Nowadays almost everyone has been exposed to comics, especially during childhood. In a way, this is a natural form of progression from children’s story books, which also contain words and pictures.
This exposure has helped us to develop the graphic competence to decipher the images juxtaposed with the text, and extract from them a meaningful narrative in an enjoyable way. This form of medium has been evolving, attracting audiences ranging from children to serious minded adults, covering a variety of topics from philosophy  to political revolutions .
Within medicine, there has been the recent creation of a sub-genre of comics titled ‘graphic pathographies’, defined as ‘illness narratives in graphic form’ . This has incorporated itself into various fields including medical education, where viewing of comics helps patients to learn more about their condition , as well as providing medical professionals with an insight into the personal life of a patient, teaching empathy and bringing out the more humanistic side of medicine.
There has alsobeen research on the use of cartoon illustrations improving patient instructions. Delp and Jones  have carried out a randomised control trial involving patients coming into the emergency department with lacerations. After they were cared for, the patients were discharged with wound care instructions, half of them receiving it in plain text form, and the other half with cartoon illustrations. They were followed up three days later and asked various questions determining the efficacy of these two leaflets. The cartoon illustrations were more favourable in terms of patients actually reading the instructions (98% vs. 79%, p< 0.001), answering the wound care questions correctly (46% vs. 6%, p< 0.001), and being more compliant with daily wound care (77% vs. 54%, p< 0.01).
Children frequently attend the paediatric outpatient ophthalmology clinics without understanding what will take place; the appointment usually consists of several stages where the patient will see the orthoptist, optometrist and then the doctor. This lack of information can have an effect on their anxiety level as there is the fear of the unknown. Parents are often upset by the waiting times, and this is one of the leading causes of complaints within the outpatient setting. This may be due to the busy nature of the clinic, but also lack of understanding that there are various stages to the appointment, besides just meeting ‘the doctor’. We have therefore collaborated with an illustrator from Korea to produce a comic leaflet, outlining the process of the visit, which aims to lessen the children’s anxiety and educate both the child and the parent in an enjoyable way (see above).
Patient satisfaction surveys will be required to assess the efficacy of using comic leaflets and we plan to study this in detail in the near future.
1. Doxiadis A, Papadimitriou CH: Logicomix: an epic search for truth. Bloomsbury; 2009.
2. Satrapi M: Persepolis. Pantheon Books; 2003
3. Green M, Myers J. Graphic medicine: use of comics in medical education and patient care. BMJ 2010;340:c863.
4. Delp C, Jones J. Communicating information to patients: the use of cartoon illustrations to improve comprehension of instructions. Acad Emerg Med 1996;3(3):264-70.
TAKE HOME MESSAGE
Comics are widely read.
The readers range from children to serious minded adults.
There are various ways of applying comics into medicine.
Patient information leaflets are one way in which this medium can be effectively used.
Declaration of Competing Interests: None declared.