Cover image for Graphic Medicine Manifesto By MK Czerwiec

Graphic Medicine Manifesto

MK Czerwiec, Ian Williams, Susan Merrill Squier, Michael J. Green, Kimberly R. Myers, and Scott T. Smith


$32.95 | Paperback Edition
ISBN: 978-0-271-06649-3

Available as an e-book

208 pages
8" × 9"
34 color/86 b&w illustrations

Graphic Medicine

Graphic Medicine Manifesto

MK Czerwiec, Ian Williams, Susan Merrill Squier, Michael J. Green, Kimberly R. Myers, and Scott T. Smith

“Absorbing and accessible. . . . The authors explain themselves in both words and pictures (five sketch themselves as standard-issue professionals, and one as a small, cheerful chicken). They outline what drew them to graphic medicine and append excerpts from favorite works.”


  • Description
  • Reviews
  • Bio
  • Table of Contents
  • Sample Chapters
  • Subjects
This inaugural volume in the Graphic Medicine series establishes the principles of graphic medicine and begins to map the field. The volume combines scholarly essays by members of the editorial team with previously unpublished visual narratives by Ian Williams and MK Czerwiec, and it includes arresting visual work from a wide range of graphic medicine practitioners. The book’s first section, featuring essays by Scott Smith and Susan Squier, argues that as a new area of scholarship, research on graphic medicine has the potential to challenge the conventional boundaries of academic disciplines, raise questions about their foundations, and reinvigorate literary scholarship—and the notion of the literary text—for a broader audience. The second section, incorporating essays by Michael Green and Kimberly Myers, demonstrates that graphic medicine narratives can engage members of the health professions with literary and visual representations and symbolic practices that offer patients, family members, physicians, and other caregivers new ways to experience and work with the complex challenges of the medical experience. The final section, by Ian Williams and MK Czerwiec, focuses on the practice of creating graphic narratives, iconography, drawing as a social practice, and the nature of comics as visual rhetoric. A conclusion (in comics form) testifies to the diverse and growing graphic medicine community. Two valuable bibliographies guide readers to comics and scholarly works relevant to the field.
“Absorbing and accessible. . . . The authors explain themselves in both words and pictures (five sketch themselves as standard-issue professionals, and one as a small, cheerful chicken). They outline what drew them to graphic medicine and append excerpts from favorite works.”
Graphic Medicine Manifesto draws its strength from the way the individual voices coalesce to confirm not only the ability of comics to unravel medical culture and the pedagogical possibilities of graphic medicine but the transformative and community-building competence of graphic pathographies. In short, Graphic Medicine Manifesto is an essential read for scholars in comics studies, cultural studies, medical humanities, bicultural studies and visual studies, and to any reader who values the intersection of literature and medicine.”
“Something remarkable and game changing is being sparked by the alliance between comics and medicine. It’s becoming clear that these graphic narratives can deepen understanding, not only of facts but of feelings, between patients, families, and professionals. A spoonful of comics really does help the medicine go down.”
“Published in 2015, this book was one of the very first on graphic medicine. It continues to provide fundamental information for getting started with graphic medicine and building an appreciation for comic scholarship in medicine.”

MK Czerwiec is a nurse and comics artist. She is the artist-in-residence at Northwestern University’s Feinberg School of Medicine.

Ian Williams is a visual artist and illustrator, a medical doctor, and an independent humanities scholar. His most recent book is The Bad Doctor: The Troubled Life and Times of Dr. Iwan James.

Susan Merrill Squier is Brill Professor of Women’s Studies and English at Penn State.

Michael J. Green is a medical doctor and Professor of Humanities and Medicine at the Penn State College of Medicine.

Kimberly R. Myers is Associate Professor of Humanities at the Penn State College of Medicine.

Scott T. Smith is Associate Professor of English at Penn State.



MK Czerwiec and Ian Williams

1 Who Gets to Speak? The Making of Comics Scholarship

Scott T. Smith

Excerpt from Swallow Me Whole, by Nate Powell

2 The Uses of Graphic Medicine for Engaged Scholarship

Susan Merrill Squier

“Bad Blastocyst,” by Ruben Bolling

Excerpts from I Am Not These Feet, by Kaisa Leka

Excerpts from “Where Babies Come From: A Miracle Explained,” by Ann Starr

3 Graphic Storytelling and Medical Narrative: The Use of Graphic Novels in Medical Education

Michael J. Green

Excerpt from The Infinite Wait, by Julia Wertz

4 Graphic Pathography in the Classroom and the Clinic: A Case Study

Kimberly R. Myers

Vita Perseverat (Life Goes On), by Ashley L. Pistorio

5 Comics and the Iconography of Illness

Ian Williams

Excerpt from The Nao of Brown by Glyn Dillon

6 The Crayon Revolution

MK Czerwiec

Excerpt from Cancer Made Me a Shallower Person, by Miriam Engelberg

Excerpt from Old Person Whisperer, by Muna Al-Jawad


MK Czerwiec and Ian Williams


Selected Bibliography

Comics Bibliography

Author Biographies and Acknowledgments



Who Gets to Speak?

The Making of Comics Scholarship

Scott T. Smith

My earliest reading memories are of comics. As I grew up in the rural Midwest during the 1970s and 1980s, comics were available to me in limited and often unpredictable ways. The local drugstore carried some mainstream comics, as did the local grocery (along with a few edgier black-and-white magazines like Cracked or The Savage Sword of Conan), but there was no bookstore and certainly no specialty comics shop in our small town of 800 people. But there were yard sales. Long before the days of the collector market and eBay, people were quite happy to sell off their old comics for next to nothing. One of my uncles might stop by our house and drop off a few grocery bags of old comics he had picked up on the cheap at an estate auction, or I might manage to hit the annual yard sale of a local collector before the other kids got wise, hauling home a pile of four-color treasures with giddy joy. In such ways, I accumulated a makeshift collection of comics, which, when combined with the substantial holdings my friend Eric had inherited from his older brother and sisters, made up a scattershot archive of mainstream comics that reached back into the 1960s. Certain titles and runs from our shared hoard are forever burned into my memory: Steve Gerber’s iconoclastic Howard the Duck, Chris Claremont and John Byrne’s famed X-Men run, a handful of bizarre Weird War Tales comics, Frank Miller’s noir-with-ninjas Daredevil, and the hokey-but-always-cool Legion of Super-Heroes from the 1960s Adventure Comics.

I also unearthed a stash of forgotten comics tucked away in my Grandma Jean’s house, consisting of older titles from Marvel, Charleston, Gold Key, and Classics Illustrated. She also had a copy of the oversized Smithsonian Collection of Newspaper Comics, which reprinted early strips like The Katzenjammer Kids and Little Nemo in Slumberland. These classic newspaper comics amazed me with their scale and ambition—all this material together made me think that comics could do anything, be about anything. What strikes me now about this patchwork archive is how utterly random it was. I read what I could find locally, much of it older comics, supplemented by whatever occasional new titles I might pick up at a nearby store or through an occasional mail subscription. And aside from a very few collections in book form, I read comics as individual issues.

These reading experiences gave me an abiding appreciation of comics as a popular medium with a long and rich history. At the same time, I was completely unaware of underground and alternative comics—there were simply no venues for their distribution in rural Missouri (or at least none that I was aware of at the time). My interest in comics took a turn after 1986, though, when I was old enough to drive to a recently opened comic shop about forty miles from my hometown. In this modest little store, run by a teenage entrepreneur out of his family garage, I encountered comics that were then driving innovation in the mainstream: Frank Miller’s The Dark Knight Returns, Alan Moore and Dave Gibbons’s Watchmen, Frank Miller and Bill Sienkiewicz’s Elektra: Assassin, and J. M. DeMatteis and Jon Muth’s Moonshadow (none of which had been published under the content restrictions of the Comics Code Authority). These comics were all doing something new, and they all felt groundbreaking in some way. Suddenly the medium looked very different.

After I went to college a few years later, my interest in comics began to wane, largely due to fatigue with the superhero genre. If I had lived in a larger city, perhaps, I might have found comics like Paul Chadwick’s Concrete or the Hernandez brothers’ Love and Rockets to provide an alternative to the bloated mainstream, which had largely transformed into a collector’s market that would soon prove fatal to many publishers and comic shops. By my junior year, I had pretty much given up on comics and taken up with the literary fiction fashionable among earnest English majors. I would occasionally dip back into comics—drawn to titles like Neil Gaiman’s literary-baroque Sandman or Garth Ennis and Steve Dillon’s grossly irreverent Preacher—but I wouldn’t read them again on a regular basis until I returned to graduate school in the early 2000s.

My interest in comics was reignited when I was working through a rigorous English doctoral program with a focus on Anglo-Saxon language and literature. My return to comics coincided with my return to the university, and this convergence has undoubtedly shaped my thinking on the medium and its scholarship. At that time, I also found a public library with a substantial collection of comics and graphic novels as well as two local comic shops that carried more mainstream fare. For the first time I had easy access to a wide variety of comics new and old, alternative and mainstream.

Comics at first provided an anodyne for the grind of graduate school, but I soon began to think about the possibilities of comics criticism within an academic environment. I read whatever scholarship I could find on comics, even as I went through blogs and other online forums on a regular basis. I was struck by two things. One, it seemed that scholars weren’t yet sure what to say about comics or how they should go about saying it—in part due to the lack of an established scholarly tradition on comics. (This was in stark contrast to my experience with other areas of literary study, especially medieval literature, which had generated a vast field of secondary scholarship and resources.) Two, much of what I read by nonacademics was more insightful, informed, and rhetorically effective than what I was reading in university press publications and professional journals. It seemed to me at the time that the academy was running behind. Things have certainly changed over the last decade, as comics studies has become charged with an energy and open potential that seem entirely uncommon in academic disciplines. But part of that energy has come from comics criticism’s prehistory.

This past life in the public sphere, prior to and largely outside of academic discourse, makes comics studies especially exciting as a field that has the capacity to include and speak to diverse communities. Comics studies has the real potential to produce a public and open criticism that is responsive and accessible to both specialists and nonspecialists, to creators and critics, to casual readers and aficionados, to academics and nonacademics alike. Currently, comics criticism is quite strong outside the academy, as a number of writers and creators regularly produce quality work across a number of venues. Academic writing on comics stands to benefit from the contributions of those outside the university by engaging in an open conversation that welcomes and values many voices and perspectives.

Academic writing on comics has itself gained steady momentum and mass since the early 1990s. The last decade, especially, witnessed a flurry of academic publishing and activity interested in or featuring comics. Indeed, comics studies looks very much like a genuine growth area in academic scholarship. A number of online and print journals are now dedicated to or include work on comics, for example, while both university and popular presses have issued new and reprint titles in a competitive rush. Comics have likewise gained more presence in university classrooms and libraries, a development that demonstrates a growing level of institutional interest and support among teachers, librarians, and administrators. At the same time, comics scholarship remains an emerging field currently engaged in the ongoing (and occasionally tortuous) process of its own self-definition and delineation. Charles Hatfield has recently noted that “much of the work that goes on in a new field involves trying to define it. Academic comics study, not exactly a new but certainly a newly self-conscious field, has been particularly notable for this sort of anxious throat-clearing.” As Hatfield suggests, much current scholarship seems preoccupied with establishing definitions and justifying comics studies as a legitimate area of academic work. The time and need for this defensive reflex, though, has largely passed—comics studies no longer needs to apologize for its subject matter. In Greg M. Smith’s opinion, “For Comics Studies to mature as a field, academics need to assert they can study comics (as complex texts, as industrially produced objects, as culture in circulation) without making excuses for their devalued status. My suggestion would be to do solid, complex scholarly work on comics without apology, work that undisputedly provides insight. If we act as if we don’t need to justify our place, then the work itself will be its most powerful justification.” Unfortunately, through a lingering commitment to apology and self-justification, academic writing on comics has fallen into a number of habits and assumptions that keep the field in a prolonged moment of self-identification and self-defense.

This essay aims first to assess the current state and status of comics studies, with a particular focus on English-language comics and scholarship, followed by some suggestions on how the field might move forward in productive ways, especially as a discipline that is not primarily confined to (or claimed by) academic departments of literature.

Comics, Criticism, and the Academy

What follows is an overview of general trends in English-language comics scholarship since the 1980s. This thumbnail sketch is not comprehensive, but instead aims to chart a number of important developments and turns in academic writing on comics. One preliminary point is that much pioneering criticism was written not by academics, but by journalists, practitioners, fans, and enthusiasts. In the long view, the academy came late to comics studies. Since it has been taken up by academics, comics scholarship has generally followed familiar paths of development and traditional models of academic criticism in terms of its content and interests. Early studies from the 1970s and 1980s often worked to combat stubborn discrimination as they endeavored to establish the comics medium as a coherent and viable field of academic interest. Earlier publications were often quite specific in focus (such as Jules Feiffer’s The Great Comic Book Heroes) or primarily archival (such as The Smithsonian Collection of Newspaper Comics and A Smithsonian Book of Comic-Book Comics). These were important books, to be sure, especially as they presented older comics to new readers in a way that recognized and valued the history of the medium, but they were not what we would today typically recognize as scholarship or criticism.

A number of more ambitious studies later moved beyond these more specialized predecessors: David Kunzle’s monumental histories of comic strips, an ambitious survey of the early history of the English-language “picture story,” beginning from the early days of print in the fifteenth century and continuing through the nineteenth century (in two volumes, 1973 and 1990); Martin Barker’s A Haunt of Fears, which analyzed the ideological forces driving the 1950s British campaign against American crime and horror comics; and Joseph Witek’s groundbreaking Comic Books as History, in which his formal readings of comics texts brought welcome critical rigor and insight. As a representative group, these books exemplify a set of disciplinary approaches that have remained active in comics studies to the present day: historical and archival scholarship that charts a long prehistory and history for the medium; a cultural studies approach that considers how comics acquire significance through social use and exchange; and literary interpretation that balances formal analysis with a consideration of the medium as an ongoing and self-aware tradition. These books also show the great potential of interdisciplinary work in comics studies; such approaches can acknowledge and value the unique history and form of the medium in productive ways. And concurrent with these pioneering academic works, The Comics Journal, edited by Gary Groth, has long offered a lively forum—first in print and then online—for insightful coverage of comics. At its advent in the 1970s, The Comics Journal provided an important popular venue where writers, creators, and readers could discuss comics in an engaged and critical way. By the end of the 1980s, serious criticism of comics had become a visible and viable enterprise.

Comics were suddenly on the academic map. More scholarly work appeared in the 1990s, some of it no doubt in response to the occasionally hyperbolic coverage of the emergence of the “graphic novel” as a sign that comics had achieved a transformative maturation, especially as evidenced by the publication of three titles in 1986–87: Frank Miller’s The Dark Knight Returns, Alan Moore and David Gibbons’s Watchmen, and the first volume of Art Spiegelman’s Maus (each of which had appeared in serialized format prior to being published in book form). “Graphic novel,” apparently coined in the 1960s, seems to have entered regular circulation as a marketing term in the 1970s, when it appeared on long-form comics like Richard Corben and Robert E. Howard’s Bloodstar, but since then it has become an increasingly common descriptor for comics in general, most often with the misleading implication that the graphic novel represents a new kind of medium altogether. The idea seems to have been that comics had finally evolved into a higher art form, one fitting for older, more serious readers. This often-repeated but reductive account of a sudden ascendancy—which designates a decisive historical turn coupled with the cachet of a new label—has proven quite resilient in both popular and academic writing on comics.

In 1993, Roger Sabin voiced an early criticism of this manufactured narrative in his Adult Comics: An Introduction, arguing that “the idea of an evolution from ‘comics’ to ‘graphic novels’ had a specific purpose—to add prestige to the form and thus to sell more product.” Moreover, Sabin contended that “for such a story to have had any currency, there had to be one crucial extra element—public ignorance . . . the general public has traditionally been profoundly unaware of the potential range of the comics medium, and has continued to see it essentially as entertainment for children.” Sabin mounts a useful critique of prepackaged narratives—such as the triumphal rise of the “graphic novel”—that are convenient and accessible but that ultimately misrepresent both comics and their history, often while masking the power of market forces. Despite its potentially misleading title, Adult Comics provided an important early intervention in comics criticism. The book offered a useful overview of the medium that aimed both to expand general knowledge and to challenge assumptions new and old. The general awareness of comics is undoubtedly much different today than it was in the early 1990s, but Sabin’s hard-nosed criticism still encourages us to maintain a healthy skepticism of fossilized truisms about comics.

Also in 1993, cartoonist Scott McCloud published Understanding Comics: The Invisible Art, which remains perhaps the most widely read and cited book on comics to date. McCloud’s book, which is itself in the form of a comic, became something of a rallying point for comics studies. Like Kunzle and Sabin, McCloud proposes a long history of comics, which for him goes all the way back to cave paintings. Building on Will Eisner’s Comics and Sequential Art, McCloud offers an accessible vocabulary for analyzing comics as a visual medium with its own unique modes of signification. Understanding Comics importantly draws attention to the formal aspects and visual grammar of comics, offering useful definitions, categories, and rubrics for thinking about comics in a more systematic and precise way. McCloud’s book opened new possibilities for the study of comics: it asked readers to think about comics as a flexible and storied art form, and it offered a vocabulary for analyzing comics formally, one that has been readily adopted by many critics.

Other notable publications from the 1990s include a number of essay collections by individual authors. M. Thomas Inge’s Comics as Culture gathers a number of essays on comics (many of them previously published) that cover a range of topics and creators, including Winsor McCay, Krazy Kat, Charles Schulz, and EC science-fiction comics, along with a generous (and, for its time, comprehensive) annotated bibliography. In his introduction, Inge makes a case for comics as “another form of legitimate culture” (xxi) but also underscores some of the difficulties facing comics criticism at the time: “This is the most difficult area to write about because we lack the critical vocabulary and have only begun to define the structural and stylistic principles behind successful comic art. Instead we tend to rely on terms borrowed from other areas of creative expression” (xviii). This particular challenge still occupies comics studies today. How can the field draw productively from other disciplines and critical vocabularies without losing a sense of its own particularity? How can comics studies both inform and be informed by other areas of intellectual and social interest?

Other significant essay collections from the 1990s include those of Robert C. Harvey (himself a cartoonist and a frequent contributor to The Comics Journal), The Art of the Funnies and The Art of the Comic Book. Both books outline and model ways of evaluating visual elements in comics with attention to what Harvey calls “visual-verbal blending.” Harvey, like McCloud, broadcasts a bright sense of optimism and excitement for the future of comics, anticipating a “golden age” that lay “just ahead.” This was criticism charged with enthusiasm.

All the books from the 1990s surveyed above share certain features and interests: they offer some manner of historical overview for comics; they extend an introduction and invitation to comics; many of them include some theoretical content; and they work to justify comics as a “respectable” art form. All of these writers set out to educate a general audience about the comics medium—its history, its accomplishments, and its possibilities. In this sense, their writing functions as both criticism and advocacy. And while Inge has worked as an English professor, both McCloud and Harvey are writers and cartoonists, while Sabin was a journalist when he was invited to write Adult Comics. A significant amount of this emergent scholarship on comics, then, was written not by academics but by practitioners and enthusiasts whose considerable learning and experience laid crucial groundwork, both historical and theoretical, for the continuing formation and development of comics studies. This diversity of backgrounds, vocations, and interests—and the range of expertise and the discourses that came along with it—made it possible for comics studies to move forward in productive ways.

The rising quality and quantity of comics scholarship in the 1980s and 1990s increased the status of the medium within the academic world. Whereas a good deal of the early scholarship had appeared under the rubric of cultural studies or popular culture, more and more scholars in other disciplines began to “do comics” in their work. Indeed, beginning in the late 1990s and rapidly accelerating throughout the 2000s, something of a frontier spirit manifested as academic writers and publishers realized that a vast territory lay open before them, ready to be explored (and exploited) by enterprising spirits. Not surprisingly, some scholars, unwittingly or not, introduced careless errors and/or imported inherited attitudes about the “low” cultural value of comics as they moved to appropriate the newly available medium. Consider the following statement from Victoria Nelson, for example, which appears in her award-winning The Secret Life of Puppets (published in 2001 by Harvard University Press), wherein she considers the enduring presence of the spiritual and supernatural in popular media and entertainments: “In the 1980s comic books began to be translated from children’s reading and matinee serial fare to the medium of adult mass movies. Comic books themselves had always attracted a shifting adult readership—from the crude pornography of the earliest forms though the counterculture comics of the 1960s to the sophisticated ‘graphic novels’ of the 1980s, such as The Nightwatchman, written by Alan Moore and drawn by Dave Gibbons, which feature an exaggerated cinematic style.” These sentences appear during a discussion of the migration of the supernatural from high to low culture in the United States during the twentieth century, part of a process that Nelson calls “the ghettoization of the American fantastic.” The most howling error here, of course, is the botched title for Moore and Gibbons’s Watchmen, but the passage also recycles a worrying number of crusty assumptions and associations about comics in general: the development of “mature” comics, for example, begins with “crude pornography” (?) and ends with the “sophistication” of the “graphic novel” in the 1980s; the comparison between comics and film as a vague mode of praise for artistic accomplishment in the comics medium; and the seemingly indestructible idea that comics have evolved in fits and starts from children’s fare to attract, finally, a “shifting” readership among adults. Indeed, the above passage presents a miniature case study of uninformed academic writing on comics. As we can see, the increased availability of comics to academic scholarship can yield unfortunate consequences when that scholarship is careless. While such egregious missteps are generally rare, it is still not uncommon to encounter errors that have escaped the vetting process of peer review and editing. By the end of the 1990s, many academics had become interested in comics, but not all of them possessed the expertise and diligence necessary to create scholarship of lasting value.

The 2000s then ushered in a flood of titles on comics from both popular and academic presses—guides, anthologies, readers, textbooks, reprints, and more. Aimed at various audiences (fans, new and prospective readers, librarians, teachers, and scholars), the sheer number of such titles testifies to the explosive interest in comics in recent years. It is also noteworthy that both the National Council of Teachers of English (NCTE) and the Modern Language Association of America (MLA) have issued books to meet this burgeoning interest among their respective professional constituencies. Still, this mass of texts has generally remained dedicated to introducing comics to new readerships, to creating a corpus of notable content and creators, and to establishing comics as a legitimate area of intellectual interest. This current state of affairs indicates that comics studies is still very much occupied with announcing itself to the general public and defining (and justifying) itself as an academic field.

Within this prolonged start-up period, academic books dedicated to comics have tended to align themselves with established specializations and fields. This subscription to familiar paradigms has allowed easy recognition and dissemination across established disciplines, but it has also meant that the academic study of comics has largely been articulated through older critical movements and discourses.

A number of scholars have been critical of this reflex. Bart Beaty, for example, has argued that “Comics Studies has so far failed to develop analytic and theoretical innovations that could be exported to cognate fields. Rather, it continues to rely on terminologies and theories handed down from other disciplines.” This is certainly not to devalue wholesale such a diverse body of scholarship, much of which has proven productive and insightful, but rather to underscore the point that recent scholarship has primarily articulated comics studies within or through already recognized systems of academic writing. Beginning in the late 1990s, many books on comics began to fall in line with established and comfortably familiar (at least to academics) fields in order to achieve quick legitimacy.

While the earlier work from the 1970s through the 1990s had established the groundwork for later scholarship, it had also tended to imagine a tradition marked by designations of periodization, generic categories and hierarchies, and major creators. This work of classification and definition formed a lasting catalogue of touchstones, transformations, and turning points that continues to define comics for academic consumption and use. Such a process clearly resembles traditional disciplinary formation. Comics scholarship, for example, has assembled a short list of master texts (think Maus, Persepolis, and Fun Home) and creators (think Will Eisner, R. Crumb, and Chris Ware) that constitutes a makeshift canon, despite the fact that the very notion of canonicity has fallen under scrutiny over the last several decades in literary studies. Canon formation traditionally favors certain genres and creators at the expense of others, an exclusionary process that risks producing an encoded elitism that can obscure or deny the multiplicity of comics. In terms of genre, for example, memoir and nonfiction have been especially favored in recent academic studies of “literary” comics. This valuation has provoked some important debate over the status of particular genres in comics scholarship and the implications of generic privileging for the field. Debates like these, which are essentially contests over appropriate content and direction, are indicative of a young field that remains preoccupied with marketing itself as a worthy subject of serious scholarship.

Comics as Serious/Literature/Art

This preoccupation with self-presentation and justification emerges in a number of ways, some of which I want to consider here. These areas include debates over terminology and classification (definition), rehearsals of the marginal status and/or the justification of comics (apology), and exaggeration of the medium’s “potential” or “power” as culture, be it high or low or somewhere between (promotion). These reflexes must be at the very least interrogated, if not discarded, if comics studies is to move forward and produce enduring and far-ranging work. These preoccupations run the risk of overextending the field’s preliminary moment, but—perhaps even more important—they can also keep scholars from reading and discussing actual comics (or even encourage them to continue circling the same insular group of established “worthy” texts). Tactics of generalization and/or celebration too often misrepresent comics and in the process limit the conversations we can have about the medium and its cultural significance. Through a focus on the general, we lose a sense of the particular and the possible.

The very fact that so little agreement exists on what to even call the medium testifies to the current self-consciousness in comics studies. Is the preferred term “graphic novel,” “sequential art,” “comics,” “graphic lit,” or “graphic narrative”? Many of these labels represent name-brand bids at a quick respectability that can somehow magically shed old stigmas and misconceptions. I prefer “comics” as a generally inclusive term that recognizes the medium’s long history as a diverse popular form. Increasingly, however, academic writing has favored “graphic novel” over “comics,” no doubt in part because the newer label implies a transformation from low to high culture. Despite its enduring use, however, “graphic novel” remains a notoriously imprecise descriptor. Artist and writer Eddie Campbell has nicely described the term as being

currently used in at least four different and mutually exclusive ways. First, it is used simply as a synonym for comics books. . . . Second, it used to classify a format—for example, a bound book of comics either in soft- or hardcover—in contrast to the old-fashioned stapled comic magazine. Third, it means, more specifically, a comic-book narrative that is equivalent in form and dimensions to the prose novel. Finally, others employ it to indicate a form that is more than a comic book in the scope of its ambition—indeed, a new medium altogether. It may be added that most of the important “graphic novelists” refuse to use the term under any conditions.

Campbell sardonically outlines the problematic aspects of the term and its inconsistencies as a general catchall for comics in all their diversity of production, format, and content. Catherine Labio is likewise troubled by the term’s ability to exclude certain work, arguing, “the eagerness with which the phrase ‘graphic novel’ has been adopted in academic writing points to a stubborn refusal to accept popular works on their own terms. ‘Comics’ reminds us of this vital dimension. ‘Graphic novel’ sanitizes comics; strengthens the distinction between high and low, major and minor; and reinforces the ongoing ghettoization of works deemed unworthy of critical attention, either because of their inherent nature . . . or because of their intended audience.” One problem with “graphic novel” as an inclusive term, then, is that it shuts out some forms of the medium: single issues and pamphlets, instructional comics, propaganda, web comics, minicomics, and so on. This omission both misrepresents the medium—its various forms, uses, and means of distribution—and devalues (intentionally or not) a broad range of material which does not neatly fit into predetermined models and expectations, many of which have been generated and sustained by fields and interests outside of comics.

Similar to the question of naming the medium—and sharing many of the same intellectual desires and evasions—is the debate over a proper definition for comics. Equally important to these enterprises is determining what the medium both can and cannot be. What counts as comics, and—perhaps more important—what is at stake in answering such a question? Working toward a definition of comics has proven both a productive and limiting exercise. This dialogue has, if anything, increasingly suggested that while no definition of comics will ever prove satisfactory, each new one proposed advances its own restrictive set of value judgments. The question of definition has been with us at least since Coulton Waugh’s early attempt in 1947, with its focus on comics as a form of mass entertainment, while the definition game has come under increasing scrutiny in recent years, especially since McCloud proposed his own definition in Understanding Comics. McCloud influentially defined comics in this way: “Juxtaposed pictorial and other images in deliberate sequence, intended to convey information and/or to produce an aesthetic response in the viewer.” This versatile formulation avoids limiting aesthetic or value judgments, and it even encourages us to look for comics in places we might not expect to find them (although its insistence on sequence does preclude one-panel or single-image cartoons).

At the same time, McCloud’s definition and methods have generated a good deal of debate, especially his committed effort to “separate form and content.” Cartoonist Dylan Horrocks, for example, has argued that McCloud “constructs a way of talking about comics that affirms and supports our longing for critical respectability and seems to offer an escape from the cultural ghetto.” This recuperative work occurs in part through an ambitious revision of the history of comics that distances popular and conventional genres from the “essential” form of the medium. McCloud’s definition “is more than simply a descriptive model,” Horrocks argues, “it is also necessarily prescriptive. By reinforcing some values and suppressing others, it can influence the way we read and create comics, discouraging experimentation in some directions and imposing particular narrative structures and idioms.” Horrocks writes as a cartoonist, and his concerns consequently turn on the creative choices and possibilities for making comics, but his reservations are relevant, as well, to the work of criticism and its potential avenues of investigation and circulation.

The prescriptive element of definition appears frequently in academic writing on comics. Hillary Chute, for example, in an essay published in PMLA (the flagship journal for literary studies), defines comics as “a hybrid word-and-image form in which two narrative tracks, one verbal and one visual, register temporality spatially.” Chute’s succinct definition, couched in academic discourse, notably imagines the medium’s form as separate from its history. Her definition—along with her use of “graphic narrative” as a preferred term for nonfiction comics, in her opinion “the strongest genre in the field”—seems specifically designed to appeal to the academic readers of PMLA; at the same time, however, much as McCloud does in his own way, Chute implicitly separates the medium from its popular past and thus presents it as serious fare for serious scholarship. Moreover, through the work of discourse and the strategic selection of texts, Chute transmutes comics (or at least nonfiction comics) into “literature.”

Indeed, the “comics as literature” credo became increasingly prominent (if not clichéd) throughout the 2000s. In This Book Contains Graphic Language: Comics as Literature, for example, Rocco Versaci argues that comics represent “a sophisticated literary art form,” formulating his position through a series of comparisons between comics and other genres and media, such as memoir, photography, film, and literature. As one reviewer has noted, this comparative approach “is intended to loan comics some of the legitimacy of the established work, but the implicit suggestion is that comics are only worthy of serious consideration because they resemble the accepted literature.” In other words, comics gain value only through their association with other art forms—they are defined and discussed through the properties of other media rather than as their own particular form. Such a model of interpretation runs the risk of passing over aspects and potentials that are unique or especially well suited to the medium of comics. Why must comics be coded as “literature”? Leaving aside difficult questions of how even to define literature, the motive behind naming comics in this way is clear enough: to acquire a transformative legitimacy through a change of nomenclature. Moreover, naming comics as literature suggests that scholars can easily and without distortion apply existing discourses of literary criticism to comics.

But what do such shortcuts mean for our understanding and appreciation of the medium? What might we lose when comics become literature? In part, the championing of comics as literature imports hoary standards of aesthetic excellence, genius, and innovation. It can also promote the valuation of certain genres and creators at the expense of others. Calling comics “literature” begs an immediate credibility, but it does not accomplish the real work of thinking about comics as an artistic medium with its own history, forms of signification, and cultural uses.

These strategic definitions and name games all emerge in part from the uneasy awareness that comics were not considered a high art form in the United States for most of the twentieth century. Comics, we are incessantly reminded, were, for a long while, disposable entertainments, the trashy heirs of pulp magazines, written for the masses and churned out for profit. Scholars have worked very hard to dispel this negative association even as they repeatedly call attention to its existence. In the opening sentence of her PMLA essay, for example, Chute writes, “Comics—a form once considered pure junk—is sparking interest in literary studies.” The implication seems to be that comics have finally moved away from the vulgar and into the literary. New art forms, of course, have always inspired suspicion or been measured against, or (de)valued through, already established forms, models, and paradigms. Consider, for example, the low opinion of the novel that was common in the eighteenth century, as evidenced in the comments of Thomas Jefferson in a letter written in March 1818:

A great obstacle to good education is the inordinate passion prevalent for novels, and the time lost in that reading which should be instructively employed. When this poison infects the mind, it destroys its tone and revolts it against wholesome reading. Reason and fact, plain and unadorned, are rejected. Nothing can engage attention unless dressed in all the figments of fancy, and nothing so bedecked comes amiss. The result is a bloated imagination, sickly judgment, and disgust towards all the real businesses of life. This mass of trash, however, is not without some distinction; some few modelling their narratives, although fictitious, on the incidents of real life, have been able to make them interesting and useful vehicles of a sound morality.

Jefferson’s attitudes might strike us today as anachronistic, but his distinction between “trash” and “useful” reading is familiar enough. In many ways, Jefferson’s outlook recalls the recent privileging of graphic memoir and nonfiction works in academic writing on comics. Such texts, perhaps because they are not “fanciful,” can be taken seriously. One can read Spiegelman, Satrapi, and Bechdel without embarrassment, the idea goes, because they transcend the “mass of trash” by virtue of being part of a new comics literature that draws from “the incidents of real life.” Classifying comics as literature—or celebrating a particular work, genre, or creator—can be the valid work of criticism, but when these reflexes proceed from insecurities over the cultural position of comics, they run the risk of prolonging or perpetuating many of the obstacles that comics studies has worked to overcome, especially when scholarship marginalizes parts of the medium in order to justify what it considers to be serious or literary—or art.

Finally, the imperative to establish comics as literature has led many well-intentioned scholars to celebrate the medium in exaggerated terms. Such boosterism can be self-defeating. Consider the example of Stephen E. Tabachnick’s essay “A Comic-Book World,” which proposes several reasons why the graphic novel stands uniquely poised to eclipse, slowly but surely, the reading of books without pictures. The essay contains a number of dubious claims, such as its statement that Watchmen is “known as the Ulysses of the graphic novel for its subtlety, stylistic variety, philosophical reach, and depth of characterization, and which is much more approachable than Joyce’s Ulysses,” and later, that Moore and Gibbons “prove that verbal and visual poets can indeed be seers, as the Romans believed.” Such reckless overstatement stands little chance of winning the lasting interest of skeptics (or even the casually interested). And what does it mean that all the images in Tabachnick’s essay come from recent film adaptations of comics texts? The essay primarily (and problematically) discusses comics through something else—film, video games, 9/11, traditional literature, electronic reading, and so on. Indeed, we never see any actual comics in the essay. Overselling the medium in this way, without ever representing comics themselves, relies too much on often-repeated and easily anticipated talking points rather than on responsible and convincing analysis. For comics studies to move forward, we must stop appropriating value for comics through associations with other media and art forms. We need not valorize comics at the expense of rhetorical credibility.

The recurrent problems and pitfalls in comics criticism that I survey here generally proceed from the lingering perception that scholars must justify comics to an assumed audience of doubters and naysayers. These defensive reflexes, I contend, are both unnecessary and counterproductive. Academics are trained to think within established critical disciplines and to write primarily for other academics within those disciplines. One of the most exciting aspects of comics studies, however, is its potential to speak both to and beyond any one audience. As we have seen, comics criticism began in the public domain, and it still thrives there today. Aaron Meskin has called attention to the high quality of comics coverage in magazines and newspapers, for example, which can often “amount to more than reports of preferences. This is fully fledged criticism—albeit in compact form.” Likewise, a wealth of critical insight and expertise appears daily on online blogs and forums. And finally, as Greg Smith has observed of comics scholarship in general, “Some of the most useful published work comes from those who are outside of the academy because as writer-artists, they pay close attention to the production, distribution, and circulation contexts.” University scholars have much to learn about comics from nonacademic writers and practitioners.

Comics studies has the potential to speak to a heterogeneous audience with various interests and backgrounds. Consider, for example, the mission statement of the Institute for Comics Studies, which works “to promote the study, understanding, recognition, and cultural legitimacy of comics through communications within the scholarly, professional, and fan communities, and with the general public.” The Sequart Research and Literacy Organization likewise describes itself as a group that “publishes scholarly non-fiction books on subjects related to the medium of sequential art. Our books attempt to be scholarly but accessible to a general audience. We specialize in literary analysis that avoids the insularity that can typify academic writing, trying instead to open critical discourse on comics to a wider, intelligent audience.” Initiatives like these imagine a middle voice capable of speaking to multiple audiences. They also suggest that comics scholarship need not always follow well-blazed byways in order to navigate a short path to respectability. We need not transform comics into “literature” through the alchemy of discourse. Instead, we might look at comics more on their own terms even as we consider the different ways in which people read, create, distribute, and value comics. And, although it should go without saying, we must simply read more comics (certainly more than Maus, Persepolis, and Fun Home). We might think about how comics work formally, yes, but also how they are made and experienced by different communities of creators and consumers and how they acquire value through use and circulation. Since comics are a popular art born from a mass medium, shouldn’t comics studies also be pluralist in its interests and methodologies, considering how comics work as social objects that are used, exchanged, and/or contested by different groups?

Such a model of criticism can aspire to analysis that includes but thinks beyond comics as textual artifacts or as art objects that invite and reward interpretation, in order to consider also a multiplicity of uses, communities, business models, and institutional forces as well as influences and intersections outside of comics. This method might more freely include comics that do not conveniently demonstrate well-established attributes of the literary (e.g., memoir, “serious” matter, artistic excellence, formal innovation) as well as comics that come from multiple forms of distribution and consumption (online comics, strips, minicomics, small print runs, periodicals or floppies, personal work or work intended for limited circulation, and so on). From my own perspective as a literature scholar, this might mean attention to the ethical and social functions as well as to the aesthetic aspects of comics. Rather than championing canonical texts and creators, privileging certain kinds of narratives (especially those that fit comfortably within learned expectations of the literary), or even attending primarily to formal innovation, we might ask how comics work among and for a diverse public readership.

In closing, this essay calls for an open discourse that values collaboration over competition, inclusion over exclusion. By considering comics as cultural objects situated within and across different networks (social, institutional, textual, experiential, and so on), we can begin to answer Joseph Witek’s longstanding call for “critical discourse to use the conceptual tools at hand to examine the connections between the specific textual attributes of comics and the social, economic, and ideological matrices in which they are enmeshed.” Such a broad vision would effectively interrogate the cultural formation and value of the literary—and the place of comics within that ambiguous field—and consequently reengage literature with the social realm. The time has come for comics criticism to reflect the range, energy, and innovation of its subject.

Nate Powell’s Swallow Me Whole offers one example of a long-form comic that represents the variable experience of illness in several characters and raises questions over how standard medical discourse and diagnosis might be incomplete in response to those experiences. We especially see this effect when the character Ruth is diagnosed as schizophrenic by her doctor, who most often looks down at a desk when explaining the condition, its diagnosis, and the debate currently surrounding the “disorder.” Interspersed throughout the scene are silent images of Ruth’s brother, Perry, as he is elsewhere assaulted by another teenager and then interrogated by a passing police officer. Side-by-side panels show a simultaneous moment as Ruth receives a prescription from her doctor (the form is covered in illegal scribbles) and Perry reads a written citation from the policeman. This visual joining suggests an uncertainty in the diagnosis and treatment of mental illness, with additional associations of violence and institutional failure arising through the juxtaposition of the two scenes on the page.

Partial representation and silences in each scenario also mean that the reader must extrapolate from fragmentary evidence in order to assign meaning to the sequence. The side-by-side juxtaposition of prescription (physician) and citation (police officer) combines intimations of treatment, punishment, judgment, shame, and guilt, all of which are determined by the authority that diagnoses a situation or condition and then issues an official response in writing. This compelling scene calls attention to the multiple aspects and positions that shape the interpretation of texts, persons, and conditions. And when the penultimate panel assumes Ruth’s perspective as she receives her inscrutable prescription, the comic deftly challenges the reader to make sense of the text that he or she has been given. These pages accordingly invite the reader to both interpretation and empathy.