The theme of this year’s Graphic Medicine Comics Forum is “Visualizing the Stigma of Illness.” Stigma in illness often arises simply from close association with death. Dying is frequently an integral plot element in medically themed graphic novels and memoir, but it frequently happens “off-panel” thereby avoiding challenging visual representations of death and dying. There are notable exceptions to this, of course, such as Lisa’s Story: The Other Shoe by Tom Batiuk (Kent State University Press, 2007).

Three notable graphic memoirs published in 2011 visually portray dying and death. To this hospice nurse, these three representations of family hospice experiences struck me as refreshingly honest. They portray the kinds of experiences I’ve witnessed professionally but not previously seen presented in graphic narrative, and they stayed with me. Each is intimate, honest, and, I’m guessing, was challenging to produce, as in each book, the creator is presenting the death of their parent.

In Seeds by British artist Ross Macintosh, (published by Com.x) Mackintosh’s father is dying of cancer.

Ross is summoned during the night. His father has died.

Depicting a character, particularly one’s own parent, after death, is not something the norm in graphic texts about illness, and Mackintosh does this beautifully in Seeds. The simple graphic sensibility of the book is in stark contrast to the emotional complexity of the content. In addition to drawing his own dad moments after death, Mackintosh confronts in the text of this section the existential nothingness that is death, avoiding religiosity and spirituality. Further in the panel shown above, for example, he compares his dad’s body to a cut toenail – an artifact of life that no longer carries meaning. I found this treatment of death bold and refreshing.

In Special Exits by American underground comics artist Joyce Farmer, (Fantagraphics) the protagonist character (meant to represent Farmer) is not present for the death of her mother, because the nursing home staff failed to make contact with her in time.

When it is Farmer’s father’s time to be in hospice, she seems committed to being with him, and showing us, every arduous step along the way.

She is not present for the actual death again, but is with her father moments after.

In Tangles, Vancouver artist, writer and editor Sarah Leavitt (UK publisher Johnathan Cape) presents her mother’s struggle with and death due to Alzheimer’s disease. Like Macintosh and Farmer, she represents this difficult experience with unflinching honesty. Again, here a last visit before death:

And a visit immediately after death:

Interestingly, each of these texts also point out things caregivers did that were remembered as less-than-helpful during a difficult time. For Farmer, it was the nurse not reaching her in time preventing Farmer from being present for her mother’s death. For Ross, it was the way in which a hospital staff member chose to inform him of his father’s death.And for Leavitt, less-than-helpful volunteers appeared shortly after her mother passed away.

These unhelpful persons seem an integral part of the narrative of each death, burned into the memory of the storyteller for the obvious contrast they represent to what is needed by families at a time of loss.

It is my hope that these three texts released in 2011 represent a shift toward visually representing family experiences of dying and death. The results are twofold – for the person experiencing the very personal loss, creating the graphic narrative can serve to integrate the experience of a loved one’s death into their ongoing life story. The narrative can also serve as a remembrance to and for those who experienced the loss. Addressing both of these points, Mackintosh told Deborah Vankin in an interview for the Los Angeles Times:

 I created the comic for myself, as a way of removing pictures and phrases from the maelstrom in my head. The secondary purpose was a subconscious need to express to my mom and brothers that the awful events didn’t just happen quietly.

For those of us who are readers of the texts, they help us to begin to think about the deaths we have encountered or will encounter, and give us models for how to (and perhaps how not to) approach them.

Margaret Edson wrote in her Pulitzer Prize winning play W;t:

We are discussing life and death, and not in the abstract, either… Now is not the time for verbal swordplay, for unlikely flights of imagination and wildly shifting perspectives, for metaphysical conceit, for wit… Now is a time for simplicity. Now is a time for, dare I say it, kindness.

MK Czerwiec RN, MA worked as an AIDS nurse from 1994-2000. When antiretrovirals enabled her Chicago AIDS ward to be closed, she started making comics under the pseudonym Comic Nurse. Czerwiec then earned an MA in Medical Humanities and Bioethics. She teaches “Drawing Medicine” at Northwestern Medical School and is working on an illustrated oral history of the AIDS crisis, “Taking Turns: A Medical Tragicomic.”

All image copyright belongs to the creators.

You can read previous editions of Graphic Medicine in the Comics Forum Website Archive.

Comics Forum 2011 is supported by Thought Bubble, the University of Chichester, the Henry Moore Institute, Dr Mel Gibson, Routledge, Intellect and Molakoe Graphic Design.