Diversity and sensory disorders in comics the case of Diego Agrimbau and Lucas Varela’s Diagnósticos

Introduction

Historically, comics have shown an interest in representing the human figure as a key element of its discourse. However, for decades, this representation has lacked diversity in terms of physical appearance, ability, gender, race or sexual expression. According to El Refaie, representation of human bodies (as well as their abilities) is always “a profoundly social and political activity” (2012, p. 73). A debate has surged even within mainstream comics such as superhero stories, dominated by the stereotyped representation of exaggerated and monstruous bodies, to push for greater diversity, accompanied by a serious attempt in Comics Studies to analyse and conceptualise that diversity (Kirkpatrick & Scott, 2015; Smith & Alaniz, 2019; Cocca, 2020; Brown, 2020). As Eckhoff-Heindl and Sina point out, “even though comics have been perceived for decades as a pop-cultural mass phenomenon, which manifests, establishes and perpetuates stereotypical representations, the medium never completely became one with this role of a reactionary stabilizing force” (2020, p. V). Since the beginning of the 21^st century, and parallel to the rise of the so-called “graphic novel”, there has also been a rise of comics about social themes that have allowed the graphic representation of collectives who were previously invisibilised. Thanks to the arrival of the graphic medicine movement, patients with illnesses whose symptoms and conditions might be difficult to represent exclusively though words have been given a voice, as in the case of mental1 and neurological2 conditions; the medium, in sum, has proved to be fertile ground to represent the complexities and “nuances of illness” (Farthing & Priego, 2016, p. 83).

Comics are also a privileged medium to represent the various senses. Scott McCloud, in his very influential but also questioned3 Understanding Comics. The Invisible Art, affirms that “comics is a mono-sensory medium. It relies on only one of the senses to convey a world of experience [...] Within these panels, we can only convey information visually” (1994, p. 89). McCloud did not discard the presence of the rest of the senses, but always relegated them to the visual. One of the main criticisms to this monosensorial conception has been the one made by Ian Hague (2014), who has attacked the traditional “ocularcentrism” that ignores the material aspects of comics as objects; reading is a multisensorial experience in which the rest of senses (touch, smell, hearing and taste) play a key role. Indeed, it is important to remember that materiality is often ignored4: we do not read comics only in our mind, but we interact with an object (frequently a book, but also a screen or a wall) through a corporeal experience (flipping through the pages or clicking the mouse) and a concrete space (sitting or standing, with surrounding noise or in silence, etc.). As Szép comments, “knowledge and understanding can be achieved because vision is not an isolated sense but is linked to other senses and to the proprioceptive awareness of the body” (2020, p. 157). Senses are thus integrated and are key to generate knowledge despite the influential idealist tradition that throughout history has tended to separate body and mind5. On the other hand, it should not be forgotten that seeing is not the same as reading; this difference represents one of the fundamental tensions of comics as a medium. Reading is an intentional and vectorized activity in which readers perceive the whole and its parts, the panel and the page or double page (Fresnault-Deruelle, 1976; Peeters, 2003; Hatfield, 2009; Arredondo, 2015).

This article analyses the representation of diversity, more concretely that of sensory diversity, in Diego Agrimbau and Lucas Varela’s Diagnósticos (2013). The main characters of this work - all women - suffer from conditions that alter their perception of reality. The authors use this common thread to develop six stories in which each condition is visibilised to the reader, offering the subjective point of view of the characters, which is graphically revealed through formal experimentation with the language of comics. What follows explores the ability of comics to represent sensory disorders, showing the potential of the medium to make the invisible visible. Diagnósticos makes an interesting example of the representation of sensory diversity, combining comics’ most traditional characteristics with more innovative graphic resources in a work that shows that not only non-fiction comics can establish an interesting dialogue with graphic medicine. For the analysis of this comic, a mixed methodology within Comics Studies will be applied to consider Diagnósticos from the perspective of graphic medicine (particularly in connection to the representation of diversity) but also talking into account a formalist approach due to the experimental nature of the work. In addition, a material approach will also be taken into account; in this regard, Eszter Szép’s Drawing, Reading and Vulnerability (2020) will be especially useful.

Diagnósticos and graphic medicine. Experimental comics to represent sensory disorders

The six stories that make up Diágnosticos were originally published in the Argentinean magazine Fierro between 2008 and 2011, but some of them were created in France thanks to an artist residency in La Maison des Auteurs at Angoulême. In fact, this comic also was awarded a grant by the Centre National du Livre, so the first edition of the complete work was published in France by Tanibis in 2013, and a couple of years later in Spain (2016, La Cúpula) and then in Argentina (2017, Hotel de las Ideas/Historieteca)6. Even though the work has been edited as a graphic novel in a single volume, its episodic and fragmentary nature cannot be ignored. What unites the various stories is their depiction of sensory disorders. As pointed out by Agrimbau, who oversees the script:

This clarification concerning the nature of the disorders is indeed significant. In fact, the artist, Lucas Varela, corrected a journalist in one interview when he declared that “they are not diseases actually, but mental disorders.” (Martínez-Pita, 2016). As a matter of fact, Diagnósticos uses a mixture of neurological sensory disorders (agnosia, prosopagnosia, akinetopsia o aphasia), anxiety disorders (claustrophobia) and conditions that are not necessarily pathological such as synaesthesia. Therefore, this work can be understood within the framework of graphic medicine, a discipline that in these last years has greatly developed to the point that it can be almost considered a discipline on its own7 that combines “the principle of narrative medicine with an exploration of the visual systems of comic art, interrogating the representation of physical and emotional signs and symptoms within the medium” (Czerwiec et al., 2015, p. 1). In general, most works claimed by this movement tend to belong to non-fiction, particularly to the domain of autobiography, but Diagnósticos approaches the fictional experience of a series of women suffering from the already-mentioned disorders and conditions. This fact, which has implications that will be approached in the last section, does not erase the reality of some of those experiences. It is remarkable that the authors choose to start each story with a definition of the condition, a technique that perhaps seems necessary to introduce the reader to less-known conditions (such as agnosia, prosopagnosia or akinetopsia). Definitions also stress the medical character already mentioned on the title that contextualise and conditions the narrative; moreover, on the margins of the pages that precede the definitions there are drawn flaps that make the work look like a medical handbook. Despite the fictional nature of the stories, they do participate in the representation of the disorders, helping to build

Due to the sensory nature of the depicted conditions, it should be noted that the symptoms are not visible externally (as with other conditions), so they could be part of the third category of illnesses established by Williams after “The Manifest” and “The Concealed”: “The Invisible” (2015, p. 119). Comics as a medium is especially suited to depict this type of disorders, as it can make use of different types of visual and textual focalizations to invite us to share the internal conscience of the character that lives with the condition. Let us explore, for instance, “Agnosia”, the story that opens Diagnósticos. The condition is defined in the story as “inability to recognise objects by their qualities (shape, colour, temperature, etc.), even though sensory functions (vision, hearing, etc.) are intact” (Agrimbau & Varela, 2016, s.p.). In fact, agnosia is also present throughout the volume under different manifestations in other stories in which the disorders do not allow to recognise faces (prosopagnosia), movement (akinetopsia) or verbal messages (aphasia, which could be interpreted in this case as verbal agnosia). “Agnosia” starts with illegible abstract images; only thanks to the use of text can the reader discover that it is the perspective of the main character, Eva, a patient with agnosia who is receiving a new treatment. As the story progresses, the depicted elements (faces, objects) start to materialise and become more recognisable, but the reality they represent is delusional and threatening: a doctor dog, a statue with legs, a flying fish, etc. The last panel of the last page (figure 1) resolves the mystery: the elements that Eva sees do exist in reality, but she (and the reader until that moment) perceives them decontextualised, mixed. Agrimbau and Varela make use not only of subjective vision but also of another important visual resource of comics: the holistic vision that allows the reader to perceive the whole page. Thus, in figure 1, if we proceed by reading each panel individually there is no visual anomaly. However, peripheral vision makes it impossible not to perceive the continuity of the drawing beyond the borders of the panels. Through the continuous background one can appreciate, for instance, the doctor dog and the walking statue that had previously appeared in earlier pages. In this way, as the doctor himself declares, the efficacy of the new medication is questioned: “Creoquen ohabi doefec tose cunda rios. Lapru eba hasi douné xito. Llamare mosat uspa dres” (Agrimbau & Varela, 2016, s.p.). As it happened in the famous scene of Paco Roca’s Wrinkles in which Emilio, the main character, listened to the altered word “talope” (instead of “pelota”) (Roca, 2007, pp. 30-31), the reader of Diagnósticos is invited to share Eva’s perspective in which both visual and verbal perceptions are altered.

Figure 1.Agrimbau & Varela, “Agnosia”  Diagnósticos (2013)

Interaction between language and image, between text and drawing, is used by Agrimbau and Varela in other stories. Thus, in “Afasia” the main character can understand written verbal messages, but not oral ones. That is why the story is narrated not through balloons (that traditionally represent oral verbal language and sounds) but captions, revealing the main character’s internal narrative voice. But these captions are not displayed framed, as it is common, in rectangles inserted on the panels, but fused with the elements depicted on the image: billboards, objects, etc. (figure 2). In this way, the authors oblige readers to share the language disorder that the main character suffers as they must locate, identify and connect the diegetic text to move forward in the story. In order to do this, the story subverts the use of diegetic text that is part of the image: the text is connected in an “inherent” way, according to Neil Cohn’s terminology (2013, pp. 35-37). Furthermore, in “Sinestesia” the main character, Lola, can see sounds in the same space they originate up until three hours after they were produced8. As it was mentioned earlier, synaesthesia is not actually a pathology as such, rather representing a variation in the perception of sensory stimuli: the association, for example, between a concrete colour or taste and a number, a letter, or a sound. The kind of synaesthesia that Valera and Agrimbau use is fictional and is closer to a superpower (which allows Lola to be a forensic expert) but is perceived by the main character as a disorder, as a burden: “I can't stand it anymore” (Agrimbau & Varela, 2016, s.p.), she announces in the beginning. This ability of perceiving sounds is employed by the authors to experiment with the representation of sound effects and balloons, two of the most recognisable elements of the medium: Lola, like readers, can literally “see” sounds (figure 3), first only sound effects but then also balloons. Therefore, the text stops being an intrusive sign on the image to become a diegetic element. It could be said that Agrimbau and Varela follow the inverse process in this story: if in “Afasia” they denaturalised the integrated text of the image to transform it into the internal monologue of the main character, in “Sinestesia” the opposite happens, as balloons and sound effects are read as images, integrated on the space represented in the panels.

Figure 2.Agrimbau & Varela, “Afasia”  Diagnósticos (2013)

Figure 3.Agrimbau & Varela, “Sinestesia”  Diagnósticos (2013)

As we start to realise, despite the promise of the title concerning the depiction of illnesses, Diagnósticos does not intend to provide with a faithful realist representation of the chosen conditions. As Gual points out, they are rather “interference in perceiving the world as it (we think) is. These women live in another reality, unique and exclusive, which is governed, from their point of view, according to the parameters of comic books.” (2017, p. 227). Only as a metacomic reflection one can truly understand the stories of the volume. The main character of “Claustrofobia”, Soledad, knows that she is the character of story, and her phobia is expressed by playing with multiple perspectives9 in which panels become oppressive architectural elements. “My cloister is these four lines” (Agrimbau and Varela, 2016, s.p.), she declares pointing at the panel itself. In “Akinetopsia”, the main character is Ryoko, an animator that paradoxically is not capable of perceiving movement. The story focuses on one the of the most important formal aspects of the medium: how to depict movement through static images. Again, Agrimbau and Varela invite us to perceive the world as it is perceived by Ryoko thanks to the use of multiple images overlapped to a single object or figure, which corresponds to the perception of the neurotypical population (figure 4). Her condition forces her to become a manga artist, an ironic decision taking into account that we are reading the story in comics form: “I never liked manga. Comic books. Whatever you call it. It always seemed dead to me. Something still, lifeless. It's not my thing. But if I want to work, I'll have to put up with its stillness, Miku. At least I can see them.” (Agrimbau & Varela, 2016, s.p.). Miku is Ryoko’s pet frog, named in honour of the animation character that she created and appears frequently in the story in the form of merchandising objects. Ryoko compares herself to Miku when she tells him: “With food you are like me, but the other way around: if it doesn't move, you can't see it. I only see it when it's still” (Agrimbau & Varela, 2016, s.p.). Indeed, frogs are adapted to their vital needs, so they “have an insect detector. An object larger than a bedbug does not stimulate these particular ganglion cells, even if it is moving. And an object of the same size does not stimulate them if it is still” (Professional Association of Biologists of the Autonomous Community of Madrid, 2019). Ryoko’s identification with Miku grows and becomes total, as her akinetopsia evolves to the point that everything she can see is movement. This story reminds us to other works that have tried to depict sensory diversity in the animal word through comics: Matt Fraction, David Aja and Matt Hollingsworth’s Hawkeye (2013) 10, and one of the pages of Nick Sousanis’s Unflattening (2015, pp. 40) try to represent the sensory world as experienced by dogs through their sense of smell.

Figure 4.Agrimbau & Varela, “Akinetopsia”  Diagnósticos (2013)

The conditions depicted in Diagnósticos, as it was pointed out earlier, demand to be analysed taking into account the formal characteristics of comics. This is especially true of stories that belong to narrative genres. For instance, in “Sinestesia” the ability to see sound effects and balloons that correspond to the past is in fact a narrative technique associated to analepsis and prolepsis that provide readers with clues to the mystery they need to solve, a classic detective story that uses some of the iconic elements of the genre (dark atmosphere, hats, raincoats, etc.). For its part, “Prosopagnosia”, the only story that has not been mentioned here so far, the inability to recognise faces is linked to an extra-terrestrial invasion that clearly connects to science fiction. Given this fictional narrative interest, can this work be truly considered a depiction of functional diversity? In the following sections of this article, we will evaluate the limits of these representations in Diagnósticos, as well as other aspects related to empathy, identity, and the body.

Functional diversity and empathy

In this section, although we will quote some academic works that explore the intersection between disability and comics, we prefer the term “functional diversity” due to its more global and inclusive nature. Coined by Romañach and Lobato (2005), this term does not have so many derogatory connotations as other words used before, especially “handicap” but also “disability”, as both present the difference in negative terms. By focusing on the idea that people have different abilities and skills (for diverse reasons that include not only conditions but also genetics, age, gender, etc.) we can erase the idea that these people need to be “fixed” to adjust. If we apply this framework to the sensory domain, we soon realise the great diversity that exists in the way in which each of us process sensory stimuli. When can we speak of this diversity as a disorder? It is a difficult question, but James Fleming, a sensory therapist specialist, declares: “We all have different thresholds that we can tolerate – the key is that it is not a problem until de sensory issues begin to interfere with their everyday lives” (St-Esprit, 2020). In the case that concerns us, the main characters of Diagnósticos perceive sensory stimuli differently from most of the population, which interferes in their participation in society. Neurotypical readers approach these stories from a medical perspective, more so if we consider that the first thing they find is their diagnosis, the definition of the condition. But Agrimbau himself pointed out in an interview that his intention was not “to make a real diagnostic manual, but to tell stories that work as stories in their own right.” (Soquiransky, 2018). From this point of view, the conditions in Diagnósticos represent functional diversity as “prosthetic narrative”. This concept was coined by Mitchell and Snyder (2001) to refer to disability as narrative and characterisation trope used in literature and cinema, a technique that ends up perpetuating marginalisation of the depicted collective as disabled and dependent. In Diagnósticos, we thus identify some of the hegemonic discourses and representations of diversity enunciated by Disability Studies academics such as Thomas Couser and Rosemarie Garland Thomson: the rhetoric of horror, the abject and functional diversity as “strange” or grotesque (Dolmage & Jacobs, 2012, p. 76). But Diagnósticos is filtered through the style of Agrimba and Varela and the presence of dark humour. Varela, when describing his style, declares the following: “I like exploring the darkness in stories [...] My darkness is more playful, more absurd. I try to find the beauty in the monster.” (Vázquez, 2021). It should be pointed out that Diagnósticos is fictional and does not intend to teach citizens about functional diversity11 in a likely way. However, the fact that stories do not intend to educate does not mean that they do not participate in the representation of functional diversity. Readers will probably discover for the first time thanks to this comic less-known neurological conditions (and perhaps it will make them look for more information about them). But due to the narrative and structural nature of Diagnósticos, most of the main characters are presented as people fundamentally defined by their difference, conceived as an “anomaly” or a “problem”.

What consequences do these stereotyped representations have when it comes to generate empathy between the reader and the characters? Agrimbau pointed out that some critics have mentioned that in Diagnósticos it is difficult for the reader to identify with the main characters, but he declares that the effect is deliberate (Rodríguez-Millán, 2016). This distance is further intensified by Varela’s caricature-like style, dark humour and the intense formal experimentation, as well as by the fact that every comic is, as we already pointed out, a material object with drawn pages whose language (balloons, captions, panels, gutters, etc.) is always visible. But the work’s greatest potential is precisely the use of these graphic innovations to visibilise sensory diversity. The stories in Diagnósticos do not only describe the existence of this diversity, but they also communicate the experience that represents that unique perception of reality. It is true that the main characters do not seem to have any way out, which seems to give a deterministic vision of their condition. Miranda (“Afasia”) declares that she has “99.9% chance of never recovering[se] and a 50% chance of getting worse.” (Agrimbau & Varela, 2016, s.p.). However, by presenting recovery as something difficult they do not fall into other stereotypes present in diversity narratives that are not always plausible, such as the necessary overcoming of the condition. In this sense, they do represent faithfully the difficulties that the characters have to integrate in society, a long and complex process that does not always have a satisfactory solution.

Identity, body and diversity

Finally, it seems necessary to point out that functional (and, more specifically, sensory) diversity in Diagnósticos is articulated together with some other significant categories such as gender, sexuality, class and ethnicity. There is not enough room to analyse all these in detail, but this final section will be dedicated to explore how the identity of the main characters is defined by other elements linked to functional diversity.

First, it stands out that all main characters are women. Concerning this, Agrimbau declares that

If the fact that the characters are exclusively feminine might be explained by the intention of giving some cohesion to the volume, the truth is that the impact thereof cannot be ignored. Women, as remarked by Marshall and Gilmore, are often depicted in dangerous situations presented as inevitable (2015, p. 95). This vulnerable condition is stressed due to the fact that each story starts with an image of the main character as if she were a cut-out doll, accompanied by some clothes to dress them and some of most representative elements of the story (also in cut-out form12) (figure 5). Agrimbau points out that

Figure 5.Agrimbau & Varela, “Sinestesia”  Diagnósticos (2013)

Characters and their experiences, in this fashion, could be conceived as tools for graphic experimentation. Again we can appreciate determinism as a key factor in the nature of Diagnósticos; read from a gender perspective it can be problematic, as both authors are men and characters are presented semi-naked or in underwear in their doll form. In fact, this nakedness might not be explained by an interest in sexualising and it is possible that, following the authors’ interpretation, the choice is purely aesthetic and conceptual in favour of graphic experimentation, “una forma de acentuar lo lúdico del proyecto” (Rodríguez-Millán, 2016). However, as Nochlin protests discussing the Gustave Courbet’s painting L’Origine du monde (1866), “why must transgression—social and artistic alike—always be enacted (by men) on the naked bodies of women?” (Nochlin, in Miller, 2020, p. 65).

However, it is fair to mention that the main characters are not totally devoid of agency and they are not mere guinea pigs at the service of the story. They might be dolls, but they all have a name (even if sometimes it is symbolic, such as the case of Soledad, the lonely main character of “Claustrofobia”). If Eva (“Agnosia”) does not seem to have any other character trait than an ill woman who is almost insane, that is not the case of all of them, as many have professional careers: for instance, Lola (“Sinestesia”) is a forensic expert and Olivia (“Prosopagnosia”) works in radio astronomy. Although their conditions worsen and push them to madness or suicide, some of the main characters prove to be resilient against difficulties. In this way, Ryoko (“Akinetopsia”) announces her will to kill herself at the beginning and the end of the story, “pero no será hoy. Tal vez mañana” (Agrimbau & Varela, 2016, s.p.); Olivia (“Prosopagnosia”), after the extraterrestrial invasion that has deprived humans of their identity (metaphor of the condition that prevents the main character from recognising faces), stoically declares that “siempre hay que seguir viviendo” (Agrimbau & Varela, 2016, s.p.).

The story of Soledad (“Claustrofobia”), who also shows the representation of sexual diversity (in one of the panels she kisses another women), is an interesting example. As many of the main characters Diagnósticos, she is aware of her existence as fictional comics character, so in order to flee from her claustrophobia and traumatic past she is forced to escape the panels. The story concludes with an interesting sequence in which she addresses the reader: “Y entonces, por primera vez, puedo veros a vosotros. Mientras me leéis. Éste es mi punto de vista. Vosotros sois ellos” (Agrimbau & Varela, 2016, s.p.). Readers, in this way, are compared to those people who during her life looked at her passively but did not help her (figure 6). Soledad thus questions the scopophilic regime that places women who suffer as passive narrative subjects, an act described by Byrn-Køhlert as the “counter-stare”, “staged as a way to resist the gaze that has too often constructed people with disabilities as passive, medicalized subjects” (Dolmage & Jacobs, 2016, p. 18). This challenge is held until the end, as while falling in the void she makes the reader responsible for her failed suicide: “Aquí estoy, inmóvil. Permanente. Para siempre. O al menos hasta que os decidáis a pasar la página. Y, por favor, nunca volváis a leer esta historia” (Agrimbau & Varela, 2016, s.p.). Soledad recognises that “o livro em si, em seu formato similar ao dos quadros, é também instrumento de aprisionamento” (Queiroz & da Silva, 2018, p. 141) and, by breaking the fourth wall, she questions the pleasure obtained by the reader thanks to her suffering.

Figure 6.Agrimbau & Varela, “Claustrofobia”  Diagnósticos (2013)

Agrimbau and Varela draw attention to the materiality of the book as an object, which is linked to the corporality of the main characters of the stories. We see again the important role of senses in comics, even more relevant in a comic about sensory perception. As Szép states:

Szép reminds us that comics propose an “embodied” encounter between three bodies: that of the artists (who frequently draws by hand), that of the readers and that of the book itself that the readers have in their hands (2020, p. 5). Due to the importance of materiality, comics offer a privilege space to represent the vulnerability of bodies and, without a doubt, Diagnósticos obliges readers to face this vulnerability.

Conclusions

Throughout these pages we have explored some of the possibilities that comics as a medium has to depict sensory disorders. First, we have stressed that reading comics, contrary to the traditional monosensory approach that considers sight as the only sense that counts, is a multisensory experience.

Our approach has been, of course, partial, as, even if we have mentioned a series of works that represent the subjective vision of patients who suffer from different diseases and conditions, this article has only focused on one of them: Diego Agrimbau and Lucas Varela’s Diagnósticos (2016). This work represents an interesting case within graphic medicine and sensory diversity, as there are not many comics that tackle sensory conditions such as agnosia, prosopagnosia, akinetopsia, aphasia and sinaesthesia. The collection of short stories is framed by its fictional nature, so it does not approach these conditions from a realist or educational perspective; in this way, the depiction of functional diversity in these stories works as “prosthetic narrative”, as a mere narrative resource.

Despite the distancing effect and the medical and gender stereotyped representations (to a great extent, intentional) that are present in this work, its formal experimentation with the language of comics is noteworthy and original to visibilise the sensory perceptions of the main characters of Diagnósticos, experiences that are far from those lived by neurotypical population. At the same time, its focus on materiality emphasises the fragility of the bodies of the main characters (and, by extension, that of our own bodies). Diagnósticos makes an unusual sensory trip that not only represents diversity but invites us to feel it.