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Any culture watcher can tell you there is a difference between trends and fads. Both start small. Both eventually cover the waterfront. But fads, the flotsam of popular culture, leave the shoreline unchanged. Trends erode and deposit, reshaping both the shore and the horizon over time, changing them forever.

For all their evanescence, fads often prepare the way for trends. Knit shirts emblazoned with little alligators may be a fashion memory, but they were a large step toward a branded world in which even toilets come with logos. Perhaps no one understands the symbiotic relationship between fad and trend better than the shape-shifting superstar Madonna, who has managed to surf from one fad to the next (most recently, from sexual entrepreneur to devoted mum), while all along steadily consolidating the cultural power of celebrity.

Which brings me to two recent arrivals on the American cultural landscape, both of which have, as it happens, a Madonna connection.

Let's start with tattoos. Tattoos go back far enough that Leviticus 19:28 prohibits them. But they are current enough that 15 percent of the population has one (including Madonna, who sported a kabalistic Hebrew anagram on her arm in a recent video). Since the Lycos Internet search engine started keeping track in 1995, tattoo has consistently been one of the most-searched-for items on the Internet.

If tattoos are a fad, they are an unusually deep and durable one. Indeed, the appeal of tattoos is their claim to permanence. Compared to the flickering images on computer screens and the fluctuations of fashion, tattoos make a stab at lasting significance. This desire to rise bodily above the limits of time isn't unfamiliar to those of us who believe that a resurrected human being, complete with pierced hands and feet, is even now in heaven and will someday return to a recreated earth.

But in 20 years, I'm pretty sure that tattoo removal will have replaced tattoo on that Lycos list. The very permanence of tattoos will eventually run up against a powerful trend: Americans' insatiable demand for novelty. Madonna, who let it be known that her Levitically prohibited Hebrew tattoo wasn't permanent, knew what she was doing. Moreover, in a few decades most tattoos will be fading, wrinkling reminders of a lost youth. And if there's one thing Americans cannot bear, it is the bodily evidence of aging—which is why the smart money is on another needle-based form of bodily modification.

It would be easy to see Botox, the muscle-paralyzing cosmetic treatment, as a fad. After its approval in 2002 for cosmetic purposes, it appeared on the cultural map as rapidly as frown lines disappeared on network television. (Madonna is widely rumored to be a user.)

But Botox has the makings of a true trend, because it is small, invisible, and above all frequent. Since Botox's effect wears off after a few months, its users will require a lifetime of injections to ward off the signs of aging, making Botox nothing less than a discipline of age consciousness, a recurring trip to a magic mirror that reminds you of your age even while promising to erase it. As Christians know, disciplines are what shape both our bodies and our souls. Disciplines are the stuff that trends are made of.

Where could the Botox trend lead? Last year, impelled by the fear of looking old, 1.6 million people asked a doctor to inject them with small amounts of one of the world's most poisonous substances. Imagine them practicing that discipline every few months for 30 or 40 years. What will they do when even Botox can't hide the frown lines? They will simply increase the dosage. Today's devotees of Botox are tomorrow's customers for euthanasia. Within a few decades, a generation of elders will be quietly, conveniently ending their own lives once they are irretrievably old. Their years of practice will pay off.

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August 2003, Vol. 47, No. 8