Med students put themselves in the picture

Last week I met with an academic who uses comics to build empathy in medical students.

Her name is Shelley Wall and she's illustrator in residence in the medical school at the University of Toronto.

She drew the picture above to better understand her husband's experience of having early-onset Parkinson's disease. It shows the way he adapts his clothes to deal with problems with balance, movement and pain. For example, he wears knee pads to combat frequent falls and boots that help prevent foot cramps. 

When Shelley presented this series at a conference on comics and medicine, people in the audience noted that it was apt that she, as caregiver, appeared in the margins. "There were people in the audience who were caregivers and they said 'We don't often see our story told. The caregiver is, literally, marginalized.'"

Shelley, who's an assistant professor in U of T's biomedical communications, uses comics in a five-week seminar for medical students. "I choose snippets of graphic novels that relate to a scene of a clinical encounter between a doctor and patient," she says. "I get my students to do thought balloons for the other characters. So if the piece is about a doctor's perspective, they come up with what the patient or family is thinking."

Another exercise involves students telling a story about a health encounter or ethical dilemma by drawing three panels of stick figures. After they produce their narrative, they need to go back and redraw it from a different point of view. "It's a way of manipulating stories from different angles," Shelley says.

"As a result of going into the head of someone living through an experience and trying to personalize an event, they come to insights that hadn't occurred to them."

Students are often surprised to discover that each patient has a unique story. "One student said: 'We're going through these checklists to come up with a diagnosis  but every patient has a completely different story and interpretation of what's going on.' That was such a revelation to her."

Shelley says that images are a powerful way to convey health-care experiences. "The reader puts his or her own self and feelings into the image, and there's so much interpretation involved."

When drawing illustrations students need to pay attention to details they might not otherwise. "When you draw someone you really see them in their individuality in a way that you don't if you're just looking at them. You notice things you don't notice if you're not trying to set it down visually."