Graphic Novel Review: Lissa: A Story About Medical Promise, Friendship and Revolution

Review by Karen Throsby

The graphic novel Lissa: A Story About Medical Promise, Friendship and Revolution is written by Sherine Hamdy and Coleman Nye and illustrated by Sarula Bao and Caroline Brewer.

Sherine Hamdy is an Associate Professor of Anthropology at the University of California, Irvine, where she joined the faculty in the Fall of 2017, after being a professor for eleven years at Brown University. She is currently working on a Young Adult graphic novel about a Muslim-American girl’s experiences growing up in New York (with Beirut-based illustrator Myra El-Mir), under contract with Penguin. Hamdy’s first book Our Bodies Belong to God: Organ Transplants, Islam, and the Struggle for Human Dignity in Egypt (University of California, 2012) received Honorable Mention from the 2013 Clifford Geertz Prize. Her current book project Doctors of the Revolution, co-authored with Soha Bayoumi, critically engages with physicians’ roles in the political upheavals in the Arab world that began late 2010.

Coleman Nye is Assistant Professor of Gender, Sexuality, and Women’s Studies at Simon Fraser University. She is currently working on a monograph Biological Property: Race, Gender, Genetics, which mines the epistemological relations between genetic understandings of relation and property-based models of inheritance. Nye’s work on science, medicine, and performance has been published in such journals as Social Text, TDR: The Drama Review, Women and Performance, Global Public Health, ADA: A journal of gender, new media, and technology. In 2017, she edited a special issue of Performance Matters on “Science and Performance.” 

Lissa is a graphic novel, written by anthopologists Sherine Hamdy and Coleman Nye and illustrated by Sarula Bao and Caroline Brewer. The novel centres on the experiences of two female protagonists – Layla and Anna – whose relationship bridges, and is occasionally fractured by, differences in class, nationality, religion and culture.  The novel opens in Cairo, Egypt. Layla is an Egyptian Arab whose father works as a bawab (a doorman or porter) and Anna is a white American whose family has been brought to Egypt by his job in an oil company, but in spite of their differences, they are inseparable friends. Both girls (and later, as women) have to negotiate very different, but intersecting, medical dilemmas that test their relationship and highlight the ways in difficult medical decisions are inextricable from the wider context of gender, class, religion, nationality and culture in which they have to be navigated.

The opening sections of the book follow the death of Anna’s mother from breast cancer – a traumatic loss that later leads Anna to seek out genetic testing, culminating in the discovery that she carries the BRCA1 mutation. Now a student living in the US, she opts to undergo a prophylactic double mastectomy, but feels unable to share this with Layla, who is deeply opposed to her ‘mutilating’ her (currently) healthy body. Meanwhile, Layla has to confront her father’s gradual decline from kidney failure. Trained as a doctor, she is frustrated by his refusal to seek a kidney transplant – a resistance to intervention that reflects not only his religious concerns, but also fears of the ruinous financial costs to his family as a result of the surgery, the post-transplant medication and the loss of income while recovering. These two intertwined illness narratives disrupt any attempt to dislocate health and illness from their social contexts, raising critical questions about the insidious harms of environmental pollutants and unequal access to health care while at the same time exposing the cruel constraints surrounding many of the ‘choices’ offered to those forced to make difficult medical decisions. 

This turmoil occurs against the backdrop of the political disruptions of the 2011 Egyptian Revolution, which led to extensive civil unrest, the killing and wounding of civilians and the arrest and torture of protesters and activists. Layla provides medical care to wounded protesters and Anna travels back to Cairo to transport supplies to the volunteer medical teams and later, to help identify the dead and wounded. It is a cataclysm that pushes their relationship to its very limits as they wrestle with their twinned encounters with the limits of both medicine and revolution. The book concludes with their friendship restored and the cautious optimism of a political movement that endures in spite of everything, but this is no fairy tale ending. It is a complex, nuanced story of global politics, inequalities and solidarity for which there are no easy or comfortable conclusions; it is both uplifting and devastating.

The decision to use the medium of a graphic novel to tell this story is integral to its success. I am slightly embarrassed to confess that I have never read a graphic novel before – not out of some kind of intellectual snobbery, but simply as a result of the habitually text-based world in which I live and work. And so, when I started reading Lissa, I realised that I wasn’t sure how to read it. At first, I think I went too quickly; I felt like 8-year old me, galloping through the Saturday comic my Dad had brought home from the newsagents. So I went back to the start and forced myself to slow down, to relish the artfulness of the book and to register the small touches that reveal the spectacular attention to detail that characterises the work – a butterfly flit-flit-flitting across a page; the cats that appear as a continual motif throughout the book; the evocative portrayal of Cairo through long vistas and intricate ethnographic details. I particularly loved the ‘sounds’ of the book: a laptop slammed shut with a WHUMP; the FWUP of a closing book; the CLOP CLOP of shoes on tiles. The levity of the comic genre in these moments opens up evocative spaces for the serious work of the novel.

As I read, I came to realise that the organisation and craft of the genre does the work of pacing for the reader. This is explained in an intriguing Afterword to the book by cartoonist and comics instructor, Paul Karasik, who describes the techniques used to lead readers in tracking a story across panels and pages; how particular points on a page can be used to drive the reader to pause or to turn the page; and how the reader’s focus can be drawn in or moved on with only minimal use of words. I was also amazed to learn that the two lead characters were not only drawn by two different artists, but that they use different drawing techniques (digital / hand drawing), and yet still managed to produce a work that is visually and narratively coherent. But this is only one collaboration among many in the making of the book, including not only the writers and illustrators, but also a much wider cast of collaborators encountered during a team field visit to Cairo, several who appear in the novel as themselves. A further layer of collaboration occurs in the incorporation of the work of Egyptian graffiti artists, including both extant graffiti drawn during the Revolution and the creation by Egyptian artist, Ganzeer, of a composite mural relaying the book’s concluding message that not all hope is lost.

In its own terms, Lissa is a thought-provoking book that makes productive use of the graphic novel genre to explore the complexities of medical decision-making and the vast inequalities which frame those decisions. It is visually stunning and a remarkable reading experience, especially for this graphic novel novice. But the book is also much more than that, including extensive supplementary material that explores the motivations behind the project, the processes through which it came into being, a documentary about the making of the book and a useful teaching guide. Without question, Lissa constitutes a new and exciting way of effectively and engagingly communicating research across diverse constituencies. But more fundamentally, it also offers up a taste of how research can be made more collaborative, more creative and more accessible without sacrificing nuance, detail or critical edge; it is an exciting vision of how research can be done differently.

This thought-provoking intervention reflects a growing interest more broadly in arts-social science collaborations that aim to realise the manifesto call by Les Back and Nirmal Puwar to “make sociological craft more artful and crafty” (2012: 9). Exciting examples of these principles in practice abound. For example, in April 2018, Bethan Evans and I organised an event, funded by the Sociological Review Foundation, to explore the possibilities and challenges of arts-social science collaboration in relation to critical approaches to fatness. Contributions ranged from performance poetry to poster activism, and included two examples of collaborations with graphic artists: the animation Flying While Fat by Bethan Evans and animator Stacy Biasand the comic, The Weight of Expectation by Oli Williams and graphic artist Jade Sarson. Another innovative example is Imogen Tyler’s ongoing work on the Stigma Machine. This includes the Stigma Machine GIF, developed with graphic artist Tom Morris (see Tyler 2018), and the graphic comic, From Stigma Power to Black Power (Tyler and Bailey 2018). This latter was made in collaboration with graphic artist, Charlotte Bailey, and translates a published article into comic form in order to make visible the long tradition of Black critical thought on racial stigma that has been otherwise marginalised. This is just a handful of examples and in no way does justice to proliferation of innovative arts-social science collaborative work being done.

One of the key observations to come out of the Artful Fat event was that while arts-social science collaboration is replete with possibilities, it also poses many challenges. Among our participants, these included locating suitable collaborative partners; the time-consuming labour of bringing together very different work processes; and institutional barriers around prompt and fair payment for creative work. Nevertheless, Lissa stands as an inspiring example of what can be achieved by a properly resourced and genuinely collaborative team who are committed to the process of mutually listening and learning, and to finding new ways of developing our shared crafts. The fact that this is the debut publication for the University of Toronto’s ethnoGRAPHIC series, which aims to realise ethnographic research in graphic novel form, demonstrates the future promise of, and investment in, work of this kind. Lissa sets the bar high and I’m excited to see what it inspires and what else is to follow.

Karen Throsby is an associate professor in the School of Sociology and Social Policy at the University of Leeds, and the Director of the Centre for Interdisciplinary Gender Studies (CIGS). She is the author of When IVF Fails: Feminism, Infertility and the Negotiation of Normality (Palgrave, 2004) and Immersion: Marathon Swimming, Embodiment and Identity (MUP, 2016). She tweets at: @thelongswim

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