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David P . Steensma , MD , is senior physician at the Dana- Farber Cancer Institute and associate professor of medicine at Harvard Medical School in Boston , Massachusetts .
David P . Steensma , MD
ASH Clinical News 13
Letters to the Editor
Marrow-Minded
In November ’ s Editor ’ s Corner , David Steensma , MD , recounted the “ absurdly exotic experience ” of eating bone marrow in a café in Milan after speaking about marrow failure at a conference , and walked us through a brief history of the
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culinary delicacy . We received responses from readers who also appreciated the irony of eating bone marrow as a hematologist and offered their own experiences eating what chef Anthony Bourdain has called “ God ’ s butter .”
what a nice article “ On Eating Bone Marrow ” by Dr . Steensma . I have sampled great bone marrow dishes at Brasserie Georges in Lyon , France , and I have fond childhood memories of my mother preparing a Filipino side dish of bone marrow mixed with warm rice and bananas on Sundays . Her special spaghetti was a family favorite because she added bone marrow to the sauce . So , to me , bone marrow dishes are comfort food .
Interestingly , my mother was a biochemist who studied cholesterol .
Emmanuel C . Besa , MD Emeritus Professor of Medical
Oncology Division of Hematologic Malignancies and Hematopoietic Stem Cell Transplantation
Kimmel Cancer Center Thomas Jefferson University
Philadelphia , PA
i really enjoyed reading Dr . Steensma ’ s musings on eating bone marrow . I must say , I also have been fascinated by this food form , but am not the biggest fan as I have difficulty separating the gastronomy from the pathology . On a recent trip to Los Angeles , my family and I ate at a very popular restaurant called Bestia , where bone marrow on pasta was the restaurant ’ s specialty . While I ’ ve had bone marrow before , this time I found it to be particularly gritty . Do you suppose this is due to the trabeculae ?
Thanks for an entertaining read !
Laurie H . Sehn , MD , MPH Chair , Lymphoma Tumour Group
BC Cancer Agency Vancouver , British Columbia
Editor ’ s Corner
T
On Eating Bone Marrow
HE FIRST TIME I ATE BONE MARROW was , fittingly , shortly after I spoke on marrow failure at a conference in Milan , where osso bucco with saffron risotto is a local specialty . The tiny , back-alley trattoria where I could afford dinner on a hematology fellow ’ s salary was praised in a guidebook written by public television ’ s European travel guru , Rick Steves . ( At the time , I bore a close resemblance to Steves . When friends later pointed this out , it suddenly was clear to me why Italian restaurant owners seemed so friendly and generous , and why antipasti so often showed up at my table “ on the house .”)
I grew up in a middle-class home in 1970s suburban New Jersey , where food was plentiful but culinary options were limited . My Dutch mother was a competent cook and often made rich desserts , but dinners were heavy on boiled vegetables , mashed potatoes , and the less expensive cuts of meat from the local A & P supermarket . My dad grilled , but , like many men of his generation , he considered the linoleum-floored kitchen to be slippery foreign territory .
Our family didn ’ t go out to eat much – maybe once or twice a year – and either to the local red-sauce Italian restaurant , or a classic greasy-spoon diner owned by a family friend . I didn ’ t try seafood or any dish originating in Asia until I left for college . Eating bone marrow in a café in Milan , therefore , felt absurdly exotic .
Both the name and the hearty flavor of osso bucco come from the marrow in the center of a cross-cut veal shank . Chef Anthony Bourdain calls marrow “ God ’ s butter ,” and for good reason . Accurate nutritional information about marrow is surprisingly hard to come by , but marrow is so rich that , in his novel Walden , Henry David Thoreau made it a metaphor for carpe diem : “ I wanted to live deep and suck out all the marrow of life .” High in protein , fats , and essential elements , and clocking in at around 250 calories per ounce , marrow packs a potent nutritional punch .
Once upon a time , back when indentured servants in New England complained about their masters serving them a diet with too much lobster ( considered then a low-class meat because of the work involved in eating it ), eating marrow was more common in the West than it is today . No proper 18th-century kitchen was complete without a marrow spoon , the scoop of which looks like a hypertrophied biopsy needle . Martha Stewart demonstrated the use of marrow spoons in a recent episode of her television show , ladling mouth-watering cooked marrow onto toasted croute and obviously enjoying herself , pronouncing , “ It ’ s a good thing .”
Surely the English theologian and geologist William Buckland must have tried eating marrow . A noted 19th-century eccentric , Buckland was known for intentionally eating his way across the animal kingdom , from crocodiles to panthers to weasels . ( He rated moles and bluebottle flies the lowest .) This obsession with edible adventure occasionally crossed over into the grotesque : At a party outside Oxford in which the desiccated heart of French King Louis XIV was being passed around , Buckland either intentionally or accidentally mistook the relic for a novel hors d ’ oeuvre and ate it , grievously offending his host .
While the majority of marrow eaten across the globe today comes from cows , this has not always been the case . There is anthropologic evidence that early humans used crude stone tools to break into wild animal bones and suck out the marrow . For a long time , humans were far from apex predators and could only have a go at the corpse of a downed animal after the lions and hyenas were done with it .
The use of stone tools to crack open marrow and get at a food source that no other creature could access ensured the survival of our ancestors , while the fatty marrow fueled their brain development . There is far less anthropologic evidence that our ancestors ate the marrow of one another , and perhaps that ’ s a good thing , because infectious prions such as the ones that transmit kuru can be found in marrow .
For many years I ’ ve been keeping back a story , looking for just the right forum in which to share it , and this seems as good a time as any , as well as a fitting last word .
I once saw an older patient in consultation for anemia . She had worked on the home front during World War II at the Hormel factory in Austin , Minnesota , where Spam is made . When I examined her , I noticed that she had only four fingers on one hand . Where had the other one gone ? She told me she ’ d lost it in a grinder at the factory during the war . I asked her if the manager had at least stopped the factory line to retrieve it . She shook her head , offering only a short explanation , “ We had quotas .” On a later visit , she confessed that for years she had nightmares about some unfortunate 19-year-old GI opening up his C-ration meat tin after a long day spent storming Monte Cassino , only to find her digit and its marrow inside .
The content of the Editor ’ s Corner is the opinion of the author and does not represent the official position of the American Society of Hematology unless so stated .
Have a comment about this editorial ? Let us know what you think ; we welcome your feedback . Email the editor at ACNEditor @ hematology . org .
November 2016 Editor ’ s Corner
Have a comment about an article ? Let us know what you think ; we welcome your feedback . Email the editor at ACNEditor @ hematology . org .
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