Graphic Medicine 2016: Stages & Pages

It was lovely to spend a weekend in Dundee, Scotland for the Graphic Medicine Conference at the University of Dundee. Despite coming on the heels of the Brexit vote (or perhaps because of–Scotland voted overwhelmingly to remain in Europe), the city and university provided a perfect location for doing graphic medicine. The University of Dundee is home to the Scottish Centre for Comics Studies and the vibrant DeeCAP (Dundee Comics/Art/Performance) scene. Participants were treated to fabulous keynotes (by Elisabeth El Refaie, Al Davison, and Lynda Barry, who also taught a comics and writing workshop with Dan Chaon). Check out the #stagespages hashtag on Twitter.

Comics&Medicine cfp image

I presented on a panel with Ariella Freedman (Concordia University), Andrew Godfrey (University of Dundee), and Sarah Hildebrand (CUNY-Graduate Center). Andrew was one of the main organizers of the conference and created the fabulous image for the conference above.

Our panel,”Performing Illness,” blended the theoretical and the personal in order to reflect on “illness as performance” in graphic narratives. Calling attention to both form and function, we analyzed how the genre shapes and is shaped by the experience of being ill, and how we might more critically engage with Graphic Medicine by making our own readings more performative. We asked: If comics are indeed stages upon which authors perform their illness, how might Graphic Medicine be used as a filter through which to view and respond to other people’s experiences, as well as our own? How might the subject “become” through drawing? And how might a better understanding of the performativity of patienthood help us break down obstacles to care?

Below is the abstract to my paper, “Drawing en abyme: staging illness and identity in graphic narratives” (for the sake of time, my paper focused mostly on drawing en abyme in Alison Bechdel’s Are You My Mother?).

Jules Valera, a comics artist from Dundee, sketched our panel presenting our papers. You can’t get more meta than being drawn while presenting on drawing en abyme! That’s Jules on the right with her drawing of Sarah and Andrew in the middle presenting his own drawing en abyme.

Meta-drawing-en-abymePerforming IllnessJules Valera's drawing of Sarah Hildebrand


“Drawing en abyme: staging illness and identity in graphic narratives”

In a reading of Jacques Derrida’s use of the concept of mise en abyme[1] as a “fundamental operation of the text” that is “synonymous with textuality” itself, art historian and critical theorist Craig Owens argues that what the mise en abyme does is show how representation is staged in the text.[2] For Derrida, the mise en abyme stages the staged-ness of textuality—textuality en abyme. With this double operation in mind, Owens discusses photography in general and several photographs with mirrors in particular—a “photography en abyme,” arguing that what is depicted in such photographs is not some truth of identity, but “the process of becoming self-reflective.”[3] I want to extend Owens’s extension of Derrida’s use of the concept mise en abyme in order to explore the double operation of what I call drawing en abyme in graphic narratives. Graphic narratives work formally to deconstruct subjectivity in general and the experience of illness in particular. By emphasizing the subject as becoming through drawing, graphic narratives work to render the subject not as something one is, but rather as something one does, in relation to nonhuman objects and other human subjects.[4] Through particular formal elements, including drawing en abyme, graphic narratives demonstrate the ongoing and recursive processes of subjectification and de-subjectification. In this paper, I will explore in particular the way the representation of illness and identity is staged through the doubling of mirrors, photographs, and other imaging technologies in the graphic narratives of Lynda Barry, Alison Bechdel, and Brian Fies.

[1] According to the OED, the phrase “mise en abyme” describes the heraldic device in which a shield includes a smaller version of itself at its center. Andre Gide borrowed the term from heraldry to suggest the device of self-reflection in psychological novels.

[2] Craig Owens, “Photography en abyme,” in Beyond Recognition: Representation, Power, and Culture (Berkeley: University of California Press, 1992), 20.

[3] Ibid, 22. Owens discusses Brassaï’s “Groupe joyeux au bal musette” (1932), Lady Clementina Haywarden’s “At the Window” (c. 1964), and Robert Smithson’s series “Yucatan Mirror Displacements (1-9).” In his essay, Owens is interested in historicizing the device of photography en abyme in relation to the changing understanding of subjectivity in modernity and postmodernity. Although beyond the scope of this essay, I find Owens’s analysis useful in contemplating the concept of self-reflexivity expressed in the age of the selfie.

[4] I am, of course, drawing on Judith Butler’s theorization of gender as something we do, and are compelled to do, not something we are or have as a kind of attribute, as first articulated in Gender Trouble: Feminism and the Subversion of Identity (New York and London: Routledge, 1990). I am also drawing on the work of Annemarie Mol, who describes illness as “something being done to you, the patient. And something that, as a patient, you do,” The Body Multiple: Ontology in Medical Practice (Durham and London: Duke University Press, 2002), 20.


Cover for Indirect Action

This just in from the production folks at University of Minnesota Press–the cover image for my book Indirect Action: Schizophrenia, Epilepsy, AIDS, and the Course of Health Activism (forthcoming in Fall 2016).


Compassion: Keywords in Medical Humanities and Health Studies at MLA 2016

I was thrilled to participate in the inaugural session of the new Medical Humanities and Health Studies forum at the MLA. Catherine Belling organized an invigorating lightning session on Keywords in the Medical Humanities and Health Studies. Here is the list of keywords and presenters:

Pathology (Catherine Belling, Northwestern University)

Care (Sally Chivers, Trent University)

Empathy (Ann Jurecic, Rutgers University)

Compassion (Lisa Diedrich, Stony Brook University)

Mortality (Erin Lamb, Hiram College)

Disability (Rosemarie Garland-Thomson, Emory University and Allison Hobgood, Willamette University)

Health (Kari Putterman, Virginia Polytechnic University)

Life (Matthew A. Taylor, University of North Carolina, Chapel Hill)


We had five minutes each to cover these complex concepts. Here’s what I had to say about (and against) compassion:

In order to consider the term “compassion” in relation to Medical Humanities and Health Studies, I will discuss two recent rhetorical shifts in the use of the term that I argue might help us to diagnose the condition of the Medical Humanities and health care in late liberalism.

The shifts in usage I will discuss are 1. from compassion to compassion fatigue (compassion as modified) and 2. from care to compassionate care (compassion as modifier). I argue that these shifts in usage are signs (or etymological structures of feeling) of the condition of the Medical Humanities and/in health/care in late liberalism.

Big claims + no time = lightning presentation!

The first definition for “compassion” in the OED is “Suffering together with another, participation in suffering; fellow-feeling, sympathy,” but this usage is now obsolete. The current use shifts the emphasis from suffering with another to feeling for or being moved by the suffering of another. Fellow feeling disappears from the definition, and is replaced by a dichotomous and unequal relationship between the one who suffers and the one who is moved by the suffering of another.Even more recently, however, the etymological structure of feeling of the meaning of the word moves us, paradoxically, from feeling (with or for) to the absence of feeling or “compassion fatigue,” first used in the U.S. in 1968 and defined as “apathy or indifference towards the suffering of others or to charitable causes acting on their behalf.”[1] The most frequent early use of the term referred in particular to the numbed response of people in countries with a large and seemingly sudden influx of refugees. Here, a geopolitical phenomenon becomes about the capacity (or lack thereof) for individual feeling. The term is added to the definition of the word “compassion” in March 2002, and currently stands at the end of the entry, almost as if all compassion eventually and inevitably leads to compassion fatigue.

The other rhetorical shift I want to briefly mention is the increasingly frequent use of the phrase “compassionate care.” In the past, care could be good or bad (and everything in between), but when and why did we come to emphasize that our care is or should be compassionate? I contend that this shift happened around 1980, which is also the same time that the phrase “compassion fatigue” became increasingly popularized.

What does the rhetorical redundancy of the phrase “compassionate care” tell us about how we care now?

Emergence of the use of “compassion fatigue” and “compassionate care”: circa 1980

“compassion fatigue” “compassionate care”
0 in 1950-1960

0 in 1960-1970

0 in 1970-1979

117 in 1980-1990

915 in 1990-2000

1241 in 2000-2010

0 in 1950-1960

0 in 1960-1970

2 in 1970-1980

77 in 1980-1990

567 in 1990-2000

992 in 2000-2010

I argue that the redundant phrase is a sign of what we might call, paraphrasing feminist anthropologist Elizabeth Povinelli, the culturalization (and depolitization) of care in late liberalism.[2] It is also a sign of a phenomenon that critical theorist Steven Colbert has described as “truthiness.”

Colbert Truthiness

In fact, I would go so far as to say that compassionate care is to care as truthiness is to truth = the quality of seeming or being felt to be true/compassionate, even if not necessarily true/compassionate.

Colbert No thinking Colbert Head bad heart good

Colbert’s axioms of truthiness emphasize feelings as opposed to thought: “No Thinking”; “Head Bad, Heart Good”; “Check Gut.”

My work seeks to consider these shifts in relation to the emergence of the Medical Humanities as a new discipline—a feeling discipline—in medicine in the late 1960s and early 1970s, and the attempts to institutionalize practices of feeling in medicine in the four decades since. I am interested in this phenomenon in relation to the emergence around the same time of the hegemony of biomedicine and evidence-based medicine. The logic of biomedicine maintains an illusion of separate spheres between science/medicine and art/feeling—that is, compassion as supplemental to rather than internal to medicine.

Thus, I argue in general that compassion has become the “disciplinary imperative”[3] of the Medical Humanities. I conclude by offering three problematizations of the field in relation to this disciplinary imperative: 1. Medical Humanities is the spatial and temporal repository of feelings in and for medicine; 2. Medical Humanities participates in rather than challenges the instrumentalization of care in medicine;[4] and 3. Medical Humanities promulgates a negative disposition toward theory and abstraction that suggests that theory hurts. I offer an alternative that is against compassion, not in the sense of being opposed to feeling in general and compassion in particular, but in the sense of being proximate to it. Such a position helps avoid the trap of Medical Humanities as the soft place where doctors get to feel good about themselves as feeling human beings rather than a hard place of thought about the practice of medicine.[5]


[1] For an even more extensive genealogy of the word, concept, and practices of compassion, see Marjorie Garber, “Compassion,” in Lauren Berlant, ed. Compassion: The Culture and Politics of an Emotion (New York and London: Routledge, 2004): 15-27. Garber’s essay and Berlant’s introduction historicize the term in relation to the political discourse of “compassionate conservatism” around the turn of the 20th century. This feels like a very different moment politically, with the popularity of Donald Trump as reaction formation against a social expectation of the performance of compassion. Berlant seems to anticipate such a reaction formation noting that she was “struck by an undertone accompanying the performance of compassion: that scenes of vulnerability produce a desire to withhold compassionate attachment, to be irritated by the scene of suffering in some way,” “Introduction: Compassion (and Withholding),” 9.

[2] Elizabeth A. Povinelli, Economies of Abandonment: Social Belonging and Endurance in Late Liberalism (Durham and London: Duke University Press, 2011), 26.

[3] I take this term from Robyn Wiegman, whose brilliant work on the disciplinary imperatives of various identity studies and their “proper objects of study” has influenced my thought in immeasurable ways, Object Lessons (Durham and London: Duke University Press, 2012).

[4] In her ethnography of responses to the epidemics of tuberculosis and suicide among the Inuit in Canada in the 20th and 21st centuries, Lisa Stevenson notes that, “Caring, as it becomes an operationalizable concept—something that can be measured and evaluated, fed through a system of best practices and evidence-based science—simultaneously becomes invested in a certain way of being in time. Caring now occurs on shifts, with most shifts between 9 and 5. It is no longer professional to care after hours. Implicit in the system of care is that the object of care must learn to mime the caregiver’s attitudes to time and to care,” Life Beside Itself: Imagining Care in the Canadian Arctic (Oakland: University of California Press, 2014), 134.

[5] For more on compassion as the disciplinary imperative in the Medical Humanities, as well as a call for doing “critical medical studies,” see my essay “Against Compassion: Attending to histories and methods in medical humanities; Or, doing critical medical studies,” in Franziska Gygax and Miriam Locher, eds. Narrative Matters in Medical Contexts across Disciplines (Amsterdam: John Benjamins Publishing, 2015): 167-182.



Cinema and Precarity: Treatment, Risk, Trauma

Looking forward to the NWSA Conference in Milwaukee. I’ll be presenting on a panel entitled Cinema and Precarity: Treatment, Risk, Trauma with Kristin Hole, Dijana Jelaca, and Victoria Hesford.

Here’s the panel description:

This panel brings together papers that explore multifold representational economies of screen precarity in a variety of political, cultural and historical settings. We address the Distortion/Dispossession theme of the conference in examining how controlling images of precarious lives (Butler 2004) are reiterated or countered in various films. From the AIDS crisis and recent engagement with treatment activism, to challenging notions of bodily sovereignty through film language, to female directors’ take on gender and trauma in the aftermath of a violent ethnic conflict, this panel engages in the question of what political and ethical challenges screen precarity circulates culturally. Does screen precarity, as a representational frame, inevitably fetishize bodies in physical and psychic pain, or does it also challenge political complacency (Butler 2009)? How does screen precarity, even when purportedly about past events, inevitably address present-day anxieties, and moreover, how does it stage a screen enactment of “fantasy echoes” (Scott 2001) across temporal and spatial boundaries? In examining how various forms of screen precarity might challenge standard approaches to political agency, the panel pays particular attention to the ways in which screen illness, disability and trauma circulate affective economies (Ahmed 2004) that might constitute an archive of feelings (Cvetkovich 2003) envisioned outside of the temporal and spatial frameworks of neoliberalism.

My paper, Screening Treatment Activism: The Precarious Temporo-Politics of Illness, analyzes the phrase and campaign “Drugs into Bodies” as expressing an ontology of the late capitalist present, a condensation of the complexities of the interaction of medicine, politics, and the multiple and conflicting demands of different temporalities: the emergency time of immediate action and the precarious time of reaching for new forms and phrases to articulate what is and is not yet coming into being, indirectly. I discuss two recent examples—How to Survive a Plague and Dallas Buyers Club—of screening treatment activism, in order to suggest both the ways treatment activism is depicted on screen, as well as what else these representations screen from our view.

Figure A.2

[The viewer is made to feel like a voyeur, as she watches at very close proximity the bare-chested man insert the drip into a line right above his left nipple. Screen capture from How to Survive a Plague (David France, 2012)]