Down to the Bone: A Leukemia Story by Catherine Pioli

What an absorbing, educational and ultimately devastating graphic novel depicting the artist’s own journey with cancer, from diagnosis through treatment until her own untimely end.

Catherine Pioli never got sick or injured as a child, so thinks she’s finally outrun her long streak of good health when her back and shoulder pain get so bad that she can barely walk, much less work. Her doctors finally schedule her for a hospital stay so they can run all the tests, and are just as surprised as she is to discover that she has leukemia.

As a graphic artist, she decides to chronicle the journey via drawings, not only of her own life grappling with the disease and often debilitating treatment, but also cartoony illustrations bringing her cellular processes to life. The effect of the latter is both cute and informative, as she educates readers on the clinical details of leukemia in accessible language with engaging illustrations.

But it’s the more sophisticated depiction of her personal life that really leaves an impact on the reader, as she shows how the diagnosis and treatment affect her everyday existence. There isn’t a mawkish moment in the book as she wryly examines how her life changes, from the first extended hospital stay to how the diagnosis affects her relationship with her family and loved ones to just trying to survive, never mind thrive, within the constraints of her new reality. It’s no small triumph that her narrative stays so fresh and lively throughout. The hair loss subplot is common throughout many cancer stories, but the way Ms Pioli talks about her own experience with it feels vital and new.

So it hurts to discover that she dies of the disease in 2017. Her last few months aren’t depicted — understandably, as she’s frank about how exhausting everything is as the disease progresses — but there is an important coda about bone marrow donation, about how the process works and why it’s so important. I rather wish there’d been more transparency about who continued working on this book after she passed, whether it was an editor or loved one who collected what she sent and chose to organize it in this way, just to know whom she loved enough to trust with this deeply personal, deeply impactful tale. But hers seemed a life well-lived, even if it was cut far too short by this terrible disease.

The only thing that didn’t elicit a ton of sympathy for me will come as no surprise to anyone at all familiar with the state of American health care. Whenever Catherine expresses surprise over her pharmacy bills, I’m reminded of how medicine is treated in the civilized world, as a public service and right, not a profit-making operation as it is in the US. Tbh, I don’t think I could handle reading something like this set in this country. Death is bad enough without having to worry about penury as well.

For all that, this is a life-affirming graphic novel that ably illustrates not only the medical issues but also the very personal ones that affect a person diagnosed with leukemia. Elegantly translated from the original French by J. T. Mahany, it’s an excellent read for anyone interested in cancer, mortality and life in France. Recommended.

Down to the Bone: A Leukemia Story by Catherine Pioli was published December 13 2022 and is available from all good booksellers, including