Caitlin Whyte (Host): What if healthcare could begin long before a patient ever walks through the doors of a hospital? At UPMC Memorial, that idea is taking root through the UPMC Pinnacle Foundation Farm-to-Hospital Program, an innovative initiative connecting fresh, locally grown food with prevention, education, and better health.

In part one of our two-part series, I'm joined by Dr. Kimberly Mudge, the physician whose vision helped bring the program to life. Dr. Mudge shares where the idea began, why she believes nutrition and prevention belong alongside modern medicine, and what it means to see that vision growing today.

This is In Their Words, brought to you by the UPMC Pinnacle Foundation and UPMC in Central PA.

KimberLee Mudge: Hello. My name is Kimberly Mudge, and I'm a physician with UPMC Memorial in York, Pennsylvania. I had the vision of a farm-to-hospital program, and I'd like to tell you my story.

Before I tell you about the Farm-to-Hospital, I think I need to give you a little bit of background about who I am. I'm from a small town in northern Pennsylvania called Mansfield. And Mansfield is a small little town, one stoplight, very Americana in character. I come from a family of tough love. I was taught to fight, to survive, and to succeed. We lived a life of reap what you sow, and hard work was really the foundation of everything in life. And these principles and values that my parents showcased in their every day made me who I am.

I believe in heritage. I believe in sustainability. I feel very strongly about environmental stewardship and education. I live with the principles of modern medicine. I'm a breast surgeon on this campus. I'm a general surgeon by trade. I believe in leadership and leading by example primarily. And most importantly, I believe in community.

And this campus, the trail, the Breast Cancer Garden of Hope, and the Farm-to-Hospital Program are about this community and UPMC Memorial, and primarily the Pinnacle Foundation helped me attain dreams. And several years ago, in the pre-dawn hours of a winter Saturday morning, I was nerding out in my chair reading about sustainability. I was reading a magazine titled Mother Earth News. And in the back was an article about a Farm-to-Hospital concept. And the nerd that I am just latched onto the concept, and I really genuinely felt like my head was going to explode. This became another passion point for me as I was pushing for some changes in medicine.

I realized the concept would be a hard sell to the healthcare community. But I also realized I would likely fail. And yet, that push, that foundational learning that started back in Mansfield, you have to fight to succeed, I decided to give it a go. The concept seemed more than worthwhile. And if you listen or reflect on a statement once made by Mother Teresa, "Alone, we cannot change the world, but we can cast a stone across the waters to create many ripples."

I was very good at skipping stones in Mansfield. And so, moving forward, this quote became pivotal. And about the same time, my partners and I, Leader Surgical Associates, were in the beginning phases of conversations with UPMC. At the time, it was Pinnacle. And the leadership at that time supported the vision and basically said to Jess Ricci, the president of the Pinnacle Foundation, "Make it happen."

At the time, there were members of the team. Joe Iandolo was at UPMC Memorial. And collectively, there was a group of four of us that pushed to create this Farm-to-Hospital program, and it started with a sell to leadership. And we created a mission statement, and the process started.

Our Farm-to-Hospital initiative recognized that healthcare begins long before a patient enters the hospital. And by encouraging fresh, locally grown produce, minimally processed foods, and a return to homegrown and homemade meals, we promote nutrition as a cornerstone of wellness. Combined with modern medicine, these healthy lifestyle choices can actually help reduce obesity, improve overall health, and support better outcomes for patients, including those facing cancer. It's a simple but powerful reminder that food is not only nourishment.

It's an important part of prevention, healing, and lifelong health. This really struck a chord with me as a breast cancer care provider. In fact, digging deeper into some of the statistics that support this initiative poor diet contributes to about 5% of all new cancer cases in the United States. That equates to about 80,000 preventable cancers each year.

Among these, colorectal cancer is a leading problem with obesity. Excess body weight is linked to 13 different types of cancer, including breast, primarily in post-menopausal women. And as I said, colorectal cancer, endometrial cancer, pancreatic and ovarian cancers. It's hard to believe, but really not hard to believe that in the American diet, 50% of the calories we consume are from ultraprocessed foods. And there's a real push to convert to more healthful plant-forward nutrition. And in fact, the American Cancer Society recommends a plant-forward diet, limiting processed meats, limiting red meat, sugar-sweetened beverages, and highly processed foods.

Within the last ten years, I've become aware of a new fellowship and residency called lifestyle medicine. And this concept supports our endeavors on this campus. It's a part of our vision. And their principles and the care they provide their patients focus on six pillars of care. The principle pillar is nutrition, followed by exercise, good restful sleep, stress management, avoidance of risky substances like smoking and alcohol, and positive social interactions.

Our campus at UPMC Memorial is poised. It's one of a kind, and it's ready to make a difference in York. Our walking path, our emotional garden, the Breast Cancer Garden of Hope, and our hoop houses, which are the foundation of the Farm-to-Hospital program, have been a success already. And while modern medicine saves lives, true health begins long before someone enters a hospital. With fresh, minimally processed foods, healthy lifestyles, and a return to the simple principles of homegrown and homemade nutrition, just like where I grew up in Mansfield, prevention starts at the table.

I frequently have pondered the why, why I feel so passionately and continue to fight for the reform of our medical culture. My patients are getting younger. Many more have bad disease. Even some of my elderly patients are diagnosed with aggressive diseases, and something clearly needs to change. And so, on other occasions, I've asked myself, what is the difference between reflection and vision?

Reflection asks how well we did to care for our patients, while vision asks, how can we create fewer patients? Initiatives like Farm-to-Hospital remind us that healthcare extends beyond hospital walls and begins in our homes, our schools, our farms, and our communities. And so, I leave you with this thought.

As a breast surgeon, the program director of our nationally accredited breast program, and a person who can cast a pretty good stone across the pond. We can choose to make a difference in this community in South Central PA and throughout Pennsylvania. We can lead by example.

And I hope we continue to foster the growth and programmatic development of our Farm-to-Hospital program. We can reflect on the remarkable achievements of modern medicine, and our vision should be equally bold, a healthcare system that values prevention as highly as intervention. By combining scientific innovation with better nutrition, healthier lifestyles, and a stronger community partnership, we can move from simply treating disease to cultivating health.

I think when we can walk through a hospital and instead of seeing vending machines, we see fresh produce in the cafeteria, farmer's market. We can see options on the inpatient menu for healthful nutrition. We can go to the women's cancer support group and listen to educational discussions and watch the enthusiasm as cancer patients gather fresh produce to take home and transform their diet.

It really is bringing it full circle. Yet I know that there's so much more we can do on this campus and in the community. It is heartwarming to hear nurses talking about the veggies in the cafe and talk about the green beans that are so delicious. One of my colleagues stopped me in the hall and told me about purple green beans that are just the most flavorful green beans he had ever had and told me how he prepared them. So, I actually followed his lead and bought some purple green beans myself, and I totally agree. So, it's fun, exciting. It's been ambitious, and there's still a lot more that we can do to promote the vision of wellness. Heartwarming.

When I first started practice 30 years ago, it was a rare occurrence to have a patient in her 30s diagnosed with disease. Similarly, elderly patients usually had slow-growing, good-behaving cancers. And over the years, I've seen a significant shift in the character of disease within my breast cancer population.

A much larger percentage of women are diagnosed in their 30s and even some in their 20s. And similarly, elderly patients have more aggressive diseases than I ever remember. You know, we're coming a long way with the treatment of disease and outcomes are improving, and yet something is horribly wrong, seemingly so. I do see a tremendous problem with obesity, particularly in post-menopausal women. And that's a natural process as we lose our estrogen and our metabolism changes. But fat stores estrogen. And then, I think about our community and I drive down the street and I love Chick-fil-A just like anybody else, but the lines at Chick-fil-A and other fast food restaurants are never ending. And I think to myself what happened to the days where people sat down as a family and ate a home-cooked meal? And rushing seems to be the norm. And to that point then, we see these processed foods. People are drinking high-energy drinks and artificial sweeteners and lunch meat and, you know, all sorts of fried foods.

And so, I think, it starts somewhere. And the younger people are eating less healthy foods for longer periods of time. And then, all of a sudden people are obese. And that sets the stage then for cancer. I think it's all hand in hand. And we as healthcare providers have to lead by example. Exercise is the next most important thing behind nutrition.

And people need to walk. People need to get outside. And so, our campus really is poised to lead by example. But something's got to give, and we've got to start having those tough with patients about taking an active role in healthcare rather than a reactive role.

We owe a lot of our success for our trail, our Breast Cancer Garden of Hope, but most importantly, our Farm-to-Hospital program. There have been people who have been committed to the development of these three-pronged wellness initiatives. One is the Memorial Health Fund of the York County Community Foundation, the Powder Mill Foundation, First Capital Credit, Federal Credit Union, and York Excavating. And these organizations really have been incredibly supportive throughout the years, and we owe a tremendous amount of thanks to all of them.

But I also think there are other people in the community that are like-minded, passionate folk that really could be a great help as we continue to grow this program. For those that are like-minded with aspirations to make a difference in this community, I would encourage you to reach out to the Pinnacle Foundation, visit their website, and learn more about what we're doing on this campus and the outreach we provide to our community in York.

Caitlin Whyte (Host): Today, the vision Dr. Mudge describes is becoming part of everyday life at UPMC Memorial. From fresh produce in the cafeteria and patient meals to programs helping put nutritious food directly into the hands of patients.

But the story of the Farm-to-Hospital Program is about more than what grows on the farm. It's also about addressing food insecurity, expanding access to nutritious food, and exploring how food can become part of the way we support healthier patients and communities.

In part two, we will be joined by Dr. Andy Dessell, Director of Strategic Initiatives for the UPMC Pinnacle Foundation, to explore where the program is today and where it could go next. Thanks for listening to In Their Words. Be sure to follow the podcast. And if you enjoyed this episode, please consider rating, reviewing, and sharing it.