Chef Ryan Conklin’s haute hospital cuisine

Rex Hospital kitchen motto.

Rex Hospital kitchen motto.

by  Katherine Connor

photographs by  Lissa Gotwals

In the coming season of celebration and indulgence, a visit to the hospital is not on most folks’ to-do list. But for some savvy Raleighites, the hospital is exactly where they’re headed, and not to tend to an ailment or visit a loved one. They’re going to the hospital for Thanksgiving dinner.

“I was at the farmers market demonstrating pickling when a woman approached and said she came to Rex last Thanksgiving for our phenomenal holiday meal,” says Rex Hospital chef Ryan Conklin. “This is happening more and more. We have a real culinary culture here. We’re not serving typical hospital fare.”

Ryan Conklin, executive chef at Rex, and his team. (mimi collected names)

chef Ryan Conklin (smiling in center) in the Rex kitchen with members of his team, from left, Collin Jennings, Christian Scott, and Ian Krohl.

The wider world agrees. For almost seven years at Rex, Conklin has been collecting accolades. Most recently, he beat out a fleet of 16 top restaurant chefs for the grand prize in the Triangle’s Got to be NC cooking competition. He’s won two gold medals at the Association for Healthcare Foodservice Culinary Competition, and even helped get Rex on Conde Nast Traveler‘s list of Nine Great Meals in Unexpected Places.

“When it comes to dining, hospitals are great places to get crushed ice and little else,” Conde Nast Traveler wrote. But Conklin and his boss, Jim McGrody, Rex director of culinary and nutrition services, “apply (their) Culinary Institute of America training to hospital food,” the magazine wrote, “and serve up salmon (pan seared, not microwaved) and risotto with blueberry panna cotta for dessert. Kind of makes you think maybe you should fly to Raleigh and get that cough checked out, doesn’t it?”

It’s that kind of recognition that hints Conklin just might be succeeding at his unlikely mission “to reinvent hospital food.” A visit to the Rex Hospital kitchens will turn a skeptic into a believer. No hairnet-wearing lunch ladies, mashed potatoes, or defrosted broccoli here. Instead, Conklin keeps it all as fresh and personal as possible. All of his pizza dough is made from scratch. Herbs come fresh from the garden he planted in the hospital courtyard. Recipes are ever-changing. The results resemble a chalkboard menu at your favorite local café, featuring lime-and-ginger-glazed salmon, fresh caprese salad, or made-to-order omelettes. “We have a standard here,” Conklin says. “And I keep to that standard.”

Stock from cooked collard greens is used to marinate porkloin.

Stock from cooked collard greens is used to marinate porkloin.

The assembly line for hospital room service is anything but average where cooked-to-order meals are the norm.

The assembly line for hospital room service is anything but average where cooked-to-order meals are the norm.

Getting there hasn’t been easy. When Conklin arrived at the Rex kitchen – which prepares about 4,500 meals a day for 400 in-room patients, two cafés, four doctors’ lounges, multiple day care centers, rehab centers and more – he found little cooking talent in the kitchen, poor cooking techniques at work, and a culinary system that was simply not built around cooking. “How do we take a culinary experience and recreate it here?,” Conklin asked himself.

The first thing the former Four Seasons Hotel chef did was get rid of the deep fryer, making Rex the first hospital in the South to make that move. Conklin wanted to show that there’s a better, healthier way to cook. Instead of fried chicken and french fries, Conklin offered up dishes like roasted potatoes with rosemary and sea salt or grilled chicken with spinach, mozzarella, basil, and roasted bell pepper coulis.

And he got creative with logistical hurdles, like the fact that food for patients needs to travel for about 30 minutes before it reaches its destination. Different methods of braising meat, for instance, have now made it possible for him to offer cooked-to-order steaks even for folks in the hospital’s far corners.

He instilled knowledge and excitement. “A great perk to my job is inspiring others and keeping it fun,” says Conklin. He encouraged chefs to learn how to do new things, like cure bacon, grow basil, or make a sourdough starter.

He sparked seasonal menus by holding tastings of local strawberries, heirloom tomatoes, and other produce for his kitchen crew. He launched themed culinary weeks like a pork week that included porchetta, BLTs with house-cured bacon, and pork belly flatbreads with pickled vegetable slaw.

And he broadened the kitchen’s perspective with key hires. Conklin’s team now includes folks from multiple ethnic and cultural backgrounds, and he encourages them all to share their own culinary knowledge and to explore creative recipes. He’s also brought on chefs from Raleigh’s thriving restaurant scene, hiring employees who previously worked at places like Pinehurst Resort and Solas in downtown Raleigh.

Chef Franco Licciardi previously owned a local Italian restaurant and now works in the kitchen alongside Conklin. “I was on the plane in California reading about the culinary program at Rex thinking, ‘I had no idea this was in my hometown of Raleigh,’” Licciardi says. “I came home from that vacation and applied for a job and the rest is history.”

A kitchen staffer prepares caprese sandwiches with fresh basil at lunch.

A kitchen staffer prepares caprese sandwiches with fresh basil at lunch.

Rex’s elevated reputation is attracting all kinds of attention. “When you’ve built a reputation of being good, people want to be a part of that,” Conklin says. “I have culinary students that want to do their internships here instead of the Umstead,” he adds with a laugh. “That’s never happened before!”

It’s all gone so well that Rex is now training other health care facilities around the country how to create a culinary system that includes real food and an epicurean approach. “Just because you’re in a hospital the food doesn’t have to be bad or bland,” he says. “It can be flavorful, it can be exciting.” He has spoken at several conferences and met with hospital administrations from Denver to San Diego, all to help inspire and “inject a culinary passion back into their cooks.” Conklin believes a hospital kitchen’s success has to start from the top, with an administration and mission that is truly focused on patient-centered care.

That kind of focus is apparent at Rex. “All the successes go back to our culture,” says Jim McGrody, director of the hospital’s culinary and nutrition program. “We found people who really care about food and what they were cooking. I see the Rex program as a nationwide leader. Our goal is to make the patients feel better. If you just care a little bit, you can serve good food.” 

[box]In an office filled with books like The Escoffier Cookbook: A Guide to The Fine Art of Cookery, The Art of Fermentation, and The Ballymaloe Cookbook, chef Ryan Conklin is eager to talk not only about cooking, but about food as a way of life and a connection to a wider community. Growing up in New York with two working parents, Conklin says there was little time in his childhood for elaborate meals, but thanks to his grandfather, Thomas J. Smith, his interest in food was sparked. Smith cooked with passion, introduced Conklin to new dishes, gave his grandson cookbooks and a subscription to Food & Wine, and ultimately inspired his decision to attend the prestigious Culinary Institute of America. To this day, when Conklin eats tomato, mozzarella, and basil, he says he thinks of his grandfather.After the CIA, Conklin worked at The Four Seasons Hotel in Manhattan before moving to Limerick, Ireland to work in a small bistro. He learned to shop for seasonal products from small local markets there, and fell in love with Irish cooking. Returning to his native roots in the Hudson Valley as the executive chef of a high-volume restaurant, Conklin struggled to balance family life with a difficult working environment. The solution – working for the health care industry – hadn’t occurred to him. But a stint in New York managing a health care facility led him to discover he enjoyed leading a team. “You get a more personal interaction here than you do in a restaurant kitchen. And I love that part of my job.”[/box]

Ryan Conklin's Rack of Lamb at Rex Hospital in Raleigh, NC.

Ryan Conklin’s Rack of Lamb at Rex Hospital.

Irish-Style Rack of Lamb

Serves 6-8

“For me, rack of lamb has a very dear meaning. (It’s) something I would cook for my mother. That, to me, is what the ultimate holiday option is.”

2 racks of lamb, trimmed of most of the fat, Frenched bones (the butcher can do this for you)

2 tablespoons whole-grain mustard

2 cups breadcrumbs

3 garlic cloves, minced

¼ cup fresh parsley, minced

¼ cup fresh rosemary, minced

Salt and pepper to taste

Preheat your oven to 425 degrees.

Score the fat side of the lamb with the tip of your knife to make a lattice pattern. This will help hold the coating during the final roasting. Cover the exposed bones tightly with aluminum foil (this will prevent them from burning while roasting and help with the final presentation).

Season the lamb with salt and pepper. Place the racks in a small roasting pan in the oven, fat-side-up for about 12 minutes. Immediately remove, and cool to room temperature.

While the lamb is roasting, in a small bowl, combine the breadcrumbs, garlic, herbs, and a pinch of salt and pepper.

Brush a thin layer of mustard completely over the fat side of the lamb. With your hand, press a nice layer of the breadcrumb mixture on top of the mustard. Make sure the mixture adheres to the lamb rather firmly with your hand.

For the final roasting, return the lamb to a 375-degree oven.

Place in a roasting pan, breadcrumb side up, for an additional 12-15 minutes, or until it reaches an internal temperature of at least 125 degrees (for a medium rare).

Remove lamb from the oven and remove aluminum foil from the top. Let the racks rest for about 8-10 minutes before slicing.

Parsnip soup at Rex Hospital in Raleigh, NC.

Parsnip soup at Rex Hospital.

Parsnip Soup with Apple, Horseradish, and Chives 

Serves 6-8

“Growing up, we lived with (my grandfather) and he always used to cook parsnips for Thanksgiving. And we hated them! The smell of them – everything – we hated them. And all those years we actually used to make fun of them. And then, as I became a chef, I realized these are really good and we don’t make them enough. When I can promote parsnips, I can promote what (my grandfather) shared with me.”

1 tablespoon butter

2 pounds parsnips, peeled and sliced

1 small onion, diced

1 teaspoon ground cumin

2 teaspoons curry powder

1 garlic clove, minced

Salt and pepper, to taste

5 cups chicken stock or low sodium chicken broth

cup heavy cream

1 tablespoon minced chives, for garnish

For the garnish

Mix together in a small bowl and reserve

½ cup sliced apple, julienned

1 teaspoon horseradish, grated

1 teaspoon extra-virgin olive oil

In a large saucepan, melt butter over low heat. Add parsnips and onions and cook until they are tender, about 10 minutes. Add spices, garlic, salt, and pepper. Cook this for 2 more minutes, stirring frequently.

Add the stock and simmer gently for about 20 minutes, or until parsnips are tender.

Transfer the soup into a blender and process in small batches until velvety smooth. If it is too thick, add more stock.

Return soup to saucepan and whisk in cream; bring to a simmer. Adjust seasoning as needed.

To serve, ladle soup into bowls. Place about 1 tablespoon of the apple-horseradish mixture on top, and finish with chives in the center of each bowl.

Colcannon, a traditional Irish dish, by Ryan Conklin at Rex Hospital in Raleigh, NC.

Colcannon, a traditional Irish dish, by Ryan Conklin at Rex Hospital.

Colcannon Potatoes

Serves 6-8

“After living in Ireland for some time, (colcannon) was just a normal thing there. But here (in the South), no one knew what it was. It’s like the mac’n’cheese of Ireland. This is one of my favorite things to both cook and eat. For a nice local twist, you can even substitute sweet potatoes. It’s important that you add equal parts greens to potatoes. This should look more like a hash, rather than a mashed potato. Irish soul food at its best!”

2 pounds russet potatoes, peeled and halved

½ pound bacon, diced

1  pound shredded green cabbage, scallions, shaved Brussels sprouts or shredded kale

1 cup milk

½ cup unsalted butter

Salt and white pepper, to taste

Cover the potatoes with one inch of cold water and bring to a boil. Simmer until potatoes are tender, about 20 minutes. Drain potatoes and reserve.

In a medium saucepan, cook bacon on medium heat until it starts to crisp. Remove the bacon with a spoon and add scallions, shredded cabbage, kale, or Brussels sprouts. Cook this mixture on medium heat for about 5 minutes in the rendered bacon fat, stirring often. Remove from the heat.

In a large bowl, slightly mash the potatoes, but not all the way – you want some chunks. Add the cooked greens, scallion, and bacon and mix well. Add butter, salt, and white pepper.