Greeny News

Graphic novels and medical comics are proving powerful communication tools for patients and medical professionals

Brian Fies began to draw his comic mom cancer When his mother was diagnosed with metastatic lung cancer. "I wanted to share my family 's history," he said. "I thought about it as drawing a map so that other people are following us, and with similar experience will know what to expect."

He discovered that comics were the perfect medium to tell his story. "I accompanied my mother to chemotherapy one day and drew a little sketch of her in the chair getting her chemotherapy. I decided that in that one sketch I'd somehow captured something essential to that day and to that moment that I wouldn't have been able to any other way. Something about the combination of one picture with a few words told more than either the picture or the words alone would have been able to."

Fies uses the tools of comics to illustrate metaphors in a literal way. He drew his mother drowning in medical jargon, for example, and walking the tightrope that was balancing her medication. "In comics I'm able to apply these metaphors literally ... a unique application of a unique medium."

Doctors, nurses and patients are increasingly using graphic art to unpack their experience of medicine and disease.

I attended the first ever academic conference on the subject and comics Medicine: Medical Narrative in Graphic Novels last month at the University of London, where doctors, nurses, patients and comic book artists shared their experiences of medical themes in comic books.

Paul Gravett, a historian and promoter of comics, told me doctors have been playing roles in comics for a long time. "One of the first that came out was called Rex Morgan, M.D.,one of these long, continuous, serialized daily strips in American newspapers. "It was established in 1948 by psychiatrist Nicolas P. Dallis under the pseudonym Dal Curtis.

In the 1950s, two comic books about doctors stood out: Psychoanalysis and MD, published by EC Comics.

In 1955, when the two titles were first published, they were charting new territory for comics. Until then no comic had dealt soberly and realistically with the medical profession and psychoanalysis. They tapped into the public's feeling of respect â€" bordering on awe â€" for doctors in 1950s America, and the hope that new areas of medicine could bring miracle cures.

"Right back when comics began over a hundred years ago, the envisaged readers were adults rather than children," said Ian Williams, a GP and comic book artist who helped organise the conference. "Then somewhere along the line they've been kind of hijacked by people writing for teens and adolescents or children, and that has stuck."

He said comics have had to battle for years against unfortunate stereotypes. "But there was a watershed in the 1980s when serious, long, graphic novels started being produced, which have had great critical acclaim. And over the last 10 years graphic novels have been reviewed in broadsheet newspapers and academic journals. Now there's a huge cohort of comics scholars who are looking at all forms of graphic narrative."

At Penn State University Medical School, Michael Green teaches medical students how to make and appreciate comics. "I think comics are relevant to medicine in a number of ways," he said. They can help students learn about the doctor-patient relationship, how to communicate bad news, informed consent, empathy and the experience of illness from a patient's perspective.

\\ "There sa 'an increasing number of adult thematic graphic stories that relate to health relevant topics," he said. He singled out three that have recently been published: Mother 's Cancer, Cancer Vixen, woman' s experience with breast cancer, and the seams, David Small, about memories of childhood, experience with cancer.

\\ "Each of these shows and tells about the important aspects of the illness experience."

In 2005, Mom's Cancer won an Eisner award â€" the comic book industry's equivalent of an Oscar â€" for "best digital comic". Fies said this professional recognition was "amazing" and the reaction from the medical community equally heart-warming.

"I got notes from nursing instructors in Australia who said they were using Mom's Cancer to train their students," said Fies. "I got an email from a cancer physician in Arizona who invited me to come speak to his group, some of whom said they would change the way they did their jobs because of what I'd written. That's immensely gratifying. That's huge! That's more impact than I expected to have on anything in my life."

The web is spearheading a revolution in comics, allowing creators to reach a global readership. MK Czerwiec, an HIV and hospice care nurse, was one of the first medical practitioners to publish her work, Comic Nurse, online, and collections are also published periodically in print.

Czerwiec has encouraged medical students to follow her lead and reflect on their experiences through comics. "We did an exercise in which we asked students to draw a diagnosis as if they were a patient receiving it, and we also asked them to draw a different diagnosis as if they were a doctor giving it," said Czerwiec. "When they drew diagnoses as a doctor, they drew disembodied body parts, but when they drew as a patient they drew embodied experiences of illness, with reference to an emotional reaction and to their whole families and lives."

She believes comics give the opportunity to tap into both the right and left sides of the brain for insight into an experience. "Words can access one thing, but when you challenge yourself to make images you access something totally different. It's very powerful to put those two things together."

Comic artists aren't restricting themselves to physical illnesses, either. Williams recommends a graphic novel by Justin Green about obsessive compulsive disorder. "I must admit, it seems a little strange to tell a room full of doctors they should be reading Binky Brown meets the Holy Virgin Mary," he said, "but I think the tide is turning."

He believes medical comic strips are a valuable resource for training health workers. "I think that they can be used as a window into the experiences that the patient," he said. "I see doctors reading comics, to get an idea of" patient experience "- that he 's how to get through this illness."

And their entertainment value should not be forgotten. "I think that this work is so beautifully complex and subtle, I think you can enjoy again and again, they can be dissected or use; read only for works of art or enjoy on many levels," Williams said.

Gravett points out that not every kind of graphic novel is suitable for patients or family members. "But there are graphic novels that are really going to be useful. Something like Mom's Cancer really does answer a lot of key questions that people have when they first have cancer in the family."

Adults' instinctive aversion towards comics as a serious medium will change, he believes, "as people realise they simply aren't automatically kids' stuff or humorous â€" that they can deal with [medical issues] very powerfully, and very effectively ... It's an extraordinarily rich language which we're only just discovering and inventing, and learning to really exploit to its fullest."

Do you know of any medical graphic novels I've missed? Later this week I'll be posting a list of my favourites on this blog. You can see more examples on Ian Williams' excellent website.