Mikhail Bulgakov spent his first couple of years (1916-1917) after graduating as a doctor in the depths of rural Russia. He wrote a number of semi-autobiographical short stories about the experience. In one of them, he is called out in the middle of the night to deal with a difficult and dangerous pregnancy, a transverse lie, in which the baby is lying horizontally with its shoulder nearest to the birth canal. His two experienced midwives looking on, Bulgakov tries to give an impression of competence, but while he aced his obstetrics paper, he knows the task of turning the baby – called a version – in the womb is hazardous, and all his book knowledge flies from him. On the pretext of getting his cigarettes while the midwives prep the mother, he rushes to his room and goes through his obstetrics textbook. Then as he scrubbed up for the procedure, his midwife “described to me how my predecessor, an experienced surgeon, had performed versions. I listened avidly to her, trying not to miss a single word. Those ten minutes told me more than everything I had read on obstetrics for my qualifying exams…”
After the procedure, which was successful, he returns to his room and starts flipping through his obstetrics manual again. “And an interesting thing happened: all the previously obscure passages became entirely comprehensible, as though they had been flooded with light; and there, at night, under the lamplight in the depth of the countryside I realised what real knowledge was.”
We sometimes think of explicit technical knowledge and tacit experiential knowledge as distinct things, because they come in different forms. In knowledge management we certainly manage them in different ways. But Bulgakov’s story reminds us of how intimately connected they are. The knowledge in the obstetrics manual is codified for reading no doubt. But it is itself a hardening and crystallisation of centuries of experiential knowledge. And getting the words into your head gets some knowledge into your head, for sure, but the experience of working with bodies is what brings that technical knowledge to fruition. What Bulgakov describes is a process of reciprocal enrichment and fusion between outer and inner knowledge, making the outer knowledge more accessible than before. So now I’m thinking, how do we manage for that kind of process?
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