The Tumor in the Clay

By Paul Flippen

Graphic Medicine is presently established well enough as a field to enjoy an avant garde. We have exemplary works of personal narrative offering glimpses into direct experience with the medical community. We have important nonfiction contributions that educate, explain, or elucidate. With The Tumor in the Clay by Nick Francis, we now also have a poetic work that communicates an intersection of health and humanity through metaphor (and dazzling visuals).

Lacking text narration, the graphic novel retains legibility through a flexible four panel layout of stacked horizontal frames whose aspect ratio comfortably alludes to cinematic storytelling. Moments of emphasis are achieved by combining frames into larger spaces or speeding up action by fracturing panels into choppy sequences.

Although Francis creates an experimental graphic novel, the work still makes for an engaging reading experience. He demonstrates fluent understanding of when to exploit the conventions of comics (well-realized pacing between establishing shot and significant close-up, reveals after the page turn, clear sequential action) and when to frustrate our expectations (our main character is unnamed, no dialog humanizes him, no captions offer context).

Not quite entirely wordless (there are a few, non-English phrases used as visual layering in an abstract sequence), The Tumor in the Clay encourages a close “reading” of the artwork as we puzzle our way through a narrative of a surgeon attempting to heal himself. In the settings, background details, and jagged rendering Francis employs, we see evidence of his occupation (photos in scrubs and medical journals), the recognition he has earned in his career (framed awards and magazine profiles), and the disorder of his current state (garbage piled up and insect infestation).

An introductory sequence establishes the surgeon’s failing health through sharp, angular linework layered over a cool grey spot color. The surgeon’s desperate circumstance is communicated by his actions (failing to prepare a meal, frustratedly attempting to light a cigarette, collapsing to the floor) and embodied in an artistic language that combines well-observed precision with expressive distortion.

We follow along as the character moves to the bathtub to perform guerrilla self-surgery in the company of creepily anthropomorphic cicadas. (I did mention this is not a conventional example of graphic medical narrative.)  Relying on a contradictory collection of supplies (professional scalpels, syringes, and advanced medical imaging that is then casually printed – targets circled in red – and taped to the bathroom wall) he operates in sanitary conditions that fall far short of standard practice.

After the surgeon successfully(?) excises several masses from his own abdomen, he and the reader are transported into a visual-mental realm bursting with saturated color. Yellows and cyans compete for our attention in a visual language that owes as much to woodblock printmaking traditions as it does to digital color separations. Francis orchestrates density and layering to create framing elements and mark making that are both other-worldly and expressive.

In this realm of memory and metaphor, clarity of linear narrative is sacrificed, but communication is not. There is tension in reading-as-collaboration: we may not know entirely what is occurring, but we understand how it feels. Desperation and pain, dislocation and wonder, fragility and acceptance are all elicited, even if a precise iconographical key is not provided.

The narrative closes the circle by revisiting the surgeon in his black line and spot color living space, order restored, but with scars of the experience in evidence.

The book concludes with an interview with the creator, shining light on his inspirations and process. An appreciation of the personal status of Francis as a disabled artist dealing with chronic conditions (Chronic Daily Migraines and Crohn’s Disease) may retroactively inform our sense of the surgeon’s isolation depicted in the graphic novel, in much the same way that museum wall text can provide context for the viewer’s interpretation of art.

The Tumor in the Clay is a fascinating contribution to graphic medicine, less as a didactic examination of a specific health care issue, and more for the invitation it offers the reader to go through a shared experience and form a personal understanding of its meaning.

—

Paul Flippen was born in Berlin, Germany and as an Army Brat bounced around between Germany, Texas, and California at the whim of the Pentagon. Now living in Colorado, Flip is a painter whose work features layers of imagery that invite the viewer to enter a dialog with the work. He has published work in Ilanot Review, The Gateway Review, District Lit, and the Keywords/Keyimages in Graphic Medicine anthology from Penn State University Press. His first book, 36days, was published by Shanti Arts Press in 2019.