Ramping up for Springtime


Southerners eat weird things. Turducken, that Cajun concoction, is a good example: a turkey stuffed with a duck which is itself stuffed with a chicken. Weird.

Of all of the culinary delights the South has to offer, though, the ramp stands alone in the geographic isolation of its aficionados. Consumed almost exclusively by West Virginians, it is said to be an acquired taste at best. Ramps grow wild in moist places in the early spring and in flavor are a cross between onions and garlic. Botanically, they are members of the onion family. Ramp festivals are an eagerly awaited staple of spring in West Virginia. If you did not grow up in West Virginia, however, you should exercise some caution if you feel the urge to harvest some yourself.

My patients were a transplanted yuppie couple from New England out for a taste of Appalachia. They had harvested (illegally) some ramps from Shenandoah National Park and sautéed them up with some bacon crumbles and a splash of vinaigrette. Shortly thereafter they became violently ill and presented to the Emergency Department, retching in agony.

Ramps have no toxicity whatsoever (outside of bad breath) and so we undertook treatment for common food poisoning. Things took a turn for the worse, however, in short order. Both patients became increasingly agitated and even seemed a little delirious.

At first the staff wrote off their bizarre behavior as a sort of yuppie overreaction to a little tummy ache, but when their blood pressure and pulse rates began fluctuating wildly, we took a closer look. These two were sick. In fact they appeared to have been poisoned.

One of their neighbors had been contacted by them earlier, and he helpfully brought in some of the remaining ramps. These were not ramps; these were young lily of the valley shoots, which do bear some resemblance to ramps. Lily of the valley contains high levels of digitalis compounds that can be quite deadly if ingested. Now that we knew what we were dealing with, we were able to stabilize them, and they went home the next day no doubt in search of the next gastronomic new thing.

Perhaps they could consider making marinara sauce with freshly harvested inky cap mushrooms from the backyard, like the family that came in to see me a few years ago. Dad had picked the mushrooms with the help of a field guide that labeled them non-toxic and made the sauce himself. The whole family agreed that it was delicious but only the mother and father had become violently ill immediately after consuming it. The three kids were fine.

It wasn’t the mushrooms themselves that were the problem, rather it was the two glasses of Chianti the adults had washed down their meal with. Inky cap mushrooms are non-toxic generally that but they contain a compound that inhibits the breakdown of alcohol and leads to a buildup of extremely unpleasant toxins if you drink after eating the mushrooms. In fact one the oldest common names for the inky caps is “tipplers’ bane.” The field guide had neglected to explain that derivation.

Ah well, as we say in toxicology, there are old mushroom hunters and there are bold mushroom hunters, but there are no old and bold mushroom hunters.

Enjoy the coming spring. I’m going to get something to eat!