People usually don’t have courses in school on empathy: how to be compassionate towards each other. There are some professions, however, where empathy is part of the formal learning process — with health care professionals leading the way, learning how to listen and how to consider the patient’s perspective. This is critical for any context in which doctors and patients need to communicate, but even more so when they seek to collaborate.

But don’t doctors and nurses deserve empathy, too? At the University of Michigan, this was the question we faced: How could we help patients and clinicians find a way towards empathy for each other, to make participating in health care more rewarding for both?

Our first thought was, naturally, storytelling; but what kind of storytelling? Medicine is chock full of stories — from case studies to patient narratives and more. Structured abstracts can even be considered to tell research stories! None of these, however, are terribly accessible to the general public.

The articles published in most life science publications tend to be exclusive, using language that is full of jargon, as well as figures that require not only an in-depth understanding of the data and context of that article, but also familiarity with statistics and research methods. Plain language abstracts help with understanding the most important points of the science, but tend to pull even further away from the stories behind the discoveries.

Why Use Comics to Build Empathy?

What attracted us to the idea of making a comic was partly its ability to carry stories along, but also that combining visuals and words increases retention and (hopefully) comprehension of the content presented. In other words, comics are almost magically designed to tell stories and make them memorable.

Our campus has a Graphic Medicine Interest Group, with students and clinicians who are using or studying uses of comics in health care. The very existence of this group on our campus, along with the Graphic Medicine website, helped lead us to examples of comics used in health care, including those designed to describe patient experiences, provide patient instructions, encourage therapy, teach prevention and public health skills, and more.

These examples provided a context showing us that making a comic is do-able (even if you aren’t an artist yourself), and that stories and pictures — when put together — can enhance a message in important and powerful ways.

Making the Comics

Making a comic can be both simpler and more challenging than people expect. Two of the co-authors had prior experience making comics, which was a distinct advantage, and one of us taught workshops on comic creation tools and strategies. We used a prototyping tool from these workshops to create a storyboard for our comic (after we agreed on a goal and medical context), brought in an artist, and had group discussions to clarify the story concept and characterizations.

In these conversations, we were fortunate to be able to include people with clinical as well as patient experience. Negotiating the boundaries of the clinical experience from both perspectives led to poignant juxtapositions, such as the one in the accompanying comic where a doctor leaves a teddy bear with a hospitalized child, while a patient wakes from a nightmare about the procedure to be reminded they can’t even have a cup of coffee until it’s over.

Rough sketches of the original concept art for two frames of the comic, overlaid with a more polished version. See the final version of the published comic in the JACR Special Issue: Patient- and Family-Centered Care.

Graphic medicine offers powerful ways to connect storytelling in visible, memorable ways to the experiences that we as patients and clinicians wish to share, to have understood. They can support richer conversations around difficult topics, create awareness of potential unshared issues, and encourage thoughtful listening across cultural boundaries.

We hope that you will be intrigued enough to read more about using comics to build empathy in the December 2016 JACR Special Issue: Patient- and Family-Centered Care. And join us in a Tweet Chat to discuss the concept of graphical medicine on February 23, 2017, 12:00pm ET at #JACR.

Anderson PF, Wescom E, Carlos RC. Difficult Doctors, Difficult Patients: Building Empathy. J Am Coll Radiol December 2016;13(12 Pt B):1590–1598.