Review

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In: Blog, Medical Independent, Review, The practice of Medicine

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When’s the last time you read a comic?

As a boy I loved reading The Beano and later, like lots of other adolescent boys, immersed myself in the more violent worlds of Action and 2000AD. As a medical student, I became attracted to the subversive allure of Fat Freddy’s Cat, The Fabulous Furry Freak Brothers and then, in my late 20s, to Viz magazine. Then I stopped. Whatever role comics might have played in my childhood and young adulthood, it was time to move on. So why do I find myself, in my early 50s, back reading comics again?

Because of GP and cartoonist called Ian Williams. Williams is responsible for coining the term ‘Graphic Medicine’ which describes, according to the graphicmedicine.org site that he helps run, “the role that comics can play in study and delivery of healthcare”. Williams has also produced a wonderful new semi-autobiographical graphic novel, entitled The Bad Doctor — “a darkly humorous tale of medicine, cycling, obsessive-compulsive disorder and heavy metal”. The book details the life of the flawed (in his own eyes), yet deeply human, Dr Iwan James. This wonderful meditation on medicine, humanity and healing is a great reason to start reading comics all over again.

As soon as the book starts, we are drawn into Dr Iwan’s world and sympathise with him as he hilariously navigates the daily grind of heartsink patients, difficult colleagues, middle age, baldness and self-doubt. It is particularly touching where it deals with his experience of growing up, trying to maintain relationships and work, all while suffering from OCD.

concentrationIn a scene depicting his childhood, it describes the early development of an exaggerated sense of responsibility for the health of those around him (something many of us will identify with). He even demonstrates how his unique experience of living with an illness can help him to help his patients. In another touching scene in the book, he breaks the usually unspoken boundaries of the doctor-patient relationship by sharing the details of his own illness with a patient struggling to cope with OCD — and in doing so, helps his patient.

 

Writing comics, and bearing witness to his own problems may also have had a cathartic effect for its author. Writing in The Independent, Williams describes how comics gave him a means to talk about an area of his life he hadn’t, as a doctor, felt able to share before.

“In fact, I almost never discussed them with anyone before finding my voice through the medium of comics, in which I found a way to articulate my own earlier struggle with mental illness.”

The book also details the attitude of his professional colleagues to his mental health problems. When he confides with his practice partner that he has fantasised, throughout his life, about killing himself (“Wouldn’t act on it, though… don’t worry. It’s only a mental habit. I don’t own a gun or a guillotine”), his partner’s primary concern is that this might invalidate the practice insurance.

I read the book three times in 24 hours (although it runs to just over 200 pages, it can be read in 30-to-40 minutes). There is something unique about the reading experience of being pulled along by the combination of the framed pictures, the text and the gaps in between. Using cartoons, he manages to describe Dr Iwan’s world in a way that would have been impossible in the form of an essay or through fiction.

With great bravery, wit and technical skill, Williams has managed pull off a number of impressive feats simultaneously. By digging under the surface of a doctor’s working life in the context of his day-to-day existence, he gives an insight into how the theory of medicine is so different from its practice. He also demonstrates what it is like to live life with a mental health illness, while simultaneously showing an excellent doctor practising good medicine, despite it. All the while keeping us laughing and entertained.

This funny, sometimes sad and courageous book will, I hope, go some way to help non-medical readers to understand the challenges of practicing medicine and show that doctors, like them, are human and suffer.

It might even help a few doctors to think a little differently about mental illness amongst their own.

This article was originally published in The Medical Independent

Although readers of this blog will be aware that I’m a big fan of the new RSS Reader Feedly, I sense that its use by the broader medical community may be limited by a general lack of familiarity with RSS technology in general. A show of hands at a presentation I gave last week indicated that only 2 out of a room of about 20 healthcare professionals had actually heard of RSS.

I was therefore interested to learn about new iPad app called Docwise which allows users to collect updates from their favourite medical journals without having to use RSS directly.

Docwise is an ejournal / magazine for iPad which allows doctors to easily gather and display content from multiple medical journals, news sources and search terms all in one place. Once a doctor has registered their area of specialist interest on the app, journals relevant to their specialty are offered for inclusion. All recent articles from their chosen journals are then displayed in a nice clean ‘card’ format across the screen, along with some appropriately linked stock pictures (which help liven up the usual dull appearance of a short text summary of an article).

Clicking on the relevant article then links automatically to the original article abstract on the journal Website. Where you are a member of an institution which has signed up for the service, it is also possible to see the full text of the article. There is also an option to allow push alert which notifies you when the full free text of the article is available.

It possible to ‘favourite’ an article for later reading, download an article for reading offline, and add search terms (which will allow automatic searches across all subscribed journals). It is possible to share articles on Twitter, Facebook and email. The app also tracks the amount of time spent using and and reading artciles and allows this information to be collected by Docwise to produce a summary which can be sent to users.

The screen output is very attractive (resembling Flipboard), easy to read and navigating the various screens is very intuitive. The great strength of this app is that it allows content to added without having to search for the relevant RSS feeds for relevant journals (the term RSS isn’t mentioned once). It all works in the background.

Although I appreciate that this app is new and that additional features and platforms (iPhone, Android and browser compatable versions) will likely be added over time, I think it could benefit from a few additional features e.g.;

A wider range of options for social sharing (e.g. Evernote, Buffer.app, Google Circles).
It would also be great to see what other people are sharing i.e. ‘most Tweeted’ or ‘Most emailed’ articles for any particular journal.

Like many doctors, I’m interested in a lot more than what is presented to me from medical journals or trade press. It would nice to see some additional news sources added (e.g. from lay press – New York Times, The Guardian Health etc) or the ability to add blogs. The ability to subscribe to, or at least manually add RSS feeds, from other sources would also be welcome. A more seemless way of making posts disappear from the feed once read would also a good addition.

Docwise will appeal strongly to healthcare professionals who want to keep up with updates relevant to their specialty without the nuisance of having to receive those ever so annoying table of contents emails. At present it is likely to suit those who are happy to keep their information feeds exclusively related to healthcare but those with broader interests might have to wait a little while before more features are added.

I’m looking forward to future updates.