Health Kitten

Health Profile: Nick Dawson

I’ve known Nick for a number of years and we both share similar interests. We met through the now-defunct social network Pownce, but over the years we’ve had phone conversations and even met in person (Nick is taking graduate classes through the University of Minnesota) a time or two. Here’s his bio off his own website:

Nick Dawson bridges the gap between healthcare operations and strategic vision. With more than 13 years experience in hospital operations, he understands what makes healthcare tick. As the champion of an innovation success story, Nick is the Director Community Engagement at Bon Secours Virginia Health System. Previously he was a Director of Revenue Cycle for the 14 hospital Bon Secours system. In the past, he has worked for other multi-hospital systems and been a consultant on staff for a major health IT and strategy vendor.

Today, Nick works with senior leaders within the Bon Secours system on innovation projects including the exploration of an accountable care organization and affiliate physician and community health strategies. He is passionate about the patient experience as a driving force in healthcare.

Nick is currently pursuing an executive Masters of Hospital Administration from the University of Minnesota. He is a past member of the Healthcare Financial Management Association and can frequently be found posting about healthcare and cooking on his blog, twitter and Flickr. He speaks nationally and has been published on the topics of innovation, community engagement, revenue cycle and healthcare communications. On many Sunday evenings Nick participates in the #HCSM Twitter Chat.

Nick and his wife Susan live in Richmond, Virginia where they enjoy extreme skiing, camping and vintage Land Rover restoration.

When I found out that Nick went vegan for a short amount of time, I was intrigued. As you’ve read my own journey to going vegetarian, seeing that Nick and his wife doing the same thing at the same time was amazing. Especially since my nickname for Nick is “Mr. Bacon Man!”

The idea came up to interview Nick for Health Kitten about his own journey. Here is his story!

What inspired you to adopt a vegan diet?

If there is one straw which breaks the camel’s back, there are also a ton of other straws piled atop the camel first. For the last few years, I have been working with a trainer at the gym on strength training. My goals had always been improving my overall fitness, training for ski season and hopefully losing weight. I didn’t put a lot of emphasis on weight loss, largely because I was so opposed to making many changes to my diet. I think I was looking to do just enough to balance out my bacon-loving, omnivore lifestyle; a net even. In the summer of 2011, I decide to listen to my trainer who had been suggesting I work some cardio into my routine. Reluctantly, I pounded out some brutal runs on the treadmill a few times a month which turned into a few times a week.

In August, a confluence of events sped things along. My father was diagnosed with cholangiocarcinoma, a cancer of the common bile duct. He is fortunate, the cancer was operable, although the Whipple procedure is one of the most challenging elective procedures one can endure. As a total coincidence, around the time of his diagnosis, my wife Susan and I were watching a bunch of food-related documentaries. Some were grounded in fact, some were a little lighter on the science. But it doesn’t take a rocket scientist or even a dietician to know the old maxim is true: we are what we eat. We are increasingly surrounded by processed, mass produced foods and animals from factory farms. Ingesting processed foods cannot be healthy, it’s that simple. The film which made the biggest impact was Forks Over Knives which presents the findings of a physician and a researcher who have concluded a plant-based diet can prevent heart disease and most cancers. Sounds radical, I know, but both studies were scientifically conducted and worthy of consideration.

I first heard about Forks Over Knives from a physician co-worker. He’s a cardiac surgeon who has preformed heart transplants, valve surgeries with surgical robots and seen more heart attack cases than one could comfortably count. He is a believer and has adopted a vegan, no-fat diet. It’s hardcore! No nuts, no oil, no avocado… just plants and fruits and grains.

In September, he and I were traveling together for a conference. I had ramped up the cardio, my dad was doing well, and starting chemo, and my mind was full of food documentary propaganda. I suggested to him that, while we were traveling, I wanted to follow his diet – I’d eat only what he ate. How hard could it be?

Turns out, when visiting Northern California, it’s not hard at all. We ate really well. I never found myself thinking “ohhh I wish I’d ordered the cheeseburger.” In fact, I remember thinking “I haven’t tasted, I mean really tasted, a salad like this in a long time.”

How long did you initially plan on being on this diet?

My plan had been to follow my physician friend for the week we were together. In fact, my wife and I were planning a camping trip for the following weekend and homemade sausages were on the menu.

While we were traveling, we heard an amazing presentation from BJ Fogg, a professor of technology and behavior from Stanford. Fogg, addressing a group of healthcare innovators, said the easiest behaviors to adopt are what he calls “Purple Path” (you can read more here: http://behaviorgrid.org/). Purple Path behaviors involve a small, self-identified change which one does for a defined period of time. It’s a lot easier than saying “I’ll never eat meat again” or “I’ll only eat vegan for the rest of my life.”

Truly, I hadn’t given a lot of thought to Fogg’s lecture in terms of my diet. We were brainstorming how his approach might apply to patient and health behaviors. On the trip home, when my airport food court choices were a chain burger joint, fast food pizza or a salad bar, I decided to keep in line. I went with the salad, no dressing, no cheese.

The next day, I decided to go one more day. I wanted to show off what I had learned about tasty grain and bean dishes, so I cooked a vegan meal that night. And so it went, day by day.

For the camping trip, we made lettuce tabbouleh cups. They were awesome!

Since early September, we’ve refined our version of the diet to include some dairy (hello, cheese!) and seafood no more than once a week (you’ll have to pry the oyster knife out of my cold, dead hands). As of November, we’re still at it.

What physical changes has your body gone through while on the diet?

The biggest change, literally, was weight. I don’t know if it was all the cardio I had started, or the diet or a combo of the two – when I came home from a week of in California, I was down 5 lbs (in addition to 5 I had already lost). Today, I’m down 25 lbs. I’ve also continued to put on muscle.

The weight loss is great. People noticing is even better. But the real benefit is the feeling. Since my post-college bachelor days, I’ve been perfecting a burrito recipe using buffalo meat (considerably more healthy than beef). Even with the lean buffalo, we often joke about “burrito belly” after a big meal. It knocks you out, you are couch-bound for the rest of the night. Try as we might, we simply cannot get burrito belly from too many veggies, beans and grains. In fact, for the first time I can remember, there are nights when I feel like I could get off the couch and run laps around the block at 9pm.

That feeling is part of what sustains the lifestyle for me. When I see a burger on a menu and the drool reflex kicks in, I just think about how I’d feel after I ate it vs. the same portion size in veggies.

I’m sleeping less, more energetic and just generally feel more healthy. I’m a data driven guy, I wish I had done some measurements and even lab tests before. But the reality is, based on how I look and feel, the proof is evident.

Did you have support from your spouse?

Yes, Susan is tremendous! She had been on her own fitness journey, working with a training group and prepping for the Richmond ½ Marathon (last weekend, she set a personal best). Like me, Susan is also a foodie. She has had similar success both in terms of body composition and overall feeling. In September, she set a personal best on a very hilly 4 mile course.

Ironically, being into food and cooking makes the move towards a vegan or vegetarian diet easier. The same techniques apply to prepping vegan meals. Food needs the right amount of salt and acid to bring out flavors. You have to layer flavors and textures just as you would in a dish with meat. Some things need high heat, some need roasting, some should stay raw. It’s still exciting to cook and eat – we didn’t expect that. It has been a pleasant surprise for both of us.

Do you have favorite recipe that you would like to share?

I have to pick just one? Ok, if I must. Like I said, one of the best parts of this experience has been regaining an appreciation for the taste of raw or simply prepared vegetables. A lot of my go-to foods have been things like cauliflower and quinoa with a little lemon, sea salt and olive oil. Generally, I’ve found most faux meats to be just that, a pale misrepresentation of the real thing. Tofurky? I’ll pass. The one standout has been TVP – textured vegetable protein. TVP is billed as a substitute for ground beef and is sold dried, in a refrigerated block or, in some cases, pre-seasoned.

Right out of college, my bachelor meal of choice was a take on my very American mother’s burritos. She used the kits from the ethnic isle of the grocery store and they became a sort of comfort food growing up. When I went to make my own, I looked at the seasoning packet and thought, I can make this from scratch. Over the last 13 or so years, I honed the dish into a real masterpiece (probably bearing little resemblance to a real burrito), layering flavors like marjoram and garlic in with homemade chili powder. I was using ground buffalo for a while, more for flavor and to support local farms, although it is certainly a healthy alternative to beef.

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Nick’s Bufafaux Burritos

[adjusted for a quick meal, feel free to substitute home ground chilies, homemade salsa, etc]

• 1 medium red onion, diced
• 6-8 cloves of garlic, sliced thinly
• 1 Tbsp marjoram
• 2 Tbsp red wine or sherry vinegar
• 1 Tbsp ground chili powder (to make at home, grind equal parts dried chipotle, poblano and ancho chilies)
• 1-2 chilies in adobo sauce, with some reserved sauce (smoked jalapenos in a vinegary sauce)
• 1 lb of hydrated (refrigerator section) TVP
• 1/4 c. flour
• Package of your favorite veggie or vegan tortillas
• Olive oil, salt, pepper, chili flake to taste
• (Optional) Shredded cheese – have found a 50/50 mix of Grafton Village Cheddar and local queso fresco to be best
• (Optional) salsa, guacamole, chopped onion

1. Working in your cast iron pan, start by slowly melting the onions over medium heat, salting liberally to draw out moisture early. Once they have a translucent, brown hue, add ½ the garlic on top of the onions, push to the side of the pan. Add a tad more oil.
2. In the remaining 2/3rds of the pan, add the TVP, salting to taste. Using a wooden spoon, begin to mash up the TVP, pushing it into the bottom of the pan. Leave the TVP in the pan, over medium-high heat long enough for the bottom to begin to brown. Once browned, incorporate the TVP and onions in the pan. Continue cooking and stirring for another 3-5 minutes, if it sticks move to next steps.
3. Add in the chili powder, and minced chilies in adobo, spooning a 1 – 2 teaspoons of the adobo sauce into the pan. Incorporate over heat.
4. Add the flour and mix well. The texture should become even more dry and the ingredients will want to clump. Stir occasionally for 3 minutes to ensure the flour is coated in the remaining oil and has started to cook.
5. Add ½ the marjoram and the remaining garlic and vinegar. Using the vinegar to deglaze the pan, add enough water (up to ⅔ cup) to come ½ way up the mix. Use your wooden spoon to loosen stuck bits from the bottom.
6. Once the water boils, reduce to simmer and allow to thicken until the mixture is tight – no visible pools of liquid. Sprinkle in remaining marjoram. Turn off heat, cover until you a ready to serve.

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We like to heat tortillas right over our gas stove, flipping after about 30 seconds on each side. You can also use a pan over high heat.

Top with your favorite toppings and have a beer ready for the heat!

What was your biggest challenge in changing how you eat? Any tips?

Not to get all existential about it, but I am probably my own biggest roadblock. I would have predicted the usual suspects – eating out, dining with or cooking for friends, family support. In reality I had to come to grips with giving up (or putting on hold) one of my biggest hobbies and in some ways part of my identity. Friends know me as someone way into food and cooking, particularly ‘noise to tail eating.’ Making the shift to a plant-based diet meant disconnecting some of those associations. I guess in some ways I’m still wrestling with that, my twitter profile still includes “fan of all things porcine” and I haven’t thrown out the 5lbs of hog casings (intestines for sausage making) in my freezer. Contrary to my expectations, eating out has been easier than I expected; friends and family have also been supportive.

The best advice I can offer is a reinterpretation of the same comments from BJ Fogg that pushed me off the cliff: make any dietary change a personal choice, it can be a small change, do it for a short and defined period of time then reevaluate. For me, it was a big change, but a short period. Vegan for 5 days. When I got home, I reevaluated and went for a few more days. I’ve settled in to a mostly vegetarian with a hint of pescitarian routine with a commitment to myself to reevaluate before Christmas (I mean, look, this foie gras terrine with Virginia apple butter I make for Christmas is really outta this world).

Thanks for your time, Nick!

21. November 2011 by Carolyn
Categories: Living | Tags: change, health, health profile, inspiration, not a diet | 1 comment