A "foodie's" life

      On the door of my hospital room was a warning sign: “Nothing by Mouth.” 

      I was gravely ill -- double pneumonia, with an infection in my lung cavity and acute malnutrition. I was weak and frail, weighing only 118 pounds. 

      So, I was getting antibiotics intravenously plus a plant-based peptide formula going directly to my stomach in a feeding tube to bypass both my mouth and esophagus. That mix of 500 calories in 11 fluid ounces, my sole source of nutrition, was poured into me four times a day.

      It worked. 

     After 12 miserable days, I not only conquered rampant infections, but also began to regain strength and weight.

      With that progress, I was discharged by the hospital.

      But as I recovered at home, I realized that “Nothing by Mouth” was more than a treatment protocol. It was my “new normal.”

      The situation was not unexpected. Three years earlier, I'd been diagnosed with "silent aspiration," which meant that anything I'd eat or drink would leak imperceptibly into my lungs. 

     An x-ray swallowing test revealed the cause. There was damage to a small piece of cartilage, called the epiglottis, that is supposed to prevent food and drink from getting into the windpipe. The damage was done a decade earlier during radiation to treat a cancerous tumor on one tonsil. 

      That put me at high risk for pneumonia. I was strongly advised to take all hydration and nutrition with a feeding tube to forestall future re-infection.

      I followed orders. The only things I put in my mouth were  a toothbrush and mouthwash, which I expunged. 

      Before long, I was thriving again. With a daily diet of 2000 calories, I'd picked up 25 pounds and resumed most activities.

      The formula, a vegan concoction, had all the protein, vitamins and minerals that I needed. My consumption never varied. It began at 9 a.m. and was repeated every four hours until the last at 9 p.m. I also had eight ounces of water each time, so I was more hydrated than I'd ever been before. 

     There were some practical benefits, too..

     The regimen saved time. In about 10 minutes, I could pour my “meal” into my tube. With the schedule, I never felt hungry or ate too much. In fact, I was comfortably full all the time. 

      And I no longer had to gather food or prepare it. A month’s supply of formula was sent to me by a nearby medical provider.

      But there were just two flavors -- vanilla and an even-more-bland plain. Because the vanilla registered sweeter than the plain, I could sense the difference even though the radiation of 10 years earlier had compromised taste buds on my tongue.

      That was true in other cases, too. For instance, when I poured morning triple espresso (Lavazza) into the feeding tube, I could smell the aroma and savor a hint of coffee in my mouth.

      I could also taste peach flavor in kefir, peanuts in a soluble peanut powder, mango in a drinkable yogurt smoothie and the yeasty tartness of Guiness stout.  Yet I really did miss spicy flavors such as curry and distinctive mild ones such as tomato.

      If anybody asked why I didn't seem to be angry about my circumstance or envious of others’ eating, I had two explanations. First, the use of the feeding tube was the only way to stay alive. The other was that rich memories sustained me. For many years, I’d been on a food odyssey and indulged in numerous pleasures, with few denials.

      My culinary history began in Oklahoma where I grew up in a conventional meat-and-three family. My favorite meat was chicken-fried steak with gravy. We all ate fish my dad caught including bass, perch, catfish and trout. A mainstay was calves’ liver (smothered in onions) that my mom made for her anemia.

      But after leaving Tulsa, I joined the Peace Corps and served in Malaysia, where I became an adventurous eater.

      Putting it simply, I was willing to try anything that the locals ate. A prime example was darah, fresh blood of a water buffalo, which was deep fried in oil and served hot. I also found that I liked durian, a Southeast Asian fruit that smells like rotten eggs, but tastes like vanilla pudding.

      In recalling some of my favorites, I realized I accrued standards for quality ingredients and skillful preparation. And the experience itself — location, fellowship and vibe— enhanced my memories of foods. 

      For example, on a summer hike in the Italian Alps with friends, I helped gather fresh porcini mushrooms, sauteed them in butter over a campfire and ate them in the moonlight. Buonissimo! 

      Or the time in the San Juan Islands when I helped bring in the crab traps and we plopped the bounty into a pot of boiling water pot for a delectable dinner.

      Over the years,  I began to think of myself as "a foodie" -- with catholic and egalitarian tastes. I developed preferences by going to food-focused festivals.  

     In Mississippi, I sampled about 20 bowls of gumbo during a visit to Biloxi before deciding which one I thought had the most robust flavor. In Texas, I went to a chili cookoff in San Marcos to assess multiple variations of that statewide staple. In South Carolina, I once ate only shrimp and grits during a long weekend in Savannah so that I could compare a variety of local recipes.

      I’ve dined on street food around the world and have memories of true bliss when everything was done perfectly.

     Shanghai soup dumplings on a Hong Kong street. 

     Porchetta off the truck in Cortona, Italy. 

     Satay, popiah and other hawkers’ fare in Penang food courts.  

     Grilled meats in a roadside stand in the hills of Puerto Rico.  

     Fresh-off-the-boat lobster on a Maine wharf.

     I’ve had barbecue pork throughout the South and concluded that Dreamland in Tuscaloosa serves the tastiest. 

      I’ve really enjoyed British pub grub such as Shepherd’s pie or lamb shank in mash.

      I’ve never had better seafood chowder than in a café-bar in Kenmare, Ireland. 

      In New York, the pastrami on rye sold at Katz’s Delicatessen in Manhattan is consistently excellent. So is the cheesecake from Junior’s in Brooklyn.

      I’ve also been willing to splurge occasionally for high-end fine dining. My best was at da Pescatore, which served sublime classic Northern Italian fare in a small, refined restaurant in a cornfield near the Po River. But I'll also never forget a sumptuous lunch -- seven courses over three hours -- at Chef Pierre Gagnaire’s elegant restaurant in Paris.

      And still others stand out I savored the exalted New American cuisine of Chef Thomas Keller at Per Se in New York. A traditional Chinese dim sum brunch at the venerable Luk Yu Tea House in Hong Kong was another all-time favorite.

      Even meals at home at home have been splendid.  My wife, Karen, is an excellent chef with a curated library of cookbooks.

     So the many exquisite and satisfying meals which I've had in the past made it easier to switch to my “new normal.”  And I found that I was appalled when I looked at unhealthy junk food available both in fast-food drive-ins and aisles of supermarkets.

     I continued to go to restaurants with family and friends to socialize, without salivating from envy. Even if a dish smelled appetizing, I was  not tempted for an instant.

     Looking back, I had to be grateful. I'd survived cancer and double pneumonia. My risk for silent aspiration was minimal at that point. 

     So living with "Nothing by Mouth" didn’t seem all that harsh -- compared to the alternative.

------

Editor's note: Although John still was "feeling fine" late in 2023,  he developed a severe case of pneumonia a short time later. That disease took his life quickly because his overall health already was badly compromised.