“Variation exists everywhere, and that’s an exciting prospect. There are so many different ways to be a human.” – Hilary Wilson, The Picture as Portal Blog
On December 2, an illustration by medical student and illustrator Chidiebere Ibe began trending on Twitter. The image was of a near fully-grown fetus inside a womb. While it may seem unremarkable, the fetus – and the person who carried it – were both illustrated to have dark skin*. Users began sharing it on the platform because it was the first medical illustration of a darker-skinned body they’d seen.
Historically, Western medical texts overwhelmingly use white bodies in their illustrations, failing to capture the beautiful diversity of the nation. What’s worse these, bodies are almost always male, able-bodied, young, thin, and cisgender. According to a 2019 VICE article, a study by Rhiannon Parker, a researcher at the University of Wollongong in Australia, found that “only 36 percent of the anatomical images with identifiable sex were female. Only 2.7 percent of the images the team analyzed depicted visibly disabled bodies. And only 2.2 percent of the textbook images depicted elderly patients” (VICE).
• Follow #AMIdiversity on Twitter to find more diverse medical illustrations and illustrators.
• Search “anatomy” in Google and scroll through the image search results. What sizes and shapes of bodies do you see? What color skin, if depicted, do they have? How long does it take for you to find an image that reflects how you view yourself?
Naturally, this narrow view of what a body “should” look like excludes the vast majority of the population. And it can lead to how we’re treated when entering a doctor’s office. These issues are sometimes, quite literally, skin-deep. Because lighter skin is the norm in dermatological education and clinical trials, doctors often misdiagnose or fail to diagnose medical issues for darker-skinned people (Stat News). It can also lead to false notions, like, Black people have thicker skin than white people and higher pain tolerance (AAMC).
Lack of representation also affects how people take care of themselves. Take skin cancer, for instance. Since people of color are often left out of clinical trials for suncare products and ignored in sunscreen marketing, the misconception is that darker-skinned people don’t need to worry about it. However, skin cancer can develop regardless of the skin’s protection from the sun. And darker-skinned people are most likely to experience the deadliest stages of skin cancer because it’s likely to go undiagnosed (NYTimes).
With more nuanced illustrations, we have a greater opportunity to educate the medical field about issues affecting marginalized communities. Medical illustrator Hilary Wilson has created a series of illustrations depicting conditions common to the Black community, like traction alopecia and razor bumps and keloids. Katja Tetzlaff created a skin surface assessment tool with a larger body that reflects the standard body size in the U.S. Not only may it help to reduce stigma and shame, but it also allows for more accuracy in assessment (Katja Tetzlaff website).
Medical illustration is more than just visualizing bones, muscles, and tissue. It’s an art of communication, an educational vehicle, and a message of care. At one time, it was used to perpetuate phrenology, a false science that justified labeling women and people of color as inferior (Aeon). Moving forward, it should be leveraged as best it can to accurately reflect the attention and respect we all deserve.
*Note: We’re aware that because most melanin production for a newborn baby doesn’t happen until after they’ve exited the womb, it might be unlikely for a fetus to be this dark-skinned. However, that doesn’t negate the illustration’s value nor the skin color of the person carrying the illustrated fetus.