This first panel from Brighton directly addresses the overall theme of the conference, Ethics Under Cover. To see images associated with this podcast, go to https://www.graphicmedicine.org/graphic-medicine-podcast-panel-1a-ethics-under-cover/
Susan M. Squier presents “Asomatognosia and Anders Nilsen’s BIG QUESTIONS”
Anders Nilsen’s comic BIG QUESTIONS, OR ASOMATOGNOSIA: WHOSE HAND IS IT ANYWAY? (Montreal: Drawn and Quarterly, 2011) uses a medical diagnosis as a metaphor to raise ethical questions about death and life, warfare and nurturance, humans, animals and machines. As Nilson describes this medical condition, in which one is unable to identify parts of one’s own body, “Our hands are the organs we use to manipulate and control our world—they are as uniquely human an attribute as it gets. That sort of alienation from one’s own sense of control, our own agency, to me works as a kind of metaphor for the displacement of responsibility that a belief in the supernatural, or in god can sometimes entail.”(Romberger 2011) Nilsen’s comic diagnoses us all with asomatognosia, because we cannot answer the central question that links microcosm to macrocosm, self to world: “Whose hand was it?” Whose hand was it that flew the plane, that dropped the bomb, that raised the boy, that let the grandmother die, that crashed the plane, that let the pilot survive, that fed the birds, that killed the pilot, that revived the dead, that created the universe in which we can ask these big questions? The answer to those big questions is not, this comic suggests, nature or nurture, or even God or man. BIG QUESTIONS exemplifies the philosophical and bioethical implications of Asomatognosia.
Ian Williams presents, “The Bad Doctor: showing what might not be told”
In this oral presentation I shall report on my current project: the production of a graphic novel on the themes of family medicine, obsessive compulsive disorder and heavy metal. The project is due to be delivered in November for publication by Myriad Editions in June 2014. This fictional story, focalised through Iwan James, a general practitioner in a small rural market town, winds two narratives gradually into one. The first strand is a series of vignettes from Iwan’s day-to-day work as a doctor. These sketches are sometimes darkly humorous, sometimes quotidian and sometimes tragic, the gentle drama being provided by the patients’ experiences and attitudes, which Iwan finds fascinating. Running counterpoint to these chapters are a series of recollections, delivered in ‘immediate scene’ without narration, which tell the story of a young boy who, in adolescence develops a paralyzing obsessive compulsive disorder (OCD). It gradually becomes obvious that it is indeed Iwan who is subject of both strands and the two narratives become intertwined towards the end of the book. Suffering with recurrent anxiety and depression since childhood, he managed to conceal his OCD from even his family and closest friends, throughout medical school and early years working as a doctor, trying to ‘pass for normal’ and fearful of being labelled insane. Fiction is invariably informed by experience. In this case directly so as I used to be a GP in a small rural practice and I also suffered from OCD as a young man. In this personal talk I shall relate how becoming involved in comics enabled me to articulate, for the first time in my life, my experience of mental illness, and how I found a community within comics in which this type of disclosure is positively prized. I believe the author should ‘reach down his throat’ to dig out and portray that which most people do not talk about, and so I try to highlight the secrets that my characters would rather not disclose.
MK Czerwiec presents her collaboration with Martha Montello, “Mapping What Matters: Mattering Maps, Graphic Medicine, and Bioethical Discourse”
Philosopher Rebecca Goldstein, in her 1983 novel The Mind-Body Problem, introduces the concept of a mattering map. She states, “People occupy the mattering map. A person’s location on it is determined by what matters.” Dr. Montello added in her 2012 presentation to the American Society of Bioethics and Humanities, “A mattering map reveals not just people and places, but events, and moments in time, and descriptions that guide us toward why these moments and times matter: stories.” In this oral presentation, Dr. Montello’s work in adapting the concept of a mattering map to bioethical decision-making will be explored visually. First we will examine existing examples of mattering maps as they are employed in graphic medicine texts to visually map “what matters” in the story. Second, we will explore the assertion that the creation of mattering maps could be a valuable reflective tool for moral situations in clinical medicine in which no clear path is apparent. We will draw on examples from exercises in Northwestern Medical School’s seminar course “Drawing Medicine,” as well as describing situations in which mattering maps are being used in patient care.
Maria Vacarella presents, “Visualizing Patients’ Unreliability”
This paper addresses the representation of impaired cognition in graphic pathographies and the ethical issues it is connected to. In graphic storytelling, insight into characters’ consciousness and cues to the fictive reality around them are highly condensed: as it is often the case, characters’ perception of reality (in captions or bubbles) overlaps with the surrounding reality (visually represented) in the same panel. According to Seymour Chatman’s traditional definition of unreliability in literary works, the unreliable narrator’s account diverts from the implied reader’s speculations about the story: then, how do graphic novelists manage narrative unreliability when it stems out of the narrator’s (maybe temporary) cognitive impairment, not from greed or credulity or lack of information? Furthermore, in graphic pathographies on neurological conditions, the narrator is often a carer, not the patient: what is the role of narratorial intervention here and which techniques are privileged to raise ontological doubts in graphic storytelling? More importantly, how can authors represent this kind of unreliability, so that it engenders sympathy, rather than suspicion in the reader? In my presentation, I will first analyse the construction of narrator’s and character’s unreliability in graphic pathographies on neurological conditions (e.g. Elodie Durand’s La Parenthese, David B.’s Epileptic or Sarah Leavitt’s Tangles), in order to argue that cognitive deterioration is a privileged entry point into the question of the validity and limits of narrative in medicine. I will then link my analysis to recent criticism on the issue of patients’ reliability and authenticity in both clinical and literary settings.
(Maria was unable to join us the day of this panel, but has sent her audio and slides, enabling us to include her in this podcast.)