Exploding medical communication

A hand holds a cardboard square approximately 8cm across. The square is covered in white paper with cartoon-style red love-hearts. Across the centre is a white ribbon with red hearts, tied in a bow. A title (cut from paper, with red text on a white background) reads "About heart failure."
‘About heart failure’

This month’s haiku theme (Medical Terminology/Communication) has been proving challenging. I didn’t feel like anything I’d written was saying what I wanted it to, so, while supervising multiple summer-holiday sleepovers this week, I started putting together this “explosion book,” using actual medical information I’ve been given in recent months/years. There are lots of excerpts of letters and appointment notifications, plus some charity-produced patient leaflets and the information booklets you find inside boxes of tablets.

Obviously this cover is misleadingly cutesy and positive…

The book from the first image lying open on a table top, with the edges of the covers slightly visible behind black pages. Rather than being assembled like a typical book, this one has been folded in various squares and triangles so that it explodes outwards when the ribbon is untied. The black sections have parts cut from patient information leaflets and medical letters arranged centrally on each page. Some of the sections have multiple texts layered one on top of the other, making them harder to read. The sections on the left-hand side have more white spaces, the amount of text increases as you move to the right.
Information, letters, appointments, diagnoses.

…while inside it’s all darkness and “necrotising fasciitis of the perineum” – the very rare (thankfully) side-effect I learned about recently while reading the information leaflet in my new tablets. Yikes.

The book from the first image is lying open on a table top, showing the opposite side from that shown in image 2. The covers are visible at each end of the book from this angle. Rather than being assembled like a typical book, this one has been folded in various squares and triangles so that it explodes outwards when the ribbon is untied. The black sections have parts cut from patient information leaflets and medical letters arranged on each segment/page. Compared to the pages in the previous image, these pages are far more deconstructed, with individual words cut out, more overlapping layers of text and some pieces folded into origami hearts or cut into tiny heart shapes.
Sometimes it all gets TOO MUCH.

I enjoyed making this book, believe it or not, and please don’t let it make you concerned for my sanity/existence – I’ve purposefully extracted phrases out of context and reassembled them in some of the worst ways I could BUT all these phrases were there in the leaflets and letters, all designed to inform and support. It’s all too easy to focus on the scary/negative, even without trying.

One of my lowest heart-failure lows was when I was discharged from hospital, sent home (without my new baby) with a massive tome called The Everyday Guide to Living with Heart Failure, published by the British Heart Foundation. One day, home alone, I steeled myself to read it. The advice about asking your grandchildren to climb onto your knee rather than lifting them, alongside pictures of smiling silver-haired people in gardening gloves, was pretty depressing to read as a 31-year-old new mum. Looking at the contents page, however, I saw a section called “The Future” and assumed it would be about medical developments and new treatments that might become available in my lifetime. When I turned to the relevant page, I found “The Future” contained nothing but advice on procuring a Do Not Resuscitate order and writing a will. This was ten years ago but, while I can and do laugh about the awfulness now, I am still tearing up at the memory.

A close up view of some of the pages from the previous image. Some sequences of words (mostly individually cut out and collaged) are visible. For example, one section reads, "Waiting patient. Chronic symptoms breathless severe failure to function on your own." Another panel, made up of two triangles has "She denies [illegible layered text] attempting hills or stairs there has been some decline she needs advanced heart failure therapies Patients at the heart of progress" arranged vertically, and " cancel [underline] distress depression feelings of dread difficult conversations. She is compliant - she is happy with this plan." Another segment has illegible multiple layers of text running vertically, with the words "how/to tell you" glued on top, horizontally. There's also an incomplete anatomical diagram of the heart, divided across two sections and an origami heart folded from a medication information leaflet, with various short sections of text glued across and around it, e.g. "side-effects: ; addition of Dapagliflozin; shaking, sweating; necrotising fasciitis of the perineum; change in your mood; tiredness; pain; keep her under surveillance and monitor her."
“Keep her under surveillance and monitor her. Cancel distress depression feelings of dread difficult conversations. She is compliant – she is happy with this plan.”

I don’t know what the solution is really. Honest and practical information is so important and I wouldn’t want to be misled by sugar-coated half-truths, but being given “facts” in black and white, to read and interpret, to reread and obsess over, on your own, with nothing more reliable than Dr. “Death-Knell” Google to assist in your understanding… No matter how carefully organisations (and individuals) word things, I can’t see it ever ending well. Would I prefer not to know? No, but I would like the people who write these things to be aware of how hard it can be for patients (especially new patients) to absorb the information in the helpful way it was intended.

Anyway, these were the thoughts I had while messing about with my scissors and glue stick – messy thoughts, messy process.

Can I distill any of this into a haiku? We’ll see. Maybe you can? If anything in my explosion of thoughts has inspired you to write something about Medical Terminology or Medical Communication for the zine, you can do so by leaving a comment here, or on this post.

Hand holding a small, open explosion book made from yellow card with pictures from a Beano annual stuck on the square- and triangle-shaped pages. In the background some mess of family life is visible.
Doesn’t always have to be about hearts 🙂

These explosion books are surprisingly easy to make. I followed this YouTube tutorial (aimed at those teaching children) which made the whole process even simpler. I’d love to see any explosion books you make, about your heart or about anything else. Here’s another one I made using an old Beano annual.


    • Thanks 🙂 Definitely one of those things that looks more complicated than it really is. You should try it if you ever tire of haiku writing 😂


  1. This is wonderful! I would love to meet you in person at a workshop while you teach how to do this or some of the other incredibly creative things you do.

    Liked by 1 person

    • Thank you, Margarita – that would be so lovely! 🙂 Maybe workshops will happen one day, but look at the YouTube video I linked to in the meantime – such simple instructions to make the basic blank book and then your imagination can run free filling it up. I would love to see any explosion books you create. I’m thinking they would make lovely haiku containers, or maybe a haiku/collage mash-up. I’m definitely going to keep playing with them for a while.


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