On Health Humanities and Graphic Medicine: An Interview with Sathyaraj Venkatesan

Thakurdas Jana

Guest Lecturer, Department of English, Bhatter College, Dantan, Paschim Medinipur, India.
Email: thakurdas0901@gmail.com

 

Health humanities is a rapidly growing transdisciplinary field that incorporates aspects of the arts and humanities to health and health care. Embracing various branches of the humanities such as religious studies, cultural and language studies, history, literature, philosophy, health humanities not only illuminates the nuances of the human condition but also has a wide-ranging application to medical education and health practice. In this email interview with Thakurdas Jana, Sathyaraj Venkatesan, one of the pioneers of graphic medicine (intersection of health and comics) in India discusses his experience as a literary practitioner of health humanities; the implications of the term health humanities in the Western and Indian contexts; his perspectives of incorporating health humanities into academic curricula; and his current research projects. An alumnus of IIT Kanpur, Sathyaraj Venkatesan is currently an Associate Professor of English at the Department of Humanities and Social Sciences at the National Institute of Technology, Trichy. His research concentrates on health humanities, graphic medicine and literature, and medicine. In addition to his four influential books, Venkatesan has published several research articles on graphic medicine and health humanities in highly-cited and indexed journals such as Perspectives in Biology and Medicine (Johns Hopkins University Press), Journal of Medical Humanities (Springer), Health (Sage), Journal of Creative Communications (Sage), American Medical Association Journal of Ethics, Journal of Graphic Novels and Comics (Routledge) among others. Presently, he is at work on three book projects: “India Retold” (contract under Bloomsbury/USA); “Gender, Eating Disorders and Graphic Medicine” (projected release: September 2020/Routledge/UK); “Travails of Motherhood: Infertility Comics and Graphic Medicine” (contract under Routledge/UK). His interview/article/profile is mentioned in media such as The Hindu, The New Indian Express, JoongAngLibo (South Korean newspaper), Malayala Manorama and Mathrubhoomi.   

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Thakurdas Jana: You are one of the pioneers in the field of graphic medicine/health humanities in India. Given the interdisciplinary scope of the field, how did you develop an interest in health humanities/graphic medicine?

Sathyaraj Venkatesan: Thank you so much for interviewing me. I started my professional career as an African Americanist concentrating on women writers in the 1960s. Later, I extended my research to cover emerging African American writers such as Colson White, Terry McMillan, Marvelyn Brown among others. In my earlier days, I had a habit of using a website called stumbleupon.com. As the name suggests, it stumbles upon interesting websites and articles. Call it a day, I stumbled upon a website called graphicmedicine.org. Founded by Ian Williams, along with his collaborators, this website is a treasure trove of information neatly arranged chiming with social-media feeds, weekly updates, and book reviews about graphic medicine. My increasing interest in the subject provoked me to trace the history of this emerging field. This led me to Brian Fies’s Mom’s Cancer (2006). On the website of the book, I was particularly piqued when Fiesjestly remarks: “My mother was diagnosed with incurable lung cancer. I made a comic strip about it.” There started my journey and the rest is history. Though it is tempting to explain my interest in health humanities in a rational and academically sound way, the heart of the truth is, it was an admirable accident. Serendipity is what it is! As Philip Larkin puts it, “Most things are never meant.” Of course, thanks due to stumble upon!!

Thakurdas Jana: What is health humanities and how is it different from medical humanities? Are they same or different? If different, in what ways?

Sathyaraj Venkatesan: Coined by historians George Sarton and Frances Siegel in their obituary of science historian Edmund Andrews published in 1948, the term “medical humanities” embraces humanities-related subjects such as literature, history, philosophy among others to improve empathetic, (cross)communication and social skills of doctors. In this phase, the humanities was utilized (instrumental use of humanities) to improve the ethical, social, and empathetic dimensions of the doctors. Second, medical humanities was predominantly concerned with the doctor-patient relationship and clinical encounters. In short, medical humanities was limited in scope as it was used only to realize the pedagogical goals of the medical curriculum. Health humanities, on the one hand, is broad and is premised on the fact that medicine is just one aspect of health. It considers environmental, social, cultural, and psychological factors and illustrates how health is shaped by several such factors. Given the interdisciplinary nature of the field, health humanities borrows ideas from medical sociology, medical sciences, anthropology, philosophy, literary/artistic/performative cultures, health policy among others. What is striking is how health humanities at once compresses arts, social sciences, and science. It is hard not to credit Dr. Rita Charon, a general internist and literary scholar at the Columbia University Medical Center who formalized ‘narrative medicine’ and health humanities, broadly speaking.

As a cultural scientist, I am particularly interested in reflective accounts of illness created by patients/caregivers/physicians in a comics medium called graphic medicine. Each of these narratives pulls off a gripping vital story and puts you in touch with a fundamental truth: the universality of illness and the force of impermanence. Reading them is a humbling experience as they reveal the experiential realities and the unspoken truths of illness, aspects that biomedicine conveniently buries. As they demystify illness by talking of it, graphic medicine also critiques contemporary medical practices and its overdependence on technologies at the expense of human empathy. My research projects which investigate cultural/philosophical dimensions of illness, narrative/visual aspects, generic and language conventions of illness narratives in memoirs/essays/visual materials utilize cultural studies approach(as opposed to anthropologic-ethnographic-sociologic approach) and sometimes, employ historical and cultural materials to study the rich history of health/illness across media types. In short, I treat illness narrative as an object both of literary/rhetorical inquiry and medicine as a cultural practice.                                                            ~~~~~~~~~~~~~~****~~~~~~~~~~~~~~~~~

Each of these narratives pulls off a gripping vital story and puts you in touch with a fundamental truth: the universality of illness and the force of impermanence.

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Thakurdas Jana: What is graphic medicine and what are its scope? How is it linked with humanities?

Sathyaraj Venkatesan: Pathographies are personal narratives about an illness and its treatment written by the ill person or a family/professional caregiver and includes a wide-range of text and media types. Graphic medicine is a version of pathographies, which uses drawing and comics and its rich vocabulary of narrative conventions to communicate illness and wellness experiences. Coined by the British doctor and graphic novelist Ian Williams, graphic medicine refers to “the intersection of the medium of comics and the discourse of health care.” Later, Michael Green and Kimberly Myers popularized the term in their article, “Graphic Medicine: Use of Comics in Medical Education and Patient Care” (2010) in the British Medical Journal. While these narratives are predominately autobiographical, they also address a wide range of important humanistic and ethical issues in healthcare, such as medical negligence; the vexed doctor-patient relationship; industrialism and commercialization of health care; patient identity; the role of insurance providers; challenges of caretaking; demands of being a doctor, among others. As a subfield, it is related to disciplines such as women’s studies, disability studies, visual and comics studies, post-humanistic studies, and Science and Technology Studies (STS).

Thakurdas Jana: I recently read several of your co-authored articles relating to infertility, motherhood, and graphic medicine. How is infertility related to graphic medicine?

Sathyaraj Venkatesan: This is a joint work with my graduate student, Chinmay Murali. We are interested in the questions of infertility for one major reason: infertility is a taboo subject that requires visibility and discussion. Medically speaking, “infertility” is a health condition where couples cannot reproduce even after repeated intercourse. Although it is a gender neutral problem, infertility is often treated as women-specific problem. So our research articles and our forthcoming book titled “Travails of Motherhood: Infertility Comics and Graphic Medicine” (contract under Routledge/UK) explore the cultural, literary and philosophical (phenomenological) aspects of infertility inviting critical interrogation of social stereotypes and stigmas.

Thakurdas Jana: AIDS in Cultural Bodies: Scripting the Absent Subject (1980-2010) (2016, Cambridge Scholars Publishing) is your first and an influential book on AIDS and health humanities. Share the major concerns of the book.

Sathyaraj Venkatesan: This was the time when I was still interested in African American literature. AIDS in Cultural Bodies: Scripting the Absent Subject, my first co-authored book on health humanities, examines the various psychosocial and sexual ordeals of African American people living with HIV/AIDs (PLWH/PLWAs) as depicted in African American literary narratives dealing with HIV/AIDs published from 1981 to 2010. Central to these texts are the psychosocial and sexual challenges faced by the African American PLWH/PLWAs and the various adaptive strategies they choose to come to terms with their HIV/AIDS identity. Although PLWH/PLWAs irrespective of race confront these brutal realities, the intersection of a mythologized black sexuality, homophobia, and intra-community marginalization places African American PLWH/PLWAs in an unenviable position. While abjection and social death rupture the social self of PLWH/PLWAs, the ostracization they suffer as a result of their diagnosis affects their sexual self, leading to sexual death. In addition to illustrating the social and sexual issues of PLWH/PLWAs in relation to race, sexuality and gender, the African American HIV/AIDS literary narratives studied here also foreground various coping strategies conscripted by PLWH/PLWAs to surmount the onerous psychosocial and sexual challenges they face. In view of the above concerns, this study analyses social death, sexual death and coping in relation to HIV/AIDS at three levels, namely the intersection of blackness, sexuality and HIV/AIDS; the impact of such an intersection on the sexual life of black PLWH/PLWAs; and, finally, the envisioned coping strategies for affirmative survival. This book offers insightful critical analysis of HIV/AIDS literary narratives by celebrated authors such as Samuel R. Delany, Cheryl L. West, Essex Hemphill, Michael B. Hunter, Steven Corbin, Charlotte Watson Sherman, Sapphire, Pearl Cleage, Sheneshka Jackson, Gil R. Robertson, and Marvelyn Brown.

Thakurdas Jana: Is there any relationship between history of medicine and health humanities?

Sathyaraj Venkatesan: History of medicine is an approach to health, sickness and disease from ancient times to the present. It is part of health humanities and would always remain an invaluable resource to understand not just the measure of medical progress but also to recognize cultural and folk beliefs across time periods. Sample this: some of the earliest named doctors were women or diseases were treated using four humors in the Middle Ages among others. In short, medical history is a retrospective purchase of the evolution of medical science. In the Covid-19 context, medical history can offer valuable lessons from the past. For instance, we can learn valuable lessons from the way we handled Flu pandemic which killed more than five million people during the 1920s. The much-touted plasma/serum therapy which was introduced by Emil von Behring in 1900-1901 is recommended as one of the possible solutions to Covid-19. Put differently, the history of medicine is a valuable record of events, practices, procedures, and is both useful to the patients and the physicians.

Thakurdas Jana: Do you think medical knowledge has excluded the valuable insights provided by illness narratives?

Sathyaraj Venkatesan: Yes, medical knowledge and practice adhere to a set of scientific and clinical norms that focuses on the biological body of an individual, and often they overlook the value of biographical and cultural dimensions of the illness experience. Besides exercising its authority, medicine has a tendency to dismiss the voice of the patient as irrational, personal and emotional. Put differently, medical knowledge and practice treat illness experiences and its sufferers with considerable skepticism. Given the fact that illness is experienced as a disintegration of one’s world, medicine’s devaluation of the illness experience and suffering of patients, loved ones, and caregivers results in the suppression of vital information about disease itself. Worse still, the narratives that make sense from a patient’s point of view are often rejected as inauthentic, ambiguous or as lacking quality. In short, through monitoring, controlling and regulating the bodies of the individuals, the medical knowledge functions as a monolithic, authoritative, and hegemonic discourse putting doctors and medical truths in prime focus at the expense of the subjective realities and illness experience.

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Given the fact that illness is experienced as a disintegration of one’s world, medicine’s devaluation of the illness experience and suffering of patients, loved ones, and caregivers results in the suppression of vital information about disease itself.

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Thakurdas Jana: What is CAM? Do you think that the medical systems like homeopathy, Ayurvedic medicine have been suppressed by the powerful corporate allopathic medicine?

Sathyaraj Venkatesan: “Suppress” is a strong word. Given allopathy’s ability to provide quick relief, I am not surprised that allopathic medicine has a stronger appeal compared to other forms of medical science. Complementary and alternative medicine (CAM) is an assemblage of a variety of health and healing practices. It is by no means a monolithic phenomenon but encompasses an assortment of alternative practices shaped by divergent philosophies. It is predicated on holistic approach and conscious cultivation of a healthy attitude towards life. As opposed to the euro-centric health philosophy which segregates health from disease and attempts to implement cure through the investigation of symptoms and treatment, CAM is predicated on the interrelationship between mind-body and the world. Unlike the reductionist and biomedical approach of diagnosis and treatment, CAM treats the patient-experience as paramount and is predicated on the interrelationship between body, mind, and spirit. As such, CAM is at the crossroads of metaphysical, axiological (value-based) and empirical. Although nonallopathic medical practices find acceptance and has witnessed dramatic rise in recent times across the globe, unhealthy scepticism towards CAM is still in vogue. Having said that, we should not underestimate the politics of knowledge production and power/knowledge nexus which sidelines non-allopathy treatments. For instance, Traditional Ecological Knowledge(s) (TEK) are often sidelined.

Thakurdas Jana: Is health humanities a novel idea in the twenty-firstcentury as stated by different academicians or did it exist before? For instance, the pioneers such as Leonardo da Vinci was simultaneously interested in medical science/anatomy and the arts and so are many unknown creators of folk literature?

Sathyaraj Venkatesan: Though the term medical/health humanities is a recent usage, some version of health humanities was always available. For instance, there is an interesting and popular course titled “Ancient Medicine: The Classical Roots of the Medical Humanities” offered by Michael Goyette and Emily Fairey which introduces“the main themes and ideas in the medical literature produced by the ancient Greeks and Romans.” Put together, it implies that there were prototypes of medical and health humanities in the past as well.

Thakurdas Jana: Diseases, suffering and the reality of inevitable death are presented in many literary/cultural and in different media types. How is disease, death, disaster related to the evolutionary existence of humankind as reflected by the branches of humanities?

Sathyaraj Venkatesan: Time-honored themes such as identity, sexuality, pain, suffering and the self are the accepted core of literature. Diseases/pestilence/death have always appeared in literary and cultural works either as a metaphor for moral and social decay or to symbolize internal suffering. Think of Henrik Ibsen’s Ghosts, the works of William Shakespeare, James Joyce’s The Dead among others. Having said that illness narratives are slightly different. Imagine a whole book from the jacket to the last page about one’s illness. Of course, illness narratives also incorporate literary elements, craftsmanship and conventions of genre and rhetoric. Having said that, these are mostly autobiographical texts (of course, there are fictional and imaginative ones too!) which reflect on one’s disease conditions and the ways they navigated them. In illness narratives, illness experience of the narrator is arguably the only central concern of the text. What is interesting here is that the second half of the twentieth century through the post-millennial decades witnessed fever pitch publication of illness narratives in a wide ranging format (from diaries to blogs). Cultural critics even had to scour for a neologism as more and more covers boasted of illness narratives. It is so thriving that it would shudder Virginia Woolf and even compel her to withdraw “On Being Ill” that once complained how we ignored body and illness. Although it ties in with the ubiquity of illness and public appetite for personal stories, illness narratives, in one sense, expeditiously actualized C.P. Snow’s vision, that is, to integrate “the two cultures” of sciences and humanities. 

Thakurdas Jana: In most academic institutions health humanities is not studied as a distinct course. Do you think it is necessary to introduce health humanities as a course to the students in Indian universities given the fact that we are in the middle of the Covid-19 pandemic?

Sathyaraj Venkatesan: There is no better time than this! Health is on everyone’s mind these days and the Covid-19 pandemic has amplified our concerns about health. Truth is: health/illness is the ontological condition of beinghuman. Universities and academic departments have to seriously think of introducing health humanities as part of their curriculum. Here one has to approach health from multiple perspectives. This would imply that we should include modules that will embrace different aspects of health and well-being.

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       Truth is: health/illness is the ontological condition of being human.

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Thakurdas Jana: What steps should we take to popularize the study of health humanities in India?

Sathyaraj Venkatesan: We should introduce health humanities as part of graduate studies (MA/M.Phil.) either as credit/audit course. Sufficient research should be encouraged at the Ph.D level. Interestingly, there are immense opportunities in the Asian contexts of medicine. Regular conferences/workshops should be held to bring together academics and practitioners from the fields of humanities, social sciences, medicine. Research clusters should be formed within the departments/centers to encourage cross-pollination of disciplines. Reading groups/book discussion club should also help to popularize health humanities. My Graphic Medicine Lab in NIT/Trichy includes many of the above discussed elements.

Thakurdas Jana: What does teaching health humanities to the students mean? What kind of teaching-learning resources are available in India and elsewhere?

Sathyaraj Venkatesan: Being an interdisciplinary field, teaching health humanities demands you to develop interest in multiple areas of humanities including philosophy (for instance, phenomenology), medical sociology (for instance, works of Arthur Kleinman and Byron Good), anthropology (for instance, works of Veena Das), ethics (bioethics), cultural and literary studies (for instance, body studies) among others. I have to admit that it is slightly demanding to keep tab of multiple disciplines.

This is not to say that there is no health and well-being related research/academics/courses in India. Health is mostly studied in economic, political, sociological, communicative and policy terms in India. I am sure you will find health humanities courses in medical science curriculum—for instance, bioethics, disability studies, health communication, history of medicine etc. Again, centers such The Rekhi Centre of Excellence for the Science of Happiness in IIT Kharagpur is an interesting case in point in that improvises the principles of health humanities to promote happiness and well-being of individuals. My argument is that health/illness is not sufficiently studied in cultural and literary/philosophical perspectives/contexts. Resources in India are too limited and insufficient.

Health humanities as an academic discipline is emerging in the West. Most medical schools now seriously think of incorporating humanities informed and arts based teaching into their curricula. Reciprocally, health/illness is seriously investigated from the cultural and literary perspectives and is pursued as a part of humanities curricula. They are available as concentration, credit and audit courses. In some universities, there are centers for health humanities. Then there are dedicated listservs (healthhum@simplelists.com), associations (Association for Medical Humanities/UK) and institutions (Wellcome Trust, UK) which promote health humanities in the West.

Thakurdas Jana: What are your suggestions and advice to the students of humanities?

Sathyaraj Venkatesan: Future of humanities will be interdisciplinary. Unfortunately, too often interdisciplinarity is left out of curriculum. Interdiciplinarity raises interesting questions that cannot be limited to one field. I suggest students to choose modules from across social sciences and humanities. With regards to health humanities, I recommend students to audit/credit online courses (for instance, “Introducing Medical Humanities” in Future Learn). On my part, I am sharing most of my research articles on health humanities at<https://nitt.academia.edu/SathyarajVenkatesan>. My suggestion (not an advice!): cross disciplinary boundaries and be future ready!

Thank you!

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