The invisible gears: pain that isn't believed

In 2016, a University of Virginia team published a troubling study in the Proceedings of the National Academy of Sciences. It asked 222 white medical students and residents about false beliefs: that Black people's skin is thicker, that their nerve endings are less sensitive, that their blood clots faster. Half endorsed at least one of these ideas.

These beliefs do not stay abstract. Faced with mock cases, those who endorsed them rated a Black patient's pain as less intense than a white patient's, and their treatment recommendations were less accurate. Those who rejected them showed no such bias.

These ideas have a long history: medicine has often treated "race" as a biological fact, right down to its formulas. In 2023, the American Thoracic Society recommended abandoning race-adjusted spirometry equations. For a breathing test to be judged abnormal, they required a Black patient's results to be lower, sometimes by 15%, than those of a white patient of the same sex, height and age, at the risk of delaying diagnoses.

What has been learned can be unlearned. The 2016 study suggests as much: it is on these specific beliefs that we can act. Ubuntu reminds the caregiver that another person's pain concerns them. Believing it is already the beginning of care.