Enlarge / The Martinique-born psychiatrist Franz Fanon dealt with the bioethics of studying and treating traumas in his book The Wretched of the Earth from 1961. A scientific work written in comic form examines a case study especially from a modern perspective.
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Is it possible to ethically treat someone with post-traumatic stress disorder (PTSD) caused by torture? That’s the question that was asked in an article published last summer in AJOB Neuroscience, but there is a twist. The work was written and illustrated as a comic by the artist and neuroscientist Ann E. Fink from Lehigh University.
Fink is part of a growing movement called “graphic medicine”, a term coined in 2007 by physician and comic artist Ian Williams to describe the use of comics to improve professional and general public discourse on health issues. Comics can be a form of visual rhetoric that is ideal for medical education and patient care. Proponents include M.K. Czerwiec, also known as “Comic Nurse”, worked in an HIV hospice at the height of the AIDS epidemic. When the clinic closed in 2000, she struggled to find a point of sale to express the bittersweet feelings she felt, but she found the comic book format to be perfect.
“I found that the combination of image and text in sequential order really helped me organize my thoughts,” Czerwiec told the University of Chicago News last year. “It just worked.” As an artist in residence at the Feinberg School of Medicine at Northwestern University, she published a graphic non-fiction treatise in 2017: Alternating stories from HIV / AIDS care unit 371. Czerwiec and Williams, together with Michael Green from Penn State University, were among the first participants in 2010 at the now annual international conference for graphic medicine. In 2015, they published the Graphic Medicine Manifesto, a collection of scientific essays with visual narratives.
Like many others in graphic medicine, Fink has been interested in comics for a long time, although she was initially trained in psychology and neuroscience, with a particular focus on the larger social and ethical issues related to learning, memory and mental health. During a scholarship to the University of Wisconsin-Madison, she met comic-art legend Lynda Barry and a group called Applied Comics Kitchen. At this point, Fink is using comics to convey topics related to biology and health. “Many of these are really about putting the personal narrative, the patient’s experience, and the provider’s experience at the center,” she said to Ars. But the AJOB Neuroscience Paper is her first comic-style scientific paper.
A case study on torture
In the newspaper, Fink takes up a bioethical dilemma in comic form, which the psychiatrist and political philosopher Franz Fanon described in his pioneering book The Wretched of the Earth from 1961. Fanon was born on the Caribbean island of Martinique (then a French colony) and trained in France. In his book he described the dehumanizing effects of colonialism on the colonized people and presented numerous case studies that he had encountered in the last chapter.
The best known is the story of a white male police inspector in Algeria who tortured prisoners of the colonial government for many hours every day. He would probably have been diagnosed with PTSD today because the man regularly beat his wife and children at home due to his work-related stress – including a 20-month-old child. Fanon wrote that he was looking for a treatment to deal with the stress and guilt he experienced when torturing people so that he could continue to torture people at work with “total peace of mind” and suppress the impulse, his own Inflict physical abuse on family.
The bioethics dilemma and the decision tree of the police inspector
Ann E. Fink
Should he help this man suffering from PTSD to be a better torturer?
Ann E. Fink
Outline the basics of PTSD
Ann E. Fink
Useful lessons for today’s torturers?
Ann E. Fink
In a nutshell: a dissertation on Icelandic sagas in comic form
This presented Fanon with an ethical dilemma. The police inspector is both a victim and a perpetrator: he insults Algerian prisoners and his family, but is also a farmer himself and victim of the greater socio-political pressure and psychological trauma that arises at work. So should Fanon treat the man and make him a better torturer, protecting his wife and children while the Algerian citizens continue to suffer? Or should he refuse to treat him and keep the family suffering? And was it even possible to treat the man in a meaningful way if he continued to work in the context of an inherently violent colonial regime?
Fink’s interest in learning and memory – especially her early experiments on the plasticity of individual neurons in the amygdala region of the brain – led to an interest in PTSD. “I always wanted to put it in a broader context,” she said. When she read Fanon’s case study by the police inspector in The Wretched of the Earth, the psychiatrist’s ethical dilemma struck a blow. “How do you see PTSD as a reducible biological phenomenon in the context of a society that is sick, violent and inhumane?” She said.
“How do you see PTSD as a reducible biological phenomenon in the context of a society that is sick, violent and inhumane?”
For Fink, the case is a useful starting point to examine the larger ethical issues related to the social dimensions of traumatic stress. She developed a “decision tree” to clarify the complex ethical issues. “PTSD can be thought of as a biological entity or as something socially contextualized,” said Fink. “And you can think of it as a personal narrative question.”
However, there are no simple solutions to the dilemma. “I don’t have an answer, and that’s the whole point,” said Fink to Ars, “it wouldn’t be a good ethical dilemma if there were a clear answer. The narrative shows us where the problems are.” Fanon’s own solution was not a solution at all. He quit his job in the hospital and joined the Algerian resistance. “This situation was unsustainable for him in the long run,” she said. “His final conclusion is that you cannot treat PTSD. In this inhumane context, there is no cure you can do.”
The comic trend could spread beyond the fields of health and medicine. Last fall, a doctoral student at the University of Iceland created a comic book version of the abstract for his doctoral thesis on a famous 13th-century Icelandic saga. The Ljósvetninga saga has several versions, and science has usually focused on dating the different versions to determine which ones could be the earliest. But Yoav Tirosh wanted to find out how the construction of the saga was constantly changing. His comic abstract is written in the form of a dialogue in which a fictional version of Tirosh meets the spirit of one of the central characters in the saga (Guðmundr inn ríki, a Godi(also called priest or chief) in the toilet of a hotel in Reykjavík.
“I liked the challenge of visually interpreting something that is very text-based like a doctoral thesis, and I originally even wanted it to be integrated into the work itself,” he told Medievalists.net. “However, this would have delayed my submission by at least a month and time was running out. That’s why I decided to do this during my vacation after submission. ”It also served as preparation for a larger goal: Tirosh hopes to produce an introduction to Old Norse literature in a comic form someday.
DOI: AJOB Neuroscience, 2019. 10.1080 / 21507740.2019.1632970 (About DOIs).