Excerpt: Shapeshifters; On Medicine & Human Change by Gavin Francis
In the Sherlock Holmes stories, Arthur Conan Doyle implies that the discerning detective can learn much about a person from their tattoos. ‘I have made a small study of tattoo marks,’ Conan Doyle has Holmes say, ‘and have even contributed to the literature of the subject.’ The tattoo is valued as a living testimonial to the life history of its bearer – as valuable to the physician as to the detective.
Often, when I roll up a sleeve to take blood pressure, or pull up someone’s shirt to listen to their lungs, I see tattoos that ordinarily go unseen. Some are about family allegiance: the names and birthdays of children, or fidelity to a particular partner. Some tell me about military tours of duty, or time spent in the merchant navy. Tattoos of bikers, soldiers, sailors and prisoners all bear witness to membership of a closed, strictly tiered society. I remember opening a shirt to test a man’s belly for appendicitis, to see his torso inscribed in a flowing copperplate: ‘worrying is praying for the worst to happen’. His tattoo was a kind of self-uttered enchantment: he told me that since getting it, his lifelong anxiety had gone.
Tattoos can be helpful to the clinician in a very direct, practical way: one patient of mine could point to exactly where among a writhing sleeve of snakes to plunge a needle to be sure of getting blood. Sometimes skin is tattooed to show a radiotherapist exactly where on the body a tumour is to be targeted. Some are about forging an allegiance between the present and the future self – a lifelong keepsake of how its bearer used to be: a flower at the ankle, a rosette at the base of the spine, a cartoon character on a shoulder. And I’ve seen some that are emblems of transcendence and celebration: a phoenix rising from the ashes of a mastectomy scar, a garden of flowers blooming over stretch marks.
Tattooing must be among the earliest of art forms – the body as canvas, as symbol, as commemoration, as welcome, and warning. They’re frameless works of art, transformations of the body surface – itself subject to ceaseless change. They break down the distinction between subject and object. Sometimes they’re dismissed as something you’d get on impulse, but for most people, getting a tattoo is painful – as the poet Michael Donaghy pointed out, you’d need a ‘whim of iron’. The word is Polynesian – it came into global usage with the voyages of Captain Cook, and refers to the ‘tat-tat-tat’ repetition of the needle as it punctures the skin (the drum roll ‘tattoo’ of a military band has the same origin).
It can be the puncturing of the skin that brings a tattoo to my medical attention – infections, blistering, sometimes inflammatory reactions to ink. Psychological reactions too – around half of tattoo recipients regret them. In the United States a quarter of all young and middle-aged people have a tattoo, and there are more than 100,000 tattoo-removal procedures each year. James Kern, a tattoo artist specialising in transmuting unwanted tattoos into new designs, has written: ‘You will never have a happier client than someone who no longer has a tattoo that they hate. It destroys their self-esteem. I love the transformation physically and spiritually.’
Historically there have been hundreds of reasons for getting tattooed – perhaps as many reasons as there are people who have them. Anthropologists have listed a few: camouflage for hunting; to mark and propitiate puberty and pregnancy; to counteract disease; improve fertility; to mollify malign spirits. Some of the motives identified among tribal societies are just as relevant among my own patients: to take on new characteristics; to honour ancestors or descendants; to enhance one’s respect among the community; to frighten enemies; to make the body a register of life events; to beautify oneself; to express an emotion (patriotism, love, friendship); to demonstrate group allegiance. Some motives seem unique to contemporary culture: as permanent facial make-up, or even to make money exhibiting yourself. … And there are more baleful reasons: being branded by a fascist regime; as an act of deliberate self-harm; or to relieve boredom in a prison cell.
Of the latter two, the tattoos of prisoners tell a story of bravado, isolation and violence, or affirm allegiance and status… Tattoos are a way of bringing disorder, playfulness and creativity to a body living within the drudgery and order of the prison. The body in chains comes to tell a story of its own liberation.
Excerpted with permission of Profile Books from Shapeshifters: On Medicine and Human Change by Gavin Francis