Author Archives: James Weber

The Tongue-Drive System

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(Editor’s note: This article will be published in the summer 2012 issue of The Point, the publication of the Association of Professional Piercers.  James Weber the article’s author, have given BME permission to publish this article for the continued education of professionals and body art enthusiasts. Enjoy.)

Late last February a rather curious news story made the rounds on Facebook and other social media sites and pop culture blogs. Various publications1 reported on an article2 about a project from Georgia Tech, one that enables a person with quadriplegia to control a wheelchair through the movement of the tongue by moving around a magnet worn in a tongue piercing. Piercers everywhere were sharing, reposting, and reblogging the article in a variety of places—including on my Facebook timeline. Fortunately, this was not news to me, as I’ve had the unique opportunity to be involved with the project as a consultant for several years. But after a dozen piercers forwarded me the article I realized it was time to write about my experience with the clinical trials of the Tongue Drive System.

In late October of 2009 I was contacted by Dr. Maysam Ghovanloo, Associate Professor at the School of Electrical and Computer Engineering at the Georgia Institute of Technology. Over the phone he explained the project that he was working on, titled in the research protocol Development and Translational Assessment of a Tongue-Based Assistive Neuro-Technology for Individuals with Severe Neurological Disorders. Simply, this is a system that allows persons with quadriplegia to perform a variety of computer-aided tasks—including operating their wheelchairs—by changing the position of a small magnet inside their mouths. The magnet’s changing position is monitored by a headpiece that looks like a double-sided, hands-free phone headset.

His team had, at that point, experimented with different ways to attach the magnet to the tongue with varying degrees of success. Adhesives were only effective for very short periods, and the idea of permanently implanting a magnet into the tongue was not considered a workable alternative.3 This left a third option suggested by Dr. Anne Laumann: attaching a magnet to the tongue with a tongue piercing.

He then came to the reason for his call: he asked if I would be interested in being involved in the clinical trials as a member of the Data Safety Monitoring Board. As I listened to him describe the details of my involvement, I thought about the incredible places my life as a piercer—and my job as an APP Board member—have brought me. I enthusiastically and without hesitation said “Yes!”

(Note: The article is pretty lengthy, so we’ve put a break here to same some space. Click the Read More button to continue)

For those not familiar with clinical trials (and I was not when I initially agreed to be involved with the study), the Data Safety Monitoring Board (or DSMB, alternately called a Data Monitoring Committee) is a group of experts, independent of the study researchers, who monitor test-subject safety during a clinical trial. The DSMB does this by reviewing the study protocol and evaluating the study data, and will often make recommendations to those in charge of the study concerning the continuation, modification, or termination of the trial. The inclusion of a DSMB is required in studies involving human participants as specified by the Common Rule,4 which is the baseline standard of ethics by which any government-funded research in the United States must abide. (The clinical trial is sponsored jointly by both the National Science Foundation and the National Institute of Health, but nearly all academic institutions hold their researchers to these statements of rights regardless of funding.)5

I was excited to be part of the project, and the following May I received the full details of the study. The clinical trial was to be performed in three phases, with three sets of participants. The first involved ten able-bodied individuals with existing tongue piercings. These participants were to test the hardware and software created by his team and to quantify the ability of those participants to operate the wheelchair with the specially-designed post6 in their tongue piercing. The second group consisted of ten able-bodied volunteers without tongue piercings. These participants were to be pierced, given time to let the piercings heal, and then monitored operating the Tongue Drive System. The third group of participants was to be a selection of thirty people with quadriplegia—without existing tongue piercings—who were to be pierced and then monitored while the piercing healed. Afterward, they were to be evaluated on their ability to operate a computer and navigate an electric wheelchair through an obstacle course using the magnetic tongue jewelry.

The study was to be conducted in two different locations: in Atlanta, at the Georgia Institute of Technology and the Shepherd Center; and in Chicago, on the Northwestern Medical Center Campus and at the Rehabilitation Institute of Chicago, with half of the participants in each phase of the study coming from each location. (Five from each city for the first two phases, fifteen from each for the last.) Drs. Maysam Ghovanloo and Michael Jones were to oversee the trials in Atlanta, and Drs. Anne Laumann and Elliot Roth were to oversee the trials in Chicago.

The DSMB charter specified the eight people who had been drafted to be part of the DSMB: The board chair is a professor of rehabilitation science and technology; one member is a director of a rehabilitation engineering research center; one a professor of rehabilitation medicine. There are two M.D.s: one a neurologist; one an associate professor of dermatology; two biostatisticians (one acting as study administrator); and me. Also included in the documents sent was the full study protocol. This document outlined the finer points of the study, including the protocol for tongue piercings to be performed by the doctors involved with the study. The email also specified the possible times of the first meeting of the DSMB, to be conducted via conference call.

As I participated in the conference call several weeks later it was hard not to feel I was out of my element. While I routinely lecture at several local universities, it’s been quite a while since I’ve been in academia. But I soon realized I was not there for my academic credentials but for my position and experience—and as a de facto authority on piercing. This I could do.

During that first meeting I expressed the concerns I had about the piercing protocol, specifically about physicians performing the piercings—physicians with little or no experience doing so. “Do any of the members on the research team have prior piercing experience?” I wrote. “Even though it is not a complicated procedure, it is better for doctors who are involved in this task to have prior experience with tongue piercing.”

I was told that the physician overseeing the piercings in Atlanta had performed at least thirty tongue piercings in his private practice. And although Dr. Laumann—who was responsible for the tongue piercings in Chicago—had no prior piercing experience, she had conducted extensive research on piercing and tattooing7 and had often observed professional piercers at work. (Furthermore, she is considered an expert among dermatologists in the field of piercing and tattooing.) While my concerns were addressed, I do remember feeling hesitant at the close of that meeting.

The second DSMB meeting was held six months later, in December of 2010. At this time the results of the first and second phases of the clinical trial were to be discussed. Before the meeting I was given information about the second study group and about the tongue piercing method performed at the Chicago location—and including images from both locations. From the images provided, I was concerned that the piercings performed by the physicians looked as if they were done by first-year piercing apprentices—which, in a way, they were.

Of the twenty-one study participants who received a tongue piercing, five were noted as complaining about the placement of the piercing, and three piercings resulted in embedded jewelry. Based on the photos I guessed this was because either the piercing had been placed too far back on the tongue or the length for initial jewelry was improper—or both. I pointed out to the committee this left only about 60% of the subjects who were both comfortable with the placement of the piercing (at least enough to not state the contrary to researchers) and who did not have problems with embedded jewelry. I stated I thought this was far too small a percentage to ensure the well-being of each research participant. Even though it was outside my role as a DSMB member, I further stated the results of the study may be affected by the improperly placed piercings, as more than a few of the study participants had taken out their jewelry and dropped out of the study within a few days of being pierced, saying they were either unhappy with the placement or found the position of the piercing uncomfortable.8

I went on to express concerns about the piercing protocols and to question whether piercers could perform these procedures instead of physicians. Unfortunately, I was told the parameters of the study, and the rules at the medical centers where the piercings were being performed, did not allow non-medical professionals to perform the piercing procedures.9

Despite my concerns, my suggestions and criticisms were well-received. Dr. Ghovanloo agreed to re-evaluate the piercing protocol and I offered him whatever help he needed. Most importantly, I got the impression the two doctors performing the piercings were somewhat humbled by the experience. While there was no doubt that these physicians have anatomical knowledge and surgical experience that far surpasses mine, they were quickly realizing this didn’t make them proficient piercers.

Several months after that conference call, I had the opportunity to finally meet Dr. Ghovanloo in person. The quarterly meeting of the APP’s board of directors was scheduled in Atlanta in February of 2010, and Dr. Ghovanloo arranged for me to meet some of the trial staff at the Shepherd Center. I had the sense he was excited as well, and he also arranged for the physician doing the piercings during the clinical trials in Atlanta to be there: Dr. Arthur Simon. As I was at a board meeting with Elayne Angel (the APP’s then-Medical Liaison, current President, and resident expert on tongue piercings), I asked about having her attend as well. He readily agreed.

When Elayne and I arrived we were greeted by Shepherd staff member and study coordinator Erica Sutton, and we were soon led to our meeting with Dr. Ghovanloo and Dr. Simon. Compared to the necessary formality of the DSMB meetings, it was a friendly and relaxed meeting. Dr. Ghovanloo and his colleagues were somewhat starstruck by Elayne (she often does that to people) especially since her book, The Piercing Bible, was used so extensively in drafting the trial piercing protocols.

As we talked about the clinical trials, it was hard to not be affected by Dr. Ghovanloo’s enthusiasm for the project. We spoke at length about the issues the doctors encountered when performing the piercings. Doctor Simon in particular was humbled after his experience. “How do you hold those little balls to screw on?” he asked at one point during the several hours we met, a little exasperated and only half joking. I can’t speak for Elayne, but I left with an immense respect for Dr. Ghovanloo, his staff, and the whole project. I also left with the impression that they had a lot more knowledge of—and a little more respect for—what we do as well.

Since that time, stage three of the clinical trials has already taken place. I’ve been informed by Dr. Ghovanloo that the third and final meeting of the DSMB will be scheduled in the coming weeks. In fact, trials are being planned using a new prototype that allows users to wear a dental retainer on the roof of their mouth embedded with sensors to control the system (instead of the headset),10 with the signals from these sensors wirelessly transmitted to an iPod or iPhone. Software installed on the iPod then determines the relative position of the magnet with respect to the array of sensors in real time, and this information is used to control the movements of a computer cursor or a powered wheelchair.

I’m looking forward to hearing when the project is out of the trial phase and more widely available to all who can use it. When that happens, I’m sure I’ll be hearing from Dr. Ghovanloo—and seeing the news again posted on Facebook.

More information about the current trials can be found on the Shepherd Center’s web site: http://www.shepherdcentermagazine.org/q3_11/#/feature2/

Links:

1 http://www.wired.co.uk/news/archive/2012-02/21/tongue-drive-system, http://news.discovery.com/tech/tongue-drives-wheelchair-120222.html#mkcpgn=rssnws1, http://boingboing.net/2012/02/24/tongue-piercing-steers-wheelch.html

2 http://www.gatech.edu/newsroom/release.html?nid=110351

3 Unlike implants under the skin, the tongue has no “pockets” in which to encase a foreign object, and there was also concern about the need to remove the magnet for surgeries and MRIs.

4 http://www.hhs.gov/ohrp/humansubjects/commonrule/index.html

5 The history of research ethics in the country is simultaneously fascinating and shameful. Most of the modern rules now in place concerning clinical trials in the U.S. are as a result of the public outcry over the Tuskegee Syphilis Experiment, a study that ran for four decades, from 1932 and 1972, in Tuskegee, Alabama. This clinical trial was conducted by the U.S. Public Health Service and was set up to study untreated syphilis in poor, rural black men who thought they were receiving free health care from the U.S. government. The study was terminated only after an article in the New York Times brought it to the attention of the public. More information about the history of research ethics can be found here: http://research.unlv.edu/ORI-HSR/history-ethics.htm

6 In one of my early conversations with Dr. Ghovanloo I gave him the name of several manufacturers who I thought would be willing and/or able to make the jewelry needed for the trials. Barry Blanchard from Anatometal came through by manufacturing special barbells with a magnet encased in a laser-welded titanium ball fixed on top. Blue Mountain Steel also donated the barbells and piercing supplies for the initial piercings.

7 Dr. Laumann has co-written several published papers on body piercing and tattooing. The most recent is titled, “Body Piercing: Complications and Prevention of Health Risks.”

8 Dr. Ghovanloo and the other physicians had suggestions for the reasons for the high dropout rate among healthy subjects. In response to an early draft of this article, he wrote, “We simply lost contact with a few subjects after piercing, and cannot say for sure what their motivation was in participating in the trial and consequently dropping out after receiving the piercing.” Dr. Laumann, commenting on the Chicago site, wrote, “We prescreened thirty-two volunteers. Ten of these were screened and consented. Three of these were ineligible due to a short lingual frenulum, or ‘tongue web.’ This would have made the use of the TDS impracticable and for research it would have been considered inappropriate to cut the lingual frenulum. We pierced seven subjects and—you are correct—our first subject dropped out related to embedding of the jewelry and pain on the first day. After that we were careful to measure the thickness of the tongue and insert a barbell that allowed for 6.35 mm (1/4 inch) of swelling. Otherwise drop-outs came much later during the TDS testing phase related to scheduling and unrelated medical issues. One of the subjects, a piercer herself, was particularly pleased with the procedure, the tract placement and the appearance.”

9 Though the protocols did not allow the procedure to be conducted by non-medical personnel, Gigi Gits, from Kolo, was present during one of the phase-two health subject’s piercings and Bethra Szumski, from Virtue and Vice, was able to offer advice at the first phase-three piercing session in Atlanta.

10 Dr. Laumann: “The problem with headgear is that it needs to be removed at night, which means that the disabled individual cannot do anything in the morning until the headset is replaced and the TDS recalibrated. With secure intra-oral sensors, recalibration will not be necessary in the morning, nor will the sensors slip during use, which gives the wearer a great degree of independence. Of course, a dental retainer takes up space in the mouth and this may be difficult with a barbell in place.”

Help out the youngest member of the BME family. Get a limited edition 2012 BME Classic Logo t-shirt. Read all the details here.

Surface Anchors, Punches, and Legislation Issues

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(Editor’s note: These articles were first published in The Point, the publication of the Association of Professional Piercers. Since part of BME’s mandate is to create as comprehensive and well rounded an archive of body modification as possible, we feel these are important additions.

Jim Weber and David Vidra, the article’s authors, have given BME permission to publish this article for the continued education of professionals and body art enthusiasts. Enjoy.)

After Luis Garcia’s article, titled Surface Anchor Legislation Issues, was published in the last issue of The Point (#48), many questions have been raised about the information presented, specifically regarding statements about the legality of using punches to install jewelry.

As an organization, the Association of Professional Piercers has historically declined to address the use of punches by piercers. Their use has always been considered outside of the scope of body piercing—much the same way the organization has viewed branding, scarification, and tattooing. But recent legal regulations, interpretations, and determinations about the use of punches with surface anchors have made continuing this position untenable.

From the APP’s position as an educational organization, it has become obvious that many piercers in our industry are in need of education on this subject. This is not to imply there is currently a willful ignorance among piercers, but simply that there is not an educated dialogue taking place in our industry on this topic. Recently, several states have prohibited the installation of surface anchors by body art practitioners. These legal prohibitions are, in many ways, a reaction by local medical and health boards to a procedure without a convincing record of safety. But several of these determinations are a direct result of what many medical and health boards consider the indiscriminate use of punches by our industry.

In his article, Luis stated punches are “illegal to use if the practitioner is not a licensed medical professional.” While this is true, this issue is much more complicated than this short statement explains.

Currently, dermal punches are classified, but not regulated by the FDA. They are class 1 devices, for use by medical professionals only. State medical boards determine who can use each classification of products, and what level of certification, education and/or competency testing each user must have. Unless your local health department or medical board specifically allows the use of class 1 devices by body art practitioners, the use of punches by body art practitioners is prohibited.

So what does this mean for those of us who are using punches to install surface anchors and other types of body jewelry? The answer, again, is not so simple.

State medical boards have the authority to decide who can use certain devices based on FDA classification. As of this writing, state medical boards have determined—based on their classification and intended use—to specifically prohibit the use of punches by our industry in Nevada, New Jersey, and Florida. When speaking with several health inspectors and medical board members about the issue, the reason many gave for the prohibition was the concern over the indiscriminate use of dermal punches in installing jewelry—as evidenced by videos of piercers they had seen on YouTube. Currently, the biggest problem with the increased popularization of the use of punches is not their legal status, but that in several states their wanton—and very public—use has contributed to the prohibition of surface anchors and other body art procedures.

In Nevada, not only is dermal punching and performing single-point piercings specifically prohibited, but also suspension, branding, scarification, and implants. In Florida, a determination by the Florida Board of Medicine stated dermal punching constituted the practice of medicine. Suspension is similarly categorized, as is branding, tongue splitting, implantation, and labia reduction. In New Jersey, the same medical board determination that specifically prohibited the use of punches by our industry—and classified surface anchors as implants—also prohibits branding and scarification if performed by a body art practitioner.

Other states that do not currently address their use by our industry will almost undoubtedly be doing so after prohibitions are in place in other states. Anyone who is familiar with legislation knows that, quite often, states adopt other state regulations—often word-for-word—after the first state has done the work writing them. As a piercer and body modification artist, the debate on whether to use punches to install jewelry is not as simple as what will be better for healing. There are legal implications, and these extend far past the relationship between you and your client; all piercers should be fully aware or the ramifications and possible repercussions of their decision to use punches.



In response to this, there are many among us who loudly proclaim, “It’s my right to use punches!” There is not an argument—at least from us—against it being our ethical right. But unfortunately, in most states, it is clearly not our legal right to use them. There is a big difference.



There are also those who argue for the punch as being an “industry standard.” Unfortunately, this argument doesn’t carry much weight, as needles have been the industry standard for the insertion of jewelry since the beginning of modern piercing. Admittedly, there is a history of punches being used, but not as the predominant instrument of choice. (And to many legislators, our industry simply didn’t exist before about twelve years ago—around 1997—which is when the first regulations on body art went into effect in Ohio and Oregon.)

Lastly, few responsible piercers will offer their services to clients without first securing liability insurance to protect themselves and their studio, both legally and financially. While both Professional Program Insurance Brokerage (PPIB) and National Insurance Professionals Corporation (NIPC) offer liability insurance that covers surface piercings and surface anchors, their coverage does not extend to procedures where the jewelry is installed with punches. (Western States Insurance does not specifically exclude coverage of anchors inserted with punches, but the company representative I spoke to stated the coverage is not valid if the instrument used for the procedure—or the procedure itself—is prohibited by local or federal law.) If no other argument affects a practitioner’s personal decision on whether to use punches, this one should.

In closing, we urge all body art practitioners to carefully consider every side of this debate when choosing what tools to use when installing surface anchors on their clients. All of us should be aware of the legal ramifications, for not only yourself and your clients, but for the rest of the industry.

And if you choose to use punches, please—for all our sakes—don’t post the videos on YouTube.

[This article is intended to start a discussion on the use of punches and the implication their use has on legislation. It is not to be considered the definitive argument for or against their use, but simply an effort to educate all industry professionals on some of the possible legal repercussions this use may bring to our industry. A lot of help went into researching this article. We would like to thank Jonny Needles and Luis Garcia for their help with New Jersey legislation, Maria Pinto from Industrial Strength Needles for her help with FDA questions, and the various members of health and medical boards who were able to clarify their state’s position on punches and surface anchors.

Anyone who has comments or corrections about information contained in this article, or has information about similar legislation issues in other states, is invited to e-mail us.]


Legislation Links

Florida:

http://www.doh.state.fl.us/environment/community/body-piercing/

http://www.doh.state.fl.us/environment/community/body-piercing/newinfo.htm

On 10-5-2002, a determination by the Florida Board of Medicine stated dermal punching constituted the practice of medicine. The practice of suspension is similarly categorized, as is branding, tongue splitting, implantation, and labia reduction. While the Medical Board has prohibited the use of punches by body artists, the authority to enforce this prohibition has not been granted to the Florida Health Board. As the Health Board oversees inspection and licensing (not the medical board) this leaves the enforcement of this determination in question.

Nevada:

http://www.cchd.org/body-art/tattoo-regs-sec8.php

Dermal punching and single-point piercings are specifically prohibited, as is suspension, branding, scarification, and the “implantation of jewelry under the skin.” The Nevada Board of Medical Examiners determined surface anchors are to be categorized as implants, therefore prohibiting their being performed by body art practitioners. The Nevada Health Board then enforces this prohibition.

[I was fortunate to speak to Jamie Hulbert, an Environmental Health Specialist for the Southern Nevada Health District, at the annual American Public Health Association conference in Philadelphia in early November. She stated the concern of the Health Board was about the risk of anaerobic bacteria with surface anchors, and listed this as one of the reasons for classifying them with implants. She said there was currently no discussion about repealing the ban.]

New Jersey:

http://www.state.nj.us/health/eoh/phss/bodyart.pdf

Earlier this year, the Director of the Health Department approached the New Jersey Health Board with questions regarding surface anchors. The Health Board then contacted the Medical Board, and was advised that surface anchors are to be considered implants, and are therefore prohibited under New Jersey Administrative Code 8:27-2.6. As stated in the preceding article, this same determination prohibited the use of punches by body art practitioners, in addition to implants, branding and scarification.


[Jonny Needles, of Dynasty Tattoo and Body Piercing in Newfield NJ, has been in conversation with Tim Smith, New Jersey Public Health Sanitation and Safety Program Manger and Head of the NJ Body Art Department in Trenton. Together with Luis Garcia (former APP Board member), they have been working to repeal the prohibition on surface anchors. According to Jonny, Mr. Smith has stated the intention of the NJ Health Board was to start a pilot program. This program, starting before the year’s end, would give an as-yet-undetermined number of piercers the authority to perform surface anchor piercings. Jewelry quality will be specified, client numbers are to be monitored, and clients will be provided a number to directly contact the Health Board to report complications. If this program is considered a success at its completion, other piercers can apply for the authority to perform this piercing. This program is to be open to all piercers who have 3 or more years of experience.

Both Jonny Needles and Luis Garcia are optimistic that the two groups can come to an agreement on the best way to allow this procedure while still looking out for the public interest.]

Author Bios:

David A. Vidra started in the piercing community in the 1980s. He opened northern Ohio’s first piercing studio, Body Work Productions, in 1993, and it remained in operation for more than 15 years. David founded Health Educators, the first industry-specific health education company for the body modification industry, with its focus on OSHA guidelines and all health and safety issues related to body modification. He has been honored by many organizations including the APP, the Society for Permanent Cosmetic Professionals (SPCP), and BME for his efforts in the educational arena and in legislation. He has worked as a nurse for more than 20 years, has recently completed his certification in wound care, and is celebrating his 15th year teaching Bloodborne Pathogens.

Started in California in 1994, the Association of Professional Piercers is an international non-profit organization that is committed to the dissemination of vital health and safety information about body piercing to the piercing community, health care professionals, legislators, and the general public. The APP holds its annual Conference each year in Vas Vegas, Nevada in the first week in May. More information, including free PDFs of The Point, can be found at safepiercing.org.


ADHA and NEHA: A Travel Diary

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(Editor’s note: In addition to Paul King, APP President James Weber will also be contributing to BME on what will hopefully be a regular basis. As a means of staying abreast of and maintaining healthy relationships with various spheres in the medical community, APP members can often be found at conventions and conferences that may not ostensibly relate directly to piercing itself. In this piece, James visits two such conferences.)

Thursday, June 19

6 a.m., Philadelphia, PA: My alarm goes off. My lover/ride-to-the-airport doesn’t even move. I have to get up now to make my 8:20 flight. I wonder why I agree to do these conferences.

8 a.m., Philadelphia International Airport (PHL): My flight is delayed one hour. Shit.

11:15 a.m., Tucson International Airport (TUS): Since my first flight was delayed, my one-hour layover is now a 15-minute layover. I grab a disgusting chicken sandwich from the only food counter without a line, grab a bottle of water and run to my flight. I’m so hungry I’m angry, and I’m really wondering why I do these conferences.

Crystal
Photo credit: James Weber

2 p.m., Albuquerque International Sunport (ABQ): I finally land. The chicken sandwich sits like a weight in my stomach; I managed to sleep very little on either of my flights; it feels wonderful to get off the plane. Crystal’s employee, Angela, picks me up at the airport, curbside. In her silver Honda Civic she has the huge box with the booth and a second large box with the art for the booth filling the back seat, pushing our seats forward. The trunk is filled with nine boxes of brochures, posters, magazines, pens, stickers and everything else needed to set up the APP booth. We have three hours to get to the convention center and set up everything for the exposition at the American Dental Hygienist’s Association (ADHA) conference, which starts tomorrow.

It’s hot as hell. It was light jacket weather when I left Philadelphia, and it’s in the mid-nineties here now. Angela and I drive around and finally find a place to unload. The boxes, while not too unwieldy in moderate weather, are unbearably heavy in the heat. I wait on the sidewalk in the hot sun with the boxes while Angela parks the car.

The booth set-up is easy; I’ve done it often enough, and air conditioning makes anything easier. We escape by about 4 p.m. and head to Evolution, where Crystal warmly greets me in the parking lot in back — I feel a lot better. We head to her house — it is very red — and then go out to eat. She goes out, and I stay at her apartment to check my email; I’m soon asleep on her sofa.

Photo credit: James Weber

Friday, June 20

6 a.m.: I’m awake. My body still thinks it’s in Philadelphia — actually, I don’t think my body knows where the hell it is.

9 a.m.: Crystal and I arrive — a little late — to the convention center. The expo is already overflowing with people as we make our way to the booth and hastily set up the APP material: brochures, including four new Spanish-language ones; posters; procedure manuals, both hard copy and disc; pens and stickers; and about ten different issues of The Point. (The back issues of The Point are always eye-catching, and make me very proud.) As we set up, we’re swamped with people asking questions, wanting information, thanking us for being there. I remember: this is why I love these conferences.

10 a.m.: As a representative from the ADHA introduces herself — thanking us once again for being there — a small gaggle of people slowly walks towards us, deferentially surrounding an old woman as she makes her way down the aisle. As she comes nearer, I am told, with a tone of reverence, that the woman making her way to us is the “Queen of the dental hygienists.” Before she could say more, the woman reaches us and is ushered behind our table and into our booth space. Evidently, the juxtaposition of a septuagenarian dental hygienist posing with two tattooed and pierced exhibiters is a photo opportunity not to be missed.

She poses, flanked by Crystal and I, while our picture is taken. After the first set of photos, she looks at the booth behind her to see where she is — not out of mental frailty, but as someone important enough that they were used to being shuttled from one photo opportunity to the next without having to concern herself with more than being diplomatic. We were motioned together for a second set of photos, and as my hand brushes against hers she grabs it and holds it tightly with the kind of clasp that can only come from someone older, someone who has no time for worrying about misunderstanding, who holds your hand as though there could be no other reason for that grip than pure warmth and understanding. I immediately know why everyone held her in such regard, why she commanded such respect. After the pictures are taken, she turns to me and says, simply but earnestly, “I don’t like tongue piercings.” She says it in such a way that I don’t hold it against her, as I know she doesn’t hold it against me.

She then slowly walks away, followed by her entourage, her court. This was my experience meeting Dr. Esther Wilkins.

Photo credit: James Weber

Saturday, June 21

10 a.m.: Crystal and I arrive just as the exposition hall opens on the second day.

From the several ADHA representatives that stop by the booth, we get information on attendance: There are approximately 1,300 attendees this year — the highest figure they’ve ever had, with 300 of those being students — up from about 100 last year.

The response we receive is amazing. It may have been the increase in attendance, the spike in the number of students, or the fact this is our second time exhibiting, but people are very enthusiastic about our presence there.

(It’s also worth noting that, with the huge booths from Colgate, Johnson and Johnson [makers of Listerine], Tom’s of Maine, etc., and dozens of other manufacturers selling everything from medical instruments to office lighting, we’re the only booth not selling anything — not anything besides information.)

The encouraging part of the day isn’t talking to new people — to people that haven’t heard of us — but to people who already have. Repeatedly, people come up and talk about how they had done a presentation on the topic of piercing for their school, for other students, at a local health conference, for the local health board; how they had been involved in education on some level and how invaluable our material was to them.

4 p.m.: Angela helps me break down the booth and pack up for the next leg of the trip — Tucson.

Photo credit: James Weber

Sunday, June 22

6:30 a.m.: As Crystal and I are driving to pick up the rental car we run out of gas. Completely. The car simply sputters and dies as we’re going down the road. It seems that Crystal has been hanging her ADHA badge on the steering column — over the fuel gauge — and she simply hasn’t noticed how little gas we had left. Luckily, the two-lane access road is deserted (it’s early Sunday morning) and the car comes to a stop at the curb about a quarter-mile from the rental car lot. While Crystal waits for her business partner/ex-husband to come with gas (we owe him a BIG favor), I hoof it to the lot and pick up the car. Crystal joins me shortly, we transfer the booth and boxes to the rental and I’m back on the road a little after 7 a.m.

12 p.m.: I’ve been barreling through the desert for five hours. My only stop was a Denny’s in Truth or Consequences, New Mexico. My soundtrack so far has consisted of Hank Williams, the O’ Brother Where Art Thou soundtrack and Bob Dylan’s Blonde on Blonde and Highway 61 Revisited. Things are good — until I realize the fuel gauge is on “E.” Fuck — twice in one day. I hear Caitlin in my head: After I told her the drive would be an “adventure,” she replied that it’s only fun until you run out of gas on the highway 50 miles from anywhere in the hot sun and they find you dead on the side of the road, your corpse picked over by vultures. (Actually, she didn’t mention the vultures, but they were certainly implied.)

The last sign I remember seeing was a “Last Rest Stop For 78 Miles” sign. How long ago was that? I’m going a steady 90 mph now and sweating, a little from the nervousness but more from the fact that I’ve turned off the air to conserve gas, and it’s 105 degrees outside. And I have no cell phone reception out here.

I finally see a sign: “Wilcox — 10 miles.” Please let me make it. Please, please, please, please … I make it the 10 miles to the exit, and I see another sign: “Wilcox – 4 miles.” It seems it was 10 miles to the exit. Shit. I make it to what I assume is Main Street — Wilcox isn’t much more than a stop on the highway — and with great relief I roll into a gas station. Whew …

2 p.m.: I arrive at the Tucson airport as Didier’s plane from San Diego is landing. We have three hours to find the convention hotel and set up the booth.

3 p.m.: We find the convention hotel — it’s a huge Hilton “resort” — and we find the hotel where we are registered. They were supposed to be close, but are four miles apart. It’s now 110 degrees. We decide to hold on to the rental car.

4 p.m.: We arrive at the expo hall. The other exhibitors give us “the eye” as we set up. It’s the annual meeting of NEHA, the National Environmental Health Association, and the hall is full of health inspectors and others who deal with public health and policy. It’s the APP’s first time here, and we’re not quite sure what to expect. They don’t know what to make of us either. We quickly set up the booth and the table and high-tail it out of there. We have to be back for the expo opening and “party” at 6 p.m., and we’re already exhausted and drenched in sweat. It’s 112 degrees outside.

6 p.m.: Didier and I open the doors and walk into the expo hall, and it’s like the scene out of Animal House where they go to the bar in the “wrong” part of town: Conversation stops and all eyes are on us. (I imagine the silverware dropping and a needle going “scrrrrrrtt” over a record as the music stops.) It’s a long walk from the doors to the table …

We set ourselves up and wait. (We’re right in front of the door — you can’t overlook us.)
The attendees start to slowly trickle in, and then we are deluged with people. Everyone, it seems, is working on legislation/policy/protocol in their state/county/city dealing with body piercing. We give away the majority of our material in two hours. They love The Point. They grab handfuls of the brochures. They take the CD manuals like they’ve been handed the scriptures. (Well, that may be a bit of an exaggeration, but they are incredibly appreciative.)

I meet a health inspector from Florida who I’ve previously talked to only by phone. I talk to inspectors from Colorado and Albuquerque that have already worked with APP representatives on policy. I talk to people who have never heard of us but promise to contact us — and they will.

It was absolutely amazing, and this was only the first three hours.

9 p.m.: The expo closes, and Didier and I grab our things and head back to our hotel, as the floor opens again on Monday at 8 a.m. It is a little cooler outside — only 103 degrees.

Didier
Photo credit: James Weber

Monday, June 23

8 a.m.: After a hurried breakfast at the hotel consisting of a precooked omelette and stale pastries, Didier and I arrive at the opening of the expo. Most other attendees are complaining about the early start time. I, however, am still on East Coast time; I was up at 4:30 a.m.

The second day is much less busy than opening night, but the people to whom Didier and I speak at length are no less appreciative of our presence or the work we do. We meet with representatives from Arizona, New Mexico, Florida, Alaska, Georgia, New Jersey, Washington DC, Utah, Minnesota, Oregon, Washington, California, Hawaii, Idaho, Oklahoma, Louisiana, Arkansas, Massachusetts, Alabama, Indiana, Michigan, New York, Maryland, Ohio, Illinois, Nebraska, Colorado, Montana, British Colombia and Great Britain. (This may not be a complete list, but it’s what Didier and I could recall after brainstorming in our hotel room.) Many of these people are directly responsible for either the inspection of body art establishments or the policies or legislation that governs and informs those inspections.

The most memorable thing I hear comes from a woman from Montana, who talks about regulations and inspections in her state. She thanks us for our efforts as an organization and closes by saying, “We couldn’t have done it without your help,” which just about knocks me over.

The stated mission of the APP is to disseminate information about body piercing to piercers, health care professionals, legislators, and the general public. As piercers, we will most likely never all fly the same flag, and the crusade to educate the public is just at the beginning of a long and hard road. But health care professionals now know who we are and where to find us; my trips to the annual conferences of APHA (the American Public Health Association), ACHA (the American College Health Association), and ADHA (the American Dental Hygienists’ Association) have proven that to me. The reception that Didier and I received at NEHA showed that we are succeeding with legislators as well. “We couldn’t have done it without your help” speaks volumes.

2 p.m.: The expo closes, and Didier and I pack up the booth and load the car. (The temperature gauge in the car says 116 degrees; we can’t tell if that means outside or inside the car.) We head to the Post Office to ship what few supplies we have left to San Diego along with the booth in preparation for the APHA conference at the end of October, and then drive the hour to the airport for Didier to catch his flight. I don’t leave until tomorrow morning, so after dinner I head back to the hotel to finish my blog of the trip and prepare for an early bedtime. I will not be leaving the comfort of the room or the air conditioning again until I leave for the airport tomorrow morning — I have to return the rental car before 6 a.m., so I’ll be up at 4:30 yet again.

Didier
Photo credit: James Weber

While this may not be the typical experience manning the APP booth at health conferences, it’s certainly not unusual. As part of our outreach to the medical community, the APP has a yearly presence at the annual conferences for the American Public Health Association (APHA) and the American College Health Association (ACHA). As of last year we added attendance at the American Dental Health Association (ADHA) conference, and this year was our first time at the National Environmental Health Association (NEHA) conference as well. While there is a significant time commitment involved in volunteering (and with my new duties as President I may not be able to attend as many in the future as I may have hoped) they are tremendously rewarding, for they give you the opportunity to talk face-to-face with people who are directly affected by the outreach we do, the material we provide, and the education we offer. Like most work on behalf of the APP, it can be incredibly hard, but the rewards more than make up for it. Many thanks to all who have helped represent the APP all over the country through the years, and thanks in advance to those set to do it in the future.]

Copyright © The Association of Professional Piercers. Reprinted on BME with permission. Articles in this column are published simultaneously in The Point: The Quarterly Journal of the Association of Professional Piercers. PDFs of back issues are available for free download at SafePiercing.org, and subscriptions are available by contacting the APP office at [email protected].

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