I don’t have the inspiration to ask Carol any more questions right now, because I have exceeded the limit to which I really want to be interviewed. They were intimate portraits for people who have never been introduced to my world, and they were questions I wouldn’t have asked of myself but based on what she read on my own blog. Sometimes, she pulled prompts from people who sounded like me; people also writing personal blogs. That’s because there are hundreds of web sites for bloggers with jumping off points. Again, I don’t use Carol (AI) to write my entries for me, but to analyze my past and give me hints on what I should write about next.

In the moment, I’m thinking that I should get out the immersion blender Zac got me and see if it will froth milk. If it does, the coffee my dad sent me to try would be the perfect cafe au lait. I’m drinking it with plain whole milk now (padding down the possibility of acid reflux). I love spice, tomatoes, and alcohol. All three are no good later, so I avoid them. Zac and I had great mocktails at the sushi restaurant we went to- just Asian fruit syrups that you wouldn’t think to put together, frosted with egg white. I also learned that AA has a different stance on O.O proof distilled spirits, because it’s not fermented to have any alcohol, rather than something like a kombucha or a beer. It’s not that they’re loaded with alcohol. That’s not the problem. It’s that tasting the flavor at all is a trigger for some people. It’s not the quantity that matters. It’s what you taste, even in something as innocuous as a Fentiman’s Curiosity Cola, because they use fermentation for CO2 instead of infusing the soda with gas later. It’s a balance with me. I want to be able to make great drinks no matter who shows up. I am not opposed to alcohol, but I am pretty solid about wanting to divorce stomach problems.

Therefore, coffee is one of my go-to favorites in creating nonalcoholic beverages, but I still have to be careful with how much I drink because the hangover is no sleep and lots of sugar to help fuel the manic call of workaholism when writing is your response to life. It’s a natural high and crash, so not as crazy as alcohol……… and absolutely no less a drug.. But, a few B vitamins, lots of water, and maybe a little more coffee on the way to work is all it takes to fix you and not two days of saying “a hangover at 24 is different than at 46.” The older they are, the harder they fall. I don’t make the rules.

When I first met Zac, I made the mistake of thinking that I was still a line cook. That my tolerance was still up at “Navy.” It took me twice of being absolutely so hung over that I threw up everywhere that I realized, “you are a different person now. Your tolerance is in the toilet. Let’s keep it that way.” The flip side of the coin is that I learned that Zac is a real boyfriend. I learn that all the time, but this was early days, so it’s a moment that sticks with me. I had luckily fallen asleep before I’d drunk so much that I was still plastered in the morning. That’s what gets you. When you’re still drunk, so you think you’re fine. Then, about 9:00, just about the time you get to work, you realize you have made a terrible mistake. I knew this in my line cook days, so I knew when I woke up that it was better to feel like ass at Zac’s house than it would’ve if I’d been drunk enough to wait until I was on the train to be in dire straits.

My beautiful boy sat a large glass of water with ibuprofen on my nightstand, along with a cup of coffee, and kissed my head. He had to get to work, but luckily he was working from home (at least for the morning), so I could sleep right up until we had to leave if I had to, or when the ibuprofen kicked in and I was again human. Ibuprofen is your friend during a hangover, because it’s an anti-inflammatory and stops your brain from swelling. Sudafed also helps by shutting down your capillaries. Tylenol is good if you’re in pain, but most of the time the pain is caused by the swelling and you won’t need both.

This is the one instance I would choose naproxen sodium over ibuprofen because it’s such a strong drug that you are unlikely to need a second dose. The problem with Naprosyn (what we call it in the US and in the South, pronounced “Napperson” most of the time. 😛 ) is that it wears off before it’s time to take a second dose and you’re stuck. Ibuprofen is king because you can take some more frequently. Fresh doses matter. I would also take a second dose 30 minutes before the time runs out on your dose so that you do not experience an interruption- i.e. all of the sudden feeling like walking is too much work.

Keep in mind that this is my experience from growing up in a rheumatologist’s house, a HIGHLY specialized form of medicine, and having been her medical assistant for a number of years. The only reason I couldn’t follow her to Methodist is that the hospital required you to be certified as an MA, and she didn’t require that of me in her private practice.

Let me tell you why this is my recommended advice and nothing you should take as seriously as you should with your own doctor.

I have fucked up. Like, really fucked up. I read something wrong and told a patient something that was a note to her, not a note to me. It was in the same place that she left notes for me to give the patient when I was calling them back to tell them about their bloodwork. 90% of the time, it was innocuous, like “you’re fine,” or “the doc says you’re fine, but you need to take some OTC Vitamin D pills.” or whatever.

So, in this particular case, the note said that the patient had rheumatoid arthritis and I told him that. I immediately regretted it because he completely freaked out. I understand him so much better now that I’ve had my own reaction to autism. A patient’s reaction is not based on a medical diagnosis. A patient’s reaction is to the stigma around what they have. This man thought he’d never be able to walk again, and I was crushed. I switched into minister patois and got off the phone. Doc called back and cleared it up immediately. That was in the 90s and I still feel bad about it, even though she was laughing on the phone with the patient within minutes, and none of it was at my expense. Therefore, it couldn’t have been so bad a mistake that I was going to be punished forever.

Because here’s what no one tells you when you become a medical assistant. You become as attached to the patients as the doctors, especially the ones you’ve seen over years and years.

Even half the doctor she is could see that I would beat myself up better and more often than she ever could, and it wouldn’t happen again. I kept my mouth shut about all sorts of things, but talked inside baseball with my dad and stepmom as I learned more on the job and got into the rhythm. Because of my childhood, I am DAMN GOOD at patient care, because it is a job I can do while ADHD. It doesn’t get so overwhelming because you’re only talking to two or three people at a time, and when you’re in a patient room, you have enough bandwidth to talk to someone and take notes at the same time- now patients understand that you’re filling out their chart based on their actual dialogue, not what they remember from the conversation at the end of the day. I don’t know how other patients feel about it, but my stepmother and I type like demons. It was never a problem in our case.

And because I’m an IT geek, I set up the first content management system in the office, called “Soapware.” I don’t know and I’m too lazy to look up whether it was bought out and turned into something else, or whether another company’s content management system became more popular, like Centricity. I just know that it’s possible, because it happened to me at University of Houston. WebCT was bought out by Blackboard. It wasn’t the same product, the way I have loved and hated WordPress over time.

In any case, I can’t think of anyone who needs a content management system more than a doctor, one that connects to an encrypted cloud so that the files are always up to date when the server goes down. All you have to do is either fix the server and re-sync, or replace the server and re-download everything. No downtime, especially with physical backups off-site AND an encrypted cloud. With backups off-site, you only have to sync a day to a week’s worth of files, not everything on the entire system. However, with the kind of internet connectivity a hospital has (the ability to move images in RAW- enormous file sizes- in seconds, syncing a backup would take less than an hour, depending on how many TB of information are missing on the fixed/replaced server. By images in RAW form, I’m talking about MRIs, CAT scans, PET scans, etc. They’re ENORMOUS, and yet the connection can transfer information to the radiologist in seconds.

I learned this when I had to have a CAT scan of my shoulder to make sure nothing was torn. The x-rays were taken on top of a tablet that costs more than a Lexus so that it was SO fast with SUCH a stable internet connection that the X-ray machine itself could transmit the images. I was impressed out of my mind. It’s the same with any procedure. Broken leg, mammogram, whatever. Images fly fast and furious. Because the images were so large, I literally got a DVD (4.8 GB of space) full of images by the time I left the office. Beat that with a stick. It was a miracle I still had a DVD reader on my computer, though. ;P

In a hospital or private practice setting, the CMS does not just stand for “Content Management System.” It also stands for “Customer Management System,” because even though patients aren’t customers, you manage them internally the same way. Every patient has a file, and all of those files need to go into a database that contains your name, your address, your insurance information, and every note the doctor has ever written about you. It is far superior than paper charts, because again, they don’t expire. The paper doesn’t yellow and the ink doesn’t fade. I think you’re only required to keep medical records for 7-10 years, but I’ve had good luck with doctors’ offices that have digitized records, because sometimes you’ve gotten within the window where something has been scanned in by a doctor that just keeps everything on the server in case the patient comes back.

I have never had good luck with meeting gay teachers as role models, but I have had several queer doctors and all of them allies. I like the axiom in medical school:

“What do I do if treating someone conflicts with my personal beliefs?”
“Find a new profession.”

Here’s the other thing that I would love to do if I actually thought I’d be worth a damn at medical school. I’d go into trans medicine, which in my world the connection is vegan cooking. It’s an area I know absolutely nothing about. I got interested in vegan cooking because I was bored with my current repertoire, and I had friends making insane dishes that drew me to it, like mushroom pate and amazing olive oil pie and pizza crust. Salad with only oranges and shaved fennel.

Everything weird and exotic to the palate, I just don’t like filters. No liver, no kidneys…. however, if someone orders fois gras for the table, I will take a bite of the corner just to taste the crispy edges. Everyone else can have the rest, because even if I only eat the corner, I’ll taste it forever and the burnt edges are as much as I can take, especially if it comes with raspberry jelly.

I like nose to tail restaurants, because my favorite meals are very simple. Excellent toasted bread. Bone marrow to spread on it. A simple table wine. Maybe a salad.

It’s Mel’s fault that I love dessert because she’s a pastry chef and tempts me all the time. She keeps saying she’s going to mail me a postcard, and I can’t wait. I just don’t put any pressure on her because she’s in the middle of opening a new restaurant that is going like gangbusters. She hasn’t said one way or the other if she wants me to promote her, but if she does and you live in the Norwich area, you’ll want to stop by. She’s got some amazing pictures and they’re already doing well, like only being open for a few months and already being able to pay off their business debt. That is some seriously good food. I hope they get a Michelin, because The Michelin guide isn’t about fancy. It’s a travel guide. Even tiny restaurants get three stars, but then they become three star restaurants and create their own traffic.

(It’s also a brilliant marketing strategy- planned obsolescence for the tires no matter where you live.)

This leads me to a really funny story. My car needed tires, all four replaced. So, I go to this place called “Bridgestone,” and because I didn’t see any branding on the side of the building, I told them that I would take any set of tires, but that I preferred Michelin because I’m a cook. I looked like a pretentious jackass because I pronounced Michelin in French because it’s a force of habit. I. AM. A. COOK.

They looked me deadass in the face and said, “ma’am, this is a Goodwill store.”