On Picturing Epilepsy: An Informed Reading of ‘Epileptic’

Claire Jeantils explores David B.’s Epileptic through the lens of graphic medicine, arguing that care must be taken when using illness comics as teaching tools.

In 2010, Ian Williams identified the specificities of illness comics and coined the term ‘graphic medicine’ to describe (auto)pathographies in comic form (Czerwiec et al. 2015, 4). While novels and autopathographies are restricted to the use of words only, comics can renew the illness vocabulary as well as its iconography. Graphic medicine draws upon narrative medicine to understand how illness is portrayed in comics, and what this says about the ways society treats the sick (Charon 2006). It brings forward different (sometimes marginalised) experiences of illness and helps conceive of healthcare in a new way. Comics, informed by graphic medicine, can make it easier for readers to understand illness, updating their knowledge and challenging them to modify their previous perceptions.

The cover of Epileptic by David B.
Cover of Epileptic by David B. published by L’Association https://bit.ly/3L44jFK

Graphic medicine seems like the perfect tool to read David B.’s Epileptic (B. 2015), which tells the story of David B.’s brother Jean-Christophe, who has epilepsy, and his family’s attempts to fight against the illness. Epilepsy is a neurological chronic illness that manifests mostly through seizures, which often surprise the sick person and/or people around them. Many specialists consider that there are as many epilepsies as there are people with epilepsy: epileptic seizures can vary from one person to another as well as from one period to another. This diversity is still not widely understood and people with epilepsy suffer a great deal from stigmatisation and misunderstandings about their illness. We generally picture epilepsy as a tonic-clonic seizure where the ill person convulses and releases different secretions (urine or saliva). However, there are many other types of seizures, such as absence seizures, where there’s barely any bodily movement. Moreover, there are other symptoms that most people don’t know about: strong headaches, memory loss, mood swings, difficulties in focusing, etc. But for a lot of people, epilepsy equals seizure so, for them, when there’s no seizure there’s no epilepsy. The person with epilepsy only seems to be sick/not their self/weird ‘from time to time’. Thus, the stigmatisation process is doubled.

Questioning the links between picture and symbol

Graphic medicine focuses on the apprehension of narrative in the illness or care relationship, as well as on medical discourse and the language of pictures. In doing so, it questions the links between picture and symbol. According to Sander Gilman, the icon is what “represents objects through a relationship of similarity by exemplifying some property associated with the object” (Czerwiec et al. 2015, 118). Pictures in comics are based on simplification and generalisation. So, what are the symbols of illness in Epileptic; how have they been simplified and generalised?

For a picture to ‘work’ in a comic, it needs to be already stored in the reader’s mind so that it can be deciphered. The author needs to guess/deduce what the reader knows or not. Will Eisner argues that the absence of dialogues explaining the action in a comic proves that drawings based on shared experience actually work (Eisner 2019, 16). This implies that when comics deal with representations of illness and the body, they use a gnomic visual vocabulary. Eisner goes further by assembling a facial expressions repertoire. According to him, we all share a nonverbal gesture vocabulary (Eisner 2019,109). But the bodily codification truly depends on the author’s point of view.

Ethical issues: external viewpoints and framing

Epileptic is a pathography; David B. tells of Jean-Christophe’s epilepsy and not his own, so some drawings can be stigmatising for people with epilepsy. The reader gets to see the epileptic seizure from an external point of view (in the form of a monster) and how it is experienced by the people surrounding Jean-Christophe. This monster, which looks like a mythological snake, cannot be restrained to just one box; the reader only gets to see parts of it. Its eyes and body, covered in lines and circular figures, symbolize the chronic aspect of the illness, as well as the never-ending pains epilepsy inflicts on the body and the mind. However, Jean-Christophe’s seizures are always represented in the same way, whereas we know that his epilepsy evolves.

Framing is another aspect of comics’ grammar that raises several ethical issues. The comic box frames the chosen events and scenes and acts like punctuation. The reader must imagine what links each box as it is impossible to represent everything on the page. Still, the concept of framing underlines the fact that the reader has access only to what the author agrees to give them. Of course, this is already what’s going on in literature. However, those black lines, acting as walls within the artwork, are far more impactful than a mere full stop. The box determines the length and the importance of the scene. According to Will Eisner, the boxes are organised in a way that seems to bridge the gap between each one of them (Eisner 2019, 45). But when dealing with epilepsy, many symptoms other than the epileptic seizure can drop into this in-between void, the symbol of forgetfulness. It is the reader who must bridge the gap within their understanding of the story and their representation of the world. Because the seizure is the event, it is the focus of attention, whereas the other aspects of the disease are just ‘occasional’. So the actual temporality of the seizure, as well as the ontological troubles and the memory loss one can experience because of epilepsy, risk disappearing in the reader’s mind. If they appear it is as a proper event, which means in a box. Framing can trouble chronicity’s representation by hiding some facts and underlining others.

Reading Epileptic with full attention

Epileptic is generally seen as a masterpiece in the comics world as well as in healthcare disciplines. From graphic medicine to epileptology (Watson 2020, 20), many scholars praise this artwork’s representation of epilepsy. The density of drawings (in motifs and lines) and their honesty, create a new perception of epilepsy: that of the patient’s family. By documenting the evolution of his brother’s epilepsy and how his family tried to help him, David B. opens up on how he felt personally and how he used to picture epilepsy as a child. This take on chronic illness is very interesting because as the reader we get to see the illness’s evolution and how the family suffers also from it.

However, many aspects of Epileptic need to be read with attention. In Epileptic’s Volume 2 for example, Jean-Christophe suffers a seizure on a train after six months without any. The seizure is summed up in only seven boxes. The previous comic strip boards don’t allow the reader to see the period in-between seizures (what we call the interictal phase), how Jean-Christophe experiences it, and what the other symptoms were during this period. Only three aspects allow the reader to identify the seizure: bodily contortions, saliva, and uncontrolled onomatopoeias coming from his mouth. Here we see once again the basic and generalised iconography of epilepsy also because it is set from a witness’s point of view. After this box, the post-ictal phase is forgotten, and the narrative focuses directly on the consequences of the seizure on Jean-Christophe’s mother and her first thoughts after ‘the event’. This page also explores the other passengers’ reactions, but not Jean-Christophe’s, how he seems to feel afterward, nor the psychological consequences/risks of suffering a seizure after being seizure-free for six months.

The medium cuts up experience, and readers need to be aware of that when they read illness comics. I argue that it is also the author’s ethical responsibility to give resources to their readership so that they can bridge the gap between each box. Scholars in graphic medicine, healthcare, or medical humanities must be careful when using those tools for teaching purposes. It is our role to decipher what can be shameful, stressful, or stigmatising for persons with chronic illnesses and to bring it forward. Thus, graphic medicine, although a pertinent interdisciplinary field, still needs to be more critical.

 

References

B., David. 2015. L’Ascension du Haut Mal. Paris: L’association.

Charon, Rita. 2006. Narrative Medicine: Honoring the Stories of Illness. New York: Oxford University Press.

Czerwiec, MK, Michael J Green, Kimberley R Myers, Scott T Smith, Susan Merrill Squier, and Ian Williams. 2015. Graphic Medicine Manifesto. Penn State University Press.

Eisner, Will. 2019. Les clés de la bande dessinée, Vol. 1, L’Art Séquentiel. Paris: Delcourt.

Watson, Neil. 2020. “Epileptic: David B.” Practical Neurology; 20: 433. http://dx.doi.org/10.1136/practneurol-2019-002437

 

About the author

Claire Jeantils is a third year PhD student in medical humanities at the French National Centre for Scientific Research. She researches French and Anglophone epilepsy narratives. You can find her on Twitter @ClaireJeantils.

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