This piece was previously published in
Texas Medicine 91:48-50, 1996.
A strange package came yesterday. Inside a giant packing box, tightly bound with a web of heavy cord, I found a series of ever smaller boxes nested one within the next like Russian matrushka dolls. I dug through layers of padding to find at last a mysterious object thickly encased in bubble wrap, as if it were a precious Fabergé egg. As I struggled to free it from its cocoon, my eyes fixed on the return address on the outer box: “Box 12, Clover, Texas.” Now, who do I know in Clover, Texas, I pondered, my hands entangled in sticky tape. Then I remembered: Mrs. Branch! And my thoughts drifted back to Texas.
I met Mrs. Branch on my first day as an Assistant Professor at University Hospital. She had been delivered to our emergency room by ambulance, clutching a note from her family doctor scrawled on a prescription pad: “Vomiting, weight loss, syncope, abdominal pain - please evaluate for pancreatic cancer.” The housestaff had obtained a CT scan which suggested “fuzziness” at the head of the pancreas, and now she was about to be wheeled off for a CT-directed needle biopsy.
“Let's talk to her first,” I said, halting the gurney at the door and ignoring my scowling resident. Mrs. Branch was a small, tough woman with snow-white hair, wire-rim glasses, and a face that was more carved than wrinkled. For most of her life a healthy woman who “had no use of doctors,” she was now utterly convinced that she was “fixin' to die.” But she had not lost any of her feistiness.
“Doctor, Ah've done mah share of livin', and Ah don't want to be a burden,” she declared as I stood by her bedside. “The Lord's given me sixty-five years. Now you just tell me how much time Ah got left, and don't be doing any fancy stuff to keep me alive!”
Fortunately, no fancy stuff was required, for we soon determined that Mrs. Branch's decline was the result of a misadventure in polypharmacy that would have been comical had it not caused her so much distress. A year earlier she had complained of some chest pain and was empirically treated with digoxin. When she subsequently complained of “swellin',” a diuretic had been prescribed, and this had precipitated digitoxicity. Plagued with nausea and anorexia, Mrs. Branch had lost enough weight that she began to experience attacks of hypoglycemia from the sulfonylurea she had been taking for mild diabetes. The abdominal pain, it turned out, was from constipation.
We stopped all of her medicines and almost immediately she developed a respectable appetite, gained a few pounds, and cautiously began to believe that she wasn't going to die from cancer - although she was certain that without her “heart pill” a fatal heart attack was imminent. After a week in the hospital Mrs. Branch went home with a prescription for bran tablets.
I had forgotten Mrs. Branch until she appeared in my clinic, filled out, but still visibly anxious. “Doctor, Ah'm so tahred - Ah'm sure its mah heart,” she declared. There was no arguing with her, so I proceeded to conduct a cardiac exam that would have made William Osler proud. As I listened to her heart I caught her scrutinizing my face for the slightest clue.
“Strong and steady,” I pronounced. But she was obviously unconvinced, for, despite the two hour drive to our clinic, she became a frequent visitor. Each visit began with a recitation of a list of new aches and pains, every one of which she took as a sure sign that her heart was about to “give out,” I resisted her entreaties to give her digoxin, and continued to insist that she was fine; she continued to request medications and insist that something was dreadfully wrong.
After several such unhelpful visits, in exasperation I finally asked the right question. “Mrs. Branch, you're as healthy as can be. What's wrong?”
“Ah've had a hard life, Doctor,” she sighed, and proceeded to tell me her story: she had lived all her life in a small town in East Texas. Her family had barely survived the Depression. She had married as a teenager, had two daughters, and had lost her husband to The War. There had never been much money, but she had managed to raise her daughters by herself and send them through college. And when a mentally retarded nephew was faced with institutionalization, she had adopted and raised him too. But now her children were all grown up and she felt useless - and she was failing at living alone.
“Ah'm so ashamed,” she confessed. “Ah ain't never had to lean on nobody, and Ah ain't fixin' to now.”
And it was then that I finally understood the origin of her symptoms and the purpose of her visits. She was lonely. But she was too proud to ask for help. “You know Mrs. Branch, you don't have to be sick to come and visit me,” I told her.
She didn't complain of a physical ailment again. We dispensed with examinations and spent our time chatting. Every visit she came dressed in her Sunday best, with even a bit of rouge on her weathered cheeks. “Momma gets excited for days before she comes to see you,” her daughter confided to me outside the examining room. Mrs. Branch regaled me with engaging stories about her life and the memorable characters in her town, and I told her about my family, my career, my new wife.
But I sensed a continued sadness, and realized that our chats were only a palliation for her loneliness, not a cure. Everyone has a central purpose to their lives, and for Mrs. Branch it was caring for others. She needed to be needed again. There had to be something that could reconnect her with her proud past and her community.
I stumbled onto the answer by chance. One day she was telling me how she had taken in ranch hands as borders to help make ends meet. “Mrs. Branch, who fed all those hungry cowboys?” I inquired.
“Ah did. Ah had a right good reputation as a cook.”
“What was your most famous dish?”
“Huevos rancheros. They say that my green chili sauce was the best in the county.”
“Really. I love chili. Do you think you could still whip up a batch?”
Her face brightened. "Ah ain't cooked in a right long spell," she protested, but the very next visit she proudly presented me with a small jelly jar and a spoon. I looked at its liquid contents with apprehension. It had a frightening electric green iridescence that counseled extreme caution. But I didn't want to hurt her feelings, so I dipped the proffered spoon into the jar and swallowed a spoonful.
At first it didn't taste like much. But then with terrifying velocity, a tidal wave of liquid fire engulfed me. My mouth was aflame, my throat constricted, and a crushing pain pierced my chest. It felt as if an incandescent sword had been thrust down my gullet.
“HUHGG!” I shouted.
“Ah know Ah ain't got it exactly right yet, but Ah'm right certain Ah got the recipe in my attic somewheres.”
“HO!” Sweat poured from my forehead. I could hear my pulse pounding in my ears.
“You reckon I made it too strong?”
“Hoooo! That's HOT!” I croaked out.
She looked at my flushed face with concern. “Do you need a glass of water, Doctor?”
“No, I'm fine,” I reassured her in a high, squeaky voice. “It's just my Yankee stomach.” But for the rest of the day my abdomen emitted strange noises which were most unbecoming a Gastroenterologist.
Thereafter our visits settled into a fixed ritual. After some small talk, Mrs. Branch would produce a jar containing the newest batch of chili sauce and await my verdict. Her cooking was definitely improving, but not fast enough, I feared, for my gastric mucosa. “Momma spent all of Sunday going through the attic trying to find her old recipe box,” her daughter informed me. I hoped she found it soon.
My stomach was saved when I accepted a new position back East. Mrs. Branch was quite somber at her last visit before I left; she brought no samples that day. “Ah think mah heart is acting up again,” she declared with grave concern.
“Mrs. Branch, I don't want you to worry about this anymore. You have the strongest heart in Texas.”
“You reckon Ah do?”
“Absolutely. Mrs. Branch, if you chopped a cord of wood every day for a year, what would happen to your arms?”
“Ah reckon they'd grow as big as Popeye's and twice as strong.”
“Right. And the same goes for your heart. You've given a lot of love to a lot of people in your time, and it's made your heart mighty strong.” And that had seemed to make perfect sense to Mrs. Branch.
“Now, you take care of yourself, Mrs. Branch, and when you get your chili sauce perfected, I want to know about it.”
And now it appeared that she had. I finally peeled away the last layer of bubble wrap and found a large pickling bottle labeled: “Mrs. Branch's Award Winning Green Chili Sauce.” Taped to the bottle was a card inscribed with a shaky hand:
“Dear Doctor, I finally remembered my secret. My daughter got me hooked up with the 4H girls, and I'm teaching them how to cook.” (And a good deal more about their Texas heritage, I mused). “Well, my girls got it into their heads to enter my chili sauce in the County Fair, and it won a Blue Ribbon! I have lots more if you like it. I hope you’re happy in your new home, but I sure miss coming to see you. Your Friend, Edna Branch. P.S. My heart is just fine, thank you very much.” On the back of the card in a neater hand was a short note from her daughter: “Momma's back to her old self again. You should see her fussing over those 4H girls - she's got them buzzing around her kitchen like bees. God Bless you, and you come visit when you get back to Texas. P.S. I hope Momma's sauce isn't too hot for you.”
I regarded the bottle with wary suspicion. My heart was warmed enough without any further help. But still, the judges at the county fair had awarded it a blue ribbon. Well, let's do this right, I finally decided. I put some tortillas into the oven, opened a can of refried beans, and set some eggs frying in a skillet. When everything was ready I assembled the dish and covered the eggs with a few spoonfuls of chili sauce. I carried the plate to the dinner table, spread a napkin on my lap, took a deep breath, and took a bite.
I was greeted with a burst of pure pleasure which flowed in a sultry wave from the tip of my tongue to the back of my throat - not a fire, but a glow, warming my belly, and teasing my mouth with its bridled incendiary power. I now understood the popularity of the dinner table at Mrs. Branch's boarding house. I poured more chili sauce on the eggs, and savoured my unexpected evening meal.
Some say that the chili pepper embodies the essence of life. Raw and untamed, its fire can burn and torment. But transmuted by the wisdom and love of the cook, its warmth comforts us and entices us to partake of more. Some aficionados even claim they can hear the voice of the chili. That night as I sat at my dining table, Mrs. Branch's Award Winning Green Chili Sauce spoke to me and assured me that I had restored the health of the strongest heart in Texas.