Spaghetti is the throughline
The comfort food that has endured through my life, cancer, and over four hundred hospital meals
Well, we made it… It has officially been one month of writing Good Marrow. It has been fun and therapeutic and more work than I thought— but hey, that’s writing. If you have been enjoying my work, please consider subscribing for free below, it is a small encouragement to continue noodling amidst all the other writing. I promise to do my absolute best to be an email you look forward to on Tuesdays.
Food is the whole thing now. It is the thing that I am looking forward to, or seeking out, or rewarding myself with. It answers the question of “what should I do?” It is the thing that fills my leisure time. In years past, there were other things. As a kid, videogames may have been the first thing that became a whole thing. Girls were a big thing. Sports. Music. Travel. They were all things. But now, food is the whole thing.
If I am traveling somewhere, the best food comes first. Sports? A viewing activity ideally involving food or a way to burn calories to deserve better food. Girls? Yeah, me and my wife love to eat great food.
The requisite metabolic process has consumed our lives. It is baked into the algorithm of our social media. It marinates in our brains, the entirety of the world in our hands as we scroll through endless things waiting to be eaten. There is no more strictly regional cuisine, no more limits to a consumer’s imagination. Buffets may be out of style, but our hunt for food feels insatiable. Whatever Wonka mad person invents lickable screens will bring us, mouths watering, into the final stages of our lived existence.
But in a world of overgrowth, there remains one desert. The hospital.
Hospitals are famously known for their bad food. It is the number one complaint when spending a night in one. A rough mental image begins with slop-level cafeteria food which you can then degrade a few shades, any taste dissolving into the antiseptic ambiance as you treat yourself to jello cups in an unflattering gown seemingly designed to reveal yourself at the worst possible moment.
I am here to come to partial defense of hospital food, though it entirely depends on the hospital that you are in. When I was first diagnosed, I was shuttled to the nearest hospital in distress. There was no time for Yelp reviews or a quick peak at The Infatuation. I was on death’s door—and as is the case when making rash decisions, I was punished for a lack of research. And while hospitals don’t yet have Michelin stars, I would bet money someone somewhere is pushing that pitch.
The food they serve you in a hospital is bad, but only to the extent that you hope they are spending all of your money on more important things—chiefly being your life.
Some people have certain food items that they are “maxed out on”. They are usually foods that they have eaten so frequently that they simply cannot eat them anymore. They are done with it.
Multiple people have told me that they have reached their lifetime limit on spaghetti. A previous roommate of mine would recoil in distaste at the sight of it, citing a collegiate overdose as the reason for his abstinence.
This is not the case for me. I love spaghetti. It gets knocked for being cheap or simple because its final form is possible if you only buy two things… But I would argue that even at its most base concoction—it still tastes good.
Spaghetti’s utilitarian nature is also its appeal. It is easy. It is affordable. It is filling. You can dress it up or down. You can slave over your own “gravy” or pop a can and be on your way. It can feed a lot of people. It reheats well. You could accidentally kiss a cute dog if you both start slurping down the same noodle. It’s iconic.
For some of these reasons, my mom made spaghetti once a week (or at least that’s what it felt like). I have fond memories of coming home from gymnastics practice and reheating what everyone else ate earlier. My dad used to put frozen peas in it—perhaps the beginning of my affinity for peas. Sometimes he’d add a fried egg—both great additions, both evidence of spaghetti’s malleable beauty.
I continue to make spaghetti to this day. I save it for days when my wife is working (in a hospital, with cancer) so I can commune with my silly ritual in private, surprising her as she steps in the front door.
I consume it with the same gusto I did when I was a hungry kid, teen, or young adult coming back from whatever “whole thing” I was into at the time. Made fresh or reheated out of fancy Pyrex (previously stained Tupperware), there is no surprise or revelatory gasp. If I could combine the ephemeral joy of eating over a sink with the simple contentedness of eating spaghetti, I might achieve nirvana (I know I could try it, but sinks are for crumbly items not saucy items).
In cancer there is a “lifetime limit” on chemo. There is a maximum amount that your body is allowed to consume before its effects outweigh its benefits, any further binging or indulgence is too dangerous to the organs and systems that are your body’s whole thing. It is one less weapon in the doctor’s arsenal but a good excuse to branch out into the fusion cuisine of clinical trials and immunotherapies (if not already dabbling).
But as the most popular entree, chemo is most famous for destroying your appetite, your GI tract, your taste buds, your everything. And despite my body’s gurgling resistance to it, food remained the whole thing for me, even in the hospital.
In the hospital it was the whole thing because you still needed to eat to survive. Calories are counted and if you are not pulling your (diminishing) weight, they will give you Ensure or some soylent green type beverage to boost your numbers. If you can’t muster that, they will put a feeding tube in your side and do the work for you.
There is nothing wrong with that. That’s just how terrible cancer is and how important food is.
For me, food was also one of the few remaining arenas of choice in the hospital. At a time when control was an illusion and the word “no” was almost always pitted against medical advice, the ability to choose between tacos, a personal pan pizza, or chicken cacciatore was a welcome return to feeling like I actually had one hand on the wheel.
In sickness, the illusion of control is sometimes a necessary placebo. I often felt like a cartoon character in free fall, blithely assembling a cup of rattling tea as the world rushed past me, distance until impact unknown, just enjoying a small opportunity to focus on something I knew I could do.
Eating was not always something I could do, but it was something that I had to do. Three times a day, I would be reminded by nurse or phone call to look at a menu and upload its words into my addled mind, trying to heave the thought of ordinary flavors now turned repulsive onto the desert of my tongue.
And then I would find my oasis. It had always been there, calmly awaiting my return. It didn’t even matter if I didn’t eat any of it. It took away the burden of choice, knowing that so long as the acid reflux wasn’t drowning me—I might just have a nibble.
It was spaghetti. And as always, it welcomed me with open arms.
Any food writer can wax more poetically than me about the many intersections of food and life and why, when combined, they make food the whole thing. Community, history, hospitality—it is a biological need that we have evolved into something transcendent.
In the Venn diagram of food and hospitals, you will most likely find “comfort” at the center of each. Comfort food is simple, it is meaningful, it is not expensive, it requires no dress code, it can engender a sense of peace. Comfort in food is knowing that that gas station donut or mom’s chicken noodle soup is there for you so long as you care enough to find, make, or receive it.
Talking about the comforts of food in a hospital will usually spawn stories of family or friends bringing meals to someone trapped within. It is a gesture of love and an acknowledgment that the hospital cannot fill the void that food made at home, by the hands of a loved one, or from a beloved restaurant can fill.
Comfort from the hospital itself is more elusive, if only because comfort often comes after “care”, the catchall word for the treatments and necessary pain you may have to endure in order to become comfortable once again. It is kindness in the delivery of terrible news. It is a warm towel as they push you through the halls before being stuffed in a magnetic tube. It is a nurse caring to spend time with you at your worst.
But put together, the term “comfort care” in a hospital means that you are dying. Generally, it means that now it is time for your comfort to supersede your care—that they have done everything that they could and now only relief matters. In the endless hallway of this decision, the greatest comfort can be found in knowing that you or I or any one person will never stop caring about those have tried their very best to remain.
By some rough calculations, I have spent around one hundred and forty-six (146) total days in hospitals. Multiplied by three, that means that I have eaten roughly four hundred and thirty-eight (438) hospital meals, give or take the times when family or friends bailed me out.
For most regular people that will be a large number but for some cancer veterans it could be low. But having spent forty-percent (40%) of a year living in a hospital room, I’m going to (somewhat regretfully) qualify it as a home away from home.
No one wants to think of a hospital as their home, but it can become one. The doctors, the unfailing nurses, the PCN’s who graciously cleaned away the tides of illness day after day after day—the nameless cooks who fulfilled my requests for spaghetti— it was a place where I lived.
Life takes us to strange places, which has taught me to make those strange places into homes. Wherever home may be will eventually generate its own comforts and its own version of a home cooked meal. Somehow spaghetti will find a way back into my life, like an embroidered pillow it reminds me that here is where the heart is—wherever here is, for however long I am there (even if I cannot wait to never return).
I take some comfort in knowing, and believing, that those things (and people) that we cherish—they will find a way to follow us wherever we go.
Sensory Activation: Things I Was Into This Week
wrote a great piece for his newsletter Escaping Flatland about the leaps in Go players’ performance after an AI called AlphaGo defeated them. After analyzing how they lost, players’ performance then improved, reaching previously thought unattainable heights. A similar, simple example that Karlsson notes is the running of a sub 4-minute mile. Once thought impossible, it is now commonplace.
As a WGA writer we struck hard against AI encroachment in guild-covered television and film work, and I maintain a healthy sense of caution over AI’s ability to replace writers and artists, but… I also have a healthy curiosity towards its potential beneficial applications.
My mind immediately went to that holy grail— The Cure for Cancer, and how it has always been thought to be impossible. I don’t know all of the practicalities (what do AI models and LLM’s look like in healthcare/cancer research), but the core of the idea resonated— that something previously thought impossible might not be. And if that’s what we use the robots for, I’m cool with it.
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I live in Portugal, and at the day treatment center, if your treatment is over a certain number of hours you get lunch. It’s surprisingly good for hospital food, albeit a bit bland, and as long as you don’t choose the vegetarian option. But the thing that makes it better is what you touched on... you feel cared for on a different level. And you feel like you have some sort of choice and control on a day you get hooked up to the chemo bar.