GRSJ224/Graphic Medicine and Autopathography

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Introduction

What is Graphic Medicine?

Graphic medicine is the use of comics to tell fictional or personal stories of illness and health, and used in medical education and patient care.[1] The phrase, “graphic medicine[2]” is coined by Dr. Ian Williams, who founded the website Graphic Medicine, which explores the various roles comic books play as an alternative and additional mode of communication of healthcare and medicine. The website houses comic reviews, critiques and other research curated by medical professionals, artists, authors and academics.

Graphic Medicine Manifesto

The Graphic Medicine Manifesto, is co-authored by six pioneers of graphic medicine whose essays and original narratives establish the principles of graphic medicine. It is a collection of research about the benefits of reading and creating comics; challenging traditional medical education and care-giving practices; and how graphic pathographies can engage with healthcare workers, patients, and educators in new ways[3]. The volume demonstrates the value of comics as an effective communication tool and healing medium[4]. The manifesto also speaks to the need to offer increasingly culturally sensitive, tailored and inclusive perspectives of medicine, illness, disability, care-giving, and being cared for.[5]

Graphic Autopathography

Autopathography is patient-centered storytelling that documents the lived experience of illness, disorder and/or disease as experienced by the author. "Graphic autopathography combines the explicit meaning of words and symbols with the abstract expressiveness of art to create the unique, multi-layered language of comics."[6] Scott McCloud, a comic scholar adds "...the text and images work together to create meaning that neither convey alone."[6]

Benefits of Using Graphic Medicine Within The Medical Field

Graphic medicine communicates the author's internal perspective and mindset in regards to their personal experiences of illness and health. They are able to reclaim their emotional and psychological experience away from the medical gaze by choosing how to depict themselves in their own narrative.[7][8] The emotional and subjective realm through personal visual art is paired alongside external, clinical and medical diagnoses of illness. The combination of these allows the author to represent their experience within the health care system. It also offers valuable feedback to health care providers, promotes effective treatment, and provides insight for family, the public and individuals dealing with similar health situations.[2] Medical professionals who document personal medical narratives in conjunction with being a practitioner can further humanize the medical system and complicate professional and patient perspectives of the system. [4][6]

Graphics of specific clinical information can be folded seamlessly into a story, expanding on the author’s subjective experiences. Such can be found in the pregnancy memoir, Kid Gloves by Lucy Knisleywho includes medical explanations for mastitis and pre-eclampsia; and statistics like percentages of natural vs. anesthetized childbirth in the USA, infant mortality rates and urinary tract infections.[9][10] The same factual seamlessness with illness narrative can be seen in Trauma Is Really Strange by Steve Haines. It illustrates a highly complicated issue about how the brain is affected by traumatic events, how it physiologically manifests in the body and how to overcome it.[11] Learning about illness and treatment can be an effective coping and cathartic experience for the author, and sharing that information with readers can transform a negative experience into a positive one.[6]

Social Justice Through Medical Humanities

As part of medical humanity studies, graphic pathologies often reach beyond explicit health, healthcare and medicine facets to encompass social justice themes because any “social determinants of health” is relevant to a person's health[12]. These comics can expose readers to wider ranges of lived experiences and, how health challenges further complicate certain lives, build empathy and allow underrepresented individuals the chance to see themselves reflected in mainstream media.[1] They explore how health issues and impairments impact individual lives; how they make their lives more complex; and how they bring about challenging conversations around issues of access, inclusion, equity, and related topics as they touch on healthcare.[5]

Value of Intersectional Health Education and Practice

The libraries within early education classrooms to legal and medical libraries, need more quality texts featuring the health stories of people of color, different gender identities and sexualities, and abilities.[13][14] Aligned within the social model of medical care, intersectional graphic pathographies increased the growing value gained from using comics to: promote patient awareness during the informed consent process and empower patients in their situation; balance expectations between care providers and patients; and increase narrative medicine and factual storytelling abilities for practitioner and patient.[15][16]

Science and medicine influence, contextualize and help people understand their responses to physical and mental states of living. Therefore different insights into the human condition affect our awareness of health, addiction, illness, disease, suffering, recovery, and death[16]. It allows for more attention to be drawn to the cultural coding of how issues of gender, class, race, sexual orientation, or other cultural biases and stigmas change perceptions of health, disease, suffering and death.[3]

Critical race theory and intersectionality are not cerebral exercises. The practice of intersectionality is proactively seeking opportunities to eliminate a range of oppressive forces on people’s lives. It is an alive tool that helps identify whose identities are being (un)centered, (un)heard, (un)protected, and (un)benefited. It also works to locate the subject’s identity within a power structure and looks at all the forces at play to contextual a person's experience.

Education and Medical Narratives

Psychiatric Tales

In Psychiatric Tales, Daryl Cunningham documents his perspective of mental illness as a caregiver and as a client.[17] He works to destigmatize schizophrenia, dementia, depression and personality disorders while delivering his own experience of living with anxiety and depression.

Taking Turns

In Taking Turns, MK Czerwiec, chronicles seven years as a nurse at the HIV/AIDS Care Unit at Illinois Masonic Hospital. Czerwiec "provides basic education throughout the book on the etiology of AIDS/HIV, how symptoms of the illness manifest, and how the advancements in medication dramatically improved treatment outcomes for those dealing with AIDS/HIV.[18]" She also illustrates emotional moments from "professional detachment" to deep compassion and care in creating patient-provider intimacy; the unfortunate truth of human mistakes as a medical professional and client family breakdowns; and how frequently witnessing death affect her own mental health.[18]

Sexual Violence

The definition of sexual violence varies depending on political, legal, clinical or scientific perspectives. Sexual violence is unwanted sexual experiences by force or coercion, or by someone incapable of giving consent because of age or physical or mental incapacity. “Sexual assault violates the victim’s fundamental rights, including the right to physical and psychological integrity and security of the person[19].” In the United States, approximately one in five women and one in thirty-eight men have experienced attempted or completed raped in their lifetime.[20] One in three women experience this between 11-17 years old with one out of eight reporting incidents occurring before 10 years old[20]. The experiences of sexual violence, stalking, and intimate partner violence is increasing despite under reporting[21]. Individuals who are mentally ill, physically disabled, Indigenous, people of colour and/or queer experience higher rates of violent victimization[22].

Disrespectful and offensive depictions of sexual abuse outnumber authentic representations of abuse survivors. Comics are political when sexual violence is used as a tragic plot device[23]. Authors, editors and publishers are accountable for stopping the perpetuation of problematic tropes such as the women in refrigerators, where women in comics are violently and unnecessarily killed off.

Done well, depictions of sexual abuse in comics provide can aid in the healing of victims, positively inform care takers and shape the legal actions society takes against abuse. Those who have experienced oppression or trauma, survivors of sexual violence or work with those who do, can look to comics to validate their personal struggles and build community with others.

Bezimena

Nina Bunjevac uses her experience as a sexual assault survivor in her memoir, Bezimena[24], to depict the imagined psyche of a sexual predator who stalked and sexually assaulted her at 15 years old[25]. She critiques and complicates the healing process of trauma as seemingly straightforward in self-help and therapy-saturated culture[26] when in actuality memory, sensuality and consent are sometimes not apparent for herself.[25] Bunjevac dedicates her memoir to all forgotten and nameless victims of sexual violence in hopes this book will support the body’s innate ability to discharge trauma[25]. 

Drawing Power: Women's Stories of Sexual Violence, Harassment, and Survival

Diane Noomin edited the anthology, Drawing Power: Women's Stories of Sexual Violence, Harassment, and Survival,[27] in reaction to the #MeToo movement. Roxane Gay opens the book by validating the use of visual communication as a language that provides valuable insight into the women's’ experience of sexual violence; how they make sense of traumatic experiences; and how each person has their own coping skills for dealing with trauma and the ramifications from them.

Dragonslippers: This Is What an Abusive Relationship Looks Like

Dragonslippers: This Is What an Abusive Relationship Looks Like[28] is Rosalind B. Penfold’s commitment to teaching other women to recognize the danger signs of domestic violence and how to provide support to victims.[29] She drew in her moments of dissociation to cope with her experience of suffering through isolation, psychological manipulation, and other tactics of controlling behaviour. She also alludes to suspected child abuse by the abuser. It is by looking at her drawing records that she recognized patterns and signs of abuse which helped her leave the abusive relationship. She also expresses her reasons for why victims stay in abusive or unhealthy relationships and the complexity involved in leaving them. This is suitable for those looking to support abused women, and social workers who work with children who deal with post-traumatic stress disorder (PTSD) developed from domestic abuse situations.

Conferences/Symposiums

Graphic Medicine Conference

The Graphic Medicine conference[30] aims to encourage critical dialogues and interventions that explore the intersections between personal, environmental and social health as well as equity, and justice within comics. The overarching focus is to critically address issues of institutional powers that affect health through comics; how comics enrich healthcare education and practice for healthcare professionals; and how graphic medicine can increase awareness and solidarity with people whose experiences have been silenced, misunderstood, misrepresented and underrepresented in mainstream health culture.

"Cripping" the Comic Con

"Cripping" the Comic Con is a biennial symposium that celebrates disability culture and reclaims the word crip to subvert problematic representations of disability that exist within mainstream popular culture, particularly within comic books. "Cripping" the Comic Con highlights the importance of discussing and seeking justice for all intersecting identities with disabilities to create a more inclusive and accessible world. The event is free, open to the public and live streamed as a small part of their accessible and inclusion guidelines[31]. American sign language (ASL) interpretation is available for the entire symposium and communication access real-time translation (CART) is available during the plenary session.

See Also

References

  1. ↑ 1.0 1.1 Myers, Kimberly R.; Goldenberg, Michael D. F. (February 2018). "Graphic Pathographies and the Ethical Practice of Person-Centered Medicine". AMA Journal of Ethics. 20: 158–166.
  2. ↑ 2.0 2.1 Williams, Ian (2007). "Why "Graphic Medicine"?". Graphic Medicine. Retrieved July 25, 2020.
  3. ↑ 3.0 3.1 Sharma, Gunjan (February 26, 2015). "Pathographies". The Medical Student Press Blog. Retrieved July 30, 2020.
  4. ↑ 4.0 4.1 Green, Michael J.; Myers, Kimberly R. (March 3, 2010). "Graphic medicine: use of comics in medical education and patient care". BMJ (Clinical Research Ed.): 340.
  5. ↑ 5.0 5.1 Robbins, Margaret (Summer 2015). "Using Graphic Memoirs to Discuss Social Justice Issues in the Secondary Classroom". The ALAN Review. 42: 35–47.
  6. ↑ 6.0 6.1 6.2 6.3 "Graphic Medicine: Ill-conceived & Well-Drawn". National Library of Medicine. May 29, 2019. Retrieved July 25, 2020.
  7. ↑ Radtke, Kristen (August 29, 2019). "Body of work: how the graphic novel became an outlet for female shame". The Guardian. Retrieved July 30, 2020.
  8. ↑ Zimmerman, Edith (December 20, 2018). "These Are Not Sad Stories: How graphic medicine humanizes the world of health care". The Cut. Retrieved July 25, 2020.
  9. ↑ Knisley, Lucy (2019). Kid Gloves: Nine Months of Careful Chaos. New York, New York: First Second Books. pp. 1–248. ISBN 9781626728080.
  10. ↑ Wolf, Kevin (June 18, 2020). "Bearing Stories". Graphic Medicine.
  11. ↑ Hains, Steven (2017). "Trauma Is Really Strange". Body College.
  12. ↑ Anderson, PF (June 21, 2019). "45 Graphic Memoirs and Graphic Novels on Social Justice Themes". Emerging Technologies Librarian. Retrieved July 25, 2020.
  13. ↑ Moeller, Robin; Becnel, Kim (February 19, 2018). "Drawing Diversity: Representations of Race in Graphic Novels for Young Adults" (PDF). School Library Research. 21: 1–17.
  14. ↑ Gianfrancesco, Michael (January 26, 2018). "Opening doors for all students: Comics featuring characters with disabilities". Pop Culture Classroom. Retrieved July 25, 2020.
  15. ↑ Fernandez, Karina Therese G. (July 16, 2019). "Draw Me Your Thoughts: The Use of Comic Strips as a Cognitive Behavioral Therapy Intervention". Journal of Creativity in Mental Health. 15: 17–29 – via Taylor & Francis Online.
  16. ↑ 16.0 16.1 Yu, Megan (February 2018). "Roles of Graphic Pathographies in Clinical Training". AMA Journal of Ethics. 20: 115–121.
  17. ↑ Zhang, Melanie (February 18, 2015). "Psychiatric Tales". Graphic Medicine. Retrieved July 25, 2020.
  18. ↑ 18.0 18.1 McCreight, Devlyn (April 21, 2017). "Taking Turns: Stories from HIV/AIDS Care Unit 371". Graphic Medicine. Retrieved July 25, 2020.
  19. ↑ "Sexual Assault: What is it?". Media Kit on Sexual Assault. Retrieved July 30, 2020.
  20. ↑ 20.0 20.1 Smith, Sharon G.; Zhang, Xinjian; Basile, Kathleen C.; Merrick, Melissa T.; Wang, Jing; Kresnow, Marcie-jo; Chen, Jieru (2015). "National Intimate Partner and Sexual Violence Survey: 2015 Data Brief". Centers for Disease Control and Prevention.
  21. ↑ Morgan, Rachel E.; Oudekerk, Barbara A. (September 2019). "Criminal Victimization, 2018" (PDF). Bureau of Justice Statistics. Retrieved July 30, 2020.
  22. ↑ Cotter, Adam; Savage, Laura (December 5, 2019). "Gender-based violence and unwanted sexual behaviour in Canada, 2018: Initial findings from the Survey of Safety in Public and Private Spaces". Statistics Canada. Retrieved July 30, 2020.
  23. ↑ McConnell, Kelsey (July 30, 2017). "Trauma isn't a Prop: Sexual Abuse in Comics". Comicsverse. Retrieved July 25, 2020.
  24. ↑ Bunjevac, Nina (2019). Bezimena. Seattle, Washington: Fantagraphics Books. pp. 1–248. ISBN 978-1683962090.
  25. ↑ 25.0 25.1 25.2 Lechoczky, Etelka (May 30, 2019). "Black And White 'Bezimena' Is Colored By Trauma And Yearning". NPR. Retrieved July 31, 2020.
  26. ↑ Schwartz, Alexandra (January 8, 2018). "Improving Ourselves to Death". The New Yorker. Retrieved July 31, 2020.
  27. ↑ Noomin, Diane, ed. (2019). Drawing Power: Women's Stories of Sexual Violence, Harassment, and Survival. New York: Harry N. Abrams. pp. 1–272. ISBN 9781419736193.
  28. ↑ Penfold, Rosalind B. (2005). Dragonslippers: This is what an abusive relationship looks like. Canada: Penguin Group. pp. 1–272. ISBN 9780802170200.
  29. ↑ Penfold, Rosalind (2005). "Dragonslippers: This is what an abusive relationship looks like". Friends of Rosalind - Dragonslippers.
  30. ↑ "Comics and Medicine Conferences". Graphic Medicine. 2020. Retrieved July 25, 2020.
  31. ↑ "Cripping" the Con (2019). "Some Notes about Accessibility and Inclusion". Retrieved July 25, 2020.

Further reading

External links

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