Before Francis Crick and James Watson unveiled DNA’s double helix, a colleague dismissed Crick as incompetent—he couldn’t recall basic facts about DNA’s four bases. But, as economist Arthur M. Diamond notes, the intuitive knowledge that drives discovery and progress often lies beyond language. Despite this, we still invest our money in those with the slickest pitches over those with unspoken insight, stifling progress. Diamond’s solution is radical: we must totally redesign how money flows through society. Judge creators by what they build, not what they write; replace bureaucratic applications with practical contests; and tear down institutional barriers blocking self-starting scientists and creators.

An experienced nurse in the neonate intensive care unit is mostly focused on the infant who is her main responsibility. But she notices that a nearby infant is cycling through minor changes in skin color. That infant’s primary nurse sees it too. The infant then turns blue-black. The experienced nurse knows it is pneumopericardium, where air pressure around the heart keeps the heart from sending blood into the infant’s body. She knows it because she had been the nurse for an infant who died from pneumopericardium. The heart monitor misleadingly seems to show that the heart is still beating, so the infant’s primary nurse thinks the problem is a collapsed lung. As the chief doctor arrives the experienced nurse “slaps a syringe in his hand” and tells him to “stick the heart” to release the air. An x-ray tech confirms the diagnosis, the doctor acts, and the infant lives.

The experienced nurse was out of line. The infant who lived was not her responsibility and it was not her job to tell the chief doctor what to do. She could have been punished, but she took a chance and acted on intuitive knowledge that she could not immediately articulate. She had intuition that proved correct and her acting on her intuition was literally a matter of life and death. But we set up barriers to discourage ourselves and others from acting on our intuition. We establish regulations, credentials, protocols, manuals.

___

Breakthrough innovative entrepreneurs often have limited formal theoretical knowledge, but high levels of informal unarticulated knowledge.

___

Dr Min Chiu Li was an oncologist at the National Cancer Institute in the US in the early days of administering methotrexate chemotherapy to women who had choriocarcinoma cancer. The NCI protocol mandated that when the visible symptoms of cancer were gone, he should stop chemotherapy. But he had an intuition that small amounts of cancer still lurked after the visible symptoms were gone. So he violated the protocol and gave his patients a longer course of chemotherapy. The administrators at the NCI fired Min Chiu Li for violating the protocol, but later were surprised to observe that the patients treated according to the protocol were dead, and the patients treated by Min Chiu Li were alive.