Graphic Medicine: Comics Creation as Knowledge Formation

Stevanovich Institute on the Formation of Knowledge, University of Chicago 

Spring 2021

Brian Callender, MD, [email protected]

MK Czerwiec, RN, MA, [email protected]

Course Description: 

What does the medium of comics contribute to our knowledge and understanding of illness, disability, caregiving, and disease? How can making comics help us form individual and community knowledge about our bodies and health? Graphic Medicine: Comics Creation as Knowledge Formation is a course designed to introduce students to the basic concepts and practices of the field of graphic medicine. To do this, we will closely engage with the elements and process of making comics as applied to the goals, principles, and applications of graphic medicine in particular, but also in relation to the health humanities.

Broadly defined as the “intersection between the medium of comics and the discourse of healthcare,” graphic medicine allows for unique explorations of health, disease, and illness through the use of sequential images and textual elements within a narrative structure. Students will learn about conceptual and practical aspects of the field. Through critical analysis and discussion of key works, they will also be exposed to a variety of styles, genres, and applications that capture the breadth and diversity of graphic medicine. An important component of the class will be exercises through which students will create their own graphic medicine works as a way to explore knowledge formation about health, illness, and one’s body through comics-making. Taught by a nurse cartoonist (and a founding figure in the field) and a physician, the course provides a perspective of the field from within the practice of medicine. Through didactics, discussion, and practice, this course will provide students with a thorough understanding of the field of graphic medicine and key elements of comic creation as an act of knowledge formation. 

No prior knowledge or experience of graphic novels, comics, drawing, or medicine required. 

Course Objectives:

By the end of the course, we intend for students to:

  • Understand basic concepts and practices of the comics medium
  • Examine the use of comics to convey ideas and formulate knowledge about health, health care, the body, illness, caregiving, and disability
  • Focus on the elements and process of making comics as applied to the goals and applications of graphic medicine and the health humanities

Meeting times:  

  • Tuesdays, 2:40-4:00pm
    • Remote only
  • Thursdays, 2:40-4:00pm
    • optional in-person, Stevanovich Institute on the Formation of Knowledge, 5737 S University Ave, Classroom 104

Select readings available in book form here:

Introduction to Graphic Medicine

Topics:

    • Personal introductions – students and teachers
      • Create your avatar/self-portrait
    • Introduction to the course
    • Introduction to Graphic Medicine
      • What?
      • Why?
      • How?
      • What graphic medicine has to offer:
        • Graphic Pathographies
        • Patient Education
          • Materials
          • Activities/Exercises
        • Professional development/training
        • Comics as a form of knowledge formation and understanding
    • Basic Tools of Comics-Making

Readings:

    • Czerwiec, MK et al. “Welcome to the Graphic Medicine Manifesto.” Graphic Medicine Manifesto. Pennsylvania State University Press, 2015. 
    • Del Rey Cabero, E, M Goodrum, and JM Mellado. How to Study Comics & Graphic Novels: A Graphic Introduction to Comics Studies. Oxford Comics Network, 2021. 
    • Wood, Wally. Wally Wood’s 22 Panels that Always Work. 
    • Cohn, N. Beyond speech balloons and thought bubbles: the integration of text and image. Semiotica 2013; 197: 35-63.
    • Hortstkotte, S. Zooming in and out: panels, frames, sequences, and the building of graphic storyworlds. From Comics Strips to Graphic Novels: Contributions to the Theory and History of Graphic Narrative, edited by Daniel Stein and Jan-Noel Thon, DeGruyter, 2013.
    • Madden, M. 99 Ways to Tell a Story: Exercises in Style. Chamberlain Bros., 2005. 
    • Cartooning in an Anxious Age (late add)

Exercises:

    • Drawing a skeleton (shortening of time) – getting to the essence of the image, acknowledgement of innate ability to represent visually (see Lynda Barry’s Making Comics) 
    • Drawing 9 faces – facial expressions to convey emotion (based on Lynda Barry’s work) 
    •  FAST – Marek Bennett’s theory of comic content: panels should contain two of the following: 
      • Faces
      • Action
      • Setting
      • Text 
    • Blind contour object setting up dialogue – moving toward making comics – how panels can interact (idea from Lottie Corr) 

 

Scott McCloud’s theory of facial expressions (from his book Making Comics) is excerpted here.

Scott McCloud, from Making Comics, Harper Collins, 2006

In our last exercise, we worked with cartoonist Marek Bennett’s F.A.S.T. theory (every comic panel should have at least two of the following: face, action, setting, text). Here’s a great video of him showing how he used primary source materials to create a character from stick fixture to Civil War soldier.

Illness Narratives

Topics: 

Introduction to illness narratives and graphic pathographies

      • What are they?
      • What is their purpose?
      • Categories and genres of illness narratives

Reading(s):

    • Moss, Marissa. Last Things: A Graphic Memoir of Loss and Love. Conari Press, 2017.
    • Hyden, LC. “Illness and Narrative.” Sociology of Health and Illness 19(1); 1997: 48-69.
    • Hunsmaker Hawkins, A. “Pathography: patient narratives of illness.” Western Journal of Medicine 171(2); 1999: 127-129.
    • ‎Beck, J. Story of My Life: How Narrative Creates Personality. The Atlantic, August 10, 2015
    • Hidden Brain: The Story of Stories (Part 1) ‎Hidden Brain: The Story of Your Life on Apple Podcasts (Part 2)
    • Lamprell, K and J Braithwaite. “Patients as story-tellers of healthcare journeys.” Journal of Medical Humanities 2016; 0: 1-3.
    • Woods, A. “The limits of narrative: provocations for the medical humanities.” Medical Humanities 2011; 37: 73-78.

Exercises:

Scribble Monster warmup (via Lynda Barry):

          1. Draw four boxes on a page
          2. Make a large, random scribble in the first box.
          3. Turn that scribble into a monster.
          4. In the second pext panel, draw your monster’s parents.
          5. Next panel, draw scribble monster as a child.
          6. Next panel, draw scribble monster as a 90 year old.

Close Reading a comic – three approaches: (Using p. 9 of Marissa Moss’s Last Things.)

        1. Draw a panel that could appear in the gutter between two existing panels.
        2. Draw a panel from the perspective of a different character in the book.
        3. Annotate the page – Nick Sousainis on annotating comics pages.

Phenomenology and the Illness Experience

Topics: 

    • What is phenomenology?
      • Key features of embodiment
      • Key features of illness
    • What is the illness experience?
    • Illness-Disease-Sickness triad
    • Why comics as a medium to express and understand the illness experience

Readings: 

    • Dunlap-Shohl, P. My Degeneration: A Journey Through Parkinson’s. Penn State University Press, 2015.
    • Toombs, SK. “Illness and the paradigm of the lived body.” Theoretical Medicine 1988; 9(2): 201-26.
    • Williams, Ian. “Comics and the iconography of illness.” Graphic Medicine Manifesto. Pennsylvania State University Press, 2015.  
    • Myers, KR et al. “Use of a graphic memoir to enhance clinicians’ understanding of and empathy for patients with Parkinson disease.” The Permanente Journal 2020; 24: doi: 10.7812/TPP/19.060
    • Kukkonen, K. “Space, Time, and Causality in Graphic Narratives: An Embodied Approach.” From Comics Strips to Graphic Novels: Contributions to the Theory and History of Graphic Narrative, edited by Daniel Stein and Jan-Noel Thon, DeGruyter, 2013.

Exercises 

      • Disease, Illness, and Sickness: a Venn diagram exercise
      • Draw a Clinical Encounter
        • draw the panel that came before that encounter (Context)
        • draw the panel that came after that encounter (Consequence)

Drawing as Knowledge Formation

Topic(s):

    • Comic-making as a form of understanding and knowledge formation
    • Ethics of representation in (auto)biographical comics
    • Authenticity in (auto)biographical comics

Reading(s):

    • Czerwiec, MK. Taking Turns: Stories from HIV/AIDS Care Unit 371. Penn State Press, 2017
    • Raphael, LS and M Rowell. “How should we judge the ethics of illustrations in graphic medicine novels?” AMA Journal of Ethics 2018
    • Chaney, MA. Introduction. Graphic Subjects: Critical Essays on Autobiography and Graphic Novels. The University of Wisconsin Press, 2011. 
    • Kuhlman, M. “The autobiographical and biographical graphic novel.” In: Tabachnick, SE, ed. The Cambridge Companion to the Graphic Novel. Cambridge University Press; 2017: 113-129. 

Exercises: 

      • Make a drawing to represent an abstract concept (selected from research articles brought) 
      • All students draw a visual abstract for a single article: https://journalofethics.ama-assn.org/article/how-should-we-judge-ethics-illustrations-graphic-medicine-novels/2018-02 
      • Create a visual abstract for the journal article that you brought to class. By “visual abstract” we mean an image that represents the main concept in the article. If you Google “visual abstract” what you get are somewhat text-heavy infographics. That’s not exactly what we are after with this assignment. We’re challenging students to use as little text as possible and be creative with the comics medium to do this work. 

Drawing the Body

Topics:

    • Embodiment in comics
    • Depictions of the body and disease/illness in comics

Readings:

Exercises: 

    • Body Mapping: sharing images of body maps as they appear in graphic medicine texts, discussion of the relationship between maps and comics
    • Draw your body map – consider creative body gesture, and narrative 
    • Suggestion round – add elements representing: childhood, scars, favorite organ, least favorite organ, enviornmental impact, mood, stress, perception (the 5 senses) 
    • Student suggestion round: color, robotic adaptation, superpower 
    • Building off of the importance of senses to embodiment and the lived-body, as well as the body mapping prompts about senses, this assignment is meant to further explore the senses and memory: 
      • For each of the below prompts, write your answers:
        • Favorite or Most Memorable Taste
        • Favorite or Most Memorable Touch
        • Favorite or Most Memorable Smell
        • Favorite or Most Memorable Sound
        • Favorite or Most Memorable Sight
      • For each of those answers, sketch them onto a sense body map similar to the Mundus Intellectualis drawing by Robert Fludd.
        • Use this image as a rough basis for creating your sense memory body map or trace/copy it directly and layer on your images/text
      • After you’ve sketched out the distillation of each memorable sense, diagram that memory to another sense. 
        • Think about how other senses augment the primary memorable sense. 
      • Consider connecting a primary memorable sense to multiple senses.
      • The goal is to build a comics diagram of memorable senses.
      • This is meant to be more of a quick sketching exercise and not meant to be a full production comic.

Mood, Emotions, and States of Being

Topic(s): 

    • Depictions of mood and emotions in comics
    • How do you express feelings in comics?
    • Drawing as a way of knowing, knowledge formation revisited

Reading(s):

Exercises: (via guest speaker, Nick Sousainis)

    • Readings:
      • Sousanis, N. Frames of Thought. PMLA 2018; 133: 154-159.
      • Sousanis, N. “Mind the gaps.” On Narrative Inquiry, edited by D Schaafsma and R Vinz, Teachers College Press, 2011, pp 123-127.
      • Monastersky, R and N Sousanis. The fragile framework: Can nations unite to save Earth’s climate? Nature. November 24, 2015.
    • Supplemental Reading(s):

Comics, Scale, and the COVID-19 Pandemic

 

Topic(s):

    • Comics as a multi-scalar medium
    • How scale is depicted and connected in comics
    • The COVID-19 Pandemic as a multi-scalar narrative

Readings:

    • Boileau, K and R Johnson. The COVID Chronicles: A Comics Anthology. Graphic Mundi
    • Callender, B, S Obuobi, MK Czerwiec, and I Williams. :COVID-19, comics, and the visual culture of contagion.” The Lancet 2020; 396: 1061-1063.
    • Charles and Ray Eames. “Powers of Ten and the Relative Size of Things in the Universe”. 1977. [Video]
    • Saji, S, S Venkatesan, and B Callender. “Comics in the time of a Pan(dem)ic: COVID-19, graphic medicine, and metaphors.” Perspectives in Biology and Medicine 2021; 64: 136-154
    • Squier, SM. “Scaling Graphic Medicine: the porous pathography, a new kind of illness narrative.” Pathographics: Narrative, Aesthetics, Contention Community, edited by SM Squier and IM Kruger-Furhoff, Penn State Press, 2020. Available as a podcast (keynote address) here.
    • Wellcome Centre for Integrative Parasitology. Series of comics available for free download here.
    • Koch, F. Plagues: the microscopic battlefield. First Second, 2017.

Exercise: Creating your pandemic narrative while testing tools brought into the seminar room

Comics in Medical/Health Education and Advocacy

Topic(s):

    • The use of comics in health education
      • Public health campaigns
      • Patient education
    • The use of comics in health advocacy

Readings:

Exercises: via guest lecturer Shirlene Obuobi, MD

 

Pulling it All Together

Topic(s):

    • What does the field of GM say about medicine?
      • Role of patient
      • Role and perception of providers
    • What does GM have to contribute to medicine?
    • What does GM contribute to the formation of knowledge?
      • About medicine
      • About illness, disease, and sickness
      • About one’s self and body

Reading(s):

    • Kinsley, L. Kid Gloves: Nine Months of Careful Chaos. First Second, 2019.

Exercises:

    • White wall/board improv (Yes, and!) drawings:
      • 4 panel Jam comic warmup
      • three panel before and after drawings, then adding on panels with 100 years in the gutter on beginning and end
      • worse educational comic ever (topic= signs & symptoms of infection)

Course Resources

On maintaining stability during challenging times: Ch. 1 of Rock Steady by Ellen Forney

On graphic medicine

On drawing:

On comics: 

Drawing Music: Class playlist on Spotify