumbs past his dying lips, the morsels could easily have been kisses. Like the washing of a body before burial, feeding the dying can be a loving familial sacrament.
Cooking for Thelma was intimate in its own way. Being an emissary for food to the tribe of the dying is a duty with much less gravitas attached to it than you might think. Like the Meals on Wheels drivers who were always buoyed up by their deliveries no matter how somber their customers, cooking for the ill and dying is a calling to a moment of grace. Despite some of Thelmas more unsavory qualities, I felt truly honored to be able to feed her delicious, nourishing food while she was struggling with the very act of being alive. I only wish I’d cooked her some Jewish dishes. I bet she would have liked Latkes.