The unlikely but promising partnership between comics and healthcare
Some time ago, indie comic artist Sam Hester found herself spending endless hours in the hospital, not as a patient but as the primary caregiver for her mother, Jocelyn, a patient from long-time sufferer of Parkinson’s disease who had recently started hallucinating – she saw ghostly figures around her – while showing signs of early-stage dementia.
Then another symptom appeared. During a visit to the hospital, Hester observed her mother leaning to the left, her body slumped on her side. Hester was torn: she wanted to alert the night nurses but needed to get home urgently to her children. It was then that she had the idea of conveying her message through simple drawings, which she titled “Help for Jocelyn” and taped to her mother’s bed. A sketch illustrated Jocelyn’s new symptom, with a circled problem area; another showed her in bed, artfully supported by pillows. Alongside this, Hester wrote, “That’s a comfy sleeping position!”
The next morning, she found Jocelyne sleeping comfortably, as the drawing depicted her. From then on, Hester brought pictures to every doctor’s appointment, using them as a kind of visual shortcut. And that eventually led her to the emerging but still little understood field of “graphic medicine”. The term was coined in 2007 by Dr Ian Williams, a graphic novelist and physician based in Hove, England, who defines it as “the intersection between the medium of comics and healthcare discourse”.
For Hester, it was an ideal place. Although she had no medical training, she had started creating autobiographical comics in art school in 1997 and found them a good way to tell stories about health issues and other struggles. personal. She later became a leader in graphic recording – another emerging field – which involves listening to lectures or conversations, picking out key ideas and presenting them in visual form. When Hester discovered graphic medicine in 2016, it struck a chord. As she says, “I realized that, in a way, I had always been a practitioner of graphic medicine.”
Graphic medicine takes many forms, reflecting both patient and physician perspectives. It includes visual narratives that run the gamut from patient memoirs to biographies of medical researchers to dystopian pandemic stories. In fact, any comics that deal with physical or mental health issues can be considered graphic medicine – and professional drawing ability is not a requirement. A transgender person seeking gender-affirming surgery, for example, might create comics to explain how a procedure could improve their quality of life. Or a child can draw stick figures to show exactly what hurts.
Uses for comics range from teaching to therapy
Research suggests countless other applications. A 2018 study conducted at a New Delhi medical college found that while less than 22% of its students had even heard of graphic medicine, almost 77% favored the use of comics as an educational tool in India. Last year a project based on fieldwork in Norway brought together a social anthropologist, a graphic designer and people with drug addictions to challenge the stigma associated with illegal drugs and hepatitis C. Another 2021 studypublished by Springer, saw therapeutic potential in comics created by cancer patients, citing the medium as a way to “explore their medical trauma” and a way to “revive their bodies”.
“Does comics work… in educational contexts? Can reading comics help doctors better understand the patient experience? Can we really help develop empathy by reading comics? These questions, and many more, are all being explored in graphic medicine,” says Matthew Noe, chief librarian at Harvard Medical School, who serves on the boards of the Graphic Medicine International Collective and the Graphic Novels and Comics Round. Table of the American Library Association.
Community building is another goal of graphic medicine. Insisting that anyone can draw, its practitioners invite everyone involved in healthcare – doctors, nurses and public health workers as well as patients – to share their own stories. For patients, it gives a sense of agency. Creating comics can also help medical professionals deal with their own trauma. “We take the collaborative nature of comics and the understanding that health is a community project and come together to share, learn and support people,” says Noe. “That’s been the most important thing, especially during the pandemic.”
Comics naturally lend themselves to humor, irreverence and a free spirit, giving patients a new way to communicate with doctors. “Autobiographical graphic novels derive from a sort of underground, subversive aspect of comics, where people would talk about angry or taboo topics like sex or drugs,” says Williams, who is also co-creator of the graphic medicine website. “[These] the novels retain a wry sense of humor, which can be very light-hearted, but also go into great detail about patients’ lived experiences that medical textbooks may not cover. The comics, he adds, can reveal “problems that may never occur to you as being associated with a specific condition”, potentially important information when it comes to making a diagnosis. .
Give the patient a voice
At the same time, graphic medicine offers patients something that is often missing in a formal medical setting: the feeling that their voice is heard. Even people with dementia can use it to document their journey and keep track of their symptoms – or to speak out in collaboration with a caregiver. This was confirmed by a 2021 study project involving several universities in the UK, as part of a larger study called “What Works in Dementia Education and Training?” He found that “graphic storyboarding” was more likely than academic text to foster empathy.
Making your voice heard is, of course, particularly difficult when there is a language barrier. In the United States, where healthcare information is generally communicated in English, only 6% of physicians describe themselves as Spanish-speaking, even though 18.9% of the population is Hispanic and that number is on its way to reaching 25% by 2045. For those who are not fluent in English, the pictures clearly help. The demographic trend also signals a growing need for creative solutions such as bilingualism Comic of the dayby Elvira Carrizal-Dukes, PhD, a series of health-related comics for the diverse community of El Paso, TX.
Too often, the voice of the patient is subsumed by the voice of the doctor. When patients are bombarded with new information, often expressed in medical jargon, it becomes difficult to digest. Questions that might come to mind are left aside. And the problem can be compounded by sexism, as evidenced by studies showing that women wait longer than men for emergency care and are less likely to receive effective painkillers. Writer-illustrator Aubrey Hirsch recounts her own experience of this bias in “The problem of female doctors“, a graphic memoir that remembers that the doctors diagnosed her “based on my age and gender, not my actual symptoms” (one of their preconceptions boiled down to “young + female = eating disorder”), with the result that his autoimmune disease went undetected.
In pediatrics, on the other hand, the value of graphic medicine seems self-evident, given the difficulty children may have in explaining both symptoms and their emotional response to illness. A child who is unfamiliar with the term “burning sensation,” for example, might express this feeling by drawing fire on a human body. And when it comes to drawing, children tend to be less inhibited than adults.
Chart medicine can also be useful for explaining everything to children, from potty training to minor surgery, according to Jack Maypole, MD, director of the comprehensive care program at Boston Medical Center and associate clinical professor of pediatrics at the Boston University School of Medicine. “It helps them better understand the procedures they’re going through,” says Maypole, adding that comics “can even be used in therapeutic contexts — for example, in art therapy, to help children process their emotions.” .
The Global Future of Graphic Medicine
Cartoonist MK Czerwiec, RN – aka “Comic Nurse” – considers it all a start. A co-author, with Williams and others, of Manifesto of graphic medicine, she teaches a comic class at Northwestern Medical School and envisions a more global role for them in the future. “I would like to see cross-cultural exchange between graphic medicine movements internationally,” says Czerwiec. Such an exchange, while generally promoting cultural awareness, would help physicians treat immigrants, who may have different presentations of a disease. Symptoms of depression, for example, are known to vary depending on cultural beliefs.
Supporters of graphic medicine say it needs to be taught more widely in medical schools – and to reach everyone involved in the healthcare system, including orderlies, housekeeping staff and even receptionists . This could benefit trans people, for example, who have reported feeling uncomfortable in clinic waiting rooms, where they may feel judged or discriminated against. Educating receptionists with comics that explain the trans experience through accessible images and jargon-free language might alleviate the problem. One of the advantages of the medium is its simplicity.
Another is how it can evoke emotion. Last year, Sam Hester spread the gospel of what she calls the “unlikely partnership between health care and comics” in a TEDx talk which has nearly 2 million views on YouTube. “Just imagine if your new doctor opened your chart and saw images that aroused the person’s curiosity, not just the symptoms,” she said toward the end of her talk. She then added:
“When I looked at all the pictures I drew of my mother, I saw her symptoms. But I also see my mother. She is there, in all the words and images that have continued to unite us.