For a growing number of artists whose work falls under the umbrella of graphic medicine—and the readers who make up their audiences—words and drawings in short- or long -form works, the genre provides an effective platform for not only exploring these questions, but for understanding and education, advocacy and activism. In publications that include single frame cartoons, self-published zines or “floppies” (comic-book-style publications) as graphic memoirs and novels, the message is often both less and more complex than text alone. In a single cartoon frame portraying, for example, the relaying of a prognosis, the expression on the face of a patient, the body language of a physician, and even the choice of lettering in the thought or speech bubbles that accompany the drawing, can create an emotional impact that resonates deeply and immediately. (For some graphic medicine cartoonists, what’s left unsaid appears to be just as important as the language they include.)

Those newer to the art form, may find the Graphic Medicine Manifesto (Pennsylvania State University of Press, 2015 and 2025) a fine place to start. Authored by a group of six creators* made up of clinicians and caregivers as well as those working in the medical humanities, the volume serves as a kind of bible for the community. Co-author Ian Williams, a physician and graphic novelist, coined the term graphic medicine to describe comics and graphic novels with medical content. The field is variously described by other members of the informal collective behind the manifesto as including, but not limited to, “the intersection of the medium of comics and the discourse of healthcare”, a “movement for change that challenges the dominant methods of scholarship in health care offering a more inclusive perspective [on medicine and caregiving]” and comics that “give voice to those who are not often heard”. While a significant segment of the work produced focuses on the physical and emotional aspects of illness, medicine, and caregiving, graphic medicine also serves as a means of demystifying disease and injury, professional and lay education, and even patient advocacy.

Creators in the broader graphic medicine community frequently cite its reputation for friendliness and inclusivity; numbered among their ranks are clinicians, researchers, allied health professionals, educators, public health experts, patients, medical illustrators, and others.

A quick survey of the virtual or actual graphic medicine bookshelves reveals the seemingly inexhaustible array of subject matter, with entire sub-genres devoted to specific diseases and conditions. For those on either side of the healthcare divide – providers and patients—these documents can create a bridge to understanding.

Drawing styles employed in graphic medicine are as various as in other art forms. Political cartoonist Peter Dunlap-Scholl, for example, uses a “jangly” drawing style in My Degeneration, which depicts life with Parkinson’s and the effect the illness has had on the way he makes art. Moka Onmae’s graphic novel, Good Morning, Good Night, and See you Tomorrow, based in part on her experience as a cancer patient, adheres to many of the conventions of manga (Japanese comic books and graphic novels with distinctive visual characteristics) to great effect.

Complementing the vast body of patient narratives is an abundance of graphic medicine content that focuses on medical education and clinical practice, including memoirs specific to illnesses that were once thought to be untreatable and diagnoses/conditions that have recently emerged or been identified. Graphic medicine pioneer, MK Czerwiec’s Taking Turns, for example, describes her experience as a nurse in a Chicago hospital caring for patients on an AIDs unit, and includes oral accounts from patients, family members, and staff. The book serves as a historic document as well as a memoir. Palliative care physician Nathan A. Gray’s forthcoming graphic memoir, The Human Remains: Drawing Out Compassion in Medicine, addresses the author’s efforts to maintain his humanity through residency in a system that doesn’t always allow the time and space to do so, and his continued striving while working with patients approaching the end of life.

Use of graphic medicine in the medical school setting has also grown in recent years. Penn State physician and bioethicist Michael J. Green, was among the first group of educators to teach graphic medicine; in his case, introducing the curricula to fourth year medical students in 2009. Writing on this topic in the Graphic Medicine Manifesto, Green elaborated, “[Comics] can tell compelling stories about illness and demonstrate the complexity of medical culture. Reading comics can help students think critically about the environment in which they learn and work, and making their own comics can help students communicate more clearly and precisely.” Moreover, Green wrote, “Being challenged to tell a story by drawing pictures can be an uncomfortable and often daunting exercise…. a reminder that they (and doctors in general) seldom have all the answers or skills to solve every formidable problem that comes before them.”

The relatively recent explosion of graphic medicine comics, zines, novels and memoirs, notwithstanding, it’s worth noting that there’s also a much earlier tradition of cartooning that centered on illness, the medical profession and the public. British caricaturist James Gillray’s The Cow-Pock—or—the Wonderful Effects of the New Inoculation (1802) memorably depicts the wildly imagined consequences of inoculation against smallpox among contemporary anti-vaxxers. William Hogarth (1697-1764), who famously skewered politicians, the upwardly mobile, and the morally dissolute, did not spare physicians his merciless critique in his engravings. In A Consultation of Physicians, or The Company of Undertakers, the artist depicts a gathering of doctors led by three notorious “quacks”, including John Taylor, the “oculist” said to have performed botched eye surgeries on Handel and JS Bach. More on Hogarth and his role as a member of the board of governors and muralist at St. Bartholomew’s Hospital in London, can be found on www.drawing-blood.org, a website associated the Billy Ireland Cartoon Library & Museum at Ohio. Those wishing to go even farther down the rabbit hole on the history of medical cartoons, may be fascinated by Professor Jared Gardner’s piece on the Gumps (a long-running comic strip from 1917 to 1959) in which family members contend with the threat of the Spanish flu epidemic.

State of the Art

Among those graphic medicine creators approaching the complexity of the human body, disease, and delivery of care from a distinctive perspective, are Kriota Willberg and Gianna Paniagua. Willberg, who has worked as a dancer, massage therapist, and anatomical illustrator, and holds certificates in bioethics, medical humanities, and gerontology, is the creator of numerous pieces including the Cadaver Diaries, in which she documents her experience as a student and later as a co-teacher of a drawing class for medical students in a cadaver lab. The booklet not only offers a nuanced description of this work, but also explores how Willberg grew to view bodies in other contexts, as when she sat at her father’s bedside at the end of his life, her understanding of anatomy and physiology making his death more real. “Learning …from textbooks and models taught me perfect anatomy. Dissection taught me how a body’s anatomy can vary and survive illness,” she notes in Cadaver Diaries.

Currently a part-time adjunct professor at Parsons School of Design and an instructor for Art and Anatomy at NYU Langone, Willberg’s time as the Artist in Residence at the New York Academy of Medicine led to the creation of her comic, Silver Wire. Placing herself in the story as a character, a technique that allows her to represent the naïve and curious layperson, Willberg gets a hands-on lesson on ligatures and suturing techniques (her use of fruit as “patients” makes for some intentionally humorous moments) from her friend Mollie, a palliative care physician. Throughout this section, Willberg draws the parallel to stitching techniques used for centuries by needleworkers.

The narrative then advances to a discussion of medical knowledge acquired via unethical and sometimes deeply disturbing practices over the centuries, including experiments on servants, enslaved people, and prisoners by Galen, Paré, and Bell. Willberg’s focus on J. Marion Sims and his experimentation on enslaved women—which included surgeries performed without anesthesia—in his work on vesico-vaginal fistula, serves to illustrate how the surgical techniques and advances that benefit so many women grew out of this history. The title of the comic refers to the silver wire Sims used during surgery to reduce infection. “Because Sims findings were shared internationally, individuals of all genders in countries where there was no legacy of slavery benefited,” Willberg notes. “In fact, he probably saved the lives of some of my ancestors. I think it’s important to share this information.”

Gianna Paniagua, an artist who has been both a painter and a papercutting sculptor, and is a two-time heart transplant recipient, is making another unique contribution as a graphic medicine cartoonist and patient advocate. In both mini-comics and several pieces published in Bonus Days, a magazine by and for transplant patients, among other publications, Paniagua has documented her complicated history. After receiving an initial transplant at 14 months of age due to hypertrophic cardiomyopathy, she then required another as a young adult to address transplant coronary artery disease that developed after a period of non-compliance with her treatment.

Finding an institution that would approve her for a second surgery proved challenging, and it took a great deal of perseverance to find the team at Vanderbilt University where her second transplant surgery was performed. Even with the highly supportive team in place, Paniagua says, “I thought I would die in the surgery, because it was very high risk. I was trained for years not to expect something good to happen [and] I was trying to find something where I could quickly leave a legacy and tell a story others could learn from.” Although she had focused on oil painting as an art major at the University of Pittsburgh, it was important to avoid exposure to toxins in the medium. Paper cutting was also too strenuous at the time. Graphic medicine turned out to be the natural fit for someone who had spent much of her childhood drawing. Her comic about life after surgery and the expectations of others regarding her health are powerfully shown in “Are We Ever Really Recovered?” published in Literature and Medicine in 2023.

With her second heart surgery now five years behind her, Paniagua is still immersed in the transplant world, not only as an artist, but as a patient coping with chronic pain and the demands of remaining vigilant against rejection. Her work as an advocate for other young adult heart transplant patients also takes center stage. “Dealing with the side effects of immunosuppressive drug regimens and noncompliance remain major concerns [for this population]”, Paniagua says. She also notes the importance of adequately educating female transplant recipients about issues specifically related to gender, including the impact of their condition on childbearing.

“I think there are creative solutions for this. It’s important to hear true stories about other transplant patients. It’s a way of feeling less isolated. Graphic medicine breaks barriers of education and language,” Paniagua adds. “If you see an image, it can cling to you. There’s a magic in it.”

Her commitment to helping clinicians communicate clearly and empathetically to those in their care is another driving force behind her comics. When possible, she attends conferences and participates on panel discussions on graphic medicine as well as on care for young heart transplant patients.

Paniagua also acknowledges the role of graphic medicine comics in helping her process a lifetime spent in the medical world. While enrolled at Columbia University in the Narrative Medicine program, Paniagua conceived of a capstone project depicting a heart transplant surgery for a Medical Education comic that would benefit other young transplant patients. Already in the process of founding a support group for this population, she had maintained a connection to her own transplant team and with strict adherence to HIPAA guidelines she was granted permission to be present during a transplant surgery. Although one of her advisors had expressed some reservations, thinking that Paniagua might be unsettled by the experience, she was amazed and inspired and plans to co-create more work in the future with other transplant recipients. She is also deeply gratified to know that the patient whose surgery she observed is doing well.

Owing in great part to the efforts of Graphic Medicine International Collective (www.graphicmedicine.org), comic artists like Willberg and Paniagua, among numerous others, continue to receive exposure and opportunities to network with their peers in cities around the world, both through the organization’s conferences and on their website. The widely attended Comic-Con in California has also hosted programs in graphic medicine, bringing awareness to mainstream comics audiences, while smaller conferences hosted by universities and professional societies are proliferating.

As many in the graphic medicine community will acknowledge, there is still resistance to the value of the genre in some quarters. But this, too, appears to be changing, as demonstrated by the online exhibition maintained by the National Library of Medicine: Graphic Medicine: Ill-Conceived and Well Drawn! With the imprimatur of the National Institutes of Health lending support for graphic medicine – and a growing number of published titles by physicians and other healthcare professionals receiving glowing reviews, there’s surely more widespread acceptance to come.

Selected Notes and Resources
The book alluded to in the beginning of this article is Memento Mori by Tiitu Takalo, which chronicles the artist’s recovery from a ruptured cerebral aneurysm, its effect on her life as an artist and on her personal relationships. In her introduction she also notes that citizens in her home country of Finland are spared the added burden of medical debt as they recover from a serious medical event.

The Graphic Medicine Manifesto was authored by M.K. Czerwiec, Ian Williams, Susan Merrill Squier, Michael J. Green, Kimberly R. Myers, and Scott T Smith

More of Kriota Willberg’s work can be viewed at http://kriotawelt.blogspot.com and on Instagram at @kriotawillberg. Her full-length memoir, Over My Dead Body, will be published in 2027 by Fantagraphics.

Gianna Paniagua’s website, https://giannapaniagua.squarespace.com, showcases her work in various media. She is on Instagram as @tragicdarling.

Web image created by Medhum.

AIDS in the Comics: The Graphic Memoir Taking Turns with MK Czerwiec

Russell Teagarden 09.11.26 25

A nurse’s graphic memoir reveals the human stories, suffering, and compassion behind the AIDS crisis.

The latter decision unarguably constitutes a significant setback in the struggle for reproductive rights for American women, but the history of access to abortion—and a sense of what the future might hold—may best be understood by taking the long view, across cultures. In Pushback: The 2,500-Year Fight to Thwart Women by Restricting Abortion, historian Mary Fissell does just that. Starting with the story of an enslaved woman in ancient Greece who becomes pregnant after being hired out as a prostitute by her enslaver, Fissell presents a series of case studies. Each one illustrates how women continued to have abortions through the centuries despite changing mores, laws, the influence of the church, and the irregular availability of experienced or qualified providers. The stories also demonstrate a pattern: as women gained more social and economic freedoms, the laws governing abortion became more restrictive, with the pendulum eventually swinging back in the opposite direction to a more liberal stance on abortion.

The enslaved woman in ancient Greece would likely have faced no moral sanction for seeking an abortion—her value lies in her continued availability as a sex worker, and, in her case, a singer. Documents suggest that women in her position would have had the knowledge to end her pregnancy, most likely with an herbal abortifacient, though squatting, jumping and sneezing were also recommended methods of preventing pregnancy immediately after sex. In ancient Rome, the focus on controlling fertility was somewhat different; Roman women had greater freedoms than their Greek sisters, raising concerns about adultery, which Augustus declared as a criminal offense. With  a focus on increasing the number of upper-class Romans who would rule the growing empire, controlling the fertility of elite married women was one way to achieve this end.

Leaving antiquity behind, Fissell nimbly guides us through the Middle Ages. In an era where Christianity is on the rise, and the issue of ensoulment is linked to the experience of quickening (when the pregnant woman first feels the fetus moving), the story of Brigid of Kildare was recorded. Brigid, a holy woman whose historical existence cannot be confirmed, was said to have helped a young woman miraculously end her unwanted pregnancy (a subsequent miracle attributed to Brigid helped a woman preserve her chastity).  The Church’s codified position on abortion was still more than 500 years away and for many of these early Christians, discussions of ensoulment notwithstanding, concerns around abortion as a means of covering up illicit sex appear to have weighed more heavily than any harm to the fetus.

In early modern Europe, in some parts of the continent, abortion had become a capital crime punishable by execution, a development that reflected “a larger cultural shift that sought to control female sexuality in the interests of Church and state.”  The story of Anna Harding who went on trial in 1618 was a case in point. Against the background of a witchcraft panic, Harding  admitted to providing both married and unmarried women with herbal and floral preparations to end their pregnancies. A “confession” under torture to having consorted with a demon led to Harding’s conviction and being burned at the stake. 

Indeed, herbal preparations to end unwanted pregnancies were common to societies as disparate as enslaved women in the Caribbean, who used abortions as an act of resistance, to Victorian women of all classes who sought abortions for many of the same reasons as women do today. Use of one of the herbs best known to induce abortion, pennyroyal, persisted up through the early 20^th century, although not without risk to the pregnant woman.

By this time, the idea that life begins at conception had gained a greater hold in the United States. Hugh Hodge, a professor of medicine at the University of Pennsylvania, argued this “scientifically-based” premise as early as 1839, while the Pope’s 1869 declaration that life begins at conception would have been presented as divine revelation, though Fissell posits that concern on the part of European monarchs in Catholic countries worrying about depopulation and “degeneration” may well have influenced the pronouncement.

The story of Beatrice J, a Baltimore woman, who safely achieved two self-managed abortions in the 1940s through the aid of a catheter and ergot pills to induce uterine contractions, serves as a more modern example of women who had ended a pregnancy going on to administer abortions to others. In Beatrice’s case, after her trusted pharmacist helped set her up as an abortion provider, an undercover police operation exposed her practice. A trial followed, but charges were ultimately dismissed by a progressive judge on the basis that the “client”  who visited Beatrice was not actually pregnant.

In addition, Fissell points out this was not an isolated example by any means. Even in the most restrictive settings and time periods, there appears to have been a fair amount of  tacit acceptance.  In the U.S., for example, “Physicians performed legal abortions for a variety of indications, and the rest, so-called criminal abortions, went largely unremarked. In the 1920s and ‘30s, abortion providers were rarely prosecuted, whether physicians or not, and the former were at risk only if a woman died.” Moreover, once antibiotics and blood transfusions became available in the 1930s and 1940s, the morbidity and mortality associated with these procedures would have been reduced.

The presence of abortion providers who practiced under the radar persisted throughout the ‘30s and early ‘40s, albeit with some providers using their own judgement as to who was morally deserving of their covert services.  But the 1940s and 1950s also brought a more punitive attitude toward abortion in the United States. With an increasing number of arrests of providers administering safe abortions, dangerous practices became more widespread, as did abuses by practitioners, including sexual assault on clients. In turn, these tragic stories led to the underground movement of women and their allies who supported those in need, including the Jane Collective in Chicago, a group of women who risked criminal prosecution to help others obtain safe abortions. 

While the individual stories of women seeking abortions constitute the throughline of Pushback, Fissell consistently addresses the broader factors that affected access in each of the societies she describes, including eugenics, racism, nativism, and concerns about fidelity and heredity. Enslavement and labor demands, the appropriation by physicians in the 19^th century of care that was formerly the domain of midwives, and superstitions linking women’s fertility to fertility of livestock and crops, also come under scrutiny, as does the relatively recent shift of emphasis from the importance of the life of the mother to that of the fetus.

Readers might also consider the role of medical advances as factors that have altered our understanding of pregnancy, development of the fetus, and access to abortion. Among them was the development of simple urine tests that eliminate the uncertainty surrounding pregnancy, a means of confirmation light-years away from those early societies where pregnancy was confirmed by quickening. Sophisticated imaging of the fetus via ultrasound not only confirms pregnancy at an early stage, but packs an emotional punch. Moreover, the availability of medication through pharmacies and online sources for self-managed abortions, while under threat, has created a new landscape for pregnant women. This last means of obtaining an abortion, though formulated in a laboratory, suggests a new iteration of the herbal abortifacients used by so many generations past.

Pushback succeeds at being both highly readable and meticulously researched—the volume includes an extensive list of notes and references for each chapter. Fissell, who is the Inaugural J. Mario Molina Professor in the History of Medicine at Johns Hopkins University, also writes the Substack A is for Abortion: Snapshots from the Past. As a pre-modern historian of the 17^th century, she particularly enjoys the kind of “detective work” that accompanies that study. But she was also pleasantly surprised by how much she enjoyed researching and writing on the modern period, where sources are more readily available, including data she found through Ancestry.com.

Fissell completed her manuscript before the start of the second Trump administration and aside from allusions to Roe v. Wade and Dobbs v. Jackson, Pushback does not explore the ways in which abortion became a flashpoint in our most recent national elections. (A description of politically motivated anti-vice campaigns that targeted abortion practitioners and pregnant women in the late 1940s and 1950s is included in the chapter dealing with that time period.)

But in a discussion with this writer, Fissell weighed in on current data that shows more American women than ever are having abortions despite the 2022 Dobbs ruling. “Restriction has an impact and makes abortion much more difficult and dangerous to access,” she said. “But it never stamps it out.” She also cited data that suggests roughly 66% of Americans think abortion is a decision that should be made between a woman and her doctor.  

Interestingly, Fissell did wonder at the onset of her research for Pushback whether she might change her mind on the issue. In the end, she describes holding the same views as when she started.  “Given that abortion was often shameful and secret if not [completely] illegal, I was amazed by how much I was able find out.” Her appreciation for insights from the reproductive justice movement deepened considerably as well, as it informed her understanding of women in earlier societies and the use of the term “choice,” then and now, for women in untenable circumstances.

“[Choice is] something a white woman with money can afford to have,” Fissell said. “Choice [does not apply to] a struggling waitress in a small Southern town who was raped and has two kids at home, and her wages won’t even cover their care…Casting the decision as choice means we don’t understand many women’s experiences.”     

Pushback by Mary Fissell was published by Seal Press (2025).
Web image by Medhum.org.

From the closest bus stop, the shift in focus is immediately apparent. A walk along the Avenue de la Paix (Peace) takes one past sculptor Daniel Berset’s monumental broken chair statue, conceived to encourage a multi-national ban on anti-personnel mines and cluster munitions. In the background, stands the European headquarters of the United Nations in the beautiful Palais des Nations (originally built in 1929 to house the League of Nations). A bit farther on, a statue of Gandhi greets passers-by, adorned one recent day with tributes to the late Russian political activist and prisoner, Alexei Navalny.  

The Red Cross/Red Crescent museum itself sits at the foot of the International Committee of the Red Cross (ICRC) headquarters, a large white building atop a hill. A modern glass and steel structure houses the collection where visitors are invited to learn more about the organization’s origins, as well as the long-standing alliance between individual Red Cross and Red Crescent national societies that provide humanitarian relief around the world. 

While the organization of exhibits in the museum’s permanent collection is not strictly chronological, a sculptor’s dramatic all-white rendering of Henri Dunant seated at a desk—and accompanying text—explains the Geneva resident’s role in the founding in 1863 of what is now the International Red Cross. Dunant, who was first inspired to create a relief effort to alleviate the suffering of soldiers after witnessing the 1859 battle of Solferino, Italy, also participated in the framing of the original Geneva Convention of 1864. On display in a nearby case, copies of that document contain language that reflects the authors’ optimism, “Ambulances and military hospitals shall be recognized as neutral…Wounded or sick combatants, to whatever nation they may belong, shall be collected and cared for.” Subsequent versions that expanded on the protections outlined—thereafter referred to as the Geneva Conventions—were drafted respectively in 1906, 1929, and 1949, with the lattermost document still remaining in effect.  

To safeguard both those providing care and wounded soldiers, the Convention “established a universally protective symbol: a red cross on a white background.” (There has been some debate about whether the white cross on the emblem was intended to carry religious significance or was simply chosen as a readily recognizable symbol, i.e., the inverse of the Swiss flag.) A little more than a decade later, use of the red crescent—a symbol more readily recognizable to Muslim soldiers—was initiated, with formal adoption of this symbol in 1929. Today, the red crystal emblem is used by allied societies in regions where the population does not identify with the cross or the crescent.  

Throughout the museum, the response of the Red Cross and the Red Crescent to humanitarian crises around the world is documented through a variety of materials including photographs, artifacts, and facsimiles of official records. The experiences of survivors in more recent conflicts and natural disasters are brought to life through additional media, including music, graphic representation, and recorded testimony. A striking example is found in the Hall of Witnesses where visitors can sit face-to-face with greater-than-life-size videos of survivors describing their experiences—among them, a former child soldier, a civilian who lost his legs but now works with other amputees, and a woman who experienced multiple displacements from her home country. 

The youngest victims of conflict come into focus in a haunting display of photographs posted along the wall of a nearby room; the accompanying text explains that the children portrayed are survivors of the 1994 Rwanda Genocide. Separated from their relatives at such an early age many did not know their family identities, or even their own names, making reunification difficult and sometimes impossible.  

Fortunately, there is hope to be found as well. In the Restoring Family Links section of the museum, more testimony may be viewed and heard, describing instances in which families separated by conflict have been reunited by the Red Cross and Red Crescent. Stories of recovery and resilience, even among individuals who might have given in to despair, amaze and inspire. 

In another gallery, a display of artwork crafted by prisoners and made primarily from found materials serves as testament to the desire for creative expression among those who have yet to attain their freedom. Among these works: a locomotive made by a French prisoner in Germany in 1941; a set of playing cards drawn by a Moroccan prisoner held by the Polisario Front (a group seeking independence in the Western Sahara) in 1998; and a miniature palace put together by Lebanese prisoners in Israel in 1999. (A book of this artwork is available in the museum shop.) 

With not all threats to human dignity stemming from civil wars, nationalist movements, repressive governments and militia, the Red Cross and Red Crescent also work to prepare vulnerable populations for natural disasters. A small area of the museum is devoted to this work, while a newer threat, cybersecurity is addressed at the Data Detox bar, where a pick-and-choose your own cocktail metaphor is used to provide “…steps you can take to control your digital privacy, security, and wellbeing”; cards that summarize this information are available to take home. 

Leaving the exhibits behind, in the lobby of the museum, the departing visitor is reminded of the power of literature and art to communicate our moral obligation to alleviate human suffering, as well as our capacity to do so. A quote from Dostoevsky that runs along one wall recalls our universal responsibility to one another, while nearby, observers are invited to add their own bit of weaving to artist Zahrasadit Hakim’s tapestry-in-progress, an example of how the cumulative efforts of many changes, supports and enhances the whole. 

The Museum of the International Red Cross and Red Crescent
https://redcrossmuseum.ch/
Av. de la Paix 17, 1202 Genève, Switzerland.  

Photo of the Red Cross/Red Crescent museum from wikicommons