Nicolas Keramidas’ Open-Hearted is a frank and engaging account of his second heart operation at the age of 43, told with much warmth and humor as he strives to and succeeds in fully conveying the breadth of his experience. Born with a heart murmur, his first surgery had come soon after birth. Yearly check-ups would show everything to be fine, until one day in 2016 another look necessitated another procedure. Keramidas gives us all the details - technical terminology such as ‘tetralogy of fallot’ and all its corresponding scientific definitions - but he also acknowledges in the artwork that such words are hard to understand. As he puts it in the text, “waking life consisting of complicated technical terms, an unbroken flood of language that is totally abstract to me”. He will also use this technique later when describing the “not fun read” of the operating protocol, the comic relief again provided by his animated heart acting out his own interpretation of the incomprehensible medical language. This really connects with the reader as it is how almost anyone would react, the human and humorous ‘what the hell does all this mean?’ as one attempts to make some sort of sense of this terrifying new information. It is Keramidas’ use of humor that really shines through the whole tale - not poking fun at anything but rather exaggerating, playing with, slipping in and out of, as a means to understand, live through, and at times escape from the extreme seriousness of the situation.
This combination of frankness and fun is also present in the artwork, right from panel one, as we’re immediately confronted with the infant Nicolas with a huge scar down his chest, nevertheless smiling in his crib in a room with rad 70s red and orange sphered wallpaper. The fact that Keramidas would go on to work for Disney is foreshadowed by one of his stuffed animals being Mickey. His art though doesn’t look anything like what we associate with Disney, and as characters also surface later, they are distinctly portrayed in his individual style.
Such biographical information as working for Disney and his being called up for military service, coincidentally happening around the same time, are only given in relation to the main focal point of the story - Keramidas’ heart condition. We meet his family in much the same way during the first 26 pages that lead up to the incident in 2016 that necessitates his second operation. There’s a charming, and colorful, story about the origin of the scar on his chest, a fictional account of swallowing a marble, that nicely leads into the truth of the matter.
The breadth of Keramidas’ style is impressive - it appears to change and then you realize that it hasn’t actually, that he is just adept at covering a wide spectrum of moods. The freedom of his outdoor shots, the coldness of the hospital rooms, the worry in his and his family’s expressions as they wait for him to make it through the procedure. And, as mentioned before, the art giving nuance, often presenting a humorous take on what the words are saying, lightening the mood as surely is needed to deal with such a distressing situation. Keramidas is great at going with a theme. To illustrate a feeling, he’ll turn himself into a bird or a bowling pin, and in doing so the other characters will morph to match him, and he’ll keep this up for pages for pages at a time, sometimes returning to it. In another instance, after showing and stating how futuristic the hospital is, he continues this with space exploration-esque scenes as a probe is sent into his body for more information. And you can feel in his description just how painful it is. Likewise, how difficult he finds being in the hospital post-operation. And on page 163 you can really sense the tension and drama increase as another incident occurs when he is almost released from rehab.
Keramidas emphasizes just how vital keeping a journal was for both himself and his wife during the whole ordeal. These two records of events and feelings were often consulted in the writing of Open-Hearted as it transitioned from the notes of a diary into the words and pictures we now hold in our hands. The book is full of double page spreads and we get these in spades at the end as Keramidas is recovering at home and visualizing the future. These nicely segueway into the book at hand.