Walking Med

Lorenzo Servitje is a Ph.D. candidate in English at the University of California, Riverside, and the coeditor of Endemic: Essays in Contagion Theory.

Sherryl Vint is Professor and Director of the Speculative Fiction and Cultures of Science program at the University of California, Riverside, editor of Science Fiction and Cultural Theory: A Reader, and an editor of the journals Science Fiction Studies and Science Fiction Film and Television.

Foreword

Steve Schlozman

Preface

Lorenzo Servitje and Sherryl Vint

Introduction

Lorenzo Servitje

Diagnosing Zombie Culture

1. Don’t Point that Gun at My Mum: Geriatric Zombies

Gerry Canavan

2. Viral Virulence, Postmodern Zombies, and the American Healthcare Enterprise in the Antibiotic Age

Kari Nixon

3. “The Cure Has Killed Us All”: Dramatizing Medical Ethics through Zombie and Period Fiction Tropes in The New Deadwardians

Tully Barnet and Ben Kooyman

Reading the Zombie Metaphor

4. The Walking Med: Zombies, Comics, and Medical Education

Michael Green, Daniel George, and Darryl Wilkinson

5. Zombie Toxins: Abjection and Cancer’s chemicals

Juliet McMullin

6. Administering the Crisis: Zombies and Public Health in the 28 Days Later Comic Series

Sherryl Vint

Visualizing Medical Zombies

7. Blurred Lines and Human Objects: The Zombie Art of George Pfau

Sarah Juliet Lauro

8. Open Up a Few Zombie Brains: Objectivity, Medical Visuality, Brain Imaging in The Zombie Autopsies

Lorenzo Servitje

9. The Anorexic as Zombie Witness: Illness and Recovery in Katie Green’s Lighter Than My Shadow

Dan Smith

Lorenzo Servitje and Sherryl Vint have combined the disparate threads of medical science, the graphic novel, and zombie studies into an unlikely yet highly successful anthology of essays. By assembling a cast of some of the most influential scholars working today in these fields, they have produced a valuable interdisciplinary collection of thought-provoking and timely essays. —Kyle Bishop, author of How Zombies Conquered Popular Culture: The Multifarious Walking Dead in the 21st Century

The Walking Med represents interdisciplinary scholarship at its best, situating the necropolitical stakes of zombie media in relation to the undead tropes of clinical discourse, addressing the liminal condition of the body—even life itself—under the regime of contemporary biomedicine. Ghastly smart stuff! —Colin Milburn, author of Mondo Nano: Fun and Games in the World of Digital Matter

The Walking Med shows, in no uncertain way, the power of interdisciplinary inquiry at the intersection of medical humanities, visual culture, and monster studies. This highly innovative and original collection illustrates how contemporary zombie narratives and images help us think of crises and opportunities in medicine and health care systems. As a whole, The Walking Med convincingly argues that zombies are powerful and necessary symbols of medicine and its politics. —Marina Levina, coeditor of Monster Culture in the 21st Century: A Reader

The approaches and methods that have emerged from the rapidly growing field of graphic medicine reveal new ways to think about how zombies draw from and shape biomedicine. In addition to looking at how zombie images and texts have appropriated medical tropes and narratives, it is worth considering how “real medicine” has adopted the figure of the zombie as an explanatory metaphor and investigating the implications for graphic medicine. As we suggested in the Preface to this volume, there has been a significant shift in the medicalization of the zombie figure, which has become understood through rubrics such as contagion, microbiology, and neuroscience. In this capacity it has become an important figure in shaping our current biomedicalized healthscape. The biomedicalized zombie lends itself to medical humanistic approaches; moreover, the figures pronounced presence in visual culture merits a new way of thinking about its relationship to biomedicine. Enter graphic medicine: a field that continues to spur academic, pedagogical, and fan interest, growing into a substantial area of interdisciplinary research, especially in the medical/health humanities. Its most appealing quality is often cited as the way the juxtaposition of image and text creates a world of possibilities, as Ian Williams (2012) suggests, for depicting the complexities, ambiguities, taboos, and absences of languages for disease, illness, and bodily sensations (25). With the zombie in mind, Graphic Treatment attends to these possibilities in comics and extends this to picture-and-word forms that are not strictly bound by that genre of “sequential art.” Due in part to its ability to resist classification in the liminal state between life and death, subject and object, as Sarah Juliet Lauro and Karen Embry (2008) argue in their frequently cited “Zombie Manifesto,” the zombie is a particularly productive figure to express and reflect on William’s world of possibilities within human medical experience. The zombie compounds graphic medicine’s ability to critique and theorize medical culture. As the authors of the Graphic Medicine Manifesto note, graphic medicine disrupts notions of techno-medical progress, universal patient experiences, and the dominant scholarly methods in healthcare (Czerwiec et al. 2015, 2-3). While a number of chapters in this volume addresses the zombie in terms of its more frequently identified tropes (plague, contagion, and epidemiology), other chapters move beyond identifying the similarities between the etiology of infectious disease and zombie plagues to question how medical discourse constructs and is constructed by popular iconography pertaining to the boundaries of life and death, illness and health. This introduction serves three aims: to think through what the implications are of using this language of the zombie in medical culture by considering the how biomedical researchers utilize the figure of the zombie i; to examine a case study of the visual zombie/medicine intersection in the case of zombie parasites; and finally, to show how the zombie introduces perspectives from science and technology studies into graphic medicine, providing a richer way to think about figures such as the zombie within this emerging field. Metaphors, Biomedicine, and “Real” Zombies Like many tropes in science fiction, the zombie crosses discursive boundaries to become a metaphor used in clinical and scientific literature. As Michael Green notes in his chapter on comics created by medical students, “zombies are good to think with.” Because the zombie is so frequently identified as dehumanized figure, it is useful to conceptualize patients who experience the “zombification” effects of illness and/or medical treatment, such as the numbing affect of clinical depression or ataxic effects seen in psychiatric patients who perform the “Thorazine shuffle”—a physical side effect that connotes more than the inability to ambulate properly and which has been read as a “zombie” symptom (Fhlainn 2011, 147). These are medicalized examples of the “cultural zombie,” a non-literal figure of zombification engendered through its cultural milieu (Boon 2011, 8). The popular press has a history of thinking of zombies in medical, specifically pharmacological frameworks. This can be traced back to Canadian anthropologist Wade Davis’ ethnobiological research on tetrodotoxin and tropane alkaloid intoxication with respect to zombification, what appears to be the first instance of an investigation of the “science” of reanimating the dead. His article in the Journal of Ethnopharmacology was excerpted in Harpers in 1984, and he went on to publish the highly popular The Serpent and the Rainbow (1985), which was later adapted to a film in 1988, now a cult classic, and Passage: The Ethnobiology of the Haitian Zombie (1988). Three decades later, the zombie was reintroduced to pharmacological discourse, this time strictly as metaphor. Since 2012, there has been a rash of “zombie” drugs reported in the news and popular media. The reports of psychosis-inducing bath salts, which resonated with the PCP “epidemic” of the late 1980s and 90s, were frequently likened to zombies and zombie apocalypses. In another instance, desomorphine has been characterized as a zombie drug due to its propensity to cause severe gangrene and necrosis, which manifests as decaying flesh falling off of skulls and long bones. In the case of drugs, it is clear that zombies, as figures of epidemics and societal threat, align with other medical metaphors such as the war on drugs and the war on infectious disease. Drawing on the fascination for the epidemiological zombie, the Center for Disease Control made perhaps one of the most visible and publicized incorporations of zombies into biomedicine. In May 2011, the CDC made headlines when it advised the public on how to prepare for a zombie apocalypse. “That's right, I said z-o-m-b-i-e a-p-o-c-a-l-y-p-s-e," writes Dr. Ali S. Khan on the CDC’s Public Heath Matters Blog (2011), advising people how to stock up on food, create emergency kits, and know evacuation routes. They went on to publish a full-length digital graphic novel, in which the authors adopt the common viral narrative of zombie contagion—labeling the pathogen “H5Z1”, resonating with the panic surrounding avian flu or H5N1. Here, the zombie most obviously and explicitly stands in for the emergency preparedness for any public health emergency. According to some biomedical research, however, zombies are not so much metaphorical as they are very a “real” phenomena—this, of course, depends on what you mean by zombie. In the case of zombies being the dead come back to life, they are purely fictional. If, however, zombies are defined by the older definition, as an organism “enslaved” through a form of behavior or “mind” control, there are two ways this can actually occur: drugs, as in the case cited by Wade Davis, and parasites. Before explaining these “real” zombies, I would like to consider the significance of the fact that scientific research has taken an interest in making such claims. A brief bibliometeric analysis illustrates the degree to which biomedical culture has appropriated the zombie figure as a metaphor, an object of study, or in some cases both. Before 1990, there are eight biomedical publications that reference the term zombie, two of which are directly discussing the case(s) of tetrodotoxin and tropane alkaloid poisoning in Haiti either by Wade Davis or by those discussing his findings. Between 1990 and 2010, there were eighteen publications that used the term. From 2010 to today, there were thirty-seven. Beginning with publications in 1990 the zombie came to mean a side effects from psychotropic drugs and/or cognitive dysfunction, with some exceptions. Though the use of the zombie for psychiatric and neurological discourses, such as Alzheimer’s Disease, still remains a common application, the most prevalent usage from the early 2000s until today is linked to epidemics and parasitical relationships, namely those where the “zombifying” parasite alters the host’s behavior by hijacking the nervous system. In 2013, the Journal of Experimental Biology ran a special issue (216, No.1.) on “Neural Parasitology.” The Journal of Integrative and Comparative Biology followed a year later with its own issue “Parasitic Manipulation of Host’s Phenotype, or How to Make a Zombie” (Weinersmith and Faulkes 2014). Some notable examples of this phenomena include the Jewel Wasp, phiocordyceps unilateralis fungus, and the gondii species of toxoplasmosis. Interest in Toxoplasmosa Gondii has extended outside of zoological parasitology, and researchers who study human behavior and psychiatric pathologies have developed theories which suggest that t. gondii may be a contributing factor in schizophrenia or other psychiatric conditions, in effect, altering human behavior and personality by increasing the incidence of reckless choices (Flegr 2013). Though these parasites have sparked some fears and sensation in the popular press about literal human zombification through infection and a “real” zombie apocalypse (Brune 2013), there are a number of practical and theoretical implications for studying such parasites beyond this “what if” scenario, such as new models of animal behavior for studying human affective disorders and novel understandings of how neurobiologists alter behavior in contrast to the evolutionary nature of parasitic relationships (Adamo and Webster 2013, 1). We can relate this iteration of the zombie as “slave” to research that has theorized the influence of the microbiome on human behavior (Cryan and O’Mahony 2011). Consistent with the zombie’s penchant for challenging binaries, these connections among the zombie, parasites, and neurology question monolithic and anthropocentric models of subjectivity. The case of zombie parasites illustrates the very real influence that popular culture has on biomedicine. Although the zombifying parasites have been known to parasitologists and entomologists for some time, they have not been characterized by researchers as such until recently. Take Phiocordyceps unilateralis, popularly known as “the zombie ant fungus,” as an example. The fungus was discovered during the mid-Victorian period (Hughes et al. 2011). It is not, however, until 2011 that researchers begin to call the organism the “zombie ant fungus” in peer-reviewed publications, although popular Internet culture uses the term circa 2005. These dates are not only temporally close to the resurgence of the zombie’s popularity but also mark the period the zombie becomes medicalized, discussed and represented through epidemiological discourse and frequently following what Priscilla Wald (2008) calls “the outbreak narrative.” While real-life epidemics do not always, and in fact rarely have narrative components like a climax or resolution, the ways we think and talk about them do. As a figure of fiction that draws from some biomedical fact, the zombie is shaped by and shapes how we conceptualize the outbreak narrative. Even though the parasitic narrative draws on the older model of voodoo-slave zombie, it does so through the trope of infection and contagion. Considering this current conceptualization, especially the research on t.gondii and behavior, we can see the slavery trope from the early twentieth century has not disappeared but instead has been displaced: from magic and Voodoo to biology (Evans 2009). The nexus of the epidemiological “infectious” application of the zombie to the neuro-cognitive suggests that the plasticity of this figure to understand biomedical phenomena is both vast and resonant with contemporary culture. If medical educators are using zombies to teach neurobiology or, in the cases cited above, medical researchers are adopting the figure to explain parasites, the real/fictional binary is no longer a sufficient mode for describing the exchanges between culture and medicine. In spite of the fact that biomedicine increasingly looks toward a fantasy of permanent life extensions, zombie images and narratives are continual reminders that, in the case of brain-infecting parasites, our autonomous subjectivities are contingent and constructed. Moreover, because even their parasitological and epidemiological iterations more broadly still carry their earlier histories—in this case reanimated corpses—they underscore that death is permanently part of the state of life. Despite medical advances, “we are the walking dead.” The zombie also reminds us of this inevitability and of the desires and technologies that seek permanently to forestall death—a central logic in our current biomedical moment of chronic disease management, with new specialties like geriatric and anti-aging medicine, even the resurgent popularity of cryogenics. As Eric Cazdyn (2012) writes, “the paradigmatic condition illustrating the already dead is that of the medical patient who has been diagnosed with terminal disease only to live through medical advances that then turn the terminal illness into a chronic one” (2). These exposures and the problematization of these kinds of anxieties and preoccupations are well-suited to the graphic medium through its specific capacity to bring forth what purely textual or purely pictoral and filmic narratives cannot fully articulate. As I have argued elsewhere (2015), the graphic medium invites and allows for extended reflection during narrative progression, a quality that film generally lacks. Furthermore, graphic texts can play with time in ways other mediums cannot. Susan Squier (2015) notes that comics can represent time spatially both diachronically and synchronically; they can capture both the traditional narrative time of illness and the “extralingustic,” more difficult to express experiences of the temporality of illness (51-53). In these capacities, we look to graphic texts, instead of film or television, to see the cultural work the zombie performs within medical discourse. Graphic Parasitology The cover of National Geographic’s November 2014 issue portrays an image of an insect that most educated readers would not recognize; however, the cover text labels this image with a term few would fail to recognize— REAL ZOMBIES. The National Geographic story beautifully portrays via close-up photographs and detailed narratives the zombifying parasites previously mentioned. Each subsection dedicated to a particular parasite narrates the process of host zombification in comic form. This use of a graphic narrative to explain an example of “real zombies” emblematizes precisely the kind of discursive intersection this book addresses and speaks to the timeliness of the chapters that follow. Let us return briefly to the zombic parasite, t. gondii or “toxo.” The particular mode and medium that National Geographic utilizes stands out. They have done a few comics in recent years but nothing with such a “graphic style,” suggests artist and editor Matt Twombly. There is a common visual grammar in which parasitic relationships are usually presented to both scientific and general publics in everything from posters in veterinarian offices to biology textbooks, I suggested to Twombly in an email exchange. He replies, “We wanted to do something fresh here, something that aligned with what inspired the photographer in his pictures. You’re right, the typical life cycle diagram is some kind of circular flow chart, but that was too clinical for the mood we were trying to set. We wanted something eerie, with more appeal” (Twombly 2014). Consistent with the aims of graphic medicine as a practice and field of research, the reference to “setting the mood” speaks to the ability of the graphic medium to convey the affective dimensions of biomedical experience and understanding. The short comic infuses the biological with the kind of affect produced in the horror genre—“something eerie”—like a zombie film. The grayscale color tones of the panels and title’s font recall older horror films, specifically, I would suggest, films like George Romero’s 1968 Night of the Living Dead. The circular panel, which simulates the microscopic view of the protozoa, keeps the microbiological process in the back of the reader’s mind during the depicted interactions between rat, cat, and human, haunting the panels that follow. In other words, while we get an image of the zombified rat, clearly signaled by his colored eyes which stand out from the rest of the grayscale panel, we are encouraged think about how zombification is just a matter of scientific explanation rather than mythologized figures of Hatian slavery or re-animated corpses. And yet, the mood instilled by combination of panel, text, and narrative suggests that this phenomena, in contrast to a purely “scientific process,” is like something out of a horror movie. The imperative here is not to inspire actual terror but to invoke the feeling of the genre in a somewhat playful capacity. When read closely, however, “The Case of the Fearless Rat” is more anxiogenic than it might first appear. The final panel depicts the cat’s presentation of the kill to his or her human. The text above reads “toxo can infect the brain of any mammal even humans,” qualifying that statement by noting that it is rarely fatal but “can harm a pregnant woman’s fetus”—the reason why pregnant women are often discouraged from handling cat litter (and by extension, occasionally advised to avoid cats themselves). The following text reassures us: “your cat is safe,” as it cannot infect a feline’s brain. The domestic imagery, though rural, brings the parasite home for readers, leaving them with questions that are implied by the images but left out of the text: Can it infect human brains? Can it alter human behavior? What does it do to the children? Related questions, as I noted earlier, are currently being asked and answered by researchers. The orange tint in the cat’s eye recalls the mouse’s eyes—along with the noxiously colored scent trail, and suggests a sinister influence, although the text clarifies that cats’ brains are not affected. In this specific narrative, we are left asking what happens next. Is that a female with the flats and rolled up pant cuffs? Is she pregnant? The zombie-parasite narrative leaves the reader to fill in the gaps—literally the gutters between panels—and the questions posed by the interaction between reader, text, and image. There is a certain immediacy to this visual that would not be present in a “clinical” life cycle image. The parasite-host relationship is dramatized to instill fear and curiosity, to delight as well as to educate. While it is not meant to be clinical in visual rhetoric, as the artist suggests, it does draw on and raise biomedical anxieties by capitalizing on the comic medium and the zombie narrative, on the zombie and the medical image. National Geographic illustrates way in which the zombie contributes to the public education in biomedical science through visual culture, in this case highlighting the cultural capital and value invested in the graphic form. Conclusion Science and Technology Studies (STS), media, and philosophy of science scholars have spoken to the centrality of visualization to scientific cultures and knowledge production, making them highly suitable for graphic medicine. For instance, Regulia Valire Buri and Joseph Dumit (2007) outline a representative variety of the approaches to social study of scientific imaging and visualization. Dumit (2004) himself has done some of the seminal STS work specific to brain imaging, an approach I take up in my chapter. Lorraine Daston and Peter Galison (2007), in their landmark study of the shifting values in scientific epistemologies based on different modes of “seeing,” explore the changes in the characteristics of scientific atlases from anatomical illustrations in the 18th century to The Visible Human Project and virtual renderings of nanotubules. They suggest that atlases, scientific illustrations, “map” the sciences they serve and that they are the “systematic compilations” of “any manageable, communal representative of the sector of nature under investigation,” what they call working objects (19-23). Lisa Cartwright (1995) traces the visual culture of medicine, in terms of optical techniques, cinematic media, medical and popular images, to illuminate the ideological effects of the convergence of scientific and cultural practices in the visual medical idiom. More recently, Kirstin Ostherr (2013) investigates the way in which visual mass media like television has shaped what it means to be both a doctor and a patient by influencing clinical practice and the expectations of both sides of the medical equation. The centrality of medicine’s visual culture and the diverse actors responsible for medicine as a system of thought has practical implications for those in the medical field, as agents of its profession or as subjects under its care. Images of illness help structure the “schemata of illness” where the doctor creates and works within a differential mental catalogue of signs and symptoms by which the next image or appearance of illness can be judged. For patients, a similar logic holds true: they learn how to conceptualize and experience illness, building images of disease stereotypes (Williams 2015, 124). Since its emergence, scholarship in graphic medicine has sought to explore and complicate these schemas. Consequently, the introduction of the work of STS and visual culture scholars helps us see graphic medicine as part of a larger history of medicine as a visual culture, for example, as a kind of genealogical relative to medical illustration. Such connections put into question how different scientific histories and systems of thought inform the methods we use to illustrate medical experience and complicate its norms. It is with this scholarship in mind that we turn to consider how the zombie figure zombie reflects, produces, and critiques and complicates biomedical culture in graphic narratives and in less “orthodox” medical imagery and their accompanying text. The work of the authors in the volume builds on this established theory, bringing together scholarship in medicine’s visual culture along with critical and theoretical work surrounding zombies into the practice and scholarship of graphic medicine. And, like the zombies’ bidirectional exchange with medicine, as a whole, Graphic Treatment more broadly develops a set of ways to think about both what graphic medicine brings to cultural studies and what cultural studies brings to graphic medicine. The zombie as metaphor and figure do not appear to be ready to die any time soon. If the past is any indication, however, it will certainly not remain static in either its visual or textual forms. Furthermore, the figures shifting forms (from drugs, to viruses, to parasites) encourages to continue to see the way it draws on popular and disciplinary understandings of biomedicine, revealing how medicine is “operating” beyond its biological intervention in the broader cultural sphere. But the zombie is only one such figure, there is much more of this kind of work to be done. Graphic medicine clearly lends itself to such an endeavor. References Adamo, Shelley A., and Joanne P. Webster. 2013. 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