If you ask any Sickle Cell Disease patient how they stay healthy and out of the hospital, they’ll tell you one of the many keys is a well-balanced diet. Those who take their health for granted don’t know the often morbid reality of how a poor diet can be the final straw that sends an individual living with SCD into a crisis. For individuals with chronic illnesses, healthy eating isn’t just a passing fad done for Instagram, but a serious lifestyle choice that takes dedication, time, and knowledge. And knowledge about food is what gave Alex Garfinkel his career. Owner and Executive Chef of Balboa Catering, Alex is partnering with the Crescent Foundation this September to share his wisdom on clean eating and healthy meals you can make from the comfort of your own home. I spoke with Alex about the intersectionality of food and healthcare, and how wellness begins with what we put in our bodies.

Kiersten Adams: How did you create Balboa Catering Company? 

Alex Garfinkel: I have been cooking professionally since 2002, and in 2010 I did some traveling. I worked abroad for just over a year and I came home and I opened a close friend’s restaurant. Throughout all that time, I had some knee injuries and I had a number of surgeries. I came to the realization that due to my physical limitations, I can never really offer my mind, body, and soul to someone else I respected in the culinary world without the fear of letting them down one day. That itself is almost like Sickle Cell, the frustration of wanting to devote yourself to let’s say, the best chef in the world and being afraid to because one day Sickle Cell is going to hit and you’re just going to have to stop. That’s a deal-breaker in the restaurant industry. So I decided to do my own thing and I started my business. First, it was then called AG Catering in 2013 out of my parents’ house. But then one of the first jobs I was awarded was the Creed movie pre-production food program for 50, and then later a hundred people a day for breakfast and lunch. So I was doing that out of my parents’ house for about three months. Made enough money that we were able to take over our first supper club at a space in Fishtown in 2014 and we called it Balboa Supper Club. We were looking for a name and we couldn’t come up with anything good, then someone I was working with said why not Balboa because of the Rocky movie series, and I said that’s it. Let’s go with that. It was easy and it meant something to Philadelphia and it was relevant to our first job. 

KA: How have you come to learn about Sickle Cell Disease

AG: I guess it was basic awareness but no real understanding of it. I had an employee named Earl, Earl was a cook for almost two years off and on, and he told me when he first started, he had Sickle Cell. That meant there’d been times he’d just have to go to the hospital and he didn’t know when it was going to happen. It’s just a shitty situation, and I’m like, ‘okay, cool. Just let me know, whatever you need.’ While working with him, he had a number of episodes where he was out of commission, and it was really rough for him. At least as a boss, it’s frustrating not being able to have consistency in your employees, but then you understand people have things that are just well outside of their control. So that was my first experience working with someone who had [Sickle Cell Disease]. 

KA: What’s it like having to work around someone’s condition? How do you deal with possible inconsistencies?

AG: I have dealt with this issue through something called pericarditis. It is a very rare heart condition that’s genetic, and it took me out of work many times. You don’t know when it’s coming and when it does, you just have to stop everything and deal with it. It’s frustrating because there’s no real cure for it, it’s just something you live with. It’s not as dangerous or as painful as Sickle Cell, I think, but definitely the frustrating part of it is just not being able to control it. Not knowing what’s going to happen when it pops up. It just takes over everything that’s happening in your life, and you have to reprioritize to deal with that. It’s a hard thing for anyone to have to deal with but I was able to empathize with it [SCD] through my experiences with pericarditis. 

KA: Do you think living with your own health complications has helped you empathize with Earl?

AG: Definitely more so than I would have otherwise.

KA: As someone who employs immunocompromised individuals, how is indoor seating harmful?

AG: When you start looking at it from that perspective, that’s even more of an irresponsible and dangerous situation that we’re creating. The average worker in the hospitality field doesn’t have a lot of money, a lot of income, a lot of resources, no savings, barely scraping by, probably a lot of student debt or medical bills. Then you’re saying the only way you’re going to be able to get paid is if you go into those situations which may or may not be dangerous. That is another form of classism. I think restaurant owners and business owners are responsible for the community too. If they’re going to work, create a safe work environment. The only way to fix that is to put on social pressures through social media. That’s one of the more effective ways that could be used to fix it. Putting more social pressure, shaming, and spelling out the danger to people that aren’t really getting it. All they can see is I have to pay rent, I have to pay these bills. And in their position, their backs are against the wall. They’re facing, ‘do I give up everything I’ve worked for my life? Or do I try this? And it may be dangerous, but who’s really to say’. And so I understand both sides. And I think that ultimately from looking outward in, I don’t think anyone should be forced to work in a dangerous indoor environment right now, especially when guests are not wearing masks for whatever portion of time they’re choosing to eat or talk. 

KA: How can businesses be better safe spaces for employees who have this fear? 

AG: Open communication is something that I believe in. When I’m first meeting an interviewee, I tell them the pluses and negatives of work in my business. We want to make sure it’s a good fit for you, we want to make sure it’s a good fit for us. No one should have to be in an environment that is not a happy environment for them. Because it’s not going to produce a good product from the business’s standpoint, and the person is not going to be fulfilled. I think that discrimination is everywhere. A lot of businesses struggle to survive and the ones that are doing very well use discrimination as a business tool to make more money. But I think it’s a hard thing to say, it’s a case by case basis. And it’s based on a moral code, a code of ethics that every individual has; and that’s a society issue. There’s going to be, all over the world and in this country especially, tons of racism, tons of discrimination. They hear medical disease and an employer’s gonna say, ‘Look, I’m gonna make a choice. I’m gonna pick the person that doesn’t have a medical disease.’ It’s not the end of the world to have some workers with Sickle Cell as long as everyone’s communicating and being clear about their needs and the issues. Most businesses should be able to respect that and mitigate those issues to the best of their abilities. I’m looking at the value of the person and what they’re bringing to the table. If they’re overall great employees, that’s much more valuable than a once in a while hiccup that is out of their control. 

KA: How have you and your business been holding up through the pandemic?

AG: We’ve been doing all the various pivots you see everyone else doing from online zoom cooking classes to trying to sell meals. But we’ve been doing semi-regular small incidents like a party in someone’s home where it’s just family. We won’t do any public events and we’re keeping the numbers pretty low. We’re doing some outdoor events in people’s backyards, we did a micro wedding for 50 people outside. It’s just enough to pay the bills and keep our employees at work. And that’s how it can be for a bit until we see something else as far as the vaccine or federal intervention. 

KA: As we know, discrimination during hiring is a very real practice. Something many SCD patients, women, and people of color deal with regularly. How do you avoid these problems when hiring staff?

AG: Well A, that’s just discrimination. I’m pretty sure that’s illegal to some extent. B, I think that’s morally wrong. Whenever you’re trying something new with somebody you say, ‘hey, listen, let’s see if it works. If it doesn’t work, we’ll figure it out’. He [Earl] said he’ll do his best to communicate with me when episodes are happening. Then I came to realize, you’re not going to have time to give someone notice or make the phone calls. Maybe the pain is just overwhelming or mind-numbing and just takes over. I think for someone that has to have a job they need their employer to understand this is reality. If they don’t communicate it with their boss, they risk having a [pain] episode and risk that job because no one knows about it. I think that there are probably lots of young professionals out there that have to face that choice. 

KA: Many with chronic illness often won’t bring up their disease out of fear of discrimination, even if they feel comfortable — they might still be seen as a liability.

AG: They have every right to be afraid. They should be afraid. There’s discrimination everywhere. So they should be fearful of that. I may be a different case than the average person looking to hire. I run a very small business, and it’s people-oriented. So I pick and choose, try to find positive people that are putting out positive energy into the world to surround myself with. I look for passionate people, people that care about what they’re doing. I think that Sickle Cell is unfortunate, but it’s hard to find anyone without their issues in life or their problems that they have to deal with. 

KA: In your opinion why is it crucial for smaller businesses to make these pivots during the pandemic? Take for instance your online cooking class.

AG: Every industry is a little different from the pandemic. The restaurant and hospitality industries are suffering in a way that is unique to itself. Business owners by definition are going to be scrappy survivors. They’re taking the initiative to create something from nothing. They’re gonna find ways to survive. But then again, some industries like the restaurant industry are overly bloated and it has been for some time. While you’re seeing restaurants closed down for good and shut the doors right now, before the pandemic this industry was going to hit a bubble-bursting moment. For so many reasons the model just wasn’t working. Pay discrepancies between the front and back of the house, tipping wage is a form of discrimination and racism, there are so many issues with the industry that this could be looked at as a blessing or silver lining years from now. You’re seeing a very fierce fight right now between owners that just want to survive and can’t see the full distance of this pandemic. The indoor seating option, which a lot of people, myself included would say is a mistake. There is a sort of natural selection in the business growth and to have the legs to carry it through situations. It’s a very confusing, very upsetting situation for a lot of people out there that have put their livelihoods and all their savings into creating something and then losing it. It’s hard. 

KA: Would you accredit innovation to keeping yourself afloat during these times? 

AG: As far as where innovation really came from, today the changes we’re making are constantly just brainstorming what else we can do that’s different and might make money. We were just thinking the other day, what if we can get a movie screen and get a good projector; we can rent out a lot somewhere and have a portable pizza truck and bar. Through a collaboration with 13th Street Cocktails, Aaron Gordon who owns 13th Street is an amazing guy who builds custom bars and custom wooden pieces. In this case a mobile pizza bar. We’ve been doing micro weddings with it, but I feel it’s underutilized. So, how can we better utilize this pizza truck? Maybe come into neighborhoods and have a neighborhood buyout where it’s pizza and drinks for an hour. Innovation comes from necessity. Innovation comes from a hole in a market. There isn’t an industry [where] there’s no area for improvement or evolution. 

KA: Once we’ve moved beyond the pandemic, what do you want the culinary industry to look like?

AG: Post vaccine and when things potentially could go back to normal, I think that the wage gap between both front of the house servers and back house cooks needs to be adjusted and fixed. Servers relying on tips, that needs to go away. We need to figure out how to get rid of the tipping model and make sure people are getting a livable wage, which starts at $15 an hour minimum. I started my business back in 2013, paying people $15 an hour to start for prep, and for service, starting people at $20 and ranging up to $30. In some cases higher per hour, but we tip evenly across the board so everyone who’s worked in an event or involved with an event gets the same amount of money as everyone else. It’s a way that people get a good livable wage. I kind of built, to the best of my abilities, as high a pay rate I can handle for business. As far as restaurants are concerned, the tipping model is never going to work. Enforcing what I call a COVID tax. Put it on the state, put it on the government, but that money needs to go evenly to all the employees. There have been countless examples in every city, Philadelphia included, of chefs, owners, and managers being called out by employees for bad practices which is fantastic. That’s exactly how this gets fixed. 

KA: Why did you want to partner with the Crescent Foundation?

AG: We do a certain amount of charity events every year for various groups. I was actually surprised, it wasn’t out of the blue, but I thought it was great that they felt what we’re doing was so interesting. We’re happy to be a part of this. So when we got a chance, we talked on a zoom meeting and they [Crescent Founders] gave me a whole presentation and explained what Sickle Cell was in a way that I don’t think I ever really understood, and the impact it has both on the local community here in Philadelphia and around the world. It painted a different picture for me. 

As we move out of health and wellness week, Alex is a physical reminder that health and wellness is an internal journey we all have to find in our own time. To learn more about Alex and Balboa follow his page on Instagram here, and follow Crescent Foundation for all things adult SCD related here.