Sunday, December 23, 2018

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

 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.

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