The National Institutes of Health is directing people to an absolutely absurd paper published in the journal Advances in Health Sciences Education. I have no idea how prominent the journal is, but I have a decent idea of the prominence of the NIH. A government agency under the U.S. Department of Health and Human Services, they essentially determine medical education in this country. The NIH actually invited these authors to lay out their theories of medical education.

The paper is scary as hell. Not quite Canadian medical murder scary, but very very scary nonetheless.

Why so frightening? Well, our NIH is promoting the idea that it is time to dump our current medical education system based upon science-based Western medicine in order to replace it with a more diverse and inclusive one. Our current system is racist, sexist, homophobic, and every other super-bad thing that the woke are desperate to destroy.

Health professions education (HPE) is built on a structural foundation of modernity based on Eurocentric epistemologies. This foundation privileges certain forms of evidence and ways of knowing and is implicated in how dominant models of HPE curricula and healthcare practice position concepts of knowledge, equity, and social justice. This invited perspectives paper frames this contemporary HPE as the “Master’s House”, utilizing a term referenced from the writings of Audre Lorde. It examines the theoretical underpinnings of the “Master’s House” through the frame of Quijano’s concept of the Colonial Matrix of Power (employing examples of coloniality, race, and sex/gender). It concludes by exploring possibilities for how these Eurocentric structures may be dismantled, with reflection and discussion on the implications and opportunities of this work in praxis.

Sidenote: run away from any article that uses the word “praxis.” It is Marxist. For some reason it is one of their favorite words.

You can see the thrust: current medicine is based upon an epistemology of slavery (“Master’s House”). The idea being that using science to investigate biology and apply lessons learned is a European concept that is designed to keep the melanin-enriched in their place.

Medicine is just one of many mechanisms intended to oppress people, as literally everything is in the eyes of the woke. By focusing on science over…I’m not sure what…The Master is keeping people down. Written during the George Floyd protests, this article is very much in the tradition of the public health establishment’s endorsement of the “George Floyd protest” exception to COVID rules. Rioting, for the right reasons, is a public health necessity.

These authors believe that medical reality is determined by what is in the mind, not based upon any physical reality. You would think that an event would be a “superspreader” or not based upon some scientific criteria, but in fact it is politically determined. That is not hyperbole, that is the essence of this paper.

At the time of writing, statues are falling. There are protests on the streets. Calls for defunding resound as TikTok videos, Twitter unrolls, and gatherings proliferate on Facebook. There are tents occupying lands outside government buildings. There are declarations of racism in parliament buildings. There are boil water advisories. There are COVID-19 outbreaks in the dense housing camps offered to migrant laborers. There are names of sports franchises being reconsidered. There are bodies being subjected to violence. There are wellness checks that end in death. There are confrontations in parking lots. There are heated discussions on social media. There are some people telling other people to “go back to where you came from”. There are the “you’re wrongs”, “you’ve gone too far” and “angry mobs”. There are people on their knees. There are body cameras. There are commitments and statements and promises being made. There are temporary profile pictures. There are resignations, partings of ways, and new starts. There are interviews and conversations. There are “I told you so’s” and “what took you so longs” and “we’ve been saying this for years”. There are questions being asked and ideas being challenged. There are people just trying to breathe.

A perspective on perspectives

In the dominant white North American (Eurocentric) society, these are examples of what is being seen in the media, what is being messaged about, and what is being debated over dinner tables. This is what dominant organizations, regulatory bodies, and publishing houses in Health Professions Education (HPE) are sharing on social media and why there have been so many calls for change. This white North American framing is one perspective from “the Master’s House” (Lorde 2007). For some outside this perspective, that of equity-deserving groups who have long been marginalized, this seemingly ‘woke’ perspective has been described as possibly self-serving, perfunctory, concerningly rhetorical, and hopelessly late (Gutierrez 2020; Spaulding 2020; Yancy 2020).

As you can see in this second paragraph, the authors’ perspective is that the public health establishment’s jump into political over scientific medicine is long overdue, not a deviation from best practices. And jumping into politics should not merely performative to support the current “thing,” but totally integrated into medicine.

Best practices are political practices, and correct political practice is advancing the Left agenda.

The problem with medicine and medical education is precisely that it has been driven by science, and by all means that should stop. It should, instead, be driven by Marxist ideology in the way that Lysenko did in the Soviet Union. For those unfamiliar, Lysenkoism was a biologicaal theory that was a favorite of Stalin’s, and because it rejected the well documented biological realities of genetics it was one among many factors in the development of famines in the Soviet Union.

It is widely spoken of today as exactly the wrong way to do science. But that is the point. Medical education should drop science in favor of liberation. Lysenkoism in style, not substance, is the new way to do medicine. Pick your politics, then do your medical education and medicine.

Grosfoguel argues that the structure of knowledge upon which the Western University (and, we would argue, by extension HPE) is built on a canon of thought “based on the knowledge produced by a few men from five countries in Western Europe (Italy, France, England, Germany and the USA)” (Grosfoguel 2013, p. 74) and on a structural foundation evolved from late 15th century conquests of territories and religious genocides (Grosfoguel 2013). Rather than a Christian God as the foundation of knowledge, Descartes’s philosophy of “I” (“I think, therefore I am”) and the Enlightenment thinkers that followed him moved Western philosophy away from having one fundamental category of things and towards the separation of the body and the mind. This dualism then raises questions about consciousness, intentionality, and the self (Robinson 2020). Constructing man as having control over the mind, beyond a Christian God, afforded the Western man who held power epistemic privilege: power over how knowledge is structured (Robinson 2020). This privilege has been used in conquests over religion and territories, and continues through colonialism. We would argue that medicine and medical education rely on this privilege.

The dominant discourses at work in most Western universities and medical education have positioned knowledge production as based on the perspective of a knowing subject or zero-point epistemology (Castro-Gómez 2001; de Sousa Santos 2008; Naidu 2020). The zero point is a reference to the avowedly objective stance of how white Western science produced knowledge: the ‘truth’ scientists seek is both nowhere and everywhere; we would claim it just ‘is’, as a zero point. It is an “imaginary position of those who claim neutral objectivity for themselves—an unseen position that presumes to see all” (Soldatenko 2015, p. 140). Within this frame, science is constructed as a search for a neutral objective truth where “it is possible to achieve objectively valid knowledge about the physical and social world by merely using the appropriate method” (Castro-Gómez 2001, p. 149). This construction is heavily rooted in the global material and social interests of (white) “men from five countries (France, England, Germany, Italy and the USA) who are the ones monopolizing the privilege and authority of canons of knowledge production in the Westernized university” (Grosfoguel 2013, p. 87; Cupples and Grosfoguel 2018).

Science is nothing but a tool to impose colonialism, and hence should be dropped. Science, in other words is French, English, German, Italian, and American. This, to me, seems to be an admission that science is a gift bestowed upon the world by Western countries. Literally billions of people are fed in the world due to the advances of Western science, and the conquest of many diseases through vaccination, public health strategies, and modern medical practice are similarly so.

This would in a rational world be celebrated as an achievement, and as proof that Western countries have not merely been perpetrators of oppression, but benefactors as well. One could even argue that it more than balances the scales morally speaking.

Instead it is used as proof that science and technology are oppressive, as everything that Western science produces is part of a power structure than keeps everybody else down.

From within HPE, the rules of the Master’s House authorize what knowledges can be circulated and spoken of as truths and in turn, what role a practicing health professional serves in the community. In these educational programs there are curricula, standards, learning objectives, expected outcomes, and standardized tests set on the dominant ways of knowing. Those who graduate from these schools, members of self-regulated health professions, are seen as guardians and reproducers of boundaries and status through codified systems of thought (Freidson 2001). However, the “politics of domination are often reproduced in the educational setting” (hooks 2014, p. 39). Physicians, for example, have been viewed as contributors to imperialist struggles (Aidoo 1987; Fanon 1994). This epistemic violence endures and concerns continue to be raised about colonization through medical education (Muzzin and Martimianakis 2016; Naidu and Kumagai 2016; Whitehead 2016) and medical practice (Sharma 2018). In the pursuit of knowledge production, the House of HPE continues to place value on the ideologies of the Enlightenment—on positivism, universalism, and rationalism—rather than other potential goals of education, such as liberation (Freire 2000). In so doing, we argue, HPE creates, authorizes, and reproduces domination, privilege, and status and education is seen as an individual achievement and not a means for improving circumstances within society. Based on these dominant epistemologies, we argue that many HPE educators focus attention in demonstrating an individual’s professional responsibility in practice, and focus less on the social responsibility of that practice.

The authors are, in a sense, correct. Doctors do focus on their professional responsibilities over their so-called “social responsibilities,” and that is a very good thing indeed. Health care is not, in the main, seen as in the service of cultural liberation. This is not entirely true, as health care professionals do their best to liberate patients from destructive situations such as abusive households, but in the main they have not been focused on political liberation.

That is a very good thing. Medical professionals should be focused on health care, not the overall structure of society. That is something which, in the main, they know nothing about. Their opinions are no better nor worse than anybody else’s, and that is the point of democratic or Republican governance. We decide as a community how to govern the collective, not some group of fake “experts” who are doing nothing but trying to seize power.

There is nothing especially troubling about such a paper being written, or even published. It is, unfortunately, well within the academic mainstream and any rational person should want to know the danger these people pose. Best to have it laid out in the public so we know that these people need to be rooted out of our educational system. Publish it in some journal of Marxist theory as yet another example of Leftist mental onanism.

What is troubling is that a medical education journal actually published it as something other than a cautionary tale, and that the National Institutes for Health solicited it for publication.

Those facts are revealing, and are a good lens through which to view the “follow the science” COVID interventions over the past several years. “Science,” in today’s academic and public health parlance, is simply a propaganda term. Many in the public health profession actually disdain what you and I think of as science. They are using the term as a code word for its opposite.

Like the word “woman,” it has been stripped of meaning. The word remains solely to create the impression that the Elite are in the same universe as the rest of us.

That is false, and an intentional deception.

The development of science is one of the great human achievements, and it is under attack from the highest levels of our Elites. It has been transformed into a tool of political control, because to them it has always been a tool for political control.

This ideological rot runs deep, and now controls much of our educational establishment, including medical education. If that doesn’t scare you, welcome to an early death in an increasingly totalitarian culture where a new Lysenkoism rules the day.