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'Onward,' Says Chef Recovering From Tongue Cancer

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By HELEN O'NEILL

The Associated Press

Published: July 2, 2008

EDITOR'S NOTE: In Part 1, chef Grant Achatz's Chicago restaurant, Alinea, has been named by Gourmet magazine as the best restaurant in the country. All is going well when Achatz is diagnosed with tongue cancer.

CHICAGO - Nick Kokonas, a derivatives trader who retired in his 30s, hit the phones. He made an appointment for his restaurant partner, Grant Achatz, at Memorial Sloan-Kettering Cancer Center in New York the following week.

There is a late afternoon ritual at their restaurant, Alinea, when the wait staff, hosts and sommeliers gather in the upstairs dining room for a preservice briefing with the master. Achatz tells them about menu changes, new ingredients, how to serve certain dishes and who might be dining that night.

The ritual was broken last summer, when the entire staff was asked to assemble in the downstairs dining room, and everyone knew something was terribly wrong. Nervously, they gathered around a small black phone console. Achatz's voice crackled through. Briefly he talked about the menu. He welcomed new staff members. Then he told them he had cancer.

He was in New York with some of the best doctors in the world, he said, and he was confident. He hadn't come this far to be beaten down by disease.

When Achatz hung up, 50 pairs of stunned eyes turned to Kokonas, some in tears. What could Kokonas say? He couldn't tell them what a top oncologist had told Achatz that morning: "We need to operate immediately and remove your tongue or you will be dead in three months."

The headlines were stark: Cancer strikes top chef in his prime. At the University of Chicago Medical Center, oncologist Everett Vokes read the paper and wondered if he would see the stricken chef.

Achatz walked into his office a few days later.

By now, three top cancer specialists had told Achatz that it was necessary to remove his tongue. But one doctor had also mentioned an alternative approach being practiced at the UC Medical Center.

Doctors were struck by the irony of Achatz's case. He didn't fit the profile for a tongue cancer patient: He had never smoked; he drank just one glass of champagne a night; he was fit and healthy.

"It was just this enormous human tragedy," said Vokes, who heads a team that specializes in trying to save organs rather than remove them.

Instead of the standard therapy of removing the tumor, followed by radiation and chemotherapy, they would reverse the order. Aggressive chemotherapy, using promising new drugs, followed by radiation to shrink and kill the tumor. Surgery might still be necessary later, but for now, they would focus on saving Achatz's tongue.

They warned Achatz that it would not be easy.

His tongue would feel torn to shreds by radiation and he would probably lose his taste for a year. His face would turn into a hot red rash and he would have to wear a burn mask. He would temporarily lose his hair and his appetite. To be safe, they would remove his lymph nodes.

"We were offering him six months of pure misery," radiologist Daniel Haraf said. "But we were also telling him that there was a 70 percent chance that he would be cured."

"Where do I sign?" Achatz asked.

Achatz made it clear to everyone that he considered cancer an unpleasant interruption, not a death sentence. Illness would not affect his standards or his creativity.

The fact is most of his dishes are conceived in his head, not on his tongue. Scattered thoughts, ideas, scents. Achatz is continually jotting notes on paper napkins and then sketching great squiggly drawings of what his concoctions will look like.

His understanding of ingredients didn't die with chemotherapy, Achatz pointed out. Nor did his flavor memory. And though he no longer trusted his own palate, he did trust that of sous-chef Jeff Picus.

'I'm Barely Hanging On'

But all the mental fortitude in the world couldn't conceal the horror of being strapped onto a gurney, his head locked into a fiberglass mask, a huge black radiation machine humming as it gunned deadly rays into his tongue.

Achatz's face burned. He couldn't swallow. He couldn't eat. His mouth became a raging, itching mass of pain and even sipping water hurt. He spent some nights throwing up pieces of burnt skin.

"I'm barely hanging on," he text-messaged a friend at one point. "This is hard, even for people like us."

It was torture for Achatz to stay away from his restaurant. Though he often drove to treatment in the morning and then drove straight to work, there were days he simply couldn't let his staff or clients see how sick he was.

Achatz's absence changed the kitchen, changed the whole feel of Alinea. The man who could work longer and harder than anyone else was as human and as vulnerable as the rest of them.

With that realization, a strange protective sense took over the restaurant. It was as if the chef's battle became the staff's battle, as if by working even harder, they could somehow inspire his recovery.

"There was just this sense of responsibility," sommelier Craig Sindelar said. "The man is sick ... let's take care of his house."

Yet even as they poured complimentary glasses of champagne splashed with mead, dangled applewood ice cream on the end of a wire and explained to diners how to pull a pin that dropped a truffle-covered hot potato ball into a cold potato soup, deep down everyone wondered.

Would Achatz survive? Would Alinea?

After "one big freakish cry," Kokonas said, he knew there were practical things that had to be dealt with, things Achatz was avoiding.

Gingerly, he started the conversation. Did Achatz have a will? Had he thought about what to tell his young sons? Had he thought about the implications for his girlfriend, Heather Sperling?

And then, the question Kokonas dreaded. What do you want me to do about Alinea?

Achatz turned to him, shocked. "I am NOT going to die," he said.

Kokonas pressed on. "You have cancer. There is a chance you might not be around in five years. It's a fair question. What do you want me to do about the restaurant?"

"If I'm dead, what do I care?" Achatz said with a shrug.

It was the last time Kokonas broached the subject.

Doctors don't like to single out one patient as more extraordinary than the next. Some of the most determined succumb to disease, no matter how hard they fight. But they marveled at Achatz's stoicism and resilience. He remained an outpatient, even during the worst days of radiation.

When treatment ended in early November, he defied all expectations by flying to Washington to spend Thanksgiving with Sperling and her family.

The Scans Were Clear

In mid-December, after his lymph nodes were removed, Achatz nervously returned to the hospital for a final checkup. He still couldn't taste and his immune system was spent. He would need physical therapy, speech therapy, swallowing therapy, and it would probably be a year before he would feel normal again.

But the scans were clear. The cancer was gone.

"Onward," he told his staff.

Kokonas no longer has doubts about the future of Alinea, though he joked recently that perhaps he and Achatz should be writing a movie script instead of planning another restaurant. "Superstar chef opens restaurant that is named top in America and then gets cancer, and 'poof,' it's all over."

"What if there is a different ending?" Achatz responded. "What if it's 'poof' and the cancer is gone?"

That is not quite the ending yet, but Achatz has been cancer-free for six months, and doctors say they are "incredibly hopeful" about his long-term chances.

His sense of taste is returning slowly. Sweetness came first and then saltiness. Some days he has more sensation than others. And some days it simply doesn't matter.

On Monday nights when Alinea is closed, Achatz sometimes slips into the kitchen with Kaden, 6, and Keller, 4. The boys clamber onto stools at the gleaming, stainless-steel counter and squeal in delight as they stir pots of white smoke. Carefully, they add sugar and milk. They sprinkle in black vanilla beans.

Then, in the best restaurant in America, they sit down with Dad and devour the best ice cream in the world.

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