“We Are All Living In Finite Bodies”: A Conversation About Graphic Medicine

The Graphic Medicine website was launched in 2007 as an outgrowth of Dr. Ian Williams’ post-graduate work in the study of fine art and Medical Humanities. Now a practicing physician based in the UK, Williams has been making comics informed by his experiences for over a decade. In 2012, Williams joined MK Czerwiec, RN, MA, (also known as ComicNurse)to relaunch the website as GraphicMedicine.org. 

In the intervening years, Graphic Medicine has grown, becoming an international cohort of scholars, librarians, educators, and health care professionals whose goal is to highlight the ways in which graphic narratives can enrich the discourse around medical issues, such as health care, illness, disability, and bodily autonomy. This analysis takes a variety of forms, such as reviews, interviews, podcasts, and, yes, comics. Through their work, they have helped bring to bear a field of scholarship on these subjects and built another avenue within academia that gives comics deeper, more thoughtful consideration.

Importantly, the Graphic Medicine methodology does not just emphasize the the benefits of consuming comics, but of creating them, as well. Their scholarship indicates that this has proven empowering to health care providers and recipients, alike. Above all, Graphic Medicine espouses comics as a tool for communication. In the era of COVID-19, the benefits of succinct, easily transmissible  communication, have never been more clear and the necessity of it has never been greater. I caught up with MK Czerwiec via email to discuss Graphic Medicine’s past, present, and future. -Ian Thomas

Ian Thomas: In your words, can you describe Graphic Medicine and its mission? 

MK Czerwiec: The term “Graphic Medicine,” refers to the intersection of the medium of comics and the discourse of health, illness, disability, and caregiving. The broad mission of the graphic medicine community is to support work that takes place at that intersection. 

What is your background as it relates to comics? 

I read the Sunday funnies and Peanuts paperbacks as a kid, but was not passionately involved with most mainstream comics, simply because I couldn’t find myself in them. As a college student, I loved Matt Groening’s Life in Hell and Lynda Barry’s Ernie Pook’s Comeek in the local indie newspaper. It really wasn’t until I was working as a nurse on a dedicated AIDS care unit in Chicago during the 90’s that I stumbled into making comics. It was a surprisingly effective way to process the difficult experiences I was witnessing and having in that work. 

Taking Turns, Penn State University Press (2017). By MK Czerwiec

Can you talk a little bit about how and when you came to be involved with Graphic Medicine? 

After our AIDS unit closed, and I had been making comics for a few years and posting them weekly to my website with positive response, I decided to go to graduate school to study medical humanities & bioethics. My intention was to inform my comics about experiences during the AIDS crisis with theory about the important work that stories do in the arena of health and bodies. Also, I felt a need to think critically about the ethics of making stories that stem from the lives of my patients. My ultimate goal was to do a long-form comic, which eventually became my book, Taking Turns: Stories from HIV/AIDS Care Unit 371. 

Toward the end of grad school, I came across Brian Fies’s Mom’s Cancer. It is a ground-breaking book, and helped me expand my thinking about the potential that comics could have in health care. Suddenly it wasn’t just about me making comics, but the potential that these works could have to actually impact health and caregiving. I wondered, for example, if a book like Mom’s Cancer, an intimate and brilliantly critical account of a family’s interaction with an imperfect health care system, could be used to teach future health care professionals. It seemed to me that the insights student caregivers could gain from this kind of book were as valuable (but with less potential for harm) than clinical encounters with real patients! I also wondered what other books like Mom’s Cancer, which is to say created by the people going through illness and caregiving, were already out there. 

From Mom's Cancer, © Brian Fies

It turns out I wasn’t alone in this contemplation. A small group of people met about a year later to discuss the potential of comics and health care coming together in useful ways, and I joined them in London, England. This is where a graphic medicine community began to form. 

In the Graphic Medicine Manifesto, I read what felt to me like an overlap between illustration, graphic representation, and the sequential art of comics in the discussion of materials that Graphic Medicine champions. As it relates to Graphic Medicine, is a distinction made between these different forms of visualized expression? 

When we review submissions for the annual graphic medicine conferences and for featuring projects on our website, graphicmedicine.org, our focus is on comics. That said, our colleagues in Medicina Gráfica do cast a wider net to include some of the other visualizations of medical information you mention.

In the Graphic Medicine Manifesto, Michael J. Green writes that “while thinking emphasizes particular cognitive processes, acting stresses measurable skills and outcomes. Having students read carefully selected comics can further both objectives.” This encapsulates a sentiment that I strongly felt throughout my reading of much of the Graphic Medicine literature, which is that I think there is a lot of emphasis placed on direction toward and curation of reading materials. I wonder if this does a disservice to the medium of comics and even the mission of Graphic Medicine by limiting exposure to the medium, rather than emphasizing universal themes and qualities of the medium. I wonder if it relies too heavily on the tastes and biases of the instructor or advocating institution. 

Having taught with Michael in the context of a medical school, I think he’s referring to selecting comics not so much for taste, although that likely does come into play, but more [for] comics that meet the context and concrete learning objectives of the course in which they are being used. That said, students have often responded to the notion that comics can have a serious role in health care like a light bulb being lit - they were not aware of the great body of work that connects comics and their future career. Beyond the reading for the course, they will seek out comics that most appeal to them. In lectures and courses I teach, I try to share a wide range of titles that students can choose among, literally wheeling a suitcase of texts into the class (back when we could meet in person) and dedicating time for them to browse, so they can see the diversity of topics and styles the medium can encompass.

The Manifesto was published in 2015, can you point to any ways in which the Graphic Medicine project and mission has changed since its publication?

Two answers come to mind here. First, since the Manifesto was conceived, written, and published, our understanding of the scope of work that we consider to be graphic medicine has expanded. We’ve realized that comics on topics like racial injustice and climate change are graphic medicine, as these issues profoundly impact physical and mental health and well being. Secondly, I’d like to believe there is an effort to de-center medicine as the focal point of graphic medicine — to move the focus away from the clinical environment and into communities. 

Who is the target audience of Graphic Medicine? Who are you trying to reach and what would you like them to take away from engaging with Graphic Medicine? 

We are all living in finite bodies, so graphic medicine has something for every one of us. I think each person using graphic medicine may have a different goal, but as a nurse, simply put, I want to make things better. So I engage with and use graphic medicine in hopes that it can help make inevitable illness, decline, and/or caregiving easier to bear. For example, here is a comic that was used to help people consider the importance of creating advance directives, while recognizing the barriers to them actually doing so, and proposing an innovative solution.

Can you give some examples of recent publications that fall within the Graphic Medicine rubric? I’d like to put a finer point on what merits coverage and why. 

There are at least two new COVID-19 comic anthologies: Covid Chronicles, by Ethan Sacks, published by AWA Studios, and Covid Chronicles: A Comics Anthology, edited by Kendra Boileau and Rich Johnson. One is out now and another will be released in February from Graphic Mundi, the new imprint from Penn State Press. There are the recent sex-ed titles like Drawn to Sex Volume 2 and the forthcoming Let's Talk About It. Then there are more traditional graphic pathographies released recently, such as Kimiko Does Cancer and also Dancing After Ten. 

Also included would be a title my colleague, medical librarian Matthew Noe, recently reviewed, My Broken Mariko. This is a title, as Matthew points out, that might get missed when thinking about graphic medicine but it is definitely in our wheelhouse, as it is about grieving the loss of a friend and death by suicide. 

Scholarly texts that look at comics about health are also covered by our website and community. The most recent one that comes to mind is Gender, Eating Disorders, and Graphic Medicine by Anu Mary Peter and Sathyaraj Venkatesan. 

I’d like to say also that comics about topics such as bullying, racial injustice, war, migration, climate change, and gender identity all would be considered graphic medicine when they discuss the profound impact these issues have on mental and physical health. 

My colleague Kevin Wolf, who is the reviews editor for our website, has started doing reviews of what he calls “medical mentions”. By this he means, “books whose primary topics are not medical, and yet they cover a medical topic with some depth at some point in the work.” The first installment of those reviews can be found here. 

Can you point to some of the major successes of Graphic Medicine up to this point? 

In my opinion, the greatest success of graphic medicine is the vibrant community that has gathered at the intersection of comics and health. It’s worldwide, multidisciplinary, growing, and engaged year-round, not just during our annual conferences. 

We have also been accepted in arenas of health care that don’t traditionally take comics seriously, such as medical journals, academic programs, research studies, and more.

How has your work with Graphic Medicine informed your approach to your ongoing comics project, Comic Nurse?

They go hand-in-hand. On the graphic medicine front, I teach, lecture, curate, research, write, seek advice, and advise. My own comics work is where I explore and integrate my ideas and experiences through doing all that work.

Work from MK Czerwiec

Moreover, can you talk about how it informed your approach to editing Menopause: a Comic Treatment, which was released last summer? 

The most direct way is that it was through my work in Graphic Medicine that I knew many of the wonderful people to solicit for work in the anthology! My work in Graphic Medicine also assisted me in valuing the diversity of experiences in this arena. I worked hard to represent that diversity. Graphic Medicine also helped me to see power of comics to describe, bear witness to, and challenge the stigma around uncontrollable bodily experiences.

Can you talk about if and how your work in Graphic Medicine has influenced your approach as a health care worker? 

Well, it’s allowed me to have a “second act” as a nurse, that is, to pivot away from bedside nursing. I’m not currently working clinically. 

Graphic Medicine is comprised of healthcare workers, can you talk what the last year has been like amid COVID? How has it informed coverage in Graphic Medicine and what opportunities do you think it has presented? 

Especially in the early months of the pandemic, my work pivoted almost exclusively to working with my colleague Alice Jaggers, a medical librarian, curating COVID comics for our online collection. COVID comics quickly and efficiently demonstrated the important roles that comics can and do have in health care. This is evidenced by the main categories we’ve established for curating the comics that emerged (and are emerging) about COVID. 

After I finished my book, Taking Turns, I did some research about the role comics had during the AIDS crisis in the US. Unfortunately, though there are some examples, most were lost to history. It’s great to know that the comics being made now will not be, thanks to the worldwide community that has formed at the intersection of comics and health. 

We were, like many organizations, forced to cancel our annual conference due to the COVID pandemic. In its place, we wanted to create some way for our community to stay connected. So in April we started gathering for sessions we call “Drawing Together.” We also created an online archive of our activities. 

But I also want to clarify - members of the graphic medicine community go far beyond health care providers. We pride ourselves on the diversity of perspectives and positions from which we all come.

Does Graphic Medicine take any position on advocating for policy changes in the healthcare industry as they relate to patient care? I’m thinking of issues like the ongoing push for greater access to healthcare made by grassroots organizations and progressive policymakers, as well as efforts to advocate for greater reproductive justice and greater bodily autonomy. Do healthcare issues that cross over into the realm of politics complicate projects like Graphic Medicine or do you feel like they present opportunities? 

Graphic Medicine, just by virtue of using comics, becomes a powerful medium for doing all that work. We see our role as facilitating the kinds of relationships, learning opportunities, and networking that will produce projects that members of our community will do in their areas of work, experience, and interest. 

Can you speak to what the future holds for Graphic Medicine? 

As for the immediate future, we will be soon announcing a creative and innovative approach to our 2021 conference, so look for that. We eagerly look forward to when our community can gather in person again, and hope to continue fulfilling our mission, which is to guide and support the users of comics in health.