Feature: Comics and Medicine
5 October 2010
Comics and medicine may seem like strange bedfellows. The former you may dismiss as a frivolous medium for children, while the latter is a critically important, serious endeavour. But graphic stories are hugely popular among all age groups and are today seen as a legitimate form of literature. And not just fiction - graphic novels have dealt with all kinds of medical and scientific subjects: substance abuse, depression, HIV, diabetes, epilepsy, mental illness.
'Graphic pathographies' provide powerful, personal insights into medical conditions. The visual format can communicate the personal experience of conditions such as depression, and help destigmatise and demystify an illness. As Paul Gravett, a writer and lecturer on comics says, creating autobiography and first-person fiction allows graphic novelists to explore aspects of coping with illness, as patient, professional, carer and relative.
Credit: Thom Ferrier, 2010.
The gutter spaces between panels force readers to fill in the details and infer what happens out of sight and without words - a useful skill for doctors who have to understand what is implied as well as overtly seen. Credit: Darryl Cunningham, 2010.
Researchers have found how combining pictures and text enhances understanding. The activities of reading and viewing activate different information-processing systems within the brain, and the combination fosters connections between new information and existing knowledge.
Credit: Brian Fies
Comic artist and former journalist Brian Fies says that comics have the capacity for powerful visual metaphors and universality. The spare and stylised use of text and art allows readers to project themselves into the story.
"These powerful images illustrate the patient's and family member's experience in a way that standard clinical reportage could never achieve with such economy," says Dr Michael Green, a physician and bioethicist at Penn State University.
Green runs a course for fourth year medical students at Penn State College of Medicine. This uses comics to enhance observational and communication skills and improve understanding of patients' experience of illness. The novel approach helps students consider discrete elements more efficiently than if they'd been assigned a whole book to read. Further evidence comes from Professor Keith Stevenson, Stella Williams and Dr Paula Nunes of the University of the West Indies, who have used cartoons to help the 'mundane' topic of communication skills - which medical science students rarely take seriously - 'come alive'.
Reading graphic stories may enhance students' observational and interpretive skills, as well as raise awareness of broader social and political issues associated with medicine. The comic series Depresso by Nottingham-based artist Brick, for example, has been used to train student mental health workers and is recommended by GPs to patients.
MK Czerwiec, a nurse and graphic artist, has found that the graphic medium can circumnavigate the professional detachment that comes from wearing a 'white coat'. She has asked caregivers to draw their experience of an illness from the point of view of a professional and a patient. Those drawn from a patient perspective were full of emotion and empathy, but that was lost when taking on a professional capacity.
Obstacles remain in challenging people's preconceptions and biases against comics - presenting comic-form information might seem flippant to some.
But that challenging these preconceptions has its benefits. As Fies said, "It gives people information they didn't have before in a way they hadn’t seen before. That a comic could do that come as a surprise to people."
Credit: Thom Ferrier, 2010.
Epileptic, David B., Pantheon Press 2006
Mom's Cancer, Brian Fies, Harry N. Abrams, Inc. 2006
Couch Fiction, Phillipa Perry and Junko Graat, Palgrave Macmillan 2010
Psychiatric Tales, Darryl Cunningham, Blank Slate Books 2010
Depresso, Brick, KNOCKABOUT 2010
I had a Black Dog, Matthew Johnstone, Robinson Publishing 2007
The Red Tree, Shaun Tan, Hodder Children's Books 2010
Diary Drawings: Mental Illness and Me, Bobby Baker, Profile Books 2010
Moyashimon: Tales of Agriculture, Del Rey Books 2009
Ode to Kirihito, Ozamu Tezuka, VERTICAL 2010
My Diary, Mio Matsumoto, Jonathan Cape Ltd 2008
Green MJ and Myers KR. Graphic medicine: use of comics in medical education and patient care. BMJ 2010;340:574-77