Dr. Weaver-Hightower wrote, illustrated, and published this powerful graphic work in the Journal of Medical Humanities.  The comic itself is presented in a traditional paneled format, with a few exceptions, and rendered in a moody ink wash in black, white, and various shades of darker and lighter greys. The story is told in the authentic, sometimes faltering voice, of the father of Thomas and Ella, a pair of twin infants who died at 22 and 24 weeks into pregnancy. Beginning with their harrowing trip to the hospital, the comic describes the father and mother’s loss of Ella, shortly after she was born prematurely; their subsequent wait for Thomas to reach the “viable” age of 24 weeks; his stillbirth; and the couple’s sudden discharge from the hospital, going home with “empty arms”.  The story then transitions into “The Long After”, including the funeral and the phases of the parents’ grieving process.  The father describes his grief, frustrations, the couple’s differing ways of coping, and his ambivalence and anger toward religion as a source of comfort or deeper understanding.  On the last page, he recounts their hopes and fears as they enter into their second pregnancy, concluding with panels of the father wrestling with how to understand and process this loss.  The final panel is an image of the father in profile, expressionless, saying nothing, a fitting conclusion to a story for which words seem to fail. 

With this piece, the author introduces us to the genre of the “research comic”. The comic is followed by a methodological appendix, which explains the author’s process for choosing, capturing, and relating this history in words and illustrations, as well as his rationale for selecting a comic or graphic memoir format for the piece.  The author also elaborates upon the concept of the comic as a form of “rigorous, informative research” (226).  The appendix is very interesting and will satisfy the curiosity of readers asking the questions, “How did he do this?”, or “Why is this story a comic?”, but the piece stands on its own without the appendix, as well.  


Weaver-Hightower’s retelling of this tragic story is powerful, affecting, and rife with rich, provocative visual and written detail.  The choice of a comic as medium is compelling and brave, and ultimately extremely effective; as mentioned in the summary, words alone seem to fail this series of events, and the author/illustrator is skillful in his choice of scenes/moments depicted; the arrangement of images on the page; and the use of color, shading, and contrast to evoke emotion. Observant readers will notice the words “Do not smoke when pregnant!” emblazoned on the back of a bus (216), and the image of the mother, reclining in the bathtub with eyes closed, appearing as the iconic painting “The Death of Marat” by Jacques-Louis David (216), an ominous bit of foreshadowing inviting discussion of perinatal death and loss of identity.   

When the struggling, prematurely born Ella is depicted, she is given the entire page, floating against a white background and enclosed in what appears to be a softly airbrushed outline, mimicking the amniotic sac.  There are very few words on this page, allowing her to dominate the page, inviting the reader to pause and take a breath.  The author also touches appropriately upon the mundane, inserting it as a giant hovering pulled pork sandwich on page 222; this is the fare the couple chose to serve at the “barbecue thing” after the funeral.  This moment in the narrative evokes perfectly the awkwardness of those still alive in the shadow of death; we are paralyzed by loss, but our bodies still need sustenance, so we eat to remain vital.   

The author even dares to insert a moment of humor into the story: on page 224, a physician relates to the father that the divorce rate for parents who have experienced perinatal loss is “only” 76%.  In reaction to this information, the father is shown in classic comic caricature, complete with hugely bulging eyes, a gaping black chasm of a mouth, and even little white Mickey Mouse gloves.  “76%!!” he yells.  Somehow this moment of comedy works, perhaps because we as readers know that this probably actually happened, that it is just one example of a physician relating a statistic without considering its potential impact on the patient.  However, this comic does not demonize doctors or the health care profession, or characterize the storyteller and his wife as victims or heroes; Weaver-Hightower has deftly resisted this easy, formulaic categorization.  In the end, this is a father’s story of his incredible, immeasurable loss, and the details included in this comic are what he remembers of the experience.  We can’t know exactly what the health care team said to him and his wife during this time; indeed, he likely does not recall.  What he does remember are the images included in these pages: holding the struggling, helpless Ella as she fights for her life; washing his wife’s hair as they wait for Thomas to be born; kissing the stillborn Thomas on the head; leaving the hospital with empty arms.   

At the end of the appendix, Weaver-Hightower expresses the wish that “…Losing Thomas & Ella…might provide insights into perinatal death and its wide-reaching effects on parents,”(229).  This piece absolutely accomplishes this goal, and its impactful images and graphic format contribute to its success.


This graphic memoir also appears in Journal of Medical Humanities 2017:38(215-230).


Penn State University Press

Place Published

University Park, PA



Page Count


Secondary Source