The man was unconscious and alone when he arrived at University of Miami Hospital last summer. He was 70 years old and gravely ill.
"Originally, we were told he was intoxicated," remembers Dr. Gregory Holt, an emergency room doctor, "but he didn't wake up."
"He wasn't breathing well. He had COPD. These would all make us start to resuscitate someone," says Holt. "But the tattoo made it complicated."
The tattoo stretched across the man's chest. It said "Do Not Resuscitate." His signature was tattooed at the end.
"We were shocked," remembers Holt. "We didn't know what to do."
The tattoo, and the hospital's decision about what it required of them, has set off a conversation among doctors and medical ethicists around the country about how to express one's end-of-life wishes effectively, and how policymakers can make it easier.
A tattoo is a good idea, can't get lost with the paper trail. I'll contemplate that.
In the U.S., the standard way to tell doctors you want to be allowed to die is to sign an official form saying you don't want to be resuscitated. That means, among other things, you don't want doctors to do CPR or use a ventilator to keep you alive if you stop breathing.
But signing the official form doesn't guarantee your wishes will be followed. If you lose consciousness and end up in the emergency room, for example, the form may not come with you, in which case many doctors err on the side of intervening.