National Institutes of Health

Class 3: Exploring Normalcy, Disability, Stigmatization, and Bias Through Graphic Medicine

Introduction:

This class explores the notions of “normal” and “abnormal” in the medical context. If disease is characterized by deviation from typical or normal functioning, this presupposes that there is a state of being that we can reliably identify as normal. Comics often challenge such notions, showing how social and environmental factors influence whether and how “difference” becomes “disability.”

Students read comics that depict differences, and explore themes such as disability, bias, social construction of illness, and stigmatization. El Deafo is a story about a young girl who develops a hearing loss, and describes what it feels like when she is treated differently by others. Marbles is a memoir about living with mental illness, and shows the experience of bipolar disorder with the “ups” of mania and the “downs” of depression. Susan Squier’s article discusses disability, and investigates how comics can illuminate our understanding of individuals who have differences.

Students engage in a drawing activity that explores the related topics of taboo and stigmatization. Comics have a long history of dealing with taboo issues, including sex, drugs, incest, etc. For example, in the 1960s, underground comics were often considered illicit or obscene. Today, very little is taboo, yet some things are still not discussed openly, because of fear of stigmatization or discrimination. What topics are taboo in medicine? Are there “elephants in the room” that aren’t said aloud? Using the Taboo Scenes Template, students draw two scenes, using 4 panels for each scene: 1) the most unexpected or outrageous thing a student ever heard in the hospital or medical clinic; and 2) something a patient is afraid to talk about with a doctor.


Readings
  • El Deafo, by Cece Bell. New York, NY: Abrams Press, 2014.
  • Forney, Ellen. Marbles: Mania, Depression, Michelangelo, and Me: A Graphic Memoir. New York, NY: Gotham Books, 2012. Chapters 1—4, pp. 1—113.
  • Squier, Susan. “So Long as They Grow Out of It: Comics, the Discourse of Developmental Normalcy, and Disability.” Journal of Medical Humanities. June 2008 29(2):71—88. doi: 10.1007/s10912-008-9057-1.
Activity Materials
  • Taboo Scenes Template (PDF)

  1. Discuss El Deafo
    • How is deafness portrayed?
    • How does the author show sound? When you read a comic, how do you “hear?”
    • Is her deafness a disability? Why or why not?
    • What makes something a “disability” as opposed to something else?
    • What do we learn from this story?
  2. Discuss Marbles
    • How does Ellen draw herself when manic? When depressed? How does she demonstrate her fluctuating mood and emotions?
    • What aspects of the diagnosis and treatment most concern the author? Do you think her fears are warranted?
    • How did you feel when reading these depictions of bipolar disorder? Confused? Overwhelmed? Angry? Sad?
    • What implications does this emotional reaction have for health care providers?
  3. In the medical context, what do you think it means to be “normal” and how is this different from “abnormal?” Are such distinctions meaningful? Why or why not?
  4. How are differences represented in comics, and in what ways do comics challenge assumptions about what it means to be sick?
  5. Discuss daily diary entries as a class.
    • If students are comfortable doing so, have volunteers read their diary entries for the week while the other students listen and draw something they heard on 4 x 6 index cards. Invite several different people read their diary entries, and then have the students walk around the room and take a look at the images people drew from what they heard.
    • How did the activity affect the way you observed your surroundings?
    • What did you hear that was surprising?
    • Do you remember seeing or hearing things that you wouldn’t have noticed if you hadn’t been assigned this diary?
    • Other thoughts about the daily diary?
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