Wrapped in a protective gown with a mask obscuring half my face, I entered the isolation room. The patient was a frail 78-year-old man with marked temporal wasting and a worrisome cough. He had been transferred from another unit, labeled uncooperative and irritable. His sputum had tested positive for acid-fast bacteria, but he insisted he was not sick and refused to take any medication. Realizing that the patient resented being treated as if his illness was his one defining feature, I sat down and spoke with him about his life outside the hospital. He was a retired postal worker who had been widowed for 5 years. His favorite pastime was baking, and sweet potato pie was his specialty.
It was then that we struck a bargain: if I was able to bake a sweet potato pie that was as flavorful as his, he would take the cocktail of isoniazid, rifampin, ethambutol, and pyrazinamide.
When I went home that evening, I researched pie recipes with the same fervor ordinarily reserved for obscure medical conditions. With a combination of two different recipes and some improvisation, my pie was produced. The next day, I presented the sweet potato pie. The patient lifted a spoonful to his mouth. “Lemon juice… vanilla… cinnamon,” he murmured as he chewed. He closed his eyes and smiled. “I’ll take the medicine now.”
