Podcast Episode: Conference Opening Night

Welcome to a new season of the Graphic Medicine Podcast!

On today’s show, audio from the opening night of the Seattle Comics & Medicine conference, Thursday June 15.

You will hear from three speakers in a row. The first will be Seattle conference organizer and host Mita Mahato. Mita is a Seattle-based cut paper, collage, and comics artist, whose work explores the transformative capacities of found and handmade papers. She is also an Associate Professor of English at the University of Puget Sound, serves on the board for the arts organization Short Run Seattle, one of the sponsors of the Comics & Medicine conference. You can learn more about Mita’s work on her website. Mita’s opening remarks touch on the theme of the conference, Access Points.

After her opening remarks, Mita will introduce Matthew Noe, librarian from the University of Massachusetts Medical School, and Graphic Medicine fellow for the National Network of Libraries of Medicine, Northeast Region. Matthew will pose the opening query: “What Does the Literature Say?” (Spoiler: He needs your help!) You can contact Matthew at Matthew dot Noe at umassmed dot edu or @NoetheMatt on Twitter.

Finally, Mita will introduce our last speaker for the episode, Jared Gardner. Jared is a Professor in the Department of English specializing in American literature, comics, film and popular culture. He is the author of Master Plots: Race and the Founding of an American Literature, 1787-1845; Projections: Comics and the History of 21st-century Storytelling; and The Rise and Fall of Early American Magazine Culture. Other books and writings can be found at jaredgardner.org and he is @guttergeek on Twitter. He also serves as director of the Popular Culture Studies program at OSU and as editor of Inks: The Journal of the Comics Studies Society. Jared’s opening lecture is titled “Social Ills: Graphic Medicine Beyond the Clinic.”

Hope you enjoy this conference opening and it puts you in the mood for the entire season of Graphic Medicine podcasts that arise from our recent conference.

Support for this podcast comes from Penn State College of Medicine, Department of Humanities, the nation’s oldest Humanities Department within a medical school, pioneers of innovations in medical education since 1967. To learn more about Penn State College of Medicine Department of Humanities, go to www2.med.psu.edu/humanities.

UPDATE! Eli Bishop has transcribed the podcast for the site. Thanks, Eli! 

MK CZERWIEC: Hello, and welcome to a new season of the Graphic Medicine Podcast. I’m your host, MK Czerwiec in Chicago. On today’s show, we’ll have three speakers from the opening night of the Seattle Comics and Medicine Conference. But before we begin, I want to tell you that again this season I’m very grateful for support for this podcast coming from the Penn State College of Medicine Department of Humanities. They are pioneers of innovation in medical education since 1967, and they were the United States’s oldest humanities department within a medical school. To learn more about the Penn State College of Medicine Department of Humanities, go to www2.med.psu.edu/humanities.

So as I mentioned, today’s entire show will be audio from the opening night of the conference, which was Thursday, June 15. And you’ll hear from three speakers in a row, and the first of those will be Seattle conference organizer and host Mita Mahato. Mita is a Seattle-based cut-paper collage and comics artist, whose work explores the transformative capacities of found and handmade paper. She is also an associate professor of English at the University of Puget Sound, and she serves on the board for the arts organization Short Run Seattle, one of the very generous sponsors of the Comics and Medicine Conference. After Mita’s opening remarks, she will introduce the other two speakers, Matthew Noel and Jared Gardner.

I really hope you enjoy this wonderful conference opening, and it puts you in the mood for the entire opening season of Graphic Medicine podcasts. Most of them will arise one way or another from that great conference, and I’m really excited to share all that content with you. Enjoy.

MITA MAHATO: Okay, so, the first items I need to cover are thank-yous. A conference like this one, as many of you know, can’t happen without the support of a number of organizations, entities, and individuals. So first of all I’d like to thank the Seattle Public Library. I am so thrilled to have you guys here in this venue for this event. And I’d in particular like to single out Abby Bass and Anata Solinka[?], who provided so much behind-the-scenes support and advice to make this conference hopefully run smoothly. So, thank you to SPL. [Applause]

The National Libraries of Medicine is one of our signature sponsors, and so I want to give a special thank-you to them as well. We’re really excited to begin developing some pretty good collaborations between libraries and graphic medicine. I want to give a special thank-you to Ann Oscar[?], who has been a tremendous support with guidance for this conference, so thank you, Ann.

Our next signature sponsor that I’d like to give a special thank-you to is Short Run Seattle. And having this conference in Seattle, one of the things that we’re most excited about is getting the Seattle comics community involved in it, and that could not happen without Short Run. And beyond that too, Kelly Froh and Eroyn Franklin have been tremendous support behind the scenes, so thank you guys so much. If the rest of you in the audience are looking for a small comics non-profit to support, Short Run is the one to look for. So, thank you guys.

I would also like to thank Public Health Seattle, King County Emergency Medical Services, Penn State University Press, the Annals of Internal Medicine … and then a number of University of Washington departments and programs: the Disability Studies program in particular; Northwest Center for Public Health Practice; the Center for Global Studies; Simpson Center for Humanities; the Diversity program; Center for Communications Difference and Equity; Comparative History of Ideas; the Department of Bioethics; the Department of English; and the College of Arts and Sciences.

I would also like to briefly acknowledge everybody on the Planning Committee: Meredith Li-Vollmer, MK Czerwiec, José Alaniz, Kurt Shaffert, Susan Squier, Shelly Wall, Juliet McMullin, Michael Green, Michelle Elly[?], James Sturm, and of course Ian Williams. Thank you guys.

Finally, thanks are owed most importantly to all of you. This conference would not be the thing we keep coming back to, or this thing we’re dying to go to, without the community we’ve developed and continue to develop from within it and around it. So I want to thank you for your passion, your work, your intelligence, your creativity, your inspiration, which really is what makes one want to take on the task of hosting this conference. [laughter] There are times when, you know, you think “Wait, why am I doing this?” And then one of you would send me an email that would just say “I’m so excited,” and it would be all that I needed to keep doing this. So thank all you so much for making this community something we want to keep developing and being here for.

So, speaking of all of you … you are from all over the place. You’re coming here from Japan, from China, Australia, New Zealand, Spain, Italy, Toronto, Vancouver, Alaska, Florida, Tennessee, North Dakota … I’m not going to name all the places you’re from [laughter], apologies if I’ve left you out, but you get the idea. You’re librarians, artists, students, doctors, nurses, art therapists, physical therapists, teachers, scholars, community activists. Some of you have been all of the Comics and Medicine conferences. Many of you are here for the first time. Some of you are returning after some years … Sarah Leavitt[?] [laughter]. And I want to build on your multiplicity of experiences and backgrounds and places you’re from, to talk a little bit about this year’s conference theme, Access Points.

As you’ll see over the course of the next few days, what access means is “multiple.” And I think that the multiplicity of the term is something that we should respect and preserve and cultivate. In fact, I think that multiplicity is part of what we mean when we say access, and when we promote accessibility. We have multiple ways that we experience pain, illness, caregiving, mourning, the financial weight of health care, and I think we all know that we can learn from each other in our multiple experiences of that.

I’ve felt so connected to comics, and the communities that emerge from comics, because it’s a medium that invites and demands multiple and simultaneous perspectives. We all know this, that with comics it’s not just word and images, it’s both together, in context and in conversation. It’s a medium that at its best allows us to see in ways that might be new to us. It’s a medium designed for visibility, and designed for accessibility. As our culture becomes increasingly accustomed to polarizing attitudes, attitudes that favor one-line judgments over complex thought, I think it will become even more important to preserve the multiplicities that art forms like comics can invite, and to preserve our willingness to seek out the unfamiliar and the complex in them.

So, you’ll be at this conference, and you’ll be thinking: “How do I choose between this session and that session?” [laughter] We hear this every year, right? “I wanted to attend everything.” So I encourage you to seek out what is unfamiliar. If you have a story, and you’ve never made a comic before, there’s a workshop for that. If you’re a cartoonist and you’ve been feeling called to work with underserved communities, there are panels that will be discussing those kinds of projects that you might find inspiring. Again, access can mean so many things, and I just encourage you to have open minds this weekend.

So this afternoon we wanted to give you a small taste of the multiple kinds of topics and approaches that will come up during this weekend. So first of all, Matthew Noe is a medical librarian interested in health literacy, access to information, and the partnerships between comics and library sciences. He is currently a Library Fellow at the University of Massachusetts Medical School, and a Graphic Medicine specialist for the NNLM New England region. He is also responsible for the wonderful “This Week in Graphic Medicine” blog series, which if you haven’t checked out you definitely should. We owe Matthew a tremendous amount of thanks for cultivating interest in graphic medicine. In Matthew’s opening query, “Comics and Medicine: What Does the Literature Say?”, he’ll be talking about some research he’s undertaking through a Gold Foundation grant, and enlisting the help of some of you.

MATTHEW NOE: So, thank you, Mita, for the awesome introduction and the thanks, and for putting everything together. And thanks for giving me a chance to come up here and introduce this research project a little bit. I’m not going to take a ton of time. Really what I’m looking for here, I’ll get to in a second.

So, this illustration is by Kelly Lund … I think I have it on there, I’m not sure how big it is. She actually drew a conference poster for us about this research project, that, as Mita mentioned, is funded by the Arnold P. Gold Foundation. It’s technically what’s called a “Mapping the Landscape, Journeying Together” grant. The idea is to fund systematic reviews of some sort in the medical humanities, to try to further humanism in medicine. And so last summer I grabbed a physician and another librarian, and was like, we’re doing a scoping review: we’re going to map the landscape of comics in medical education, see what literature we actually have on this topic, see what’s out there. And so far, we’re still weeding through all of the paper, as you can see in this panel … I love this picture, because this is what my desk has looked like for the last six months, and will probably continue to look like for the next six months. But as we’re going through … if you want to know more about the whole process, I can talk more in detail later one on one, or …

But what we’re finding is that there’s stuff out there. There are 500-ish potential articles that involve comics and medicine somehow. That number is actually inflated, it’s going to be way lower than that, because the terminology for finding comics in the public literature is miserable. And this is kind of the librarian in me complaining. [laughter] Our medicine subject headings in PubMed don’t really work for comics; in CINAHL they don’t exist at all, and so on. So what I’m up here really to ask is, if you know of any of these studies in comics and medicine, to send them to me. I may already have them, but I’d rather have them more than once. And more importantly, if you’re doing work, if you’re teaching students with comics, if you’re discussing comics in classes with your patients … we’re talking education here broadly, both for medical students, nurses, and for patients … let me know about it. If it’s not published, we can still include it, because we’re doing scoping and not systematic. The idea is to see what’s out there, find everything, and then give some feedback on how easy it is to find … are there any results we can generalize from what’s being done.

So my contact info is up there. I’m very easy to find on Twitter … I’m on Twitter too much. [laughter] And I’ll leave it at that. You might see me later in the conference, I’ll be up here again, and then at the brown-bag session that if you’re a librarian, you should come to. Thanks.

MITA MAHATO: Following Matthew will be Professor Jared Gardner. Jared is Professor in the Department of English at Ohio State University, specializing in American literature, comics, film, and popular culture. He is the author of Master Thoughts: Race and the Founding of an American Literature, 1787-1845; also, Projections: Comics and the History of 21st Century Storytelling; and also, The Rise and Fall of Early American Magazine Culture. He also serves as director of the Popular Culture Studies Program at OSU, and as editor of ___[?], the journal of the Comics Studies Society. Jared will be offering our opening lecture, titled “Social Ills: Graphic Medicine Beyond the Clinic.”

JARED GARDNER: So, I want to join everybody else in thanking Mita and the organizing committee for putting this together. This is one of my favorite conferences in the world. Actually, I hate conferences, so … [laughter] and yet this is one of my favorite places to be, so … [applause]

And part of why I love it, I suspect, is the same reason that many of you do who have been here before, which is the unique conversations and possibilities across our usual borders, that too often stifle our ability to think in new ways. And this has been an incredibly welcoming space for me, as I’ve made some very large transitions personally and professionally.

Which leads me to apologize for the talk I’m about to give, which is a little bit of a bummer. I’m sure this is entirely unique to me, but I’ve been a little traumatized this year. [laughter] And because I feel safe here, and you guys have heard me over the years work through some very nascent ideas, I think of this as a place to try and work through some of my trauma, and also to think through, as a kind of provocation for myself, some of why I’ve increasingly found myself frustrated conceptually, as I’ve been working on a book project on graphic medicine, with the emphasis that we place in the field on the clinical encounter and on the patient-doctor relationship. And I also wanted to think about the issue of narrative, more broadly, particularly the question of narrative medicine. So we’ll see where it goes. Remember, the bar is open. [laughter] I will not be offended if people drink.

So, narrative medicine emerged int eh 1990s as a project of health care reform, one designed to foster— to quote Rita Sharon[?], one of the movement’s founders— “A medicine practice with narrative skills of recognizing, absorbing, interpreting, and being moved by stories of illness.” Narrative medicine was the response to long-standing trends in modern medicine and medical education. Whether as patients or caregivers or both, we all know those trends: the shift from patient narrative and the physical exam as primary diagnostic tools, to increasingly powerful and expensive diagnostic tools … scans, tests, samples, which provide what story never can: objective data. And of course that data now resides, along with the whole of a patient’s records, in electronic form, on the screen that occupies a central role in the examination room, as the doctor— available time already compressed from on high, in the need to see ever more patients to pay for the equipment and the tests and the experts who operate them and interpret their results— struggles to balance the tension between patient narrative and the reams of data on the screen by their side.

The decline of the exchange of story and touch, and the concomitant loss of skills in what Sharon identifies as “narrative empathy,” corresponds with the rise of ever more impressive expensive data, whose certitudes and clarity have also led to the devaluation of patient narrative as purely subjective, and therefore increasingly inadmissible without objective corroboration. For Sharon, narrative medicine is about restoring that competency: empathy and exchange between patient and doctor; recovering the art of hearing story and responding to it, [inaudible] as possible. It is a very exciting model, as any of you who have heard her speak or read her work know. And every time I hear her, I’m inspired, I’m hopeful for the future.

My enthusiasm only dampens when someone asks the inevitable question. The last time I heard her speak, there was a young doctor at the end of his residency. He was flushed, sitting on the edge of his seat, it was the first time he’d ever heard her talk about this stuff, and he asked— kind of breathless— he said, “I’m ordered to spend 8 to 15 minutes with a patient, while simultaneously reading from and writing into their EMR”— electronic medical record. “So, just in terms of specifics, how could I practice the kinds of techniques you’re advocating within those constraints?” I’m not sure what answer he was expecting; probably the kind of answer he was used to hearing throughout his career, from, you know, being [inaudible] student as a pre-med, to his years as a resident, which is: “You just do more with less time.” And the fact that he was still standing, or sitting on the edge of his seat, suggested that he had found ways to do that … whether for his own good or not is another question, but he was still there and very excited about it. So, as much as he might have been dreading the usual response, at least it would have suggested to him that it was humanly, or inhumanly, possible. Instead, Sharon replied— and to me it seemed an honest reply— “Oh, you can’t do that in 8 to 15 minutes. It just can’t happen. You have to demand the time you need to do your job properly.” He nodded politely and slumped back in his seat, knowing full well that it would be many years if ever before he would be in a position to insist on anything of the kind. For him, as for some of the caregivers that we have met, or that we are ourselves, narrative medicine often remains a tantalizing but utopian project.

From the patient side of the clinical encounter, where I’ve spent much of my waking life, the prospects seem at first much brighter. After all, having been for a generation now ignored, doubted, ultimately declared pathological liars by no lesser authority than Dr. House himself [laughter] … narrative medicine’s call for attention to patient narrative unleashes, and has unleashed, a torrent of narratives: narratives that quickly outstripped the clinical setting and the reach of narrative medicine on the other side of the encounter. Where once we counted the titles on a couple of hands, in the last 20 years illness memoirs have emerged as a vital publishing genre, with a section all their own at Half-Price Books, which I’d hang around often enough to creep out the kids who worked there. [laughter] They’d whisper when I walked in. That I’d spend the rest of my time in the comics section probably doesn’t actually help. [laughter]

So all of this is a good thing. But it is no less of a utopian project than the narrative medicine project as looked at from the perspective of the young doctor. Patients face their own crushing pressures, ones shaped as fully by what Arthur Frank[?] calls “postmodern medicine” as those confronting doctors on the other side of the encounter.

The first among these pressures is the desire to be heard. But close behind is, of course, time— something I’ve talked about at this conference before, and if we don’t do so again, apologies. The patient is sundered from clock time, that same clock time that relentlessly crushes the doctor on the other side of the encounter. By clock time I mean here our shared sense of time … or our denial, and surely we can deny this extremely well, of the relativity of time. Our experience of time, a fixed now from which the past recedes and towards which a never-arriving future approaches, is our one truly shared task, our unifying fiction. We are wired to tell stories, because of our need to anchor our experiences in shared time … our need, essential to sociality itself, and to the various political and economic systems that have emerged in modern life, that our relative experience of time can be made universal, exchangeable one to another. Long before we had ubiquitous and precise technologies to sync us to our shared time, necessary for global capitalism, we had stories. Today, narrative is less vital to the work of synchronizing us to social time, but it’s no less prevalent. More than a century after Einstein first spelled out his theory of special relativity, our globally networked screens have us all the more synchronized. We know theoretically that time is relative, but we live time as fixed and universal. We fall out of clock time regularly in our daily lives— a daydream, an experience of déjà vu— but we are tethered to so many devices designed to pull us back into sync, to make us discount as unreal those ruptures in time’s fabric.

Today, therefore, we are most aware of our sundering from time when we are ill— which is, in large matter, what makes illness so intolerably isolating. When we are ill, we experience time as out of joint, or broken: the rending of the veil affording rare glimpses into the relativity of time, glimpses we must discount as necessarily … ill. What we experience as broken time is in some ways more accurate or true than [inaudible] experience affords us, but it’s also incommunicable— or at least incommunicable through narrative, or the version of narrative we’ve developed to bind us one to another. To be sick is to be thrust out of time, or, to borrow from [inaudible], to be thrust out of narrative, and thus out of human time. As Elaine Scarry famously puts it, “To have great pain is to have certainty. To hear that another person has pain is to have doubt.” To be well is to be back in the master narratives that depend on clock time as technology; it is to be restored to the community of faith.

Our stories, and their circulation, are as much bound to and shaped by the demands of capitalism as the young doctor who begins his career beneath the relentless pressures of this corporate clock. Here’s where I start to venture into dangerous waters, so let me rush to say that I am conscious every day of how much illness memoir has done for me personally, for my students, for fellow patients. But I have increasingly come to worry that the stories we long for, the stories we long to tell ourselves, remain, quote, “the telling of events such that at least one occurs at time T and the other at time T1″— to borrow from Gerald Prince’s minimalist definition of narrative. [inaudible], and he is not either, about the order in which we tell that story, and of course few illness narratives are told chronologically. But their reward, their release[?], nonetheless inevitably lies in the fact that their teller’s ability to distinguish, if only in the act of telling it, for which all patients long, T from T1. That itself would be preferable to the endless repetition of T, T, T … as any Hollywood screenwriter or patient knows too well.

Story promises us as a present from which the teller can narrate the past. Narratives after all involve some pretty basic ingredients, as James Phelan’s definition puts it: “somebody telling somebody else, on some occasion, for some purpose, that something happened.” I want to pause for a second over that “purpose”— in this case, not from the perspective that Phelan would be interested, the purpose of the teller, but the purpose of the reader … to understand what it is that has made a profitable publishing marketplace, where before it did not exist.

I often get requests, and I bet many of you in this room do as well, for recommendations. The request is always pretty specific, and it takes one of two forms, broadly construed. In the first form, the request is linked to an often recent diagnosis: “Do you have a suggestion of a memoir of living with lupus?” “With Parkinson’s?” “With [inaudible]?” The patient is often atomized by this diagnosis, horrified by the factoids and hysteria that they’ve encountered on the Internet, that bane of every patient’s existence. And the search for a personal narrative promises them a return to a coherent self, a self capable of narrating what remains untellable. The very existence of the memoir promises them structure and futurity, both of which are lost at the moment of diagnosis. Perhaps equally vital, it promises them a restoration to the social fabric from which illness has sundered them.

The second kind of request I get is one I know from personal experience … it’s what first brought me into [inaudible] This request comes not from someone who has been atomized by a new diagnosis, but from somebody who’s desperate for diagnosis. Having lived months, years, in the limbo of the diagnostic merry-go-round, they’ve lost their faith in their doctor’s ability to tell their story, and they are by definition incapable of narrating their own. They fear time is running out, and only a diagnosis will save them. WebMD’s diagnostic tool has suggested possibilities their doctors perhaps dismissed based on the objective data. So maybe, just maybe, a memoir about a patient with anti-NMDA receptor encephalitis, or rapid-cycling type 1 bipolar disorder, et cetera … whatever diagnostic possibilities the symptom checker has kicked out at them … maybe a narrative told by someone for whom time did not run out, and who was restored to clock time in time to tell it, might do the same for them.

These are very different readers, and we see books increasingly marketed with sophistication to one or the other, depending in part on the rarity of the diagnostic [inaudible], et cetera. But what these readers long for in either case is the return to shared time promised by the act of narration the book represents. That shared time is the same time that has delimited their lives, and the lives of their caregivers, in countless ways, in late capitalism, isn’t beside the point; it is the point, and precisely the point we have no way of narrating. To punch the clock is to be made whole again. This is the true master narrative of modern medicine, which narrative medicine does not, cannot, offer us a way beyond.

All of this is, I think, underscored when you consider the alternative, which is not death— much as we hate to think about death— but something which our society suggests is far worse, a kind of living death. When I teach early American literature, my students are often appalled when an author refers to an infant child as “it”— actually my own personal preferred pronoun, but I bracket that. And I explain to them that in 17th century New England, on average 40 percent of children did not survive. That was actually better than it was across the pond. Of Cotton Mather’s 15 children, only two made it to adulthood, and he was one of the wealthier and more powerful citizens of Boston at the time. For them, and for their ancestors and for their descendants, the idea that one had an expectation to live without pain, without physical scars mapping their life’s illnesses, and without living in constant expectation of death, would have been as unimaginable as calling your child “it” is for us today.

Today, we expect to live without chronic pain, even as many of us do— the opioid epidemic being one consequence of this. We expect infants to survive, even though we know of many who do not. And we expect to be shielded from the inevitability of our own deaths until the last possible second. These expectations, or at least the first two of them, seem to us reasonable. But they’re extremely attenuated— bounded historically by the birth of modern Western medicine a little more than a century ago, but also by a range of other factors: race, class, gender, education, geography. We understand, we believe deeply in health care as a human right, as declared by unanimous vote in 1948 in the UN, probably the last time they were unanimous about everything. Seventy years later, one third of the world’s population does not have access to basic essential medicine; 60 percent of the world’s population doesn’t have access to water sanitation or flush toilets. The civil war in Syria has already cut the life expectancy in that country by more than 20 years. In several nations in sub-Saharan Africa, life expectancy remains under 50. And here in the United States, life expectancy varies by more than 20 years depending on geography and sociodemography. Indeed, all of our vaunted modern medicine aside, Americans are dying earlier than we have in recent decades; and this is before the Senate races to force through the AHCA before anybody gets a chance to measure its cost in human lives. Time is speeding up, and running out.

No less than the mythical white working class man who voted for Trump in 2016, we vote against our own interests every day, signing our own “hillbilly elegy”— to quote the title of a vastly over-rewarded book. [laughter] All we are asking for is a chance to sing our song, to tell our story, to return to clock time … because the alternative is to be one of the growing army of global capitalism’s living dead. To be a teller of our story is about empowerment, to be sure— an empowerment that modern medicine so often seems to strip from us. But modern medicine, especially in our country, with our system, is itself a symptom, a manifestation. And our empowerment and our demand for recognition is one more quarter in the jukebox, as capitalism wrings one more good quarterly return from a dying planet, dying population.

Man, I’m a bummer today! [laughter] All right, let me just shift in the final moments here, real quickly, to a more optimistic thing. You’ll notice I haven’t talked about comics. I could show some good ones.

So I’ve been talking about narrative medicine and illness memoir, and in certain respects we understand what we do and study here, graphic autopathography in particular, as a subset of narrative medicine and illness memoir. And certainly graphic memoirs of illness are narratives; they fit Phelan’s definition, they fit Gerald Prince’s definition. But as we know, comics do strange things. We tend to speak of it as the power of comics. Eh… [laughter] Comics are just broken things. They do awesome things because … they’re not very powerful. That is their power. Comics do strange things with time, with the relationship between author and reader, with identification. And maybe much of the power of comics derives from all that we try to rescue comics from: its runic simplicity, its elliptical incompleteness, and the speed with which it is read and can be reread and reread, and passed around the house or the community, and the grinding slowness by which it is produced. [laughter]

Perhaps more urgently for what I’m addressing here is the fact that comics as a form necessarily complicate our normal experience of time. [inaudible] wrote not too long ago that there is no time in comics. Better put, perhaps: time in comics is spread out across space, and only activated in the presence of the reader. And in so making time spreadable, and therefore having no means to prevent the reader from seeing past, present, and future, in any order their eyes desire, even inevitably, all at once, the stories we wish to tell in comics resist any order the teller would impose. Again, this is not because comics are powerful; we don’t need stories to be powerful over us. We need stories that make us powerful. It’s not because comics are powerful, but because, to borrow the productive pun from Georgia Webber, because they are so beautifully dumb. Their failure to impose story of the teller requires, as we all know, active engagement, collaboration, filling in. And this reminds me— and, this is again, the early Americanist in me— it reminds me of earlier moments in history when thinkers worried about the dangers of books, the dangers of narrative.

In 1711, eight years before Dafoe’s Robinson Crusoe—that foundational text of the rising English novel, and the fantasy of capitalist self-fashioning, which the novel has so long served—Joseph Addison borrowed a Greek proverb as his epigraph: “A great book is a great evil.” Writing 100 years later, as his beloved periodical essay [inaudible] surrendered the field once and for all to the triumphant novel, Charles Brockden Brown quoted extensively from an essay by Isaac Disraeli, who had argued that great books present dangers to the freedom of readers, risking turning the reader into, quote, “a prisoner chained to the triumphal car of an author”— with Brown arguing, picking up on Disraeli, for a form that would allow the reader to see only single parts of the whole, quote, “the imagination properly supplying the intermediate links.” Brown, like Addison before him, was thinking about the serial periodical essay as this new form, that was designed to resist the tyranny of books and authors. But we comics folks cannot help but suspect that they were both imagining or envisioning another form entirely, one whose development was actually beginning to take place, from William Hogarth to Rodolphe Töpffer, during the course of the century in which they wrote, but whose modern form of course would not find fruition until the end of the 19th century.

Comics allow us to see only certain parts; they require an active readerly imagination to supply the links; and no cartoonist imagines anyone chained to their triumphal car— or if they do, they are disabused of that fantasy very quickly. In graphic memoir, in fact, the author’s story often cedes the limelight to larger social forces. Think of David Small’s Stitches, for example, where the story of Small’s cancer— at the hands of his father and his fancy X-ray machine— and the family’s history of mental illness, is quietly, powerfully woven in with the story of postwar Detroit, its rampant consumerism, and the beginnings of its undoing due to white flight, deindustrialization, and outsourcing.

Or think about Gabby Schultz’s recent— and, honestly, Gabby Schultz, that book makes me look cheery as hell [laughter]— recent and completely gutting memoir, Sick— [inaudible] Sick, oh, you all have to read it. [inaudible]— where a graphically gooey account of the uninsured cartoonist’s illness morphs, seemingly inevitably, into a blistering denunciation of white privilege, the fiction of health, and the destruction of the planet. For Schultz, what follows is an extended insight gained from his illness, about his own life at first, but soon extended, even as time and space continues to contract, resulting in an apocalyptic vision of the plank across which the clock time of late capitalism is marching humanity and the planet itself. When at the end of the book the illness finally recedes, and we get the happy ending, everything [inaudible] okay, Schultz makes it clear that it is meant to sound as false and hollow as it does: the happy ending of the visionary who has at last drunk the Kool-Aid and succumbed to health, and with it lost access to the visions which sick time provided; the white man restored to his wellness, and his wellness understood now as the true zombie roaming the earth.

All of this pushes us beyond the domain of the clinical encounter, and beyond the story of individual patients and doctors, into the story of wellness and disease as it affects not just the body of the cartoonist, but cities like Detroit, and ultimately the planet itself. Doing so, these texts— and graphic medicine more broadly— open us up to seeing things we might not associate with the genre, and actually entirely central to it. And here I’m thinking most immediately about the work of Joe Sacco—about whom Hilary Chute, our keynote speaker tomorrow morning, has written so powerfully in her recent book Disaster Drawing. As the slowest-working journalist in the history of the form, Joe Sacco has devoted the last 20-odd years to retelling stories of those who live outside the fantasy of wellness, whether in the camps of Gaza, the besieged city of Gorazde, the displaced women of the Caucasus, the unwanted refugees from Eritrea in camps in Sacco’s native Malta, and, in his collaboration with Chris Hedges, the disaster zones of modern America. For Sacco, the comic form opens up opportunities for representing experiences of time outside the [inaudible] of global capitalism and its reasonable expectations, so that we might denaturalize our own clock time [inaudible] and hear those we have imagined to be faceless, nameless, without story to tell. He uses comics’ visualization of time as space to show his readers both the flow of universal time, and time’s stutter stop-motion, in worlds under siege … which will soon be, for most of us, the world we all inhabit. Sacco’s global graphic pathographies refuse to allow us to believe that we are experiencing the flow of time, past, present, and future, in sync and in the same way, inviting us to shake ourselves free from the fantasies of our reasonable expectations— something we can do only when we begin to finally take our call for meaningful health and reform outside the clinic’s walls, beyond the dualism of patient and doctor, and beyond the constraints of the master narrative, the great book.

Graphic medicine alone, I would argue— I told you I would [inaudible]— offers us a way of imagining the telling of the individual story as a collaborative linking[?] event. As Justin Green put it in 1972, in the prologue to his Binky Brown— arguably the foundational text in our growing canon, and many of you got to hear from Justin in Riverside a couple years ago— he writes that he hopes his most personal of stories would ultimately forge a connection to his fellow neurotics, not so that they might one day be free, but so they might be a great interlocking chain of common suffering that extends around the globe. [inaudible] we might see how graphic medicine’s representation of time serve finally not as breaks or ruptures that need to be healed, but as alternate parallel timelines with the capacity to lead us toward new ways of imagining, representing, and experiencing time, beyond the enabling fictions upon which our norms depend— master narratives of wellness and health that are quite literally killing us all. Thank you.

[applause]

MK CZERWIEC: Thanks so much for listening to the Graphic Medicine podcast. For the latest publications, news stories, events, updates in graphic medicine, be sure to like our Facebook page and follow us on Twitter. That’s really the best way to stay connected to the vast worldwide graphic medicine community. And check the website for occasional updates as well. When you’ve done that, don’t forget to subscribe in iTunes to this podcast, and while you’re there, it would be great if you could leave us a review. It’s my pleasure to one more time remind you that support for this podcast comes from the Penn State College of Medicine Department of Humanities, pioneers in innovation in medical education since 1967. Thanks for listening, and I’ll be back with another episode soon.