Drawing from experience
Comics by Jason Bitterman and students from Comics in Medicine
"Tell a story about a personal experience with health care and do that by drawing it.”
That was an assignment for the Comics and Medicine course offered in November 2022 to fourth-year Pitt Med students. They were asked to draw and write as a patient, a medical student or someone standing by a friend or family member dealing with a health issue. The experiences they chronicled varied—deciding on a career in medicine or overcoming burnout, for instance. One student was surprised to find herself recounting the aftermath of a sexual assault. Yet the projects they took on had a common outcome.
Students say they walked away from the assignment with a deeper understanding of their experiences, a new way to express their emotions and the ability to better cope with stressors—all insights they expect to rely on as doctors to keep themselves grounded and to offer the best of themselves to their patients.
For most, the course was also a chance to relax in the classroom after three grueling years of study and exams. “It was a super-not-stressful thing to do,” Vinod Rajakumar says. His classmate, Vaidehi Patel, admitted as much and adds there was a certain allure in exploring her chosen field through a different lens.
“I personally find it hard to express myself in words,” she says. “I’m more of an artistic person who finds it easiest to express my emotions through [other] media.”
Regardless of their experience level, Jason Bitterman, the MD assistant professor of physical medicine and rehabilitation who taught the class, started them at the ground floor before they really put pencil to paper.
“A lot of medical students don’t have an arts and humanities background,” Bitterman says. Yet: “This is a skill they can take on to make themselves better clinicians.” He says comic journalism has helped him process and respond to the social, economic and philosophical issues that arise in medicine.
Bitterman took the class through his creative process: First, form themes or ideas for a story. Think about how to present the ideas in pictures; draw thumbnails, then draw at a larger scale and trace in ink. “Like any kind of art,” he says, “there are steps.”
Bitterman also brought the students to the Carnegie Museum of Art to show them how the pros form certain features or postures and to give them space to think more deeply about what individual pieces express—and how those pieces may elicit different emotions and responses from different people.
For their second major project, Bitterman had the students create a patient education comic—an informative piece that might live in an emergency room or doctor’s office. “Patient education documents are often mainly text,” Bitterman says. “Visual media like comics may teach patients in a more easily digestible and engaging way. You could use them to explain most things: What are the signs of depression? What is appendicitis? What’s a colonoscopy?”
A fascination with classic strips such as “Calvin and Hobbes” got Bitterman hooked on the genre in grade school, and his love for it has persisted. The themes of his own comics reflect major stages in life, from high school (notably, social dynamics) to medical school (and its stressors) and joining the workforce (for instance, the challenges of transitioning from a resident to an attending physician). In all of it, he has looked for a common underpinning . . . something, well, comical.
Sketching comics has become a routine for Bitterman, who writes or draws several times a week, though he doesn’t always do it for publication. “It’s a skill I’ve had for a really long time that I don’t want to lose,” he says.
Drawing his initial inspiration from the likes of “Calvin and Hobbes,” Bitterman has been honing his skills as a comic artist since grade school.
Download the full PDF of Jason Bitterman's comic, "A Taxonomy of Electronic Medical Records."
Vaidehi Patel tells a story about her father—his hospitalization led her to switch gears and want to become a doctor. She also took the opportunity to articulate how health care can be “desensitizing,” but that she remains committed to being empathetic. “Sometimes we can lose a little of that empathy, but I wanted to convey that it’s not gone; it’s going to be there when the patient needs us.”
Download the full PDF of Vaidehi Patel's comic, "Little Steps."
Vinod Rajakumar vividly remembers the anxiety he endured in preparation for residency interviews and decided to explore that emotion in his personal experience project. For his patient education comic, he detailed the importance of sleep hygiene. That project also became very personal. “I felt like in med school, especially during COVID and the winter months, I kept a very bad sleep schedule. But I noticed how important it was to get good sleep.”
Christina Cheung’s project took her on a cathartic process, helping her overcome burnout. The course contributed to her change in perspective that will help when the demands of the medical profession build up, in residency or her future practice. “I definitely learned to look at things in different ways,” she says. For instance, she says she became more willing to take advice from mentors rather than put all of her stock in the expectations she’s created for herself.
Download the full PDF of Christina Cheung's comic, "My Med School Mentality."
Students shared deeply personal, and even traumatic experiences, as well. In the course, Olivia Legan revisited her experience following a sexual assault. Her comic depicts living with post-traumatic stress disorder and healing from trauma during medical school. “It was something I really didn’t anticipate exploring,” she says. “But I found it very therapeutic to sift through those memories.”
In addition to the difficult moments, like being surrounded by #MeToo headlines, Legan shows her healing process and patient interactions. She wanted to create an alternative to the common depiction of survivors as broken: “Not only can we be whole and worthy of love, but we also can use our experience to connect with and advocate for young people who have been abused or assaulted.”
Students also created patient education comics. Below is a sampling.
Download the full PDF of Darius Hossainian's patient education comic.
Download the full PDF of Vinod Rajakumar's patient education comic.