Livewell Comics to release educational series about constipation

Dr. David Suskind’s Livewell Comics line is proving that the comics medium can do something clinical language often can’t: make scary medical information stick.

Suskind, a pediatric gastroenterologist at Seattle Children’s, started Livewell Comics in 2018 after he noticed his young patients and their families often left appointments without really absorbing their diagnoses and the information he had given them about it. Whereas, adult patients can turn to Google MD or informational pamphlets provided by their doctors to learn more about their medical diagnoses; before Livewell hit the scene, there weren't health communication options built for kids. So he partnered with Archie Comics cover artist and illustrator Jason Piperberg to create Professor Nimbal – Explorations in Crohn’s and Colitis in 2018, the flagship comic that launched Livewell. It follows two kids and Professor Nimbal, a bow-tied scientist, who take a trip into the large intestine via the P.O.O.P. (People Operated Omniverse Projectile) to explain Inflammatory Bowel Disease from the inside out.

Suskind frames Livewell stories as not only patient education, but also as stigma-reduction. Comics make difficult (and sometimes embarrassing) health and wellness topics, like bowel function, more accessible by reframing them so they feel less scary and less gross, which he says leads to better patient-provider conversations and improved care. Per the GI Nutrition Foundation, the comics are built to help kids and parents understand the research behind using dietary therapy as medicine, and why that approach might be the right choice for some families managing IBD.

Removing that stigma can also lead to better conversations with providers, and ultimately, improved communication and care. “One of the Achilles’ heels of medicine is that we don’t have enough time to sit down and talk about the conditions people are facing,” he says. “This allows someone to get a better understanding in a hopefully approachable way.”

Nine comics exist so far — all are free and available to read, covering functional abdominal pain, eosinophilic esophagitis, fatty liver disease, celiac disease, cyclic vomiting syndrome, h. Pylori infection, inflammatory bowel disease, rumination syndrome, and a flu-vaccine comic born out of a hospital vaccination push. The length of each comic scales with complexity, with some running 28 pages, others far shorter. So far, translation work for these comics is grassroots: each comic has been translated into multiple languages by healthcare professionals around the world, and the original IBD comic specifically has reached 15 languages, with clinicians in Saudi Arabia and Jordan reporting success using it.

But this summer, Suskind’s putting the finishing touches on his tenth comic, which will feature constipation. Like other comics produced by Livewell, the constipation comic will use kid-friendly storylines and humor to demystify a topic that can otherwise feel complex and uncomfortable. “Oddly enough, people don’t like talking about pooping,” Suskind said in PR from Seattle Children’s. “But, when you put it out there in a comic’s funny frame, it becomes less scary and less gross.”

Read the description of the constipation comic below, provided via a press announcement by Seattle’s Children:

His latest comic, which will be out in several months, will consist of 32 pages exploring constipation. This time, he was inspired by a young child named Tatum who experienced chronic constipation, and ultimately died from related complications. While the story is tragic, the hope is that the work will raise awareness of the condition and encourage more open conversations about a topic that can be tainted with embarrassment.

Tatum’s family has been working with Seattle Children’s to spread the word about abnormal bowel functioning, explains the family’s web site. One of the doctors they’ve worked with, gastroenterologist Dr. Lusine Ambartsumyan, will appear in the comic.

With the support of the family, the comic will also include various “Easter eggs” that honor Tatum’s life. 

This matters beyond one hospital. Suskind’s project is a working example of graphic medicine, a formally recognized field that integrates comics into medical education and care delivery. The term was coined by a consortium of researchers, clinicians, and artists to name what they saw as an emerging discipline, and it’s since produced its own foundational text, 2015’s Graphic Medicine Manifesto, published by Penn State University Press. The field’s central claim is that comics communicate the health experience in ways conventional text can’t, by combining art, relatability, and empathy, benefiting both health literacy and doctor-patient communication.

Learn more about graphic medicine with the following resources: 

• Penn Nursing, Office of Nursing Research, “Using Illustrations and Comics for Better Health and Science Communication,” Innovation Colloquium, April 2021.

• Green, M.J. & Myers, K.R., “Graphic Medicine: Use of Comics in Medical Education and Patient Care,” BMJ.

• Wombles, C., “Graphic Medicine: Comics as a Patient Education Resource,” Journal of Consumer Health on the Internet, Vol. 25, No. 3.

• Czerwiec, M.K. et al., “Impact of an Educational Comic to Enhance Patient-Physician–Electronic Health Record Engagement,” JMIR, PMC8116991.

• SUNY Upstate Medical University, Graphic Medicine subject guide.

• University of Michigan Library, Graphic Medicine & Comics in Healthcare research guide.