Cover detail to Nicolas Keramidas' Open-Hearted OGN

“Open-Hearted” by Nicolas Keramidas

Nicolas Keramidas needed open heart surgery.

This is his story.

It’s a good one.

Rib Spreading Credits

Cover to Nicolas Keramidas' Open-Hearted OGN

Writer: Nicolas Keramidas
Artist: Nicolas Keramidas
Letterer: Cromatik Ltd.
Translator: Edward Gauvin
Published by: Dupuis/Europe Comics
Number of Pages: 210
Original Publication: 2020

What’s Going On?

Nicolas Keramidas, born in 1972, worked for Disney Feature Animation in the 90s. He’s been a cartoonist since the turn of the millennium. He’s worked with Lewis Trondheim a couple of times, including on the Dungeon series and on a Mickey Mouse book I positively reviewed here a while back.

He also was born with a heart issue that led to surgery at a very young age. More than forty years later, he needs to go for another round.

An anthropomorphic heart explains heart surgery

“Open-Hearted” is a beautiful, gripping, creative, and at times funny look at Keramidas’ heart’s life story. The brutal honesty he tells his story with will grab you by the feels, and the way he uses the comic book format to do it will impress you.

“Open-Hearted” is a 210 page book, but it’s very easy to read in one sitting. You can’t put it down. Nicolas Keramidas is an excellent cartoonist.

This Can’t Be Easy

Page one of Nicolas Keramidas' Open-Hearted

How do you translate a single surgery into a comic book that anyone would want to read?

When I stop to think about that question, the blank page frightens me. It’s a sequence of events, some of them very personal and very awkward. It’s also, thankfully, a sort of standard operation by modern medical definitions. It’s serious and it’s scary, but it’s common enough that things usually end well. There’s a checklist and everything, I’m sure.

So where’s the part where you create a story out of this, have a relatable and a sympathetic main character, and still put in a couple of surprises along the way?

Self portrait of Nicolas Keramidas at his art desk

Forget the three act structure. You can probably overlay one on top of this book if you really tried, but the heart surgery isn’t the protagonist’s lowest point at the end of the second act that leads into a third act confrontation with the evil villain and —

No, this isn’t that kind of book.

Also, the heart surgery happens at the halfway point of the story.

So how do you structure this story? Easy, you don’t. You break it down into a series of scenes and moments that build up on each other naturally. You start at the beginning and work your way through. You include a flashback here and there to explain things as needed. Real Life has a way of creating its own dramas.

You invite the reader into your world. You show them everything, warts and all. And you bare your soul along the way — all your fears, worries, and concerns.

Keramidas has two key weapons in his arsenal: First, both he and his wife kept notes and journals of what happened as they went along. This helps to keep everything in line, and gave Keramidas a second point of view to help him fill in the blanks during his post-op recovery.

Secondly, and perhaps most importantly, Keramidas is a highly skilled cartoonist who knows how to make a story visual. It would have been very easy to turn this into a talking head comic book, but Keramidas is much more creative and experimental than that.

Nicolas Keramidas draws himself as an astronaut in an MRI

He animates his own heart to tell a portion of the story. He draws himself as a bird or as a bowling pin or as whatever best suits the story at that point. He can personify anything and use that to his advantage. Even a simple establishing shot of a hospital building comes with a sequence of arrows that shows you how he gets in — and that continues through the next few pages to establish the new location.

He also has a variety of page layout tricks to use. There are a bunch of well-placed double page splashes. When he’s alone in a hospital room, it’s a wide-angle double page splash that helps give you that feeling of alone-ness in a sterile environment. When he goes under for surgery, it’s a blank black spread. There’s a whole series of double page splashes at the end that feels triumphant and exuberant. It caps off the book beautifully.

But Keramidas uses whatever format will work best on each and every page. Close-ups, wide angles, medium shots, 2 panels, 4 or 5 panels, or more.

This is also not one of those super detailed European books where the backgrounds are present on every page. That’s not because Keramidas can’t draw them, but because he doesn’t need them. When he does, they look great. The perspective is right, the detail is there, the coloring adds depth on top of it.

A big chunk of this book, however, is a character drama, often with a lone character on an empty stage acting out the events. A shadow behind the character is all a panel needs.

I’m guessing Keramidas did character design or animation work at Disney…

Storytelling – How It’s Laid out

Keramidas’ panel style is also not the densely packed multi-tier panel layout you might expect from your average European comics artist. This book is much airier. It’s three levels of panels, at most, with most pages only getting four to six panels on them.

The animator in Keramidas is let loose to show the worry on this face in this sequence from Open-Hearted

Stylistically, he forgoes panel borders, using mostly solid colors as backgrounds that end in naturally rounded rectangles behind whatever is happening in the foreground. To me, it’s the rounder edges of memories. This is a book with the slightly hazy quality of someone retelling a story from memory.

The hard borders of black lines would constrain that too much. These open panels project the story onto a cloudy shape. Keramidas’ memory is strong — again, he took notes — but the story’s format helps keep things grounded and reminds the reader that this is a memoir.

The style Keramidas uses to tell his story has some latitude. There are times where he’ll go with something closer “realistic” when he needs to make a point about anatomy, but it’s also a book that features a heart explaining open heart surgery to the reader, practically dancing across the page as he does so.

And there are plenty of times when Keramidas draws himself, complete with full frontal cartoony nudity. Yes, there’s frank catheter talk in this book.

Little Nemo in Slumberland is an influence for Keramidas in one sequence from Open-Hearted

There’s a lot of his animation influence showing through here. There are a number of sequences where Keramidas draws himself moving through a range of emotions. He saves a lot of words in the way he shows his emotions. The body language and the facial expressions express the story in a way a lesser storyteller wouldn’t have been able to pull off.

He even channels Uncle Scrooge, Alien, the Smurfs, The Exorcist, and Little Nemo in Slumberland, when appropriate.

Lettering, Unfortunately

English lettering for Nicolas Keramidas' "Open Hearted"

The lettering of the book turns out to be its weakest spot. I don’t like this font very much, and it once again falls victim to the crossbar-I problem, like the letterers just copy-and-pasted the script without taking the time to adjust the capital-I forms to the proper style.

For example:

Crossbar I lettering example in Open Hearted

There are other good examples earlier in this review.

This font kind of works on a title that’s meant for a more juvenile audience, like “Louca,” but it definitely doesn’t work here. Yes, Keramidas draws in a very cartoony style, but the story, itself, isn’t juvenile. It’s serious with splashes of creative comedy. It will even, at times, rip your heart out, figuratively speaking.

This font does not help any of that at all.

Sadly, it’s the same font used in the original French edition of the book.

French lettering for Nicolas Keramidas' "Open Hearted"

Keramidas uses lettering well throughout the book, though. There’s a sequence where he’s realizing his heart is having issues and the pages are filled with the “BOM BOM BOM” sound of his hear pounding in his chest. He captions a few sequences with lettering on a scroll. There are a couple of moments where the words are strewn across the page in a very specific way to help tell the story, like when he and his wife share an emotional conversation over the phone from his hospital room.

I just hate this font.

Size Issues

The lettering also feels a hair too large for the page, which made me think the original French printing of the book wasn’t a full album size. I did a quick lookup on Amazon and that this is the case. A full size album is about 24 x 32 centimeters, while this book is closer to 18 x 24.

That’s roughly two inches less wide and three inches less tall. It’s practically a manga book, by French standards. Seriously, it’s about the same size as a standard American trade paperback, just an inch wider.

That also explains why the panels are so large, with only three tiers of them on the pages, not four.

The size of the lettering and the size of the art, both, should work well in that format. On the bright side, that also makes the book very friendly for the North American market, which insists on standard smaller sizes.

But —

Grounded, and Not What the Market Makers Want in 2021

Most of all, the book works because the story feels real.

Keramidas is painfully honest, at times, about the surgery and the complications of living life afterwards. But he doesn’t turn the story into a melodrama. He doesn’t need to.

There’s not a moment at the end of the book where he’s about to give up during therapy, only for his wife to walk in the door, love to conquer all, and unicorns to jump over rainbows.

Nicolas Keramidas pulls off a split screen effect as he and his wife lay in separate beds, at home and in the hospital

There are, instead, heartfelt moments of his concern over how he’s leaving his family and what he’s doing to them. There’s the personal journey of facing the possibility of death, of meeting an inevitable physical failing, and of facing the challenge afterwards of recovery.

Any of those things could be a book on their own, but would likely descend into navel-gazing. Keramidas maintains a good sense of timing with his plotting, keeping the story moving while including these moments in a way that doesn’t stop the overall story in its tracks. He’ll linger over key moments, as he should, but it never feels too long.

Likewise, this book isn’t going to win any prizes because there’s not a side story about his children becoming drug addled nightmares due to their father’s neglect during this time, or about how his wife left him and he had to struggle through squalor and an ill-fated career choice to get back up on his own two feet.

This isn’t an autobiographical tome about a marginalized person for whom society has given up, whose lack of privilege drives him to extreme measures, and whose situation is an indictment of society’s infrastructural lack of caring, etc. etc.

It’s a book about a guy who has a major operation and the impacts it has on his life. It’s about the small moments along the way and all the questions it raises. It even has a happy ending.

Yeah, I can’t imagine the critics being kind to this one at awards time in North America.

For all of those reasons, it’ll likely have a tough time finding a North American print publisher. But the size of the pages is right!


I’d love to be proven wrong on all of this, though. It’s a great book.


Cover to Nicolas Keramidas' Open-Hearted OGN

Yes, absolutely. It’s a value at 200+ pages of story. It’s a great autobiographical comic that has a story, a heart, and a joy of comics about it. This is about a cartoonist displaying masterful control of story-telling and telling a personal story in a very honest and open way. It’s a joy to read.

“Open-Hearted” by Nicolas Keramidas is available now through the usual digital channels mentioned below.

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