Book Review by A. David Lewis
Shimizu, A. (2015). Cells at Work!, Volume 1. New York: Kodansha. 978-1-63236-356-5
Shimizu, A. (2016). Cells at Work!, Volume 2. New York: Kodansha. 978-1-63236-357-2
Shimizu, A. (2017). Cells at Work!, Volume 3. New York: Kodansha. 978-1-63236-390-9
Shimizu, A. (2017). Cells at Work!, Volume 4. New York: Kodansha. 978-1-63236-391-6
Shimizu, A. (2017). Cells at Work!, Volume 5. New York: Kodansha. 978-1-63236-426-5
Shimizu, A. (2021). Cells at Work!, Volume 6. New York: Kodansha. 978-1-63236-427-2
The body is not a democracy. Of course, the body is not directly of any political bent or ideology. However, when we anthropomorphize its systems and narrativize its processes, some of the underlying assumptions and forces of the body manifest as such. In transforming the body’s routines and responses into a manga narrative, Cells at Work! fashions a social system for its cellular characters.1 That system, notably, more resembles a socialist autocracy than the democracy familiar to its Japanese or North American audiences. This authoritarian socialism, more common to China and Soviet-era Russia, creates a necessary distance between the reader and their subject matter, namely one’s own body. Cells at Work! utilizes that distance to establish a neutrality between the reader and the body as subject. One’s physical being and somatic activities do not become totally alien as much as the inward is turned outward; the mismatch of political realities opens a gap between the reader (i.e. the possessor of a body) and the body as its own, independent space.
True to its title, the characters in Cells at Work! are defined by their work. Many of the stories, each addressing an illness or injury, center on either Red Blood Cell (RBC) 3803 or her ally White Blood Cell (WBC) 1146.2. RBC 3803 is a bright-eyed rookie at the start of volume 1, needing help in directing her supply of oxygen to the appropriate destination. WBC 1146 intervenes to fight off a pneumococcus bacterium threatening RBC 3803. “For cells like us, this is just another day at work,” narrates WBC 1146 as he violently mutilates an invading germ (vol. 1, p. 9). The two have no lives outside of their duties: RBC 3803 is one of trillions delivering nutrients throughout the body, and WBC 1146 is likewise one of a vast legion fighting off invaders. In fact, it could legitimately be said that they all share one life, that of the whole body, rather than truly having individual existences.3
The comic must strike a careful balance between cells as individuals and their working as a collective. While RBC 3803 and WBC 1146 are not given proper names, they do exhibit personalities that suggest individualism; RBC 3803 is spunky and apologetic, while WBC 1146 is grim and decisive. Like nearly all the cellular characters (e.g. the militaristic Killer T Cells, the authoritative Helper T Cells, etc.), both are dedicated to their purpose, even if it means their demise. “I’m going to carry oxygen until the end. Because that’s my job” (vol. 4, p. 113). To be a cell is to be part of a larger enterprise, where the collective is valued above the individual. In fact, the only native cells to express outrage at this arrangement is the Cancer cell, likewise part of a larger whole but targeted and hunted due to its desire for growth. “Why do we have to die…?!” cries the cancer cell. “We didn’t do anything wrong…We were just born like this!” (vol. 2, p. 144).
Individuality is destructive, and the body requires coordination and subjugation of all its components to survive. Common citizen cells infected with viruses, particularly COVID-19, are destroyed without pity or compunction, often graphically. RBC 3803’s pupil observes, that neutrophils like WBC 1146 “conflate justice with violence. They’re walking contradictions” (vol. 4, p. 71). Moreover, in the rare instance where WBC 1146 opts not to eliminate a bacterium, it turns out that lactic acid bacteria benefit the body by boosting dendritic cells rather than threatening it. That is, in proving its utility, the lactic acid bacterium proves its worth.
In animating WBC 1146 – or any of the cells – with a personality, something of a subtle contradiction does arise: they act as a human would, but not a one existing in a democracy. The irony to this is that, by many measures, democracies provide the best health environment to their citizens (see Safaei 2006, Kreuger et al 2015, Templin et al 2021). “The persistent association between democratic governance and health suggests that the political organization of societies may be an important upstream determinant of population health” (Kreuger et al 2015, p. 137). Yet, the massive nurseries and role-specific siloes into which each of the cellular characters are developed strongly suggests an autocratic organization within the body. Blackshirt militias of Killer T Cells destroy anything determined by the authoritarian Helper T Cells as alien and unwelcome,4 and bureaucratic Brain Cells give no explanation for their orders (even in the case of volume 6, when it might cause the body to go blind).
Ultimately, the effect of this contradiction is to make the reader regard the body as something unfamiliar and, in turn, knowable. If the inner workings of one’s own body were too recognizable and common, then the educational value of Cells at Work! would be greatly diminished; it would be considered already ‘known’ and obvious. Instead, establishing the body as a foreign environment5 allows for it to be considered fresh and anew. Audiences from democractic societies are challenged by a socialist setting and autocratic tone, thereby making them feel like outsiders to this inner world. The body becomes knowable by holding it apart – not abject but not intimate – and a collectivist polity educates the individual reader by subjugating any individual character.
 This article is limiting its commentary to the collected Cells at Work! manga volumes and not its serial magazine publication, its anime series, nor its spin-off titles (e.g. Cells at Work! Code Black, Cells NOT at Work!, etc.).
 Strictly speaking, the cells have no sex nor gender. However, in being anthropomorphized, RBC-3803 is depicted with feminine attributes and WBC-3803 with masculine. These pronouns are used gingerly for this article, to aid in clarity but without the suggestion of uniform or necessary gendering.
 Moreover, one fiction Cells at Work! employs is the relative lifetime of each cell, allowing WBC 1146 and RBC 3803 many encounters and stories rather than a real-world lifespan of 6-to-120 days, respectively.
 Notably, outside materials that work to aid the body, such as intravenous rehydration, iPS cells for the eye, or blood transfusions, are not considered foreign in this way. “This place is different from our old body,” comments a transfused red blood cell, “but I’m glad to be workin’ in one again” (vol. 4, p. 131).
 Though areas like the stomach or heart are also made up of cells, they are not personified nor anthropomorphized. Instead, they could be considered “communomorphized” as large industrial buildings, heavy piping, and sometimes markets or even bars.
Krueger, P. M., Dovel, K., & Denney, J. T. (2015). Democracy and self-rated health across 67 countries: A multilevel analysis. Social Science & Medicine (1982), 143, 137–144. https://doi-org.ezproxymcp.flo.org/10.1016/j.socscimed.2015.08.047
Safaei, J. (2006). Is democracy good for health? International Journal of Health Services, 36(4), 767–786. https://doi.org/10.2190/6V5W-0N36-AQNF-GPD1
Shimizu, A. (2015). Cells at Work!, Volume 1. New York: Kodansha.
Shimizu, A. (2016). Cells at Work!, Volume 2. New York: Kodansha.
Shimizu, A. (2017). Cells at Work!, Volume 4. New York: Kodansha.
Templin, T., Dieleman, J. L., Wigley, S., Mumford, J. E., Miller-Petrie, M., Kiernan, S., & Bollyky, T. J. (2021). Democracies linked to greater universal health coverage compared with autocracies, even in an economic recession. Health affairs (Project Hope), 40(8), 1234–1242. https://doi-org.ezproxymcp.flo.org/10.1377/hlthaff.2021.00229
A. David Lewis is an Assistant Professor of English and Health Humanities at the MCPHS University School of Arts & Sciences. He specializes in graphic medicine and depictions of cancer in comic books and graphic novels.