Ismail Ax was the strange red inscription found on the arm of the Virginia Tech killer. An obscure reference to it can be found in a public domain book called Ishmael.

But there, my dear! that boy has slipped out, and is cutting the wood; I'll go and do it for him," said Reuben, as the sound of Ishmael's ax fell upon his ears.

Hannah arose and followed Gray to the door, and there before it stood Ishmael, chopping away at random, upon the pile of wood, his cheeks flushed with fever and his eyes wild with excitement.

"Hannah, he is ill; he is very ill; he doesn't well know what he is about," said Reuben, taking the ax from the boy's hand.

"Ishmael, Ishmael, my lad, come in; you are not well enough to work," said Hannah anxiously.

Ishmael yielded up the ax and suffered Reuben to draw him into the house.

The only other references to it can be found in this list and on this site referring to the guy in the middle of the photo.

UPDATE: There is also the Muslim connection that I didn't want to report initially, but is making more and more sense. Ismail is the son of Ibrahim (or Abraham to most Americans.) Ismail Ax is considered to be the ax Ibrahim used to destroy the idols in the temple as well as attempt to sacrifice Ismail to Allah. One of Islam's festivals is Eid ul-Adha which celebrates this tradition. Writing a persons name in red is traditionally taboo for Koreans because it symbolizes death. It appears that he might have viewed himself as a symbol of both Ibrahim destroying the false idols of the West as well as Ismail sacrificing himself to Allah Why?