Patients benefit from garden at Winston-Salem clinic

Published 12:00 am Monday, August 6, 2012

WINSTON-SALEM (AP) — Above the contaminated soil on a small patch of land between a parking lot and major thoroughfares, a downtown clinic has created a garden that not only feeds patients but brings to life what doctors typically only share through words and pictures on a page.
Patients who once worried about dirt on the squash now rush to get the free produce, sometimes waiting for their doctor with a bag of food at their feet instead of picking it up on their way out. They learn how to cook the food so that the health benefits don’t disappear into a pan of lard or get cooked out with a ham hock.
And doctors say the garden lets them go beyond the well-worn admonitions and shiny brochures about healthy eating.
“There’s no way we could feed everybody, but we do what we can,” said Dr. Elizabeth Gamble, a driving force behind the garden and its chief caretaker.
Doctors, nurses, students, patients and community volunteers tend the garden outside the Downtown Health Plaza, a clinic that’s part of Wake Forest Baptist Medical Center.
Cucumbers, eggplant, tomatoes, yellow squash, acorn squash, bush beans, okra, jalapenos and red potatoes are growing this summer on the approximately quarter-acre garden, along with dill, rosemary, basil and Greek oregano. Later on, the garden will produce fall vegetables such as kale, collards and Swiss chard. The gardeners are experimenting with blueberries and will add strawberries.
Once picked, the gardeners cart their food inside the clinic, where patients choose what they want and bag it themselves — for free. Collards and okra are particularly popular.
“Fresh vegetables are so high sometimes, you can’t afford them,” said Regina Dobson-Johnson of Winston-Salem, a clinic patient who picked up produce one day after an appointment .
With 65,000 patient visits a year, the Downtown Health Plaza is among the largest indigent care clinics in the state. The majority of patients are overweight, and many have high blood pressure, heart disease or vascular problems. Many live in a food desert with no grocery store nearby; others say they can’t afford fresh food .
In her nondescript khakis and short-sleeved shirt and red garden clogs with white ankle socks, Gamble looks more farmer than physician, and that’s intentional. She doesn’t want to intimidate anyone who wants to work in the garden or needs to ask questions.
“Our mission from the beginning was to produce food as naturally as we could that we would share with patients,” Gamble said. “We wanted them to learn by example.”
At a retreat in spring 2009, two doctors suggested the clinic plant tomatoes. That idea didn’t take off until a friend who was a landscape design student at N.C. State University told Gamble about a project in Raleigh that involved using an urban space for a farm. From there, a group of hospital and community activists decided to start a garden, which was planted in fall 2009.
Last year, the garden produced about 2,000 pounds of vegetables for patients.
All that fresh produce arises from a patch of land that, ironically, likely is contaminated from the days when railroad tracks and the former Depot Street ran there. The remains of that transportation lie beneath the soil, so the gardeners don’t grow food in that dirt. Instead, all 18 beds are raised, and soil is trucked in from elsewhere. Sunflowers do grow directly in the dirt, their roots breaking up the clay and, over time, improving the soil. Their stalks will be shredded in the fall, and leaves brought in from parts of campus will be plowed under in the hopes of creating decent soil for flower crops.
“This is a work of art — an amazing project,” said Dr. Claudia Campos as she surveyed the garden one hot July morning. “The best thing about it is being able to translate what you tell your patients into reality .”
Robert Jones, the clinic’s administrator, compared working in the garden alongside patients to sharing a meal. Patients open up and share their stories. He’s learned that telling patients they need to eat healthy and handing them a brochure isn’t enough if they live in a high-rise and lack money for a taxi. The bus doesn’t go to the farmer’s market, and the east side of the city is considered a food desert because it has few grocery stores.
“It might be a challenge the provider hasn’t thought about,” Jones said. “They get off work, go to the Whole Foods, and it’s not a big deal. What we think of as a simple challenge can be overwhelming for patients. It can impact their health and their ability to follow a diet .”
The garden provides numerous lessons: Tomato plants growing in the recycling bins that the city used previously teach patients that they can grow vegetables even if they don’t have a yard. Gamble recites recipes to patients unsure of how to cook squash so it’s healthy or unsure how to cook eggplant at all: Slice it, put salt, pepper and a smidgen of olive oil on it, and bake in a hot oven.
Gita Little, a patient at the clinic, drives about 40 miles round-trip to the State Farmers Market in Greensboro when she can. But having free vegetables nearby is a gift since she was hospitalized several weeks ago for a heart problem. “They just put me on a low-carb diet so I have a lot of restrictions,” she said.
Although the clinic doesn’t have research to show whether the garden is helping patients with their health problems, Little has lost 18 pounds recently and hopes the produce will help her stay on track .
Community gardens date to the 1890s, when the first ones appeared in Detroit as a way to help unemployed workers in large cities and to teach young people about good work habits, according to the University of Missouri Extension website. First lady Michelle Obama brought them back in the public eye when she started one at the White House. Mayor Michael Bloomberg, as part of his push for healthier New Yorkers, last month supported a plan to make coupons good for $2 worth of fresh fruits and vegetables accepted at the city’s 138 farmers markets.
The clinic patients first eyed the food warily. They were suspicious of food with dirt on it. Someone called Gamble to ask if the food was safe. Cooking classes and food demonstrations followed. Some patients had to learn that their old ways of cooking vegetables weren’t healthy.
“You can ruin a tomato by deep-fat frying it and covering it with mayonnaise,” Gamble said .
Gamble’s husband, Dr. Peter Lichstein, said his patients now worry the produce will be gone if they pick it up after their appointment. Fifty pounds of vegetables and herbs disappear in a few hours.
“He said patients ask now if the veggie lady is coming,” Gamble said.
Martha Waggoner can be reached at
08/05/12 16:50