The next patients were in their late teens, dressed entirely in black, and punctuated by an array of silver studs and chains. What skin showed was festooned with tattoos, the significance of which I could only guess—a simple “Mom” was not among them. While ostensibly here for an upper respiratory issue, it soon became clear that STDs were on their mind. A previous boyfriend had called, and it sounded like Chlamydia or GC was likely.
A dozen half-formed connections permeated my thinking: Gothic, Columbine, raves, plain ol’ weird. My mind drifted back to a study proposed for a practice-based research network: were tattoos or piercings a marker for risky behaviors? Did such patients have a higher risk of hepatitis or HIV? What was with all these body modifications anyway?
An article in this issue of the Journal of Family Practice offers interesting insights into these questions (“Piercing among adolescents: Body art as risk marker,”). While the population studied is from Switzerland, I suspect many of the report’s findings are transferable to the US. And though concerns about STDs and drug use are not entirely misplaced, we need to remain mindful that our mental profiling can quickly slip into prejudice.
For as I talked to this couple, I was surprised to hear their articulate discussion of college plans, predictable problems with parents, the desire to travel and see more of the world, and a curiosity and naïveté belied by their appearance. They claimed neither to drink nor to use drugs, though they readily acknowledged the availability of recreational substances. They believed in long-term relationships and monogamy. In short, these kids could have easily been poster children for well-adjusted teens, if you saw beyond their body art.
And while I really struggled to be comfortable with the piercings and tattoos on all those body parts (that has got to hurt!), I was once again reminded how privileged we are to enter the lives of our patients, and that appearances are only skin-deep.