According to Chef Vikki, how to best to cook a filet is all about best managing the “Maillard Reaction.” The Maillard reaction is a type of non-enzymatic browning which involves the reaction of simple sugars and amino acids. They occur at far lower temperatures than “caramelization.” As the moisture on the surface of the meat evaporates, the juices become concentrated, forming the succulent brown crust chuck full of rich and complex meat flavors.

“Cooking is pretty straight forward,” said Chef Vikki. “But certainly there is an art to it that comes with experience.”

Chef Vikki coat the steak with olive oil and seasoned it, kneading lightly with her fingertips. She then preheated a heavy cast-iron frying pan over medium-high flame, adding approximately 2 tablespoons olive oil. She then seared the steak for about 5 minutes per side. After it was lightly charred on both sides, she put the steak on a plate and covered the plate with aluminum foil for approximately 10 minutes.

“It is essential to let the steak rest,” said Chef Vikki. “This lets the flavors settle and saturate the meat evenly.”

At approximately 6:31 PM Saturday, November 26, 2005, I was served. From the first bite, it was beyond delicious. It was melt in your mouth “spectacular,” a culinary perfection.

Well, right up to the last bite. It was then things took a turn. Centimeters before my gullet, the last bite stopped; and there it stayed. Next morning I walked on over to the emergency room at Northwestern Memorial Hospital.

Our healthcare system at its finest, revved into action. Peeps, pings, needles, x-rays, a few nurses, a few doctors and two GI specialists… after various diagnostic services, it was medically certain that I indeed had a piece of steak stuck in my throat. The proper term is “Steakhouse Syndrome.” Apparently, there is a slight narrowing of the lower esophagus that becomes more prevalent in older adults. It is seen in about 15 percent of the population. Not to put too sharp a point on it but it is there that things like “steak” can get stuck.

Anyway, I was told that the doctor(s) would perform an endpscopy which would dislodge it. I was told then that a follow-up procedure would be necessary to dilate the esophagus some. Dilation, like dislodging the steak, involves sedating the patient, placing a tube in the esophagus and passing the tube down to where the esophagus meets the stomach. As dislodging and dilation are near identical procedures, I asked why they just didn’t do both simultaneously. Technically speaking I was told it’s because, “they just don’t.”

Well, both procedures took about 10 minutes each. Tube in; tube out. As it was so brief and as the pharmacy included Versed and Deladid, the former a mild amnesia agent and the latter a synthetic heroin, the experience was incidental and not unpleasant.

That is, until I got the bill! That would have been a more appropriate time for the Deladid (not to be confused with “deluded” as in to deceive or delude consumers out of their money).

I have yet to receive the bills for the individual doctors that participated so this is only a preliminary accounting. The hospital total thus far is $8,381.85. Again, that does not include gratuity. Here is a list. I called the hospital’s Director of Finance, Mike Vaci to help clarify the charges.

- Pharmacy cost $451.85: Personally, I think this item is low. Sure heroin is cheaper on the street but I am certain if this charge were a tad higher, I would not be complaining.

- Radiology $264: God forbid I had swallowed a sharp metal object and just wasn’t telling them. I believe that this is a hospital CYA item. All things lawyers today, CYA is a must.

- Laboratory $462 for the emergency room visit and $816 for the follow up procedure for a total of $1,278: I am told it was for blood work and subsequent tissue samples. The added tests showed nothing out of the ordinary. I think (again for insurance purposes) that the hospital is obligated to confirm and reconfirm that it was indeed and only “Steakhouse Syndrome.” Just what if the steak and it being stuck were coincidental? The lawyers need to be sure.

- Emergency room $1,791: I was there for less than two hours. It would have gone much quicker if the GI doc had been readily available.

- Diagnostic services $2,216 in the emergency room and $1,766 for the follow up procedure for a total of $3,982. These charges are for the actually procedures. That take away lesson here is that redundancy aside, dislodging is more expensive that dilation. One would have thought that as dilation also uses a small balloon in the tube that would have been more. Anyway, the question is here whether the total of approximately $4,000 is worth it. I am assuming that it is high due to the fact that of all the medical specialties to pursue for a doctor, gastroenterology has got to be the grossest, i.e. with constipation, diarrhea, vomiting, etc. Simple, it’s supply and demand; maybe there are not a lot of GI guys to go around and they can command top dollar.

Now, for the record, I am NOT accusing anyone at Northwestern of puffing the bill, per se. Vaci says their pricing is competitive. He says the problem is systemic. However simple the procedure, you’ve got a whole series of sincere professionals “just doing there job.” Unfortunately, the result is a steak costing more than $8,000.

Bottom line: Cost of healthcare is totally out of control and totally without shame. In the end (not at all meant as a dig at proctologists), an $8,000 piece of steak is silly by any measure.