When I do a physical exam of a new patient, if they have a tattoo, I ask them what it means. The answers have been varied and revealing. One woman uses tattooes of hearts to represent how long she has survived since trying to commit suicide. Another man has a tattoo of a wasp because it was a wasp sting that brought him into the emergency department where he was diagnosed with cancer (several other family members also got the same tattoo). Tattooes can have very deeply personal meanings and there is always a story behind them. Just think of the character Jackie Sharp from House of Cards and what her tattoo meant as a form of remembering people lost along the way in war and politics.

Tattooes can also be a way to represent belonging, whether that’s to an ethnic group, gang, the military, or religious affiliation. This article describes how some African tattooing came out of slave trading: people were marked with the tattoo of “their tribe” so that if the opportunity presented itself, they could be identified and returned home. This PBS page talks about how Polynesian tattooing was not just a job, but a lifestyle. Other tattooes boast of the number of kills someone has made, are used to brand criminals, or remember lost loved ones.

They can also just be liberating works of art. But as this Atlantic piece observes, they are a vital work of art, whose medium is living skin: “after the owner has died…the piece loses something essential in the process.”

The Ineradicable Stain project by Shelley Jackson is an incredible and thought-provoking work that literally tattooes a story onto volunteers’ skin (the story is still unfinished, if you’re interested in contributing).

I have long been interested in incorporating tattooes and the practice of tattooing in my next series. I think they’re a rich part of human culture that it only makes sense to give significant meaning to in a new world.