TY - JOUR T1 - Written on the body JF - British Journal of General Practice JO - Br J Gen Pract SP - 470 LP - 471 VL - 56 IS - 527 AU - John Salinsky Y1 - 2006/06/01 UR - http://bjgp.org/content/56/527/470.abstract N2 - During an education session on dermatology the other day, I found myself wondering why I find diseases of the skin so difficult to master. Determined to think positively I tried to recall some of my rare successes in dermatology diagnosis. And then I had an epiphany, a sudden insight. The only skin conditions I can really be trusted to get right nearly every time are the ones I have had myself. These are pityriasis rosea, chickenpox and bed bug bites, all of which occurred in adult life and during my career as a doctor. In each case I seemed to have learned that particular dermatology lesson because it was written on my own skin.This thought led, by a process of free association, to a remarkable short story by Kafka called In the Penal Colony. It's a very gruesome tale so I wouldn't advise reading it late at night or when you are feeling depressed. The setting is an unnamed island under colonial rule. A distinguished visitor has been invited to witness the unusual form of execution used in the colony. The execution machine is explained to the visitor by the officer in charge who is extremely proud to be associated with it. The machine is a kind of horror comic version of a modern computer and printer. The prisoner is strapped into the machine, his ‘sentence’ is fed in at the top and the machine then writes it on his naked body. The ‘writing’ is done with a bank of needles, which pierce his skin and gradually inscribe the message deeper and deeper into his flesh (accompanied by many decorative flourishes) until he eventually dies, which takes about 12 hours. (I did warn you.) Around the 6-hour mark, the victim's face starts to show remarkable signs of enlightenment. … ER -