Stop Pretending Vegetables are Noodles (and other rantings)

Introduction

Before reading any of this, just by looking at the above photo, you may think you've got me pretty figured out: brunette, likes to pretend to be "chill" but is actually highly anxious, has an Instagram for my dog, probably has a food blog. You would be mostly correct - I don't have a food blog. My goal in writing this is not to brag about how interesting my life has been. In fact, I hope for the life I have yet to live to be much more interesting and book-worthy than the life I have lived already. The reason I am writing this, beyond just the encouragement from fellow Registered Dietitians (RDs) and friends, is to help others understand the areas of my life that I have become so impassioned with. Yes, nutrition and dietetics of course, but also low-income patient populations, safety-net hospitals, eating disorders, and my own experience and relationship with food. I hope for this to be a compilation of career stories of patients from an RD's perspective, with some of my personal life sprinkled in. I don't intend for this to be any kind of "diet" book, but you may find some nutrition advice sprinkled into the patient stories. Mostly the more batshit crazy ones.

The beginning of my career began in a large, urban, safety-net hospital. It's about 600-something beds (900 if it's flu season and we squeeze people in the hallways). If you know Atlanta, you know the one to which I am referring. My time there began as a student. I was a 22-year-old, fresh-from-undergrad nutrition major from a small (read: 97% white) town in the Northeast. I had never been inside of a hospital before except for, you know, my own birth. If you're not familiar with public safety-net hospitals, allow me to paint you a picture. Of course, this may not apply equally to all safety-net hospitals, but for this particular one, I feel this description is accurate.

Approaching the front entrance, you dodge patients and public alike smoking cigarettes as close to the door as they are legally allowed. A large "NO LOITERING" sign goes largely ignored. A beat up white van appears to be selling...ice cream? Two burly security guys stand guard on either side of the entrance. Their job is to keep the hospital safe, not to prevent the illicit activity occurring fifty feet to the left of the hospital doors. A lanky old man with wild, unkempt hair, wearing only a hospital gown with the back open, dodges traffic with his IV pole while trying to reach the bus stop on the other side of the street to buy cigarettes, marijuana, and/or crack cocaine. He will likely consume the drugs prior to returning to the hospital, but there is a nonzero chance that he will try to smoke inside his hospital room. Later, you'll read a nurse's note to the tune of "patient denied smoking in bed despite RN observing large cloud of smoke." Bonus points if they share the drugs with the patient in the adjacent bed, since most of the rooms are semi-private.

As you crawl through the painfully slow revolving door, you're greeted by a large atrium filled with people of all shapes, sizes, and colors. A mother of a college student admitted to the surgical ICU after a car accident. A middle-aged disabled man hobbling to wherever he needs to go without any equipment to assist him. A Spanish-speaking family seeking care at the only place they can be treated without staff questioning their immigration status. They could be sleeping on couches, loitering by the gift shop, or aimlessly wandering looking for their loved ones that are in some unit labeled with an excessive amount of letters and numbers. 6LOF-21? Oh, that's up the second set of elevators (the first only goes to the first, second, third, and fifth floors), around the entire building, through a set of staff-only doors and the PACU, behind a curtain. Obviously.

Doctors, students, and visitors line up at the "Starbucks" in the lobby that has only one elderly barista with an attitude. The last person in line is a surgical resident, deep set eye-bags and all, who just got out of an 8+ hour emergency surgery on a homeless man found down with an abdomen full of blood. They may or may not still be wearing shoe and hair covers, may or may not have blood on their shoes. That homeless patient won't pay the hospital for their services, but here it doesn't matter.