POST GRAPE-NUTS remind me of palliative care. Parts of it have a naturally sweet taste. 
 
Coinciding with my professional ascent into palliative medicine and our collective descent into
the global exercise of social distancing, I find myself pondering more at the supermarket.
Just this weekend while perusing specials, the mantra of an old sales pitch conjured up from an
ever-undersized package with a yet increased price tag. It was precisely there, in aisle five (as if
Euell Gibbons in the flesh and flannel stepped out from behind a stand of recyclable paper
boxes), that I recalled his “many parts are edible” as he went on to recommend eating Grape-
Nuts over dining on conifers. At my green grassroots level, my practice of Palliative Care is not
so different -- a throwback to a perhaps simpler and more satisfying way to well-being. To share
and care in the richness of what it is to be human is why I am on this path.
 
For the younger mid-careers out there: Grape-Nuts contain neither grapes or nuts. I had to get
back home from Safeway to read on Wikipedia about this “breakfast made from [merely] whole
grain flour, salt and dried yeast, developed in 1897 by C. W. Post, a former patient and later
competitor of the 19th-century food innovator Dr. John Harvey Kellogg. Post's original product
was baked as a rigid sheet, then broken into pieces and run through a coffee grinder.” It offers
power packed nutrition for all domains of vitality and is an excellent source of fiber for easing
the way, sometimes explosively! Mr. Gibbons was an outdoorsman and you-are-what-you-eat
health food progenitor who offered the catchphrase “a back to nature cereal” in the 1960s. By
then, and by virtue of its wholesomeness and portability, the resistant to spoilage food for
exploration had sponsored Byrd’s expedition to Antarctica and accompanied Sherpa Tenzing
Norgay plus Sir Hillary to the summit of Everest. For the longest time, Grape-Nuts packaging was
minimalistic, waste-saving, and set apart from other cereals, in that no sealed film bag was used,
just the cardboard box imbuing the original flavor thereof.

Of course, ridicule followed.  The absurdity of something so basic being so good for
you! The spoofing by the much more popular and profitable Fruit Loopers is long running.
Consumers of the now fortified Grape-Nuts continue to be derided and maligned as something
akin to old growth forest death panels. In the height of the worldwide shutdown, some adherents to
daily Grape-Nuts (surprising, given that sales of adult cereals were dipping in recent years, while
popular sugary cereals saw sales soar upward) became dismayed, if not horrified. According to
USA Today: “the wait was too long for some particularly fervent fans, [who] turned to the
secondary market to get their Grape-Nuts fix paying up to $110 per box.” To make sure those in
greatest need would not go without, the Post Company offered reimbursement to anyone who
paid $10 or more for a box as "a way to show our appreciation and thanks...for their dedication."
Revisiting Wikipedia I learn; Grape-Nuts is credited as the first widespread product to use a
promotional when C.W. offered a penny-off to get people to try his product in the late 1890s.
 
Maybe because Grape-Nuts is nowhere near anyone’s top 10-lists of favorite cereals, high stature
and status seems to elude similar “fill you up, but not out” brands – not unlike palliative care.
Wouldn’t it be lucky charmed if we in our beloved specialty had a ticket to green clovers, pink hearts, and orange stardom without requiring tons of milk and sugar and doctoring up?  For many patients and professionals, all that we represent is not palatable (let alone pronounceable), recognized, or respected. We are often top labeled as merely the last thing to do after there is nothing more to do. Talk about being soggy mush at the bottom... And then in an instant, things can change. Our once off to the tray side, person-centered care in the face of a serous illness bowl, got ravenously elevated to the mouth of a life limiting pandemic. Just like that, so many, many people couldn’t get enough of us. Our COVID sick patients, families, and colleagues overwhelmed by unprecedented uncertainty asked for more palliative care, like never before.

And so, we appeared. From our back-to-basics pantry we poured on the listening, spooned out layers of support, and hard swallowed anything and everything if only to ease the suffering – even a little bit.
Mattering most: palliative care showed that it can be nutty as much as it can be wildly fulfilling. When it comes to crunchy goodness, I can’t imagine a more gratifying direction to take my career and life. For the record, to date I have not taken a single bite out of a pine tree but will not rule it out. I am totally intrigued by the thought that someday I might try a small taste, especially if concordant with a patient’s wishes and particularly if that request comes from a zany backcountry forager touting “it reminds me of wild hickory nuts.”