Tattoos I regret: my first patient with Nazi ink

The patient is here in the emergency room with headaches, yet another patient not having an emergency, but its after hours, and we’re the only show open, medically speaking, here in Nome, Alaska.
He asks where I go to school, and I tell him Ben Gurion University, in Israel.
“I’ve wanted to visit Israel,” he tells me, “but I don’t think I can. I got some tattoos when I was younger, that I regret.”
There’s only one sort of tattoo that would make someone afraid to visit a Jewish state. I’m guessing he’s got a swastika, but it could be SS, or maybe the HH.
He won’t specify what tattoo he has, and I have no need to ask him to undress, so I never find out.
He’s a big guy, and not that old, but seems shrunken in the hospital bed. He has a mild, almost gentle manner, and sounds sheepish when he talks about the tattoos. It’s hard to imagine him part of a neo-nazi gang, but I’m gonna assume the tattoos signify more than a casual interest. I wonder how he got from there to here.
I tell him I couldn’t recommend walking around Israel with that sort of tattoo visible, but if he kept covered up he’d probably be fine, and there are enough religious groups where the men wear long sleeves even in the summer that it wouldn’t stand out.
The nurse gives him a shot of toridol and the doctor writes a prescription to fill the next day, and we suggest he stay on top of his med refills so he doesn’t have to come back here to the ER at night.
I didn’t imagine I’d be treating former neo-Nazis in Alaska. I suspect my former neo-Nazi patient did not expect to be treated by a Jewish medical student in Alaska either.
I’ve heard of Jewish doctors refusing to treat patients with Nazi tattoos before. To be honest, it never occurred to me in that situation, but I wonder if I would have felt differently if he seemed less contrite and sheepish, if I had discovered the tattoos incidentally.
I hope not. Their rules are not my rules, and I play on my terms, not theirs, and tonight that means a shot and a prescription.

[Nb. old draft that I’m finally getting up]



1. The backpack fits my body like a second skin. It feels good against the curve of my back. as it settles against my hips one hundred masks fall away. I won’t be a stylish new yorker, I may become a doctor but that won’t be all of me. But I can put on this backpack and walk for a long time.

2. The backpack fits my body like skin, like an exoskeleton, and home is where I lay my head, or where i have a friend, or nowhere. I met a woman who can’t return to her mother’s house unless she stops wearing dresses and calling herself Darlene. She just wants a place where she can live, with her cat. She has a friend upstairs in the hospital who’s in a bad way. She warned her friend “that is not working out for you.” “That” was cocaine. Her friend’s family drove up from Savannah to be with her, they aren’t allowing visitors, so her friends are worried. I know just how bad shape her friend is in from morning report; I say nothing. “I’m learning,” Darlene says, to take life one moment at a time.”

3. When the backpack is filled, I hoist it up and tighten the straps, but it still sags under its weight, pulling back against my hips, the buckle presses into my belly. My body sags under its weight.

4. It’s a stormy month to be here. The winds ground small aircraft and turn the Bering Sea into a milky green froth, like dishwater. The earth is gray with volcanic ash, coloring the mud that oozes and tracks everywhere when it rains, and coloring the dust storm whipped up by a cold wind blowing in from the interior. The wind grounds the commercial plane that was supposed to bring a sick baby in from one of the villages. The doctor orders the medevac. Wearing all of my clothes, I stagger forward into the wind like a drunk. The wind grinds dust and gravel against my skin.
On the way to the airfield, the paramedic tries to scare me. “They have polar bears where we’re going.”
From the Cessna Caravan configured with a stretcher, I watch the sun set over the Bering Sea and the snow-dusted bare hills of the Seward peninsula. Between the heavy bank of clouds and the low arctic horizon, the sunset is a long wedge-shaped streak of crimson shot against the surroundings.
When we descend, the pilot dances with the wind, dipping the plane from side to side until we hit the runway. I later learn that this is to prevent the plane from flipping over when it lands in such high winds. I want to snap a picture, but there’s no time- we’re picked up ATV to drive to the clinic.
The baby is fine. We medevac him anyway, stuffed down his mother’s jacket. The ride back to the plane is the coldest I’ve ever been. The paramedic is still trying to scare me about polar bears.

5. When it’s time to leave I find my skin has turned translucent in the subarctic light. Beneath it small blood vessels tangle like roots. My belly softened with winter’s lethargy. And my body has hardened to the backpack.