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Abstract
Decolonising the curriculum is a complex endeavour, with the potential to cause harm as well as benefit. People doing the work might find themselves questioning their personal and political identities and motives, it is common for people to get disillusioned. While surveys and toolkits are important to help us start the work, we are interested in finding out how decolonising practices can be sustained. We believe to practise meaningfully in this area we need to understand ourselves as practitioners, make sense of the work and have deep connections with colleagues and possibly our institutions.
This research uses collaborative autoethnography; our personal experiences, reflected through the lenses of each other’s point of view; to help us know ourselves and make sense of our practice. We also show how art, in the form of comics, poems and a song, can be used to deepen our research by adding meaning, connection and joy. We present this research as a patchwork text of writing, art and conversations. Our work is underpinned by theory, particularly drawing on Sara Ahmed and bell hooks. It is produced by the three of us to illuminate the process of decolonising a curriculum. We see this paper as part of our collective resistance: resistance to colonialism, to scientism and to inhumanity. We hope you will find resonances with your practice, and perhaps discover new ways to find meaning and connections.
- art and medicine
- medical education
- Graphic Medicine
- poetry
- Qualitative Research
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
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Introduction
Despite calls for anti-racist action (Cerdeña, Plaisime, and Tsai 2020; Iacobucci 2020; Powell et al. 2022; Wise 2022b) and work beginning to decolonise medical schools and medicine itself (Lokugamage, Ahillan, and Pathberiya 2020; Khan et al. 2021; Nazar et al. 2015; Wong, Gishen, and Lokugamage 2021), we have yet to see an in-depth exploration of the experience of decolonising within a medical school. Decolonising the curriculum (The Guardian 2019) starts with an acknowledgement that our current curriculum carries historical structural baggage. It combines work on equality, diversity and inclusion, with a sense that social justice is important, and especially so in healthcare.
Curriculum is more than the delivery of content. bell hooks (hooks 1994) tells us that engaged pedagogy in the classroom is how the most radical change can happen. Decolonising the curriculum relies on the people involved in education challenging the colonial norms embedded within the university, medicine more broadly and society at large. But how does this translate into practice in medical education? How might we investigate this practice in a meaningful way?
Methods such as surveys and quantitative reports on racism in medicine (Adebowale and Rao 2020; Banerjee et al. 2021; Bhopal 2001; Kalra, Abel, and Esmail 2009; Khan et al. 2015; Laird et al. 2007; McKenzie 2003; Wise 2022a) only present part of the picture. The messy, intangible nature of decolonising practice, based on human qualities such as identity and emotion, can only be understood fully through narrative and art. We are grateful to those providing toolkits and practical actions that medical educators can use to decolonise (Dasgupta 2020; Koum Besson et al. 2022; Pories et al. 2012; Turney, Law, and Phillips 2002). However, we believe surveys and toolkits cannot capture the experience of decolonising, it feels reductive to translate the emotional labour of practice into a 10-point plan. We lose some of the meaning, depth and complexity of the work when we attempt to pin down the process with scientific language.
What we offer here is a more reflective, creative piece, echoing Lorde’s maxim “Poetry is not a luxury. It is a vital necessity of our existence. It forms the quality of the light within which we predicate our hopes and dreams toward survival and change, first made into language, then into idea, then into more tangible action” (Lorde 1985).
Lorde is telling us that art is necessary for change. Art comes before the pinning down of ideas, before an action plan. Art gives us a different way of expressing ourselves which illuminates our practice anew. If we believe action plans work, then art will enrich the action plan.
Art for understanding
We are three doctors and faculty members at a UK medical school. We teach undergraduate and postgraduate students. We are involved in curriculum development and in decolonising the curriculum. This paper is a collaborative autoethnography, in which we use our art to reflect on our practice. Art-based research is gaining credibility in healthcare as a way to explore our practice and gain a deeper understanding of ourselves as practitioners (Lapum 2018). Art-based methods are used to enhance reflexivity and expose our positions as researchers (Lapum 2018). This extreme reflexivity can also be the goal of autoethnography, and as Koopman, Watling, and LaDonna (2020) tell us, this enhances rigour in qualitative research.
Autoethnography aims to make the tacit explicit and make inner worlds comprehensible to outsiders (Adams and Herrmann 2020), these are the aims of presenting our art alongside our reflective conversations.
We offer this patchwork of artworks and conversations as an expression of our joy, a collaborative autoethnography of our practice.
With this background in mind, our research questions are as follows:
How does collaborative autoethnography help us know ourselves as practitioners?
How does collaborative autoethnography help us make sense of the practice of decolonising the curriculum?
How does art deepen connections within our collaborative autoethnography?
Methods
Our method is rooted in collaborative autoethnography (Chang, Ngunjiri, and Hernandez 2016). We position the researchers as the researched and endeavour to find meaning within our own experience. Autoethnography is increasingly used in higher education research, particularly when negotiating the borders between the personal and political (Blalock and Akehi 2018; Chang 2013; Chang, Longman, and Franco 2014; Godber and Atkins 2021; Longman, Chang, and Loyd-Paige 2015; Ngunjiri and Hernandez 2017). Lahiri-Roy, Belford, and Sum (2023) used this method to explore their identities as teachers in an Australian University. They use personal narratives to illuminate the ideas of discomfort and rupture within teaching practices, as well as coming to a consciousness of their position, including their own race and racism. We hope to harness the strengths of this powerful method to explore our work in decolonising the curriculum.
We practise different art forms. Muna makes comics as part of her research process (Al-Jawad 2015), Neil is a singer-songwriter and Gaurish expresses himself through writing, particularly prose poems. There is an established literature on the use of creative methods, especially in research work which is about resistance or rebellion (Johnson 2021). For 1 year, we all kept our own reflective journal of our experiences decolonising the curriculum. We met once a month for a reflective conversation, which we recorded in our journals. We used the art we made to enhance and deepen our reflective conversations.
The songs, poems and comics, as well as our reflective journals and conversations, are considered our data (or our patches within the patchwork quilt). We show our art as a patchwork of comics, poems and a song, as well as accounts of reflective conversations. Metaphorical patchwork quilts can be seen a feminist methodology (Koelsch 2012). They allow multiple makers to show their work, they have distinct patches which combine to make a whole (Saukko 2000). They have been used to describe and reflect on various aspects of practice (Meakin 2021). As such, a patchwork is the perfect medium to allow us to remain ourselves, while being adjacent to each other and reflecting on each other’s work.
We co-produced our analysis using the lenses of each other’s experiences and reactions to the art. This was an iterative and collaborative process. We aimed to see our experiences through the lenses of art and each other’s experiences and reactions to our art. We present the data as the art itself, followed by a conversation between the three of us about the artwork. These conversations were not recorded verbatim, rather we have put together key statements and reflections recorded in our journals into a conversation format retrospectively. So they are not fully imaginary conversations as in some scholarly work (Hall and Back 2009; Lumsden 2022) but they are not fully real either (Eliastam et al. 2018). We hope an approximation of our exchanges will help the reader consider their reactions to our artworks and integrate the work into the more traditionally academic discussion which follows. This iterative process continued until we had enough analysis to create a coherent attempt to answer our research questions (or enough squares to make a metaphorical patchwork quilt).
We obtained ethics approval from the medical school. It is not possible to anonymise ourselves in this collaboration, our art is recognisable to those who know us, and we are proud to put our names on our artwork. Also, our stories are less meaningful if the reader does not know who is telling them, so we have purposefully avoided ‘author 1’ or using pseudonyms. We have found ways to not identify other people in our stories by using caricatures or adding fictional details (Ellis 2007; Lapadat 2017). There are no people in these narratives, just names ascribed to stereotypical representations.
While we believe the collaborative nature of our work adds some reliability, the nature of this methodology means that our research is not generalisable in the scientific sense (Gobo 2004). This is not our aim. We hope that our specific experiences resonate with scholars doing similar work. We hope that articulating our struggles inspires other medical humanities scholars to incorporate arts-based methods with their research or practice.
Results
In this section, we present our data. As described above, we have used a ‘patchwork approach’ (Meakin 2021). We have stitched together our art and writing in sections. The titles of the sections are verbs to emphasise the active process we are attempting to expound.
Section 1: Knowing ourselves. This introduces our backgrounds and perspectives, along with a piece of art reflecting our positions within the context of the decolonising project.
Section 2: Making sense. We use our art and reflections to help us understand how the practice of decolonising works.
Section 3: Deepening connections. We consider how collaborating through art helps our practice as curriculum developers and researchers.
Knowing ourselves
In this section we describe ourselves in the context of this project and present an artwork from each of us, followed by a reflective conversation about the artwork, illuminating the contribution of the artwork to our understanding of ourselves and our situation.
Muna’s perspective
Muna is a senior lecturer in medical education and a consultant geriatrician. She is a queer woman of mixed Arab/British heritage. She mostly passes as white, except for when people see her name. After the Black Lives Matter protests of 2021, Muna managed to secure funding from the university for students to be paid to help decolonise the undergraduate medical curriculum. Through partnership working, she has been the lead for this project over the past 3 years. The comic in figure 1 shows some of her reflections on this project. Note that Muna, Neil and Gaurish are represented as characters in the comics.
Decolonising the curriculum as more than labelling statues (Murris 2016).
Muna: I’m very excited that I managed to make a comic that includes Beyoncé and Fanon.
Gaurish: Yes, you seem to enjoy the juxtaposition of a pop star and a post-colonial theorist. Is that a subversion of academic norms for you I wonder?
Muna: Yes, in the same way as putting comics in an academic paper feels subversive.
Neil: Beyoncé is an icon not just a pop star. I guess Fanon is too for some of us.
Muna: I like the idea that even though she is a glamorous famous person and I am a middle-aged woman, we could both do some damage if we wanted to.
Gaurish: Maybe you do your damage through your art.
Neil: To be fair, it does have me talking about making space for creativity and community.
Muna (pondering): Yes… yes it does. I am naturally a positive person so I think the comics always have some kind of lightness or hope in them, to balance the despair.
Gaurish: Well yes, and humour of course. I mean you’ve got swearing and a poo joke to keep us smiling through the rage!
Muna: Smiling but also it helped me understand the rage I feel.
Neil’s perspective
Neil is a general practitioner and a senior teaching fellow in primary care. His heritage is South Asian, he grew up in the UK. Neil teaches and writes about racism and healthcare. Neil has been involved with decolonising the undergraduate curriculum with Muna and undergraduate students over the past 2 years. The song lyrics below are Neil’s initial reflections on the project and our work in this area. You can use the QR code in figure 2 to hear the song performed by Neil.
Rubber girl QR code.
Rubber girl
By Neil Singh
Most of the splash page is rendered in deep greens.
A pink church tower is seen poking through the trees,
A red-eyed bird lands on a crooked branch and screams.
A close-up of a cup, the cut bark, and the bleed.
Beads of sweat jump from the plantation owner’s scowl.
A full width panel of a girl who’s been kicked down
and left for dead. The mean man heads back to the house.
A drop of rubber falls into our hero’s mouth.
“Three years later…” the slanting caption reads
In black and white now, a fan spins in the heat.
Shadows slice a wide veranda into pleats.
On wicker chairs a man looks out at drying sheets.
The world is thirsty so the blood must always run.
Each tree is numbered and spaced out for the sun.
Our hero’s family do what they’ve always done. But where there were many, now there’s only one.
One night she bounces through the window and meets our villain by his bed.
And with a series of ALL CAPS sound effects the battle’s over, the monster dead.
No one thought they’d ever see the rubber girl again.
But the bad guy’s goons still keep her people locked in chains, draining all their goodness out, straight into their veins.
Up goes the signal, in the final frame.
I know she’s coming, soon…
Here comes the rubber girl!
Erasing evil from the world.
Holy smokes! Have you not heard?
Here comes the rubber girl!
Neil: My mother grew up in a Christian family in Kerala, in southern India. It is common for Malayali families to own a house with surrounding land, so that each household can grow some of their own vegetables, fruit, and spices. In addition to this, my maternal grandparents owned a modest rubber plantation. Rubber epitomises the ecological and economic impact of imperial ambitions in the tropics. As part of land reforms after Independence, my family acquired a stretch of land that was later used to grow rubber. So I wanted to write a song to tell the case study of rubber in Kerala, and to resonate with Muna’s work, create a comic in the listener’s head.
Muna: Yes I really like the jargon (like ‘splash page’) and visual tropes (like the fight scene described in sound effects) typical of comics.
Gaurish: I like how you have woven colonial history into your family’s story. The juxtaposition of the two really brings out the connection being the personal and the political.
Muna: I love the clichéd superhero origin story. Classically exposure to what should have been a lethal dose of radiation or poison instead gives the victim a super power.
Neil: Yes Rubber Girl is the superhero who emerges and puts right the damage colonial exploitation inflicted on the region. It needs to be a fantasy as the damage can’t ever really be undone.
Gaurish: So the art allows us to beat up the bad guys, without actually hurting anybody.
Muna: That’s one of the reasons I guess superhero movies are so popular.
Gaurish’s perspective
Gaurish is a senior lecturer in the department of medical education. He grew up and qualified as a doctor in India, moving to the UK. He has lived through and researched the now infamous ‘hostile environment’ policies of the UK Home Office (Chawla 2021; Equality and Human Rights Commission 2020; Goodfellow 2020). In the past 2 years, Gaurish has run a national conference on anti-racist practice in medical education and is actively involved in equality, diversity and staff development at the medical school. Online supplemental figure 1 is a prose poem he wrote as a reflection on the work of decolonising the curriculum as an immigrant. The poem is shown in Gaurish’s handwriting in online supplemental figure 1.
Supplemental material
Hostile environment
There will be shouting
there will be swearing
there will be anger
If you cut me do I not bleed?
When they shout go back
to where you came from
Do they not understand
the fractures are in
space-time continuum
What ignorance of their own- our
own, histories, present and futures
There will be fear turning to anger turning to fear turning to words
Words turning to rants- rants-
of course
Of course I rant. Rant is in my name
Immig-Rant
Muna: This resonates massively for me. I’m not an immigrant at the moment, but understand the idea of rage and ranting as an appropriate reaction to injustice and particularly when that affects us personally.
Neil: I think we are probably all thought of as ‘nice’ people by most of our colleagues and perhaps we don’t pay enough attention to the work involved with not raging and ranting at work.
Gaurish: It has always frustrated me how little of the policies and procedures around the Hostile Environment are in the public consciousness. Everyone knows a little bit and has an opinion on immigration but do people really know, for example, the cumulative impact of unrelenting checks that you have to satisfy on an almost daily basis for years.
Muna: I was quite shocked when you told me what you had been through personally, I naively thought that being middle-class and working for a University would somehow protect you.
Neil: When you read this poem out at a conference, you recorded it. You said it was for your daughter.
Gaurish: Yes, my family was once displaced at the time of partition and now as an indirect product of neo-colonial structures I find myself displaced again. I realise that these displacements mean that I have precious little in the way of heirlooms to pass on to my child but this recording is now a piece of family history.
Neil: Art is not just a way to express ourselves but also is a way to remember our histories.
Making sense
In this section, we consider our work as decolonisers, and use art to make sense of how that work affects us as people.
Figure 3 shows Muna’s experience of reactions to curriculum development work to decolonise the curriculum.
The worrying work of decolonising the curriculum (Albayrak-Aydemir 2018; Ross 2019; Said 2014).
Neil: These are all very real reactions we have had. I do try to respond with evidence and a helpful tone but people can be quite rude.
Muna: And it’s a shame that I now expect these comments from a few people when I send out emails like this. I think drawing it allowed me to empathise and so I see it as their defensiveness and distress at feeling accused of doing harm. This helps me respond with kindness.
Neil: When I write songs about specific characters, I sort of inhabit the character while I’m writing.
Muna: Yes that’s the same with drawing, you have to imagine the person, physically but also emotionally to get their expression right so you end up being ‘in’ them somehow.
Gaurish: So that helps with empathy, even for those we disagree with.
The poem below (and in online supplemental figure 2) shows Gaurish’s reflections on the institutional actions which perpetuate colonial structures and undermine work to decolonise.
Supplemental material
If
If your normal is
People dying of Hunger while food wastes away on shelves/homes lying empty when humanity freezes to Death
If your normal is
People dying to uphold artificial lines/people drowning in oceans/
Us burning away the surface of our planet
If your normal is this.
Give Me
Madness
Any Day instead
If you think about it, Normality is
Pretty Mad itself
Gaurish: So this attempts to address colonial writer Kipling, and his poem, ‘If’ which encourages us to be calm, be a leader and generally lots of things which Kipling considered virtues of a good man.
Muna: Not woman of course.
Gaurish: Well yes, he is misogynist as well as racist. By placing a value on calmness he pathologises people who act for change.
Neil: To me this is you pushing against the idea that we should just be quiet and be grateful for what we are allowed to have by institutions and society.
Muna: It is a privileged position to be comfortable in what we call ‘normal’ and that can disconnect us from empathy towards other humans.
Section 3: deepening connections
In the next section, we use our art and conversations to consider collective resistance, positive actions we can take and how we connect with each other. We wonder if these actions and connections can protect us from the worry, frustration and exhaustion we have expressed.
Muna’s comic in figure 4 considers how medical education reinforces colonial structures and uses bell hooks’ work (hooks 1994) to illuminate how we might resist this.
Tabula Rasa: Notes on blank slates (hooks 1994; Duschinsky 2012; Tufayl 2015).
Muna: This shows my realisation that diversifying the content (such as images or text) is the easier part of the curriculum work. It’s still work but it doesn’t seem to annoy most people.
Gaurish: Yes what is much harder and perhaps, more important to students, is to teach and encourage learning in a decolonised way. Just changing the skin colour on your slides isn’t enough.
Muna: I think I came to understand that one of the key aims of our work was to challenge the structure, pull at the threads which hold the whole colonial system together, like capitalism, like the idea of neutrality.
Neil: That is definitely where we have got the most heat, is when people feel we are suggesting they are biased in some way. Really all we are saying is the whole system is biased and it’s up to you to notice that and try and change your bit of it.
Muna: I really only got to this position through discussions with you two and working with the students on decolonising. The comic helped crystallise our position.
Neil: You translate the words of Goddess-like bell hooks into things we can actually do to help.
Gaurish highlights what it means to be different in his poem (online supplementary figure 3) about being seen as ‘International’.
Supplemental material
‘International’ student
So, today in Co-op, while buying
Coffee; it struck me how there is an
international isle. I paid attention
to what was on it. But then, I
looked around—the fruit, the veg,
the beverages, the snacks—everything
is ‘international’. A lot Completely,
almost everything at least partially.
‘International’ was the food ‘for
foreign people.
I am an international student.
I am in this international aisle on this
isle as an international. In. But under
SCRUTINY
I’M NOT CURRY—YET.
Muna: I had never thought about this before, that the whole supermarket effectively counts as ‘British food’ and I hadn’t thought about why we label a few things as ‘International’. Why do those items count as weird?
Gaurish: Yes, it struck me that the label ‘international’ does not refer to where the ingredients are sourced from or else most tea, all coffee, chocolate and most fruit would be in that aisle. It also doesn’t strictly refer to the cuisine or else curries and pasta would be there too. It is used to label stuff that the supermarket thinks only outsiders will want.
Neil: I guess we came together as outsiders a bit, that was our starting connection, none of us quite fit in the white neoliberal medical school.
Muna: When we come together we can use our collective privilege to make our arguments legitimate. My comics would be less powerful without your poems and songs next to them.
Our ongoing attempts to really listen to each other led to one of our research conversations happening as part of a walk (Bridger 2010; Reading and Moriarty 2022). This was probably the most fruitful of our creative exercises. What happened is set out in Muna’s comic (Figure 5).
You cannot decolonise alone: walk to the Chattri.1
Muna: This is my favourite comic that I did for this research. I had the idea to include that selfie of us, to make us real and especially as it shows us together.
Neil: It’s quite emotional to read it.
Muna: Yes I cried as I drew it.
Gaurish: I think decolonising work is emotional and it is about connecting with other human beings in an emotional way. If we are resisting the pretence of scientific lack-of-bias and lack-of-feeling, what better way to do it than with feelings?
Muna: I think it situates our work in a place as well. Geography was so important to the colonising project and that memorial is very significant in remembering that Indian people also died to help people in a land far from theirs.
Neil: The land we live on is important for decolonising as it is often about reclaiming our places and our histories. Remembering the oppression, recognising its ripples are still being felt and continuing to resist, to push against it. One way of doing that is standing together as people who are bound by a shared space.
Gaurish: It also connects with our earlier conversation about histories routed in places. I love the Chattri because it reminds me that our histories are connected.
Muna: I guess good institutions are trying to be those spaces where people can connect with each other through their work, but it seems hard to achieve that some of the time.
Gaurish: Well for all our criticism, we managed to do this work as academics in our institution, and it is being published in a mainstream journal.
Muna: I’m still worried that we have been neutralised somehow by complying with the rules of their game.
Neil: Oh, come on, take a small victory where you find one.
Discussion
As artists we hoped our art would speak for itself, we would not need to explain. However, as researchers we know that explanation forces us to look at our work critically and to consider how it fits into our field and the wider context of medical humanities research. Our discussion is split into three sections. These attempt to answer our research questions, linking our data to existing theory on collaborative autoethnography and arts-based research.
Collaborative autoethnography to know ourselves.
Collaborative autoethnography to make sense of practice.
Art to add connection, meaning and joy.
Collaborative autoethnography to know ourselves
As minoritised people involved in decolonising the medical curriculum, we are inevitably forced to confront questions of identity. Our identities—especially in this case our perceived race and ethnicities—are partly what qualify us to do this work, given some (at least perceived) shared commonality in our lived experiences as darker bodies. In short, we are all read as racialised people, or othered, in most interactions in our institution, and tussle with if and when to emphasise or downplay our difference. We worry whether we are accurately depicting ourselves, or overplaying our hardships, given our relative privilege along other axes of oppression. As a result, we may feel simultaneously authentic while also feeling in some sense phoney.
The extreme reflexivity required in collaborative autoethnography has given a way to examine our identities in relation to each other and our institution. We reject the narrow self-centred style of reflexivity, encouraged by the capitalist-driven individualistic self-help movement, ignoring the structures that cause of actions (Bauman 2013) in favour of a more relational form of reflexivity, rooted in intersectional feminist self-care as espoused by Barker (2017). We know ourselves better, both internally and in terms of how we are perceived by others. We are angry but also joyful. We are different shades of brown, but all love drinking tea, going to gigs and quietly smashing the system. We are more comfortable with the degree to which we assimilate, and the degree to which we resist the modern hegemonic culture we live within. We realised that this standpoint could make us ‘Feminist Killjoys’. Sara Ahmed fully explains this term in her book ‘The Feminist Killjoy Handbook’ (Ahmed 2023). She stands at the intersection of feminist, queer and race studies as she explains how our everyday experiences can reveal uncomfortable truths about our society. She calls on us to notice these and complain about them when we can. For us, this means we foreground autobiography as a way to understand and illuminate the political and theoretical. We use our art and our research as part of activism to engender positive change. We make art to make sense of our world, to connect with each other and to show others our work. Ahmed discusses her poetry thus:
“Sometimes we only hear something about ourselves when we share our work with someone else. And so, I also learn, killjoy poetry might be how we get in touch, and stay in touch, with the most difficult parts of ourselves and of our histories” (Ahmed 2023). Although the work can be hard, Ahmed also entreats us to find our killjoy joy, revelling in solidarity and connection with others.
An advantage of collaborating around these issues is that it has encouraged us to resist the binaries of white/black, oppressor/oppressed, coloniser/decoloniser and admit that we are all hybrids (Bhabha 2004). Looking outside our small group of authors, we acknowledge hybridity everywhere. In terms of decolonising, hybridity allows us to exist within colonial structures (ie, the university) while at the same time resisting them through our work (Said 2014). Perhaps institutions could help with feelings of ‘us’ and ‘them’ by giving opportunities for people to know themselves in a work context, and be known by others. We should find places for the others to be, and be comfortable outside the mainstream. Maybe the mainstream is not for everyone and maybe belonging to an institution is the wrong goal to encourage. Collaborative autoethnography enables us to develop a collective sense of belonging to each other, which may be as important as belonging to the institution.
Collaborative autoethnography to make sense of practice
Ellis (Ellis 1999, 2004, 2009; Ellis, Adams, and Bochner 2010), in her extensive work on autoethnography, describes eloquently the criticism faced by this way of working. In trying to find a way between what we commonly understand as two distinct categories of art and research, it is open to criticism from both sides. For artists, it is not artistic enough; for scientists, it is not scientific enough (Ellis 2011). Our counter-argument is that this critique fails to transcend the epistemological border that is our way of seeing (Berger 2008). ‘What’s the temperature of this room?’, and ‘How warm or cold do you feel?’ are two questions aimed roughly at the same situation, but while the former is a scientific one, the latter is an interpretive one. The answers to these are not interchangeable, nor is one more clearly important than the other.
Scientism (Sorell 2013) is the term sometimes used to indicate a way of seeing in which scientific (and sometimes pseudo-scientific) epistemologies are privileged over and above non-scientific ones. A counterpoint to Scientism can therefore be provided by an alternative epistemology such as that which underpins autoethnography.
By making the object of study ourselves, autoethnography counters the way traditional research processes can exploit participants. Research is the creation of knowledge and in an institution with decolonising aspirations, decolonising methodologies need to exist. This is not only a political position, it is a position generated by the need of the research question: if the question is interpretive, perhaps we cannot survey our way out of it. We may get a quick answer that looks slick on a PowerPoint slide, but we have to ask whether that compounds the problem rather than resolving it. Without understanding of the underpinning histories and the currents of power, we may think we are doing the right thing but we may inadvertently do more harm.
Our collaborative authoethnography is a way for us to make sense of it all, navigating spaces where sometimes the narrative becomes us biting the hand that feeds us. It is not science, but it is not meant to be, and that is okay. If our just right is too warm for you, you are welcome to open the window.
Doing this work in collaboration has allowed us to share, converse and reflect deeply on our practice. We believe this makes us better practitioners and makes the research more rigorous. This may not make sense when we are asked for numbers to back up our assertions, but numbers do not make sense when we examine human experience. We cannot measure anger or joy.
Art to add connection, meaning and joy
We have highlighted the need to exist as hybrids, to break down the binaries imposed by society. Art takes us further in this resistance, not only can we use a grey, rather than black and white, we can also imagine a full palette of colours. Lynda Barry, the comics artist and teacher, introduced us to ‘autobiofictionalography’ in her work One! Hundred! Demons! (Barry 2021). In this she asks, “Is it autobiography if parts of it are not true? Is it fiction if parts of it are?” (Barry 2021, 7)
Our work, in the form of comics, songs and poems, is part autobiographical honesty and part made-up fantasy. This resistance to the idea of true versus not true is what enriches the research. We have space to respond to our practice in a much freer way. We can express emotion. We can make jokes. This can feel dangerous (should we be questioning reality?) but we believe representing the unmeasurable parts of human experience deepens understanding and allows meaningful connection. Kae Tempest writes about this eloquently, they describe how “In a disconnected state, self-awareness is one of the first frequencies to be scooped out and muted. When this happens, I need creativity to reconnect me” (Tempest 2022).
Figure 1 shows the tension between wanting a violent revolution, while also wanting creativity, discussion and humour. Decolonising work has been a site for some of those tensions. There has been no physical violence, but we have had some difficult emails, as shown in Figure 3. These are upsetting because we truly want to be part of our community. Sara Ahmed, in her book ‘Complaint!’ (Ahmed 2021), notes the problems that arise when we, in minoritised groups, complain. The biggest disappointment being that we are often then framed as troublemakers or the source of the problem. Ahmed urges we resist this by not complaining in isolation, but as part of a network. We need our network of decolonisers, complainers, anti-racists and feminist killjoys (Ahmed 2010) to keep us going. When one of us is exhausted, the others take some of the burden. When the burden overwhelms us, we forgive each other for missed deadlines, we allow a break, we regroup. Sometimes expressing ourselves through art allows our message to be more palatable and gives us a way to connect to those we might see as our oppressors. We hope we have shown this through our data, we invited you in, and perhaps made you a bit uncomfortable but you still kept looking and listening.
Art can be a way to connect with our students and so it fits with a pedagogy of belonging within a medical school. We want to treat relationships with students as more important than the learning objectives, and creating art together, with an emancipatory agenda (Freire 1996) can be a way to connect and learn together. We hope our methods apply to areas beyond decolonising, anywhere with contested ideas or a hidden curriculum is enriched by using art as a mode of study.
Some might say that art is not real but the photograph at the end of figure 5 symbolises the need to show our readers and ourselves that we are real, this work is real. Our art connects you to our reality.
Lorde tells us that ‘the master’s tools will never dismantle the master’s house’ (Lorde 2018) and we take this to mean that science and colonial institutions will not be the way to decolonise the curriculum. Art offers an alternative tool, owned by us, the others. Bhambra (2014) suggests that decolonising knowledge means that it should be conceptualised in the communities, developing away from dominant structures of knowledge production. Art allows us to express ourselves and explore our practice within our communities and alongside more traditionally academic work. Art offers us a distinct way of thinking, aligned to the generative analytic approaches encouraged by Go (2023). Go (2023) suggests that anti-colonial thought, which foregrounds relationships, solidarity and intersocietal dependence should be a way to proliferate standpoints and gain greater understanding of our social world. We believe that our art, and our analysis of it, adds to anti-colonial thinking in the area of medical education. You may think us hypocritical, writing for a mainstream journal, maybe we should just go and make art, outside the confines of word counts and academic language. However, we also know that the master’s key will unlock the master’s house (Boulé and Abbey 2019). Perhaps we do not need to dismantle the house (or smash the statue as in Muna’s comic), perhaps taking ownership and opening the door to everyone is enough (making a space for creativity and discussion).
Conclusion
We realise, through writing this paper, that we have been doing the work of decolonising for a long time. The harms of racism and colonialism are well established (McKenzie 2003); people have been resisting these harms for many decades. We hope that this research provides a new illumination of old ideas. We come back to the wisdom of Lorde:
“For there are no new ideas. There are only new ways of making them felt, of examining what our ideas really mean (feel like) on Sunday morning at 7 AM, after brunch, during wild love, making war, giving birth; while we suffer the old longings, battle the old warnings and fears of being silent and impotent and alone, while tasting our new possibilities and strengths” (Lorde 1985).
We position this collaborative autoethnography as new way of making ourselves and our experiences known. Through art, discussion and connection we present our collective resistance. Resistance to colonialism, to scientism and to inhumanity. We hope readers will feel resonances with their practice, and perhaps be inspired to speak up, connect or make art in solidarity.
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
Ethics statements
Patient consent for publication
Ethics approval
This study involves human participants and was approved by BSMS Research Governance Ethics Committee on 11/8/21, ref: ER/BSMS9DER/1. Participants gave informed consent to participate in the study before taking part.
Acknowledgments
We thank Elaney Youssef, Francesca Hall and John Anderson for their comments on earlier iterations of this manuscript. We are also grateful for the help and support of Brandy Schillace and the editorial team at BMJ Medical Humanities.
Notes
1. “The Chattri is a memorial built to honour the Indian dead of the First World War. It stands on the Downs near Patcham at the place where Hindu and Sikh soldiers who died in Brighton war hospitals during 1914–1915 were cremated.”((Chattri Memorial Group n.d)‘Chattri Memorial Group’ n.d.) Author’s note: another such memorial is ‘The Peace Garden at The Muslim Burial Ground’ in Woking, UK.
Bibliography
Supplementary materials
Supplementary Data
This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.
Footnotes
Twitter @opwhisperer
Contributors MA-J conceived and designed the research. MA-J and GC refined the methodology. MA-J and GC obtained ethics approval. All authors produced and analysed data. All authors contributed to writing up and revising the manuscript for publication. Art, poems and songs were made by the authors as indicated in the paper. MA-J acts as guarantor for the work.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.