Graphic medicine

Graphic medicine uses comics to communicate about health, illness and care. Sequential images and words can explain processes, convey personal experience and invite reflection, while their use in health information calls for evidence, cultural relevance and transparency about how the story was made.

Form and development

Graphic medicine is an interdisciplinary field within the health humanities covering the creation, use and study of comics in medicine and health. ^{1, 2} Comics place images in a deliberate sequence to convey information or evoke an aesthetic response, often combining text and pictures as parallel narrative tracks. ^{1, 2} Related terms include graphic novel, sequential art, graphic literature, comics journalism and graphic narrative. ³

Health comics were common from the mid-eighteenth century, largely as public-health morality tales, and US newsagents sold medical titles alongside superhero comics in the 1950s. ¹ Health comics revived around HIV/AIDS, and physician-artist Ian Williams founded the Graphic Medicine website in 2007 as a forum for exploring their use in healthcare. ¹ By 2024, communities existed in Italy, Japan, at Berlin’s Freie Universität and in Spain, where Mónica Lalanda co-founded Medicina Gráfica. ¹

Uses and reading experience

Graphic-medicine content has three overlapping uses: ^{1, 2}

• Educational comics can explain complex processes, support patients’ involvement and treatment decisions, ease anxiety about procedures and potentially encourage behaviour change.
• Personal illness stories, or graphic pathography, can voice anxiety and fear, provide reassurance through shared experience and foster empathy among clinicians and students.
• Therapeutic reading or collaborative comic-making can help people explore possible outcomes and cope with distress, including patients’ anxiety and clinicians’ burnout or moral injury.

^{1, 2}

Personal stories can use humour as well as direct accounts of illness. ² MK Czerwiec’s Taking Turns exemplifies comics addressing clinician distress, while the Graphic Medicine International Collective’s virtual Drawing Together sessions illustrate collaborative production. ^{1, 2}

Comics can also make technical material accessible to time-poor professionals. ¹ Argha Manna’s Beware of Droplets and Bubbles presents fluid-dynamics research on disease transmission in the COVID-19 context, reducing the need to work through a mathematically dense report. ⁴ Text and image appear together, and the permanence of a panel lets readers return to it and control their own pace. ^{1, 4} Studies have linked comic formats with improved understanding and retention. ^{1, 5}

Comics can attract attention and provide enjoyment; their visual narrative can also reach people who understand the pictures more readily than the text. ⁶ They adapt readily to digital publication and social sharing, while motion comics add dynamic elements to otherwise static panels. ⁷

Acceptance, evidence and trust

Limited awareness and perceptions of comics as juvenile or lacking academic rigour can impede their use in health communication, particularly in the United States. ^{8, 2} Counterexamples include the CDC’s 2011 zombie-apocalypse preparedness comic and Surgeon X, set in a near-future antimicrobial-resistance dystopia. ⁸ In France, the bande dessinée is culturally mainstream; resources include SantéBD’s free, expert-reviewed health comics and the BD Medicales directory. ⁸

Graphic medicine can include anecdote, politics, aesthetics and emotion, which differ from conventional scientific discourse. ^{9, 10} Narrative and emotional appeal can be used cynically, so health comics should be evidence-based, fact-checked, referenced and subject to rigorous peer review. ^{9, 7} Target-audience review is also desirable to check cultural relevance. ⁷

Drawings visibly interpret reality, and uncertainty about the creator’s interpretation can make viewers distrust a health comic. ² Transparency about research strategies, methods, sources and production helps viewers distinguish fact from fiction and judge that interpretation. ¹¹

Five authentication strategies

Weber and Rall’s five authentication strategies were applied to an eight-panel health comic based on an interview with an aesthetic nurse about platelet-rich plasma treatment. ¹²

1. The writer’s presence: the writer appeared as the client but disclosed that she had received a similar facial treatment rather than the procedure depicted, a creative liberty she judged consistent with showing how the treatment was performed.
2. Physical resemblance: headshots of the interviewee, illustrator and writer accompanied the comic, showing the people behind it.
3. Style: cartoon devices such as motion lines, sound words and thought bubbles were limited, and the spa was drawn from a photographic reference.
4. Documentary evidence: fact boxes described the procedure, with links to the nurse’s business page and the device manufacturer’s website.
5. The meta-story: the comic supplied its interview date and biographies of the interviewee, writer and illustrator, making research and production circumstances visible.

^{13, 14, 15, 16, 17, 18}

Showing who made a comic, whom its drawings represent and how it developed can also challenge the assumption that comics are only for children. ¹⁹

Production and visual techniques

A writer can learn to draw and use graphic-design software or commission an illustrator or comic artist when the project warrants it. ⁷ Basic design knowledge is recommended, and achieving polished work takes time. ⁷

A physician-illustrator’s workflow

In 2024, physician-illustrator Mónica Lalanda described turning medical literature, institutional information and personal ideas into simple drawings and text. ^{20, 21} Her outputs included single cartoons for patient or professional information and activism, and comics of one or several pages. ^{22, 23} She concentrated information, filtered out complication and sought a simple visual expression of its central idea. ^{23, 24}

Her style used very simple drawings, few backgrounds, no shadows, consistent fonts and yellow as a signature colour, aiming to convey the idea rather than display drawing technique. ^{24, 25, 26} She had little formal drawing training and followed the keep-it-simple principle, inspired by the creator of Mafalda and a Spanish cartoonist whose work captured medical life. ^{27, 24, 28} Since 2019 she had used a tablet rather than crayons. ²¹

Drawing devices

• An empty white coat represented a doctor, became a Christmas tree or a bullet, and appeared in images about working conditions, dismissal and remembrance; one memorial honoured 144 Spanish doctors who died working during the pandemic. ^{25, 29} Its absence could emphasise that a doctor was a person first. ³⁰
• Viewpoint changed whose experience was shown: an overhead view for a death in intensive care, a patient’s view of a doctor looking at a screen, or a doctor’s view of a patient with a relative behind them. ^{30, 31, 32}
• A divided frame contrasted different views of the same person, while a central image with text or smaller drawings around it used emotion to draw attention to the surrounding material. ^{32, 33}
• Relative size conveyed power or difficulty, such as a patient shrinking as consent information became harder to understand. ³⁴ Repeated panels with small changes showed waiting, fatigue across a shift or a lifetime. ^{34, 35}
• Hyperbole and metaphor made abstract ideas visible in one look; sea and wave imagery supplied metaphors, and drawing also helped her communicate about mental health. ^{35, 36, 37, 38}
• Simple facial expressions carried meaning, and lettering could itself become part of the image. ^{39, 38}

She also adapted familiar pictures for amusement or commentary, revisiting a pandemic-era superhero image to portray health professionals as society’s broken toys. ^{37, 40}

Publication and conversation

For social media, Lalanda preferred square drawings that could be understood at one glance and short, simple text. ⁴¹ She found that text-heavy drawings were shared less widely. ²⁶ A simple drawing about a difficult subject such as death could invite reflection, open a deeper conversation or prompt someone to read the article behind it. ⁴²

In 2024, she described most of her work as online and freely shared for reuse, with a medical-ethics comic textbook, a card pack and collaborations among the printed exceptions. ^{43, 44, 45, 46} Searching her name could locate many of the drawings. ^{43, 45}