"Sometimes it is helpful to run into things in an imaginary world before you actually have to run into them in the real world," said the cartoonist, whose comic strip runs in more than 400 newspapers.
"Funky Winkerbean" was created in 1972 in a weekly Ohio newspaper. The early days have been described as "a gag-a-day strip set in a small-town high school."
But over the years Batiuk, like other popular comic strip authors, tackled a range of social and personal issues including teenage pregnancy, the war in the Middle East and substance abuse — topical issues that also generated feedback from his faithful readers. But nothing like this.
The cartoonist says most of the e-mail he has received via funkywinkerbean.com is positive and supportive of the way he handled Lisa's illness and death.
Though some of the criticism has been very sharp, dailycartoonist.com reports reaction in the blogosphere seems split 50-50.
The American Cancer Society, however, is thrilled with Lisa's story line, from beginning to end.
"Tom Batiuk and the 'Funky Winkerbean' strip are a classic example of a willingness to take a traditionally taboo issue and make it part of a very real, dynamic, ongoing conversation," said Greg Donaldson, national spokesman for the American Cancer Society.
"It has prompted vigorous discussion, which I would argue is empowering, raises awareness and ultimately will save lives," said Donaldson.
One of the issues angry readers have with the strip is the creator's decision to have Lisa end chemotherapy treatments, opting for a better quality of life before the terminal illness ended it. Some saw it as giving up, as the end of hope.
Doctors are trained to do everything they can to save a patient. For some, the brutal side effects of chemotherapy can bring a person to the brink of death in pursuit of extending life for as long as possible
Weighing the ravages of some kinds of treatment against the quality of life in the last stages of the disease are difficult choices for doctors, patients and their families.
But as breast cancer is predicted to claim more than 40,000 lives in the United States this year, many experts maintain quality-of-life questions are important issues for patients and their loved ones to address.
"I certainly support anyone who says 'enough is enough,'" said Dixie Mills, a surgeon and breast cancer researcher with the Susan Love, MD Research Foundation in California. (www.susanlovemd.com)
"People are sometimes unrealistic. They do chemo and the chemo kills them and they have not had time to say their goodbyes or do the things they'd always wanted to do and never had a chance to do," Mills told ABC News.
As for the strong reaction to the comic strip character's choice for "death with dignity"?
"Death is just one of those taboo subjects. It should be brought up and talked about so people are not left hanging in the last minute," said Mills.
In response to the attention that Lisa's story has gotten around the country, Lisa's Legacy Fund has been set up at the University Hospitals in Cleveland. Money raised and donated will go to support cancer research and education.
Batiuk has written a second book about Lisa, updating her life. It is called "Lisa's Story: The Other Shoe."
The author and King Features, which syndicates "Funky Winkerbean," will donate the royalties from sales of the book "so that her story can continue to help others."
And while the character of Lisa has died, there is still "closure" to be had, according to Batiuk.
Over the next two weeks, Lisa's ashes will be spread and the cartoonist will use artistic license to "flash forward" 10 years to see that her husband, Les, and daughter, Summer, survive and thrive after a period of mourning.
Batiuk wrote on his blog: "For those of you who want a miracle, here's the real miracle in this story. At its core, this is a love story. Grief is the price we pay for love, and this is a story about how you do that."