Decolonization: CPSBC retires the crowned lion

Her Majesty Queen Elizabeth II died on 8 September 2022, the same day the College of Physicians and Surgeons of BC (CPSBC) surveyed the province’s doctors on a proposed new logo. The decision to retire the colonial crest coincides with the closing of the Second Elizabethan Age. In 2021, the registrar explained: “Since its adoption in 1886, the College crest has been the official stamp used on all our communication and documentation. The College crest is a distinctively colonial symbol with a lion wearing a crown on its head while sitting on top of another crown, reflecting the royal coat of arms of the British monarchy and all of its rights. This year we will be undertaking a significant rebranding process, which includes replacing the crest with a new identifier that reflects our current-day values of inclusivity and accessibility to all British Columbians.”

The coincidence of these two events marks an opportunity to examine medicine’s colonial roots in BC. In March 1778, Royal Navy captain James Cook was greeted by the Nuu-chah-nulth people in the place currently known as Nootka Sound, setting the stage for British colonization of present-day BC. In little under a century, the enormous land mass now known as BC was claimed for the Crown, with small reserve tracts set aside for the Indigenous population, whose numbers declined rapidly in the face of colonization.

In recent years, the CPSBC has recognized the need to improve its relationship with the Indigenous population and the care provided by the province’s doctors, retaining Stormy Lake Consulting to assist in the rebranding process. Stormy Lake distributed a questionnaire to physicians requesting feedback on the proposed new CPSBC logo. As its website states: “We live in a world of eroding trust. Brands are letting us down, facts are not constant, and social justice is having a moment. . . . As a result, trust has become the new currency. Marketing needs to work through the channels of trust: experiences, community, individual advocates, and reliable products.”

Can the CPSBC adopt new values, ensuring that physicians practise in a manner that is accessible, inclusive, and trust enhancing for Indigenous patients? Is substantive change possible in a body with a statutorily defined mandate to regulate a conservative profession firmly anchored in Western tradition?

The CPSBC is a direct descendant of the Royal College of Physicians of London, established by King Henry VIII in 1514. Medicine as practised by BC’s physicians today conforms to the Western medical model; academic physicians constantly refine the classification and treatment of illness based on data obtained via scientific study. Disease-focused Western medicine could hardly be more disparate, in both philosophy and practice, from the traditional techniques employed by Indigenous healers prior to colonization. And perhaps not surprisingly, it has been unable to ensure that the health of the Indigenous population rises to that of other groups.

What of the proposed new logo? The CPSBC survey questions whether it may be problematic or offensive. Could anyone genuinely take offense at such an innocent array of blue rectangles and half-circles? Perhaps they should have asked whether the logo truly signifies a break with colonial tradition. For while the regal lion and crowns are gone, the proposed logo consists of geometric figures not found in precolonial BC. They trace back to Euclidean geometry, a classical Greek discipline foundational to mathematics, relentless Western scientific progress, and ultimately colonization.

In fact, Western thinking is so ingrained that, in practice, it constitutes our only philosophical and political frame of reference for resolving issues of social justice. The notion that past harms against Indigenous people should be atoned for reflects an intrinsically Western, Judeo-Christian world view. Such harms are now being acknowledged and rectified through Western means: following years of litigation, the Supreme Court of Canada recognized Aboriginal land title in the landmark 1997 decision Delgamuukw v. British Columbia.

Change at the CPSBC is managed as it is in other Western institutions. Consensus has emerged that the medical profession and its regulator have failed Indigenous patients and that this wrong must be righted and the brand revised. With the problem identified, the issue has been outsourced to recognized experts in the field. In its own words, Stormy Lake Consulting is “a world-class strategy firm that uses research, facilitation, consultation, deep analysis, and insightful synthesis to bring sense-making strategic solutions to clients. In short, we turn ‘complex’ into ‘clear, compelling and useful.’”

The CPSBC will certainly rebrand, but can it truly “decolonize”—that is, discard the Western colonial mindset that governs its every action? Readers are invited to review a final quote form the Stormy Lake website to reach their own conclusion: “Strategy needs to identify . . . rational milestones and emotional states, matching the product to the moment, identifying the tools and information stakeholders use at each stage, and constantly updating itself as more information about the customer’s journey is learned.”
—David J. Esler, MD

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