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26 November 2008

Permanent Ink

I can remember as a teenager having my mother tell me repeatedly that decisions that I made came with consequences. This continued through college as she reminded me on a weekly basis that only I was responsible for my actions. In light of this, I was often not a spontaneous person, and in some ways, this has continued into my adult life. Take tattoos for example...

I always thought about getting a tattoo. The fun was in trying to decide what
to get and where to put it. I remember in the first season of "Road Rules" one of the contestants who was a pre-med student got a tattoo of Kermit the Frog wearing a stethoscope on her hip. I thought that was kind of cool, especially when I got into med school. But then, I started thinking... what would that tattoo look like when I was 80? Would that still be cool?

I trained at the V.A. during med school, so I had a great reference of tattoos as the WWII vets were mostly my patients. Following them, the Korean War and Vietnam Vets. A lot of them tattooed. You get to
see the effects of time. So I continued to ponder.

As a fourth year medical student working one of my first shifts on my E.D. rotation, I remember a patient who came in. She was in her 80's and as I examined her, I noticed that her tattoos seemed especially bright. I commented to my senior resident, and they too wondered how the tattoos could have stayed so bright all of these years. Finally, before discharging her, I asked her about her tattoos. She smiled as she held out her arms. She told us
that she had always wanted to get a tattoo, but that her husband had always been opposed. She said that when he died, about a year later she got her first tattoo. She now had her second. And, this had been within the last two years.

I was thinking about my own permanent ink fancies recently when I had a young female patient who came in with a complaint of "bloody urine." After a few minutes of discussion, "bloody urine" turned into abdominal pain, then she got teary as she described that she was really having pelvic pain
. As in most cases, I asked about her sexual activity, and she admitted that she had a single boyfriend but that they didn't use protection because she was trying to get pregnant.

I went through my usual abdominal exam, noting a fresh new tattoo that started above her bikini line and wrapped around her waist. I then explained that I would have to do a pelvic exam because she could have an infection causing her problems. She became more teary as I performed the pelvic, and it became clear that she was having cervical motion tenderness, one of the signs for pelvic inflammatory disease, a process most often caused by an STD.

She started to cry as I explained what I felt was causing her pain, what medications I would be giving to her, and further instructions for her care. She then admitted that her boyfriend had cheated in the past, and she was feeling very stupid because she had just gotten the tattoo. That's when I took a second look and noted a name as part of the design. It's not my place to counsel patients on how to lead their lives, but I silently hoped that the ink would be the only consequence of her relationship with this other person.

I still think about tattoos from time to time... maybe when I'm 80. Now, where would I put it?? Where are yours?


Julie said...

I have thought about the tattoo's and have decided that something I would hide 98% of the time wouldn't be worth it to me. I see these black blobs on old patients that I can't even recognize and it doesn't do a thing for me. But what ever sends you. Personally, I am not letting anyone stick a needle into me repeatedly unless absolutely necessary, LOL.

Claudia's thoughts said...

Also working in health care and seeing old tatoos I have decided not to get any....The people I talk to always seem to regret getting them...


Anonymous said...

I have 3 tattoos....

Claudia's thoughts said...

Another thought, Too bad most people do not heed the advice of consequences of their actions. It is amazing sometimes that one little mistake can change your life forever. Hope you are off today, and have a Happy Thanksgiving. My husband worked yesterday, guy came in with "the worst headache of my life" and then went out. It is sad when people die around the Holidays, it will be remembered forever as the day whomever died.


Melissa D. K said...

I have a medically relevant tattoo and love it. I had wanted a tattoo for years before I got it. I gave it to myself as a gift for working my butt off to get my MD!! It's hidden most of the time, but I got it for ME and not for anyone else.

a corgi said...

Happy Thanksgiving Veronica!

I want a tattoo but I'm like that elderly patient of yours, my husband doesn't like them so out of respect for him, I won't get one. I would get something on my shoulder out of sight. My son has the word "Cadillac" across his back. He obviously likes Cadillacs :)


Lisa said...

Interesting read. I have two, both are very special to me and I have never regretted them.

I have a black stallion on my right shoulder. He is small & represents my first horse, who has since passed.

My other work of art, and it is just that, is a portrait of my three labs...yellow, black & chocolate. It is their heads with each dogs special detail captured, the artist did a fantastic job. Since getting the tat 5 years ago, I've lost my black & yellow labs - I see them every day though and they will always be part of me.

Jeanie said...

The only tattoos I have are five little black dots given to me in radiology where they marked out where the radiotherapy was going to go. My neck, chest and under arm. I don't know how anyone can lie ther having them done 'cos those ones were uncomfortable and as I said they were only dots. I'm not brave enough to lie there and have one done.
Jeanie xx