A Chef Faces His Worst Fears
Battles Tongue Cancer
August 31, 2007; Page B1 WSJ
A year after chef Grant Achatz opened Alinea here in 2005, Gourmet magazine named the restaurant the best in the country, and the prestigious Mobil guide gave it its highest rating of five stars. The young chef's exotic, lavishly presented creations -- a mango duck dish is served on a deflating pillow that releases lavender-scented air -- have connoisseurs lining up to book meals that cost an average of $240 a person.
But last month, doctors gave Mr. Achatz, 33 years old, devastating news. A cancerous tumor was growing inside his tongue. The disease was so advanced that three doctors told him the only way to cure it was to cut out part of his tongue, leaving one of the world's most celebrated chefs to ponder life without the ability to taste.
"I was just in disbelief," says Mr. Achatz (pronounced ACK-etz). There are about 35,000 cases of head and neck cancer a year in the U.S., and most afflict older people and smokers. "I've never had a cigarette in my mouth in my life," Mr. Achatz says.
The diagnosis sent him looking for an alternative treatment that would save his life and his tongue. The tumor had made it so painful to chew that Mr. Achatz couldn't eat solid food and had lost at least 10 pounds.
Saving his tongue hinges on whether a team of doctors at the University of Chicago can cure the cancer using an atypical method of treatment. Instead of the standard therapy -- removing the tumor surgically, followed by radiation and chemotherapy -- his doctors are starting with a course of chemotherapy that adds a drug called cetuximab to two more conventional drugs. Then they will follow that with a combination of radiation therapy, more chemotherapy, and drugs.
Everett Vokes, one of the oncologists treating the chef, says there is a 70% chance of recovery for these types of cancers, though he won't give odds for Mr. Achatz. If the treatment doesn't cure him, doctors will have to consider removing part of his tongue.
Mr. Achatz, skinny and boyish with scraggly auburn hair, says he is optimistic about his recovery, is feeling great and is determined not to let his illness slow him down. Alinea's owners stress that so far, nothing has changed at the restaurant, and that they don't anticipate it will. Despite starting a typically tiring regime of chemotherapy a month ago, Mr. Achatz continues to spend long days creating and preparing dishes at Alinea, sometimes staying past 3 a.m. Already the treatments have improved his condition enough that he can chew more comfortably.
He grew up helping his parents prepare family-style dishes at their St. Clair, Mich., restaurant. After graduating from the Culinary Institute of America in New York, he worked under chef Thomas Keller at the prestigious French Laundry restaurant in Yountville, Calif., then became the head chef at Trio in Evanston, Ill., north of Chicago.
It was there that his avant-garde creations began to attract critical plaudits. In 2002, Chicago Tribune restaurant critic Phil Vettel wrote a rave four-star review of Trio, singling out a miniature ice-cream sandwich of parmesan-laced shortbread wafers around savory olive-oil ice cream that Mr. Achatz sent to his table as a starter.
In 2004, Mr. Achatz detected a tiny sore growing on the side of his tongue. A dentist told him it was probably from unconsciously biting at the spot, and fitted his mouth for a night guard. That year, he left Trio to open his own restaurant in Chicago's tony Lincoln Park neighborhood.
He decided to call it Alinea, after the name for a typographical symbol that indicates a new train of thought. His ambition wasn't only to present his food as art, but to make the entire dining experience into a form of theater that would appeal to all of diners' senses and elicit emotional responses. For instance, Mr. Achatz had an architect design Alinea's entrance so that people would walk in, not be able to see the dining room and briefly think they were someplace other than the restaurant, creating a moment of tension.
As soon as Alinea opened in 2005, critics began heaping praise on the hypermodern cuisine and eclectic dining experience. Meals consist of as many as 30 small courses and have taken diners more than seven hours to consume.
To evoke autumn, Mr. Achatz served a piece of pheasant breast on an oak-tree branch lit on fire so it would be smoking as it arrived at the table. For a dish called "Hot potato, cold potato," Mr. Achatz skewered a marble-size potato and suspended it over a paraffin wax bowl of chilled potato soup so the palate would sense the temperature contrast.
But as Mr. Achatz's reputation grew, his ability to eat was deteriorating. By May, the sore on his tongue was causing him so much pain that it was difficult for him to talk and bite into solids. He had trouble eating one of his favorite foods, pizza.
One day in July, doctors told him it was stage-4b squamous cell carcinoma of the oral tongue. Mr. Achatz says he brooded for a day, then set out to find an alternative to surgery.
"I never said, 'I'm done,' or 'What am I going to do?', or 'Do I have to change careers?'" he says.
Dr. Vokes says it's too early to predict exactly what might happen if doctors removed the tumor from Mr. Achatz's tongue. Typically, removing a significant part of the tongue leaves a patient unable to taste and interferes with his or her ability to speak and to swallow. The sense of smell isn't usually affected.
But other senses contribute to Mr. Achatz's talent. Much of his acclaim derives from the way his dishes look. Before he cooks a new creation, he writes down the ingredients he wants to use and how he'll manipulate them. Then, he sketches what it might look like on the plate before discussing it with the chefs who work under him.
"He has such a spiritual connection with food and the visuals, and the taste is just a part of it," says Rick Tramanto, executive chef at Tru in Chicago. "He's way too connected to what he's doing to have [a loss of] one of the elements deter him at all."
Associates say it is Mr. Achatz's passion, not just his senses, that make his food successful. "You could take out his tongue and his eyes, and it would be Grant's restaurant," says Nick Kokonas, co-owner of Alinea. "I can't imagine that he wouldn't be able to overcome any limitations." Mr. Kokonas says they're laying plans to open a second Chicago restaurant, and that he'd "love to do something like Alinea in San Francisco."
Next month, Mr. Achatz will begin the more intensive combination of chemotherapy and radiation treatments that could slightly dull his ability to taste, though Dr. Vokes says taste gradually returns to patients after the treatments stop.
One recent night at the restaurant, he hunched over a row of white platters assembling short ribs with a topping of peanuts and a Guinness-flavored covering. Moving intently from dish to dish, he broke his concentration only to call out instructions -- "You bringing lamb, or what?" -- then refocused on his task.
As he sees it, tackling cancer isn't much different. "The thought process that goes into building these dishes are little miniversions of what I face with my illness," he says. "Your mind just deconstructs it and pulls it apart, and you're left with the same challenges you face every day."
Write to Janet Adamy at firstname.lastname@example.org