WHEN GRAPHIC MEDICINE IS COMICS JOURNALISM: PANDEMIC STORIES IN COMIC STRIPS
Abstract
The comic book genre, understood as "a juxtaposition of words and images, in a certain sequence, to communicate stories and ideas", has leaped health communication through what is known as Graphic Medicine, which combines the language of comic strips, with health information content, from graphic pathographies to autobiographical or informative stories. An emerging and trendy concept. Also, historically, Comics Journalism has been considered as a mere reporting format, chronicle, or, according to some studies, as a subgenre of graphic journalism. Although it is clear that this "slow journalism", which, in the words of Joe Sacco, focuses on "the people who are under the headlines", is already something different, innovative, and unique that goes beyond the theoretical and conceptual framework of journalistic genres, leaving these works in a complicated limbo to classify. Major newspapers and magazines such as The New Yorker, Details, Time, New York Time Magazine, XXI, El País, El Norte de Castilla... have used these non-fiction comics in the same way and at the same level as their reports, photographs, or infographics. This global phenomenon has also been established, reaching the point of moving into first-rate informative or narrative proposals in traditional media, beyond the longest works of graphic novels. Comics Journalism and Graphic Medicine are two novel concepts that converge on a fine line, especially when in 2020, a global pandemic came to change everything. From then until now, several pieces on the limits of journalistic comics and graphic medicine have emerged all over the world. Along these lines, the following stand out in Spain: Side Effects. 19 covid comics, by AA.VV.; Pandemic, by AA.VV, and A Tale of Confinement, by Paco Roca. This text intends to delve into the use of journalistic comics in graphic medicine with the case study of the works that emerged during the COVID-19 pandemic, within these informative parameters, such as a new format, a new communication and health trend full of potential. A review; a roadmap of this new journalistic genre that is on the rise, slowly but surely, and its confluences with the concept of graphic medicine.
CUANDO LA MEDICINA GRÁFICA ES PERIODISMO CÓMIC: HISTORIAS DE PANDEMIA EN VIÑETAS
Resumen
El cómic, entendido como “una yuxtaposición de palabras e imágenes, en una determinada secuencia, con el objetivo de comunicar historias e ideas”, ha dado el salto a la comunicación sanitaria en forma de lo que se conoce como Medicina Gráfica, que aúna el lenguaje de las viñetas, con el contenido de información para la salud, desde las patografías gráficas a las historias autobiográficas o divulgativas. Un concepto naciente que está en boga. Asimismo, de forma histórica, el Periodismo Cómic se ha considerado como un mero formato de reportaje, de crónica, o, según algunos estudios, como un subgénero del periodismo gráfico. Aunque está claro que este “periodismo lento”, que, en palabas de Joe Sacco, se centra en “la gente que está debajo de los titulares”, es ya un objeto diferente, innovador y único, que desborda el marco teórico-conceptual de los géneros periodísticos dejando a estas obras en un limbo complicado de catalogar. Grandes cabeceras como The New Yorker, Details, Time, New York Time Magazine, XXI, El País, El Norte de Castilla… han usado estas historietas de no ficción del mismo modo y al mismo nivel que plantean sus reportajes, sus fotografías, sus infografías… Este fenómeno global también se ha asentado, llegando a trasladarse en propuestas informativas o narrativas de primer orden, en medios de comunicación tradicionales, más allá de las obras más largas en forma de novela gráfica. Periodismo Cómic y Medicina Gráfica; dos conceptos novedosos que convergen en una fina línea, sobre todo cuando en el 2020, una pandemia global llegó para cambiarlo todo. De entonces a ahora, varias piezas en la frontera de los cómics periodísticos y la medicina gráfica han surgido en todo el mundo. En esta línea, en España destacan: Efectos Secundarios. 19 historietas del covid, de AA.VV.; Pandemia, de AA.VV, y Una historia del Confinamiento, de Paco Roca. En este texto se pretende profundizar en el uso del cómic periodístico en la medicina gráfica con el estudio de caso de las obras surgidas durante la pandemia de la COVID-19, dentro de estos parámetros informativo-divulgativos, como un nuevo formato, una nueva tendencia en comunicación y salud repleta de posibilidades. Un repaso; una hoja de ruta de este nuevo género periodístico que está en auge, con paso lento, pero firme y sus confluencias con el concepto de la graphic medicine.
QUANDO A MEDICINA IMPRESSA É JORNALISMO EM QUADRINHOS: HISTÓRIAS DE PANDEMIA EM VINHETAS
Resumo
Os quadrinhos, entendidos como "uma justaposição de palavras e imagens, em uma determinada sequência, com o objetivo de comunicar histórias e ideias", deram uma abertura na comunicação em saúde na forma do que é conhecido como Medicina Gráfica, que combina a linguagem em quadrinhos, com conteúdo de informação em saúde, desde as patografias gráficas até as histórias autobiográficas ou informativas. Um conceito nascente que está na moda. Além disso, historicamente, o Jornalismo em Quadrinhos tem sido considerado como um mero formato de reportagem, crônica ou, segundo alguns estudos, como um subgênero do jornalismo gráfico. Embora seja claro que esse “jornalismo lento”, que, nas palavras de Joe Sacco, foca “nas pessoas que estão nas manchetes”, já é um objeto diferente, inovador e único, que vai além do arcabouço teórico-conceitual de gêneros jornalísticos deixando essas obras em um limbo complicado para catalogar. Grandes títulos como The New Yorker, Details, Time, New York Time Magazine, XXI, El País, El Norte de Castilla , e infográficos... Esse fenômeno global também se consolidou, chegando ao ponto de passar para propostas informativas ou narrativas de primeira linha, na mídia tradicional, além das obras mais longas na forma de graphic novels. Jornalismo em Quadrinhos e Medicina Gráfica; dois novos conceitos que convergem em uma linha tênue, especialmente quando em 2020, uma pandemia global chegou para mudar tudo. De lá para cá, várias peças na fronteira da HQ jornalística e da medicina gráfica surgiram em todo o mundo. Nesse sentido, na Espanha destacam-se: Efeitos Secundários. 19 quadrinhos covid, por AA.VV.; Pandemia, de AA.VV, e Uma História de Confinamento, de Paco Roca. Este texto pretende aprofundar o uso de histórias em quadrinhos jornalísticas na medicina gráfica com o estudo de caso das obras que surgiram durante a pandemia do COVID-19, dentro desses parâmetros informativo-divulgativos, como um novo formato, uma nova tendência. em comunicação e saúde cheio de possibilidades. Uma revisão; um roteiro desse novo gênero jornalístico que está em ascensão, lenta mas seguramente, e suas confluências com o conceito de medicina gráfica.
Keywords
comics journalism, graphic medicine, COVID-19, communication, information, comic, graphic novel, comic strip, health.
INTRODUCTION
Comics, understood as a juxtaposition of words and images in a certain sequence to communicate stories and ideas, have leaped health communication in the form of what is known as Graphic Medicine, which combines the language of comics with health information content, from graphic pathographies to autobiographical or informative stories. A new concept that is trending in our country, with consolidated congresses, specialized publishing houses, and even an academic master's degree.
Likewise, historically, Comics Journalism has been considered as a mere format of a report, chronicle, or, according to some studies, as a subgenre of graphic journalism. Although, it is clear that this "slow journalism", which, in the words of Joe Sacco, focuses on "the people underneath the headlines", is already a different, innovative, and unique object, which overflows the theoretical-conceptual framework of journalistic genres, leaving these works in a limbo that is complicated to categorize.
Comics Journalism and Graphic Medicine are two novel concepts that converge in a fine line, especially when a global pandemic arrived in 2020 to change everything. Since then, several pieces on the border of journalistic comics and graphic medicine have emerged around the world. In this line, in Spain the following stand out: Efectos Secundarios. 19 historietas del covid, by AA.VV.; Pandemia, by AA.VV., and Una historia del Confinamiento, by Paco Roca, in terms of edited volumes; as well as Charly y la otra pandemia. De la herida económica de la COVID a la solidaridad vecinal, a comic adaptation of the story by Carlos San Miguel de la Fuente, which was told in El Norte de Castilla, and was published in the supplement "Vivir" on March 13th, 2021.
This research aims to delve into the use of journalistic comics in graphic medicine with the case study of the works that emerged during the COVID-19 pandemic, within these informative-divulgation parameters, as a new format, a new trend in communication and health full of possibilities. A review, a roadmap of this new journalistic genre that is slowly but surely booming, and its confluences with the concept of graphic medicine.
COMICS AS A COMMUNICATIVE TOOL
What are comics?
Understanding comics is essential, with their own characteristics; knowing their history, evolution, trends, and tools, is fundamental to being able to analyze them and find the points of union between Comics Journalism and Graphic Medicine.
Comics are more than the sum of their parts, they are not simply sequences of images over a series of consecutive pages in a booklet, a book, or a computer screen. They are not just beautiful images illustrating a story. They are not reduced to the words, the fonts, the text bubbles, the size and shape of the vignettes, or the presence or absence of a frame in the vignettes. Comics are a combination of all these elements and much more. (Spencer, 2010, p. 8).
Comics, in any format, are a combination of words and images in a certain sequence to communicate stories and ideas. Will Eisner used the term "sequential art" (1998). Scott McCloud defines the comic book as "a set of juxtaposed illustrations and other images in deliberate sequence to convey information or elicit an aesthetic response from the reader" (2007, p. 9). While Guiral highlights the narrative nature of the medium: "Sequential narration of a story through vignettes that combine drawings and text (or not), all manufactured with a narrative technique that is unique to it" (1998, p. 11).
Let us briefly state, as a principle, that comics are a figurative expression, a narrative in images that achieve a perfect interpenetration (and interrelation) of words and drawings thanks, fundamentally, to two conventions: the vignette (which distinguishes the continuity of the story in time and space) and the bubble (which encloses the text and delimits the protagonist). (Arizmendi, 1975, p. 7).
In Reinventing comics, Scott McCloud rethinks his theorems exposed in Understanding comics, a work in which he explored the inner workings of this art form. And he does so from the ground up:
The medium we call comics is based on a simple idea: that of placing one image after another to show the passage of time. The potential of the idea is unlimited, but it is perennially overshadowed by a limited application in pop culture. To understand comics, we need to separate form from content... To observe with a fresh eye how in other eras that same idea has been employed to beautiful ends... And how limited the spectrum of concepts and tools that have been applied to it in our own era is. (2016, p. 1)
Therefore, comic books come from an idea that is then artistically executed in vignettes and on pages, through the conjunction of drawings and texts. It could be stated that comics are art, but a very special art, an art that sometimes intermingles with craftsmanship, an art that has been transferred to industrial processes. A sequential art that contains its own language.
The language of comics
Comics are a narrative medium that serve to tell stories. What makes them different from other media is that they tell those stories in their own way, with specific language and codes.
The language of comics is defined by: a) Having a word-image character, which uses iconic (drawings) and verbal (words) elements, with a union between them within the vignette; b) A sequentiality based on narrative ellipsis, to tell its story it does so by advancing through the vignettes that make it up, which are usually read from top to bottom and from left to right, and between each other, there are small narrative ellipses.
Due to the iconic-literary character of their language, comics appear somehow related to theater, novels, painting, advertising illustration, photography, film, television, and the stylistic features of the object world in which their creators live (Gubern, 1972, p. 83).
This language is based on a complex system of conventions, learned since childhood through the habit of reading them, with a highly symbolic character. A comic book is read, but, at the same time, a comic book is seen.
[...] It is the receiver who, reading the images in rapid succession, establishes a relationship between the frames, a continuity between the vignettes, and allows an interaction that determines that a vision on a flat, static surface acquires a dynamism. Not only that, but to understand the totality of the message, the reader must complete the meaning because the image of the comic is indisputably elliptical, that is to say, it suppresses, in its approach to reality, a series of attitudes, choosing the most representative gesture, the most significant for the clarity of the story. And the receiver also intervenes with his apprehensive capacity to prevent this lack of synchronization between the static gesture of the protagonist and the expression of verbal discourse from distorting the narrative continuity. (Arizmendi, 1975, p. 50).
Comics have different semiotic conventions that could be divided into three easily distinguishable sections: the first one related to iconography, the second one to literary expression, and the third one to narrative techniques. The comic shows and narrates.
The vignette is the basic narrative unit of comics, the essential element characteristic of any graphic story.
Subsequently, the vignettes can be articulated to form superior units such as the sequence -as happens in cinematographic language- or the page -which can also be constituted as a narrative unit according to the criteria of simultaneity that dominates in the reception of the comic. [...] The expressive quality of a good comic will depend to a large extent on the narrative skill of the author when "freezing" the moment to be expressed by each vignette; the temporal logic and the significant relevance of the narration will depend on it [...] (Varillas, 2009, pp. 106-107).
The vignette is the lexicographic representation on which a page is composed, which determines the steps of the narrative. The set of vignettes represents space and time, which pass from one vignette to another.
Therefore, the vignette pictographically represents a space and a time or, more precisely, a space that acquires a dimension of temporality [...], since the vignette is composed of static iconic signs, which despite their immobility can assume a temporal dimension thanks to the conventions of reading. We find ourselves, therefore, before a case of temporalized space or spatialized time. (Gubern, 1972, pp. 115-116).
Psychologically, it arranges the reading order and has a sense and a direction. There can be several vignettes per page or even pages formed by a single vignette. Gubern speaks of "pictogram" (1972). The placement of the vignettes represents the form of the comic.
Because in the vignettes, time is wider, the reader can move forward or backward at his own pace, as well as the author. Between the vignettes, time ellipses can occur, and between the pages, different points in time can be observed at the same time. The language of the comic, as a graphic narration, has special potentialities which stand out. One of the keys of the comic is the sequence, measured in vignettes and pages.
Within the design of a comic book, from its particular language, it is necessary to take into account the time and rhythm, the frames of the vignettes and the streets of the pages, the composition and design within each vignette, the points of view (framing, planning, and perspective), the black spots (both in the backgrounds and in the figures), as well as various techniques and narrative tricks (such as panning or panoramic video cameras, which some authors simulate using a drawing in several vignettes) specific to each author. (Spencer, 2010).
Roberto Bartual goes a step further and, in his work, La Secuencia Gráfica. El cómic y la revolución de su lenguaje (2020) he talks about the fact that the true unity of the comic is not the sequence, but the page, and "this allows us to see at the same time, in a single glance, all the narrative pieces contained in it. Unlike other narrative arts, comics are sequence and simultaneity at the same time. First, we see all the images contained in the page at once; then we read them in order".
To recap, in comics, the narrative is everything. The elements of each vignette compete with each other and you have to know how to resolve this relationship. That's why the size at which each element is drawn within each vignette is so important. The story has to flow and the elements within the story have to attract the readers, but without drawing all the attention to them.
COMICS JOURNALISM
The relationship between comics and journalism is long, ancient, and has always been very productive. The American daily press was the first mass media that welcomed the publication of comics continuously. As strips during the week and as full pages on Sundays. This led to the configuration of creative and commercial proposals that were emerging in the comics and gave name to the famous "press strips". From these daily press strips, we moved on to different basic forms of publishing: comic books, periodical magazines, albums, or graphic novels.
Wait a minute: are we talking about comics and journalism? Yes, but let's leave Tintin aside. And Clark Kent, Peter Parker, and their respective professional covers in the Daily Planet and the Daily Bugle. We're talking about sequenced reports, chronicles narrated in vignettes, interviews transcribed in text snippets, and drawn news. In reality, it has been practiced for decades, but now it is gaining real strength, driven by the possibilities offered by new technologies. (Pissed off Readers, 2013).
Thomas Nast (1840-1902) was one of the pioneers in the use of comics in journalistic work with his collaborations in newspapers of the time and Harper's Weekly. From Nast to Art Spiegelman, to Joe Sacco, without forgetting others who have continued with this type of work afterward, such as Sarah Glidden, Susie Cagle, Mark Fiore, or Dan Archer.
These comics journalists inherit their strength from that of the news painters of the era before photography. Those battle cartoonists would travel to the scene, make drawings, and then send the resulting pieces to their newspaper or magazine editorial offices to be reproduced through a laborious process of craftsmanship. All this, together with the connection between journalism and comics has also been boosted thanks to the autobiographical genre and the complete authors, who do script and drawing work.
Comics Journalism, therefore, takes the best from each side. It uses the routines, tools, and codes imported from one, leaving behind the immediacy and the dictatorship of the news, with the plasticity, the impact of the full page, and the graphic force of the other. There are techniques of data journalism and investigative journalism, as well as the chronicle of events, all with audiovisual documentary planning and a plurality of sources as a basis. Most of the time they have a journalist witness who builds autobiographically an honest and self-critical non-fiction story, with which they describe reality from the point of view of those who have no voice, those who are under the headlines. Without grandiloquent speeches. No final moral story. Let each reader think for themself and draw their own conclusions.
With this journalism in vignettes, readers can work with their imagination in its sequential dimension and establish emotional connections and links with the protagonists (who are often the authors themselves). In this way, complex themes are transformed into something more accessible to different audiences. Gary Embury and Mario Minichiello look at the relationship between this type of work and the usual reportage, focusing on the spirit of objectivity and the thematic difficulty as the keys to illustrated reportage:
The reportage is characterized by being based on facts; that is to say, it is an artistic discipline applied to some relevant event. The illustrator plays the role of a particular type of visual journalist, who captures in his drawings the dynamics of these events. Illustrated reportage combines the capture and graphic representation of a given scene, to understand and communicate a story using visual language. [...] The result provides visual authorship of an immediacy that can only be achieved with words. Illustrated reportage is often employed to bring this kind of clarity to matters that are complex and difficult. (2018, p. 1)
On the durability of Comics Journalism, it is worth stopping to understand the importance of this genre in the transmission of information related to the coronavirus pandemic as a graphic and literary element of what happened.
Understanding comics as a journalistic genre is something new. Although there are more and more authors who have been thinking about information in cartoons. It is experimental journalism in which we experiment from the mix; it is transmedia journalism that brings narrative novelties with journalistic routines applied to the virtues of comics. It is slow, honest, immersive journalism, with rigor and great loyalty to the sources. It has a special versatility and reaches all kinds of audiences. It is more than a report or a chronicle; with a mixture of languages to tell non-fiction stories.
It can be observed that this type of work goes beyond the mere reportage style, becoming, as proposals emerge, a particular way of informing, in an independent genre, which leaves aside discussions about subjectivity and objectivity because it is honest journalism.
WHAT IS GRAPHIC MEDICINE?
Although health has been a subject of comics at least since the 1940s, with the appearance of educational comics about infectious diseases and celebrity doctors in magazines such as True Comics and Real Life Comics, it was not until 2007 when the British physician, professor, and comic creator Ian Williams coined the term "graphic-medicine" using it on his website (he baptized it precisely that way) to name those comics that had usefulness, beyond that of art or reading experience, linked to health and sanitation.
It was he, along with MK Czerwiec (American nurse, teacher, and comic author), who started this movement at an international level. Their team continues to grow as well as their activities, congresses, and conferences... They also have the foundational book The Graphic Medicine Manifesto written by the six pioneers of this movement: Susan Merrill Squier, Michael J. Green, Kimberly R. Myers, Scott T. Smith, and the aforementioned MK Czerwiec and Ian Williams.
So, what is "Graphic Medicine? It is the intersection between comics as a medium and health discourse. Graphic Medicine combines the principles of medical narrative with the exploratory resources and visual and artistic systems of comics depicting the representation of signs and symptoms, both physical and emotional, through cartoons. It is also a different approach to the education of healthcare professionals, as well as an emerging area of interdisciplinary academic study. It is a movement for change that challenges the dominant methods of health education, offering a more inclusive perspective on medicine, illness, and care. Comics give voice to those who are often not heard. (AA.VV., 2015, p. 2).
In the last sentence, we find parallels with Joe Sacco's exposition. Those who often go unheard, one of the keys to graphic medicine, would be the ones the journalist comic was talking about, the ones underneath the headlines. Because as you can see, both movements focus on people and their stories. Once again, comics appear as a tool, in this case, oriented to educate, disseminate, and inform in the field of medicine and health. With the same functions as Comics Journalism, also focusing on the diseases suffered by those people who are protagonists, within what is known as "graphic pathographies". Mª Blanca Mayor Serrano explains it very well in her article in Tebeosfera:
The novel combination in most of the graphic pathographies of personal experience and scientific-medical dissemination makes it possible for readers to do the following. On the one hand, to soak up the personal experiences, the most intimate feelings of their protagonists, and their perception of the environment that surrounds them. They are works that, besides helping to break taboos, neutralize the social stigma surrounding certain diseases. […] On the other hand, these works convey to the reader rigorous information about a given disease in a comprehensible manner despite the complexity of the issues addressed. The reader, in short, is instructed on topics specific to the health sciences that some comic book artists explain in meticulous detail on a graphic and textual level. (2018)
These types of works focus on real anecdotes and personal experiences, and talk about effort and overcoming. Thanks to the combination of text and drawing, with all the plasticity of the language of comics, they reflect yearnings, uncertainties, grief, and various fears in the face of an illness, humanizing the act of health care. And what is achieved is an immediate identification representation by the readers. A greater empathy thanks to the process of individual, calm, meditated reading. In an interesting process of closeness and remoteness at the same time.
Inés González quotes Ian Williams in her work (2017) who considers that "in light of the proliferation of graphic narratives concerning illness in recent decades, these must be introduced into the field of study of the medical humanities since they constitute valuable material for the teaching and learning of medicine and health care". This graphic representation of the disease can influence the perception of the disease.
On the Spanish website of the Medicina Gráfica movement (a collective project initiated by the physician Mónica Lalanda), they also focus on what lies within the definition in terms of its communicative potential: "[...] the term encompasses material that is useful as an information tool for the patient and the healthcare professional, valuable for teaching and appropriate for simple reflection. Its potential is infinite and its strength lies in the way it humanizes the disease".
PANDEMIC COMICS
Since 2020, life has changed. Everything was changed by the SARS-CoV-2 disease, which filled hospitals, opened daily news bulletins, and forced measures such as global lockdowns. Social interactions were removed and mandatory masks, hydrogels, and, later, vaccines from Pfizer, Moderna, or AstraZeneca were introduced... The new coronavirus became entrenched both in public opinion and in interpersonal conversations. A complex situation that, not surprisingly, was soon transferred to the comic strip, too. From then until now, several works have appeared all over the world that contain common elements between Comics Journalism and graphic medicine. Several informative borderline pieces combine the tools of comics, the will of journalism, and the possibilities associated with health communication. As Álvaro Pons points out in his text "Viñetas a la realidad", included in the volume of Efectos Secundarios, comics have infiltrated everywhere:
[...]Comics, that art that has been linked to the people in the street all its existence, entered Instagram, Twitter, or Facebook to tell us what was happening anywhere in the world. Comics created with the rage of impotence told us how to live that confinement from a paradoxical drawn window that, in turn, told us what was seen in the other windows, whether real or virtual. [...] We all agreed on the power of the image as a universal language that allowed us to understand and share situations in which we recognized ourselves. The scenarios could be very different, but the feelings and sensations were the same [...] (2021, p. 10).
In Spain, this global phenomenon has also settled, transforming itself into first-rate artistic-informative proposals, elaborated by journalists and artists, which have been transformed into volumes of comics such as: Pandemia, an anthology of several authors published under the Flow Press label; Efectos Secundarios. 19 historietas del covid, a choral initiative of Cultura en vena, published by Astiberri; or ¡Venceremos! Una Historia del Confinamiento, by Paco Roca, published by Bimedica. Furthermore, they have also found a place in traditional media, such as El Norte de Castilla, where Charly y la otra pandemia was published on March 13th, 2021, in the supplement "Vivir". From the economic wound of COVID to neighborhood solidarity. A different account of the pandemic, moving and very human, which was based, in turn, on two previous reports by journalist Laura Negro published on January 24th and 28th of the same year. For the adaptation, the team was joined by the journalist Víctor M. Vela, as support for the scripts, and the illustrator Iván San Martín in charge of the drawings, color, and lettering.
Like any good adaptation, it is not a copy of the original, but a work that makes sense and has a life of its own. Charly's journalistic comic book connects with the health and social reality lived during 2020 and 2021, especially, and thus emerges as a work with its own entity, independent, which also works in a complementary way to the other informative materials. A different way of telling, narrating, of sharing what has been lived with the plastic force of comics.
Another small work that is part of this corpus to be analyzed is ¡Venceremos! Una historia del confinamiento, the comic that Roca made for Bimedica as a gift to the health workers in the times of COVID-19, which becomes one more piece in this puzzle of collective memories, dealing with the shared memories (lived and lost) by the same family during the pandemic. A beautiful tribute to the hardships experienced during confinement and to personal and professional relationships with change as a banner. "No one could have imagined that we would live through something like this. We had seen it in movies of catastrophes, of uncontrolled pandemics... But we never thought that, even in such a situation, life would continue with its routines, and that we would assimilate the exceptional until we normalized it", begins Roca in the second vignette (2021).
Twenty cartoonists come together in Efectos Secundarios to stimulate reflection on the pandemic and its immediate side effects but also on the problems that have come to the surface and that were considered, to a certain extent, "normal". Alfonso Zapico, Amaia Arrazola, Ana Galvañ, Ana Oncina, Antonia Santolaya, Carla Berrocal, Cristina Bueno, Cristina Durán and Miguel Ángel Giner Bou, Javier Olivares, Josune Urrutia, Laura Pérez Vernetti, María Herreros, Martín López Lam, Meritxell Bosch, Núria Tamarit, Paco Roca, Raúl, Sole Otero, and Susanna Martín are part of the exhibition project promoted by the Fundación Cultura en Vena (whose objectives are "to bring art and music to health environments and places at risk of depopulation; as well as to research the effects of artistic practices on health and wellbeing") that brings together a new life in the form of a publication. Nineteen short stories of reality in the form of vignettes, another example halfway between graphic medicine and Comics Journalism that invites us to enjoy reading through memory. Mónica Lalanda dwells on them and their strength, both individually and as a whole, in her introductory text:
This volume that occupies us collects a spectacular sample of several of those stories. I read and reread them looking for traces of graphic medicine among them, trying to find the story of covid-19 and its consequences. And yet, what they convey to me in a varied and very diverse way and with little direct presence of the virus and its consequences, are the effects of the measures taken to prevent the disease which, in themselves, have avoided contagion, but in some way have also affected us, upset us, altered us. We are a wounded society. They are stories that describe both our vulnerability and our strength, and that represent many angles of these months that have changed us (2021, p. 12).
These are also the pieces included in Pandemia, the Spanish landing of The Nib, an American independent comic book publisher dedicated to publishing authors who draw about relevant topics, about current issues. They speak of "non-fiction comics for complex times". It is a reference publication in alternative comics that comes to Spain by the hand of Flow Press and brings together the best of the independent universe of comics to analyze in-depth, with texts and drawings, the chosen topics. The coronavirus is the protagonist of this first issue, with several artists and journalists, among which the following stand out: Laura Athayde, Molly Brooks, Niccolo Pizarro, Kalle Benallie, Lisa Rosalie Eisenberg, Ryan Alexander-Tanner, Tuck Woodstock, Sarah Mirk, Will Evans, Anjal Kamat, Gemma Correll, or Pia Guerra, among others. An unbridled "graphic journey to the heart of the year that changed everything", they specify. All this in a reflection on the chaotic absurdity of trying to live in the year of the plague. The editor of the publication, Matt Bors, details it in the introductory text:
We visit a few countries where life has been affected by the virus and the response to it: South Korea, Lebanon, Brazil, the Navajo Nation, and the former epicenter of Queens, New York. We also hear stories of comic artists who have married, given birth, gone to funerals, and attended protests during this major restructuring of society (2021, p. 2).
As can be seen in these pandemic comics, life always makes its way, and reality surpasses fiction. Within the informative-divulgation parameters mentioned above and from the focus of current affairs, with the prism of graphic medicine in the background, these studied examples are hybrid works, between information and health, from the social aspect.
CONCLUSIONS: WHEN GRAPHIC MEDICINE IS COMICS JOURNALISM
Pandemic works are comics of reality; life stories. Like a transcript reflected through the mirror, with the vignettes as windows. Non-fiction comics, with health themes, but also social themes. With vital testimonies, a plurality of sources (almost as many as authors), and a strong autobiographical component. With the interview as the main tool and with the journalistic chronicle in the background of everything.
Graphic medicine is thus situated at the intersection of the language of comics and health discourse, a place from which it is possible to question the dominant methods of health education through the multidisciplinary perspective that combines the principles of narrative medicine with the particularities of comics. And it intersects with Comics Journalism, understood as a type of hybrid journalism that combines comic tools with journalistic routines to achieve an experimental genre that focuses on the story and results in immersive stories that hit in the gut, highlighting those who are underneath the news.
In the words of Álvaro Pons (2021, p. 10), in his text "Viñetas de Realidad": "Comics had already been demonstrating their capacity for communication in the medical field for years, but, amid the dazzling evolution of the Graphic Medicine Movement, they have revealed not only an immense communicative capacity but also all their analytical and reflective potential".
Milagros Arizmendi (1975, p. 7) said that "comics have gone from being simply read to being read, meditated upon, and studied". Comics redefine and subvert everyday representations. The asymmetrical reading and the individual rhythm make the combined possibilities of both, graphic medicine and Comics Journalism, enormous in the practical, didactic, therapeutic (and cathartic) field, and also at an informative level. They are, therefore, complementary formats; a new trend in communication and health, full of possibilities.
If health journalism has become so prevalent that it can decline, finding new formulas such as health Comics Journalism could be a path to follow to reach new readers, through new ways of informing and narrating what has happened: the drawn health reality.
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AUTHORS’ CONTRIBUTIONS, FUNDING, AND ACKNOWLEDGMENTS