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(Almost) No Decision Is Final

So stop acting like they are

10 min readJul 14, 2025

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At fifty years old, I walked into a tattoo parlor for the first time. (Second, technically, but the first was to sit with someone else while she got her first tattoo).

My artist, a woman half my age with intricate ink climbing both her arms, greeted me with a smile. I found her through Instagram, paid her deposit, and then waited nearly six months for the date of my actual appointment. She knew it was my first time.

The bunch of trainees practicing their fine lines on what looked like pork trotters, on the other hand. They didn’t. One of them—I kid you not—looked up from her work, caught my eye, and said, “First time?”

She read my nervousness like tarot cards.

I’d been thinking about this tattoo for ten whole years. 3652 days of a debate with myself. That’s a lot of days.

See, I love tattoos. They’re one of my favorite art forms. I’ve watched every season of Ink Master, that horrifically antagonistic art competition, and I follow a bunch of tattoo artists on Instagram. I’m blown away by what master artists can do on skin.

When people find this out—and find out that I didn’t have any of my own—they invariably ask why. And for decades, my response has always been, “I just don’t know what I’d want on my body for the rest of my life.”

And then, on June 3, 2024, I lost one of the most steadfast presences in my life. Max the cat was 20 years…

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Mark Shrime, MD, PhD
Mark Shrime, MD, PhD

Written by Mark Shrime, MD, PhD

Author, SOLVING FOR WHY | Global surgeon | Decision analyst | Climber | 3x American Ninja Warrior Competitor