Like many kids, cartoonist Ellen Forney grew up in fear of the demon that lived in the toilet. Each late-night trip to the bathroom was punctuated with the same beats of terror: hopping out of bed, exiting her safe bedroom, blasting her retinas with the shockingly bright bathroom light. And then, worst of all, she had to lift up the lid and unleash the horrifying creature surely waiting for her each time.

Later on, Forney made a comic about the commonly feared "demon in the toilet" and that comic found its way into the office of a pediatrician who uses it as a tool to help tell kids and parents that yes, children will probably be scared of things that they actually know aren't real. And parents, don't worry, your kid isn't the only one scared shitless of what might live in the toilet.


Forney is one of four keynote speakers at the 2014 Comics and Medicine Conference, which focuses on the significance of visual language in the medical community. This year's topic, "From Private Lives to Public Health," intends to highlight the potential for sequential art to connect and foster communication between physicians and patients.

Ian Williams, a physician and artist based in North Wales, started what ultimately became the group behind the conference, Graphic Medicine, as a website in 2007. That space quickly attracted professionals from both sides of the Atlantic. The conferences began in 2010 and have since been held in London, Chicago, Toronto, Brighton, and now Baltimore.

This week, Williams also releases his first graphic novel, The Bad Doctor, the fictional story of Dr. Iwan James, who must navigate the intricacies of his professional and personal life, including frustration with his patients, institutional concerns, and his own ability to get through the day feeling OK with himself.

Along with Ellen Forney, this year's keynote speakers are James Sturm, Carol Tilley, and Arthur Frank. All of them will share their individual work investigating the ways in which comics can teach us about communication and health.

Forney is the author of the graphic memoir Marbles: Mania, Depression, Michelangelo and Me. "Graphic memoir" is an apt term for the medium in which Forney investigates her past and personal struggle through diagnosis, treatment, and life with bipolar disorder. Via Skype, she points out that the visual nature of comics provides an ideal platform for the intimate, emotional details of her life.  But "health care is ideally the combination of the clinical and the personal," Forney says. So, while still evoking raw honesty over Forney's fluctuating mental state on the page through drawing, Marbles is also annotated with facts culled from professional resources like the Diagnostic and Statistical Manual of Mental Disorders. Her experimental manipulation of style allows Forney to visualize the link between the physical and the subjective aspects of her mood disorder, changing the linework to evoke the chaotic emotions she was feeling at the time in her story. Forney's work points to one of the many ways comics helps communicate the experience of illness and add empathy to the discourse.

"[Marbles] was only going to be true to other people if it was true to myself," Forney declares. The truth Forney suggests is a holistic one, a combination of clinical and personal information—with a healthy dose of humor. Marbles reads like someone telling her incredibly heavy story and laughing to keep from crying. "Humor is really disarming," she says. "It lowers the tension and allows the reader or listener in and allows some sort of connection."

James Sturm, comics artist, teacher, and co-founder of the Center for Cartoon Studies (CCS)—best known for work such as  the quizzically nostalgic Fantastic Four: Unstable Molecules and personal-is-political graphic-novel history lessons Satchel Paige: Striking Out Jim Crow and Market Day—also brings up the role humor can play in relieving anxiety and fostering conversation about difficult subjects. "I know from a case study of one that comics has a lot to do with mental health," Sturm jokingly admits over the phone. "It has really helped me out over the years."

Sturm, whose recent work with the CCS employs cartooning as therapy for war veterans, suggests that humor has "an incredible detoxifying effect" on those with PTSD and other emotional traumas. "To kind of laugh at oneself [and] take fear and put it on a page in a way that's humorous" is incredibly important, Sturm says. But the therapeutic potential of comics isn't limited to those with severe problems.

"No matter who the audience was [that] I was in front of, they always had a positive association with comics," Sturm, who describes himself as a "cartoonist slash educator," says. "Cartooning is a really good starting point for engaging students and [then] you can build from there."

This broad appeal makes comics can provide young people with a significant entry point into literature—but the same appeal also carries a certain stigma among adults. Carol Tilley, a librarian and professor, wants to change that. She focuses her comics-positive work on young-reader advisory and the history of the interpretation of comics by those in power.  Her talk at the conference will analyze Dr. Fredric Wertham's 1954 book Seduction of the Innocent, a fear-mongering text that speciously connected comics to juvenile delinquency and led to significant censoring of comics in the 1950s.

To some extent, this comics-phobia continues to this day, though things are changing. "When I started out as a librarian 20 years ago, it was still really difficult to collect comics from a library standpoint because the traditional book media vendors didn't make comics available," Tilley recalls over Skype. She believes comics are an important part of the world of information, particularly to young people. "The development of [literary] fluency in the experience of reading comics is valuable for general literacy development," Tilley says, rejecting the belief that reading comics stunts emotional and intellectual maturity. "[Comics] provide a great opportunity to develop empathy, learning about other people's experiences, about insights into other cultures or historical periods."

Although libraries now collect comics more readily, the medium still faces an unusual set of almost contradictory challenges. On one hand, Tilley explains, librarians, school administrators, and others in charge of library collections often view comics as a childish waste of thinly-stretched funds. On the other hand, many of the very same people are concerned about the material presented in comics, deeming it "too adult." Tilley notes the inconsistency with those "concerned about offending people with the visual depiction of what we would read everyday in a prose novel."

This contradiction can, however, be seen as a boon. Arthur Frank, whose writing on illness narratives began with his own battle with cancer (detailed in 1991's At The Will of the Body: Reflections on Illness), investigate the importance of communication about illness, even for those who aren't sick. "Comics are especially good at integrating illness into the everydayness of life," Frank says over the phone.

Comics, which present the readers with both text and visual information, often interacting and sometimes countering one another, afford the reader a more visceral experience. This is particularly important in regards to the daily realities of living with a sickness: "Pictures enable a level of everyday living to be in the story that just doesn't work [the same way] in prose," Frank says.