The lack of critical thinking and cultural self-reflection in Western science knowledge about humankind is one of the most overlooked harms to patients. Skin cancer is a poignant example of how Eurocentric Western healthcare design feeds patient inequities through a deadly cocktail of ignorance, a phenomenon I dub Western science’s magical thinking. In this case, it blends three toxic ingredients and could be addressed with simple antidotes requiring what over-intellectualizing Western science misses the most: emotional intelligence.
1) Under- and miseducation and intellectual dishonesty (antidote = education and intellectual honesty)
Western medical science often works outside its culture because of the unacknowledged outstanding work of non-Western healthcare professionals who fill the gap between Western knowledge and humankind and inadvertently sustain the legend of Western superior knowledge.
Indeed, many Western experts are convinced of what I could only qualify as European ethnoscience’s perceived universality. Medical education predominantly focuses on diagnosing symptoms on the skin of European descendants, believing it would benefit humanity. This is the perceived objective and universal Western logic that replaced traditional indigenous science’s perceived magical thinking during the European colonization of humanity’s reality. This Western magical thinking is still shockingly the standard today, even in Africa, where Western institutions “assist” by establishing educational systems often infused with un-decolonized Western knowledge. As a regulatory scientist of African descent, I am curious and anxious to observe how the European Medicines Agency will support the newly established African Medicines Agency.
While Western uniform medical knowledge tries to improve its knowledge of humanity upon the pressure of scientists with diverse socio-cultural backgrounds, like me, it still has many myths to address. For example it still often neglects the impact of the medical folklore that African descendants with dark skin cannot have melanoma, a skin cancer whose risk increases with sun exposure. As myth-buster Black American medical student Joel Bervell explains in the embedded post below from May 2024, acral lentiginous melanoma, a skin cancer developing on hands and feet, is more prevalent in people of African and Asian descent.
2) Cultural incompetency and irresponsible science (antidote = cultural competency and responsible science)
Western science’s magical thinking of “what is good enough for European descendants is good enough for humanity” indecently perpetuates colonialism’s economic and social inequities in the 21st century.
To adhere to Eurocentric beauty standards favoring lighter skin, many individuals of African descent resort to using whitening skin creams containing hydroquinone, inadvertently heightening the risk of skin cancer. As an African descendant, my community has taught me to recognize signs of whitened skin, a skill overlooked in my medical and pharmaceutical education. Besides, studies showed that melanomas in individuals of African descent tend to be more aggressive and lethal. Delayed diagnosis, stemming from the myth that individuals of African descent are unlikely to have melanomas, coupled with undereducation, might contribute to this undesirable outcome.
For decades, public health policies directed citizens’ tax-collected resources to skin cancer prevention campaigns that privilege people of European descent with light skin. Healthcare professionals declared other citizens couldn’t have skin cancer and built a deadly myth. Then, in the last few years, upon evidence of the contrary, Eurocentric so-called inclusive prevention has newly assimilated people with dark skin along with decades-educated European descendants with light skin. It doesn’t actively demystify entrenched targeted misinformation that Western science and previous recent healthcare policies left. Likewise, it doesn’t educate African and Asian descendants about acral lentiginous melanoma and the danger of skin-lightening products.
Consequently, I am still aware of more individuals with so-called white skin being treated at a pre-cancerous stage compared to individuals with so-called black skin in Europe, where I live, including in my family. Due to the lack of dedicated studies and consecutive evidence-based facts in that region, I’m left with wonder. Meanwhile, racialized Western communities rely only on the benevolence of overworked healthcare professionals with dark skin to educate humanity and run targeted public health campaigns through oral tradition, as African American medical student Joel Bervell does on TikTok.
3) Underrepresentation of humanity and intellectual insincerity (antidote = representation and intellectual sincerity)
Perceived objective and universal Western science debunked the myth of race and white supremacy it co-created. However, in influential positions, diversity remains lacking in science, technology, engineering, and mathematics (STEM).
Diverse representation is imperative at all decision-making levels, spanning policies governing medical education, medical professions, healthcare and wellness products, and patient and customer organizations. It helps to fill the gap between Western science and humankind, as Malone Mukwende, an African British medical student at St. George’s, University of London, did when he teamed up with Margot Turner, a lecturer in diversity and medical education, and Peter Tamony, a clinical lecturer. After noticing the lack of diversity in his training material, Mukende co-created “Mind the Gap” in 2020. It’s a free online medical book that helps physicians diagnose skin diseases in skin tones other than those of European descent. The visibility of such lifesaving collaborative work in the medical community is critical for racialized patients’ effective treatment.
Despite marginalized communities’ unremunerated advocacy and other concerned citizens’ valuable efforts, we are still far from achieving an inclusive, equitable Western reality. As Joel Bervell notes, the American physician community is overwhelmingly White. Only 4% of professionals are from other cultures. In response, US Ethnic minorities formed dedicated patient organizations advocating for their overlooked and misunderstood reality since at least the nineties.
The situation appears even bleaker in Europe following the departure of the UK, from the European Union in 2020. It was the leader in a leader providing highly educated policymakers with diverse backgrounds. Even European institutions acknowledge their failure to represent all Europeans, especially post-Brexit. Still, their proposed solution is more talks at this stage. We still wait for palpable actions and witness intellectual sincerity. Meanwhile, uniform, overworked physician communities educate uniform, underfunded patient organizations with ingredients 1 and 2 if there is no active correction policy. No matter how much those people care about humanity, it’s a recipe for disaster. And no one who cares that much should be set up for failure.
I may be an ethnic minority in the Western healthcare system, but beyond its confides, I’m the majority. And when the majority of humanity encounters similar experiences with Western science, it’s time to abandon the claim of objectivity, universality, and critical thinking, for there’s a term that aptly describes this belief: magical thinking.
Happy May 1st to my fellow scientist; much work still lies ahead, and it will get emotional
Reappearance 