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I edited ruthlessly. My guiding principle was that if it didn't focus like a laser on advancing my mother's story, it was out. For starters, I chopped out almost everything about me. There were a lot of other people, including my own wife and kids, who were important to Mom's life but not essential to propelling this story. I also knew it would fail if it were an iota more self-indulgent or maudlin than it had to be. If someone still finds it sickeningly sentimental, I won't argue, but I did my best to dial down the pathos.

As script or sketches or even finished art, I probably had at least twice as much material as I ended up using. In the end, I'm afraid now that the story might be too lean, but when I look at what I cut out I can't imagine putting any of it back. I think it is what it is, for better or worse.

Contino: So much of what you described -- especially the way doctors double-talk and confuse the patients -- rings so true to home. How frustrated were you going through all of this with your sisters and your mother?

Fies: Frustrated, outraged, dumbstruck with disbelief. Once we got Mom to the oncology specialists, we thought she received excellent care. But even so, there were so many disconnects in how people relate to people and how the system relates to patients.

I think medical professionals forget that though they have hundreds of patients and see dozens of these routine little dramas every day, for each family and patient this is The Most Important Thing In Their Lives. We've never been through this before. We don't know things that they take for granted. We're in shock, with too much information coming too fast. It can be ridiculously hard to get a straight answer to a simple question. Taking an extra 20 minutes to explain everything very clearly at the first appointment could prevent days of confusion and uncertainty later.

On top of that are countless trivial frustrations. Your chart is always on someone else's desk. Someone will order tests you don't need or just took. Someone will insist you show up an hour early and then make you wait for four. Wal-Mart has better information-tracking technology than most hospitals.

One of the most gratifying results of doing Mom's Cancer has been letters from medical professionals saying that it gave them real insight into the patient's point of view. A nursing instructor in Australia wrote to ask permission to include it with the training materials they send to nursing students working in remote rural areas. The idea that someone on the other side of the planet thinks my cartoons might help their students become better nurses blows me away. What could be better than that?

Contino: How did you decide which style to use to illustrate this story?

Fies: Another question I appreciate, because I put a lot of thought into it. Almost every other similarly themed comic I can think of is dark, anguished, grim, and gritty. I can do that, but I deliberately went the other way, toward light and clean -- partly just to be contrary but also with an eye toward my audience.

Accessibility is very important to me. I'm not aiming to impress a jaded, comics-savvy crowd that's seen it all. Mom's Cancer is drawn for grandparents and kids who've never read an adult comic or graphic novel. I wanted it to be an inviting, quick read, with an almost retro comic strip feel that I've described as "Family Circus in Hell." Let the folks get comfy and then hit them with this story, which I trusted enough to tell plain and straight -- and even humorously -- without slathering on the gothic gloom.

And honestly, some of my choices were driven by expediency. For the first half of Mom's Cancer, my goal was to get it done while my mother was still alive to see it, and I knew that wouldn't happen if I filled every panel with meticulously crosshatched bric-a-brac. I was working faster and looser than I might otherwise want to.

Frankly, I'm not sure I made the right decision. It's interesting that, within a medium that celebrates individual expression, there are a fair number of people who think a comic strip about cancer should look a certain way and react pretty badly when it doesn't. One of my favorite reviews was from a blogger who wrote something like, "The art is very clean and uncluttered, but I liked it anyway."

Contino: Who or what were some of your creative influences for Mom's Cancer?

Fies: That's a tough question. Most of the people whose art and writing I admire have nothing to do with cartooning. I know I need to mention Harvey Pekar -- acknowledging that my 105 little pages don't amount to a pimple on the pinkie of his body of work -- but except for his Letterman appearances, he was never high on my radar. Our storytelling couldn't be more different. I knew about Our Cancer Year but deliberately avoided reading it until after Mom's Cancer was finished. I may be fooling myself, but I'd like to think it would have turned out about the same anyway.

I've cartooned as long as I can remember and sort my influences into two groups: those I passively absorbed growing up and those I actively sought out later. The first group includes people like Charles Schulz, Stan Drake, Neal Adams, Gus Arriola, and John Buscema. The latter includes people like Winsor McCay, George Herriman, Milt Caniff, Roy Crane, Cliff Sterrett, and Will Eisner. My dad had several Pogo books from the 1950s that I devoured as a teenager, and if I had to point to one person and say, "That's everything you want in a cartoonist," it'd probably be Walt Kelly. Underground comics never really interested me, which probably accounts for the distance I feel from a lot of graphic novels that share similar sensibilities.

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