A Chef's Nightmare

updated 10/22/2007 AT 01:00 AM EDT

originally published 10/22/2007 AT 01:00 AM EDT

The flurry of raves was almost embarrassing. In 2006, Gourmet magazine crowned his innovative 17-month-old Chicago restaurant, Alinea, the country's very best. "A pitch-perfect palate," declared the New York Times. Besides awarding Alinea four stars, the Chicago Tribune dubbed its 33-year-old chef a "Haute Cuisine Hottie."

"It was an avalanche of attention," says chef Grant Achatz today. And it hasn't let up. Alinea's reservation calendar remains solidly booked for months with the names of guests happy to pay $195 for a 24-course menu, which has included such out-there creations as a whimsical take on PB & J (one perfect peeled grape encased in peanut butter and brioche) or a vichyssoise so deconstructed, it comes with eating instructions from the waiter.

Equal parts scientist, sculptor and food magician, Achatz (pronounced AKitz) isn't a celeb chef seen more routinely on TV than in the kitchen, where he puts in 17-hour days. Adding to the challenge: In July he was diagnosed with Stage 4 tongue cancer.

"'Young, successful chef has tongue cancer.' The irony of the situation is tragic to people," says Achatz, plainly uninterested in being a tragic figure. "People don't realize that 90 percent of what I do is up here," he says, tapping his head, with its chemo-induced buzz cut. "Anyone determined isn't going to let this get them down."

Determined he is. From early on, "I wanted to be on the cutting edge of gastronomy," says Achatz, who showed predilections as a teen working in his parents' St. Clair, Mich., diner, where he would slip curry sauce on the meatloaf or adorn omelets with herb bouquets.

After graduating from culinary school, Achatz worked at the Northern California foodie mecca French Laundry for chef Thomas Keller, who became his mentor (and for whom he named son Keller, 3; brother Kaden is 6). He later became the executive chef at Trio in suburban Chicago, and soon felt ready to open his own place.

During the fall 2004 planning stages of Alinea, Achatz was bothered by a small white spot on the left side of his tongue; it hurt when he ate spicy food. A biopsy came back negative, and Achatz tried to ignore the spot. "He'd tell me, 'I'm too busy to be sick,'" says Alinea co-owner Nick Kokonas. For over two years the pain came and went, and Achatz saw a string of doctors, none of whom lit upon the right diagnosis.

When the pain was at its worst, staffers would rush out to fetch him Orajel or Achatz would wedge chewing gum between his teeth and tongue. He kept cooking, but sometimes couldn't chew or talk. In July, a biopsy of his tongue brought a new diagnosis: Stage 4 cancer, meaning a large area of his tongue was affected and the cancer had spread to lymph nodes in his neck.

"Devastating," says Thomas Keller, among the first to hear the news. "A sick joke on someone so talented and so in need of his taste buds."

Young, fit and never a smoker, Achatz hardly matched the profile of the 9,800 Americans diagnosed annually with this rare form of cancer. Doctors were stunned and suggested the most common route of treatment: removing two-thirds of his tongue, plus radiation and chemotherapy.

"Their focus is 'Save this life,' not my passion or my soul," says Achatz, who also faced losing the ability to speak and swallow, quality-of-life issues for anyone with the disease. He sought other opinions until Dr. Everett Vokes, a University of Chicago oncologist, told him that, with a new drug protocol (see box), he might be able to avoid surgery. "He thinks the way I think about food," says Achatz. "Innovative."

So far Achatz has completed eight weeks of chemotherapy, which helped shrink the tumor. Now he is in phase 2: seven weeks of radiation and more chemo. The treatment has caused some nausea but, remarkably, has had no effect on his taste buds. (On a recent morning he popped open the first of his many daily Diet Cokes to find the flavor odd. "I thought, 'Damn, the radiation's affecting my taste.' Then I realized it was a Dr. Pepper.")

His illness grabbed headlines and brought in crates of get-well notes, but Achatz says he thinks of it only at the hospital. At home, the divorced dad focuses on his boys, who like to cook (homemade mayonnaise is a recent hit) and "love watching Gordon Ramsay."

At work, his creativity is undimmed. Fall brought thoughts of autumn leaves and pumpkins. That inspiration became a tempura pumpkin pie, smoked over burning oak leaves and served on a single branch, that delivers "not just a bite of comfort food, but a smell from a particular season."

He looks forward to how winter will shape his menu; to putting out a cookbook next summer; to opening future restaurants in New York and San Francisco, plus one in Chicago with a lower-priced a la carte menu.

But now, his priority is the 1,400 plates he and his 48-member staff will send out during tonight's dinner service. "I'm a chef," Achatz says. "My cooking, my art, has kept me going. Take that out of me, and there's nothing left."

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