MK Czerwiec is a cartoonist, teacher and nurse. She is the co-author of The Graphic Medicine Manifesto, and the cartoonist behind the graphic memoir Taking Turns: Stories from HIV/AIDS Care Unit 371. She also runs the website GraphicMedicine.org.
Czerwiec’s new project is Menopause: A Comic Treatment, just published by Pennsylvania State University Press. The book is the first anthology Czerwiec edited, and she assembled an incredible lineup of comics creators and scholars to tell stories about the complicated personal experience and medical concerns of menopause. Alternately educational and funny and enlightening and heartening, the book finds a way to encompass many facets and experiences and perspectives, and in doing so, to offer a new possibility for people to understand what menopause is and what it can mean on so many levels.
Czerwiec and I met at last year’s Queers and Comics conference in New York City, and we spoke recently about her work, Graphic Medicine, and what comics can do to help medical professionals and patients learn about illness.
To start, how did you come to comics?
You’ve read Taking Turns so the story is kind of in there. I was working as a nurse during the AIDS crisis and trying to process all the difficulties of that work. I would write in a journal, but the words were too traumatizing. They just weren’t right. I would paint images, but I felt like that wasn’t telling the whole story.
One day I came to comics in desperation. I’d had a horrible evening at work, and the next day I had to be ready for work at 3 o’clock for those patients, not busy grieving my own losses. I sat down with a piece of paper and drew this picture of myself. I put some words over it, something like, “I feel miserable” and then drew a box around it. Then I thought about Lynda Barry, about her comics were not happy, they could be about serious, difficult times too. Her work felt like a window into a different world where you could talk about serious stuff. So I drew another box and kept going. Nine panels later, I found myself in a place of hope. It blew my mind. Drawing this comics did what I needed it to do – help me come to a place of hope and healing. I couldn’t believe it. There’s something about image and text sequentially that’s such a powerful way to process information and experiences. That’s how I started making comics.
From that moment to making a book like Taking Turns, what was your journey?
I just kept making comics to survive during that time. I had amassed this group of comics and I knew I wanted to take them to the next level. This was about 2000 and I didn’t think you could study comics. I suppose I could have learned to draw, and I am still working on that all the time, but what was important to me then was to inform the comics I was going to make with some theory. I wanted to make more formalized comics about the AIDS crisis and it was important for me to understand how and why story helps us heal. What is the illness narrative? How do we tell stories about our bodies? Also, what were my ethical responsibilities making stories about my patients? That was important for me to understand deeply before I could move forward with this work.
It turns out there’s a whole field called Medical Humanities and Bioethics, also now called the Health Humanities. So I got a master’s degree in that field, thinking about my comics all along. Right as I was emerging from that program, I was at the Museum of Contemporary Art in Chicago and stumbled on Brian Fies’ Mom’s Cancer. This is after I spent two years focusing from different disciplinary lenses on what we do in healthcare — critiquing healthcare from a literary perspective, a medical anthropology perspective, a bioethics perspective, etc. Thinking so much about healthcare, and then to read that book – and know that that book was in comic form! Until that point, I wasn’t talking about my comics in my academic pursuit, but in the back of my mind, I knew I was doing all this to make better comics. Brian’s book gave me the courage to say, “Are there other books out there like Mom’s Cancer? Do other comic books exist by people going through these kinds of experiences, targeted to people wanting to learn? I thought that if doctors and nurses would read this stuff, they would get some insight into the lived experience of illness that we don’t see outside of hospitals and clinics. These nonfiction comics show us what happens at home, how patients feel about what we do to and for them. What a powerful teaching tool! I started looking around and exploring this topic, and in the process, I met Ian Williams – who had run into Mom’s Cancer at the Tate Museum in London! The same book was this pivotal event for both of us. Ian coined the term Graphic Medicine. He’s a physician who is also a cartoonist. He was studying medical humanities as well. He said, “I’m at an institution that could sponsor a conference.” My colleagues Michael Green and Susan Squier from Penn State worked with Ian to organize the first conference on comics in health care, and I attended, in London. Then a group of people got together to ask, could this really be a thing? The answer was yes! It has just grown and grown, for the past decade. I think part of the reason we’ve seen so much expansion in this area is because a lot of people were already combining comics and health care, but not really talking about it. So once we gathered this critical mass of people, the community started becoming bigger and bigger. It’s a great marriage of this medium of comics, how good they are at distilling complex information and how complex our health experiences are. That’s the long story of how this whole thing happened. Once I finished grad school I developed my own elective course at Northwestern Medical School, using comics. A group of us got together to write the Graphic Medicine Manifesto. Then the movement has just continued to grow.
You write in the introduction to Menopause about how the project started. Why did you want to make an anthology as opposed to making a book on your own?
I’m very influenced by the disability rights movement and a frequently used slogan in it is, “nothing about us without us.” To me that means that everybody speaks their own voice. I wanted the wisdom of other experiences of others experiencing menopause in their own hand. I knew I could only tell a part of the story, and I wanted a bigger picture. Since it was going to be an anthology of comics, I turned to people from Graphic Medicine and the Queers & Comics communities. Between those two groups, I knew enough people who I thought would be amazing at this. I wanted to learn from what they had to say and show me about this often disorienting bodily experience.
This was your first time editing a book, so once you start with that premise, what comes next?
I started by targeting people that I knew would do great comics on this topic. And then I tried to be intentional about making sure I was attending to different stories. I wanted a variety of perspectives. I wanted to make sure it was a diverse group of stories in content, cultural history. The first step was just sending out an e-mail, asking if people would be interested in contributing to this kind of collection, and if they would be, sharing what I was looking for in terms of content and philosophy of the collection. I also emailed people like Jen Camper who knew a lot of people who could ensure I was getting that kind of diversity I wanted. I still didn’t have absolutely as much as I wanted, but I feel like I did a decent job in terms of stories and backgrounds. There were a few more people I wanted to include, but they were on a book deadline or for another reason couldn’t contribute. The book took so long to go to press, that two of those people actually finished their books and I was able to circle back to them. For example, I really wanted to know what Carol Tyler had to say. I really shook her down because I wanted her in this collection and when she finished Fab4Mania, she made a great comic. Ellen Forney was another person I really wanted in the collection after she finished Rock Steady.
You have a trans artist talking about what menopause means. You have a piece by the late Teva Harrison about surgical menopause. You were clearly trying to get at menopause and what it means from as many perspectives as possible.
The Teva Harrison example reminds me that there were pieces I knew were out there. Three pieces in the book had been published elsewhere.
Teva’s piece, Roberta Gregory’s piece and I forget the other.
Mimi Pond’s “When the Menopause Carnival Comes to Town.” It wasn’t in print, but it had been published online on Topic. The book was about to go to press, and I saw that comic and I said, “We must have this!” That’s why it’s a little oddly formatted because there was no time for it to be redrawn or make a new layout. It was drawn for online.It’s a show piece, it’s beautiful.
The comics by her and Carol [Tyler] and Joyce [Farmer] are especially amazing. Joyce’s piece really brings the house down. You had to close with her comic.
Isn’t she amazing? I am so grateful to have gotten to know Joyce from featuring Special Exits at Graphic Medicine conferences. She is amazing. She came to our conferences and you probably know, sometimes you have guest speakers and they do only their talk and then leave. She wasn’t like that at all. She went to something every session.
Lots of comics readers will know them or people like Lynda Barry and Jen Camper and Leslie Ewing. You also included a number of other people involved in Graphic Medicine that comics readers might not know. This is also part of what you were saying about different perspectives.
Absolutely. One that comes to mind is Ann Fox. There were a couple reasons of why it was important to me to include Ann’s work. One is that this was the first comic Ann ever made. She’s a Disability Studies scholar and she teaches Graphic Medicine, she gets her students to make comics. I said, “I want to see what you’ll do!” I knew her story about being a “crockpot runner” and I wanted something in the book about conquering something new during this time of life, something about physical activity that wasn’t judgemental, punitive, but rather wholistic, honest, and, for lack of a better word, empowering. Body stuff for women can be such fraught territory of policing and you should be doing x,y, or z thing. I didn’t want a piece that said, you should do x,y, or z. What I did want was to gesture to the empowering story that Ann had to share. On the surface her story has nothing to do with menopause, but I think it does. I love the sense of acceptance of one’s body as is, and moving in the world from that place. As she says from a disability studies perspective, embracing the capacity that my body has and adaptation of the world to our real bodies, rather than the other way around. Also patience with our bodies. I wanted to make sure to include that approach in they collection.
There’s a famous saying that the plural of anecdote is not data. I’m curious in this book, and Graphic Medicine in general, how do you find a way to talk about the value and meaning of individual experience without getting caught in the fact that it is just anecdotal?
That’s a good question. Arthur Frank, who’s a medical sociologist, talks about this notion of letting stories breathe. The first thing that comes to mind is that if a story has enough breathing room in it we can find a place to connect with the story. As an editor, that’s what I’m looking for. Does the story have enough room to breathe in it? Can readers walk around in it and have empathy? Someone reading this collection may not find themselves in it, but it’s generous enough and has enough room to breathe that we find a commonality of human experiences or empathy for these experiences, and learning about these realities.
I keep thinking about how much of medicine regarding women does not get acknowledged or examined. Women present autism differently than men, so don’t get diagnosed. Heart attacks, same thing. There are so many examples. I kept thinking about menopause and how much misogyny and indifference have affected what we know. And individual experience is a way to fill that gap and push against that.
I think so, too. Since doing this book I’ve gotten to know people who are really trying to build community around this area and some kind of consensus. Part of it is, as you were saying, this lack of knowledge. Well, that’s exactly what it feels like when you’re the person going through it. As I wrote in the introduction, I couldn’t find any information that was actually helpful for me. I know someone who’s working to establish an agreed upon set of symptoms. It’s the product of lack of data and lack of research – because of a lack of priority. You can’t come up with a drug to fix it or make it go away. That’s part of it, too. We’re all scraping together information and trying to figure out a consensus and what we can agree upon.
That’s the flip side of the anecdote/data line. In the absence of solid data, lots of anecdotes are information.
And ultimately that becomes data. When you’re asking people if you can find a common ground, it becomes data.
Because this was the first book you edited, what its made you think about your work and what you want to do next?
Two things come to mind. I want to edit an anthology about nursing. Our field is called Graphic Medicine, I teach at a medical school, but I’m a nurse. Nursing has obstacles that are specific to nursing and not medicine. I did a bunch of translational comics for this study called the Woodhull Study, and the gist of it was that nurses are not quoted in the media about health – doctors are. Even if the subject is in the realm of nurses. This was a study done in 1990 and then was replicated to see what the change and it actually got a little worse. There were a lot of factors looked at why that is, and one is that people don’t really know what the day-to-day work of nurses really is, the full range of our expertise. Many nurses can be terrible at making their work known. One of the goals of Graphic Nursing would be to take those varied expertise areas of nursing, and the work that do and show that work in comic form. I think that would be the next editing project I will do.
Then, the second project I have in mind is following along the lines of my book Taking Turns. The area of Graphic Medicine and nursing that I focus most of my expertise on is in end-of-life and hospice care. I think I want to do a long-form comic on this topic, integrating personal, academic, and professional perspectives. The project has to do with end-of-life care, the notion of “the good death,” trying to provide that for my patients and for my own family members. There’s a lot there and I’m trying to sort it all out. I had a great instructor who once said, “You bake a whole cake, but you serve slices.” So, I know what the cake is now, I just don’t know what the slices are for this project.
Someone told me recently that the Pieta became popular during the Black Death. That we couldn’t be with people as they died so we found a way to represent that. I haven’t really been able to stop thinking about that, but I’m curious what that means about comics and graphic medicine at this moment.
It’s funny you should ask, because I just delivered a lecture last week about COVID-19 comics to my graduate program in Medical Humanities. It’s so interesting that you said that. I hadn’t heard that connection between the Pieta and the plague, and I think it’s really interesting to think about that because there is a kind of image that has emerged from COVID comics, of this lone caregiver in PPE sitting with a patient in an ICU. Sometimes too the presence of an electronic device, trying to connect with the family member who are not there. You can see the presence of the professional caregiver and the ventilator – one relative stranger and technology.
The other thing I think is really interesting about comics in the COVID pandemic is that comics are uniquely situated to be relevant in this moment. Because HIPPA and the contagion making it unsafe for cameras and news crews in the hospitals, you’re not going to get the images of what is happening inside these units, the sense of crisis, of agony. Comics are able to do that work.
They’re difficult images, but they are important. Just like Menopause, to bring it back to the book. It’s a great book. And I’m sure Joyce and others were like, I’ve been waiting for someone to say, tell me what you really think about menopause!
Yes. It’s funny because I was teaching at the University of Wisconsin and the collection was getting wrapped up and KC Counsilor, one of our contributors, who had brought me to work with students there, asked, “Do you have a comic from Lynda? I really think she wants to do one.” I didn’t want to push, but he said, “You really should follow up!” Lynda said yes, and, despite all her other work and deadlines, and teaching, made this amazing comic! We are so grateful to have her in the collection!