Transcription of interview conducted in person on 9 November 2014. Parts of this interview were used in Farthing, A. & Priego, E., (2016). ŌGraphic MedicineÕ as a Mental Health Information Resource: Insights from Comics Producers. The Comics Grid. 6(0), p.3. DOI: http://doi.org/10.16995/cg.74


DR IAN WILLIAMS, FOUNDER OF GRAPHICMEDICINE.ORG AND COMICS CREATOR

WHAT DID WORKING WITH MYRIAD GIVE YOUR BOOK THE BAD DOCTOR THAT WAS MISSING FROM THE SELF-PUBLISHED WORK YOU DID AS THOM FERRIER?
Kudos, I suppose. ŹWhen I was doing self-published work, I had people sort of feeding back, but thereÕs a sort of added kudos to having a publisher like your work enough to publish it. ItÕs really hard to get published, and so that was a big boost really. And I think that it is really good working with an editor. They were quite nurturing and they were very important in actually forming the whole novel Š in a fairly non-interventionist way. Throughout the writing of it, Corinne Pearlman, whoÕs my editor, was full of good advice. Corinne really does all the graphic novel work, and sheÕs really good. ŹI mean, sheÕs a cartoonist herself, and sheÕs very helpful and sheÕs got a really good idea of what sells and what attracts readers and the shape of how it should be. I wrote it, obviously, and I drew it, but she would say, ŌI donÕt know Š that bit doesnÕt really ring true,Õ or ŌI think you should cut that one out or have him find some other way of expressing that.Õ ŹMyriad are very nurturing, very supportive of their artists, and also theyÕve got a really good publicity department. A lot of their authors are first-time published, and they look after them and I think thatÕs important as well. With a bigger publisher, you might get a bit lost if theyÕve got big names that theyÕll be concentrating on promoting.

I think itÕs a much better work than it would have been if IÕd just done it on my own and printed it up. I mean, even down to the copy editing Š I realised how bad my copy editing is. And maybe because Myriad actually started off publishing novels, and novels are a big part of what they do, they have very fastidious copy editors. To be honest, before doing this book, IÕd never really paid that much attention to punctuation within comics, and I realised how bad my punctuation and spelling was.

YOUÕVE SPOKEN AND WRITTEN ABOUT THE BENEFITS OF GRAPHIC MEDICINE FOR PROFESSIONALS AND PATIENTS. TO WHAT EXTENT DID THAT INFORM THE CREATIVE PROCESSES BEHIND THE BAD DOCTOR?
Obviously everything you read and everything you know informs what you do in some way, but I wanted to do it as a work of fiction, and it evolved really. ŹItÕs like a Ōwrite what you knowÕ type of thing, so IÕd been doing comics about medicine, and those all ended up with some kind of autobiographical element, even though you change and disguise patients and change experiences. But, inevitably, a lot of the action is based on some kernel of truth or something that happened or something that might have happened. The story in The Bad Doctor isnÕt really about me, and although some of the anecdotes happened in real life, the structure of the story and the practice partnership isnÕt really autobiographical. ŹAnd I wasnÕt really trying to put over any message Š itÕs just an amalgamation of my experience and worldview I suppose.

ThereÕs an OCD element in it, and I thought that would make a good story. I wasnÕt trying to particularly illustrate or say anything about OCD, because I think whenever you write about an experience Š and the OCD bits in it are semi-autobiographical Š I think itÕs your own experience. Some comics do have a theory bit in the middle to explain about a condition, and that can work sometimes, but I didnÕt particularly want to do that. It wasnÕt meant to be a self-help book ŹŠ the character in it didnÕt seek any help. I was reading a summary of OCD and, apparently, not getting help in OCD is really common Š the average delay between first symptoms and seeking help is 11 years. The character in the book gets over its own way but if I were writing a self-help book, I wouldnÕt say that Š IÕd say, ŌGo and get some helpÕ. So it wasnÕt meant to do anything other than be a good story.

ARE YOU THEN GOING TO TRY TO KEEP YOUR ADVOCACY FOR GRAPHIC MEDICINE AND YOUR COMICS WORK SEPARATE?
Well, it was separate and that was why I used the Thom Ferrier pseudonym first. Well, actually, I used the pseudonym because I was still working in North Wales as a GP, and I really didnÕt want people to know about me making comics. But IÕve amalgamated the two, mainly out of egotism really, because I was fed up with doing the Graphic Medicine stuff under my real name and then making comics but not really having any recognition as somebody that made comics. I was going to keep them separate, and it was Myriad that suggested combining the two, because they thought that when it came time to market The Bad Doctor, it would be good to have the Graphic Medicine angle on it as well. So they wanted me to be identified as somebody who did a bit of academic writing but also made comics. ŹAnd then, once I thought about it, I started thinking, ŌWell, actually, that will be goodÕ because then I wouldnÕt have to explain anything and say, ŌYeah, but I also do comics under a pseudonym.Õ

And the funny thing was, they suggested it and I resisted it at first, but then I came to the decision Š ŌRight, that would be really good Š IÕm going to use my real name.Õ I then went back to them and they said, ŌActually, we were thinking that Thom Ferrier is actually a more exotic name than Ian Williams.Õ In the end, we used my real name, and itÕs fine. 

DOES THE FACT THAT YOUÕRE NOW A NAMED CREATOR GIVE YOU SOME AUTHORITY AS A COMICS SCHOLAR AS WELL, BECAUSE YOU MAKE THESE THINGS TOO?
Maybe, although IÕm always worried about just looking like a clever dick or something. But yeah, I suppose it does.

WHEN YOU WERE MAKING COMICS AS THOM FERRIER, HOW DID YOU CHOOSE YOUR SALES PLATFORM TO SELL YOUR WORK? AND DI YOU EXPLORE OTHER OPTIONS BEFORE DECIDING?
I had the Graphic Medicine website first, then I started making up little comic strips and put those online under a site called Disrepute. I started making contact with other people via Twitter Š I think Twitter was probably instrumental in forming connections within the comics community. Then, the other thing that I did was, I went to Thought Bubble in Leeds and gave a talk in the academic Comics Forum thatÕs run by Ian Hague. While I was there, I had a quick scoot around Thought Bubble and saw all these people printing out comics and so I thought, ŌWell, that looks quite a good thingÕ. Prior to that IÕd been to Comiket in London, and then I made a few friends via Twitter, and there seemed to be people who were making comics and writing about them Š Sarah Lightman, particularly, and Sina Shamsavari. So I met these people who were doing some academic work in comics but making them as well. Then I made loads of connections on Twitter with people from Bristol. 

At the time, I was into making stuff, I was into printing and bookbinding, so I made these comics that were sort of halfway between comics and artistsÕ books, which were hand-stitched with weird cardboard covers Š they were meant to represent a file of patient notes in some ways, and they were just collections of short strips. ŹSo I started doing those and I took part in Comiket and then Thought Bubble, and various zine fairs in Bristol, and I just got to know people. I got to know a lot of people like Katie Green and Nicola Streeten and all the people that go to the academic things. They had a lot of makers there as well, particularly in London, things like Laydeez Do Comics. And then people started buying the little mini comics.

So thatÕs how that started. IÕm very gregarious, I enjoy talking to people and meeting people at fairs and it was a good laugh. It wasnÕt economically viable but it was a good weekend and going out and drinking with all the comics people was good. And then thatÕs also how I got to be known by Myriad Š because I met Corinne through going to Laydeez Do Comics and she bought some of my mini comics and liked them. I got to know her and we talked over a number of years. But they only offered me a contract after I did the First Graphic Novel Competition and I was shortlisted for that. Gareth Brookes won it that year, and he was a very worthy winner, I have to say, but I think three of us on the shortlist also got picked up as well. But I think the web is a really good way of just getting stuff out there, and I think social media is really important in promoting yourself.

BUT IT SEEMS THAT IN-PERSON SOCIAL INTERACTION IS IMPORTANT.
The comics community is a very supportive and good place to be. IÕd never talked about any mental-health issues, virtually to anybody before being involved in comics. And then, suddenly, I started writing about it or drawing about these things. I think that comes from the cultural background of underground comix. I see illness memoirs growing out of that American underground stuff from Justin Green, ŹArt Spiegelman, Spain Rodriguez and Robert Crumb. And itÕs like what people like Joe Matt are doing now or Chester Brown. ItÕs about baring your soul, failure and what might be seen as flaws or shameful things in other contexts. Things that you might be ashamed of or not want to talk about are actually currency within comics and, in a way, the more stuff you can get out there and express about yourself, the better.

And also IÕve found that the comics community Š and I suppose that includes comics makers and academics Š has very interesting, diverse people. A lot of them are into studying what were once repressed minorities. Maybe not so repressed anymore, but a lot of people are into disability studies, feminist studies, queer theory Š just diverse cultural studies. IÕve found that a very liberating place to be Š especially, I suppose, because I probably come from, or have been embedded in, fairly conservative cultures Š ŌconservativeÕ with a small ŌcÕ.

When I studied, medical school was an extremely conservative type of place, very competitive and very macho. Any form of mental illness or failure or physical illness for that matter Š it was like a stigma. We had about five people in our year of 150 probably that were known to have mental-health problems. I did, at that time, but I just kept it hidden. ŹThose people were stigmatised and not seen as being fit to be there, the same with physical illness. Obviously, there are different stigmas attached to different physical illnesses, but it was a very judgmental type of place to be.

And then, for most of my working life, I lived in North Wales, which is actually a very conservative society, very traditional and like a small town. And without slagging off the society of North Wales, it doesnÕt really celebrate diversity. ItÕs probably about the least ethnically diverse place in Britain Š itÕs just a fairly narrow culture. And so to suddenly be coming down to London or going to Leeds or whatever and mixing with all these people who were just writing about diversity, I suppose it encouraged me to unburden myself.
YOU MENTIONED THAT YOU USED TO GET FEEDBACK FOR YOUR THOM FERRIER COMICS. DID ANY OF IT CHANGE THE WAY YOU OPERATED OR THE WAY YOU EXPRESSED YOURSELF?
Not really. If you make mini comics or small collections and you put them out there, youÕre not really going to get much critical feedback. The feedback you get is people saying, ŌIÕve read this, IÕve bought this and I really like it and I relate to it in some way.Õ ŹBut you donÕt get people emailing you, saying, ŌLook, you could have done that better or that could be...Õ ŹSo you donÕt really get much critical feedback, you generally get positive. I did send it to various blogs and things like that, but most of those people are nice and theyÕre not going to slag you off. ŹThereÕs the Forbidden Planet blog or Broken Frontier Š they donÕt really do panning people, and they did like me. I think that they genuinely liked them, but theyÕre not going to do harsh critiques of peopleÕs comics, and so I think you donÕt really get much. ŹI think people like Darryl Cunningham [creator of Psychiatric Tales] probably did. He was already published by the time I knew him and he had a big presence online, I suppose, in psychiatric terms. And because he writes about contentious issues to do with other groups Š heÕll get hate mail and stuff like that, whereas mine was mostly about myself. I didnÕt have a broad enough social media presence to really get much in the way of critical feedback.

I donÕt in any way want to dis self-published mini comics and strips that people make, because actually I think that theyÕre really valuable. And in some ways, because theyÕre unedited, I think that they are really great raw material. As people are putting in stuff that an editor might actually take out, I think that they are really valuable sources of knowledge. But if you want to make a longer sort of thing or a graphic novel, and you want to get it published or sell it, then I think that you probably do need an editorÕs input. I look back at my older strips now and I think ŌGod, that was really self-indulgentÕ and they are a bit cringe-worthy. And actually being involved with Penn State University Press [to help produce an upcoming series of Graphic Medicine publications], we get people sending stuff to us and IÕm acting as a sort of editor, although I donÕt work in the same way as Corinne does. But I look at things and feedback on them and think about how they can be improved. ŹIÕm not saying this as if IÕve got some great experience or anything, but you can see, as a third party, where people could improve stuff. You feed back to them and then they do improve and you think, ŌThatÕs so much better than it was originally.Õ ŹSo editors are really, really important people, whether itÕs in whatever Š prose or graphics, comics or in academic. ŹItÕs like editors have a profound effect on a lot of peopleÕs work, and that is really important. ŹGood editors are incredible Š theyÕre doing incredible work for actually not a lot of recognition.

DO YOU THINK YOUÕD EVER SELF-PUBLISH AGAIN?
You see lots of comics people that do. The only reason that I havenÕt really made much in the way of handmade comics recently is just because I havenÕt had time. IÕve had one book published, and I may never get another one published [laughs], so I think itÕs a really good thing to be involved in the indie comics side. And I like that community and itÕs a really important side of it. People like Gareth Brooks are really committed to self-published, small-press stuff. Because heÕs got a fine-art background, his handmade stuff is really interesting as well. You lose that a bit with things that are produced by publishers, lose that fan-base type quality, thereÕs something nice about that. But also thereÕs a bit of freedom with self-publishing, because if youÕve got a short story or something, you can make it as a little mini comic. But you can also publish it in a journal or a collection Š you retain the copyright on it, so youÕve always got it there, and could submit it to an anthology. There are publishers, like Avery Hill, which put out mini comics, and I do certainly intend to do more, once I get a chance.

WHAT MADE GRAPHIC MEDICINE CHOOSE PENN STATE AS A PUBLISHER OF THE MANIFESTO AND THE BOOK SERIES THATÕS PLANNED. AND DID YOU CONSIDER SETTING UP INDEPENDENTLY?
Well, I did vaguely consider it, but IÕve already got three jobs, and it would be ridiculous for me and MK [Czerwiec, who co-runs the Graphic Medicine website] to try and set up a publishing company. And why Penn State? ŹWell, itÕs partly that two people who were involved in the comics and medicine conferences Š Michael Green and Susan Squier Š work there, so they knew Kendra Boileau, who is the editor-in-chief. Their University Press is really interested in art books and lovely high-production-value books, and they were really interested and, in a way, they made the running. And it made sense because itÕs like something offered to you. In fact, part of the reason I got talking to Myriad was that I pitched to them a Graphic Medicine anthology, and they really liked the idea, but they thought that it would be too difficult from a copyright and permissions point of view. But from that, they said, ŅBut weÕd like to see more of your work, Ian.Ó

So Penn State just wanted to do it, I suppose, and weÕve got these direct connections. Kendra is really keen to get it into the mainstream as well Š not just into academic shops, to get it into normal bookshops and comic shops. And because sheÕs got this excitement and passion about it, it seemed to make sense, rather than trying to sell it to somebody who might think of it as a good idea but not really be excited about it. ItÕs like she was doing a lot of the ideas work, I suppose. ŹSo we all started talking about it and then itÕs grown organically, I suppose, from there. ŹThere are other publishers Š Mississippi Press does quite a lot of academic comics work Š but it was just there, so we took it, I suppose [laughs]. Why make it any harder? With academic publishing, itÕs not like youÕre being offered loads of money or anything, it just doesnÕt run on big budgets. I guess it would be great if you could have some big comics publisher that might want to do it, but itÕs not that likely.

CAN YOU IDENTIFY ANY BARRIERS PREVENTING THE WIDER USE OF COMICS IN THE STUDY OF BIOMEDICINE AND MENTAL HEALTH?
Yeah Š well, like the public perception. And the quality of the work, I suppose. I and other people have been evangelising about them, but there are loads of comics that are pretty mediocre, so itÕs not like everythingÕs good. And also, I donÕt know that comics work for everybody. I like them because I find them really so rich and I can read comics really quickly. I read prose really slowly because thatÕs just the way my brain works. But it probably depends on your reading style.
IÕve never suggested that they were better than any other medium Š I just think that they should be treated as equal with essays and prose, but other people might like film. The medium should be seen as equal to other media and I think that they can be extremely powerful. And itÕs becoming really popular Š Graphic Medicine got mentioned in some item by a pharmaceutical advertising agency who were advertising to drug companies saying, ŌComics are a great way to promote your medicines, weÕll do some fantastic stories for you, promote it in comic form, get over all this information. ThereÕs even a website devoted to comics in medicine.Õ And they actually had some web screenshots of the Graphic Medicine site. ItÕs good that they know about us, but you donÕt really want to be dragged into promoting pharmaceuticals Š because I find that one of the most tedious bits of medicine. Comics were originally made as advertising, so it makes sense. But when comics have got a really didactic message to put out, then they usually are not as good as stuff thatÕs coming from the heart. So things that are contrived, things that people try to just jump on the bandwagon or something, theyÕre not going to be particularly interesting, and that prevents people from getting to the really good stuff. ŹAnd the really good stuff, I think, doesnÕt necessarily look that slick or pretty.

BUT DO YOU THINK FOR COMICS TO BE VIEWED AS MORE FUNCTIONALLY ACADEMIC, THEY NEED TO COMPROMISE THE AESTHETICS?
No, I donÕt think so. I think they could have both. For me the pleasure, and the attraction of both Š and there are comics out there that are really rough and I like them for that. But actually, I think that if you got something that attracts you in an aesthetic way as well, itÕs easier to get into it in some ways. I mean, I think that handmade, scrawly, rough comics can be fantastic, because once you get into them, thereÕs always raw stuff going into them. But they can also be slightly off-putting and, if you were faced with a load of different choices, you might actually go to the one that you find aesthetically pleasing Š and I donÕt mean slick necessarily. I really donÕt like superhero-type artwork very much, but I really like people like Chris Ware and Daniel Clowes Š partly through the colours and the line or panel layouts and stuff like that. Although having said that, Chris Ware can be off-putting as well. His last thing, Building Stories Š I like it as an object, but where do you start? ŹWhat do you? I suppose you can get too clever. Yeah, IÕd like some sort of compromise to be had. ŹThe other thing that puts me off actually, while weÕre on that subject, is that sometimes people could do with editing work. ŹSome people pack just too much text into it and itÕs off-putting. I prefer there to be far more pictures than text, because I think if people put too much text in comics, then theyÕre not really making the comics language work.

Some people just pack too much text in, frames full of speech bubbles or prolonged narration. I donÕt really like narration in comics. ŹIn The Bad Doctor, thereÕs hardly any narration. I made it without narration and without thought bubbles, because I didnÕt want internal dialogue Š particularly with OCD, you just have this massive internal dialogue. And then, yeah, some comics just break down into whole pages of text, especially handwritten text, which I think can be tedious and cumbersome.

I prefer comics that are made by people with first-hand experience or by carers, I suppose. Obviously you can write textbooks or whatever, but I find those less interesting. I think that you can use comic strips to illustrate Š Paul Mayhew, whoÕs at JP Medical Publications is working on some medical textbooks and theyÕre using comic strips almost like video inserts or something like that, just to illustrate something. IÕm less keen on whole textbooks that are written in comics format. If theyÕre written by academics or clinicians Š I find them often a bit tedious, I suppose. I think you can do prolonged comic essays and stuff like that, but I think they work best where they come from a very personal point of view. ŹSo like, say, Woodrow PhoenixÕs Rumble Strip Š that sort of essay or polemic is great because itÕs like a really personal view and the visuals draw you in. Whereas I havenÕt seen so much really interesting stuff thatÕs trying to do an essay in comic form, where itÕs less personal. ThereÕs that whole Introducing... graphic series about everything. I find those just notÉ IÕve got loads of those, because somebody actually gave me about 30 of them, and I love the Oxford series, A Very Short Introduction to..., but I find the Introducing... series havenÕt stuck in my brain or added much to the subjects. TheyÕre not really comic strips. They use comic elements, but theyÕre not Š but they are just an example of something thatÕs trying to use the medium, I suppose.

ONE OTHER COMIC THE TAVISTOCK AND PORTMAN LIBRARY HAD BEFORE I STARTED THIS RESEARCH PROJECT WAS PHILIPPA BERRYÕS COUCH FICTION.
Well, I think that is something different again. I really like PhilippaÕs book, and itÕs really interesting from a number of points of view, because itÕs got a story that runs through it and sheÕs drawing from personal experience, so it is realistic. And I like the running commentary of it as well Š so sheÕs got the comics bit and then sheÕs got a running commentary like a directorÕs commentary type of thing, and I really like that. But I wouldnÕt class that as a textbook in comic form. IÕm not really discounting textbooks Š IÕm just saying that I prefer personal stuff.

ARE YOU AWARE IF ANY OF YOUR WORK HAS BEEN USED FOR ACADEMIC STUDY?
Michael Green has used them in an article Š my Thom Ferrier stuff, I think. And theyÕve been used in Seattle Š Źthat comes under English Studies really. IÕm not aware that theyÕre standard reading on any course over here or anything. People have used, say, standalone strips over here in discussion groups. ŹSomebody used a chapter called Culpability in Health Humanities Reader. People have used other things Š I canÕt actually tell you where, but they have [laughs]. Obviously, it would be great if The Bad Doctor was taken up as standard reading.

WHAT ARE YOU AMBITIONS FOR DEVELOPING THE GRAPHIC MEDICINE WEBSITE AND CONFERENCES?
The conferences seem to go from strength to strength, and weÕve so far resisted formalising ourselves into any sort of society or anything like that. But that might be on the horizon, if only from a practical point of view, for the sake of funding and things like that. ŹSo the website, MK Czerwiec and I run it and we get sent loads and loads of stuff now. ItÕs actually becoming quite difficult to keep on top of it. ŹWe get funding from the Wellcome for it, but we havenÕt really needed much funding as yet, because itÕs just like we do it in our spare time. But actually it would be really good to fund somebody to work part-time on it, to actually update content, like a content editor and formalise it in some way.

And MKÕs actually working on funding from the States for the podcast side of it. So it would be great if we could get more help on that and maintain it as a hub site. And the book series with Penn State Š well, the plan there is to launch the series, publish standalone academic texts, and reprint maybe other work Š either work thatÕs out of print, publish new comics and graphic novels, and bring out anthologies at some Źpoint. So there are a few already lined up, because they bought the rights for The Bad Doctor as well, which is good, so thatÕs going to be launched in the States at the same time as the Graphic Medicine manifesto, and then there are, I think, three other graphic novels in the pipeline that are getting set up. Kendra really wants to make that the go-to place for people to publish work that fits with that theme.

ENDS