If I had cared, I’d have written Jane Austen meets black people and sold some books: Marlon James

'Anybody who plays with the fantastic is actually tapping into our oldest literary tradition.'

Marlon James is exhausted. By the time I meet him in the lobby of his Jaipur hotel, he has spent several days doing sessions at the Jaipur Literature Festival, where he’s one of the headliners, and has done multiple interviews on each one of those days. The 45-year-old Jamaican novelist, who won the Booker prize last year for his third novel, A Brief History of Seven Killings, remains witty and graceful through our conversation. Excerpts from the conversation:

Does speaking about your last novel over and over again change the way you look at it?
Not really, because people always ask me the same questions.

What kind of questions?
How long it took to write, the usual banal questions… what are my influences, when did the idea first appear in my head, all of that stuff. Reading it aloud, however, sometimes changes perception. I’ve not looked at that book as a reader since probably reading the first draft. Other than that, reading it has been work, and a matter of editing and re-editing, downright fixing. Reading it as a reader is something I haven’t done, and in fact I won’t do it for another - I don’t know, I give myself 10-15 years to come back to a book. I’ll give myself 10 years to see what it’s like. My first novel is now 10 years old, I probably want to re-read that one.

I read your Facebook update where you said that in starting a new novel, you have to learn how to write it all over again. Can you tell us a bit more about that? Is it a kind of anxiety?
It is a kind of an anxiety. Usually by the time a book is published, certainly for this novel, it means five years since I’ve started a book. I’ve literally forgotten how to do it. I also think each book demands its own process. That’s why this one took so long to write, because I kept trying to write it using my previous novel’s process.

Each book teaches you how to write that book. I just wish I was already at the stage (with my next novel) where it has taught me, as opposed to flailing around, which I’ll probably do for a good two hundred pages before I hit what I want to say, and the voice in which I want it to be said. I have no idea what that is yet.

But I’ve spent so long grappling with a finished work, this sort of starting from scratch thing I’m pretty sure I’ve totally forgotten how to do. My next novel is certainly the most different of all the books I’ve written. For all the other books I’ve written I have a language and always a personal stake in the story, whereas with this one, I don’t.

There’s this narrative of your having found success because you moved to the US. But does anyone talk about the pitfalls of being there? Or is it just in terms of you having made this “positive” journey and having left your “third world” country behind?
Or my den of homophobic vigilantes, which is not true either. I do think the US has a way of taking credit for people’s success, freedom, whatever. But what it gave me was a free space and a safe space, and I think those are important, and yeah I did not have them in the country that I grew up in.

But no aspect of my artistic sensibility was formed in the States. By the time I got to the States I was already a fully formed creative person – no aspect of my education or knowledge – most of the books that shaped my literary sensibility I read in Jamaica, so what the US did so far is give me a safe space to write my third novel. The other two were written in Jamaica. And that’s it.

I’m grateful for it, but I do get that… any person, especially an immigrant of colour who shows “sophistication” by the world’s standards, a first world country wants to take credit for it. When people say you must’ve gone to school abroad… it’s just another version of “You speak so well” and it reflects an ignorance.

Europeans are sometimes taken aback when I say to them, almost out of pity, it’s not your fault, you’re just ignorant, you really don’t know any better. Some people are still surprised that there’s a university in Jamaica, that tertiary education is possible in the former colonies… I just feel sorry for them. I’m like, oh, you poor thing.

How much can you tell us about your new fantasy novel?
Last time I overspoke about a novel, I ended up never writing it, so I won’t say too much about this one. It is inspired by Central African and West African history, folklore, mythology and religion. Usually when we talk about Africa we talk as if it is a country, but we also think the only noble past is in Egypt… I’m not writing a historical novel, I could have, but I’m just looking at African continental history. I mean, African storytelling doesn’t need my help. I’m just plugging into a rich, creatively fertile storytelling tradition that’s already there.

Do you feel there’s still a snootiness about genre? This kind of distinction between “serious” literary fiction and genre fiction?
Oh, totally. Even the people who write science fiction and fantasy still have a snooty attitude towards it. Their attitude is that they’re sort of slumming, and that it is a sort of lower form of literature, despite the fact that there’s a whole new generation of writers –Junot Díaz, Michael Chabon, me – who don’t see that distinction at all. I read more crime fiction than literary fiction, and I’m certainly a huge, huge fan of sci-fi and fantasy. I’ll even watch bad sci-fi. (Laughs.) But I think even that kind of snobbishness and snootiness just smacks of a kind of ignorance and a kind of backwardness, quite frankly.

Did anybody baulk at the thought of you writing fantasy?

I’m sure there are people who will think that, they thought that about (Kazuo) Ishiguro’s books, he’s a Booker winner who went off into writing something speculative and fantastical. I’ve never thought of what people want or expect from me. If I had cared, then I would never have written a 400-page slave novel written in patois, I’d have written Jane Austen meets the black people and sold some books.

It’s an ignorance of our most enduring stories, which are fantastical. We talk about the Arabian Nights, the Bible, Beowulf, Adventures of Amir Hamza, it’s the myths are what we always come back to. The myths are what tells us how we used to live, and Margaret Atwood had this great line when someone interviewed her and she said human nature hasn’t changed in a thousand years. How do you know? Look at the myths.

So anybody who plays with the fantastic is actually tapping into our oldest literary tradition. The type of writer or critic who would look down on that is somebody with a very limited idea about the history of storytelling.

Did you follow the Sad Puppies business of exhorting people to vote up novels for the Hugo Awards? What did you think of it?
I did follow the Sad Puppies saga. There are lots of problems with it. I don’t think people realise just how misogynist and racist nerds are, because they’ve usually gotten this kind of free pass, because you know, who are more persecuted than nerds? Yet they’re still sending threats to the journalists who criticise GamerGate.

I think people are a little surprised just how racist, and unevolved, and how vicious they can be with that. I’m sure that if someone came across what I’m saying to you now, I’ll be bombarded with crap for the next couple years. I think it was sad that – that whole thing about the “tales of derring-do” (and I’m like, seriously?) being replaced by, I guess, “political correct sociology lessons.” I’m like, you’ve clearly never picked up the past one hundred years of sci-fi.

What they want to go back to is Tarzan. And if that’s what you want then fine, but that’s never disappeared, and there’s always been an audience for it. But there’s always been science fiction that actually tried to do some science, that has always pushed things further. I mean, Samuel Delany’s older than every single Sad Puppy and his work is both a fantastic imagination of the world, and also serious literature.

The other problem with Sad Puppies is that it creates the idea that there are just no black people, Native Americans, Asians, gay people who have been writing sci-fi. I’m like there you go, you’re ignorant again, because people of colour have been writing fantastical fiction from day one. So it’s bad enough that – let’s call a spade a spade – they’re being racist and homophobic. And thank god you have people like George RR Martin and John Scalzi who won’t stand for that crap. Ultimately, you know, we may have given them too much time, because I’m sure they’re even more convinced of their importance.

We welcome your comments at
Sponsored Content BY 

What hospitals can do to drive entrepreneurship and enhance patient experience

Hospitals can perform better by partnering with entrepreneurs and encouraging a culture of intrapreneurship focused on customer centricity.

At the Emory University Hospital in Atlanta, visitors don’t have to worry about navigating their way across the complex hospital premises. All they need to do is download wayfinding tools from the installed digital signage onto their smartphone and get step by step directions. Other hospitals have digital signage in surgical waiting rooms that share surgery updates with the anxious families waiting outside, or offer general information to visitors in waiting rooms. Many others use digital registration tools to reduce check-in time or have Smart TVs in patient rooms that serve educational and anxiety alleviating content.

Most of these tech enabled solutions have emerged as hospitals look for better ways to enhance patient experience – one of the top criteria in evaluating hospital performance. Patient experience accounts for 25% of a hospital’s Value-Based Purchasing (VBP) score as per the US government’s Centres for Medicare and Mediaid Services (CMS) programme. As a Mckinsey report says, hospitals need to break down a patient’s journey into various aspects, clinical and non-clinical, and seek ways of improving every touch point in the journey. As hospitals also need to focus on delivering quality healthcare, they are increasingly collaborating with entrepreneurs who offer such patient centric solutions or encouraging innovative intrapreneurship within the organization.

At the Hospital Leadership Summit hosted by Abbott, some of the speakers from diverse industry backgrounds brought up the role of entrepreneurship in order to deliver on patient experience.

Getting the best from collaborations

Speakers such as Dr Naresh Trehan, Chairman and Managing Director - Medanta Hospitals, and Meena Ganesh, CEO and MD - Portea Medical, who spoke at the panel discussion on “Are we fit for the world of new consumers?”, highlighted the importance of collaborating with entrepreneurs to fill the gaps in the patient experience eco system. As Dr Trehan says, “As healthcare service providers we are too steeped in our own work. So even though we may realize there are gaps in customer experience delivery, we don’t want to get distracted from our core job, which is healthcare delivery. We would rather leave the job of filling those gaps to an outsider who can do it well.”

Meena Ganesh shares a similar view when she says that entrepreneurs offer an outsider’s fresh perspective on the existing gaps in healthcare. They are therefore better equipped to offer disruptive technology solutions that put the customer right at the center. Her own venture, Portea Medical, was born out of a need in the hitherto unaddressed area of patient experience – quality home care.

There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.

When intrapreneurship can lead to patient centric innovation

Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.

Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.

Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:

  • Check-out management: Exclusive waiting rooms with TV, Internet and other facilities for patients waiting to be discharged so as to reduce space congestion and make their waiting time more comfortable.
  • Space for emotional privacy: An exclusive and friendly space for individuals and families to mourn the loss of dear ones in private.
  • Online patient organizer: A web based app that helps first time patients prepare better for their appointment by providing check lists for documents, medicines, etc to be carried and giving information regarding the hospital navigation, the consulting doctor etc.
  • Help for non-English speakers: Iconography cards to help non-English speaking patients express themselves and seek help in case of emergencies or other situations.

As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.

According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.

Creating an environment conducive to innovation is the first step to bringing about innovation-driven outcomes. These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott, which is among the top 100 global innovator companies, is working with hospitals and healthcare professionals to improve the quality of health services.

To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.

This article was produced on behalf of Abbott by the marketing team and not by the editorial staff.