THE ARTS AND MEDICINE

Graphic Medicine—The Best of 2020

Michael J. Green, MD, MS; Shelley Wall, AOCAD, MScBMC, PhD, CMI

U
nsurprisingly, some of the most important and inter-
esting work in graphic medicine in 2020 related to
the coronavirus pandemic. The sheer volume of com-
ics-based material related to coronavirus disease 2019 (COVID-
19) is immense and growing daily. For this reason we focus on
web-based COVID-19 comics rather than individual book pub-
lications as we have done in past year-end reviews and group
some of the more notable efforts into emergent categories of in-
structional, personal stories, and therapeutic comics, highlight-
ing some of the most interesting exemplars in each category.

Figure 1. Creativity in Captivity

Published with permission from Gemma Correll.

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Figure 2. Excerpt from In/Vulnerable, June 8 interview with Dr Rajnish Jaiswal, New York
By Anjali Kamat, Thi Bui, Sarah Mirk, and Amanda Pike. Copyright Reveal News, 2020. Reproduced with permission.
Instructional Comics
Comics are particularly well-suited to visually explaining com-
plex processes and to harnessing narratives for behavioral
change. In the COVID-19 era comics have served the instru-
mental purpose of explaining complex information and visu-
ally presenting public health advice.
Early in the pandemic, various artists created comics that
introduced the novel virus to the public, showing how it’s trans-
mitted and what people can do to protect themselves.1 These
ranged from comics geared toward children to highly sophis-
ticated explanations. One particularly illuminating example is
Argha Manna’s beautifully illustrated “Be Aware of Droplets
and Bubbles!!”2 Manna created this comic during strict lock-
down in India, basing it on highly technical research from MIT’s
fluid dynamics lab.3 Manna’s drawings are both informative
and entertaining, showing what happens at the microscopic
level when viral particles are discharged via a cough or sneeze
and incorporated into a bursting fluid bubble. Manna further
scales the drawings to show the human toll the virus takes
when people do not heed commonsense recommendations re-
garding coughing, sneezing, and spitting. Like many of the best
comics, this one transports readers into another world through
visual imagery, teaching us about fluid dynamics and conta-
gion along the way.
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Another comic, The Side Eye by Toby Morris and Siouxsie
Wiles,4 uses static images and .gif animation to show how the
virus replicates and spreads, employing visual metaphors to
connect viral replication on the micro level with transmis-
sion at the macro level. By scaling up and down and using se-
lective colors, the authors explain the epidemiology of the pan-
demic, showing the impact one person’s infection can have on
an entire population.
Knowledge about how the virus has spread is reflected by
the changing tenor and focus of COVID-19 comics. Early in-
formational comics centered on questions such as the mean-
ing of “flattening the curve,” viral transmission, and self-
protection. More recent comics address specific aspects of the
disease such as pandemic modeling or the impact on particular
subpopulations.
Personal Stories
Comics are also helping to document the vast range of lived
experience during the pandemic, including the absurdity of life
in social isolation. Gemma Correll, for example, 5 in her
“Creativity in Captivity” comic, uses split panels to contrast
“what I think I’ll do during the ‘shelter-in-place’ order vs what
I’m actually doing” (Figure 1). While funny, her scenarios verge
on a kind of hysteria, hinting at the disorienting limbo brought
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on by the disruption in routines that we previously took for
granted. The sense of teetering on the edge of despair is pres-
ent in many of her comics—increasingly so as the months wear
on. In “Save it for a Rainy Year,”6 readers are invited to use cray-
ons with names like “viral particulate green” to color in im-
ages of “unhealthy coping mechanisms”; the comic con-
cludes with a dark circle, labeled “the void,” into which the
reader is invited to scream. Correll gives voice to the anxiety
so many of us are experiencing and mitigates it with humor.
The deadly reality of the pandemic has been captured by
graphic journalists, who combine reportage and the comics me-
dium to document real-life stories.7 A notable example has
been the series “In/Vulnerable: Inequity in the Time of
Pandemic,”8 a collaboration between the Center for Investi-
gative Reporting and The Nib, illustrated by Thi Bui. This se-
ries translates interviews with people from all walks of life, liv-
ing across America, into graphic snapshots of the ways
COVID-19 has affected individuals, and it reveals the fragility
of our institutions. For example, the story of Dr Rajnish Jaiswal,
an emergency physician, questions what it will take to pro-
cess the experiences of frontline workers as he and his col-
leagues fall ill while trying to help an overwhelming influx of
patients. Douglas Hawkins, a funeral director, asks what ef-
fect social distancing measures will have on the grieving pro-
cess. Tawanda Jones, a teacher, weighs the threat of COVID-19
against the call to protest the simultaneous scourge of anti-
Black racism. Each comic uses a unique monochromatic hue;
together, they form a multicolored quilt that reflects the di-
versity of people’s experiences (Figure 2).
Comics as Therapy
A final category is the use of comics-making for therapeutic pur-
poses. Many people have turned to comics-making as a way to
combat the stress, anxiety, and isolation during the pandemic
via online drawing sessions and the publication of reflective
activities. The Graphic Medicine International Collective,9 for
example, has hosted regular “Drawing Together” sessions in
which participants are guided through live participatory exer-
cises that use comics as a vehicle for self-reflection, coping, and
community building. Moreover, The New York Times has fea-
tured a regular “Diary Project” in which comic artists some-
times provide prompts to readers in the form of drawing/
writing exercises. Anders Nilsen, for example, depicts his own
experience and offers a drawing activity for “wrapping our
heads around something this big.”10 These participatory uses
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The Arts and Medicine
of comics have expanded the medium from one of passive con-
sumption to collaborative, therapeutic production.
In this extraordinary year, comics have helped us to un-
derstand, express, and process our collective experience with
an unprecedented global health crisis. Many of these comics
can be found on the Graphic Medicine website, and more are
appearing each week. As the pandemic advances, we are for-
tunate to have such a rich and nuanced visual documenta-
tion of this borderless disease.
Author Affiliations: Departments of Humanities and Medicine, Penn State
College of Medicine, Hershey, Pennsylvania (Green); Biomedical
Communications Graduate Program, Institute of Medical Science, Temerty
Faculty of Medicine, University of Toronto, Toronto, Canada (Wall); Department
of Biology, University of Toronto Mississauga, Mississauga, Canada (Wall).
Corresponding Author: Michael J. Green, MD, Department of Humanities,
Penn State College of Medicine, 500 University Dr, Hershey, PA 17033
(mjg15@psu.edu).
Published Online: November 30, 2020. doi:10.1001/jama.2020.19479
Conflict of Interest Disclosures: Drs Green and Wall reported being founding
board members of the Graphic Medicine International Collective.
Additional Information: The online and PDF versions of this essay contain
embedded hyperlinks to the featured comics.
1. Kow W. How COVID-19 spreads. Published April 25, 2020. Accessed October
5, 2020. https://www.comicsforgood.com/weimankow/how-covid-19-spreads
2. Manna A. Be aware of droplets and bubbles!! Published 2020. Accessed
October 5, 2020. https://drawinghistoryofscience.wordpress.com/2020/03/
25/be-aware-of-droplets-bubbles/
3. Poulain S, Villermaux E, Bourouiba L. Ageing and burst of surface bubbles.
J Fluid Mech. 2018;851:636-671. doi:10.1017/jfm.2018.471
4. Morris T, Wiles S. Viruses vs everyone: three simple points about the science
of Covid-19. The Side Eye. Published March 25, 2020. Accessed October 5,
2020. https://thespinoff.co.nz/covid-19/25-03-2020/the-side-eye-viruses-vs-
everyone/
5. Correll G. Creativity in captivity. Published March 19, 2020. Accessed
October 5, 2020. https://thenib.com/creativity-in-captivity/
6. Correll G. Save it for a rainy year. Published August 6, 2020. Accessed
October 5, 2020. https://thenib.com/the-quarantine-fun-page/
7. Weber W, Rall H-M. Authenticity in comics journalism: visual strategies for
reporting facts. J Graphic Novels Comics. 2017;8(4):376-397. doi:10.1080/
21504857.2017.1299020
8. Bui T. Inequity in the time of pandemic. In/Vulnerable. The Center for
Investigative Reporting. Published May 18, 2020. Accessed October 5, 2020.
https://www.revealnews.org/invulnerable/
9. Drawing Together. Published March 2020. Accessed October 5, 2020. https://
www.graphicmedicine.org/drawingtogether/
10. Nilsen A. How do we wrap our heads around something this big? The Diary
Project. New York Times. Published 2020. Accessed October 5, 2020. https://
www.nytimes.com/2020/06/12/arts/anders-nilsen-diary.html
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