In my classroom, I try to engage students through a multi-modal approach to pedagogy. This means in all my classes I approach whatever the topic through a variety of forms, genres, exercises, and assignments. Comics and graphic narratives have become a key component of my pedagogy, both in terms of the materials I teach and the activities I have students do. Most of my courses take up topics and themes related to my research into what I call the conjunction illness-thought-activism in history (Diedrich, 2016). In my work, I am interested in illness and disability in action in particular times and places. Thus, I have found myself drawn to the growing field of graphic medicine, and its diverse community of practitioners, as inspiration for my research and teaching (Czerwiec, et al., 2015).

During the pandemic, graphic medicine has become even more central to what and how I teach. In this essay, I will discuss how I used comics as pedagogy in classes on illness and illness politics that I taught during the first year of the pandemic. In fall 2020, I taught an upper-level undergraduate seminar called Documenting Mental Illness in an asynchronous online modality, and in fall 2020 and spring 2021, I taught slightly different versions of a 1-credit seminar called Illness-Thought-Activism: From HIV/AIDS to COVID-19 in a synchronous format, the first to graduate students in the MS program in Narrative Medicine at Columbia University and the second to first-year students in the Leadership and Service Undergraduate College at Stony Brook University, both located in New York, USA.

Negotiating these multiple classroom genres—from freshman seminars to graduate seminars, from introductory classes to upper-level topics courses—is one of the pleasures of teaching for me. Unsurprisingly, under pandemic conditions, this negotiation became more challenging. Thus, I will begin by briefly addressing how I framed the problem of studying illness in a pandemic before discussing two assignments that show graphic medicine in action as a pedagogical tool: the first, an asynchronous online group discussion exercise in which students practiced annotation as a method of visual analysis, and the second, a documenting COVID-19 final project assignment for which students could document in comics form a pandemic experience or event.

Studying Illness in a Pandemic

Documenting Mental Illness was not a new class. I had taught it before, but always in person. As I prepared to teach it asynchronously, I worried that studying mental illness online during a pandemic might be alienating and isolating for some students. Thus, in a section on the syllabus called “On studying mental illness in a pandemic,” I tried to acknowledge at the outset the conditions under which we were approaching this sensitive topic. I wrote in the syllabus,

I know these are incredibly challenging times. New York has been one epicenter of a pandemic that is not over. We have also witnessed the horrific killing of George Floyd, and many of us have participated in the protests erupted in New York and all over the world against police violence. These are not ordinary times and many instructors, including me, have had to adapt from in-person to remote learning. I firmly believe this is the safest and most accessible way to learn at the present time. I know that many of you are pleased to be able to take your classes online; some less so. I am committed to working together to create a flexible and inclusive space for learning that takes seriously one of the themes of the class: the need to think creatively about our practices of healing and spaces of care. This includes the online space in which we will study mental health and illness in a pandemic. Feel free to reach out to me should you have concerns as we take on a difficult topic at a difficult time (Diedrich, 2020).

With this statement, I tried to address the fact that our online class was nested within larger institutional, community, and world-historical contexts, all of which impact our learning experiences. In my classes, I often teach about biopsychosocial approaches to health and illness, but I also understand and try to convey that learning itself is a biopsychosocial experience that happens in relation to other body-minds, both near and far, in the classroom and beyond. The pandemic made these lessons about the interrelationship between bodies, psyches, and social worlds more apparent. Yet, despite my concerns that students would feel isolated by the asynchronous online modality, I was pleased to discover instead that this modality helped in creating a space of care by allowing intense, yet flexible, engagement. In fact, it seemed to me that the flexibility of online spaces and temporalities increased the intensity of the engagement of many students. This was most apparent in students’ discussion board posts, and especially in annotation exercises that I had students do in groups. Small group work assignments are often fraught because many students find it anxiety-provoking to have to rely on others to complete an assignment. Yet, in this instance, group work created a bridge between students who otherwise would not have connected directly with each other. In the next section, I explain how this group annotation exercise worked in practice.

Annotation as Method of Visual Analysis

Twice during the semester, I organized students into groups to practice annotation as a method of visual analysis. I took images from two texts—Ebony Flowers’s graphic story “My Lil Sister Lena” (2019) and Clyde Petersen’s stop-motion animated film Torrey Pines (2016). I selected several images from each text—full pages from Flowers’s graphic story and screen grabs from Petersen’s animated film. I uploaded these images as separate threads on Blackboard and divided the class into 5-person groups and assigned each group an image in advance. First students had to read or watch the text and then they were required to annotate the image assigned to their group. I provided a detailed description of how to annotate, first explaining that annotation often means writing directly on the text or image. To show them how this might work with comics as text, I provided a link to Nick Sousanis’s blog [online, no date] about his Visual Analysis Comics Class, which features incredibly detailed and creative annotations that his students have done in his classes.

Since we were working virtually, I didn’t want to presume that students would be able to print out the image or write directly on it digitally, so I suggested they might take detailed notes about the image rather than write directly on it. In my instructions, I encouraged students to study the image carefully and to take notes on what they saw and felt as they looked at the image. I explained that this is descriptive work and I noted that good descriptive work takes time and care. To get them to look and look again, I instructed them not to simply look and take notes in one sitting, but to look once and then do something else (sleep on it, go for a walk, watch a film, listen to music) before returning to look again. Although my instructions did not specify this, many students organized their notes into two sections—first look and second look—and some expressed surprise at what they hadn’t noticed the first time.

Once students had fully annotated and described the image, they were then instructed to interpret the image in a short paragraph. I encouraged them to draw on key concepts from other course materials and previous class discussions to support their interpretation. Once they had completed these two components of the exercise, they posted both their notes and interpretation on Blackboard. Blackboard allowed me to make it so that they could only read posts from other members of their group once they had posted their own annotation. As I had hoped, making them post first before reading other annotations helped generate a more diverse mix of responses, as well as more enthusiastic comments. Many students were excited to discover what their classmates noticed that they hadn’t noticed, and this helped demonstrate one key theoretical point that John Berger makes in his classic visual culture text, Ways of Seeing: “The way we see things is affected by what we know or what we believe.” Looking, according to Berger, is “an act of choice” and a “relation between things and ourselves” (Berger, 1972).

The exercise worked well, both at the level of individual engagement with the text and as group work. The different components of the exercise—annotation, interpretation, and discussion—gave the students a structure for delving into material that was verbally and visually complex. For example, one perplexing aspect of Petersen’s film for some students is that there are no words (Figure 1). There is a music soundtrack, and sonic elements are key to the film’s form and content, but, except for one sentence (“he comes from a secret place,” from Beauty and the Beast (1987), which the protagonist is watching on television in one scene), no words are spoken. Petersen has explained that this makes the film more accessible: Torrey Pines can be shown anywhere, and no translation is required. Yet, when I had previously shown the film in an in-person class and tried to have an open-ended discussion after, the conversation was somewhat stilted (students couldn’t find words—at least not right away—to express what they thought and felt about the film). The asynchronous annotation exercise created time and space for students to consider the film’s form and content, analyze images from the film in relation to the film’s overall wordless narrative, and interpret the meaning of these images, all before a conversation with their classmates began. Annotation laid the groundwork for thoughtful analysis and generative discussion. Although an annotation exercise can also work in an in-person class, I think the asynchronous modality allowed more time and space for looking at and thinking about images than is afforded by doing the exercise in class. The asynchronous modality taught me a lesson that could translate to synchronous or in-person modalities: the key to creating the conditions of possibility for good discussion is to slow things down, which can be done by creating steps done over time. Synchronous and in-person annotation activities could happen both in and outside of class, so that annotation, interpretation, and discussion are extended over a longer period of time.

Figure 1
Figure 1

Twelve-year-old Clyde Petersen and his mother in the audience at a Whitney Houston concert that they attended on their cross-country road trip in the early 1990s. Screen grab from the film Torrey Pines by Clyde Petersen (2016). Ó 2016 Clyde Petersen.

Documenting COVID-19 in Comics Form

If the annotation exercise used comics as pedagogy to encourage thoughtful description, interpretation, and discussion, I also wanted to give students the opportunity to draw their own comics as a means of documenting illness experiences and events. In Illness-Thought-Activism: From HIV/AIDS to COVID-19, we explored the medical, political, and aesthetic responses to the HIV/AIDS and COVID-19 pandemics. We used the historical example of the emergence of HIV/AIDS and the increasing politicization of the illness as a lens through which to examine the ongoing contemporary emergence of COVID-19. The final assignment for the class was a Documenting COVID-19 project that had three options: an interview, a public health or illness politics poster or meme, or a comic. For a unit called “Drawing HIV/AIDS and COVID-19: graphic medicine,” students had read Jaime Cortez’s Sexile (2004) and MK Czerwiec’s Taking Turns (2017), both graphic narratives about the response to AIDS in and by LGBTQ communities in the US. They had also been encouraged to explore the COVID-19 Comics page on the Graphic Medicine website and had read Hillary Chute’s essay “Can Comics Save Your Life?” (2020) about the Rescue Party series on Instagram curated by Gabe Fowler, owner of the Williamsburg, Brooklyn comics store Desert Island. The Rescue Party project began on April 1, 2020 and has been a space for documenting COVID-19 in comics form ever since. Thus, we had spent time discussing how and why comics as a form is well-suited for capturing a variety of pandemic experiences and events. Chute’s essay helped to make this point, describing comics as an “urgent form,” and extolling the inclusive and democratic nature of the Rescue Party project.

Our discussion of Chute’s essay and several examples of COVID-19 comics from the Rescue Party Instagram site provided a framework and, I hoped, some inspiration for the comics option of the Documenting COVID-19 final project. The description of the comics option was meant to be inclusive, both in terms of content and form. Students could make a comic documenting a personal experience or that of someone they knew. I encouraged students to think broadly about what they might document. I suggested their comic might document stories about the experiences of healthcare or other essential workers; information about how and why the virus spreads and how to slow the spread; or stories that highlight the racial, sexual, and class politics of COVID-19. My only specification about what the comic should look like was that it should be at least 4 panels, and even this minimal specification was meant to be flexible, and, in the end, some students’ comics did not include panels. Finally, students also had to write a 2-page artist’s statement discussing their comic, which provided a discussion of some of their formal and compositional decisions, as well as some insight into their process and what worked well or not so well for them.

Some students were excited at the opportunity to make a comic. One student, Ashley Chopra, who has studied art, created a brilliant and aesthetically sophisticated comic about her experience graduating from high school and going to college during the pandemic. Her comic poignantly depicts how deflating and isolating her first year of college had been. One page shows her in the same position with her chin in her hand staring blankly at the laptop on her desk in the first three of four panels (Figure 2). Her clothing, hairstyles, and facial expressions change from panel to panel, indicating the passage of time, while the background and composition of the panels remains the same, suggesting increasing boredom and feelings of claustrophobia and, even, despair. The final panel shows her head down on her desk, sleeping, under the caption: “Did I just spend my entire freshman year sitting at a desk in my childhood bedroom?” “I did…” With her permission, I shared the comic on the Drawing|Teaching|Healing: Graphic Medicine in Action website (2021) and on Twitter. Later it was archived on the Graphic Medicine COVID-19 Comics page.

Figure 2
Figure 2

“Did I just spend my entire freshman year sitting at a desk in my childhood bedroom? I did…” Page from Ashley Chopra’s comic created for the Documenting COVID-19 final project in the first-year seminar Illness-Thought-Activism: From HIV/AIDS to COVID-19 at Stony Brook University in Fall 2020. Reproduced by permission of the artist Ashley Chopra.

For artistically inclined students like Ashley, the assignment was clearly an opportunity to express their creativity. Yet many other students worried that they didn’t have the drawing skills necessary to make a comic. I told them how comics artist and teacher Lynda Barry has made it her mission to work to undo the feeling in many adults that they can’t draw. Barry notes that “kids like making marks that make shapes that make stories,” yet “adults are scared to do this” (Barry, 2008: 73). She asks why we would stop getting pleasure from drawing and she teaches a variety of techniques to help bypass the negative judgement and self-censorship that prevents many adults from drawing. In my own classes, one work-around I have found to ease the anxiety some students have that they are bad at drawing, as well as their concern that they will be downgraded for their lack of drawing skills, is to explicitly encourage students to use stick figures in their comics. In several conversations with students in the first-year seminar about doing a comic for their final project, I came to realize that the stick figure not only helped students get past their anxiety about their drawing ability, but also became emblematic of their experience of the pandemic. One student revealed how lonely they had felt living on campus for the year, having arrived not knowing anyone and with most social activities curtailed for safety reasons. Others depicted being trapped in dorm rooms with little contact with the outside world. The stick figure captured their feelings of isolation and emptiness, and the flatness of life on campus. Writing the artist’s statement then gave students an opportunity to reflect on this flat feeling and the feeling of drawing that feeling. My impression was that, for some students at least, this multi-layered and multi-modal exercise was therapeutic, in that it allowed them to express a feeling they had not yet found a form for expressing: they felt like stick figures.

As the annotation group exercise and documenting COVID-19 in comics form project demonstrate, comics are effective as pedagogical tools for studying illness in a pandemic. Even more so, comics as pedagogy has the potential to create formal conditions of possibility for enacting care in the classroom and beyond.

Author’s Note

Every effort has been made to trace copyright holders and to obtain their permission for the use of copyright material under educational fair use for the purpose and criticism and review and full attribution and copyright information has been provided in the captions.

Editors’ Note

This article is part of the Rapid Responses: Comics in and of The Moment Special Collection, edited by Jeanette D’Arcy and Kay Sohini, with Ernesto Priego and Peter Wilkins.

Competing Interests

The author has no competing interests to declare.


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