Ink, Silence, Connection

Much of my career was spent in the space where two lives share one body. Shock comes

in many forms. Sometimes it walks into the room covered in tattoos, skulls and

swastikas, forcing your pulse into your throat before a single word is spoken. Sometimes

it is traumatically woven into a woman’s body, stitched there long before you ever meet

her. And sometimes it is the kind of shock that passes between two pairs of eyes in the

instant a newborn takes her first breath, the truth recognized, the silence shared. These

are the moments that stayed with me.

I was not prepared for Damien when he walked into his wife’s room. His face was

covered in tattoos. His eyes were circled in black ink with eyelashes on top and bottom.

He looked like the Raggedy Ann doll I had as a young child. Skeleton teeth circled his

mouth in an oval shape, spreading onto his cheeks. He had a swastika tattooed on each

side of his bald head, above his ears. His neck was a solid black up to his chin, as if he

were wearing a turtleneck sweater. On his right hand, four fingers spelled L-O-V-E. On

his left, H-A-T-E.

Watching staff see him for the first time was disquieting. Some were visibly shocked,

others were repulsed, and at times, speechless. But he was gentle and soft, holding his

wife’s hand as I started her IV and giving her comfort with whispered words. During my

time with him, I found myself wanting to protect him from judgment based on his

appearance. In my years as a Labor & Delivery nurse, I learned that physical

appearances can be both telling and misleading, challenging me to remain open to the

humanity that lies behind tattoos, clothing, makeup, and jewelry. I think about his tears,

his gentle touch as his wife whimpered in pain, requesting more narcotics, which we

gave generously. She rested on her side, unable to sit straight due to the pain, and I

knew she would die shortly after delivering their third son from stage four colorectal

cancer.

Amina spoke no English, and her husband spoke for her. With his broken English, he

answered every question directed toward her. With a consensual nod, she refused

interpretation services, rendering herself virtually voiceless. She was expected to remain

silent throughout the entire duration of her labor and delivery. Her face expressed no

emotions, yet in her eyes, I saw deep agony. Her silence was where I heard her loudest

truths. Her withdrawal and detachment were as chilling as the sight of her genitals. She

was a victim of female genital mutilation. Her female anatomy had been radically

altered, the clitoris and labia removed as part of a ritual performed during her early life.

The associated scar tissue was prominent and added searing agony to her already

painful, unmedicated delivery. She was a vessel to silently and repeatedly bear children.

I was shocked when I felt forced to respect her cultural values even though they were

hurting her and rooted in patriarchy, power, and pain. He controlled every aspect of her

care, challenging everything I felt I should do.

Anna and Joe welcomed their newborn daughter Olive with joy. Joe was crying happy

tears. Anna and I were both silent, alternating between looking at Olive and looking at

each other. Neither of us spoke the words we both wanted to say, and Anna started to

cry. My own tears burned behind my eyelids. My heart was beating fast, and my sweat

carried the nervousness of the moment. Olive had good color but poor muscle tone. She

had a large tongue that she kept sticking out. Her hands were wide with short fingers

and a deep simian crease across the palms. Her big and second toes had a deep groove.

Her sweet eyes were alert but unmistakably almond shaped, and her small ears were low

set. I cried most of the way home that night, not because Olive likely had Down’s

syndrome. She was born to parents who would, without a doubt, love and care for her. I

cried because I had not summoned the courage to speak my observations in the room

with them. I cried because Joe did not know the news that would come the next day.

Silence filled the room and became a room of its own.

Damien whispered softly to his wife that pain medication was coming and offered to

adjust her pillows. He held her hand as I administered her IV medication. I knew she

was dying, and her pain was uncontrollable. The swastikas and skull face became

irrelevant as I witnessed love in its purest and most devastating form. I realized how I

had misjudged him. My wish is that more men could be this gentle as they step into

fatherhood, no matter what is on the other side.

As Amina’s labor worsened, she remained detached, miserable, and mute. Her husband

appeared attentive, even comfortable in his command, yet he showed no empathy for

her pain or discomfort. This was an exceptionally difficult case for me. I struggled to set

aside my own cultural and gender biases. Like her, I was forced to remain silent, despite

my desire to be her voice, her support, her caregiver. I wanted to help her break through

the trauma that lived inside her body decades after the brutal act was performed.

The next day, I visited Anna, Joe, and Olive on the postpartum floor. As soon as I made

eye contact with Anna, we both started to cry. I sat on her bed and we hugged and cried

together. I apologized for avoiding the truth with them the night before. I wished I had a

do-over, and I told them so. I had to learn how to have tough conversations with

patients and their families. I was beginning to understand how shock, when faced

directly, can transform into connection.

Their son was born. Damien stayed close to his wife’s side, crying softly into her face,

cheek to cheek, as she lay on the operating room table. “Will she be okay if I go?” he

asked as I checked whether he could go with their son to the NICU. I felt compassion

and empathy and told him that I would stay with her and keep her as comfortable as

possible. When he followed the baby to the NICU, he thanked me in a way that has

stayed with me through the years.

I knew how to handle the messiness of blood and bodily fluids as those are the

predictable parts of birth. What I did not yet know was how to sit inside the messier

truths, the ones that arrive without warning, knock the breath from your lungs, and pass

silently between two people who recognize the same truth in the same instant. Shock

comes in many forms, visual, systemic, and deeply intimate. It can disrupt our

assumptions, expose injustice, or reveal truths too heavy to speak aloud. I have

witnessed it in the tattoos that hid tenderness, in the silence that bore decades of

trauma, and in the quiet recognition of a newborn’s face, and in the ways bodies

communicate truths too heavy to speak. Sometimes shock strips everything down to

what is most human: love, connection, and the truths our bodies carry, whether we

speak them or not.