Last Saturday night, I was watching the bartender shake and subsequently pour my salt-on-the-rim margarita, when I overheard another mid-twenties, Dwayne Johnson-looking bartender talking tattoo philosophy. “This first sleeve on the right, I don’t even like really, but I just wanted a tattoo then,” he explained before gesturing to his left forearm. “But this one here—see all the individual designs—is exactly what I wanted. This one’s meaningful.”
While the bartender and I shared a similar aim—meaning—my journey to permanent, dermis-layer modification included no dreams of stylistic expression; I never wanted a tattoo. Yet, his commentary made me glance in search of my own tattoo, which revealed itself from behind my cuffed button down as I reached with my left hand to accept my margarita.
There it was—two words that represent what I must never forget and serve as a talisman for what’s next.
When I was fourteen, my family vacationed in Destin, Florida with friends from my little league baseball team. Positioned at the end of July and early August, it was one of those gulf trips where afternoons last longer than night and day combined. One where you catch crabs for dinner. One where your sheets get sticky with aloe. And one where you witness tattoo fever.
With us on the trip was a teammate’s cousin, whose sixteenth birthday landed on the last day of the trip. There was no talk of driving. No talk of free, open road exploration. No, he spoke of one aspiration alone: getting a tattoo. For him, to be without ink couldn’t last a second longer than the second he turned sixteen—Florida’s legal age for the needled gun. As I witnessed his process, including choice in design, anticipatory worries about pain, and subsequent post-tattoo healing specifications, I thought, “Ya know, I’m good with my factory default settings. No thank you.” Too much commitment. Too much deliberation. Too much room for regret.
Then, freshman year of college, I witnessed a good friend get a different tattoo in Oklahoma—the last state to legalize tattoos in 2006. Two years before, his mom had passed from breast cancer and to honor her life and impact, he striped a childhood hymn she’d sing to him, down his spine. I always thought this aim was meaningful, almost additive; it was relationship and story.
Still, the next fifteen years leapt without a single tattoo impulse. Until the end of residency (one year ago), when life became difficult to envision without the tattoo.
During 2020, I subscribed to Ryan Holiday’s Daily Stoic Newsletter. The format is succinct, deliberate, and actionable—arriving promptly near 6AM Pacific time each weekday—and aimed at installation of the stoic mission: take responsibility. These emails were gospel that I never missed. In a time of mass uncertainty, the refocusing of my attention into what I did control was positively rooting. Each morning after stretching and stepping outside for the sun’s rise, I’d review the Daily Stoic.
By the spring of 2022, I noticed stoic mantras, lessons, and virtues were on my shoulder, offering counsel and informing decision making. I began asking myself how Epictetus (helluva name right?) would think about my looming medicine decision. What was my right way to proceed?
I was graduating from residency—something I never wanted but needed—and had designs on a more meaningful life. When I considered what I hoped to feel daily (a process illuminated by work with my life coach), one phrase propelled what I sought (and had not owned for eight years): burning aliveness.
For the previous eight years, all I wanted was to feel alive, again. From day one of medical school, a veil hung between me and that. I dared to join the dance again, to feel a part of something bigger than myself by being myself, again. But how?
Around graduation, I decided to get a tattoo. Why? I had to, like a branding of sorts. It was a rite of passage demarcation; I wanted a visual symbol of my eight-year journey and its teachings. I wanted a reminder, because knowing myself, experience has not deterred my tendency to seek acceptance and security. In my life I will need every reminder under the sun wake up. So why not stick one where I can see it, every day?
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I knew not the message, nor symbol, that could deliver that feeling. Then, on June 16th, 2022, I opened the Daily Stoic email at dawn. Holiday’s closing paragraph hit that feeling:
Every day it is true: this could be your last day on this planet. As wonderful as it would be if there was no such thing as death, we have to use death as a tool. We have to use it as a spur to move us forward. We have to let it stop us from looking forward to summer. And we have to be made better for the fact that we don’t know how much time we have. We never do. And we never will.
This moment is a gift. Show up for it. Enjoy it. Don’t cast it aside for Door #2. Because eventually, behind that door will be death. Don’t choose death. Choose life. Be here now.
There it was: choose life. Three weeks after graduation, I got it etched adjacent to my watchband.
When I went to medical school, it’s not that I’d chosen death; I’d chosen nothing. I thought I could ride the fence and have it all: acceptance, accomplishment, and happiness. Only, I failed to understand that the absence of choice is still choice. Because the clock ain’t stopping. At the end of residency, I knew it was true and hoped to never forget it.
Hence why I have two words inscribed on my left forearm. If there was one idea worth never forgetting, that was the one. But more important than the cannots, are the what-I-wants. I want a life of burning aliveness. I want to love what I do. I want to be happy. I want to love my family and friends.
And for that to happen, all I have to do is look down, remember, and choose.
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