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"Chiu, Monica"
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Show Me Where It Hurts
In Show Me Where It Hurts , Monica Chiu argues that
graphic pathography-long-form comics by and about subjects who
suffer from disease or are impaired-re-vitalizes and re-visions
various negatively affected corporeal states through hand-drawn
images. By the body and for the body, the medium is subversive and
reparative, and it stands in contradistinction to clinical accounts
of illness that tend to disembody or objectify the subject.
Employing affect theory, spatial theory, vital materialism, and
approaches from race and ethnic studies, women and gender studies,
disability studies, and comics studies, Chiu provides readings of
recently published graphic pathography. Chiu argues that these
kinds of subjective graphic stories, by virtue of their narrative
and descriptive strengths, provide a form of resistance to the
authoritative voice of biomedicine and serve as a tool to foster
important change in the face of social and economic inequities when
it comes to questions of health and healthcare. Show Me Where
It Hurts reads what already has been manifested on the comics
page and invites more of what demands expression.
Pathbreaking and provocative, this book will appeal to scholars
and students of the medical humanities, comics studies, race and
ethnic studies, disability studies, and women and gender
studies.
eBook
Description of maternal and neonatal adverse events in pregnant people immunised with COVID-19 vaccines during pregnancy in the CLAP NETWORK of sentinel sites: nested case–control analysis of the immunization-associated risk – a study protocol
IntroductionCOVID-19 is associated with higher morbimortality in pregnant people compared with non-pregnant people. At present, the benefits of maternal immunisation are considered to outweigh the risks, and therefore, vaccination is recommended during pregnancy. However, additional information is needed on the safety of the vaccines in this population.Methods and analysisThis a retrospective cohort nested case–control study in pregnant people who attended maternity hospitals from eight Latin American and Caribbean countries. A perinatal electronic clinical history database with neonatal and obstetric information will be used. The proportion of pregnant people immunised with COVID-19 vaccines of the following maternal and neonatal events will be described: preterm infant, small for gestational age, low birth weight, stillbirth, neonatal death, congenital malformations, maternal near miss and maternal death. Moreover, the risk of prematurity, small for gestational age and low birth weight associated with exposure to COVID-19 vaccines will be estimated. Each case will be matched with two groups of three randomly selected controls. Controls will be matched by hospital and mother’s age (±3 years) with an additional matching by delivery date and conception time in the first and second control groups, respectively. The estimated required sample size for the main analysis (exposure to any vaccine) concerning ‘non-use’ is at least 1009 cases (3027 controls) to detect an increased probability of vaccine-associated event risk of 30% and at least 650 cases (1950 controls) to detect 30% protection. Sensitivity and secondary analyses considering country, type of vaccine, exposure windows and completeness of immunisation will be reported.EthicsThe study protocol was reviewed by the Ethical Review Committee on Research of the Pan American Health Organization. Patient informed consent was waived due to the retrospective design and the utilisation of anonymised data (Ref. No: PAHOERC.0546.01). Results will be disseminated in open access journals.
Journal Article
The influence of climatic conditions on the transmission dynamics of the 2009 A/H1N1 influenza pandemic in Chile
Background
The role of demographic factors, climatic conditions, school cycles, and connectivity patterns in shaping the spatio-temporal dynamics of pandemic influenza is not clearly understood. Here we analyzed the spatial, age and temporal evolution of the 2009 A/H1N1 influenza pandemic in Chile, a southern hemisphere country covering a long and narrow strip comprising latitudes 17°S to 56°S.
Methods
We analyzed the dissemination patterns of the 2009 A/H1N1 pandemic across 15 regions of Chile based on daily hospitalizations for severe acute respiratory disease and laboratory confirmed A/H1N1 influenza infection from 01-May to 31-December, 2009. We explored the association between timing of pandemic onset and peak pandemic activity and several geographical and demographic indicators, school vacations, climatic factors, and international passengers. We also estimated the reproduction number (R) based on the growth rate of the exponential pandemic phase by date of symptoms onset, estimated using maximum likelihood methods.
Results
While earlier pandemic onset was associated with larger population size, there was no association with connectivity, demographic, school or climatic factors. In contrast, there was a latitudinal gradient in peak pandemic timing, representing a 16-39-day lag in disease activity from the southern regions relative to the northernmost region (P < 0.001). Geographical differences in latitude of Chilean regions, maximum temperature and specific humidity explained 68.5% of the variability in peak timing (P = 0.01). In addition, there was a decreasing gradient in reproduction number from south to north Chile (P < 0.0001). The regional mean R estimates were 1.6-2.0, 1.3-1.5, and 1.2-1.3 for southern, central and northern regions, respectively, which were not affected by the winter vacation period.
Conclusions
There was a lag in the period of most intense 2009 pandemic influenza activity following a South to North traveling pattern across regions of Chile, significantly associated with geographical differences in minimum temperature and specific humidity. The latitudinal gradient in timing of pandemic activity was accompanied by a gradient in reproduction number (P < 0.0001). Intensified surveillance strategies in colder and drier southern regions could lead to earlier detection of pandemic influenza viruses and improved control outcomes.
Journal Article
Vital Viruses
For artists of graphic pathography, drawing embodiment usefully animates the effects of disease, impairment, or other conditions. Images are emotional and haptic proxies, agential actors. In this chapter, I turn to how germs, viruses, and nonhuman matter become what Jane Bennett calls “actants” collaborating within “agentic assemblages” (Vibrant Matter 9, 23).¹ Actants connect—or better yet, cleave—human and nonhuman subjects, where “cleave” denotes both uniting and severing. In her exploration of vital materialism, inanimate matter equally influences and transforms animate beings. Seemingly lifeless elements like minerals or rocks, she alleges, are composed of vital forces acting upon us powerfully
Book Chapter
Graphic Genesis and the Somatic Text
In The Minority Body: A Theory of Disability, Elizabeth Barnes states, “The intuitions of the (privileged) majority don’t have a particularly good track record as reliable guides to show how we should think about the minority [here an impaired subject], especially when the minority is a victim of stigma and prejudice” (156). Grounded in this claim, I explore manifestations of comics protagonist Al, a white man, in Al Davison’s The Spiral Cage. Not only does his self-presentation show readers a life of spina bifida and wellness through comics, but it also teaches the unimpaired, or the majority, how to read
Book Chapter
Hospital Waiting Rooms as Medicine’s Sedimented Spaces
Graphic pathography engages in both abstract and concrete definitions of the term institution. The institution of medicine, for example, constitutes a culture and ideology that subjects of graphic pathography sometimes find, ironically, inimical to their health and well-being. The former chapter, for example, advocates for innovative eldercare institutions (as physical locations and as ideological entities), relieving children of some portion of the cultural expectation to nurture incapacitated elderly parents, often alone, through the latter’s challenges of seniority, infirmity, disease, or impairment. Exhausted by other familial duties, the daughters discussed in Chast’s and Farmer’s work yearn for affordable and excellent care
Book Chapter
Conclusion
Graphic pathography critiques a reparative model of medicine that is too narrowly focused on the soma at the expense of patients’ emotional and psychological reactions to medical care, illness, and impairment. The medium continuously reminds us that well-being derived from experiential (embodied) knowledge and an ethics of care should be mutually constitutive but often are not. Hence, subjects’ hand-drawn self-depictions in graphic pathography are resistant drawing; the graphic works reinforce that a sensate subject reacts not only to medical treatment as “merely” a biological body but also to how treatment is delivered by human actors themselves bound up in biopower’s
Book Chapter