Before hearing about Columbia's M.S. in Narrative Medicine (NMED) program, Sal Marx was working as a middle school art teacher in Brooklyn and spending their free time leading visual storytelling projects with patients who had chronic illnesses.
"Looking back, I was already building a career and an arts practice in which patient voices were centered as a vehicle for change, long before I had language about narrative medicine and its applications," they said.
Growing up outside of Seattle, Marx spent years enduring a long and painful journey as a young person seeking a diagnosis for chronic pain and illness. Like many people who have had their very real pain told that it is all in their head, Marx felt invisible for years on end.
As they began to co-exist in disability justice communities, their friends and mentors taught them that as much as chronic conditions can be incredibly isolating, they also have the potential to connect people.
Marx went on to study public policy, psychology, and media studies at Pomona College, where their undergraduate thesis explored the systemic barriers that lesser-known diseases such as Spondylitis face within the medical-industrial complex and how storytelling across advocacy platforms can unite communities with diverse disease experiences.
When Marx moved to New York City to teach art to 5th-7th graders, they were reminded of the "power and possibility within messy, creative play" that is built in community.
Tell us a bit about your art and creative endeavors!
My work as an artist exists within two reciprocal worlds: one collaborative, rooted in disability justice and patient advocacy, and the other as an independent visual artist. I'm an artist because I have an unrelenting need to create, and because artmaking has long been a platform for making visible the parts of my story that went unseen. Most recently, I've been lending my time to Sick Futures Collective to build an archive of visual storytelling pieces with and for chronic illness patients. My goal is to treat storytelling as a form of care work: collaborative, non-linear, to meet access needs, and grounded in an individual's own language and representation. Instead of framing stories through pathologizing illness lenses, creative and visual ways of storytelling have the ability to re-establish agency, where people are equal creators of meaning instead of subjects of interpretation.
In addition to my collaborative work, I'm a visual artist, working in painting, illustration, and mixed media. I often work in a limited color palette—primary colors—to mirror the limitations that language offers for subject matter surrounding pain and gender expression. As with many people who have ever been asked the question, "Please rate your pain on a scale of 1-10," I know deeply the frustration and inadequacy of expressing one's pain and bodymind through the limiting structure of binary boxes. Turning to the sketchbook, the typewriter, and the canvas opens new worlds of possibility for connection and for moving through the world, internally and externally. My art explores how the body itself is a narrator when language falls short within binary ways of thinking: sick/healthy, woman/man, visible/invisible.
How has what you learned in the program contributed to your work as an artist?
During my time in the program, I got the opportunity to develop an independent study elective with MK Czerwiec (The Comic Nurse), one of the pioneers of the field of graphic medicine. That experience was foundational to synthesizing my work as an artist and bringing narrative medicine into real-world creative applications. I began to see myself as a creative illness doula, where I could combine tangible skills with projects that featured collaboration inside and outside of healthcare spaces, grounded in co-authorship, deep listening, and narrative humility. Through comics, graphic material co-created by and with people with chronic conditions, and qualitative research work I was simultaneously conducting, I interrogated questions that became central to my work today: What are the ethics of listening? Of witnessing? Of telling your story, or the story of someone else?
Systems of oppression work in violent ways, erasing patient voices and stripping them of agency in telling their own stories. My learnings in the program cemented that building creative narrative interventions is not a nice-to-have but an essential intervention to restore epistemic justice and begin to repair harm caused by the medical industrial complex.
What was your experience with such a diverse cohort, and what advice do you have for other artists?
Being in a cohort with diverse colleagues allowed me to build lasting relationships with people engaging in care-giving and care-receiving in all sorts of ways. Some of my closest friends from the program exemplify this: one is a doctor in Germany; another works in criminal justice reform in Oakland, CA. Close collaboration during the program allowed me to quickly implement real-life projects that we had imagined into being soon after graduating. For example, Dr. Anna Kitta and I received a grant to develop a qualitative research study at the Medical University of Vienna in their palliative care ward. Our goal was to give patients a voice in medical research and to investigate individual, social, and cultural aspects of living with incurable illness—through comics. Our study is now being replicated for a pediatric population at Akron Children’s Hospital and I’m excited to see it continue to evolve in diverse ways.
What is your advice to visual artists interested in the NMED program?
My advice to other artists interested in narrative medicine is to know that you will be faced with unique opportunities and challenges to make the program your own: the coursework is not developed with artists in mind, which is exactly why creative folks have so much to offer the field and community. Find ways to intentionally integrate your practice into every class, assignment, and relationship. I remember an assignment in my Illness and Disability Narratives class in which we explored a writing prompt through a different narrative lens each week. I gave myself the extra push to make an 11x14-inch painting before I even began the writing assignment every week. Ultimately, having a wide range of backgrounds and ways of thinking enriched the amount of learning we could achieve from each other, in addition to the course material.
Although traditional narrative medicine workshops have heavily leaned on the written word as an entry point for engagement, the visual arts in all their expansiveness have so much to offer too. I think creative people are often already working to build new worlds of being and imagination into care settings. Bringing these practices in will only expand what narrative medicine can offer and who it can reach.
About the Program
Columbia University’s Master of Science in Narrative Medicine prepares health professionals, writers, and scholars to apply the skills and values of narrative understanding to improve outcomes for both patients and caregivers. It offers a rigorous and in-depth study of close reading of creative texts, illness and disability narratives, narrative ethics, philosophy, creative writing, and other perspectives. The master’s program is available for part-time or full-time enrollment. Learn more here.
