A 59-year-old man with diabetes mellitus, peripheral vascular disease, hypertension and dyslipidemia was admitted to the hospital for a below-the-knee amputation due to chronic non-healing wounds of his lower extremity. Physical examination revealed a “D.N.R.” tattoo on his chest (Fig. 1). Upon reviewing his code status, he indicated that he would want resuscitative efforts initiated in the event of a cardiac or respiratory arrest. However, he did not want prolonged attempts at resuscitation. When asked why his tattoo conflicted with his wishes to be resuscitated, he explained that he had lost a bet playing poker with fellow ancillary hospital staffers while inebriated in his younger years; the loser had to tattoo “D.N.R.” across his chest.