KNOW 26230: Death Panels –
Exploring Dying and Death through Comics
Spring Quarter, 2020, Tuesdays and Thursdays 2-3:20 PM
(last updated 10/25/20)
Brian Callender, MD ([email protected])
and MK Czerwiec, RN ([email protected])
Office Hours: By appointment
Course hashtag: #deathpanelsUofC20
What can comics contribute to the discourse on dying and death? What insights can comics provide into the experience of dying, death, caregiving, grieving, and memorialization? Can comics help us better understand our own wishes about the end of life? Death Panels: Exploring Dying and Death Through Comics is an interactive course designed to introduce students to the field of graphic medicine and explore how comics can be used as a mode of scholarly investigation into issues related to dying, death, and the end of life. Through didactics, discussion, and interactive activities, this course provides students with a unique interdisciplinary and creative opportunity to explore dying and death.
This course will balance readings and discussion with creative drawing and comics-making assignments. This work is intended to provoke personal inquiry, self-reflection, and understanding about a range of topics relating to the end of life. Topics covered will include examining defining death, exploring how we die, euthanasia, rituals around dying and death, and grieving. The readings will primarily be drawn from a wide variety of graphic memoirs and comics, but will be supplemented with materials from a variety of multimedia sources including the biomedical literature, philosophy, cinema, podcasts, and the visual arts.
Taught by a nurse-cartoonist and a physician, both of whom are active in the graphic medicine community and scholars of the health humanities, the course will primarily be taught from a biomedical and health humanities perspective.
No prior knowledge or experience of graphic novels, comics, drawing, medicine, or death required.
- Develop an awareness of and appreciation for one’s values and attitudes about the end of life
- Appreciate the unique properties of comics to convey difficult and complex subject matter
- Understand how the medium of comics can uniquely explore and express end-of-life experiences, including caregiving, grief, and memorialization
- Engage with drawing and the creation of comics as a self-reflective exercise
Course Materials and Readings:
This course will explore end-of-life issues through a variety of media. While the primary focus will be on drawing and comics, supplemental articles, book chapters, and podcasts, academic and medical literature will also be used.
Students would also benefit from gathering some basic drawing supplies, such as crayons, markers, a black rollerball or felt-tip pen, and a sketchbook.
On maintaining stability during challenging times: Ch. 1 of Rock Steady by Ellen Forney
On remote learning: https://learningremotely.uchicago.edu
On graphic medicine
On making comics:
- Creating a basic, wordless story with Ivan Brunetti
- Basic Diary Comic with Marek Bennett
- Faces & Body Language with Marek Bennett
- Basic drawing with Jarett Krosoczka (creator of Hey, Kiddo and others)
- The Five Choices in making a comic
- Some free comics-making workshops
- a full comic-making online course
- More comic making resources!
- from COVID times and beyond: Comics Workshops by The Believer
- Graphic Medicine’s Drawing Together
Potential Full-Text Readings:
Readings can be purchased from independent booksellers via Bookshop here. We will also post links to online versions if they are available.
- Chast, R. Can’t We Talk About Something More Pleasant? New York: Bloomsbury, 2014.
- Czerwiec, MK. Taking Turns: Stories from HIV/AIDS Care Unit 371. University Park: Pennsylvania State University Press, 2017.
- Moss, M. Last Things: A Graphic Memoir of Loss and Love. Conari Press, 2017.
- Wright, A. Things to do in a Retirement Home Trailer Park … University Park: Pennsylvania State University Press, 2015.
- Hart, T. Rosalie Lightning. New York: St Martin’s Press, 2015.
Section One: Prior to Death
Class 1. Introductions: Why death? Why Graphic Medicine? April 7
Short assignment following class:
1. Describe or draw your current attitude towards death. Consider what emotions are invoked by the thought of dying.
2. Create a short 4-6 panel comic that depicts the main influences that have contributed to your current death attitude. Consider social and cultural entities, as well as personal experiences. Think about how collectively these can be woven into a short narrative
Class 2. How We Die: Taxonomizing/Defining Death April 9
Materials to prepare for class:
- ‘Aviv, R. What Does it Mean to Die? The New Yorker. February 5, 2018 (note that an audio option also available)
- What is Death? How the Coronavirus Changed Death – BJ Miller (late add 12/18/20)
- Truog, RD. Defining death – Making Sense of the Case of Jahi McMath. JAMA 319 (18); 2018: 1859-60
- Veatch, RM and LF Ross. Crafting a New Definition-of-Death Law. Chapter 7 from Defining Death: The Case for Choice. Washington DC; Georgetown University Press, 2016.
- Kathryn Mannix: With The End in Mind, “French Resistance”
- Veatch, RM and LF Ross. Defining Death: An Introduction. Chapter 1 from Defining Death: The Case for Choice. Washington DC; Georgetown University Press, 2016.
- Jacobsen, MH, “Spectacular Death”
- Who Wants to Live Forever? Silicon Valley Tries to Disrupt Death – comic by Andy Warner
Discussion questions for class:
- How do we reconcile differing biological definitions of death with cultural definitions and practices?
- Should there be some flexibility in allowing individuals to choose their definition of death?
- Potential problems from such an approach? What conflicts may arise?
- Which definition of death do you personally embrace and why?
Follow-up links from Thursday’s class discussion:
- Dr. Callender’s slides
- Trust and the Medical System : Tuskegee – comic by Whit Taylor
- Trust and the Medical System: Maternity Health Outcomes – comic by Whit Taylor
- Global burden of disease data visualization shared during class
- from Swathi, an example of variance between definitions of cultural, religious, and physical death
Class 3. Life-extending Technologies April 14
In this class, we will start our discussion with the naturalness of death before turning our attention to how the process of dying and death have become increasingly medicalized. We will describe the nature and history of technologies available to address life-threatening disease/injury, including CPR, dialysis, artificial ventilation, artificial feeding, and ECMO. How these technologies and a medicalized approach to dying has affected individual, societal, and cultural attitudes about and approaches to dying will be discussed.
Discussion Questions for Class:
- What is a natural death?
- In what ways has dying and death been medicalized?
- How have the medicalization of death and life-extension technologies altered our understanding of and approach to death?
- What have been the benefits and drawbacks of the medicalization of death?
- What Doctors Know About CPR, Nathan Gray
- I’d Want a Natural Death. Nathan Gray. Annals of Internal Medicine.
- Code Blue. Mike Natter. Annals of Internal Medicine
- Caring for Dying Patients: Visual Narratives From the Intensive Care Unit. Ginny Bao. Annals of Internal Medicine.
- Betty P. , Michael Green and Ray Rieck. Annals of Internal Medicine.
- A Living Death, Monica Lalanda
- Gawande, A. Letting Go: What should medicine do when it can’t save your life? The New Yorker, July 26, 2010. (PDF here.)
- Hetzler III, PT and LS Dugdale. How do medicalization and rescue fantasy prevent healthy dying? AMA Journal of Ethics
- McCue, Jack. The Naturalness of Dying. JAMA 273 (13); 1995: 1039-1043.
Class 4. Advance Directives April 16
A. The Conversation:
- Roz Chast, excerpt from Can’t We Talk About Something More Pleasant?
- A Way Forward – Jessica Zitter from Extreme Measures
- Communication About Serious Illness Care Goals: A Review and Synthesis of Best Practices, Bernacki & Block
- The Ventilator (Hidden Brain podcast episode, audio)
- Special class guest Dr. Nathan Gray – read his comics about discussing advance directives during Covid-19 (please prepare at least three questions for Dr.Gray)
B. The Forms:
- Living Will form (Illinois form) for other state’s forms, go here.
- Durable power of attorney for health care form – and Speaking for the Dying – interview with Susan Shapiro (video)
- The Five Wishes (an approach that combines the LW and DPAHC)
- Illinois POLST form – and also informational video on POLST form
Supplemental materials (optional):
- JAMA Patient Page: Advance Care Planning – What Should I Know?
- Life Kit Podcast: EOL Planning is a Lifetime Gift to Your Loved Ones
- Never the Right Time project: https://www.nevertherighttime.org/never-the-right-time (If you have difficulty reading this through the watermark, email me (MK).
- Alternative approaches: Death over Dinner
- Alternative approaches: Go Wish
- Racial Inequality in Advance Care and End-of-Life Planning Resources
Class 5. Ars Moriendi: The Art of Dying Well April 21
During this class, we will discuss the “art of dying well” and concepts of the “good” and “bad” death. We will do so by focusing on the broad historical context of these concepts before focusing on how modern medicine has redefined our attitudes about and understanding of these concepts.
Discussion Questions for Class:
Is there such a thing as a “good” death?
What might it mean to die the “good” death? The “bad” death? In what way might these concepts be useful? Harmful?
From a personal point-of-view, what do you consider a “good” death? A “bad” death? What do you consider essential features of each of these?
- Dugdale, LS. Conclusion: Toward a New Ethical Framework for the Art of Dying Well. Dying in the Twenty-First Century: Toward a New Ethical Framework for the Art of Dying Well. MIT Press, 2015.
- Thornton, K and CB Phillips. Performing the good death: the medieval Ars Moriendi and contemporary doctors. Medical Humanities 35 (2); 2009: 94-97.
Homework assignments: – due via email or upload to dropbox link by class on Tuesday 4/21
- Assignment #1: Advance Directives – read the comic and scroll down on the linked page for details of the assignment.
- Assignment #2: In a multipanel (2-6 panels) comic, depict what you personally consider a “good” death. Think broadly about the various characteristics/attributes that contribute to that “good” death.
- Assignment #3: In a multipanel (2-6 panels) comic, depict what you personally consider a “bad” death. Think broadly about the various characteristics/attributes that contribute to that “bad” death.
Follow-up from class discussion:
“Who is The Good Death For?” special topics issue of Departures in Critical Qualitative Research, Fall 2021
Class 6. The Role of the Dying April 23
In this class, we will explore the role of the dying person with regards to social and cultural expectations and duties. We will discuss the relationship that the dying have to the living and how this relationship defines the dying role, as we try to answer the questions: What should we expect from the dying? What should the dying expect from us?
During this class we will be visited by a special guest, Marissa Moss, the author of Last Things: A Graphic Memoir of Loss and Love.
- Formulate 1-2 questions for Marissa Moss after reading Last Things.
- Draw a panel “in the gutter” of Last Things: Imagine something that did happen or could have happened in this story but we don’t see it, the action is implied by the author. Draw that. It can be a quick sketch, even a single panel.
Class 7. Workshop April 28
- Outline/sketch an imagined conversation with a loved one about end-of-life issues, with a focus on the questions you would ask.
- Consider how to incorporate topics we’ve discussed in class, including definitions of death, advance directives and making one’s wishes/preferences known, the good/bad death, and the dying role and how it affects one’s other life roles.
- This is meant to be more of a thought exercise than a drawing exercise.
- This assignment does not need to be turned in by Tuesday’s class, but have it prepared and ready for the 4/28 class.
- As this class is a workshop, have your drawings supplies readily available for class. This may be your charged iPad or tablet, or paper/sketchbook, pens, and coloring materials.
- Submit, via email, the title of a song (or two) that we can add to a class drawing playlist.
- Outline/sketch an imagined conversation with a loved one about end-of-life issues, with a focus on the questions you would ask.
Section Two: Dying
Class 8. Epidemics April 30
In this class, we will discuss how pandemics alter our attitudes about death and dying, with a particular focus on the Covid-19 pandemic. We will explore the burgeoning genre of covid-19 comics and analyze what they have to say about this moment.
Assignment #1 (due before class on April 30th; email assignment to MK and Brian):
Create a comic about your covid-19 pandemic experience. It can focus on any aspect of what you are experiencing. Consider how you can use the medium of comics and color to explore space, time, and emotion.Length is up to you.
Review the Covid-19 comics being curated on the Graphic Medicine website. Pick one comic from the collection that resonates with you. Be prepared to discuss your choice during class. Feel free to include comics that are Covid-19 related, for example in a creator’s Instagram feed, that are not on the site but linked.
Brian’s slides, “Covid-19 Pandemic: Effect on Dying and Death”
Class 9. Hospice & Palliative Care May 5
- Palliative Care comic by Isabella Bannerman
- Cicely Saunders: The Woman Who Changed How We Die Annals of Internal Medicine, Nathan Gray
- You Think you want to die at home? Nathan Gray
- Curlin, Farr. A. Hospice and Palliative Medicine’s Attempt at an Art of Dying
Assignment: Project proposal due
As the mid-term assignment, we want you to write up a proposal for your final project. For the final project, we want to give you the freedom to explore a topic of interest related to death, dying, and/or material covered in the course and the medium of comics. We want this to be a thoughtful and creative exploration of the topic through the use of and experimentation with the medium of comics, including use of panels, space, time, and color. Think of it as creating a final research paper in comic form. To that end, the mid-term assignment is to write up with supplemental sketches a proposal for your final project. The length of the writing should be about a page with another page or so for the sketched comic plan. The proposal should describe:
1) what topic you are choosing and why and
2) how you plan to use comics to explore and express the topic and include
3) a few rough thumbnail sketches of your comics plan
Class 10. Medical Aid in Dying and Suicide May 7
In this class, we will continue the discussion from the previous class about autonomy and patient control at the end of life as we focus on the controversial practices of assisted dying (physician-assisted and voluntary active euthanasia). We will explore the arguments both for and against these practices within a broader bioethics framework that also takes into consideration individual choice and broader impacts on society.
- Posey’s Plan: A Memoir of My Neighbor’s Timely Death, Pat Arnow
- Right To Die (VICE on HBO: Season 4, Episode 3)
- The Champion Who Picked a Date to Die (NYT, story of Marieke Vervoort) and this follow up piece by the photographer for the story,
- The Personal Toll of Photographing a Story About Euthanasia.
Class 11. The Moment of Death May 12
In this class, we will take an in-depth look at key topics already presented as expressed in Czerwiec’s Taking Turns.
- Czerwiec, MK. Taking Turns: Stories from HIV/AIDS Care Unit 371. Penn State University Press, 2017, available through the U of C Library.
- Selwyn, PA. AIDS, the Modern Plague. In LS Dugdale (Ed.), Dying in the Twenty-First Century: Toward a New Ethical Framework for the Art of Dying Well. MIT Press, 2015.
Choose a page or series of panels in Taking Turns that most resonates with you and/or raises themes we have discussed in the class thus far. Make a short comic (anywhere from 2-4 panels) about your resonance with and/or reaction to that page. Put another way, imagine the assignment is to write a reaction to some part of the book, but do it as a short comic instead.
Class follow up:
Class 12: Bearing Witness to Death May 14
In this class we will consider the deathbed vigil, with our attention on those who surround the dying person. We will contemplate the practice of drawing the dying person during this vigil.
- Facing Death Together at the Bedside, Marilyn Mendoza
- Excerpt from Special Exits, Joyce Farmer
- Excerpt from Tangles: A Story About Alzheimer’s, My Mother, and Me, Sarah Leavitt
Excerpt from Can’t We Talk About Something More Pleasant, Roz Chast
- An Art-based Case Study: Reflections on End of Life from a Husband, Artist and Caregiver, Robbins & Gilbert, Journal of Medical Humanities
- Thoughts in Passing, Claudia Bicen ( A news piece about this project. If you can’t access that one, here is another piece about the project.)
- Daniel Fooks: Drawing the Last Breath
- Death Doulas and End of Life Care
- Now is the time to ask your loved ones about their lives
- Drawn to that Moment
- ADDED LATER: “What is it like to be dying” short film
Class follow up:
Class 13. Workshop: Death & Humor May 19
Teaching Points: In this workshops class, we will engage in drawing exercises and discussion exploring the types and roles of humor in communication about dying and death.
1. Review two articles:
- Communicating Death with Humor: Humor Types and Functions in Death Over Dinner Conversations, South, Elton & Lietzenmayer
- Gallows Humor in Medicine, Watson
Draw the grim reaper:
|Student||First option||Second option|
|Danielle||Surfing with a shark||With a mean dog|
|Swathi||As a statue in a museum||As a farmer|
|Lauren||Eating fried chicken||With a Disney princess|
|Non||In the deep sea||At a hair salon|
|Louise||In a marching band||Driving a car|
|Max||Riding an insect||Building a house|
|Ana||Dancing with a potato||Painting a masterpiece|
|Hurston||As a tightrope walker||At a funeral|
|Counti||Running from a giant snowball||With their lawyer|
|Monica||Riding a bird||With their doctor|
|Tiffany||Climbing a rope||At a swimming pool|
|Wendy||As a fountain||Climbing a tree|
|Emily||Being abducted by an alien||At the car mechanic|
|Nicole||As a pirate||At a bar|
|Andrew||With three cats||Playing tennis|
|Claud||With a kid in a Halloween costume||With a horse|
|Ariel||On a desert island||Taling to an octopus|
|Siri||In a boxing match||Meditating|
- Thesis Award deadline approaching
- From Swathi: Call for comics, PULSE Magazine submission form and instructions.
- Examples of death and humor discussed in class – and some not yet discussed:
- Key & Peele – “This Dad Will Live Forever“
- The Good Place (show recommended generally, here’s a good clip)
- “One for the Angels” episode of The Twilight Zone
- Russian Doll (show recommended generally, but here’s the trailer – warning strong language)
- “Bring Out Your Dead” Monty Python
- “Death is Just Around the Corner” from The Addams Family
- Chuckles Bites the Dust Mary Tyler Moore Show (watch whole episode or skip to the funeral scene at 17:31)
- Kramer makes his advance directive Seinfeld
- “Larry’s Mom Dies” Curb Your Enthusiasm
- “The Shooting” SNL digital short
- CPR training, The Office
- Please Don’t Bury Me, song by John Prine (who recently died of Covid-19 after surviving cancer)
- After Life – (generally recommended TV show, here’s the trailer)
Section Three: After Death
Class 14. The Dead Body/Rituals May 21
- The Movement to Bring Death Closer, Maggie Jones (online version here)
- Life After Death: On Human Decay and What Can Be Done About It, Mary Roach
- Death is Not the End: Fascinating Funeral Traditions from Around the Globe, Kate Torgovnick May
- The Body After Death (drawing of stages of a body’s decay)
Supplemental Materials (interesting but not required):
- It’s Our Funeral – comic by Whit Taylor
- Virtual Funerals and Memorials: Innovation for Now and the Future (podcast episode) and Gathering Us website
- How Are Funeral Homes Dealing with Covid-19? (via The Order of the Good Death)
- What Happens To Your Body After You Die (infographic of body’s stages of decay)
- Stages of Bodily Decay (graphic drawing of a hand in decay – may be a bit shocking)
- After You Die by Ramin Nazer
Class Followup Links:
- Departures (recommended 2008 film, link to trailer)
- How Do You Maintain Dignity for the Dead in a Pandemic? (New York Times Magazine)
- Alternate Endings: Six New Ways to Die in America, HBO Documentary (trailer)
- Cremation Ink
- Turn Your Loved One’s Ashes into A Diamond
- Covid-19 is Changing How We Mourn
Class 15. Obituary & Memorialization May 26
Required prep for class:
Supplemental prep for class:
- What will the covid-19 memorial look like? Washington Post; April 28, 2020, Aronson, JD and SG Knowles.
- Now is the Time to Ask Your Loved Ones About Their Lives
- Structured Life Review – source material for memorializing a loved one
- Arizona man’s epic obituary goes viral
- “Obit” (film trailer)
Class 16. Grief & Grieving May 28
Homework assignment: Create a four panel comic obituary. The subject of the obituary can be of your choosing and/or creation. You can adapt an existing text-based obituary, you can fabricate one for a fictional character, or you can create one for someone you know who has died. The only parameters around this assignment are that it be four panels.
Required prep for class:
- excerpt from Soldier’s Heart by Carol Tyler
- excerpt from Billy, Me & You: A Memoir of Grief and Recovery by Nicola Streeten
- Tom Hart on Rosalie Lightning – you can read some pages from the book here.
- Sharon Rosenzweig Grieving Through Drawing
Supplemental prep for class:
- MadLibs Obituary is kind of a thing
- Song from Rent referenced by Andrew
- Artist David Prifti referenced by Counti
- Forever Missed website referenced by Swathi
- Also from Swathi, Why Are There No Flu of 1918 Memorials?
- Sunday’s NYT front page used as canvas for political cartoons
- Did You Really Think Trump Would Mourn With Us? by Jamelle Bouie
- If We Had a Real Leader: Imagining Covid Under a Normal President by David Brooks
Class 17: Wrap-up: What is death? Why do we care? June 2
Class prep: Consider all the ground we have covered in this class. Write up your top 5 takeaways – they can be a bullet list or just simple sentences. Please submit that list of five to us before class on Tuesday. And then be ready to talk about at least three of those five in class on Tuesday.
Oh, and check out this comic.
Summary of Top 5 Class Takeaway topics (after preliminary review)
Class 18: Student Final Projects
Danielle, “Speaking to the Dying and Dead”
Lauren, “Dying, Death, and the EMS”
Louise, “My Sister’s Soul”
Tiffany, “Lost Things: A Story of Hyde Park”
Non “Space Death”
Hurston, “Bad v. Good Death”
Monica “Covid-19 Quarantine Diary”
Wendy, “The Corpse Shepherd”
Call for comics for a Covid-19 Anthology, Graphic Mundi