This Hospital’s Rooftop Garden Embodies a Growing Shift Within Medical Care

Lenox Hill Hospital
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Hospitals typically feature fluorescent lights, sterile hallways and the smell of disinfectants. At Lenox Hill Hospital in the Upper East Side, however, a flourishing green oasis mixes things up in that center of sickness and healing.

One of the hospital’s roofs now hosts a garden, complete with rocking chairs, picnic tables and large wooden planters overflowing with peppermint basil, Kentucky mint, tomatillos, chives, strawberries and more. Employees ranging from custodians to surgeons seek out the garden as a soothing escape from an otherwise high-pressure work environment.

Just three years ago, the hospital garden — the only one of its kind in the city — was a typical black tile roof whose door had been bolted shut to prevent employees from using it for cigarette breaks. But according to the garden’s creator, Dr. Robert Graham, its roots extend much further back in time than the installation of the first plant bed. The metamorphosis from eyesore to attraction began years ago, in his family’s kitchen in Jackson Heights. Today, Graham is an integrative medicine physician who directs resident research at Lenox Hill and integrative health and therapies at North Shore-LIJ, but his first lessons in health care started with his mother’s philosophy toward food. A flight attendant who moved to New York from El Salvador, she always cooked from scratch. Favorites included rice and beans, baked empanadas and hearty salads with whole ingredients.

“Meat was a garnish, not an entrée,” Graham recalls. “And the only time we ate out was for a celebration.”

He took those values with him to Buffalo, where he attended medical school and met his future wife, Julie. He introduced Julie to the diverse flavors of New York City — including Spanish, Korean, Indian and Thai food — and she brought a love of music, yoga and meditation to the table. “We always knew we’d work together but not really when or how,” he says.

In 2001, the couple moved back to the city so Graham could start a residency at Lenox Hill Hospital, but they soon relocated to Cambridge, Massachusetts, where he continued his education at the Harvard School of Public Health and Harvard Medical School. In 2008, they settled in New York for good, and Graham returned to Lenox Hill. Throughout those years, the hospital’s roof had remained closed.

Having gone through the medical school system, Graham discovered firsthand just how little emphasis it placed on nutrition as the basis for a healthy life. He firmly believes that we’ve lost our way when it comes to food’s importance for maintaining health. He traces this loss back to the emergence of industrialized, processed foods in the 1950s and ’60s, when our reliance on fresh, home-cooked meals began dropping precipitously. Although the scientific literature is now rife with evidence supporting nutrition’s role in over-all health, the medical education system has yet to catch up.

The eureka moment arrived fortuitously, when — as if living the setup to a joke — Julie shared a cab with a physician, a nutritionist and a gardener

“Food as medicine is not in the curriculum,” Graham says. “We marginalize nutrition’s importance, the thinking being, ‘You can eat your fried chicken and McDonald’s, because we have Lipitor.’”

Graham and his wife wanted to address that gap, starting with Graham’s own colleagues at Lenox Hill. But they weren’t sure how to begin. The eureka moment arrived fortuitously, when — as if living the setup to a joke — Julie shared a cab with a physician, a nutritionist and a gardener named Kristin Monji. The women were traveling from an urban agriculture conference at the Waldorf-Astoria to an event at the American Museum of Natural History. They got to chatting about green roofs, and Julie realized that her husband’s workplace might benefit from a green thumb. When she got home, she told Graham, “‘We’ve got to build a rooftop farm,’” he recalls. “That was the beginning.”

Graham quickly secured a $20,000 grant from Goldman Sachs, which made getting the project off the ground relatively easy. “When you have an idea and you have the energy and money to pursue it, it’s not that much of a challenge to make it happen,” he says.

Julie remembered Monji from the taxi ride, and hired her to design and install the garden, which Graham named Victory Greens — a hat tip to the Victory Gardens of World War II. At that time, the government encouraged individuals to grow their own produce so larger farms could focus on supplying troops deployed overseas.

“I like to use this analogy because I think we’re also at war now — with obesity,” Graham says. “Our first weapons in this war are learning to farm, to cook and to eat better.”

Victory Greens, which officially opened on Earth Day 2014, is all organic, down to the pesticides (they use catnip, a natural insect repellant), the soil and the planters. In summer, tomatoes ripen and sunflowers bloom, and in winter, kale, cabbage and rainbow Swiss chard brave the cold temperatures. Monji selects some plants, like lemon verbena, for their sweet fragrance or aesthetics, and chooses others because bees and butterflies love them; 90 percent of them, however, are edible. For now, herbs are the highlight, with seven types of basil, five types of mint and a smattering of other offerings, including lemongrass, rosemary and sage.

Monji now drops by at least once a week to ensure that her green darlings are thriving. “The garden is the most exciting project I’ve ever worked on professionally,” she says. “There are countless rooftop gardens in the city, but Victory Greens is unique because it’s one of the only gardens of its kind to serve health care workers.”

Staff are encouraged not only to look at the garden but to eat it, too. Monji and Graham host snip parties on Tuesdays, when staff can come and fill orders for fresh herbs and veggies to take home and use in their own cooking. The hospital kitchen also has free rein of the roof. “The ultimate goal,” Graham says, “is to offer rooftop-to-bedside dining.”

The garden is as much a culinary boon as it is a recreational and therapeutic one. “Nurses, doctors, medical residents and other hospital staff take care of us all the time,” Monji says. “The garden is an opportunity to give them a place to go to recharge and rejuvenate themselves, and then to hopefully provide better health care as a result.”

Studies indicate that medical professionals and emergency personnel are some of the most stressed-out workers in the U.S., thanks to long and oftentimes unpredictable hours, combined with life-or-death stakes at work. According to other studies, however, time spent outdoors in green spaces can alleviate stress — a finding that seems to apply to Victory Greens.

“A man eating lunch out on the garden last week came up to me and said that the garden is the best thing that has happened to the hospital,” Monji says. “Nurses have told me they feel less stressed at work because they know they have somewhere to go to decompress when they need to.”

Graham wanted the garden to be “a sanctuary amidst the chaos,” and he also purposefully installed fewer tables than the space could fit, because he wants to encourage his colleagues to sit together. “People say doctors can be aloof, but this is really a community garden where anyone from the janitor to the CEO can come together,” he says. “Out here, they can reconnect with one another, and with why they’re here.”

“I like to use this analogy because I think we’re also at war now — with obesity,” Graham says. “Our first weapons in this war are learning to farm, to cook and to eat better.”

On a recent afternoon, Graham — dapper in a navy suit with a baby yellow pocket square, a caduceus-themed bow tie (the snake-entwined symbol of medicine) and knife-and-fork-shaped cuff links —  shared the roof with a woman in scrubs quietly eating her lunch, a group of nurses chatting at a picnic table and a man in a white coat studying some notes in a rocking chair in the sun. Many greeted him by name. Another woman, sitting under an umbrella, put down her newspaper, laid her head down on the table and fell asleep.

“People can literally come here and catch a breath of fresh air,” Graham says. “This is my little medicine for them.”

The garden, however, was not Graham and Julie’s first venture into promoting healthy living, eating and cooking, although it is their crowning achievement to date. Before the garden, Graham had already began organizing Monday night cooking classes at the Natural Gourmet Institute’s cooking school — where he now serves as a board member. There, fellow doctors can learn what to do with the produce they find on the roof by learning to make dishes such as shaved Brussels sprouts sautéed with carrots and poppy seeds, or tempeh and vegetable kebabs. “Part of my whole thinking is that you can’t learn about nutrition without being in the kitchen,” Graham says. Taking that idea a step further, he also helped arrange for chefs from 16 hospitals to attend cooking classes at the institute to learn to make exceptional dishes relying only on whole-food, plant-based ingredients, and he helped arrange Meatless Mondays at Lenox Hill. “The more plant-based of a diet you have, the longer you live,” says Graham, who is a vegetarian bordering on vegan. “And at the same time, we’re reducing our carbon footprint.”

“We’re already pretty good at sick care,” he says. “What I’d love to do eventually is bring this whole idea of health, wellness and prevention into our decision-making about health care.”

To complement the nutritional offerings, Julie — a certified health coach and 500-hour yoga teacher — began hosting rooftop yoga, meditation, stress management classes and more at Lenox Hill. All of these activities — from the cooking classes to teaching — now fall under the Grahams’ Fare Wellness program, which Julie founded in 2012. Their motto? “Get with the pro-Graham!”

Eventually, Graham hopes to install six different micro-farms at Lenox Hill, one for each section of the hospital’s roof, including some that can be used for patient therapy. For now, patients can visit Victory Greens only when escorted by their doctor or nurse. On one such occasion, Graham brought a 70-something-year-old woman named Sunny up to the roof. She had been in the hospital for four weeks, and it was her birthday. “As soon as she came out here,” he recalls, “she looked up at the sky and began to cry.”

Ultimately, Graham hopes such changes can be made at hospitals throughout the country. He wants to play a role in a paradigm shift in how medicine is practiced here — a topic he spoke about at the TEDx Manhattan conference in March. “We’re already pretty good at sick care,” he says. “What I’d love to do eventually is bring this whole idea of health, wellness and prevention into our decision-making about health care.”

Slowly, those ideas seem to be taking hold, as evidenced by an uptick in medical personnel attendance at meetings such as the massively popular Healthy Kitchens, Healthy Lives conference and, anecdotally, in the requests Graham and his colleagues have been receiving lately from patients themselves.

“I think people are beginning to want more of a combination of choices for their health care,” he says, “extending beyond just pills, surgery and more doctors.”

“One patient at a time treatment is great, but to make real changes, we have to make them available for the masses,” he continues. “I hope this is just the beginning of a greater movement that emphasizes healthy eating, cooking and living.”

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