Reviews of Lissa, the graphic novel launching our new ethnoGRAPHIC series, will start to appear in the next few weeks, including reviews by academics writing for journals, blogs, and more public venues like The Lancet. But what about the students who are the target audience for this book? How do they respond to the novel, and what is their takeaway? Today we offer an advance review of Lissa from Zenab Youssef, a sophomore at Brown University studying International Relations and Middle Eastern Studies. In a freshman course called “Egypt in Revolution” she read an advance draft of Lissa and produced the following review. We are proud to publish it here.
Comics can convey hidden, intricate messages to readers in a way that other literatures void of visuals are simply incapable of. Lissa, a brilliant and captivating comic-book written by Sherine Hamdy and Coleman Nye, is proof of this uncommon effectiveness. Through a sequence of purposefully and beautifully drawn comic panels, the reader is able to instantaneously delve into the lives of Anna and Layla, and immerse themselves into the pain that comes with medical hardships, the complexities of socio-political revolution, and the strength of companionship. Although the book is jam-packed with many elaborate themes, the contrast between how Layla deals with father’s kidney failure and how Anna deals with her being BRCA positive is particularly thought-provoking. Ultimately, it is Anna and Layla’s varying perceptions of autonomy, their encounters with social expectations of gendered norms, and the disparity in their access to health care that contribute to their different approaches to illness.
Even before learning of her father’s kidney failure, Layla predicts that schistosomiasis is the cause of his general weakness. When Layla’s family is presented with the fact that her father needs a new kidney, they debate over what to do but in the end he decides against the transplant. Ultimately however, the family’s thinking is shaped by certain sources of influence. One major reason they reach this conclusion is due to their particular perception of autonomy. Even before this situation arises in the book, the reader is presented early on with Layla’s mother saying, “Only God Almighty is in control of time… it is not ours to stop or start (46).” Clearly, their understanding of their own agency is inextricably linked to their faith in God. They view their lives as outside of their control. Their submission to Allah allows them to accept what they believe is predetermined. Gender expectations also lead to the family’s decision, for Layla is discouraged from donating one of her own kidneys to her father. She’s told, “Layla, you cannot donate. How would you marry and have children (116)?” This interdiction is due to heteronormative notions of the physical capabilities of women (i.e. they are fragile and in need of protection) and gender roles that limit women to certain spaces and responsibilities (the home, as housewives and mothers). The biggest reason however for the decision to not get Layla’s father a transplant is undoubtedly the unfortunate reality that is the lack of access to primary healthcare in Egypt. When Layla takes her father on a long trip to Mansoura Kidney Center, he is astonished by the quality of the hospital. He says, “This is how Egyptian medicine should be! Free, high-quality healthcare for all (77).” This instance is the reader’s first glance on the struggles Egyptian citizens deal with due to the inaccessibility of healthcare. Later Layla explains to Anna that, “Primary care is so bad in Egypt that people often find out about their disease only after they’re already having organ failure (118).” Layla also explains to Anna how there is no donor list in Egypt, or even a law in place for organs to be transplanted. Layla’s father is just one example of the many Egyptians who must come to similar conclusions when dealing with medical hardships.
Just as these factors were influencers for Layla’s father, they also played a role in Anna’s decision making process in whether or not to get a preventive double-mastectomy. Firstly, Anna perceives her life as something she can strive to control as an autonomous being. There are many instances in which Anna expressed her “[want] to slow down time…or stop it all together (45).” Despite resistance from her father, she was determined to find out if she had the BRCA gene so she could maybe, “prevent the cancer (87).” It is evident that Anna sees her life as within her control, due to her desire to be self-determining. It’s why in the end of the book, she says, “I changed my body so that I could have a better future (235).” Although she could not control her own mother’s circumstances, Anna sees this as an opportunity to do whatever is in her power in order to extend her own time rather than perceiving it as in the control of outside forces. Additionally, Anna’s rejection of gender expectations is also a reason for why she eventually does get her mastectomy. Anna’s father tries to convince Anna that she is too young or to wait until she’s married, and to think about breastfeeding her kids, to which Anna responds, “Ugh Dad… are you seriously telling me my life isn’t worth living without breasts (88)?” She has the means and the motivation to oppose her father’s rhetoric, and in doing so is even more driven to go through with her plan. However, there is Anna’s obvious privilege of accessible and sustainable healthcare that is the main reason for her eventual choice. Although Anna initially struggled with getting the BRCA gene test, she was eventually able to obtain it. Furthermore, she had the means of getting the surgery due to living under the American health care system. Essentially, it is Anna’s own social, medical, and financial security that contribute to her ability to get preemptive surgery.
Another interesting layer to this narrative is how Layla and Anna’s friendship is challenged as a result of their different mentalities when faced with medical hardship. The reader can see how the notion of agency is tested by Layla when Anna is contemplating a double mastectomy. Layla tells her, “What?! Mutilate your body when you’re healthy?! Today is a gift from God. Why try to treat a disease that you don’t have (126)?” At the same time, the reader witnesses Anna’s inability to understand why Layla’s father would not get a transplant. She challenges Layla’s statement that “God knows the way and the time of our deaths before we are even born” by saying, “Maybe God created transplants so your Baba could live longer (163).” Essentially, their contrasting views are due to their living in completely different realities, not only when it comes to healthcare, but also socially. Layla’s community emphasizes the collective and surviving day to day, while Anna has been raised to think about herself as an independent agent, and to think towards the future. Their initial inability to see eye to eye however, does not prevent them from cultivating a supportive and inspiring friendship.
Despite Anna and Layla’s varying perceptions of the same concepts, the comic ends with a sentimental mutuality that speaks to the ultimate overarching message of hope that originates from shared struggle—a message that is demonstrated even in the name of the novel. Anna beautifully narrates, “Our scars tell the story of where we’ve been and remind us of how far we still have to go. We still have so much to fight for. There’s still time (242).” In the end while this comic-book definitely serves as an exceptionally informative and engaging piece, it more importantly emphasizes the necessity of persistent resistance through hardship, and that revolution (in all its forms) should never die.