in this post, i invite you to join me as i revisit my tour of the stone barns center for food & agriculture.  a trip i took to learn more about sustainable farming.  i went to stone barns with a group of seven doctors from the primary care innovations course - a two week intensive elective held in the department of internal medicine at yale university.  led by dr bradley richards, the course aims to identify and discuss areas in which changes can be made to improve the care of our communities in meaningful and cost-effective ways and to empower doctors to deal with these issues. 

a lot has been written about the obesity epidemic in the US, and an equal amount has been written about the etiologies of this epidemic and possible solutions.  while the cause of the epidemic is certainly multi-factorial, we can all agree that change is needed.  before we dive in, i encourage you to watch this video by dr daphne miller on organic farming as a primer.  

the need for change that i mentioned earlier is what led to our visit to the stone barns center for food & agriculture.  

OUR MISSION IS TO CREATE A HEALTHY AND SUSTAINABLE FOOD SYSTEM THAT BENEFITS US ALL.
— stone barns center for food & agriculture

the scene is picturesque, set on the top of a hill about 25 minutes north of new york city.  stone barns really gives you the feeling that you are at the intersection of agriculture, nature, and human potential.

we were greeted by zeke, the trusty dog whose primary job is to play catch, and secondary job is to herd animals (or at least that's what he thinks).

 zeke deciding that he would sit and listen to our discussion on the health of soil

zeke deciding that he would sit and listen to our discussion on the health of soil

 photo credit: stone barns center

photo credit: stone barns center

our tour began with a discussion of soil, something that i previously would not have thought too much about.  jack algiere, four season farm director, led a thought provoking discussion of how crop rotation can renew the available energy in the soil and can help make farming sustainable and resilient.  he spoke of how pests and diseases can be avoided by careful analysis of the soil and purposeful planning of what, when, and how something should be planted without the need for pesticides and herbicides.  

"the soil is completely healthy, the only thing not healthy here are the rocks" jack said as he pulled a carrot out of the ground, shook off the excess soil, and took a bite.  

THE SOIL IS COMPLETELY HEALTHY, THE ONLY THING NOT HEALTHY HERE ARE THE ROCKS
— jack algiere, four season farm director, stone barns

yaël krinsky, farm store and visitor center associate collected our carrot harvest along with some freshly picked kale to prepare lunch.  yaël has a great story. she worked with an integrative cardiologist in new york city and then came to stone barns so that she could immerse herself in a holistic approach to health and wellness.  these are the kinds of people that stone barns attracts - people who want to dive right in.

 photo credit: stone barns center

photo credit: stone barns center

 

from the carrot patches, kale plants, and asian pear trees, we walked over to meet craig on the other side of the farm to learn about livestock and how flavor, texture, and nutritional profile can be maximized in an ethical and sustainable way.  craig haney is the livestock farm director at stone barns, he is responsible for overseeing all aspects surrounding livestock acquisition, breeding, raising, and sale.  

sheep at stone barns are truly grass-fed, rotating the grazing grounds every 70 days.  this helps the ground replenish itself in between rotations and really is the crux to sustainable grazing.

 this is the view that the sheep have. sure beats a cramped barn and feed lots that many livestock are stuck with.

this is the view that the sheep have. sure beats a cramped barn and feed lots that many livestock are stuck with.

stone barns raises all sorts of animals, including turkeys.  these turkeys are pasture raised and spend daytime hours outside in open spaces.  they spend their nights indoors, but mostly so that craig can sleep better at night knowing that they are safe from predatory animals. 

we went back into the barn, through elegant walkways and pass-throughs to our next stop on the tour - a unique and revolutionary restaurant on-site.

 beautiful stone walkways and pass-throughs give stone barns a rustic and inviting feel.

beautiful stone walkways and pass-throughs give stone barns a rustic and inviting feel.

stone barns is home to blue hill at stone barns, an award winning restaurant headed by executive chef, dan barber.  dan is a published author of the third plate: field notes on the future of food, and has won multiple james beard awards.  blue hill sources much of its meat and produce from stone barns, hence ensuring that the creations are as fresh and true to the farm's mission as possible.

BLUE HILL IS NOT A RESTAURANT. IT’S AN EPIC, TEN YEARS IN THE MAKING
— alan richmond, GQ

bobby schaffer, pastry chef at blue hill restaurant shared his insights not only on bread making, but on the processing of grains in general.  whole grain in a typical store, he explained, is far from whole, and thus lacks taste and nutritional value, all in the name of extending shelf life.  while i try to avoid gluten as a general principle, i agree that freshly ground, minimally modified grains have a very different nutritional profile compared to widely available grains and thus should be considered by anyone who wants to enjoy healthier and tastier bread products.

 a real stone mill - used to finely grind grains and produce a consistent flour.

a real stone mill - used to finely grind grains and produce a consistent flour.

chef bobby shared his recipe for creating starter for sourdough bread: mix flour and water and place your trust in nature that in about a week the yeast and bacteria concentrations will be ideal for making sourdough.

 chef bobby sharing his creations with our team.

chef bobby sharing his creations with our team.

yaël finished preparing our lunch: roasted carrots with salt and black pepper, massaged kale salad with olive oil, lemon juice, salt, and crushed red peppers (very similar to my lemon garlic kale salad recipe), sourdough and apple and oat breads by chef bobby, and tomato cream soup from blue hill restaurant.

food is not wasted at stone barns.  as every good chef knows, every part of an ingredient can be used in one way or another.  here, the carrot tops are used to make a pesto.  the greens are blended on a bicycle mounted blender to engage guests when they visit the farm.

 sal riding a bicycle retrofitted with a blender.

sal riding a bicycle retrofitted with a blender.

 dr bradley richards, lead physician of the primary care innovations elective at yale university, with jessica lutz (visitor experience manager) and sara elliot (director of programs) of stone barns.

dr bradley richards, lead physician of the primary care innovations elective at yale university, with jessica lutz (visitor experience manager) and sara elliot (director of programs) of stone barns.

we (five members of the staff at stone barns and seven physicians from the yale department of internal medicine) ended our day with a round-table discussion, a brainstorming session, or a brain dump, if you will.  we asked questions about how healthcare and farming can intersect to improve the communities in which we live, because at the end of the day, that's why we went into medicine - to improve our communities.

i asked brad what he thought was most exciting about the interaction between healthcare and medicine.  this is what he said:  "talking about a relationship between healthcare and sustainable farming will likely lead to some skeptical and puzzled looks.  however, how many of us talk to our patients about the importance of diet in health?  while many of us are hoping that this education will make a difference the continued rise in obesity and diabetes rates speak to the difficulty of impacting diet through education.  health care delivery and healthy food delivery could go hand in hand.  sustainable farming goes hand and hand with sustainable health.  if we as healthcare providers see ourselves as truly helping to provide health to our patients there is a natural partnership that could allow health care providers to have a great impact on our local communities."  

"ok, but help us think about how it fits with our current payment structure" i pushed.

"right now our health care payment system will make this challenging but there will be a greater emphasize on prevention of disease as payment models shift.  what better way to help provide health then having healthcare providers provide or partner to provide sustainable and healthy foods to patients?  exactly what this partnership looks like I’m not sure but it could easily encompass a crop share delivered through a clinic, local fresh foods provided through the inpatient food service, or prescriptions for healthy food subsidized for patients with obesity, diabetes, hypertension, etc…   this area is ripe for exploration with the right individuals at the table."

THIS AREA IS RIPE FOR EXPLORATION WITH THE RIGHT INDIVIDUALS AT THE TABLE
— bradley richards md, assistant professor of internal medicine, yale university

sara elliot, director of programs at stone barns, shared a similar enthusiasm when asked about partnerships between doctors and sustainable farmers: "at stone barns, we believe that doctors and farmers have a lot to learn from one another. both are concerned with the care of a priceless resource – health. for the farmer, the health of the soil is paramount, and for the doctor, the health of their patients is the exhaustible resource that must be stewarded. doctors can also help us achieve our goal of increasing demand for good food, grown well, which is at the heart of everything we do at stone barns."

AT STONE BARNS, WE BELIEVE THAT DOCTORS AND FARMERS HAVE A LOT TO LEARN FROM ONE ANOTHER. BOTH ARE CONCERNED WITH THE CARE OF A PRICELESS RESOURCE - HEALTH
— sara elliott, director of programs, stone barns

we know that our communities need change, but that leads us to a whole host of questions.  do our patients know what foods are healthy?  do they know how to prepare food in a quick and healthy way?  can we launch an educational program to teach our diabetic patients how to eat better?  can we empower our community members to make healthy lifestyle choices?  how do we make changes for the children in our communities?  how does sustainable and resilient farming play a role in the health of our communities?  can we help doctors practice what they preach?  can we change the way we look at healthcare, so that healthcare is equally about prevention as it is about treatment?  can we redefine health altogether?

we scratched the surface of these questions and came up with great starts, but there is so much to be done.  we need to work from all perspectives - from the patient and individual side, from the farming side, from the healthcare side, and from the policy side.

do you have ideas? reach out, let's work on this together.

special thanks to those who made this trip possible:

stone barnes center for food & agriculture:
jill isenbarger, executive director
jack algiere, four seasons farm director
sara elliott, director of programs
craig haney, livestock farm director
bobby schaffer, pastry chef at blue hill
jessica lutz, manager of visitor experience
yaël krinsky, farm store and visitor center associate
zeke (the dog who plays stick)
missy (the super friendly border collie)
stanley (the big white dog who lives with and guards the sheep)

yale university and yale new haven hospital:
dr bradley richards, assistant professor of internal medicine
yale department of internal medicine
yale primary care program

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