Essay: The Tattoo

Apr 9, 2015

EKG machines and other high-tech medical equipment are common in hospitals across the country. But as accurate and sensitive as they are, they can’t always answer the questions a doctor might have:

The images were dramatic. The young man was in his early 20s, and his shoulders, chest, and upper arms were covered with a swirling image of skulls, barbed wire, spider webs, and violent messages. The tattoos were, no doubt, meant to send a message to anyone who saw them. The images disappeared underneath the hospital gown that had been draped over him.

As a surgeon, I have seen my patients' tattoos become more elaborate over the years. When I was in training, old men often carried blurred and fading souvenir images of sailing vessels, pin-up girls, and birds. Somewhat younger men had blue daggers and women's names on their arms.

As the culture changed, more and more patients displayed an ever expanding range of detailed, colorful images. Some of them are truly striking. I have been moved by memorials to lost friends and children. The pictures are sometimes remarkable and evocative. On the other hand, I have also spotted some apparent world-class lapses in judgment and some unfortunate spelling errors.

I rarely ask patients about their body art. To me, tattoos are rarely conversation-starters like, say, a t-shirt, a jacket, or a carried book. If a favorite sports team proves to be a disappointment, the patient can change sweatshirts. Not so with body art. A sexy woman in a 1940s swimsuit looks a bit incongruous on the atrophic bicep of a 90-year-old man. Since I can never know if the person regrets or celebrates the decision to get the tattoo, I usually leave the discussion alone.

Nevertheless, the artwork often makes me stop and wonder. What story is behind that particular image? What was he or she thinking when they had that done? And, sometimes, that one must have hurt!

So, in the operating room, we gently transferred the unconscious, tattooed young man onto the table. His gown was unsnapped and folded down, then we cautiously removed the hard plastic collar. The nursing staff carefully washed the skin with sterilizing solution. There were several abrasions from the motorcycle accident that had recently broken his neck.

I placed the sterile drapes before performing his tracheotomy. As I did so, I noticed that many of the images had only been sketched and the spaces between them had been incompletely filled with color. Much of the artist's work had been left unfinished, apparently with plans to return for more sessions another day.

I pulled the last of the surgical drapes into position so that only the front of his lower neck was exposed. I wondered if he would ever see the images completed. His life was still a work in progress.

Lake Effect essayist and contributor Doctor Bruce Campbell is a head and neck cancer surgeon at Froedtert Hospital and the Medical College of Wisconsin.  He writes about his experiences in his blogReflections in a Head Mirror.