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Medical uncertainty is recognized as a critical issue in the sociology of diagnosis and medical sociology more generally, but a neglected focus of this concern is the question of patient decision making. Using a mixed methods approach that draws upon autoethnographic accounts and third-party interviews, we aim to illuminate the dilemmas of patient decision making in the face of uncertainty. How do patients and supportive caregivers go about navigating this state of affairs? What types of patient–doctor/healthcare professional relationships hinder or enhance effective patient decision making? These are the themes we explore in this study by following patients through the sequence of experiencing symptoms, seeking a diagnosis, evaluating treatment protocols, and receiving treatments. In general, three genres of culturally available narratives are revealed in the data: strategic, technoluxe, and unbearable health narratives.

David L. Altheide, Ph.D., is Emeritus Regents’ Professor of the Faculty of Justice and Social Inquiry in the School of Social Transformation at Arizona State University, where he taught for 36 years. His work has focused on the role of mass media and information technology in social control. His most recent books are Qualitative media analysis (2nd ed., Sage, 2012) and Terror post 9/11 and the media (Lang, 2009). Altheide received the Cooley Award three times, given to the outstanding book in symbolic interaction, from the Society for the Study of Symbolic Interaction: In 2007 for Terrorism and the politics of fear (2006); in 2004 for Creating fear: News and the construction of crisis (2002); and in 1986 for Media power (1985). Altheide received the 2005 George Herbert Mead Award for lifetime contributions from the Society for the Study of Symbolic Interaction, and the society’s Mentor Achievement Award in 2007.

The purpose of this research is to investigate knowledge management in the textile industry specifically through the relationships and interconnections of knowledge management systems, strategy and firm performance across the value chain.

This research examines the process of acquisition, retention, maintenance, and retrieval of knowledge both within the firm through organizational memory and across the value chain. A series of case studies examines how Invista (a Du Pont subsidiary) manages knowledge internally and externally through relationships with downstream partners across a single value‐chain within the textile industry. Qualitative interviews assess the “state of the industry” regarding knowledge management systems.

Differentiation through knowledge is difficult in practice. Invista has taken the first steps to develop knowledge management systems that connect the internal and external knowledge base to gain competitive advantage. Establishing internal knowledge management systems for organizational memory creates opportunities to minimize knowledge isolation in functional departments and creates a greater base for tacit learning to be leveraged. External knowledge management systems bring value chain members closer together and add value to the product (i.e. increased quality, customer perceptions of brand platforms) throughout the value chain. Active external knowledge systems create opportunities to reap the full benefits of internal knowledge and knowledge from other firms within the network.

This paper describes the process of acquisition, retention, maintenance, and retrieval of knowledge within the firm by improving organizational memory and across the value chain through knowledge management systems to gain competitive advantage.