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lar, for organizational cultures, which the organization's members joined as adults. It doesn't mean that
changing organizational culture is easy, but at least it is feasible . xcvii
Our beliefs and behaviors emerge from interactions between the cultures of nations, organiza-
tions, communities, families; and the forces of individual personality and human nature. It's not
worth trying to draw clear boundaries. Instead, we should aim for a rough map of the relevant
co-cultures and contexts in which they exist. A deep dive into culture reveals “turtles all the way
down,” but that's no reason to give up. Between perfect vision and total blindness lies all the
truth we know.
Ways of Knowing
Brigitte Jordan, the legendary corporate anthropologist and beloved godmother of design ethno-
graphy, made a mark early in her career with a brilliant series of cross-cultural studies of child-
birth. In one, conducted in a U.S. city hospital in the 1980s, she used video, medical records, and
postpartum interviews to explore and describe the culture of obstetrics.
The people present in the labor room with the woman are her husband and a nurse…The husband ap-
pears intimidated…The nurse is in a delicate position…she needs to assess the woman's state within a
small range of error in order to be able to call the physician in time for the crucial stages of delivery that
require his presence, but not so early as to waste his valuable time…she is very much preoccupied with
the electronic fetal monitor (EFM)…even though it has never been shown that routine EFM treatment im-
proves birth outcome…The woman is not allowed to push. Every effort is made to keep her from giving
in to the overpowering impulse to bear down. She is asked to suppress the urge long enough for the
physician to come in and pronounce her ready. The physician is paged several times but does not ap-
pear…The physician finally arrives, together with a male medical student. He examines the woman and
declares she is ready to push. The staff prepare her for delivery…The child is delivered by the medical
student who announces it's a boy…Finally, several minutes after the baby is born, he is given to his
mother to hold. xcviii
In the half hour before the baby is born, the woman “knows she has to push and says so clearly.”
The nurse largely ignores the woman's body and voice but repeatedly checks the EFM (19 times
in 5 minutes). When the doctor enters the room, he doesn't talk to the woman, and after making
his decision, he says “she can push” and the nurse relays the message.
Throughout the labor, participants work hard to maintain the definition of the situation as one where the
woman's knowledge counts for nothing. They all know she “cannot” push until the doctor gives the offi-
cial go-ahead. Within this particular knowledge system, it is believed that only the doctor can tell when a
woman is ready to push - information he gains from checking the dilation of the cervix during a vaginal
examination. This fiction is maintained collaboratively, by the woman herself, her husband, the nurse, the
medical student - in the face of the fact that anybody who cares to look or listen can see that this wo-
man's body is ready to push the baby out…However, what the woman knows and displays, by virtue of
her bodily experience, has no status.
In short, the woman is treated as an object, and the doctor is in charge of the facts. Jordan uses
this powerful ethnography to illustrate the concept of “authoritative knowledge.”
Within any social situation a multitude of ways of knowing exist, but some carry more weight than oth-
ers. Some kinds of knowledge become discredited and devalued, while others become socially sanc-
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