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Inside the Comics Collection of the World’s Largest Medical Library

In 2016, the National Library of Medicine started collecting “graphic medicine” — materials that use comics to teach the public about illness and health.

Ellen Forney, page from Marbles: Mania, Depression, Michelangelo, and Me (© Ellen Forney, 2012, courtesy Gotham Books)

Millions of books, journals, manuscripts, and images fill the National Library of Medicine (NLM), the world’s largest medical library, on the grounds of the National Institutes of Health. The documents cover the long history of medical research, the oldest dating all the way back to 11th century Persia. In 2016, the ever-growing collection started gathering one of the most recent forms of scientific literature: graphic medicine, which encompasses materials (mostly books) that use comics as a means of educating people about illness and health.

Ellen Forney, page from Marbles: Mania, Depression, Michelangelo, and Me (courtesy the artist)

In an effort to publicize its collection, and the overall importance of this emerging field, NLM has launched an exhibition. Graphic Medicine: Ill-conceived and Well Drawn! is a three-part project comprising a year-long display at the library, a traveling exhibition of explanatory banners, and a website with images from the collection and lesson plans for educators. The show was guest curated by cartoonist Ellen Forney, author of what’s probably the most well-known book in graphic medicine, Marbles: Mania, Depression, Michelangelo and Me.

Published in 2012, Marbles is a medical memoir in the form of a graphic novel, in which Forney recounts her personal experiences living with bipolar disorder. As she ponders the mental health of creative people throughout history, like Vincent van Gogh and Georgia O’Keeffe, Forney theorizes how a mood disorder diagnosis affects a person’s view of themselves and their capacity for creativity. But it’s not all introspective philosophizing. Forney also offers advice on how to swallow pills in one gulp, for instance, and breaks down the Diagnostic and Statistical Manual of Mental Disorders (DSM) definitions of mood disorders into a digestible graphic.

MK Czerwiec, page from Taking Turns: Stories from HIV/AIDS Care Unit 371 (courtesy the artist and National Library of Medicine)

At a panel discussion about graphic medicine held at the NLM earlier this month — live-streamed and archived on the library’s website — Dr. Michael Green, a physician, bioethicist, and professor at Penn State University, said Forney’s DSM chart has proven helpful in teaching his students. (Green created the lesson plans for the library’s Graphic Medicine website.) MK Czerwiec, a nurse who began making comics while working in an AIDS unit in the 1990s, compared graphic medicine to airline safety cards, transcending the barriers of language. The separate speech and thought bubbles are particularly useful, she noted, in describing the delicate situations in which healthcare workers often find themselves. Toward the end of the conversation, Green said researchers are also trying to figure out whether these kinds of books can have an impact on health literacy, and perhaps even health outcomes.

“I’ve gotten feedback from patients and therapists about how [my book] played a part in their experience, and it’s amazing,” Forney said in a phone interview with Hyperallergic. “It does make its way out there.” In addition to making comics, Forney teaches a graphic medicine class at Cornish College of the Arts in Seattle. “Comics didn’t start getting respect as a literary medium until the early 2000s,” Forney continued. “And science comics came after that, so it’s still a challenge to get comics recognized as well-researched non-fiction.” For those who do recognize graphic medicine as a serious and worthwhile endeavor, there’s the annual Comics and Medicine Conference. “Some of us go every year,” Forney said.” It’s our Burning Man.”

Ellen Forney, page from Marbles: Mania, Depression, Michelangelo, and Me (© Ellen Forney, 2012, courtesy Gotham Books)

Forney, Green, and Czerwiec see graphic medicine not only as beneficial to readers, but also to the cartoonists themselves. During the panel discussion, Green cited a study suggesting that drawing lowers levels of cortisol (the “stress hormone”) in the human body. He’s been encouraging his medical students to take up drawing themselves, giving them drawing assignments as part of their regular coursework. As for Czerwiec, she started making comics in the first place in order to relax and take her mind off the stress of caring for AIDS patients.

Drawing your traumatic medical experience can serve as a way of “gaining agency over something you had no agency over before,” Czerwiec said. Forney equated her own drawing process to “pulling out a really big splinter.” Of course, this method isn’t foolproof. Sometimes drawing and redrawing a traumatic experience can prolong the pain of it for years, as Green was quick to point out.

Six years after publishing Marbles, Forney is coming out with a follow-up graphic novel. Scheduled for publication in May, Rock Steady: Brilliant Advice From My Bipolar Life is a guide to “maintaining stability with a mood disorder,” Forney said, “with information on therapies, red flags, insomnia, and how to take care of yourself and keep yourself balanced. I’m treating it as a kind of reference book. It even has an index!” The National Library of Medicine will no doubt add it, too, to its growing collection, where it will serve as an educational tool for generations to come.

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