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 angst-ridden 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 well-being 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 on California’s central coast. 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?

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