Net Carbs

Tyler Clay

I don’t think you quite understand my role here. I understand your confusion; honestly, it makes a lot of sense, seeing as I am clothed in the same logo-emblazoned, sweat-wicking sport polo that your executive weight loss physician wears on a daily basis, and yes, the shirt is tucked into a pair of standard grey slacks, which, I understand, give off some semblance of professionalism and knowledge of medically related things despite not having a degree to my name, but the wardrobe I can explain, because as you see I am the only male employed here other than the doctor himself while the rest of the staff, as you and every other power-napping, hypermasculine CEO on my patient list have not-so-discreetly made yourself aware, are women of varying heights but unvarying bust size, made all-the-more obvious by our dress code, which grants me this performance-professional combo while puzzlingly denying even the phlebotomist a reprieve from heels, and your confusion is likely heightened because I am, of course, holding a bright red medical chart with your name on it, and I am, as always, holding two syringes (one testosterone, one vitamin B12, each of which will soon be emptied into your asscheek and stomach fat, respectively); you see the testosterone (that’s the one I give from behind, pants at your ankles, hands supporting your weight on the table because the glute muscles must be relaxed for it to go in without pain, the thick juice of vitality that I silently 18-gauge into your hairy ass—silently of course because I am comparatively young and full of vitality and you personally choose to express embarrassment of your ectopic masculinity with stoicism unlike the others who do so by poking fun at themselves or by droning on about the weather or that one guy who takes his gun out of his back pocket before pulling down his trousers) and the vitamin B12 (that’s the one that you have been told burns fat, and look how gloriously neon red the liquid is, you can almost convincingly smell the calories smoke away in a chemical blaze), but it’s not even these injections or my wardrobe that I imagine really gives you the wrong impression about my role in your Health Optimization Plan©—what must truly have led you to disclose that horrible news to me is how inextricably integrated into your daily routine I have become, the hour-by-hour meal planning that I provide to you, the HIPAA-protected messages that I must contractually answer any given minute of the day through our trademarked iPhone app, you know the messages: “how many more carbs can I have today?” (none), “are beans keto?” (no), “its my wife’s birthday i had cake, sorry” (understandable, pack jerky before parties like we talked about!), but of course I already knew you had cake, as I have access to your food logs through the app, a strange diary written in net carbs eaten and ounces of water drunk, meals skipped for work and meals binged for better reasons, steps taken and days spent sleeping by a hospital bed, a picture of your life in which I get to fill in the missing pieces, the meals I think were eaten with your family, the romantic dinners with your wife, the after-hours drinks with your employees, the after-hours drinks alone, all of this narrated by your occasional commentary when you choose to make notes—“it was my birthday,” “friend in town, sorry,” “got bad news, fell off the wagon”—and then on top of all of this, you see me so often, weekly for your injections, our secret passing off of vitality, and after those, I ask you how your week was, about any unforeseen complications in the strict diet devoid of carbs mandated for you, and maybe it is that, the weekly venting about how hard it is to balance the diet with your business, your children, your friends, and of course everything going on with your wife, maybe it is those brief moments between the injections and your weigh-in that made you think that I am the right person to whom you should reveal the results of your wife’s biopsy, her prognosis, the wrong kind of weight, the kind that can’t be removed like your belt before hopping on the scale, weight that can’t slough off with fewer carbs or nutritional labels or the right type of snacking, something an injection won’t fix or prevent, so yeah, maybe there was a bit of silence before I could figure out what to say to you, to just say I’m so sorry and then without skipping a beat to tell you to hop on the scale, taking everything out of your pockets first, wringing almost every last drop of weight from your body before submitting to my judgement of the life you lived that week, disciplined or not, that’s all in the number; that there is my job: to look at the number and to tell you what to do to make it lower when you see me again in seven days, when I will greet you once again and ask, “How was your week?” even though I already know.

-Tyler Clay is a third year medical student in the UNC School of Medicine from Concord, NC.-