IT started with a sore throat. Early in 2013, Brighton-based graphic novelist, illustrator and tutor Zara Slattery had developed the symptom while sitting beside her mother’s hospital bedside. Her mum had pneumonia and wouldn’t recover.

In the days and weeks that followed, while trying to arrange her mum’s funeral, care for her children and her dad, the sore throat persisted despite antibiotics. It morphed into flu-like symptoms and on May 22 that year she was rushed to hospital in agony.

She had contracted a deadly bacterial infection and spent the next 15 days in a drug-induced coma in an intensive care unit, her life in the balance. Her husband Dan, meanwhile, tried to look after their kids while fearing the worst for his wife. Oh yes and then Slattery also suffered necrotising fasciitis, which required life-altering surgery.

 

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Thankfully, Slattery recovered, and now she has channelled all the terror and fear and hallucination and love into Coma, an artful graphic memoir which draws on Dan’s diary accounts of those fearful days and Slattery’s own memories of her hallucinations (recreated in bravura colour).

The result is a powerful and frightening account of an extreme experience. It seems strange, in the circumstances, to say that it’s also a work of great beauty.

For Graphic Content, Slattery talks about revisiting this extreme moment in her life, what it took from her and why graphic novels are great for medical stories:

Zara, this graphic novel takes you back to what must have been one of the most frightening and upsetting experiences of your life. What did it take to revisit it?

In a word, time. I knew I would explore it creatively at some point, but not until I’d done a lot of healing, which meant turning away from the experience for a while. Eventually, fascination supplanted fear and I presented an introductory “intention” of works at the 2016 Graphic Medicine conference in Dundee.

However, when I got home, I knew I wasn’t ready. My vulnerable self far outweighed my creative one, so I took a step back, got my sketchbook out and just doodled around it. Dan’s diary was pretty emotional, and difficult to read, but it felt necessary for context. Once I made the decision to include his diary, my focus was on structure and creative problem-solving. I entered an early extract to the Myriad First Graphic Novel Competition in 2018. Happily, it was shortlisted. That gave me the impetus I needed to get going.

How aware were you of what was happening to you in the ICU. Did you understand the danger you were in?

I had an awareness of being in a hospital, and that things were happening to me. I sensed the danger, however. The danger came from outside and not from within my body. The medics were reacting to my condition and I interpreted their behaviour as threatening, firstly to me and then later, my children. Despite seeing skulls and skeletons, I didn’t connect them with how critically ill I was. Only later, when I heard that I’d live, did I have any awareness that I could have died and then I didn’t believe it.

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The visions you experienced during your coma are a mixture of animals, mythological creatures, shadowy figures and disembodied heads. How disorientating were they? And how upsetting?

My first evening in hospital was completely disorientating; by the time I arrived in A&E, I’d had a lot of pain medication; much of which was ineffective. I was in extreme pain, drifting in and out of consciousness and trying to fix my location. The delirium kicked in pretty much straight away; with the myriad of voices adding to my confusion. I couldn’t anchor myself in the familiar.

The next two weeks were a mix of vivid hallucinations and an altered reality. I use a range of techniques to convey the complexity of the experience. Some scenes in the book are a literal interpretation of what I saw, others are metaphorical. I use symbolism for things not easily said; animals and creatures, repeated emblems threaded throughout the book, representing primal emotions and physical states, like pain and fear.

My altered reality came, primarily, in the form of the shadowy figures. These were medical staff and other patients that I couldn’t focus on beyond their form. These were particularly upsetting, because I sensed their presence and approach but didn’t understand what they were and so feared them.

The mythological hallucinations weren’t disorienting as such. I believed them to be real. If anything, they focused my mind, like being catapulted into the scene of a movie. I experienced a range of emotions from curiosity to fierce rage. However, fear was my dominant emotion. Everything was viewed through that lens. Initially there was fear for myself. And after my children came to visit, it was fear for them and the emotional pain that threatened to shatter their childhood. I couldn’t comprehend the source. All I knew was that I had to protect them, however powerless I felt.

Did the memory of the visions remain vivid when you came out of the coma?

My visions and the associated emotions had been my lived experience for two weeks, so the relief on waking up from that veil of fear and distrust was profound. However, as much as I’d like to have left them behind, they were a burden I couldn’t shake. The memory of the visions was ever-present, so I was aware they had to be confronted and understood before I could move forward.

You tell the story in two different registers; the wild colour of the visions and the black and white reality of everyday life of your family who are trying to come to terms with what you are going through. How quickly did you come to that decision?

Before I got to thinking about materials, I spent a long time playing with how to tell this story and sampling approaches. Originally, I was planning on only telling the coma story, and using a lot of symbolism and metaphor to do so. I’d connected my imaginings to medieval imagery, so was keen to reflect that in the rich use of colour.

Dan’s diary talks about everyday life, which is visually quite involved and complex. With that in mind, it made sense to keep to simple line. His diary is the beating heart of the book, it’s unfiltered and emotional, so it was also important to find a medium that reflected that. Drawing with charcoal or charcoal pencil feels honest, immediate; the fractured quality of its line fragile.

The Herald: Zara Slattery. Photograph Sarah McIntyreZara Slattery. Photograph Sarah McIntyre

How strange was it to hear the story from your husband and children?

I had enough awareness to know that something devastating had happened to my body and bizarrely it was a relief to see the physical evidence of my coma experience: the amputation and the swollen arms. I believed I wouldn’t die, so it was hard knowing that Dan thought I would, and for that I was sad and sorry. The children were aware that I was very ill but not how close I was to dying. Inevitably they found my time in hospital heartbreakingly difficult at times. However, I never lost sight that I was still there for them.

It was a year before I read Dan’s diary and that was a revelation. I wasn’t always aware of his being at my bedside, so reading his account of things I remember was hugely emotional. I’m indebted to him. His documenting this shared experience has lessened any loneliness.

This is a substantial piece of work, nearly 300 pages in length. How easy was it to sit down every day and work on it given the nature of the story?

Having got to a good creative headspace, it was quite easy to work through. Prior to Coma I’d only worked on short story and silent comics, so I knew I needed to be organised and plan. I had a chart, a nine-panel grid, and several phases of roughs. I made models of all the key characters, which helped enormously. They made the story less about me/us and more about them and the experience. In part, the materials were the drivers of the story. Working in charcoal and walnut ink was quite enjoyable, with them I was able to fully explore and convey the emotions.

To what extent did putting the experience down on paper help you process what had happened to you?

I pieced much of my experience together prior to the book, however, I hoped the process would plug the gaps. Some revelations came whilst I was working on it, such as realising that the circus ninjas were actually surgeons. Some came unexpectedly, once the book was in my hands. I was aware that bedside conversations had filtered through. However, I hadn’t realised how much other’s emotions had impacted me.

How has this experience changed you?

Physically, I’m a hind-quarter amputee. I mobilise on crutches. There isn’t any part of my life that isn’t affected. I manage my frustrations. Emotionally, I’m probably much mellower than I used to be. Having been to the extreme reaches of myself during my illness and later wading through PTSD, internally I’m calmer.

Creatively? That’s a hard one. When I got ill, my children were old enough for me to give more of myself to my work. And that’s what I was doing, and it was exciting. My life was put on hold for a few years and now, I’m the energised and excited artist I used to be.

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And how has working on Coma changed how you feel about your work?

Coma was a sizeable piece of work, I learned a lot and picked up new skills along the way. I’m much more confident in taking on ambitious projects now. I also turned out to be more organised than I imagined and a lot more patient with the process. Drawing has always been at the centre of what I do. However, time and necessity has meant letting some things go, and that’s OK. Not every line has to be perfect to carry the story.

Why do you think the graphic novel form is so good for telling these medical stories? Can they reach a new audience?

When it comes to medical stories, graphic novels cut across society. They speak to medics, academics, patients and the families of patients, plus anyone interested in human stories or conditions. Regardless of perspective, everyone has some understanding of the story.

For a creative, there’s so many tools to take the complex and reframe it in an accessible way, while still retaining all the nuance of storytelling. For a reader, you’re treated to multiple layers of storytelling, which makes it so digestible and rewarding to return to.

I like the idea of graphic novels reaching new audiences regardless of subject matter. We’re lucky to have so many amazing creators telling diverse stories. There’s something compelling about putting words and pictures together: an alchemy that speaks to our innate self. Plus, it’s familiar; we’re schooled in pictures from a young age and have visual literacy embedded, I think graphic novels awaken that.

What’s next for you?

I’ve got a few projects lined up. I’ve been wanting to create work about the environment and habitat loss for a long while, so when writer, Gregory Norminton, asked me to develop a graphic novel with him focusing on our relationship with nature, I was super excited. Adapted from a medieval Irish poem, it’s the tale of how a cursed man finds his humanity in nature. Alongside that, I’m working with Canterbury Cathedral, Liam O’Driscoll and Karrie Fransman in drawing a short comic inspired by the pilgrim windows.

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Coma by Zara Slattery is published by Myriad Editions, £18.99