Foreword

When I was asked to write the preface for this text on culinary arts for patients with end-stage renal failure, I was both honored and perplexed. Honored because another dialysis patient, who is both self-motivated and very talented, would ask such a thing of me, and perplexed because I would feel like for it to be anything but another mediocre introduction to one more boring tome. When one reads the text and takes the time to appreciate both the content and illustrations, you immediately get the feeling that this is not simply a task done to fill the empty hours of another disabled human being. The effort bespeaks of an extremely able and skilled craftsperson.

In the coming years, medicine will begin to develop a greater appreciation for the role played by nutrition.

During the previous century the major thrust of medicine has been in the area of acute diseases. With the advancements in technology, the major thrust had now become a war on chronic, protracted diseases and disorders, of which renal insufficiency is prominent.

With renal failure comes the inability to maintain a normal diet. The treatments currently available for renal failure are capable of sustaining life but at the same time fall woefully short of being complete replacements for kidney function. Consequently, certain daily activities of living must be adjusted to allow for these shortcomings. One of the activities happens to be the patient's food intake. To a large extent, the patient's diet, among other things, determines the patient's long-term health.

The ability to provide imaginative and appetizing meals can be instrumental in determining both the quality and quantity of the dialysis patient's life. When I started being dialyzed some twenty-plus years ago, a major contributor to a deep depression which I was then suffering, revolved around the fact that my diet was so limited that eating held no joy for me at all. I am sure that I made my family and other people around me unduly miserable because of the issue of the renal diet. Without no meaning to, I succeeded in making the entire household feel guilty because of my problems with food. At this point, I became locked into a pattern of eating for safety rather than for taste. The diet was extremely bland and unattractive, consisting primarily of unseasoned, boiled noodles or rice, a green vegetable, and for dessert, a small bowl containing two wilted cling peach halves. I came home one evening and with no consideration for my mother, who had prepared the meal, as well as continually tolerating an immature, self-pitying, spoiled dialysis patient, I grabbed the bowl of peaches and threw it across the room, sending cling peaches, glass bowl fragments, and heavy syrup spraying over the stove and kitchen wall, and then proceeded to break down into tears. Aside from the immaturity, the diet quite frankly had me at wits end. The author of this text rescues us from such a fate, for she provides both imaginative and tasty meals, while at the same time safeguarding the dialysis patient's health. She has managed to capture what few renal dieticians have been able to.

If one considers the many physical and mental aberrations one can suffer due to an extended period of poor nutrition, the author can be considered an holistic health care protector of the highest order. If there is any credence to the old cliché, "you are what you eat.". then the author has gone a long way toward making dialysis patients rational, happy human beings again.

Anthony V. Nicholson Ph.D., C.S.S.C.