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Doctor, Doctor: Gimme Your Views
By Karen Green
Friday March 5, 2010 06:00:00 am
Our columnists are independent writers who choose subjects and write without editorial input from comiXology. The opinions expressed are the columnist's, and do not represent the opinion of comiXology.
While my graphic novels exhibition is certainly--well, um, hopefully--influencing faculty to use comics in their coursework in innovative ways from one end of the Morningside Heights campus to the other, a whole new front in the comics-in-higher-education invasion has opened a few miles uptown, at Columbia's medical school, located up in Washington Heights, amidst the buildings of New York Presbyterian Hospital. On top of their already intense med-school curriculum, Columbia's aspiring doctors have a required humanities component: a choice of several six-week courses in anything from "The Philosophy of Death" to "Fiction Workshop." The course that brought me uptown for a discussion with twelve second-year med students is called "From Spoken Word to Sick Tats," and my contribution was to be a look at illness narratives in graphic novels.

I'd been invited to lead this class by Marsha Hurst, a faculty member in Columbia's Masters of Science program in Narrative Medicine. Hurst is team-teaching this med-school humanities seminar with Sayantani DasGupta, a pediatrician with a background in oral history. I'd met Marsha over a year ago through an old friend who'd had a business meeting with her and dropped my name as a Columbian of her acquaintance, and Marsha leapt on the notion of including graphic novels in her syllabus. We talked over lunch about various graphic narratives--graphic in both senses, at times--that concerned illness. I'd just written my column on Strip AIDS USA, so AIDS narratives like Blue Pills and Pedro & Me started our conversation, but we navigated through stories of cancer, epilepsy, depression...the list really does go on, and you're probably all supplying for yourselves the variety of titles we talked about. Then, in the fall, Marsha contacted me and asked if I would be willing to do a presentation on graphic novels that deal with illness. She and Sayantani and I had a long email discussion about what books they would assign the students to read. Two titles seemed to be a manageable yet still challenging number to give students to read during the week before our class. But which two? Should they be on two different illnesses, to give a sense of the variety available? Perhaps two books on the same illness, to contrast two ways of telling a story?

In the end, we decided on the latter approach, and chose two cancer narratives: Marisa Acocella Marchetto's Cancer Vixen, and Our Cancer Year by Harvey Pekar, Joyce Brebner, and Frank Stack. It seemed like a great choice; it was hard to think of storytellers more different than bubbly fashionista Marchetto and the irascible Pekar. Those differences were embodied in the visuals of their two stories: Cancer Vixen is as bright and colorful as the orange clothing Marchetto's then fiancé favored, while Stack's illustrations for Our Cancer Year are a moody, noir-ish black and white.

Right before I left for my January vacation, however, I heard again from Marsha and Sayantani: they'd both been hearing such marvelous things about David Small's Stitches that they wanted to use that instead of the Pekar. In a way, the evocative black-and-white washes of Small's art offered an even greater contrast to Marchetto's sharp and splashy day-glo lines.

I wasn't at all sure what to expect when I entered the classroom. I wasn't even sure what was expected of me: would students want to discuss the depictions of illness (in which case, was I really the best choice to talk to them?), or the specific ways these two stories were told, or the conventions of graphic novel storytelling? What had Marsha and Sayantani done to set up this section of the course—surely that would have been a useful piece of information I could have elicited? But I walked in cold, with nothing but my own copies of the stories in question and a few butterflies in my stomach.

It was a tough room. Not that the students weren't charming; on the contrary, they absolutely were. But the kind of pop-cultural verities that I assumed were nearly universal, especially among 20-somethings such as these students, were clearly nothing of the sort. They hadn't heard of either Pekar or the film "American Splendor," nor of R. Crumb. When I mentioned The New Yorker, only two were readers and those were the same lone two who'd heard of Dave Eggers and his work. (I'd brought up Eggers and The New Yorker because, in my attempt to convey how a combination of words and images can convey a story effectively as well as compactly, I'd wanted to know who had seen the magazine's excerpt of Eggers' novelization of the film version of "Where the Wild Things Are"—when I'd printed it out, it took eleven single-spaced sheets of 8 ½ x 11 paper just to get the story to the point where Max says, "Let the wild rumpus begin!")

Feeling a little unmoored, I seconded the instructors' request for a show of hands as to who had preferred which story: the verdict was 11 to 1 in favor of Stitches, with the students citing its poignance and its more sympathetic protagonist. The sole fan of Cancer Vixen defended her choice, explaining that she'd liked the brightness and effervescence of Marchetto's stylish self-portrayal, unapologetically fashion-crazed, as the opening premise establishes.

After making a few brief observations about the pitfalls of confusing genre and medium when thinking about comics, I asked what had appealed to them about the two stories. To aid the responses, Marsha and Sayantani divided the class into two groups, each with one of the two volumes, asking that each student pick a page from his or her group's book that was particularly resonant, and be prepared to explain why. (What a great idea! I should totally gank that!) I hoped that this would illustrate how each student was approaching the stories—were they responding to the story, the structure, or a melding of the two?

The Cancer Vixen group went first. One student rather hesitantly apologized for her choice, since it "didn't really use images;" it was a couple of panels completely blacked out, with some text describing how lost Marchetto had felt. "But that IS imagery!" I responded; that inky blackness does convey something visually that adds to and enhances the text, creating a complexity the text alone would not convey. After this, the others seemed less reluctant to talk about the elements that they had liked. Among the other choices were a series of panels in which the wideness of the doctors' smiles increased in direct proportion to how bad the medical news was likely to be, and a vivid depiction of how bombarded and overwhelmed Marchetto felt by the well-intentioned concern of her [innumerable] BFFs:


When one student revealed her preference for the depiction of the more tangible costs of Marchetto's cancer treatment, I pointed out the parallel to a passage nearly 200 pages earlier in the book which described an assignment Marchetto had taken on for [now defunct] Talk magazine: attempting to calculate the price of becoming the ultimate NYC "It" girl by adding up the costs of buying the It bag, going to the It colorist, submitting to the It Brazilian waxer, etc. The cost of cancer: $192,720. The cost of "It": $179,546 and counting


All the students recognized immediately how this comparison reflected the change in Marchetto's own priorities over the course of her experience with cancer, which may perhaps have affected their own perception of how the brightness of the art may have created shadows that hid the seriousness of the story.

The Stitches group, for the most part, chose pivotal moments that grabbed readers and yanked them down an unexpected path, and so I'm reluctant to use them, in the event that some of you haven't yet read the book—and I hope you will. A friend of mine, whose opinion I respect completely, wasn't impressed with Stitches; he felt it was just another memoir, without the insight or character development of a book like, say, Fun Home and without much of a resolution either. I can see his point; Stitches ends rather abruptly, and this story of how a youthful brush with cancer is handled by a profoundly dysfunctional family doesn't offer much on the long-term effects the experience had on Small. But then I don't think that's the story Small is trying to tell; rather, he's created a finely-nuanced and atmospheric study of a child's brush with death—it just happens to be him—and this study is fleshed out with descriptions of the less-than-nurturing circumstances in which that brush with death occurs. Page after page consists of multiple panels that act almost as quick-cut close-ups, depicting eyes reacting to events—eyes exposed, and eyes hidden behind reflective glasses. Small's mother's eyes are almost never shown behind her sturdy spectacles and when they are, the reader had best be paying attention. In truth, the story itself is largely told through the eyes of its protagonists.

Getting back to the med-school class, however: one student chose perhaps the most heartbreaking page in the story. "My choice was the page where he discovers his mother doesn't love him," she said. Small's tumor, initially dismissed as inconsequential by his mother, turns out to be cancerous. Believing her son could die, she buys him Nabokov's Lolita, a copy of which she'd previously discovered in his room and destroyed. When his surgery is successful, and young Small is recovering in his hospital bed, he reached into his nightstand.

(I apologize for using my typo-filled advance readers copy, by the way—the word "might" should be "night" in the first panel of the second row.)

It's interesting that a boy who loses (then regains) his voice should become an artist, and interesting that his adult self chooses this highly visual medium to tell the story of his voicelessness. Because I don't want to use many of the other student choices for fear of spoilers, I'll spend a moment showing you my own favorite passage in the book: a nearly wordless four-page passage that would be purt'-near impossible in prose, and which takes the reader down the rabbit hole of Small's cancer-surgery incision:

The gradually schematized stitches that morph into the stair treads on which the young and vulnerable David heads up to his solitary room, falling deeper into himself both literally and metaphorically—those pages take my breath away every time.

I had hoped that these books might have the same effect on these med-school students; that something in them would click with their own predilections and result in magic. But not only was this not fair to expect, it is in many ways unreasonable: if I stay true to the "medium, not genre" paradigm, then my inflated expectation is analogous to giving someone newly literate any book off a shelf and having them immediately love reading. I had a friend stay with me recently who browsed through the graphic novels on my shelves, unimpressed until she reached Guy Delisle's Burma Chronicles. As it happens, she loves documentaries, and it was the reportage of Delisle's book that appealed to her—the format was just a different delivery system. Who am I to know what sort of stories appealed to these students? Was reading illness narratives, no matter the form, a kind of busman's holiday for them?

I closed the session with an exercise I stole from three graduate students at Northern Michigan University, and which I wrote about last year. (The secret of successful pedagogy: steal from those cleverer than you.) I asked each student to draw a large box divided into 4 smaller boxes, and then to test their own comics-writing abilities by relating an anecdote from the previous day both textually and visually. The experiment was a mixed success: although everyone appeared to have been clever and creative in their 4-panel span, they presented their work by telling the story as a meta-narrative rather than describing what was in each panel and seeing if we could work it out ourselves. It wasn't a completely lost cause, of course. My favorite moment was the brightening face of one student, who'd seemed rather disaffected earlier, when I observed that his right-to-left movement conveying entry was a classic element of visual grammar; Art Spiegelman had talked about this in a talk I'd seen while dissecting an Ernie Bushmiller "Nancy" comic strip.

Am I pleased with the way the session went? I hope I've not given the impression I wasn't! I totally was. First, I loved that Marsha and Sayantani wanted to include graphic novels in their curriculum. I'm thrilled that there were so many options from which to choose. I'm ecstatic—yes, I said ecstatic—that the books got the students talking and thinking. These are all good things. Moving graphic novels into an accepted place in curricula is going to take small steps like this. And there are more and more such steps occurring all the time.

Karen Green is Columbia University's Ancient/Medieval Studies Librarian and Graphic Novel selector.

Comic Adventures in Academia is © Karen Green, 2010

Related Items



obridge (7 months ago)
Thanks! Will have to use some of these teaching ideas next semester for my "Art of the Graphic Novel" class. Oh, and isn't it "Let the wild rumpus start" not "begin"? (At least, I'm pretty sure it's "start" in Sendak's origin; it sticks in my memory since I always want to change it to "begin," too!)
klg19 (7 months ago)
In response to klg19
Sorry--that "I diocator" is supposed to be "indicator"...typing a lengthy response on a BlackBerry keyboard is hard! I always mess up the Ns and Cs. I'll be happy to get home to a real keyboard on Sunday!
klg19 (7 months ago)
In response to Danny Fingeroth
Yikes! Danny, I apologize if I implied that these stories weren't accessible to the students. They were actually quite quick to find the parts that had moved them and articulate in expressing why those parts had. I think, though, thatt the nature of a 6-week humanities course tossed into the second year of med school (with its weekly exams) and the students' apparent disconnect from fairly well-known recent literary and cinematic productions is an I diocator of med-student predilections--institutionally encouraged. Given that, I thought theii response to these works was quite impressive!
Danny Fingeroth (7 months ago)
Perhaps more melodramatic and/or superhero stories would have been more accessible to the students. Our Cancer Year and The Death of Captain Marvel, for instance.
Marioninnyc (7 months ago)
Makes sense to me that they would want to include graphic novels. As super smart as medical students are I think of them as in perpetual rush and graphics provide a quick way to get what they need.

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