Category Archives: Graphic Medicine

WE ARE ALL GOING TO DIE: Dying For Attention by Susan MacLeod review – a Graphic Memoir of Nursing Home Care

Dying For Attention: A Graphic Memoir of Nursing Home Care. Susan MacLeod. Conundrum Press. Quebec. 2021. 184pp. $20

Attention all hipsters, know-it-alls, and the like: We are all growing old and will die. Yes, it’s as simple as that. Now, a book like this may inspire utter dismissal by some self-appointed taste-makers and aspiring trend-setters, but the book I present to you is, without a doubt, a book anyone will benefit from and, yes, it is a worthy book to anyone who cherishes what the comics medium is capable of. Yep, that’s one of the driving forces for what I’m all about, sharing with you comics that are really worth a hoot. One way or another, we are all going to die. It’s the ultimate equalizer. If we care about social justice, then we must care about issues related to aging.

Sorry, Charlie, but nobody gets out of here alive. If you truly appreciated that, what a world this could be!

Aging is somebody else’s problem until it’s not. Parents in need of care can become an abstraction; a project that needs to eventually be confronted. All the while, we seem to forget that we’re all going to die. That reality should humble us. Susan MacLeod has created a book that answers a lot of questions through words and pictures on nursing home care by way of her involvement in the industry and her own personal experience with her mother and the long-term care system. MacLeod’s hand-drawn cartoons bring life and levity to this serious subject and even offer hope.

MacLeod’s approach is part whimsical James Thurber, mystical John Porcellino, and part concise reportage via sketchnoting: brief drawings and text that get to the point fast. It is a hybrid of graphic memoir and the emerging genre known as Graphic Medicine, comics focusing on medical issues. I offer up the term, personal Graphic Medicine. In the hands of MacLeod, it all adds up to an immersive and informative experience. The narrative kicks into gear with brutal honesty as MacLeod paints a picture of growing up in a highly dysfunctional family. As a child, she felt so marginalized by her parents that her way of coping was to repeatedly beat up her little brother. While the image of a big sister slugging her smaller sibling is a classic comics trope, the reality of such an exchange is dark to put it mildly. MacLeod acknowledges this and doubles down by showing how this messed up dynamic has haunted her to the present day. To her credit, she follows this line of inquiry to illustrate the potential challenges that can face a family navigating the labyrinthine world of assisted-living with its myriad of limitations. It requires real determination and a united family front certainly helps.

The title of the book, Dying for Attention, speaks not only to the ongoing struggle of elders to be heard amid bureaucracy but to MacLeod’s own journey to find a voice. Going back to when MacLeod was a child, she had a passion for drawing that was repeatedly discouraged by her mother. Drawing was her outlet, within a dysfunctional family, and she never let it go. Back then, she managed to gain attention through bad behavior which resulted in the wrong kind of attention, like her father slapping her across the face. Fast forward to the present, MacLeod is modest about her comics, as she shares in the book’s acknowledgements page. But the fact is that many authorities in comics support this book, including The Center for Cartoon Studies and various notable creatives, like comic artist Colleen MacIsaac. MacLeod’s work has a deceptively simple vibe to it, akin to the energy in a doodle. However, it’s one thing to doodle and quite another, as MacLeod does, to sustain an offbeat style. Add to that a compelling need to create. It was only after her mother’s death at 99, after a nine-year journey with her mom and nursing home care, that MacLeod reached back to her fine arts background (yes, she did end up going to art school) and set out to share her story with words and pictures. She wanted a format that would allow her to share such a heavy subject with a certain amount of levity.

Doodles are complex: enlisted as anti-art tools (look up Sunni Brown); or part of an artist’s palette. MacLeod spikes her doodle-like style, loads it and mixes it. The results are in her pacing and flourishes: the way she hurls a character through space; or the way she evokes transition. So, it is within this relatively simple, or accessible, style, that MacLeod masterfully boils down facts and insights gathered from books, her own interviews, and her own experience in the trenches. Her career was in public relations for the Canadian Health Department where she learned the hard way that spin is everything. She endured the wrath of the government when she dared to include in a public statement that there’s a waiting period of at least six months for elders seeking public nursing home care. In the meantime, they are kept in hospital, where they are less than welcome, known as “bed blockers.” MacLeod comes back to this term in her narrative, fully aware of its visceral effect, putting her skills in using concise language to good use. That is MacLeod’s appeal for me. It’s not bravura drawing skills. And, let’s be honest, skills are only part of it. Moomin, for example, is not an incredible work of art, per se, and yet there’s something endearing, worth staying with. I think MacLeod not only has her heart in the right place but she demonstrates to me a genuine need to share what she knows and make it compelling and accessible. While some cartoonists inspire suspicion in me, I don’t get that from MacLeod.

It’s actually not an easy thing to draw in an easy style. People often think they can completely lean into an easy style and just sleepwalk their way through. It doesn’t work that way. Pitfalls range from generic mush to a style that is too slick and formulaic. I don’t want to put too fine a point on it but I think MacLeod’s determination and sincerity serve her well with a style that has integrity. It’s a simple comic strip vibe punctuated with a heightened sense of whimsy here or a smart hint of perspective there. On one page, for example, one panel sums up denial quite aptly: MacLeod is racing up a flight of stairs pulling her frail and disoriented mother along behind her, who is flying like a rag doll. It’s not a “great” drawing and yet it is real and it is memorable.

MacLeod’s most ambitious motif has to do with the notorious call bell, which demonstrates the ongoing struggle her mother was having in alerting the nursing home front office about her needs. First, her little buzzer, the call bell, kept being placed out of her reach. Later, it became obvious that the staff was avoiding her buzzing. For MacLeod, this became a game of trying to figure out the nursing home culture. All this avoidance of buzzers was taking its toll on the quality of life of both residents and staff. Spoiler alert: MacLeod does find a way out of this mess. She discovers a technique which has staff regularly ask residents about their needs. By the time MacLeod is wrapping up her book, she switches from depicting her mother as a cartoon character to a more realistic rendering. The very last drawing is of her dead mother with one hand as if frozen in time, as if holding a call bell.

Keeping a tally of all the slights and missteps she must endure, MacLeod provides an uncanny report from the nursing home front lines. No curt or rude remark goes unnoticed. Each is duly noted and followed by the recurring question, Who taught this person this is the way to respond? No wrongful act goes unnoticed. For instance, when MacLeod discovers her mother’s soiled underwear in her mother’s hospital closet. This leads to a page in the book devoted to a chart that follows the chain of events. Apparently, it all comes down to a recurring problem: a breakdown in communication. And, finally, no problem-solving conversation goes unnoticed. Whether based on various meetings with small groups or interviews with experts, MacLeod consistently mines for golden bits of wisdom. For example, a popular refrain from politicians is to gut public funding for administrators when, in fact, it is going to take funds to attract the best administrators to tackle systemic problems and make sound public policy.

We don’t die in vain when we value life!

In lieu of any all-encompassing solutions, the answers to how to deal with a parent in a nursing home come right back to the child. MacLeod learned the hard way that it takes every inch of self-awareness one can muster to see it through. MacLeod’s mother wasn’t going to change and suddenly become more affectionate. MacLeod’s brother wasn’t going to change and suddenly become more cooperative. And all the other factors in the world that one could blame, from the patriarchy to ageism, they weren’t going to change suddenly either. In the end, MacLeod had to rely upon herself first in order to move forward.

MacLeod’s book is going to help many readers in search of a better understanding of what’s involved when a parent needs nursing home care. It’s not an easy process and it never really ends. In broader terms, MacLeod’s book offers insights into the search for wellness in general through self-discovery and an appreciation of what it takes to live a worthwhile life.

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Filed under Comics, Comics Reviews, Family, Graphic Medicine, Graphic Novel Reviews, Social Justice

Review: ‘COVID Chronicles’ published by Graphic Mundi

COVID Chronicles. edited by Kendra Boileau and Rich Johnson. Graphic Mundi. 2021. 296pp. $21.95

COVID Chronicles is a unique comics anthology, a testament to the collective response to COVID-19. The comics medium is exceptionally well-suited to convey, evoke and process the massive tangle of information and expression involved. We often say that comics is known for superheroes. However, on an even grander scale, comics is known for being a communication and educational tool able to make it possible to see the forest for the trees. This remarkable anthology was put together during the first half of 2020. We were lost amid the trees then and we’re still finding our way today. As a comics creator, I fully appreciate the challenges for a book like this to stay on point. I have seen countless comics anthologies and the biggest stumbling block for such an endeavor is a lack of consistency and vision. And then we have those gems that prosper because of a clear and compelling purpose. This is such a collection.

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Filed under Comics, Comics Reviews, COVID-19, Graphic Medicine, Graphic Mundi

Review: ‘Menopause: A Comic Treatment’

“When the Menopausal Carnival Comes to Town,” by Mimi Pond, in Menopause: A Comic Treatment (Graphic Medicine/Pennsylvania State University Press)

Menopause: A Comic Treatment. Edited by MK Czerwiec. Penn State University Press. 2020. 144pp. $29.95

Mimi Pond was a queen for the night at the Eisner Awards this year as she was the winner in the Short Story category for her take on menopause. Yes, folks, you heard it right, a cartoonist won a prestigious industry award on a subject that has gotten little recognition over the years outside of a Joan Rivers comedy act. What’s more, Mimi’s story is part of the book that also won an Eisner Award–in the Best Anthology category! We all need to get over ourselves on so many levels more than ever. The truth is that we all have bodies (who knew?) and they go through changes as we steadily make our way to our final stop. There is no denying that a woman’s body goes through hell. But it’s not left just to me to say that. This book says it in a variety of ways, both vivid and hilarious.

Running off with the circus!

There is so much politics, a lot of it quite toxic, attached to everything about us, including our bodies. What’s refreshing about this book, in that regard, is that it’s engaged in some primal truth. That is what is so compelling about Mimi Pond’s short story as the main character must confront who she is at the most basic level. She’s mad as hell and she’s not going to take it anymore! This comic is one of those in-your-face show stoppers that takes you out of the page, out of the book, all the way to the Eisner Awards. In the story, a mother and adult daughter are wandering around an old-fashioned carnival when a carnie lures them into a show about empowerment. On stage, there is a troupe of naked middle-aged women doing a spoken word act. The mom is overcome and joins the group on stage, strips off her clothes, and vows to run away with the circus. The mom sees her mad dash as her last chance to shine, to live her life. Psychological road blocks can be every bit as real as anything else standing in the way of fulfillment. One is left with a universal urge to push one’s way through no matter what. And, if dad’s hot casserole gets cold, so be it!

Menopause: A Comic Treatment

With Mimi’s raucous story leading the way, this collection boasts an array of significant work from 28 contributors, explaining, and expressing their views, on the many aspects of menopause, from the general to the more specific and personal. This book is another partnership with Graphic Medicine, co-founded by MK Czerwiec, this book’s editor, as well as a contributor under the pen name, “Comic Nurse.” Menopause: A Comic Treatment is the nineteenth book in the Graphic Medicine Series published by Penn State University Press. The following are some more examples from the book. As I say, it’s a great range of work: some are more medically-focused, created by medical professionals, with simple drawings; and some are from seasoned professional cartoonists more invested in a slice-of-life perspective.

“A Slow Intermittent Leak,” by Jennifer Camper

Jennifer Camper’s “A Slow Intermittent Leak” cuts to the chase with a long hard look at the menstrual cycle, from first period to last. For many men, the reality of blood alone makes periods a highly taboo subject. Of course, those men need to get a grip. Camper is a professional cartoonist and it clearly shows. This is a highly organized and masterfully composed work. The combination of the artwork and engaging prose is a pleasure to read and guides the reader through with humor and grace.

“Burning Up,” by Comic Nurse (MK Czerwiec)

MK Czerwiec’s “Burning Up” is both highly informative and entertaining and is a great example of the power of visual storytelling. For these type of educational comics, art is only part of it and can be pretty simple as it is here. What matters most to the cartoonist is finding just the right balance of words and pictures to best convey the information. Czerwiec’s pen name is “Comic Nurse,” and this piece demonstrates what she is great at: taking challenging subjects and making them relatable. In this case, we follow our main character on a journey of self-discovery and an appreciation of “hot flashes.”

“Surgical Menopause–In Ten Postures,” by Susan Merrill Squier and Shelley Wall

My final sample demonstrates how truly powerful and practical comics can be. “Surgical Menopause–In Ten Postures,” is unique in its specificity as it greatly benefits from two experts in their fields. It is written by Susan Merrill Squier, a professor of English and Women’s, Gender, and Sexuality Studies at Penn State. It is illustrated by Shelley Wall, a medical illustrator and assistant professor in the biomedical communications graduate program at the University of Toronto. The comics coming from the Graphic Medicine community, which this book is a prime example of, are said to provide insight to medical professionals that they typically do not get. It is through the combination of Squier’s eloquence and Wall’s precision that we get a window into the highly idiosyncratic individual. Too often it comes down to doctors vs. patients when, in fact, we’re all just humans. It takes a very sophisticated comic like this is prove a simple truth: we’re all vulnerable and we all need to be carefully listened to. Ironically, despite how articulate this comic is, it is speaking to how easy it is to not speak properly or to be listened to properly. The prime example in this comic: the doctor, in an all too matter-of-fact tone, asks the patient, “Do you want to keep your uterus if you’re having your ovaries removed?” The patient, in an all too defensive posture, replies, “I am not my uterus.” End of discussion. Uterus removed. Oh, but the patient didn’t really mean it, wishes the doctor had questioned her words and now regrets having her uterus removed.

About the Editor

MK Czerwiec, RN, MA, is the artist-in-residence at Northwestern University’s Feinberg School of Medicine and the cocurator of GraphicMedicine.org. She has served as a Senior Fellow of the George Washington School of Nursing Center for Health Policy and Media Engagement and as an Applied Cartooning Fellow of the Center for Cartoon Studies. She is the creator of the graphic memoir Taking Turns: Stories from HIV/AIDS Care Unit 371 and coauthor of Graphic Medicine Manifesto, both published by Penn State University Press.

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Filed under Comics, Comics Anthologies, Graphic Medicine, Graphic Recording, Penn State University Press