I am a physician not a nurse but the following surprised me:
She gave every appearance of being the sweetest little-old-lady you ever met. Her hair was snow white and drawn back in a bun. Her eyes were magnified by her specs until the color of her irises seemed to fill the space circumscribed by the gold wire of her frames like water fills a swimming pool.
As she walked down the hall there were traces of the girl in early adolescence who had begun to develop a slightly slumped posture only to be tortured by a well-intended mother who constantly admonished her “GRACE!! STAND UP STRAIGHT!”. Ultimately her mother had won that one and stand up she did. The lesson taught some 70 years before had been well and permanently taught and learned yet, although no longer ashamed of her breasts she was ever so slowly being bent forward by the constant forces of time, gravity, and osteoporosis into a posture of disobedience.
Every inch of her evoked memories of my own grandmother offering up a plate of warm cookies.
She explained she had had a cough for months and, only recently, had developed pain in her lower abdomen just above her pubic bone which seemed to be aggravated by coughing. Handing her a gown I asked her to disrobe and stepped out of the exam room. Later, accompanied by a nurse, I returned to listen to her lungs and prod her stomach hoping to find some clue of the cause of her symptoms. Grace set there smiling as if the next few minutes were nothing new to her at all.
Physicians get to see tattoos, piercings, and other body art typically concealed from the general public. Some are works of art, others are simply bad jobs. Some reflect military service, membership in fraternities, or the names of current or previous loves. Some denote gang affiliations or have served prison sentences; to the initiated these can be read as one might read hieroglyphics – which gang, how many years in prison, men (or women) killed. Some tattoos, though, require no interpretation. So it was with Grace.
“Ink” is rightly regarded as permanent but is definitely not. Over decades ink fades and diffuses through the skin so that the sharp line drawn twenty years ago becomes a faded, wider, fuzzy thing. Of course the canvas – human skin -- becomes stretched and wrinkled. After 60 years tattoos frequently resemble large smudge reminiscent of a pen-and-ink drawing on tissue paper which has been repeatedly wadded up, soaked in water, then opened back up and allowed to dry. So it was with Grace.
Only recently do women have tattoos or, at least, have many. As a medical student I was taught: “A woman with more than one tattoo has a positive serum test for syphilis until proven otherwise.” Reflecting that multiple tattoos denoted promiscuity of either an amateur or professional nature.
Beneath her long-sleeved dress Grace was covered with ink. These were not high-quality professional tats but appeared to have been either self-applied or, at the very least, by a non-professional. They had been done with what looked like the dark blue ink of the type my grandfather used to “brand” cattle’s ears. Grace’s ink, unfortunately, had not faded enough and, if you were over the age of twelve and could read English, required no deciphering. Curved above her areolae the words “Sweet” and “Sour”. Each breast bore the instruction “Suck Me”. Across the lower abdomen and on the inside of her thighs arrows pointed the way and were accompanied by written instructions. Three arrows pointed the way with the instructions “Lick Here”, “Eat This”, “Fuck This” clearly denoting what was expected of the man who had reached that point. Crude drawings of male and female genitalia dripping body fluids and a couple in the act of putting them to good use covered her abdomen.
Doctors learn, or at least try to learn, how to maintain a deadpan expression to cover their inner thoughts about what a patient says or does. Sometimes we succeed; sometimes not. I worked hard to do keep my jaw from dropping and to act as if grandmothers decorated with obscenities were an every-day occurrence in my practice. Grace did the same not mentioning the markings. It was as though between us Grace and I had agreed that what we both clearly saw was not there.
Mentally I calculated that she had been a young woman during the 1920’s and must have been one of the reasons that it roared. People can and do change and, even if she had not it was not my place to judge but this woman had presented me with a jarring dichotomy between the patient’s presentation and her past so clearly and carefully documented on the canvas of her skin.
A few more pokes and prods, some blood work and a chest x-ray and she was ready go to with a diagnosis of bronchitis and abdominal pain resulting from coughing. She smiled sweetly, offered her thanks and then walked down the hall on her shoes with the one-inch block heels clutching the strap of her large black purse in her left hand. She was wearing a long-sleeved dress covered with blue flowers which matched her eyes and hid a few secrets.