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Graphic Medicine and Medical Anthropology

This article is part of the series:

Introduction

When I began my graphic memoir series, Aliceheimers, it focused just on life with my mother Alice before and during dementia. But the revelatory insight that she has retained, even during the late stages of this sickness, has led me to sometimes let the character “Alice” metamorphose into an odd sort of sage. Here, she and I explore the relationship between Medical Anthropology and Graphic Medicine. Alice’s deeply held beliefs from life before dementia combine with her mind opened by dementia, allowing me to imagine a quasi-academic conversation that we never could have had in real life.

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A writer, artist and anthropologist, Dana Walrath likes to cross borders and disciplines with her work. After years of using stories to teach medical students at University of Vermont’s College of Medicine, she turned to writing her own. Her award winning verse novel, Like Water on Stone, was completed during the year she spent as a Fulbright Scholar in Armenia. Her recently released graphic memoir Aliceheimer’s has brought her throughout North America and Eurasia to speak about the role of comics in healing including talks at TEDx Battenkill and TEDx Yerevan. Her recent essays have appeared in Slate and Foreign Policy. You can visit her at danawalrath.com.

 

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Page 1

  • Panel 1 of 3.
    • Title: “Graphic Medicine and Medical Anthropology: An exogamous marriage or paraphyletic groups?”
    • Image: Two kinds of family trees: comics (Mickey Mouse ears) and medicine (medical text) combine to form graphic medicine; biological and cultural anthropology (represented by book spines with names of some anthropological sages like Boas, Kroeber, Mead Leakey, Levi-Strauss) combine to form “Medical Anthropology”. These two form “an exogamous marriage”, or break out into “paraphyletic groups?” Two independent family trees each with their own history.
    • Byline: Dana Walrath, University of Vermont.
  • Panel 2 of 3.
    • Alice, an older woman with round face and curly hair. Her clothes throughout the text are made up of cut-up pages from Alice in Wonderland.
    • Alice points up to the panel above, says “What sort of crazy family trees are those?”
  • Panel 3 of 3.
    • Dana, a younger woman with long hair, replies: “I’m exploring the relationship between the things I do.”
    • Alice: “It would be easier if you spoke English.”
    • Dana: “You were a biologist. You can get it.”

Page 2

  • Panel 1 of 3.
    • Alice imagines an exoskeleton and endoskeleton, and eggs and sperm (thinking the word “gamete”).
    • Alice says: “Exogamous: Like how I married Dave.”
  • Panel 2 of 3.
    • Alice imagines Greek root “para”, meaning “beside”, and relationships among vertebrates.
    • Dana replies: “Yes… my father, an odar, a non-Armenian.”
    • Alice says: “That makes for hybrid vigour you know.” and “Birds and Reptiles are paraphyletic.”
  • Panel 3 of 3.
    • Alice imagines a crocodile eating a bird.

Page 3

  • Panel 1 of 2.
    • Narration text: “For Alice, Biology was the central dogma…”
    • Alice says: “Just because you share a common ancestor doesn’t mean you have to get along. Take reptiles and birds, or my sister…”
  • Panel 2 of 2.
    • Alice stands in reverie before an array of white-coated doctors flanked by two staffs of the god Hermes, the Caduceus, instead of the correct Rods of Aesclepius, as though they were a pantheon of false gods.
    • Narration text: “…and her reverence for its designated gods absolute.”

Page 4

  • Panel 1 of 4.
    • Narration: “A reverence rooted in shame…”
    • Alice, with eyes closed: “I was in a big ward in New York hospital with lots of kids to get my tonsils out. One nurse checked under my gown and called out to the others, “Hey, get a load of this!” It was my home-made underwear.”
  • Panel 2 of 4.
    • Narration: “…outrage at false prophets…”
    • Alice, hands in the air: “They took my mother to a series of quacks! One of them said pulling her teeth would heal her joints so then she had no teeth. When that didn’t work they took her to a faith healer in Niagara Falls.”
  • Panel 3 of 4.
    • Narration: “…and passed on through the generations.”
    • Alice: “You wouldn’t be alive if it weren’t for doctors. You’ve got hybrid vigour you know, you should be a doctor.”
  • Panel 4 of 4.
    • A fractured red cross.
    • Narration: “It looked like more than basic biology to me. I saw…”

Page 5

  • Panel 1 of 4.
    • Drama: A medical soap opera on a TV. Young woman says: “Oh, Doctor! How can I ever repay you!” Doctor replies: “Impossible, I know, now let me check your heart beat.”
  • Panel 2 of 4.
    • Subjugation: A pelvic exam of a very pregnant Dana. Doctor says “You know who you remind me of, Dana? Annie Hall.”
    • Narration: That was a prenatal visit with the student health obstetrician. I chose midwives after that.
  • Panel 3 of 4.
    • Humiliation: Dana wears an open-backed hospital gown and stands on a scale.
  • Panel 4 of 4.
    • And super hero mumbo jumbo: Surgeon says “With my retractor and laser scalpel I excised the aneurysm detected on the angiogram impacting the vessels of the circle of Willis located precisely at A. cerebri media thus mitigating the subarachnoid…”

Page 6

  • Panel 1 of 2.
    • Narration: “My cortisol levels ran high until I discovered medical anthropology.” An outline of Dana in a hospital gown opening a door with medical anthropology texts and insights found behind the door. Dana thinks “Liberation with an academic spit shine.”
  • Panel 2 of 2.
    • A rocket ship taking off. Launchpad scaffolding made of words that are part of the scientific approach of biomedicine: technology, scientists, data, power, experiments, research, fight, engineering, thruster, booster, conquer, go where no man has gone before, cure, fight, conquer, booster, experiment, engineering, biomechanics, microbes, invaders, viruses, conquer, fight, research.
    • Narration: “A society’s medical system reflects its core beliefs. Our technological system is rooted in the deep scientific tradition of overcoming nature.”

Page 7

  • Panel 1 of 2.
    • Alice very annoyed, shaking a finger and frowning. Alice says “What are you doing, Dana?!? This is very disrespectful. The idea that medicine is just a bunch of beliefs and practices and not pure science is absurd. I told you this anthropology business was a bad idea, that you’d never get a job. You should have gone to medical school and become a doctor then you’d know what’s what!”
    • Narration: “No one likes their beliefs challenged.”
  • Panels 2 through 9 of 9. Argument back and forth between Alice and Dana.
    • Dana: “Medical schools like to hire anthropologists.”
    • Alice: “What on earth for!”
    • Dana: “Accreditation now requires training students to care for diverse patients.”
    • Alice: “Bodies are all alike! It’s only minds that differ.”
    • Dana: “You sound just like an old school doctor.”
    • Alice: “Thank you. That’s very kind of you to say.”
    • Dana: “But mind body dualism is just a social construct.”
    • Alice: “You’re out of your mind! I dare you to show me.”

Page 8

  • Panel 1 of 2.
    • Alice and Dana’s conversation continues.
    • Above Dana, a diagram from Descartes showing the pineal gland, another image of sunlight and a bird. Dana says: “To overcome church prohibitions against cadaver dissection and legitimize scientific study of the human body, French philosopher René Descartes (1596-1650) separated the mind and the body, locating the soul in the pineal gland.”
    • Above Alice, an image of a lightbulb and a bird, contrasting with the sunlight/bird image above Dana.
    • Alice says: “Pineal. A pine cone-shaped, light-sensitive gland that lets birds synchronize their egg-laying with daylength.”
    • Alice says: “Just where would any of us be without Descartes? Dead! How on earth would a surgeon have found your ruptured appendix?”
  • Panel 2 of 2.
    • Alice conversing with Ludwig Bemelmans’ children’s book character, Madeline.
    • Madeline says: “I would have died, too.”
    • Alice says: “You are just a character from a book, Madeline. You don’t really have an appendix and you can’t die!”
    • Madeline replies: “True. I just turned 75 while Ludwig Bemelmans, my creator, died in 1962. Our first book has taught generations the core values of our medical system.”

Page 9

  • Panel 1 of 4.
    • Alice sneering at Dana.
    • Alice says: “Ok, miss smartypants, Dr. Dana, what truths did the generations glean from this charming book?”
  • Panel 2 of 4.
    • Dana hanging upside-down from a tree branch.
    • Dana says: “That there are right and wrong ways to behave around sickness, that the ideal sick role is temporary, that when sick you will be cared for but you can’t want to be sick, that experts decide if and with what you are sick, that the body is like a care that experts can mechanically fix.”
  • Panel 3 of 4.
    • Alice yells: “Get down from there right now!!!”
  • Panel 4 of 4.
    • Alice and Dana have calmed down.
    • Alice says: “All right. That’s better and that’s all true. The body breaks and doctors fix it.”
    • Dana: “Socially true. Medical anthropologists locate sickness in three interconnected bodies: the physical, the social, and the political. That’s why medical schools hire us.”
    • Alice: “Waste of money if you ask me.”

Page 10

  • Panel 1 of 1.
    • Narration: “Medical anthropology avoids reducing the complexity of sickness and health into biological universals by incorporating biocultural interaction.”
    • Image: Three nested figures: the political body as a looming monster, arms outstretched, decorated with dollar signs; inside, a human body (the physical body) with guts visible, surrounded by other stick figures that say “yes” or “no” representing the social body.
    • Text surrounds the monster: “The political body determines who gets sick and well and how the social body gives meaning to physical states. The social body even defines the ideal physical body and then legitimizes practices such as plastic surgery, body piercing, or ritual scarring to attain that ideal. Medicine is a form of social control. Wealth means health.”
    • Footnote: “For more see Scheper-Hughes and Lock (1987) MAQI: 6-41.”

Page 11

  • Panel 1 of 2.
    • Dana and Alice conversing. Levi-Strauss’s magic field diagram embedded in Dana’s speech balloon.
    • Alice: “What a pile of mumbo jumbo.”
    • Dana: “Exactly! Mumbo jumbo lies at the heart of most healing systems. Experts have access to a world of secret knowledge that could consist of anything from spirits to science, patients and communities believe in those who can access the secrets.”
  • Panel 2 of 2.
    • A shaman with spirals, hands and other iconography in his speech balloon overlapping with that of an MD who has an EEG read-out in his speech balloon.

Page 12

  • Panel 1 of 4.
    • Alice and Dana conversing.
    • Alice: “Enough already! The content is bad enough but to mix comics with medicine is positively insulting. I want no part of it.”
    • Dana: “But you were the whole reason I got into this.”
  • Panel 2 of 4.
    • Alice: “Me? How’s that?”
  • Panel 3 of 4.
    • Dana: “You have Alzheimer’s Disease.”
  • Panel 4 of 4.
    • Alice: “I forgot. What a lousy thing to have.”

Page 13

  • Panel 1 of 2.
    • Conversation continues.
    • Alice: “Why comics?”
    • Dana: “Because when you lived with us you ate up every graphic narrative that came into the house. The pictures helped the story stick.”
    • Alice: “I did?”
    • Dana: “Also, we got along better during this sickness than we ever had. I admire and respect how you have handled it.”
    • Alice: “You did?”
    • Dana: “I wanted to tell that story. I wanted to help rewrite the dominant biomedical narrative.”
    • Alice: “Why comics?”
    • Dana: “Because the rule-breaking tradition of comics makes it the perfect medium for shifting the biomedical conceptualization of Alzheimer’s Disease.”
    • Narration: “Biomedicine gives us a zombie story.”
  • Panel 2 of 2.
    • Alice falling down a zombie spiral.

Page 14

  • Panel 1 of 4.
    • Alice with Zombie eyes and posture holds a distorted Alice in Wonderland
    • Narration: “Without minds, who are we?”
  • Panel 2 of 4.
    • Alice up in a tower, yells “Save me, doctor!”
    • A white-coated doctor runs past, says “Quick! To the lab!”.
    • Narration: “And a cure, elusive.”
  • Panel 3 of 4.
    • Image: A spiral with squares marking biological birth and death.
    • Narration: “But if we turn the zombie spirals into the lifecycle and add squares for biological birth and death – emergence from the womb or that last beat of the heart or that final breath – then these lines can show social birth and social death, when society confers personhood or takes it away.”
  • Panel 4 of 4.
    • Narration: “Stigma, silence, and social death surround states a society might fear or reject.”
    • Alice with one zombie eye and the other eye open, says “Why comics?”

Page 15

  • Panel 1 of 1.
    • Image: Alice travels around the sun.
    • Narration: “Because comics undo social death. We see you. You are real. You make us smile. Comics let us get inside different ways of being, to understand experiences that we fear right down to the core of our medical system. Graphic medicine tackles everything from cancer to epilepsy to HIV to the entire spectrum of conditions of the “mind”. It takes the stigmatized and makes it safe. Graphic medicine gives us ways to see the world through the eyes of others, those who are hurting, to feel their stories and remember our own, and to heal. Healing is not the same as curing disease. It does not involve surgery or taking a pill. This social process depends on sharing stories and letting our collective memories meet. By meeting through story, we make peace and move on even if we are sick or hurt or dying.”

Page 16

  • Panel 1 of 3.
    • Alice and Dana embrace.
    • Alice says: “Thank you.”
    • Dana says: “And thank you. … … So, what do you think: exogamous marriage or paraphyletic groups?”
    • Alice: “Both. graphic medicine and medical anthropology arose from the same primordial swamp.”
  • Panel 2 of 3.
    • Swamp with steam rising from it. Swamp contains words bubbling to the surface: “By any means”, “Pain”, “Anger”, “Discontent”, “Frustration”, “Injustice”, “Feminism”, “This is broken.”
  • Panel 3 of 3. Alice and Dana hold hands and smile.
    • Alice says: “And the marriage is exogamous. Comics and medicine, like cultural and biological anthropology, have their own languages and traditions. This makes both graphic medicine and medical anthropology exogamous before they even hooked up.”
    • Dana: “In anthropology the answer is always both, or malaria.”
    • Alice: “That makes for hybrid vigour, you know.
    • Dana: “Sure does.”

2 Responses to Graphic Medicine and Medical Anthropology

  1. This is fabulous! Really love it – and I’m not a great fan of graphic novels (much as I love Roz Chast’s recent book about her folks and dementia – Can We Talk About Something More Pleasant) – keep up the great work.

  2. Pingback: Somatosphere -an interdisciplinary collaborative website covering the intersections of medical anthropology, science and technology studies, cultural psychiatry, psychology, and bioethics | Mulford Library Blog

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