Can Comics Enhance the Practice of Medicine? A study using "My Degeneration, a Journey Through Parkinson's suggests "Yes"

Copies of "My Degeneration" await readers at Fireside Books in Palmer in 2015

This past summer, I attended a conference on "Graphic Medicine" an area of the medical humanities that considers the intersection of comics and medicine. It's a discipline that rests on the assumption that through creating and reading comics, patients, doctors, nurses and others involved with the health care system can come to a better understanding of what they are doing, and the effects it has on outcomes. This should result in better care. But can a better understanding of delivering care for complex medical issues result from reading... um, ... comics?

That's what Dr Michael Green and a team of researchers from Penn State University aimed to find out. And, in a high-stakes move for me, they chose my book-length-comic memoir "My Degeneration, a Journey Through Parkinson's" as the test subject of their- study. Pressure? What pressure? Nothing at stake here. Just the legitimacy of the work being done by the excited and enthusiastic attendees of the conference. Many of whom were assembled in the Dartmouth College classroom where the team was unveiling their results. I could imagine the wrath that would be turned on me by the classroom full of Graphic Medicine practitioners, fans and publishers (including my editor) if the book failed to deliver on the mission.

Because I'm a comics creator, that imagining took on a downright operatic exaggeration of tragedy and pathos that I did not look forward to experiencing in real life, featuring me in the role of comics martyr. So I made a mental note about location of the nearest exits, and braced myself.


The presentation began with a statement of the study question "Does reading the book help health care providers better understand the lived experience of patients with Parkinson's Disease? Subjects were recruited, given a copy of the book, filled out a questionnaire, reconvened for a discussion four weeks later and filled out the questionnaires again, prior to the discussion.

The results for the small group of medical professionals that took part were encouraging. Their scores for questions like "how confident are you that you are able to...

• understand the stigma that people with Parkinson's Disease experience?
•understand what it's like for a patient to live with Parkinson's Disease?
•understand the impact of PD on family members
•help patients cope with PD?"

 all went up between 10 and 17 points!

In addition, their experience with "My Degeneration" left them with enhanced esteem for comics. Participants views shifted positively when choosing between attributes such as "valuable" and "worthless", "good" and "bad" and, my favorite, "smart" and "stupid"to describe comics. No words minced there!

Major themes that emerged from quantitative analysis were

• The book provides a meaningful way for healthcare professionals to learn about the lived experience of patients with PD 
•The comics form successfully engages healthcare professionals in ways that differ from other mediums
•The benefits of the book extend past the healthcare team

The researchers found that "My Degeneration" had a "profound effect" on clinicians who treat PD, and helped them have greater confidence in their treatment of patients. (although it did not seem to enhance their clinical knowledge about Parkinson's. Hmm...)

This is an encouraging indicator that those of us practicing in this medium are on the right track. (other indications this is so? Testimonials by Amazon readers to the value of the book. Not as rigorous as the research by the Penn State team, but pretty darn heart-warming to this author.) And speaking of rigor...  

Researchers cited the following limitations of their study:

•Single study site
•Small sample size
•No comparison with control group
•Self-selection of of subjects could lead to sample bias

So this is not an air-tight study, but more a sign this is a promising direction for further research. It suggests that comics, or one comic, anyway, can have a fruitful and unique role in promoting relations between medical professionals and patients. In my experience, this can only be a good
thing.

 I'm grateful to the researchers for taking the comics seriously, and for selecting my book as a test-case for study. I look forward to hearing about the further research they have planned to be focused on how patients respond to the book.

Getting My JAMAs On, Journal of the American Medical Association has Kind Words for Comic About PD

It seems that there has been a gap in my role of relentless self-promoter. At the tail end of December, 20016, The Journal of the American Medical Association praised the heck out of my now-a-year-old graphic-novel-style memoir of coping with Parkinson's Disease, "My Degeneration". And somehow it never got mentioned in this authoritative blog. We here at Off&On Media Enterprises are just sick about this oversight and assure you, loyal reader, that steps have been taken, measures put in place, and the guilty tracked down and summarily dealt with. Our apologies to you, your ancestors, and of course my ancestors.

Is there anything I can do to make it up to you? Probably not. But to assure you of my future  good intentions, allow me to post a link to this article in Parkinson's Life Magazine  about the JAMA article. And if you want to see the JAMA story, why, it's right here. Again, my apologies. It won't happen again.

Book Launch for "My Degeneration" Tonight!

One night only! Laughter, tears, tremors, ogres, true love, software, life's bitter realities and moments of transcendence, all in one laff-riot, tear-fest, a wrenching roar of the imagination, a cold, hard look at reality, the "My Degeneration" book launch at blue.hollomon gallery is tonight! 6:00 to 8:00at the Olympic center, a Zamarello mall near you, 36th and Arctic Boulevard to be exact. And yes, I will personalize your copy working boldly, without spell-check. Please come, see you there!

Penn State Catalog lists "My Degeneration." Also BLURBS!

It appears that the people at Penn State Press are convinced that "My Degeneration" will be published in October. They say so right in their catalog, which also has a short description of the book and five of the finest blurbs ever written. The catalog offers a few different ways to pre-order the book, which you will be desperate to do after reading the blurbs, but the only thing I could get to work was the one that enables an email notification when the book is available. Watch this space for further exciting developments as they break!

It would be a disservice to the fine writers who agreed to read a draft of the book and then had nice things to say about it to not repeat their remarks as often as I get the chance. They appear below, for your interest and with my thanks.

“Peter Dunlap-Shohl once again brings his unique art to the table to help educate, illustrate, and demonstrate life, hope, and strength on his journey with Parkinson’s. Creative and insightful, this book reflects all of Pete’s greatest qualities, including his constant work to help and educate all those in the PD community, patients and care partners alike.” —Bill Bell, co-founder of the Northwest Parkinson’s Foundation

“Peter Dunlap-Shohl is a comic genius and a masterful artist. The fact that he came down with early-onset Parkinson’s Disease gave him the unlucky opportunity to chronicle this dogged and humorless disease. His wit and artistry, his truth telling in the face of struggle, I know, makes the struggle easier for his readers to bear. Peter is a Rock Star Artist and Humorist. Every disease like Parkinson’s should have someone like Peter Dunlap-Shohl, until there are no more diseases like Parkinson’s left.” —John Straley, author of Cold Storage, Alaska

“I could have recommended Peter Dunlap-Shohl’s book because it brings attention to a great purpose. Or because it is brave and honest work. Or even simply to acknowledge an achievement of this magnitude created under physical, psychological, and emotional circumstances that most of us will never understand.

"But I'm not endorsing Peter’s graphic novel for any of those reasons. I'm doing so because this is a damn fine work of art, by a damn fine artist.” —Nick Galifianakis, Washington Post cartoonist

“The world made fresh by a Parkinson’s patient with a wonderfully sensitive and cocked eye. He tells the tale of his fast-changing reality with compassion and wicked humor, leaping from one crazily inventive work of art to the next. Never more acute than when examining his own mind-set, Peter Dunlap-Shohl leads us from diagnosis and despair to the high ground where he could compose this lucid, moving book. A miracle, in a way—and a triumph.” —Tom Kizzia, author of Pilgrim’s Wilderness: A True Story of Faith and Madness on the Alaska Frontier

Of Course You Can Judge a Book by Looking at the Cover. Go Ahead, Judge Mine

 

  

One of the lamest sayings is "You can't judge a book by its cover". It is the job of a well-designed cover to convey a sense of why the reader should take an interest in what the book has to say.  The cover has to give us a reason to spend our precious time (and money) with this particular book. If a book doesn't deliver on the promise of the cover, it will have indicted itself as untrustworthy, a self-inflicted wound at the core of any author's most essential attribute, their credibility. 

In a sense, if a cover is badly designed, it could and often does actually function well. It's warning us the author doesn't care enough or isn't wise enough to present his work credibly. That is a strong signal that the book itself will be less than worthwhile. Good job, amateurish cover designers, and thanks for sparing us the effort of slogging through your badly-organized and poorly thought-through material. 

Above is the cover for my book, due this Fall, about coping with young-onset Parkinson's Disease.  The publisher, Penn State Press has chosen an image and presented it in a way that is compelling, and gives you an idea of what to expect from the work. You will be up close and personal with the effects of the disease. Choosing this image and setting it against the simple background tells you we are serious. In combination with the title, with its layered pop music reference, it conveys the hope that there will be wit as well. 

Does the content stand up to the promise? I invite you to see for yourself this Fall.