Veronica writes:
My story isn’t just a story, but a request for suggestions from the medical community.
I have a handful of piercings and tattoos: my navel and earlobs are pierced and I have a surface piercing on my left arm, as well as a tattoo on my lower left abdomen. I also play host to uncountable scars from my days as a cutter, scars that resurge when my depression overrides my meds.
I personally have not had much trouble with people and my scars/modifications. When I went to a dermatologist after a cutting binge, they did the whole “Are you a danger to yourself or others,” speech and I got to tell them that I was fine, but beyond that everyone has been great.
My fellow modified people, though, have had incredible difficulty receiving not only adequate but also professional medical care because of their piercings. One young man on a piercing site, BMEzine, writes of the time he was brought to the hospital after a car accident that killed his girlfriend and left him a paraplegic. He had a genital piercing when he came in. As a result, he could often, during his extended hospital stay, hear the doctors and nurses mocking him for it. Others have been forcibly admitted to psych wards because the on-call physician couldn’t believe that someone who wanted to modify his body was mentally sound. Yet another was flat out told that she deserved the infection she got (unrelated, as it turns out, to the piercing) because she had her nipples pierced. I fear that these stories are the norm and not the exception among the community.
Body modification can be dangerous. You poke holes in yourself, you risk infection. However, many young people have been dissuaded from seeking appropriate medical care because of the judgment that their providers pass on them. I do understand the need to assess whether your patient is of sound mind when performing these modifications…a tough call to make when someone desires castration, for example. On the other hand, it is no longer prudent to assume that someone who walks in looking like he or she was attacked by a box of needles is a drug-addict carrying every blood-borne pathogen on the planet. There are people who are otherwise totally mentally healthy, without delusions or pathology, who enjoy body modifications that are non-socially acceptable.
My question, which I direct to all medical personnel, regards how we can obtain better health care from you. To what, if any, treatment are we entitled? Should snide comments be expected if we have pierced unusual areas, or is it acceptable to request that the attending personnel keep their comments to a minimum? If our care is compromised because of our piercings/tattoos, i.e. being offered less pain medication or being “stabbed” with blood-drawing needles, how do we document and report it? How should we brush aside a psychological consult, especially those who do not possess a concurrent mental illness as I do? Piercers often have resources that mention modification-friendly medical personnel, but how could we go about finding those for ourselves? How should we prepare for medical emergencies that may involve the removal of unusual piercings, such as genital piercings or lobe-stretchings?
Thank you for your aid. If anyone wishes to contact me directly, I would like to compile answers and make them available to others so that our encounters with the medical profession are more pleasant.
Wow, that’s a lot of questioning! You are entitled to the same treatment as any other patient – respectful and complete. You don’t deserve to be ridiculed or made fun of. You deserve as much pain medicine as you need to be comfortable. I’d think it would be acceptable to request that your body not be discussed at the nurse’s station. People tend to talk about things they don’t understand to share their views with their coworkers to see what they think. It happens, but it’s not respectful to the patient. If you feel that your care is being compromised, ask to see someone in charge – this can be a charge nurse or shift/nursing supervisor. When reporting your concerns, be respectful, calm, and nonthreatening. People who get bent out of shape and start going off on us, regardless of whether they are tattooed or pierced, DO NOT get much sympathy from us nurses.
If after talking with someone in charge you still feel that your care is being compromised, by all means… ask to talk to someone even higher up. The manager of the unit, for example. I realize that hearing comments or feeling that your care is substandard would be extremely frustrating, but please try to keep your wits about you when speaking with Those In Charge. (And that goes for anyone with a gripe, btw). Unfortunately in this day and age, we can’t easily “vote with our feet” when we don’t like a hospital. A psychological consult should not be routinely requested just because a patient has a bunch of piercings, regardless of where they are. If one is requested anyway, just be yourself when the psychiatrist comes a-callin’. Don’t be argumentative, try not to be offended. If you are truly mentally healthy, a good psyciatrist will be able to determine this.
As for preparing for medical emergencies, I guess I’m not sure what you mean. If emergency medical treatment requires us to remove your piercings to provide care, I’m not sure what else you would have us do. Can you clarify the question?
And as always… if any readers have anything to add, please do so in the comments. My stance is this – to each his own. I have treated patients with unusual piercings (nipples, genitals) who were in comas… I just left the piercings alone and tried to clean around them when needed. Some nurses made some “ooooo, can you believe where she’s peirced?” comments, but they died down after a day or so. People like to talk about things that are unusual to them. Was it fair to the patient? No, but I didn’t see the comments as being disparaging, only curious. As always, if the patient were going for an MRI or something, all piercings would have to be removed to protect the patient. I don’t really think it’s a big deal and am not sure why others do.
I have been an Intensive Care nurse for 11 years. This blog is about my experiences as a nurse, and the experiences of others in the healthcare system - patients, nurses, doctors, paramedics. We all have stories!
Comments
Just as a comment- I was in the hopital recently, and had to remove all my piercings for the MRI scans. I wasn’t questioned about them and no psychological issues were alluded to, the doctor just said I had to take them out.
I’m sorry other pierced people have had problems, it never occured to me that anyone would though.
It seems to me that medical professionals, who would have seen body mod before in at least SOME aspect, would at least be, well, professional about it.
I am happy my doctors and nurses were.
added by Stacey on 08.13.04 11:44 pm | Permalink
I agree with geena. However I did think some of the things Veronica wrote about were disingenous.
These people do these things that are in her own words “body modifications that are non-socially acceptable”. If you do something that you know is “non-socially acceptable”, precisely because it is “non-socially acceptable” maybe because that makes a little “rebel” in your world, than why on earth do you expect some people not to voice their opinions that they find such silly things, well, silly?
added by Anonymous on 08.14.04 8:50 pm | Permalink
On the other hand…you would of course defend an interracial couple who received curious stares and unpleasant comments for their choice of partner, correct? There are things in our society that are not commonplace or acceptable, but remember that people are doing them. If you can’t see the correlation, perhaps you need a better look at history.
added by Turtle on 08.15.04 11:39 am | Permalink
Addressing the 2nd comment:
Body-mod isn’t about being a “rebel” but about using your own body as a canvas, creating art from living flesh. Some take it to extremes, some only have a tatoo here and a hoop there, but the reasoning is the same- to adorn the body in a way they find pleasing.
It’s very rude and judgemental to assume that those who have piercings or tatoos are doing it all solely for the “bad boy/girl” effect. Most times it has nothing to do with that. Sometimes it does, but they are the exception, not the rule.
So, if you find it silly, that’s fine. Just keep it to yourself- that’s the professional, and decent, thing to do.
*grabs her little soapbox and walks away*
added by Stacey on 08.15.04 12:28 pm | Permalink
However, many young people have been dissuaded from seeking appropriate medical care because of the judgment that their providers pass on them…
I agree that piercings and tattoos can bring on judgement from medical professionals. Whether the professional expresses negative judgement openly (possibly preferable) or very politely and without words, you can bet that the pierced one will be judged by some. It goes with the territory, and either you are dissuaded from piercing and putting yourself in that position, or you allow it to potentially affect your medical care or have fear of same. It’s a matter of your own priorities, and you will never change another’s opinion/judgement just as your own will not be changed.
added by Genie on 08.16.04 7:44 am | Permalink
I disagree with Turtles attempt to paint everything with one brush.
I classify the criticism by some bigots of inter-racial marriage as morally deficient. There is a moral component to that issue. So I will condemn such bigotry on moral grounds, just as I would condemn murder, rape, and stealing.
Body piercing does not have a moral component to it – it is neither moral nor immoral. It is something done for superficial, cosmetic, “aesthetic” reasons. It is perfectly reasonable to be critical of it as one is critical of lousy art or pottery – especially when it is the reason someone is in hospital with infections etc. For many of these people, as the original writer pointed out (Veronica) they do this precisely because it is “non-socially acceptable” (veronica’s words not mine) – a fact lost (or purposely ignored) by Stacey.
Thus Turtles argument that one should not be critical of “body-mod” just as someone should not be critical of interracial marriage fails. Perhaps if she can’t see the difference, she needs a better look at history, ethics, and moral philosophy.
added by Anonymous on 08.18.04 4:54 pm | Permalink
Stacey, I will not tell you how to think and what to talk if you will do the same with me.
It is petulant of you to suggest that keeping my opinions to myself will be the “professional thing to do”.
If you imagine that is true, kindly take your own advice.
added by Anonymous on 08.18.04 4:58 pm | Permalink
First of all, I just want to say, I love the debate. It’s fun to hit on a controversial topic sometimes, isn’t it? I’m glad we’re keeping it civil — at least mostly. :)
Now, I think that no-name probably misunderstood what Stacey was trying to say. When she said “keep your opinions to yourself”, I really don’t think she meant “don’t express your opinions in comments on people’s blogs.” I really don’t think anyone has a problem with hearing your honest opinions.
But the post was about whether it’s acceptable for medical personnel to treat body-modified patients with even an iota less respect than others. I think what Stacey meant was, when you’re acting in a professional capacity, e.g. as a nurse, keep your opinions to yourself then. That IS the professional thing to do. You might even say that 90% of what it means to behave professionally is knowing when to keep your opinions to yourself.
But you’re not commenting here in a professional capacity, so by all means, express your opinions honestly (but respectfully).
Does that clear things up at all?
That said, in reference to the original post, I am having a hard time picturing some well-pierced individual actually being “dissuaded from seeking appropriate medical care” because they are so worried about how their provider will judge them. Don’t you kind of have to decide that you don’t care what people think of you before you get all the piercings? Note, I am NOT condoning the poor treatment, just saying that someone who avoids medical care because of something like this would have to be just generally ashamed of their piercings or something. Doesn’t make sense to me.
One last thing — did you say that assessing mental health for someone who wants to be castrated is a “tough call”? That one doesn’t seem like too tough a call to me.
added by the kiosk on 08.19.04 12:51 am | Permalink
Wow. What a bunch of interesting responses.
What I’m getting is that since someone has chosen to look different, it is acceptable to treat that person differently. I’m having some trouble understanding why it is acceptable to do so, though. Is it that their appearance is threatening to you? Is it that you are not able to overlook things you find disgusting or unappealing? Do you enjoy making other people feel inferior? I am really honestly asking all the no-names how they justify making nasty comments to people they do not know on the based of how they look. You can of course judge for yourself. I’m not asking anyone to accept as attractive a stretched earlobe, but would you be able to keep your shriek of disgust private?
I cannot envision a case in which a nurse would tell someone with a lousy perm that her hair looks absolutely terrible, nor a doctor inform a patient that he should be ashamed of the way he wears his pants. When was the last time you got a stern lecture from a medical professional on your makeup or clothing? Perhaps it is the permanence of modification that “allows” comments unrelated to the matter at hand. As I said above, though, I cannot think of any situation in which airing your opinion to someone for the sheer sake of…insulting him? Hurting him? Belittling him?…would be acceptable.
Let me give you an example: I was a cutter when I was a child and I have several scars visible on my arms. When I went to an endocrinologist recently, she asked me about them, as is right. Scars are usually a sign of injury and the professional has a duty to ensure the patient is not a danger to himself or others, or in danger in any way. However, had she then seen a surface piercing that I had, it would not be acceptable (to me at least) for her to make a commentary on why I got it or whether it were acceptable to do so. Piercing and tattooing are not necessarily related to illness and are safe if done correctly. You’re in more danger riding in an SUV than you are getting your navel pierced.
As for the castrated: my understanding of the DSM-IVTR is that there isn’t a classification for a non-psychotic desire for castration or amputation.
added by Veronica on 08.22.04 4:57 pm | Permalink
Oops…I left out something.
Most people get their modifications because they feel they are beautiful, not to piss off society, rebellious teenagers as the obvious exception. In the case of a genital piercing, that is especially true. It’s not as if the man who gets a Prince Albert walks around flashing it off to random strangers on the street, not if he doesn’t want to get arrested. My modifications are all coverable and exist purely for their meaning to me and you’ll find, if you go to BMEzine.com and read the experiences, that most of the people there are like that as well.
I personally find dye jobs, breast implants, and ridiculous hairstyles ugly as all getout, but I manage to keep my opinions to myself. And certainly, most of those modifications are done for the benefit of others and not for oneself.
added by Veronica on 08.22.04 5:03 pm | Permalink
I just wanted to say that I agree completely with what Kiosk summarized Stacy as saying.
I’m just a green nursing student, but I’ve have been taught from the very beginning that maintaining respect and human dignity through professionalism in practice is paramount to the medical profession, regardless of how a patient’s actions may conflict with one’s own personal beliefs or value system.
Now, this idealism may not spill over well into practice, but I certainly think it should be a goal.
added by Manna on 08.24.04 6:51 pm | Permalink
Good call, Manna.
In nursing, anyway, this is one of the major fundamental ethical codes.
Assuring that someone is not going to cause harm to themselves and changing the type of care you give because of your own personal perception about a behavior or a situation are two entirely different things.
I think we forget that a lot…. That as a professional, you can feel whatever you want about a person. Those emotions, the morality, that is yours. But you can’t change the care you give them.
It happens all the time with obesity. I can’t count the number of times I have seen +OBESE written on a chart or a note and believe me, it has nothing to do with the status of the patient or the care they are being given.
We just need to remember what we are out there doing this for…
added by Miss FitsandStarts on 08.30.04 3:02 am | Permalink
In all the years I worked as a tech, I’ve been hit, had my breast pinched, called a ‘waitress,’ etc. But I did not hit back, I did not alter my care for these people, because they were PATIENTS. I tried to treat them as if they were my mother, father, children…as I would like to be treated. I’ve seen nurses withhold pain med from patients because they had a “psych history,” and the same nurses had alcholic husbands. That is socially acceptable, but seeking out psychiatric help is not, I guess. Self-medicating depressive alcoholics do not get the “Oh he has a psych history, he’s probably not reliable” routine…and this was in a coronary care unit.
Don’t get me started! lol
added by Margot on 08.31.04 10:24 am | Permalink
What a fascinating subject matter! And so many thought-provoking responses. As a pierced and tattood nurse, I am always DRAWN to the patients with body modifications and seek them out. So I am somewhat surprised to hear that others have experienced discrimination on this basis. Of course, I live in a very liberal urban area, so that may account for something. But I agree that descrimination is extremely unprofessional, perhaps even more so in the medical professions. Unfortunately, I am all too well aware that doctors and nurses can behave unprofessionally. I call my co-workers (both doctors and nurses) on it when I overhear things being said that are unprofessional and encourage others to do the same.
added by Mia on 09.07.04 12:38 am | Permalink
Oh my, tattoo stories…but first to address how to get better care from health care professionals. First of all, treat them with all the dignity and respect you’d expect, and right away they will start treating you in a similar fashion. It’s not 100% guaranteed, but works wonderfully in most situations. In some situations the old ‘tooth to tatto ratio’ prejudice comes into play and it won’t, but still treat them with dignity and respect so that at least you’ve gained the moral high ground.
But tattoo stories…well, tattoos are just like scars in that every tattoo has a story. Three favorites…
First, a patient who I noticed had a tattoo on his foot. Rather than just ignore them, I try to engage the patient in conversation about them, so I mentioned to him that I thought that was interesting, since I’d never seen a tattoo on a foot before.
He immediately warmed up to this and showed it off to me with pride. It was a home made tattoo, done by himself, and sure enough he had inscribed on top of his foot, “I’m tired.” I didn’t quite know how to respond to this, so I said something along the lines of ‘that’s interesting.’
But now he was really into showing off his handiwork, and mentioned that he had one on his other foot too, as he pulled it out to show it to me too. There, on top of his other foot, he’d tattooed “Me too.”
Second story has to do with the permanence of transient feelings expressed in ink and skin. This fellow had the most extensive tattooing I’d ever seen, all over his head, face and arms, but over a large portion of his body it had been completely covered in ink. I didn’t understand this at first, since he was intubated and couldn’t really explain it to me.
As he woke and I got to see more of him, figuratively as well as literally, it became clear that he had any many bizarre and at times offensive tattoos over his entire body. As time passed, he came to feel quite differently about what these tattoos were saying about him, so he was slowly but surely taking postage sized squares and tattooing them completely black and covering up what they’d once been. His long term plan was to completely cover his body with a solid black tattoo, the only option he now had open to change his mind about what he’d once been so intent on saying in body language.
Okay, one last tattoo story, a story about the story behind the tattoo. I’d been taking care of the patient with an BKA for quite some time, and had noticed the upper half of a tattoo that had lost it’s lower half to the surgeons knife. Fortunately his daughter told me the story behind this tattoo and explained what it was all about.
She said that one time it had been a nicely done tattoo of a rooster with a noose around it’s neck swinging from a gallows. Now that she’d said this, it was clear what it had been, and she said that he’d gotten this so he could use it as a bar bet. He’d go into a bar and use it to win bets that he did indeed have a cock that hung below his knee.
I’ve really come to appreciate the degree to which a person’s tattoos can be an extension of their humanity.
added by Nurse Zen on 09.15.04 5:32 pm | Permalink
This is a facinating subject, considering the ammount of petients we recieve in Emergency who do have tattoos or piercings to recieve care.
I personally have two tattoos myself, as well as my ears are pierced three times in my left ear, once in the right ear, and I have a labret piercing. I had a right side nose piercing but had to let it grow over.
I’ve mainly met patients who were curious about my tattoos, mainly because sometimes the lower edge of my egyptian cartouch on my right bicep does peek out from under my scrubs once in a while. I’ve had 90 year old ladies asking me about them, and if they hurt, but I’ve never recieved any sort of negative attention because of it from the patients.
Some of the Nursing staff, on the other hand, were surprised when I had gotten my labret piercing done. One or two had gone as far as making some rather disparaging comments to me, even though these were my fellow co-workers.
So what to do you when someone tells you that your piercing or tattoo is gross and that you’re a “Freak” for getting it done?
Do the same thing I did, and politely tell them to keep their mouths shut…espcially when they call you a “Freak” in front of the patients.
Not trying to rag on anyone here, but it just goes to show, that sometimes both sides of the fence can have the same problem.
Personally, I find alot of the negative attention towards tattoos or piercings are negative simply because they are irgorant or un-informed about modern body modification practices. I try my best to educate all staff from my personal experiences with tattooing and piercing, so that they can and do know that it certianly is not the same as it was back in the 70’s and 80’s. Most piercings and tattoo studios now have strict codes of material handling and body substance isolation certificates, that it’s even more difficult now get catch anything blood borne from these procedures.
I usually make it a point to ask patients who have expressed that they have piercings, if they can take them out in case they need to go for an x-ray, MRI or CT scan. Most are fairly compliant if the matter is approaced in a respectful and casual manner.
Remember, people with tattoos and piercings are people too. Just because they have these procedures done, and sometimes to extremes, doesn’t mean that they aren’t entitled to anything less than the best quality care you can provide for them.
After all, they are human too. They’re just permanently decorated humans.
~Kaylin
added by Kaylin on 09.16.04 7:44 pm | Permalink
I’ve seen a lot of patients with body art. My concerns are more medical than anything else. I do ask if the piercing or tattoo was done under sterile conditions – otherwise I offer screening for Hep B, Hep C and HIV. With cutters, I do want to screen for co-morbidity, especially if they are coming to me for prenatal care. I am concerned about genital and belly piercings during pregnancy and birth, and advise these moms to carefully watch for signs of infection or irritation as the body changes over the weeks. Counselling moms with nipple piercings about breastfeeding is also interesting. Nipple piercings are actually therapeutic for inverted nipples, but there can be milk leakage through the holes. I also suggest removing the jewelry when feeding the baby. The piercing that I actually find most problematic is the tongue piercing. This is because it bothers me to see people playing with it (click, click, click) and because of the dental damage that can be done. I am also aware of the risk of ingesting parts of the jewelry or worse yet choking/aspiration injuries.
added by alicia the midwife on 09.18.04 7:30 am | Permalink
Interesting reading.I am preparing an assignment on removal of piercings that go wrong in A&E as i am studying to be a nurse practitioner.
As I am heavily pierced myself I need to educate the staff on correct removal.
Thought it would be a great subject to knock the lecturers sideways.
Any comments would be great to get .Especially dermatological,plastics etc.
Hope you can help
Jackie
added by jackie on 09.27.04 2:16 pm | Permalink
i’m not a human
added by Anonymous on 12.17.04 6:45 am | Permalink
I am continually amazed at the amount of judgement that is passed on to other people, just because of the way their hair looks. I mean, come on, Hairstyles don’t determine what kind of person you are? It’s just a way to express yourself.
added by Hairstyler on 01.11.05 9:54 am | Permalink
The ‘cutting chic’ craze worries me more than the piercing.
In a busy ER, short of staff and resources, why should people who have been injured or fallen ill through no fault of their own have to wait while young attention seekers have their self inflicted wounds stitched and dressed for the twentieth time?
Perhaps if these spoilt and selfish people were treated after everyone else, no matter if that means waiting three days, they’d be less likely to waste everyone’s precious time in the future.
One should reward good behaviour and punish bad behaviour. Rewarding ‘cutters’ with the attention they seek is to encourage such behaviour to their own long term detriment. If they think that victimisation they shouldn’t make themselves victims in the first place.
added by Nick on 08.01.05 2:32 pm | Permalink
My son just celebrated his first birthday and I wore my belly and tongue ring during my whole pregnancy. The nurse only removed them because of an emergency c-section they had to perform. None of the doctors or nurses commented negatively on them. The nurse even kindly joked that it looked funny through the hospital gown because it obviously poked out. I am also a nursing student specializing in L&D and I will treat all of my patients with the same respect as I was treated. Remember, nobody is “different” we are all “unique”!
added by Janna C. on 08.10.05 6:37 pm | Permalink
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