Taking Turns: Stories from HIV/AIDS Care Unit 371

Guest review by Dr. Devlyn McCreight

MK Czerwiec’s graphic memoir Taking Turns is one of the latest entries in the Graphic Medicine series published by Penn State University Press.  The book chronicles Czerwiec’s seven years serving as a nurse on the dedicated HIV/AIDS Care Unit at Illinois Masonic Hospital.  While it could be reasonably assumed that Czerwiec serves as the de facto “main character” of the story due to the autobiographical threads woven into the narrative, this does not actually seem to be the case.  The care that Czerwiec takes in gathering and sharing the stories of the doctors, nurses, and patients she worked alongside reflects the “part of the family” mentality that framed the patient care paradigm of Unit 371.  The author does an excellent job of illustrating how one can tell their own story without reducing others who shared in the experience to one-dimensional “supporting characters” – even the history of the hospital and Unit 371 are given eight pages of attention!  In fact, one of the most remarkable things about Taking Turns is exactly how many panels the author does NOT appear in – which allows the the book to act as more of a historical witness than a self-interested autobiography.

Not surprisingly, relationships are centerpiece of Taking Turns.  The author’s deft handling of the multiplicity of relationships involved in patient care is the strength of the book, and they are all represented throughout the narrative.  Czerwiec does an excellent job of showing how Unit 371’s commitment to care facilitated a depth of intimacy between provider and patient not often found in today’s productivity-driven medical care.  The most affecting parts of the book are when the author recalls the patients she accompanied through their final moments of life, which truly brings home how important the provider-patient relationship truly is.  In contrast, she is just as transparent regarding the less-than-ideal aspects of health care, including when human error negatively impacts the ability provide care, helping clients deal with having been abandoned / rejected by their families, and even the existential crises that accompany witnessing death on a recurring basis.  Czerwiec even goes so far as to briefly discuss the anxiety she felt regarding potential boundary issues even as she attempted to provide care that transcended the expected “professional detachment” of nurses and doctors at the time. The author’s ability and willingness to show both the profoundly meaningful and affirming side of care alongside the difficulties, ambiguity, and ugliness is a testament to her desire to tell the most honest story possible – not simply the most uplifting and inspirational one.

Czerwiec also provides basic education throughout the book on the etiology of AIDS/HIV, how symptoms of the illness manifest, and how the advancements in medication dramatically improved treatment outcomes for those dealing with AIDS/HIV – and how this ultimately led to the closing of Unit 371.  Providing important health education through comics is at the heart of the Graphic Medicine movement, and the author accomplishes this with a skillful hand.  The best example of this is on page 9, as she includes one of her patients in a single-panel diagram of how the immune system is impacted by the illness.  Amidst the multiple text boxes, her patient states quietly, “You forgot my skin.  Be sure to tell them about Kaposi’s sarcoma.”  This is a subtle reminder that symptoms do not exist independent of the people who suffer from them, which can sometimes be a pitfall when discussing clinical and medical conditions in the abstract.

While there have been some who have been critical of Czerwiec’s art (I’m looking at you, anonymous Amazon.com reviewer), I believe that her style fits the deeply personal tone of the work perfectly.  Given the preceding paragraphs in this review, my belief is that the author’s intention was to tell the story in the most direct, yet authentic and accessible way possible – meaning that the art serves the story, not vice-versa.  The simplicity and cleanliness of the art is what allows the emotional content to find its mark consistently, which only serves to reinforce the importance and immediacy of the relationships between all of those involved in Unit 371.

Overall, Taking Turns is a worthy addition to the gradually expanding pantheon of Graphic Medicine books.  It is no easy feat to balance a linear narrative, faithfully report the historical experience of others, and provide clear and concise medical information in less than 250 pages, however, the author shows that she is up to the task.  While it might seem odd to mention the number of pages in the book, it simply serves to illustrate how effective Czerwiec is her presentation given the amount of ground that the book covers.  In the end, the author accomplishes what the larger Graphic Medicine movement desires to provide, which is a comic that is accessible “because of its ability to reach diverse audiences and to provide a platform for marginalized voices— [and] can make visible and reflect upon the urgent subject of health access.”  Czerwiec’s book is an indispensable addition to the field of Graphic Medicine – and does an admirable job setting the stage and preparing the way for the next volumes in the series.

Devlyn H. McCreight, PhD in Counselor Education and Supervision

Owner, McCreight Psychotherapy & Clinical Consulting, LLC