Recently I came across an excellent book “Breast Cancer – Answers at your fingertips”. Oh how I wish this sort of book had been available to me 22 years ago when I travelled my breast cancer journey alone. Sadly this book and all the other such books had yet to be written because cancer was not openly talked about that many years ago. Consequently I experienced my bumpy, sometimes frightening ride without a lot to read to prepare me for the unexpected hazards I encountered around every bend.
Harvesting Tacit Knowledge
It is generally agreed that we have neglected the knowledge derived from experience, focusing instead on the knowledge derived from the analysis of routinely collected data, stats or information, and knowledge derived from research, namely evidence.
This is a resource of vital importance and a resource that will grow. It is expected that each Public Health professional will submit a case report each year and this will be kept as a closed resource to encourage people to describe their failures as well as their successes. It is hoped that professionals will report on the projects that did not go so well as well as on those that were highly successful, for there is a proverb in management that we learn more from out mistakes than our successes. There is another proverb that says that although it is important not to re-invent the wheel, it is sometimes necessary, but what is really important is that we do not re-invent the flat tyre.
How To Talk About Books You Have Not Read is a wonderful book by Pierre Bayard. The book can be read at two different levels as many books can. On one level it is a humorous book, a little like the book by Stephen Potter called One-Up-Manship, which has advice on how to impress people with one’s literary credentials even though one has never read the classics. Pierre Bayard, however, makes a very serious point – that no one will ever read all the books that they need to read or could read in their particular topic. It is far more important to know about a book and its core message, preferably in the author’s own words, and to understand how that book fits into the culture and relates to other books and concepts then not to know that a book existed.
Language creates reality, it does not describe it. That is one of the principles that has emerged from anthropology, linguistics and philosophy from authors as diverse as Ludwig Wittgenstein, John Searle and Benjamin Lee Whorf. Confusion about language and the meaning of the terms being used is one of the main causes of arguments, fruitless arguments, which disappear if everyone shares the same understanding of the terms being used.
One of the complaints people make about Public Health is that every public health professional seems to describe it in a different way when asked. This is necessarily so, to a degree. The Director of Public Health or a Consultant in Public Health in an inner city is likely to have a different set of priorities and problems than doing a job with the same title in a West Country rural population. We need people to understand that public health is a type of professional practice that is adaptive and is practised differently in different contexts. However the criticism has some substance too. If you were to ask twenty public health professionals to write down what they meant by ‘deprivation’ or ‘well being’ or the difference between ‘quality’ and ‘value’ then, at present, you would get very different results. Similarly if you were to ask people what the ten most important texts that they studied training you would get different results.