A David Lewis, Ph.D.
Assistant Professor of Healthcare Business, MHS Program Coordinator , School of Healthcare Business
MCPHS University. Email: ADavid.Lewis@mcphs.edu
Abstract
Graphic Medicine, the intersection between comic books and medicine/healthcare, is growing worldwide, especially in India. Among its pioneers there is Sathyaraj Venkatesan, whose approach and utilization of Graphic Medicine may come with a cultural bent. Maintaining an appreciation for cultural specificity in each Graphic Medicine community worldwide will aid, in this Blue Age of Comic Books (Resha 2020), to maintain local Identity while contributing to a transnational guild of creators, scholars, practitioners, educators, librarians, students, patients, and their families.
Keywords: health humanities, medicine, narrative, comics, graphic novels, graphic pathographies
Introduction
In May 2020, the student magazine The Golden Line at Vidyasagar University’s Bhatter College featured an interview with Sathyaraj Venkatesan, an expert in health humanities and Graphic Medicine in India. In it, Venkatesan comments widely on the span, goals, and promise of Graphic Medicine as well as health humanities in general (Jana 2020). His answers to guest lecturer Thakurdus Jana’s questions are not only compelling but also, in the spirit of collegial discourse, inviting of response and reflection by other scholars.
As such – and in good faith without the suggestion of malice – I would like to continue their dialog with some added commentary of my own, particularly in terms of Graphic Medicine’s international moment, potentially differences in its understanding, and the business of its future globally. I admit, as the boorish American, I am inserting myself into their conversation, but it is my hope that they will forgive the intrusion and, instead, welcome these outside insights. In fact, I will conclude this writing by offering an invitation of my own, one that others can determine whether or not is reasonable.
Arriving at Graphic Medicine
Beyond human health and wellnessthemselves being a worldwide concern innately, Graphic Medicine is, at its core, an international endeavor, as well. Of course, Venkatesan keenly views “medicine as a cultural practice” (Jana 2020, par. 6), however common or distributed medical technologies and practices tend to be; there will always be some figurative flavor to the healthcare of a general place, just as there will be distinct variations to their Graphic Medicine. Notably, these variations are equally permeable and valuable, making this not an opportunity to stereotype or limit but instead to learn from one and another transnationally. The work of Germany-based PathoGraphics can lend itself, say, to the approaches of the Japan Graphic Medicine Association (JGMA) which, in turn, can influence Spain and South America’s MedicinaGráfica. It is no different for the U.S. and U.K.-based Graphic Medicine International Collective and Venkatesan’s own Graphic Medicine in India.
Venkatesan, with a background in African American women’s literature of the 1960s, reports to Jana that he came to Graphic Medicine by happenstance, a not-uncommon circumstance. Originally, I had supposed that when Venkatesan was working on his first co-authored book AIDS in Cultural Bodies: Scripting the Absent Subject (with Gokulnath Ammanathil in 2016), he might have caught word of MK Czerwiec’s upcoming Taking Turns: Stories from HIV/AIDS Care Unit 371 – however, her work did not come out to well over a year later. This should not surprise me, as nearly everyone participating in Graphic Medicine, from creators to scholars and from practitioners to librarians, has come to Graphic Medicine indirectly. Until Dr. Ian Williams’s coinage of the term in 2007, individuals may have been operating in its orbit or around its boundaries but doing so without any unifying, named core. To nearly a person, each co-author of the germinal Graphic Medicine Manifesto reports their surprising shift into this world, some with a childhood that involved comics but also some without. Award-winning artists like Brian Fies (Mom’s Cancer) or Jarrett J. Krosoczka(Hey Kiddo) likewise filled a niche that, at the time, may have been unrecognized as such. Though welcome exceptions are on the rise of those studying and intending to work in Graphic Medicine, Venkatesan’s story has been more of a universal to date than an outlier.
If there is any difference between Venkatesan’s entrée to Graphic Medicine and either my own or Czweriec’s or William’s, it is that he is engaging it in India. Therefore, while I readily agree that it has “wide-ranging application to medical education and health practice” (Jana 2020, par. 1), I am also curious about those applications in his cultural context, in any divergence in “the implications of the term health humanities [and Graphic Medicine] in the Western and Indian contexts” (Jana 2020, par. 1). This is not being posited as a binary nor in any hierarchy; there is a danger in recklessly holding one culture up to another, particularly in a subjective manner. Moreover, describing them as distinct and different cultures may already be an error, particularly in a digital age.
The very fact that I can easily access an Indian collegiate magazine and Venkatesan can correspond with fellow scholars worldwide is a testimony to what Adrienne Resha calls this “Blue Age of Comic Books.” As a medium, industry, art, and cultural product, comics have embraced digital creation, consumption, and fandom widely, even for those materials delivered to readers as physical books. Resha’s contention rings as true for Graphic Medicine as it does comics overall, given that one of her primary examples for this digital Blue Age is Hawkeye #19, the issue dedicated to the character’s returned deafness and its usage of American Sign Language (ASL). She points to it first as an example of a Blue Age comic “if they are scripted penciled, lined, colored, lettered, formatted, edited, and/or otherwise mediated through a computer” (71).
However, it is also indicative of this Blue Age – an era whose onset aligns with that of Graphic Medicine’s – in that it allows for greater access to and representation of those with disabilities: “When a medium becomes more accessible to, and representative of, people with disabilities and other marginalized people, those marginalized people gain a kind of social citizenship” (77).As I have discussed elsewhere (viz., Lewis 2019), Hawkeye is just such a character, and Hawkeye by Matt Fraction, David Aja, Matt Hollingsworth, and Chris Eliopolis is one such title. Comics chronicling his heroism while highlighting his hearing impairment in such creative ways allows his marginalized group a space to convey their messages and experience. This hallmark of the Blue Age is almost exactly the same goal conveyed by Czerwiec, Williams, and their Graphic Medicine Manifesto coauthors: “Comics give voice to those who are often not heard” (2).
Determining Narrative
Therefore, while there certainly have been important predecessors, I contend that the Blue Age of Comic Books explains, at least in some part, why Venkatesan, Williams, and other like myself came to Graphic Medicine when we did – why Graphic Medicine itself arrived when it did. Even if that is a commonality among us (and PathoGraphics, JGMA, and MedicinaGráfica), it is worth returning to one point of contention, perhaps a point of cultural difference, that Venkatesan voices, namely the role of story in Graphic Medicine.
Venkatesan details to his interviewers what he sees as Graphic Medicine’s chief value:
“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” (Jana 2020, par. 6).
All of this is very much akin to the goals and functions named in the Graphic Medicine Manifesto and elsewhere, except for one subtle point. As he further discusses pathographies (or what Kimberly R. Myers would call “graphic pathographies”), Venkatesan hits on this curious point again: “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” (Jana 2020, par. 9). It would seem that his definition and examples of Graphic Medicine necessarily require story or narrative, and I have to wonder if this is fully in keeping with ‘giving voice’ to those who are not heard. That is, must one deliver on plot, on characterization, or on pacing in order to be legitimized as a creator of Graphic Medicine?
I ask this question genuinely, not pointedly, because this could either be an issue of cultural difference or, more significantly, something truly laying at the foundation of Graphic Medicine. Asked another way: Can we have non-narrative Graphic Medicine? And, if so, is that a culturally specific and regional form of the field that might not be recognized elsewhere?
To his credit, Venkatesan observes that patient pathographies are already challenged by others as being credible and legitimate. “[T]he narratives that make sense from a patient’s point of view are often rejected as inauthentic, ambiguous or as lacking quality,” he says (Jana 2020, par. 17), leading me to further wonder whether there might be more skepticism of these works in India than currently in the GMIC regions. I sense a small reversal later in the interview where he begins to introduce qualities by which to judge these narratives – “illness narratives also incorporate literary elements, craftsmanship and conventions of genre and rhetoric” – before returning to the core agency of the work’s creator: “In illness narratives, illness experience of the narrator is arguably the only central concern of the text” (par. 25). At what point does a patient’s expressions not meet our baseline for narrative? I do not hear Venkatesan as contradicting himself here as much as threading the proverbial needle: Graphic Medicine is best recognized as stories, but, as they emerge from an authentic patient experience, we should not judge them unduly. Do we even need to judge them as stories, then?
Building the Guild
Perhaps it is the audience of the interview guiding his responses or it is his interviewer’s framing, but Venkatesan seems to limit Graphic Medicine not only to narrative but also to stories of the ill. As such, that delimiting might eliminate clinician accounts, family experiences, or student education from Graphic Medicine consideration. In reading the way he explains health humanities itself in the article, I tend to doubt he meant to frame Graphic Medicine in precisely such a way – but I do wonder who might agree with this narrower conception of Graphic Medicine. More to the point, I wonder where they might hold this view of Graphic Medicine, because, as Venkatesan makes clear, branches and varieties of it are emerging globally.
I want to close my response with this idea, namely that scholars of Graphic Medicine must become better acquainted with how it is being theorized and implemented around the world. The aim here is not to standardize it nor reach a consensus. I respect Venkatesan’s views and especially his work, particularly because they make me look at my own more closely and with greater scrutiny. As I suggested earlier, the same could be said for the Graphic Medicine work being actively undertaken on each of the continents. There is a subtle network forming, an invisible one, but we are becoming part of a shared, world-wide system. I hesitate to call it an organization or association or group, because those words not only sound too small but also too hegemonic. Instead, I want to reach back and pull a more archaic, more patriarchal word into the Blue Age and strip it of its older connotations: gradually, those who study, produce, or use Graphic Medicine in Germany, in Spain, in South America, in the United States, in the United Kingdom, and anywhere on Earth are becoming part of one global guild.
Resha claims that the Blue Age of Comic Books is about the “new and different, but not all-new or all-different” (69). It may be about considering the ancient, like medicine and art, in new ways. Or else, it could be about thinking of our far-flung colleagues as members of a close unit. “[T]he Blue Age is about legacy heroes,” says Resha (69). As scholars of the Blue Age, as a global Graphic Medicine guild, what will our legacy be?
References
Czerwiec, M.K., Williams, I., Squier, S.M., Green, M.J., and Myers, K.M. Graphic Medicine Manifesto. University Park, PA: Pennsylvania State University Press, 2015.
Jana, T. On health humanities and graphic medicine: an interview with Sathyaraj Venkatesan. The Golden Line: A Magazine of English 3(103), 2020. Retrieved from https://goldenline.bhattercollege.ac.in/v3n103/ .
Lewis, A. D. How do techniques from comics narratives of deafness create a sense of disorientation and potential alienation that reveal the role of sound in graphic medicine?, Seeing Sounds / Hearing Pictures – A Round Table on Sound & Comics, The Middle Spaces, 2019. Retrieved from https://themiddlespaces.com/2019/04/09/seeing-sounds-part-one/
Resha, A. The blue age of comic books. Inks: The Journal of the Comics Studies Society 4(1), 2020. pp. 66-81.
David Lewis is the Eisner Award-nominated author of American Comics, Religion, and Literary Theory: The Superhero Afterlife as well as co-editor of both Graven Images: Religion in Comic Books and Graphic Novels and Muslim Superheroes: Comics, Islam, and Representation. Dr. Lewis is currently program coordinator for the MHS degree at the MCPHS University School of Healthcare Business where his teaching and research focus on Graphic Medicine, specifically the depiction of cancer in comic books and graphic novels. Finally, he is the acclaimed author of such comics as The Lone and Level Sands or the current Kismet, Man of Fate.