#pathography

The author of Show Me Where It Hurts: Manifesting Illness and Impairment in Graphic Pathography discusses the growing field of graphic pathography, its benefits, and more.

Why is graphic pathography such a fast-growing field, and how does it "work" for the drawing subject?

Graphic pathography allows subjects who have fallen ill or experienced a medical or clinical challenge to have their say—or rather, to draw their own representations. If the internal workings of the body disappear from consciousness when we are in good health, according to Drew Leder, their appearance as aches and pains during illness, I argue, invites artists to reenvision or revise Leder’s “recessed body.” Graphic pathography illustrates the experiences of illness, sometimes to critique a subject’s care and caregivers, other times to offer fresh perspectives on the effects of receiving chemotherapy, living with clinical depression, or struggling against anorexia, among many other experiences. Because the artists are freed from confining clinical representations to express themselves through the graphic line—one with infinite possibilities of showing what sometimes telling cannot achieve—graphic pathography invites aesthetic and personal responses by which others can learn and empathize. That medical schools increasingly are incorporating courses in graphic medicine, in addition to existing courses in narrative medicine (writing about one’s experiences of illness or impairment), teachers, students, and medical practitioners alike find that art can assist in healing.

The heart knows what it needs and it needs treatment. In 1988, my grandmother was first diagnosed with a heart disease, specifically hypertensive heart disease. It was a devastating moment for her as she was an adventurous type of person and likes to wander around. She asked the heavens why it has to be her, but I guess bad things do not reserve themselves solely for bad people.

Constant high blood pressure happens to her, but she did not pay much attention to it. She will initially avoid the food that causes her high blood pressure, then consume it again after days of religiously staying away from it. My grandmother thought this scheme would forever work until it did not. Her early mornings consisted of a cup of tea, bacon strips, and a headache. Sometimes, it is severe, but usually, it is bearable according to her. 

Once become sometimes until it is often that she was hospitalized because of her condition. There was even a time that I had to go to the hospital where she was admitted an hour after my class. I would never consider her as bothersome, but at that time, I thought it would be more nice if I was visiting her inside their house where no medical apparatuses were surrounding her. After she got discharged, she started to take her medicines seriously, the same time I realized that the times I caught her massaging her chest was becoming frequent. 

It was often that my mom would hurry to go inside the room that I am sharing with my sister to inform us that she would be out for a while because she needs to rush our grandmother to the nearest hospital. Attempts to remember our last interaction have been made and honestly, the fear that rushes inside me every time is something I hoped I would never feel again. 

Frequently, she had to turn down offers from her colleagues and close friends because of her condition. My grandmother often finds herself short of breath and gets tired easily. With a visible gloom in her face, she would say it is okay and there would always be next time for her to go with them. She knows she should do what she has to do in order to maintain her stable health. All of us were hoping to see progress on her health, and I can see that she wants the same thing too. 

Now, she was able to avoid being hospitalized for a month now. Good news came and the doctor advised her to go back for a check-up once a month. Although it was recommended that she visits the clinic twice a month, it was only encouraged if the progress was somehow not maintained. But in general, she only visits the clinic once a month, so it was really great news for our family.

Everyone was happy to assist her in her maintenance. Prescribed with Vestar, 35mg, that should be taken two times a day. Twynsta, 18mg, to treat the symptoms of high blood pressure. Clopidogrel, 75mg, is used to prevent heart attacks and strokes. There are many other medicines that she was prescribed with, but the medicines I indicated are her priorities. My grandmother often asks my sister and I for a favor by buying her medicines for her and we would go to the nearest Watsons to buy it for her. Giving us extra money to treat ourselves is her thing too. 

Words might not be enough to describe how happy I was to see my grandmother going back to her usual self. We still remind her to be vigilant of the food she is taking as no one in the family wants those hospital trips to be repeated again. While she was cautious of what she eats, I know she still tries to enjoy things that she enjoys prior to being diagnosed with hypertensive heart disease. Life is hard when you have a disease that hinders you to do most things and pushes you to adapt even though you are against it, but really, prevention will always be better than cure.

SKATEBOARD

I remember how laughter filled the starry and cold night. It was a good day, except it wasn't. I heard ringing in my ears whilst my vision was fading in and out. Everything was all blurry and the blood in my veins pumped harder than ever. I didn't know what occurred as I lay there in the cold concrete, shocked and confused.

December 20, 1994. A miracle baby boy was born; he is born with a congenital heart disease and down syndrome. Congenital Heart Disease (CHD) is a disease present at birth and refers to variations of complications of the heart; this kind of abnormality occurs during pregnancy. Under this disease, Atrial septal defect (ASD): In this condition, there is an abnormal opening between the two upper chambers of the heart — the right and left atria — causing an abnormal blood flow through the heart. Down Syndrome (DS) or also known as Trisomy 21 is a genetic condition caused by an extra 21st chromosome in the body and commonly causes an anomaly to humans. To live in a world full of difficulty and discrimination, yet, he is never the one to be deterred by such hindrances to live a life full of love, of hope to someday be better, wishes, and determination. It was never easy, no one said it was easy.

My uncle was born on the 20th of December 1994 at the Philippine General Hospital, Metro Manila, he was the 9th child of my late grandfather, Ismael A. Tolentino and late grandmother, Lilian M. Tolentino.  Life was not easy during those days, his parents, my grandmother is a manicurist while my grandfather was a carpenter, supporting all 9 children and themselves as well. At the age of 44 my late Grandmother, she gave birth to my uncle. An explanation was given to the family by the attending physician that my uncle was diagnosed with DS due to my late grandmother’s thinning of the walls of her uterus as well as because of her age, the vitamins was not enough to form a fully developed baby. After his birth, he was already on medications due to his condition; according to my mother, his older sister, my uncle had to take different medications for his heart and blood flow to regulate as he was diagnosed with ASD that caused an abnormal blood flow in his system. Almost a year old, they got back to the hospital. The same attending physician advised my late grandmother together with my mom to have a surgery to close the small gap in his heart as there were new machines to help his condition. At that time, Lola Lilian refused the surgery; he was still young and the machineries were new and it added fear to her. Instead, he took prescribed maintenance medication to alleviate the pain and his condition while he was still not ready for surgery.

Years passed, as he aged the gap in his heart became a hole, it also grew with him. My mom became his legal guardian as my lola died. During those years, my lolo was unable to help due to his age and years after, followed my lola’s side. My mother transferred my tito to a relatively closer hospital, Ospital ng Muntinlupa, and there he continued his regular check-ups and his medications. Around 17 to 18 years old, the doctor, Dra. Balderas from Asian Hospital, advised my mom to have his surgery again, as tito was having frequent attacks. For the second time, the advice was refused not by my mother but by their other siblings. Tito was going to be needing more frequent medical attention not only from medical attendees but also from his siblings. During those times, we (me, my siblings and cousins) are still all relatively young thus the refusal of the offer. Once again, he just continued his regular check-ups and medications until he was confined for a very long time and the physician told my mom that, anytime he will go. After a month, he was released, thankfully. But three months passed, another attack happened, he was rushed to Biñan Doctor’s Hospital and almost two months he was confined to the ward and later advised to be in the Intensive Care Unit (ICU) but he was put in a private room per my mother’s request. After that, he went back to us, in our house, and it was well. I, at least, thought so. Until another month passed and he had another attack during a dinner with my other uncle, our parents were out visiting my other late grandfather to the hospital. As I was there to witness it, my tito just ran into the comfort room, coughing and then suddenly, he was vomiting, calling for my other tito. Then, it became my last memory of him, he was rushed into the hospital but he was declared dead on arrival due to congestive heart failure and because of having no medical attention immediately.

Anyone can get sick with COVID-19 and become seriously ill or die at any age. It can spread from an infected person’s mouth or nose in small liquid particles when they cough, sneeze, speak, sing or breathe.

Year 2020, My mother got sick and her body is getting weak. But, my mother kept on working to help my father to provide our needs during that time. One day, my mother experienced symptoms like Shortness of breath or difficulty breathing, Muscle aches, Chills, Sore throat, Runny nose, and Headache. One night she asked me, “May pang amoy ka ba? Bakit wala akong maamoy? Kunin mo nga yung pabango susubukan ko amuyin.” I replied “Meron naman.” At that time, My mother started watching from YouTube some people who are experiencing that kind of virus to know what the symptoms are. My mother was hoping that her thoughts were not correct.

Few days ago, I heard her calling my uncle that she wanted to go to the hospital to have some tests. My uncle wanted to go with my mother to the hospital but some of my aunt's kept telling my uncle not to go with my mother but my uncle insisted and he accompanied my mother to the hospital.

My mother went to the hospital and the doctor advised her that she needs to get isolated while the result of the test is not yet out.

“Nung nalaman ko na kailangan ko ma-isolate nahirapan talaga ako naisip ko mga kailangan ko gawin nun bilang mother niyo at natatakot din ako na hindi ko na magawa mga bagay na kaya ko gawin kasi hindi ko naman alam kung mabubuhay pa ako o hindi dami natakbo sa isip ko nun kasi that time ang dami na balita na namatay sa Covid diba?”

Few days have just passed, the result came out and the doctor said that my mother tested positive for Covid-19 and that was last August 2020 she was 35 years old at that time. It really affects my mothers job and also her health. My mother was taking six medicines at that time. My mother needs to drink medicine continuously to feel better.

My auntie gave my mother a medicine named “Lianhua Qingwen '' a Chinese medicine that is used for the treatment of influenza. That will also help to improve lung ventilation, remove toxins, and help to suppress the viability of SARS-CoV.

After my mother's medication, me and my siblings also needed to have tests to make sure if we also had a Covid-19. We need to wait 14 days again to know if we are positive or not. When the results were finally out the doctor called my mother to tell what the results are and luckily we are negative from Covid-19. When my mother finally recovered, one of her sisters kept on avoiding her. My mom was hurt that time but she understood, she said that maybe because her sister wanted to be safe. “Naiintindihan ko naman kasi baka nga nag iingat lang siya pero masakit kasi kahit magaling na ako parang akala niya mahahawaan ko pa rin siya.”

“Mahirap na nakakalungkot, mag isa sa kwarto non wala akong nakakausap kaya ang ginawa ko nun nilibang ko sarili ko. Sobrang thankful ako sa mga tumulong sakin nun kasi mas namomotivate ako tulungan pa lalo ang sarili ko dahil tinutulungan din nila ako, naramdaman ko talaga na hindi ako mag isa.”

Remember that struggles do not always end, sometimes this is the lesson you need to learn. That will make you stronger and give you strength to conquer your weaknesses.

“That I suffer from no ailments is the greatest fortune.”

I'm curious as to how that feels right now. Possessing the freedom to maneuver cautiously but without restriction. Being able to open one's arms and take in the sun-kissed breeze. Having the ability to rush to your loved ones with carelessness. I have often pondered what it might be like to suddenly find myself endowed with the power to run.

Hi. I am Princess Allyssa R. Mago and I am diagnosed with patellar subluxation.

You might be wondering, what even is a patellar subluxation? To give you a brief knowledge of this, here is a description provided by the NationwideChildrens.Org. A patellar subluxation occurs when the kneecap slips momentarily out of the groove where it usually rests. When the kneecap slides out of place, it often moves towards the exterior of the body. It's possible for something to occur only once or repeatedly.

I first experienced this occurrence when I was in the ninth grade. I used to participate in Saturday training with our school's Scouting Organization. The training requires considerable physical performance. At 6 a.m., we would begin our day with military drills. Due to their difficulty, most of us wouldn't even be able to complete half of the exercises. Looking back on all of our training sessions, I can honestly say that I never once struggled with the activities. I knew I wouldn't have any trouble breathing-wise, but other than that, I felt alright. Not until that one particular Saturday had passed. We were performing our morning workout as usual. My right leg gave out as we were doing jumping jacks. At least, that's what I believed at the time.

Here's a clear illustration of how it typically works:

https://vt.tiktok.com/ZS82kRBsm/

After that, I could never go back to normalcy. I would say that before my ailment, I was a highly athletic and active person. Since I was a kid, I've participated in every intramural futsal game. Even more than futsal, I enjoy taking part in a wide variety of sports. I'll never forget the times I got to run around with my buddies, participating in school sports and leaping around in all the action. The difficulty in returning to those activities was marked.

“Out of all the people here in the world, why chose me, God?”

There were multiple incidents of "bending of my leg," most notably during the lockdown. It escalated and went out of hand. The bending of my right leg occurred each and every time I descended a flight of stairs. It would cause me to tumble down the stairwell, from which I could not recover without assistance. I'm telling you, this didn't occur just once, but  a multitude of times.

As time went on, I worried that I was becoming a burden on those around me. They often came racing to me with worried expressions whenever something like that occurred. Well, at least that catered to the worried. The insensitivity and rudeness of some of my relatives can only be explained by their lack of empathy. Words like "lampa," "lumba-lumba," "baboy na kasi," and others of a similar nature were frequently hurled at me. It sickened me that people made such statements without understanding my illness or my daily struggles with it.

My parents finally made the decision to take me to an orthopedist at our institution. Due to the lockdown, it took a bit for them to take me to a doctor. We all remember how difficult it was to get into a hospital back when swab testing and other pre-admission procedures were required. After the doctor had finished questioning my parents and I, he began to inspect my knee. What was amiss with my knee was quickly identified by him. My doctor diagnosed a patellar subluxation, he said. As a result, the knowledge he will provide has sent my feelings on a wild ride.

He continued by saying this is a common problem among teenagers, especially young women my age. I found solace in the realization that I am not alone in dealing with this issue. However, the doctor then added the tragic information that this was a permanent ailment. I felt my shoulders heave and was startled to which I couldn't continue talking after that. The doctor also indicated it's manageable, so long as I keep up with my fitness routine. Controlled but not treated. He taught me some stretches and exercises to do to prevent my kneecap from sliding.

“Falling down is part of life, Getting back up is living.”

Ever since then, I've been dead set on getting my condition under control. Regularly upon waking, I would carry out the stretches my doctor had instructed me to do. Also, I ought to learn to move with greater caution. That's why I couldn't participate in activities like jogging and jumping. I may be physically incapable of many activities, but I've found plenty of enjoyable alternatives. Reading helped me relax and escape reality. I didn't even have to leave my spot! Since I was no longer able to perform at a high level in athletics, I put more effort into my academics.

What happened to me showed me that darkness is just a small part of the whole picture. We must not allow this to become all that we are. There are numerous routes we might take to zero in on what best suits us. Allowing one setback to negate a million successes is not the way to go. This is merely a temporary state that we may find ourselves in again and again, but such is life. Challenges arise and pass. The key is to keep pushing forward in spite of this and to never settle for less than we deserve. As my favorite quote goes, “You’ve got at least a thousand capacities in you. Even if you don’t think so.”.

This is Princess Mago, a person with patellar subluxation, officially signing out.

Human immunodeficiency virus or HIV, is a virus that targets cells in the body that help it fight infection, making a person more vulnerable to other infections and disorders. It is spread by coming into contact with a person who has HIV's body fluids, most commonly during unprotected sexual intercourse. If it is unmedicated, it can lead to acquired immunodeficiency syndrome, also known as AIDS. 

According to the HARP or HIV/AIDS & ART Registry of the Philippines, the confirmed cases of positive individuals as of January 2021 were approximately 83,755 diagnosed cases. Males covered 96 percent of the reported cases.  

Alejandro, not his real name tested positive for HIV last August 2021 at the age of 19. After getting diagnosed, it really affected his mental health, the only thing that he did is to cry. He’s also down due to the fact that his mother awes him as someones who can not recover from the ill. He regrets what he did in the past and wishes to go back in time to change his decisions. On his first week of medication, there were a lot of adjustments in his body up like he can’t sleep well and the side effect of continuing taking the medicine lasted two months. 

The Mysterious Medical Case of Marie Valencia

Pathography by: Marie Rosalina D. Valencia (Grade 12 HUMSS Quartz)

[Trigger warning: The content that can be read can be considered as sensitive to any person, serving as a backstory studying previous events of my life that happened and what most likely led to my condition.]

The year 2015, although it was a great year and it paved so many good things I know now and love in the present, it was extremely terrible, horrible and dark with the events that had happened as the year had begun. I had to face studying in a school-a year after a traumatizing incident had happened to me-as my parents thought about transferring me to another school in high school, so I had to stay and survive an entire one more year in the place where I felt most unwelcomed and better to have been forgotten about-mainly because, people had twisted the story, making the victim look like the bad person, and the bullies were the ones who were misunderstood more. I considered myself as a misfit, an outcast from my peers, I was not lonely as I had two of my best friends at the time accompany me and gave me good advice that helped me to survive. It was really difficult-outweighing the fact of standing out, and the idea of wanting to fit in and be accepted, not seen as someone different from the rest of the group-while struggling to maintain good grades for the sake of my family. Every day in that school felt like a battle of insecurities, shame, and sadness, with the feeling of being a flightless bird stuck in a cage with no hope to escape until a year later.

One weekend back in January 2016, I started to feel some sort of pain in my chest. The pain felt like I ate something I could not digest quickly so it got stuck in my chest, but I had not eaten anything during that time, it was more of like something deep inside of me was sinking, and moments later it became hard to breathe. I kept panting, hyperventilating, constantly drank water, and when I saw my reflection in the mirror, my entire face was bright red, as if it were flushed, and even though I drank something, this feeling of sinking, did not stop right away. I remember that I fell asleep in my bed and when I woke up, the feeling had disappeared-it vanished and I felt better as soon as I got out of bed. When my mother got home from doing her errands, I told her about this feeling I had, and she suggested that we schedule an appointment with a doctor at the nearby hospital close to our home. 

By February, the hospital had to transfer our appointment to a different hospital since no doctor was available at the time to assist us with my check up. I remember riding a jeepney and walking far to a hospital that was across the municipal hall of the city. The doctor, who was a woman, asked me to explain what the problem was, and after I did, she checked my heartbeat, and then told my mother that she needed to have a look at my chest, because she believed what my problem was, was related or has something to do with my heart. Then next thing I knew, I was asked to change into hospital clothes, lie down on a bed, the doctor had applied some sort of jelly or oil to my chest and used something to scan and see the inside of my chest. After a while, she told my mother that when she looked at her monitor and saw what my heart had looked like, it had developed a small hole somewhere that could possibly grow big, mainly related to strong effects of my emotions.