Southern discomfort

Roper St. Francis has many healthy offerings in the hospital cafeteria, but every Wednesday the chefs cook up some of their popular fried chicken.

If you have the bad luck to find yourself hungry and without access to a home kitchen in Fairfax, S.C., your eating options are few.

“There’s Subway, there’s Hardee’s, and that’s pretty much it,” says Lari Gooding, an administrator at Allendale County Hospital.

The third choice is the hospital cafeteria, which serves the best-attended Sunday dinner in Allendale County. But the after-church herd is outnumbered by the crowd that shows up on Thursdays, when fried chicken is on the menu. The chicken is so popular that the hospital unlocks a conference room to accommodate diners who can’t find a seat, even though many customers take their meals to go.

“One person comes in and leaves with 10 boxes for his co-workers,” says Gooding, who professes to prefer the cafeteria’s baked chicken.

“Oh, I think the fried chicken is probably as good as any,” he allows. “Everyone in the South likes fried chicken.”

And in many small towns across South Carolina, they like to eat it in hospital cafeterias, a preference that’s the result of scarcity, tradition and an entrenched appreciation of adept frying. “It’s a gathering place for the community,” says Graham Adams, chief executive officer of the South Carolina Office of Rural Health. “In some communities, it’s one of the few restaurants open Sunday for lunch. And some of them have pretty good food.”

In addition to immediate comfort, the meals served in hospital cafeterias, usually priced at $5-$6, including a drink, provide lasting reassurance that the host institution is trustworthy. That’s critical information in areas around the 19 S.C. hospitals classified as “small and rural,” since residents are likely to one day rely on them for care.

“A patient can’t judge clinical outcomes,” Adams says. “But they can judge how clean the hospital is, how nicely they’re treated and how good the food tastes.”

For many years, “good” has been synonymous with pork fat, butter and salt, the very health hazards that physicians today are fighting. In Allendale County, for example, the five leading causes of death are heart disease, cancer, cerebrovascular disease, diabetes and hypertensive kidney disease, all of which have been linked to diet and obesity.

When hospitals first opened cafeterias, the sole aim was to feed employees. Limited hours and menus reflected the narrowness of their mission. “(Hospitals) just gave associates what they wanted,” recalls Cary Neff, vice-president of corporate culinary services for Morrison Healthcare, which handles 20 hospital accounts statewide, including Roper St. Francis. The eagerness to please ultimately led to the opening of fast-food outlets in hospitals.

“Then it became very evident that we’re treating people for cardiovascular disease, and it’s an oxymoron,” Neff says. “We got all of those licensed brands out, and changed the culture from a cafeteria to a restaurant.”

In Southern hospitals, though, it was impossible to completely do away with country cooking that suffered from many of the same nutritional deficiencies as cheeseburgers and nachos. At small hospitals dependent on cafeteria revenue, alienating community members and medical specialists who scheduled their weeks around Fried Chicken Thursday or Fried Fish Friday was considered too risky: “We do have a full salad bar,” Gooding says. “But if we just did all healthy, we’d lose the business.”

And as keeper of the fried chicken recipe that originated at Morrison’s Cafeterias, a beloved chain that grew from a single Mobile, Ala., location to 151 restaurants in 13 Southeastern states before spinning off into divisions including hospital food service, Morrison Healthcare couldn’t nix the dish. Neff “retooled” most of the preparations printed on the yellowing pages of a 1940s company recipe book, but the chicken was sacred. “We’re not getting rid of that,” he says.

The irony of serving fried chicken in a hospital setting is so acute that Roper St. Francis’ press office was initially reluctant to confirm the existence of Fried Chicken Wednesdays.

“In our health care system, wellness and healthy living are a priority,” spokeswoman Diette C. Casey explained, declining an interview request.

What Morrison has done, though, is relegate fried chicken to a bit role. On Wednesdays, the salad bar is discounted 50 percent, and baked breasts and thighs are offered alongside their greasier counterparts. Plus, Neff adds, “Now instead of two sides, there are five sides. Along with macaroni and cheese, we have whole wheat pasta. We have brown rice along with white rice.”

While the whole wheat pasta and brown rice are recent innovations, Morrison’s approach to hospital dining represents a continuation of the decades-old fried chicken ritual that persists elsewhere in the state, minus the gratuitous calories and trans fats. By emphasizing healthy, affordable food, Roper is striving to offer a needed amenity to its surrounding community. Although old-fangled dishes remain the top draw, “the group looking for more healthy options is growing,” Neff says.

Morrison’s orientation is apparent from the entrance to the dining area (“I rebuke the word ‘cafeteria,’ ” Neff says.) A recent display included a crate of sweet potatoes for individual sale, accompanied by a colorful informational poster titled “What a Spud.”

Still, Neff says he’s very careful not to emphasize nutrition over taste. “We try to entice with flavor,” he says. One of the company’s latest concepts is a collection of sliders, smoothies and tacos. No matter how customers mix and match them, three items add up to $5 and no more than 600 calories.

Neff likes taking advantage of trends to sneak nutritionally sound dishes onto customers’ trays. He recently developed a sriracha slaw for a black bean burger that was consistently one of the company’s worst sellers. The sandwich, rechristened a Dragon Burger, outsold every beef burger within eight months.

“If I just said ‘Mindful Choices Burger’ or ‘Conscious Choices Burger’ or black bean burger, it wouldn’t have sold,” he says.

The burger isn’t yet attracting standing-room only audiences. But Neff believes dishes such as Roper’s whole wheat, pear-and-gorgonzola pizza and wheatberry salad could ultimately prove as alluring as hospital fried chicken.

As for that fried chicken, it’s faring relatively well in the jicama-and-quinoa era. Asked about its quality, Neff says confidently, “We can compete with anyone in the city” — at least on Wednesdays.