drawing board

Line of treatment: How a dose of ‘graphic medicine’ helped doctors at AIIMS

At a workshop last month, AIIMS doctors learnt to draw comics to improve doctor-patient communication,

As part of Grassroots Comics, a social venture that uses comics as a means of communication, Sharad Sharma had conducted many workshops. But never one with doctors. He feared there might not be many takers because, as he acknowledged, it was an idea that many might consider “crazy”.

“I was going to offer comics as graphic medicine,” said Sharma. “The idea was to introduce this medium to doctors and therapists as a way to communicate better with patients or to simplify medical jargon. But I wasn’t sure whether this would be accepted as a serious idea or worth their time.”

However, as he reached the the All India Institute of Medical Sciences in Delhi last month, Sharma was told that almost 30 people had registered for the workshop, even though there were only 25 seats. There were surgeons, physiotherapists and lab technicians in attendance, all eager to learn.

Armed with paper, pencil and erasers, Sharma first got them comfortable with drawing. “Many are intimidated by the idea of drawing and give up even before they begin, thinking it’s too hard,” said Sharma, who believes in “ABCD” – anybody can draw. “It is not about the art. It’s about the story. The focus should be on communicating. If it successfully tells a story, then it is well drawn, no matter what the quality of the image is.”

Those attending the workshop were encouraged to practice drawing patterns in the air before putting pencil to paper and sketching basic figures. Next they were told to break the narrative into four panels and to tell a story in short, clear sentences. Incidents from their lives, red tape in a government hospital, ideal patient care were some of the chosen story subjects.

The resultant illustrations were simple, but each had an important message, even if told dramatically. “I was surprised at the self-critical nature of some of the stories,” said Sharma. “They were not shying away from addressing some of their flaws.”

While laboratory technologists Vidushi Uniyal and R Lakshay based their comics on the dangerous carelessness of some of their peers, doctors reflected on how they were sometimes remiss in tending to patients. Senior resident Ashutosh Kumar injected humour into his comic by noting that all the doctors were off celebrating Doctor’s Day – which fell on the workshop’s first day – and that there was nobody to see patients.

Title: Doctor's day for patients  Panel 1 – Patient: Why is there not a single doctor to be seen around the hospital? General staff member: They are all out celebrating Doctor's Day. Panel 2 – Patient: So who will help us? Staff member: Who do you think looks after the ones who have no one? Panel 3 – Patient: God? Staff member: Exactly! Panel 4 – Patient: (Panics) But who will treat us? Staff member: God.
Title: Doctor's day for patients Panel 1 – Patient: Why is there not a single doctor to be seen around the hospital? General staff member: They are all out celebrating Doctor's Day. Panel 2 – Patient: So who will help us? Staff member: Who do you think looks after the ones who have no one? Panel 3 – Patient: God? Staff member: Exactly! Panel 4 – Patient: (Panics) But who will treat us? Staff member: God.
Panel 1 – Laxmi Prasad: Can someone please guide me towards the right department? Various departments: Not here. Go to the other one. Panel 2 – Laxmi Prasad: There is such a long queue. I hope my turn comes quickly. Panel 3 – Nurse: The doctor's visiting schedule has changed. Come back later. Laxmi Prasad: Please help me! Nurse: Fine, let me check. Panel 4 – Sir, there is someone from another unit who has come for a check up. He just needs to be
Panel 1 – Laxmi Prasad: Can someone please guide me towards the right department? Various departments: Not here. Go to the other one. Panel 2 – Laxmi Prasad: There is such a long queue. I hope my turn comes quickly. Panel 3 – Nurse: The doctor's visiting schedule has changed. Come back later. Laxmi Prasad: Please help me! Nurse: Fine, let me check. Panel 4 – Sir, there is someone from another unit who has come for a check up. He just needs to be "entertained". Doctor: Sure. I have been doing that with many others today anyway.

Issues like the thankless nature of their job and patients’ apathy too came up at the workshop. While some threw light on the need to donate blood regularly, others tried to lift the stigma associated with mental illnesses. Dr Maunita Kanjilal from the Department of Rheumatology raised the problem of faith healing. In her comic she lamented that so many people place their hopes in babas and yogis, delaying proper medical attention in the process.

Title: Right treatment at the right time. Panel 1 – Parents: Our son Ramesh has been experiencing back and knee pains. Let's take him to the local masseuse for treatment. Masseuse: Don't worry, I'll cure him. There's no need to take him to a doctor. Panel 2 – Family friend: You're an educated man. Why are you putting your faith in this healer instead of taking him to the hospital? Ramesh: Father, it has been three years and I'm still experiencing pain. Panel 3 – Doctor: He is suffering from juvenile idiopathic arthritis, which is curable but you've delayed his treatment too much. Ramesh: Will I be able to walk again? Panel 4 – Parents: If I had brought him to the doctor in time then Ramesh would not have been disabled.
Title: Right treatment at the right time. Panel 1 – Parents: Our son Ramesh has been experiencing back and knee pains. Let's take him to the local masseuse for treatment. Masseuse: Don't worry, I'll cure him. There's no need to take him to a doctor. Panel 2 – Family friend: You're an educated man. Why are you putting your faith in this healer instead of taking him to the hospital? Ramesh: Father, it has been three years and I'm still experiencing pain. Panel 3 – Doctor: He is suffering from juvenile idiopathic arthritis, which is curable but you've delayed his treatment too much. Ramesh: Will I be able to walk again? Panel 4 – Parents: If I had brought him to the doctor in time then Ramesh would not have been disabled.
Title: If everyone stands by the patient. Panel 1 – Patient's relatives: She has gone mad. She constantly mumbles to herself, doesn't do anything and stays shut in her room. Panel 2 – Doctor: This illness is like any other and is curable with the right treatment and care. Panel 3 – You would have to take your medicines regularly and come for regular counseling sessions. Panel 4 – Family members: We will support her and make sure she does as you advise and see the treatment to its completion.
Title: If everyone stands by the patient. Panel 1 – Patient's relatives: She has gone mad. She constantly mumbles to herself, doesn't do anything and stays shut in her room. Panel 2 – Doctor: This illness is like any other and is curable with the right treatment and care. Panel 3 – You would have to take your medicines regularly and come for regular counseling sessions. Panel 4 – Family members: We will support her and make sure she does as you advise and see the treatment to its completion.

According to Yogesh Kumar, educational media generalist at AIIMS, the doctors have requested for more such workshops. “Those who could attend the workshop were extremely pleased,” said Kumar. “They were being able to express themselves and in such a creative way too. The posters created by them have already been displayed in places where the patients can see them. They want to learn more of this form of expression, so that they can begin using this medium in their everyday operations.”

Medical social service officer Vivek Kumar Singh, who drew a comic on the Rashtriya Arogya Nidhi, a government scheme providing financial assistance to patients, has started distributing copies of his work to create awareness about the provision.

Title: Don't lose faith. Panel 1 – Ramdhani, I'm sorry to tell you that you have blood cancer. It can be treated, but it will cost around Rs 8 lakh. Ramdhani: Oh god! What am I supposed to do now? Panel 2 – Ramdhani (to the medical social service officer): I'm a rickshaw puller. How can I afford this treatment? MSSO: Do not worry. Just get your ration card and a letter from the doctor and we will help you. Panel 3 – Ramdhani: Really? Treatment is possible if I just bring these documents? MSSO: Why not? Last year we provided around Rs 25 crore for more than 650 patients who fall below the poverty line. Panel 4 – Ramdhani: I had lost all hope, but you have given me a new ray of hope. MSSO: We are going to help in any way we can. Please don't lose faith.
Title: Don't lose faith. Panel 1 – Ramdhani, I'm sorry to tell you that you have blood cancer. It can be treated, but it will cost around Rs 8 lakh. Ramdhani: Oh god! What am I supposed to do now? Panel 2 – Ramdhani (to the medical social service officer): I'm a rickshaw puller. How can I afford this treatment? MSSO: Do not worry. Just get your ration card and a letter from the doctor and we will help you. Panel 3 – Ramdhani: Really? Treatment is possible if I just bring these documents? MSSO: Why not? Last year we provided around Rs 25 crore for more than 650 patients who fall below the poverty line. Panel 4 – Ramdhani: I had lost all hope, but you have given me a new ray of hope. MSSO: We are going to help in any way we can. Please don't lose faith.
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