Traces of Madness – A Graphic Memoir

by Karol Kovalovich Weaver

Content Advisory: this review and book contains self-harm. The crisis Lifeline number in the U.S. and Canada is 988, in the U.K. it’s 999; and for elsewhere go to https://en.wikipedia.org/wiki/List_of_suicide_crisis_lines.

Traces of Madness: A Graphic Memoir, written by Fernando Balius, illustrated by Mario Pellejer, and translated from Spanish by Richard Beevor and Mailén Sganga, depicts the experiences of the author, who hears voices and undergoes other physical, sensory, psychological, and personal issues associated with psychotic episodes. The author describes how life circumstances and the world in which people live impact voice hearing (understood medically as schizophrenia, psychosis, or auditory hallucinations). Pellejer’s illustrations complement Balius’ text: he visualizes the voices as monsters and Balius’ episodes as overpowering waves of water. The author and illustrator not only work together to tell Balius’ story, but the illustrator’s traumatic brain injury becomes itself part of the story’s purpose—that, although, we don’t know our future story, our story can change and be told in a different way. Ultimately, Traces of Madness teaches the reader/viewer lessons about self-narration and about people who hear voices.

Balius wants to share his experiences with voice-hearing. He documents that it first happened when he was a child; attending mass with his parents, he saw his embalmed grandfather’s body on the altar and heard and smelled things that others in the church did not. At age nineteen, he had another episode—his fingers and arms reached out, he was exhausted, and he hallucinated. He believed that he knew what his girlfriend thought about him and that she was not happy or pleased with him. Eventually diagnosed with schizophrenia, Balius endured drug therapy and hospitalization. Balius makes clear that personal relationships and environmental circumstances impact voice hearing, which not only involves auditory hallucinations but is accompanied by physical suffering. Teeth grinding, jaw clenching, and incontinence seize the body. He discusses his family’s inability to share their emotions and the isolation that he felt as a young adult. He offers, “Nobody I know who has gone mad is being treated all that well by life. There is a social component of psychological suffering and the people who experience it [unpaginated].” Despite the consequences of negative social and environmental circumstances, Balius makes clear that a “human network…has allowed me to come back every time I got lost…someone always knocked on my door.” This network included his friend Daniel who visited and hugged him and his ex-partner who accompanied him to a Hearing Voices Congress. The book’s dedication summarizes his views on hearing voices: “Dedicated to those who have helped us think in new and different ways about the voice-hearing experience. Their generosity makes a less bleak future possible for the rest of us.”

Pellejer’s illustrations match Balius’ descriptions. Pellejer imagines the voices that Balius and other voice hearers hear as monsters. The cover of the book shows Balius looking directly at the light-yellow, hairy, horned, and fanged monster that Pellejer draws to portray Balius’ auditory hallucinations. The monster lurks, stands close to Balius, and rides along in the car. Understanding that the voices appear when Balius is stressed, Pellejer includes Balius confronting the monster. At the Hearing Voices Congress, a gaggle of different colored and unhappy monsters stand behind members of a support group. One participant says, “When people join groups, their voices become more aggressive, more violent.” Despite the problems they create, Balius acknowledges, “Voices are buoys. They float on the dark sea to warn me of dangerous places.” Pellejer also envisions Balius’ experiences by means of water imagery. An image meant to portray the high point of a psychotic episode shows Balius holding a child’s flotation device while looking directly at the viewer. An enormous cresting and dark wave rises behind him. On the top half of the page opposite, the wave crashes over Balius and, on the bottom half, the flotation device floats on a blue sea of small waves. Both the monsters and the water portray psychotic episodes with auditory hallucinations.

In addition to his illustrations, Pellejer’s life events become integral to the book and its overall purpose—that one’s story can change. A digression appears halfway through the book. Balius writes that “it’s meant to say something important…we do know, what we can say with absolute certainty, is that, from this moment on, the story is going to be told and drawn in a different way.” During the making of the book, Pellejer suffered a traumatic brain injury due to being run over by a car while he was riding his bike. Balius’ partner also endured a life-changing illness. Balius stresses that Pellejer, his partner, and himself all “experienced events that dramatically altered our relationship with reality…Sometimes, things are much simpler than we expect them to be: you have a bad experience, and then you just want to move on and embrace life.” Despite tragedies and trauma, one must “carry on.”

     Traces of Madness teaches the reader and viewer about the power of telling one’s own story. In Balius’ case, that story is about hearing voices. Balius ends the book with an appendix that educates the reader by listing the physical, psychological, personal, and social issues that people who hear voices might face. This volume will assist people who hear voices and the people who care about and love them. Finally, it belongs in library collections dedicated to graphic medicine and in medical humanities classrooms.

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Karol Kovalovich Weaver is a professor of history at Susquehanna University. She teaches US history and the history of medicine. Her research focuses on the history of medical caregiving. She is the author of two books, Medical Revolutionaries: The Enslaved Healers of Eighteenth-Century Saint Domingue (University of Illinois Press) and Medical Caregiving and Identity in Pennsylvania’s Anthracite Region, 1880-2000 (Penn State Press). She was awarded the Journal of Women’s History Best Article Prize (2024-2025) for “’Her Infant at Her Breast’: Breastfeeding as Survival and Resistance in Colonial Haiti,” Journal of Women’s History 35, no.4 (Winter 2023) 76-96