Winemaking through a doctor’s eyes part 1: the process

The last thing I expected to happen on my wine sabbatical is that I would feel so much a doctor. Everywhere I look, I see analogies between winemaking and health care, both preventative and clinical. In this series of stories, I will take you on my journey as a doctor learning about the winemaking world, and show you what I see. This is part 1: the process of winemaking 😊

A pump machine to add oxygen to the wine to preserve good aroma's... or... a heart-lung machine in the hospital?!

Through the eyes of a doctor

Imagine you are an emergency medicine doctor, working at a medium-sized hospital. The emergency department is equipped with material for the reception and treatment of persons requiring immediate medical care. Your shift has been quiet. The weekend has only just begun. You and your colleagues received 2 patients this morning: an elderly lady was admitted with pneumonia and a baby boy was analysed for falling on his head. No biggies. You walk through the corridor and look into room 1. You see your fellow doctor giving oxygen to a patient with an asthma attack, by putting an oxygen mask on the patient’s face. You continue walking to the reception area. In the background you hear the nurse at the reception desk talking on the phone: ‘A large accident with a bus on the highway you say? How many victims do you expect?’ You assume he is probably on the phone with the ambulance control center. He continues: ‘At least 20! O my. Yes we have rooms prepared, let the ambulances come in.’

Prioritization (triage) of patients in a hospital, picture from a simulation

You feel the adrenalin pumping through your veins and prepare yourself for the patients that are expected to arrive. You page the intern who is on standby and start explaining the process to her: ‘A large accident has happened with at least 20 victims. We have to scale up and prepare ourselves. First, we will prioritize the patients based on severity of injuries. This is called ‘triage’. The patients who have already died are selected out. They go straight to the morgue. The patients who we can save are given treatment, such as stabilizing medication and surgery. They then go to the recovery room. From there, they will go to the general ward for full recovery. We observe and monitor them daily for an optimal result. Finally, they will be discharged either to a nursing home for rehabilitation or to their homes.’

Now, let’s switch perspective:

Through the eyes of a winemaker

Imagine you are a winemaker, working at a medium-sized wine estate. The winery is equipped with material for the reception of harvested grapes in order to make wine. Your day has been quiet. The harvest has only just begun. You and your colleagues received 2 boxes of harvested grapes this morning: one box of Riesling grapes from old vines (wine plants) and 1 box of grüner veltliner grapes from young vines. No biggies. You walk through the corridor and look over to tank 1. You see your fellow winemaker giving oxygen to a red wine that is starting to smell with reductive tones such as rotten eggs, by doing a pump-over of the wine. You continue walking towards the reception area. In the background you here the cellar hand at the reception desk talking on the phone: ‘The farmers all started harvesting due to the expected rain? How many boxes of grapes do you expect?’ You assume he is probably on the phone with the viticulturist (the winemaker who manages the vineyards). He continues: ‘At least 20! O my. Yes we have tanks prepared, let the trucks come in.’

Sorting of the grapes in Portugal

You feel the adrenalin pumping through your veins and prepare yourself for the boxes of grapes that are expected to arrive. You page the intern who is cleaning tanks and start explain the process to her: ‘Rain is coming so we are expecting at least 20 boxes of grapes to come in. We have to scale up and prepare ourselves. First, we will select the grapes based on their condition. This is called ‘sorting’. The grapes that have become raisins or have rot are selected out. They go straight to the compost heap. The grapes that are in good health are processed to grape juice by destemming, crushing, and pressing. They then go to a first tank for the initial settlement. After that, they go to a second tank for fermentation; that is transforming grape juice into wine. We observe and monitor them daily for an optimal result. Then, they will be racked (taken of the dead yeast cells) and moved either to a barrel for ageing or straight to a tank for storage and bottling.’

Analogy winemaking & health care process

Two very different sectors, but 2 very similar sequences of events, don’t you think? In the graph below you can see a side-to-side comparison of the main steps in both processes, through the eyes of a doctor and winemaker.

Making patients better	Making wine
Large accident happens	Grapes are harvested
↓	↓
Ambulances with patients come in	Trucks with boxes of grapes come in
↓	↓
Patients are dropped at Emergency Department	Boxes of grapes are dropped at the winery
↓	↓
Triage (prioritization) of patients takes place	Sorting of grapes takes place
↓	↓
Pre-surgery antibiotics can be given to prevent infections	Sulphur / carbon can be added for stabilization and to prevent growth of unwanted yeasts
↓	↓
Patient is operated	Grapes are destemmed & crushed (and pressed in case of white wine)
↓	↓
Patient goes to recovery room to rest	Grape juice goes to tank for first settlement*
↓	↓
Patient goes to general ward for recovery	Grape juice goes to fermentation tank to transform into wine
↓	↓
Daily observations and measurements take place until the patient is better	Daily observations and measurements take place until the fermentation is done
↓	↓
Patient is discharged to nursing home for rehabilitation or to their home	Wine is moved to a barrel for ageing or to a tank for storage and bottling**
...	...
Throughout whole process: washing, cleaning & sanitizing regularly	Throughout whole process: washing, cleaning & sanitizing regularly

*during the first settlement, which can be viewed as a resting period, the large particles in the juice sink to the bottom and the clean juice is then separated from the misty juice & sediment.

** red wine is pressed at this stage.

Generalizations & differences

Naturally, some generalizations were made in order to make this comparison work. Both the hospital and winery processes are more detailed in reality. Also, some steps are optional. For instance, giving pre-surgery antibiotics (patients) or adding sulphur or carbon (grapes) is not done by all doctors and winemakers, respectively, and depends on the condition of the patients or grapes. Another example: not all patients need surgery to recover and not all grapes need destemming and crushing before processing it to juice.

The sorting band (right), destemming & crushing machine (left) after a day of grape processing. This reminds me of the operation room in the hospital. after a day of work.

Furthermore, there are differences between the two processes too. In a hospital, only sick people come in, whereas in a winery only healthy grapes come in. And of course the comparison between a harvest season and a large traffic accident is a bit demoralizing to say the least. By most, the harvest season is perceived as a very joyful period of the year. The moment all the hard work in the vineyard is crowned by transforming the juice into wine. Nevertheless, the harvest season is very hard work too, just like the hospital work. Both are characterized by needing to adopt a marathon mindset, being prepared to work around the clock, and anticipating peaks in the workload due to unforeseen circumstances and events. And both sectors know amazingly dedicated professionals, giving their best to optimize the outcome for everybody. So summarizing we can say, yes, there are differences, but the similarities are larger.