California author uses dark humor — and a bear — to highlight flawed health system
Mother-to-be Kathleen Founds made a routine doctor’s appointment to discuss the risks of antidepressants in pregnancy. After the visit, Founds, who relies on medication to quell the manic highs and despondent lows of bipolar disorder, learned the physician was out of network.
She received a surprise bill for $650, launching her into a maze of claim forms and hours on the phone being routed from one office to the next to dispute the charges — insurance red tape that so many Americans have encountered. A decade later, Founds captured her experience in a graphic novel, “Bipolar Bear and the Terrible, Horrible, No Good, Very Bad Health Insurance,” a richly illustrated, darkly funny fable for adults about the country’s dysfunctional health system.
The book, published in November, follows Theodore, an intelligent but angstridden bear, on his quest for treatment for his own manic-depressive illness. But first he must navigate the demands of the WeCare company, a shady outfit run by cigar-smoking felines who profit unfairly from a lopsided economy and a corrupt justice system, among other things. His fellow outcasts include such characters as an overeducated owl drowning in student debt and a bomb-sniffing puppy suffering from PTSD.
America is internationally known for high-quality care, for those who can afford it. A new Gallup Poll shows that a record-high proportion of Americans — 38% — postponed medical care because of high costs in 2022. Federal and state “no surprise” laws of the past few years seek to protect consumers from unexpected medical bills. But they don’t prevent expenses like high deductibles or fees hidden in the fine print of their insurance policies.
“Bipolar Bear” joins other recent works to shine a light on health inequities — part of the emerging genre of graphic medicine. It includes seminal illness narratives such as “Mom’s Cancer” by Brian Fies and nurse MK Czerwiek’s “Taking Turns: Stories from the
HIV/AIDS Care Unit 371” as well as “Rx,” Rachel Lindsay’s memoirs about taking a job at a pharmaceutical company to secure insurance to cover treatment for bipolar disorder.
Descended from the underground comics of the 1960s, graphic medicine has grown into a new field of scholarship on the medium’s role in the study and delivery of health care, said Ian Williams, the Welsh physician who coined the term back in 2007. “It’s ideal for exploring subjects having to do with one’s life and wellbeing in an ironic and funny way,” he said.
As Founds puts it, humor is a powerful weapon against despair.
The 40-year-old mother of two teaches English at a community college in Santa Cruz County. She has never taken an art class and didn’t set out to write a graphic novel. The book began as a doodle in the margins of her notebook while studying for a master’s degree in fiction writing at Syracuse University in New York. Her 2014 novel in short stories, “When Mystical Creatures Attack,” is about a teacher who suffers a nervous breakdown and communicates with her students from a psychiatric hospital.
KHN contributing reporter Rachel Scheier spoke to Founds about bringing Theodore to life. The interview has been edited for length and clarity.
Q: How did you come to write a book about a bear with bipolar disorder?
I’d been making children’s books for my little brother. They were all about angstridden animals: a lonely giant squid, a possum with social anxiety disorder who falls asleep whenever he’s in an awkward situation, a burro who wants to be a unicorn. My goal was to write a novel. But whenever I was too depressed to string a sentence together, I’d draw bears. Then I realized that anyone dealing with a mental health issue in this country is going to have to deal with the labyrinth of health insurance. And I thought it would be fun to depict it as an actual labyrinth with trapdoors and man-eating flowers. Once I went in that direction, it was no longer a children’s book.
Q: Was the book based on your own experience with mental illness?
Yes. I had my first major depressive episode at the end of high school, but I didn’t seek out professional help. I just sort of muddled through it. Then, when I was a sophomore at Stanford, I had my first manic episode. I had a series of realizations about the nature of the universe, and I didn’t sleep or eat very much. Then, in graduate school, I went to a clinic because I was going through a depression, and the psychiatrist asked me questions like “Was there ever a time when you had a lot of energy and didn’t feel a need to sleep?” And I said, “Oh, sure, but that was a spiritual awakening.” So, I had to reframe my life story a bit after that.
Q: But religion still has a role in your life?
I’m a Quaker. It’s something I came to through my interest in nonviolent social change. When I am severely depressed, I feel like life has no purpose. So, following a code that says life does have meaning, that we are all connected by a force of love that undergirds the universe, is something that has helped me a lot.