Infertility Comics and Graphic Medicine

Chinmay Murali, Sathyaraj Venkatesan

• Publisher: Routledge
• Year: 2021
• Print ISBN:
  9780367464158
• eBook ISBN:
  9781000442113
• Topic: Literature
• Subtopic: Gender Studies
• Index: Literature

Infertility Comics and Graphic Medicine examines women's graphic memoirs on infertility, foregrounding the complex interrelationship between women's life writing, infertility studies, and graphic medicine.

Through a scholarly examination of the artists' use of visual-verbal codes of the comics medium in narrating their physical ordeals and affective challenges occasioned by infertility, the book seeks to foreground the intricacies of gender identity, embodiment, subjectivity, and illness experience. Providing long-overdue scholarly attention on the perspectives of autobiographical and comics studies, the authors examine the gendered nature of the infertility experience and the notion of motherhood as an ideological force which interpolates socio-cultural discourses, accentuating the potential of graphic medicine as a creative space for the infertile women to voice their hitherto silenced perspectives on childlessness with force and urgency.

This interdisciplinary volume will be of interest to scholars and students in comics studies, the health humanities, literature, and women's and gender studies, and will also be suitable for readers in visual studies and narrative medicine.

1Visualising illness

Comics and graphic medicine

Introduction

Comics and the related verbal-visual art forms such as cartoons and caricatures have a long history of engagement with healthcare and medicine. Premodern medicine has often been satirised by medical caricaturists for its archaic, inhuman, and unscientific practices. Again, significant landmarks in medicine’s history, including the invention of vaccines, and the threat posed by pandemics such as cholera and Spanish flu, have been well documented in the visual canvas of artists, and such depictions also reflected the socio-political and cultural resonances of the events. Modern comics and cartoons have celebrated the advancements in healthcare and medicine, portraying healthcare professionals as heroic figures. The underground comix movement which flourished in the 1960s following comics censorship was a significant episode both in the history of comics and medicine as it foregrounded the messy and obscene aspects of corporeality, paving the way for honest depictions of illness and suffering in comics. The emergence of the graphic medicine movement in the twenty-first century is a remarkable moment in comics’ engagement with healthcare and medicine as it offers a new perspective on discourses centred on health and illness. This chapter approaches graphic medicine in its generic contexts, scrutinising how this emerging discourse productively alters discourses on health and illness. The chapter delineates the ways in which comics, autobiography, and the health humanities intersect in this novel interdisciplinary field of study. The chapter contextualises the emergence of graphic medicine within health humanities and narrative medicine movements, also seeking to examine graphic pathographies as a significant addition to life narratives on illness. Specifically, the chapter discusses: the landmarks in the development of graphic medicine in relation to narrative medicine and medical/health humanities movements, graphic pathographies as a subgenre of somatographies, graphic medicine and women’s life writing, graphic medicine and medical pedagogy, therapeutic power of graphic pathographies, graphic medicine’s role in community building, graphic medicine as a critique, and internationalisation and popularisation of graphic medicine.

Humanising healthcare: from medical humanities to health humanities

Graphic medicine’s development should be understood in relation to the growth of medical humanities/health humanities in medical schools and universities. Coined by historians George Sarton and Frances Siegel in their obituary of science historian Edmund Andrews published in 1948, the term “medical humanities” refers to a multidisciplinary field that “embraces the study of medicine through the lenses of literature, history, philosophy, the social sciences, and the arts in the context of applied medicine and bioethics” (Goyette and Fairey 2020). As an approach deployed primarily in medical education and training, medical humanities seek to instil humanistic values in medical practitioners by drawing on the creative and intellectual strengths of the liberal arts. As Alan Bleakley observes, the task of medical humanities in the context of medical education involves aesthetic and political challenges. Aesthetically, medical humanities aim to transform the technical and instrumental nature of medical practice into the “art” of medicine:

communicating sensitively with patients and colleagues; close listening in receiving the patient’s history; close noticing in the physical examination; making sense of the stories that patients tell and adapting interventions accordingly; managing an identity as an expert or a connoisseur in a specialty; critically and reflexively understanding the fabric of medical culture itself; and critically and reflexively understanding historical and cultural assumptions about the body, health, disease and illness.

(Bleakley 2015, 3)

Politically, medical humanities attempt the “democratizing of medicine – shifting medical practice from an authority-led hierarchy that is doctor-centred to a patient-centred and interprofessional clinical team process” (Bleakley 2015, 2). As such, medical humanities not only advocate more agency to the patients in the clinical discourse but also accentuate the need to develop empathetic values in physicians.

Historically speaking, the inclusion of humanities courses in medical curricula was part of a broader attempt to change medical education in the United States, which began with Abraham Flexner’s 1910 report on medical education. Titled Medical Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching, Flexner’s report suggested that students with an interest to study medicine should acquire a strong foundation in sciences (Flexner 1910). The middle of the twentieth century witnessed some significant efforts to reinvent medical education. Notably, in 1937, E. E. Reinke at Vanderbilt School of Medicine emphasised the significance of “leavening technical training with a liberal education” (Bleakley and Jones 2014, 127). Subsequently, several attempts have been made to include humanities in medical education.

While Western Reserve School of Medicine in 1952 included history of medicine in its curriculum, Pennsylvania State University College of Medicine in 1967 became the first medical school to establish a humanities department, with a curriculum that “focused on engendering better understanding of families, their resources within communities, the influence of lifestyle and behaviour on the prevalence and impact of disease, and on philosophical, spiritual and ethical aspects of healthcare” (Hurwitz 2013, 673). Ever since, the growth of medical humanities in the US has been dramatic, with almost 90% of medical schools in 2011 having humanities content in their curriculum. Outside the US, the inclusion of humanities content in the medical curriculum has been slower but is steadily growing. In Canada, the University of Manitoba conducted “voluntary series of evening sessions for medical students on ‘human values’ in the early 1990s, which was eventually made mandatory” (Kidd and Connor 2008, 46–47). According to a 2008 survey, out of the 17 medical schools in Canada, 13 had humanities electives or some medical humanities content (Kidd and Connor 2008; Banaszek 2011). In the United Kingdom, Royal Free and the University College Medical School established its Medical Humanities Unit in 1998, and by 2018, 19 out of 33 medical schools offered medical humanities programmes (Association for Medical Humanities 2019). As of 2018, medical humanities courses are offered in medical schools in countries such as Australia, China, Germany, New Zealand, Norway, Switzerland, Singapore, and Sweden among others.

In recent years, medical humanities have evolved beyond medical schools and medical education, seen in the emergence of health humanities, a broader interdisciplinary academic field that subsumes health, medicine, and the arts. Craig Klugman defines health humanities thus:

The health humanities [is] … an interdisciplinary field concerned with understanding the human condition of health and illness in order to create knowledgeable and sensitive health care providers, patients, and family caregivers. As a field (meaning a focus of study rather than a disciplinary method), the health humanities draws on the methodologies of the humanities and social sciences to provide insight, understanding, and meaning to people facing illness including professional care providers, lay care providers, patients, policy-makers and others concerned with the suffering of humans.

(Klugman 2017, 421–422)

Though related interdisciplinary approaches that link healthcare and the arts, medical humanities and health humanities differ in their focus: while medical humanities deploy humanities content as a valuable tool in medical education and practice in order to enhance the “doctoring” skills in physicians, health humanities situate “the humanities, arts, and social sciences in the centre, rather than as an add-on to clinical and basic sciences” (Klugman and Lamb 2019, 3). Put differently, “a key task of this emerging field of enquiry is to breakdown the artificial boundaries between the arts and biomedical science to identify mutually beneficial fields of study” (Crawford et al. 2015, 18).

Focusing on health, which is broader than medicine, health humanities include not only healthcare professionals and patients but also “their families, whole communities, and the fabric of our societies” (Klugman and Lamb 2019, 4) who are active agents in the experience of healing and illness. Furthermore, health humanities acknowledge the social experience of health and illness, locating health in its socio-cultural environment. To quote Jones et al. (2017), “medicine is only a minor determinant of health in human populations alongside other social factors such as class, education, occupation, environment, race, and stigma” (933). As an applied enterprise, this unique interdisciplinary approach adopts diverse methodologies borrowed from multiple disciplines with a common spirit which “is not just about understanding human experience of health and healthcare; it is also about wielding a persistent voice of critique and working explicitly towards social justice” (Klugman and Lamb 2019, 4).

Several independent educational programmes on health humanities are currently conducted across universities and colleges leading to minors, certificates, master’s degrees, and doctorates. Three national societies focusing on health humanities have been established worldwide: The International Health Humanities Network in the UK (2011), the Health Humanities Consortium in the US (2015), and the Canadian Association for Health Humanities (2018). Additionally, major research bodies in the humanities such as Arts and Humanities Research Council in the UK have recognised health humanities in their programme of work, and funding bodies on healthcare research including Wellcome Trust have broadened their scope to include health humanities. In response to this gradual shift from a narrow notion of medical humanities to a broader perspective of health humanities, former centres of medical humanities are adopting more inclusive missions and nomenclatures. As Crawford et al. observe, “the genetic code of the tradition called ‘medical humanities’ has been radically altered by the health humanities movement and ‘health humanities’ looks set to become the superordinate term for the application of arts and humanities to healthcare, health and wellbeing” (Crawford 2015, 156). Interestingly, the emergence of graphic medicine as a movement and practice within academia and medical schools strengthens the medical/health humanities movements’ task of “humanising” the field of healthcare and medicine in myriad ways. With a wide range of applications in interdisciplinary research and teaching in humanities, medical education, and patient care, graphic medicine offers a unique perspective to medical/health humanities.

Narrative medicine: legitimising the patient’s perspective

Pioneered by physician and author Rita Charon, narrative medicine is a movement that emerged in the 1970s alongside the growth of medical humanities with the similar intention of “humanising” the field of healthcare. As a radical movement that aimed to revolutionise the practice of medicine, narrative medicine not only challenged the ideological supremacy of an authoritarian, empirical, and fact-based medical knowledge but also decried the power dichotomy in the patient–physician interactions. Defined as “clinical cousin of literature-and-medicine and a literary cousin of relationship-cantered care” (Charon 2008, vii) narrative medicine recognises the centrality of the patient’s perspective and therefore accords legitimacy to the patient’s experiential knowledge which was relegated to the margins by the physician’s expert medical knowledge.

Foregrounding the significance of the sufferer’s narrative of illness in medical practice, Charon argues thus: “I first used the phrase ‘narrative medicine’ in 2000 to refer to clinical practice fortified by narrative competence – the capacity to recognize, absorb, metabolize, interpret, and be moved by stories of illness” (2007, 1265). Again, while summarising the aims of narrative medicine, Lindsay Holmgren et al. underscore the significance of the physician’s skill and sensitivity in analysing the patient’s narrative thus:

The goal of narrative medicine is to restore to clinicians a skill at and sensitivity to the narrative tradition that underpins all human discourse and intersubjectivities. To be sure, narrative medicine does not seek to eradicate the benefits that modern science affords medical practice. Rather, it works to understand that technology is powerless in the absence of a relationship between two human beings whose clinical encounter is both moral and instrumental.

(2011, 255)

In sum, as an app...

Table of contents

• Cover
• Endorsements
• Half Title
• Series Information
• Title Page
• Copyright Page
• Contents
• List of figures
• Acknowledgements
• Introduction
• 1 Visualising illness: Comics and graphic medicine
• 2 Imagining “the barren”: Cultural representations of women’s infertility
• 3 Hegemonic creations: Pronatalism and the social construction of motherhood
• 4 The infertile body in the clinic: Medicalisation and loss of agency
• 5 Traversing infertility: Endurance and alternatives
• Conclusion
• Index