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Comic Storytelling in Medicine

benschwartz1Ben Schwartz, MD is a Staff Cartoonist for the New Yorker and an instructor in the Department of Narrative Medicine at Columbia University’s College of Physicians and Surgeons. After graduating from medical school at Columbia University and completing an internship in internal medicine, Schwartz decided to take the leap to becoming a full-time cartoonist. Though he no longer practices as a doctor, Schwartz has taken on multiple roles at Columbia as an instructor in their narrative medicine department, teaching classes on comic storytelling for medical school. He is also leading creative strategy for Columbia Medical Center’s surgery department, and helping design a comic-based clerkship curriculum for the ophthalmology department.

We had a fascinating conversation about medicine, cartoons, and the value of using art to make learning and self-reflection more creative in medicine:

Vidya: What got you interested in drawing cartoons?

Ben: I seriously cannot remember when I wasn’t interested in cartooning. There wasn’t any one moment that brought me to it. I was always in front of the TV watching cartoons, or looking at comic strips in the newspaper, and doodling and drawing my own. I always wanted to be a cartoonist, before I even really knew that was a job that people actually had. And as I got older, I never stopped being interested in it. It was always on my mind as a career path, but there came a point when I realized I didn’t know how you actually continued on that path. That was very intimidating to me, and so rather than figure that out, I just went with my backup plan, which was to go to medical school.

Copyright Benjamin Schwartz/Courtesy of the New Yorker

Copyright Benjamin Schwartz/Courtesy of the New Yorker

Vidya: Why was that your backup plan? What had made you interested in medical school?

Ben: My father’s a doctor; he’s a cardiologist. I thought the work he did, from what I could see of it, was really interesting—both the science and the connections he was making with people. I could tell how much he cared, and how fulfilling it was.

Vidya: What was it like doing the Columbia narrative medicine elective in your fourth year of medical school, and having an educational experience in medical school oriented towards the humanities?

Ben: I actually didn’t take the defined narrative medicine elective. I created my own narrative medicine independent study elective. I and a couple of my classmates worked together to make a children’s book, which dealt with a child going through the immediate grieving process after losing a parent.

Vidya: What was your decision-making process like when you were wondering about choosing cartooning as a career instead of medicine?

Ben: I hadn’t been happy in medical school or in my internship. A lot of people aren’t happy in medical school or during their internship—it’s tough, and it’s physically and emotionally exhausting. But I started to realize that I was not connecting with it in a way that was different from what the people around me were experiencing. From day one of medical school, when I said, “I don’t know if this is for me,” I would start hearing people say, “No one likes the first few months, it gets better after that.” And after the first few months, they’d say, “No one likes the first year of medical school, the next year is more interesting, that’s when it really comes together.” And then they get to the second year and they say, “No one likes the second year, its actually during the clinical rotations when you like it.” And I realized the goalposts kept moving, and I would look at my classmates, and see it click for this person, click for that person, and I just realized it wasn’t going to click for me because I wanted to be doing something else.

Copyright Benjamin Schwartz/Courtesy of the New Yorker

Copyright Benjamin Schwartz/Courtesy of the New Yorker

Vidya: Did you ever consider trying to do both: medicine and cartooning?

Ben: I did, and we had some discussions about whether there were ways I could continue my residency, and have breaks to do artistic pursuits. I know there are a lot of people out there who can do that, there are a lot of amazingly talented people in medicine, but it’s not me. I needed to remove the safety net, I guess, because if I could be a doctor and knew I had the security of that, then I thought I wouldn’t have the same motivation to put in the effort to do the other things.

Vidya: What was it like to break into that world of art and cartoons when you were working those long hours at the hospital and you didn’t have the same background as other people in the field?

Ben: It was kind of scary. I like to say I traded unhappiness for uncertainty. But it’s weird how things open up if you just keep at it, even if you don’t know what the right plan should be. You sort of put yourself in the right position to get lucky. As soon as I left medicine, the first thing I did was build back up my artistic skills. It’s a muscle that needs to be exercised. I took a night class at the School of Visual Arts in NYC just as a way to practice and hone my craft. I did some freelance work for a while, just some odd jobs, and then I found out about the admission process for the New Yorker. I submitted my first batch of cartoons to them, and they didn’t take any of them but they told me to come back with more. They rejected me week after week for six months, but eventually I broke through, and I sold one. Then another six months of rejection, week after week, and then I started to actually gain some traction with them.

Copyright Benjamin Schwartz/Courtesy of the New Yorker

Copyright Benjamin Schwartz/Courtesy of the New Yorker

Vidya: Do you find yourself drawing more medical-related New Yorker cartoons than the average cartoonist?

Ben: I didn’t think that I did. But there’s a website where they do studies of sort of silly subjects. They did an analysis of New Yorker cartoons, and broke them down by topics and all sorts of other things, and I learned that I did do more medical-related cartoons than the average New Yorker cartoonist. I’m sure it’s the type of thing where it was probably obvious to everyone except me.

Vidya: I’d love to hear more about your current involvement with Columbia’s narrative medicine curriculum.

Ben: I’m now an assistant professor at Columbia, teaching in narrative medicine. I teach a course for first-year students, I teach part of the elective for fourth-year students, and I also mentor fourth-year students in their scholarly projects, which are like thesis projects. Most students will do their scholarly project in clinical research, but they have the option of doing something in the narrative medicine track, so I mentor students with those. Both of the courses—for the first-years and the fourth-years—are workshop-based. I have them do drawings and comics exercises. For the first-years, the focus is on using the language of storytelling in comics to introduce them to the idea of the doctor’s role as storyteller, the idea that medicine itself is like working in a new language. With the fourth-years, the focus is on using comics for self-reflection and to think about their role, where they’ve been and where they see themselves. The students have a final assignment on our last day of class, which is to make a two-page comic narrative about some experience they’ve had related to their medical studies. When I see the amazing creative things that these students bring in, it just blows my mind each time.

Vidya: What are you doing to edit the curriculum of the ophthalmology department at Columbia?

Ben: The issue they were having was that for the clinical rotations, ophthalmology is a brief weeklong rotation, and outside of the students who know that they want to go into ophthalmology, it becomes easy to blow off, which is a problem. It leads to people going off into other fields and not really having a good baseline ability to triage ophthalmological problems. So the issue is how do you get students really interested, and how do you engage them? We thought we could try something different in terms of the text we give them. Maybe instead of a very dry ophthalmology textbook, we could do it as a comic textbook, add a little humor and personality to it, and make it accessible online and somewhat interactive. I have several chapters of this finished. Some other projects have cropped up—I’m currently also Chief Creative Officer for the Department of Surgery, so I’m setting their creative and digital strategy. They’re trying to do interesting things with social media and the web.

Vidya: Any advice for medical students or residents trying to keep up their creative pursuit while in training?

Ben: Make stuff. Just always make stuff. It’s really tempting to just say, you know, “I’ve been working a lot this week, I’ll do it later.” But if you don’t get to it, you’re just going to start losing that side of yourself gradually. You need to nourish that, you need to give it attention.

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