Anticlimactic Aromantic Acid Reflux

The leading image was stylized from an actual photo to depict the invisible yak no one else could see.

Thursday is our big family outing day. My wife and I take the boys to speech therapy, then to Chik-fil-A, and then we do all of our shopping at Costco, followed by the occasional Target pick-up order. We leave the house at about 2:30pm and get back at something like 7:00pm. This last Thursday, we left at 2:00pm so that I could get a few minutes in with my son’s speech team and record their testimonials about the app I made for him. None of this was particularly stressful. Yet as I pushed my children through Costco, something in my chest began to feel… well, wrong.

Just getting older, I told myself.

I brushed it off as my imagination when it seemed to be getting worse. I determined that when we got home I would drink several glasses of water. You haven’t been drinking enough water, that’s your whole problem, I told myself. How many times do I need to remind myself to drink more water before I finally stick to it?

I have progressed to the point in my career where my job is basically to make decisions and give, to use the modern term, prompts. I prompt other humans to do work. There are about two hundred people trying to get on my calendar and about two dozen of them have some form of direct report to me. I’m in the middle of offloading one leg of my work to new recruit so that I can start doing some design work for next year, which has temporarily spiked my meetings. That morning I had felt under the weather, so I laid down on the floor of my office and made decisions and gave prompts for nine hours with my eyes closed and a cool metal water bottle on my forehead.

You fool, I thought, you didn’t drink any water during that time. You were yacking away trying to get requirements completed for the next build and you dehydrated yourself. You didn’t use that water for anything other than cooling your giant buffalo head.

It doesn’t feel like dehydration, a smaller part of me thought.

At checkout, as occasionally happens, my oldest son decided to throw himself from the cart. The seatbelts are too small for him now, so he can basically burst out whenever he gets fed up. My wife and I have a routine for this, so I announced I was going to take him to the van. He put his hands over his ears, which is awkward because I have to hold his hand, but then at the last minute he started steering us away from the exit. He had never done that before, and I didn’t have the will to fight him. Plus, I was curious.

As an invisible yak began to slowly sit on my chest, my eldest son led us back to the toy section. I hadn’t realized his sense of direction was so strong. I felt proud of that. He grabbed a box called “Emotional Support Toys” with a bunch of stuffed… charcuterie. Cotton-stuffed sausages and cheeses on a little tray. Charcuterie toys for kids? Okay. Whatever. “This one, dada.”

I need to move beyond the point where if he asks for something, he just gets it. We’ve had so much trouble getting him to speak that’s been the rule for years. He’s communicating enough now that real discipline is possible. I think he’s going to grow up to be level 2 or maybe even level 1 autistic. But again, an invisible yak was slowly starting to sit on my chest, so I just grabbed the box and took him to the self-service line. The hardline discipline stuff could start later. I must need to burp really badly. Let’s hurry up and get outside so I can do that.

I became slightly aware I was diagnosing myself in terms of convenience.

I forced myself to burp when we got outside.

It didn’t help.

We found my wife and baby already at the van, and she began to scold me for not calling to let her know about the charcuterie toy because she thought we had been leaving the store. She was surprised when we weren’t already at the van waiting. “What if he had eloped and you were chasing him around and I wouldn’t even know! What if he got hit by a car and you were taking him to the hospital.”

It had only been three minutes and I thought she saw us walk back to the toy section, I explained. I had waived to her and she waived back when we made the course change, but I knew better than to bring that part up.

She wasn’t having it.

I apologized and explained that it was hard to do use my phone because I needed both hands to manage our oldest. She was also not having that. I tried to burp again quietly but she spotted it with the eye of an eagle and accused me of “burp-farting.” This will be important later, but burp-farting is a vulgar term I hate to even type that she invented the week prior when I had unexpectedly started burping after our previous family outing. I had tried to go away to do this quietly on my own, assuming something had been wrong with my sandwich, but my wife followed me around the house asking what was going on with me that I needed to burp-fart so much.

I said I wasn’t sure and to please stop calling it burp-farting at least in front of our children.

The baby was happy when I put him in his carseat and gave him his bubble pop toy. I fretted over him a bit and realized I forgot to buy him a toy and decided to do that when I got back home. I try to make sure they get equal toys and attention. His oldest brother can suck up a lot of mindshare so I try to be deliberate about making sure the little guy gets his fair time. My wife was still scolding me about my poor communication, so I forgot to tell her about the sensation in my chest.

I’ve never had to burp like this before, but I don’t even feel like I have to burp.

I tried to burp again before we left. It didn’t help.

Tightness and pressure.

No burning whatsoever.

We stopped at Target and the Girl who Dresses like the Ghost of a Dead Deer brought out the groceries that Costco doesn’t sell. She’s a friendly Pacific Northwest weirdo, where she presents herself as psychotic but is otherwise affable, and she works the Target car pick-up every other visit. I feel like I know her the way you come to know someone whose name you still haven’t ever had cause to ask. She doesn’t wear a name tag and I think her bosses are already so scrambled because she dresses like the Ghost of a Dead Deer they don’t even ever bring that up in discussions. In much the same way her bosses were too scrambled to ask her about her name tag because of all the other stuff going on, I still hadn’t mentioned the yak sitting on my chest to my wife because she was still upset at me about the charcuterie toys.

I helped the Girl who Dresses like the Ghost of a Dead Deer load groceries into the back of the van. Then we left.

It was shortly after this, Dear Reader, that the yak began to really sit down on my chest. Before this, the yak had been testing the waters, now it was settling down. At that point, I thought oh well… that’s definitely not a burp. I thought about my grandfather having three heart attacks. It then seemed very reasonable to me that I was having some form of cardiac event.

As my wife began to list off all the various ways I could have called her about the toy, if I’d really wanted to, I started to do a mental calculation. I was in the Black Hills. There wasn't really any spot to pull over. My wife can drive but does so very rarely and she gets nervous. Swapping her in as a driver was not a good call and the last time we had tried it she got so nervous she drove up on a curb and broke the seal on a tire and we had to get it fixed. That was ten years ago. The fastest ambulance wouldn’t be able to get there before I could get home and a quick check-in with my body showed that nothing was trembling and my vision was good. I was in tremendous pain but still functional. I knew I could make it home. I made a decision to be completely calm and put my focus on my breathing.

“Why aren’t you taking this more seriously? All you had to do was just say ‘Hey Siri, text my wife that I’m in the toy section.’ I can do that when I’m with him and you’re way bigger than me.”

“Uh huh,” I said, breathing.

“You’re not even paying attention!”

We got home and I quickly unloaded the boys. Then the worst pain of my entire life started. I set down the boys because the yak started to wiggle. The pain of it radiated up into my jaw. Tightness and pressure. Weight. Stones being slowly pressed into my jaw from each side. Calm. Breathe and stay calm. In and out. Slow. Don’t do anything that’s going to spike your blood pressure.

I was now fully in the “Hurry but don’t worry” mode of emergency management, pushing my emotions off to the side while I made sure everything was taken care of. I did the last few tasks to get the boys inside the house and into their routine. All I had to do was close the gate. I calmly googled whether shooting pain up the neck was a sign of heart attack, and yup, it was. Then I told my wife in the most calm and polite way I could.

“I need to go to the hospital. I think I’m going to have a heart attack.” I did not add, because I am a master of communication, or I just had one.

She immediately teared up and started spluttering out all sorts of plans and I said something, which in hindsight was dumb, “I’m going to take the truck. I don’t want to panic you, the boys, or myself.”

My rationale at that time was a mishmash, but mostly that the hospital would take longer to get the ambulance to me than it would take me to get to the hospital because our community is small. I was in a great deal of pain, but the fact I could function seemed to mean something. The road to the hospital was also isolated and if I really did lose control the odds of endangering someone else were very small, and I could put the truck into a ditch. This again, was stupid. I think part of me also thought about my Identical Mexican Cousin who lives four minutes away, who is a Fire Chief, and all his neighbors who are first responders, and how my whole family would know about it if I called an ambulance and I definitely didn’t want that for… some stupid reason.

I kissed my wife, told her I loved her and the boys, in probably a weirdly dispassionate manner since my whole focus was on my breathing and then I got in the truck and drove to the hospital. I kept repeating to myself don’t spike your blood pressure, don’t let your heart rate get too fast. The whole time the yak was shifting around on my chest and the pain was radiating up into my jaw.

The hospital was less than ten minutes away, and I took the backroad. I did a Siri text to my wife every two minutes because she literally just yelled at me for not doing that for the charcuterie toy. I almost recorded a big thing about my life and how much our family meant to me but that fell under the "don’t spike your blood pressure, don’t get your heart rate too fast” rule. This almost made me start sobbing but I remembered how stoic my grandfather had been when he was dying and I shut that down right away. I was going to be polite and cheerful even if this was the end. The only real emotional thing I had was sadness at not being able to see my kids grow up and leaving my wife alone to raise them.

For those who don’t know, I had a weird religious experience when I was in my late twenties. I don’t talk about it a lot because it’s one of those things that sort of sucks the air out of a room and either makes people think I’m a stark raving lunatic or that I know secret spiritual things. I’m not a raving lunatic and I don’t think I have privileged religious insights. Nor do I want to start a cult and then do elaborate theater to convince myself and everyone else that God wants me to have sex with everyone else’s wife. The thing is, though, even if you want to call it a delusion, if you were to look at an fMRI of my brain and ask me a bunch of questions it would reflect that I know there’s a higher order to the universe and that death isn’t the end. That’s the internal state of how my brain works even if you think I just self-induced a psychedelic trip and took it way too seriously. I no longer fear death. I wasn’t going to go out being ungrateful for my life and for all that I’d been given because from my perspective God gave me a gift that He usually doesn’t give to people, and I would be refusing that gift by either panicking, being angry, or having a shitty attitude about what I was fifty percent convinced might be my death. For various other reasons, I also suspected God wasn’t quite done with me yet which is why I still thought I had a fifty percent chance to live.

Ten minutes later, I was in the ER, holding my hands behind my head like a prisoner of war to expand my lung volume so I could continue taking deep breaths.

“Excuse me, I believe I’m having a heart attack.”

I wanted people to say, “I can’t believe what a nice guy he was” if they had to wheel me down to the morgue later.

The person at the desk asked me if I needed a wheelchair and I shook my head. For some reason I knew I wanted to stay upright and keep moving. I explained my symptoms, in clipped sentences, breathing through the pain of the invisible yak on my chest that was definitely wiggling around.

I posted a Substack note so my wife and kids could find it later, as I could do this less emotionally than trying to send a message to her directly. I realized I had no regrets, and would change nothing about my life. You can’t help but love the world the way it is when even the bad things led up to the births of your particular children. I think having a good life insurance policy helped with this a lot. I know that God works in mysterious ways, so if I was going to kick the bucket there, then that was part of the plan and in some larger sense it would be the right thing to have happened. And my wife would get a couple million bucks to make things easy.

They let me go back right away. Next thing I know, I’m in an ER room, two nurses are helping me take my shirt off, an ECG was on my chest, a pressure cuff was on my arm, and a small vial of blood was drawn from my arm. Then they all just sort of… left.

I later learned this was because my ECG was clean, my blood pressure was elevated but not extremely so, and my heartbeat was fine.

It’s worth noting that my wife wanted to move back closer to our hometown before having children so that we could be closer to family, and that if you are a highly skilled professional you definitely choose to live somewhere other than than the rainiest place in the United States. I spent about twenty minutes just focused on my breathing and the pain in my neck gradually decreased. Nobody entered. Then, fuck it, I opened Claude.

This was hard as I had lost track of my cellphone and there was an IV in one arm, although not connected to anything and I was covered in cords. Eventually, I found it. I took a selfie of me smiling with a thumbs up in case this was the last picture of me ever alive, although by that point I was only about 20% convinced I was dying. I also took the selfie so I could get a picture of all my stats. Then I gave that to Claude and asked him to figure out what was going on, but having used all my Fable allotment that week I had to resort to… blegh… Opus V, who is smart but has an overly officious and somewhat smug way of communicating. Still, he did his duty and started figuring out whatever the doctors weren’t telling me. This made me realize I always need to leave some Fable in reserve. You don’t want to be on your deathbed without Fable. While Opus V processed my picture, I texted my wife to let her know what had happened so far.

Someone came in to let me know my bloodwork was fine and that I wasn’t having a heart attack and their body language projected they just didn’t really give a shit at that point because they perceived me to be a drama queen. They offered no explanation whatsoever for my continuing chest pain.

This made me wonder if I was having a panic attack. Except… no. I’ve had panic attacks and this definitely wasn’t a panic attack. Those also only ever lasted a few minutes. By this point it had been several hours.

My wife’s reply text also seemed… let down isn’t the right word, but when it seemed clear I was not dying I knew I was going to be talking about that Charcuterie toy first thing when I got home. She had already committed to the drama of me being at death’s door so this was powerful emotional whiplash.

Heroically, Dr. Martin Greenwald MD reached out and I asked if I could just call him. I put my phone on speaker and placed it on my chest. I was still in pain at that point but only about 50% of peak. I shared what I knew which is all my numbers were coming back good. Then I shared what I’d learned from Claude and he helped me run through several different possibilities, in such an efficient manner that I knew he would never ever establish a medical practice in Grays Harbor County.

I leaned back. At this point I should note that I somehow instinctively knew I should not lay down and had been sitting up. As soon as I leaned back the pain in my chest exploded. I sat back up and it receded. This meant I either had some hard to detect form of pericarditis or… sigh… GERD, also known as acid reflux.

Dr. Martin Greenwald, MD told me to ask for an antacid, which I would definitely not have been offered without his guidance. If this made the symptoms go away, then I was looking at reflux. If not, I should ask for nitroglycerin and just see what that did.

Rolling his eyes, the ER doctor agreed to give me an antacid. The pain reduced dramatically as soon as I consumed it. Note, this was now after all local pharmacies and stores were closed and they did not offer me TUMS, and I didn’t think to ask, although I did get a begrudging prescription for Prilosec.

A second blood screening confirmed I hadn’t had a heart attack. Dr. Martin Greenwald, MD told me I should still follow up with a cardiologist and do a stress test. The ER doctor was less certain this was necessary. You can guess whose advice I will follow.

Now in substantially less pain, the story of the whole situation began to take shape in my mind. I’d been too busy living it to apply much perspective. There would be something noble about having a heart attack from stress, but I don’t feel that way at all about having “quite bad but very treatable acid reflux.”

Put another way:

“He just loved his kids too much and almost worked himself to death,” just feels a lot better than, “that dumbass was drinking almost two liters of Diet Coke a day and now he can’t have four chicken strips without thinking he’s dying.”

At least on a narrative level.

I got home at close to eleven and got an earful about how the boys had been fighting over the charcuterie toy I had so thoughtlessly purchased. Everyone was still awake and no one was ready for bed.

Several years ago, after my wife had been watching too much genderslop on TikTok she made us do one of those tests to see who does the most invisible work taking care of the home and family. I won’t share what the results were, but the outcome is that we never, ever talk about the results. Because it wasn’t a real test and the deep minute by minute accounting of my day that she forced me to do wasn’t a real display of how busy I was compared to her, but just a fun internet thing. I’m very good at getting things done and she is very good at being stressed over how much needs to get done and it all sort of balances itself out. Sometimes I get grumpy about this but usually not for long because she’s doing the most that she can. She’s giving me every last ounce of what she can do every day, and I’m giving her all the dozens of pounds of things I can do every day. And we are both giving 100%.

Before you judge, imagine being married to a giant buffalo-looking weirdo who is constantly spouting off about trust in media. Who is always doing some weird new thing and running all over the place to vibe-code while you’re going grocery shopping. Who is constantly listening to podcasts while he chases after the kids because there’s some new AI thing he’s trying to stay on top of. We all have our things.

Taking care to keep my esophagus straight up and down, I got the boys ready for bed and everyone was incredibly pissed off at me. The baby put his hands over his eyes when I picked him up and shouted “no! No!” But when he was in his sleep sack finally he basically immediately fell asleep. Our oldest was pissed when I brushed his teeth while he was sleeping and I had to put him over my shoulder and carry him up the stairs.

Then I got chewed out for something like half an hour about the charcuterie toy and my complete lack of self-care and how it was impacting everyone else’s lives. Our oldest boy tried to put the charcuterie toy in the oven, and did I understand how dangerous that was? Also what was I going to do about my health given that extra time to exercise was out of the question?

After that the antacid and numbing agent the ER gave me wore off, and I realized I wouldn’t be sleeping. I just had to sit up and try to doze on the couch. I reflected that probably not sleeping very much and drinking absurd amounts of Diet Coke for the last three months was the primary reason this happened. When I reflected on my modest meal at Chik-fil-A, it didn’t seem like four chicken strips and a water could have done this to me, but alas. I was also laying down all that morning giving my stomach acid extra time to chew at its container. I texted my boss to let him know I wouldn’t be in on Friday.

I got three or four hours of sleep.

A Scene from a Baby’s Birthday Party

My father is seventy-one years old. Saturday was the baby’s second birthday party, so I guess he’s a toddler now. As soon as my father arrived he began chasing after several children and tossing them in the air. My aunt and uncle of the same age watched from the deck in awe at his sheer physicality. A few years ago, he worked on a logging crew as a choker. This is a job usually reserved for nineteen year olds who age out by the time they’re nineteen and a half. Uninhibited, he picked up the children of total strangers and attacked them with two curled fingers shouting, “Snake! Snake!”

Everybody loved it.

Later, he cornered me and my Italian uncle as the baby played with a pile of rocks he particularly enjoys. Although I am certain he has never heard the rule, he followed the story-telling convention “In late, out early.”

“The third time I did mushrooms, I was watching Equalizer 3.”

“What’s that?” my uncle asked.

“It’s an action movie with Denzel Washington,” I said.

Neither of us commented on the mushroom part in case we had misheard, but I shot him a look.

“One of my stepdaughters gave them to me,” my dad said, answering my unspoken question about who gave him mushrooms. Given his propensity to get married a lot, being told one of his stepdaughters gave it to him didn’t narrow it down much, since he never stopped thinking of his ex’s kids as his stepchildren. I once spent an entire day roofing a church with a total stranger only to find out several hours later that he was my stepbrother.

“I mean, should be you be doing that…” I said.

“Fuck, I thought I was in the movie. It was great. I was Denzel. I’m not even sure if you’re real right now. And I’ll tell you what, I’ve had vertigo ever since I got hit by a car a couple years ago and it was gone after the first time I ever did mushrooms.”

My kind, extremely Catholic Italian uncle thought for a moment before he asked, “So… what did you do?”

“I fucking switched it to the golfing channel. I figured if I was going to be inside the tv I could work on my stroke.” My dad laughed at the obviousness of the answer to this question.

If you had told me on Thursday night that I would be having a conversation with my father about his new hallucinogen habit by Saturday, at my two year old’s birthday party, I would have totally believed you.

Life is such a bizarre and beautiful mess.

Don’t miss out on it.

I have a cousin who is physically identical to me, but Mexican. His neighbors will often waive to me thinking that I’m him.

I can have polite conversations about God, but to me it’s like “Do I know that Cincinnati exists?“ I’ve not ever been to Cincinnati but I saw it out of a plane window once. I know Cincinnati exists beyond any reasonable doubt. For me, it’s not a debate. Cincinnati just is. The exact nature, attributes, and character of Cincinnati are up for all kinds of speculation.

There’s a pediatrician everyone raved about because he was so highly credentialed, then I looked into it and he moved because of a scandal where he cheated on his wife, impregnated one of his nurses, and then performed an abortion of his own child to hide the evidence except his wife still found out. There are also versions where the nurse never consented to the abortion. He made no records of doing this, was fined $3k by the state, and told to attend ethics training. I don’t care how pro-choice you are. Nobody should be that pro-choice.