Book review

JM Coetzee’s new novel asks a crucial question: When everyone’s the same, can a person be different?

‘The Schooldays of Jesus’ is the second in what now appears to be a series by the 2003 Nobel Laureate.

Strangeness is a difficult quality to represent in an age when it’s all around us, all the time: from a species of bees becoming endangered to thousands of Americans even considering voting for a certain businessman in the running for President, and celebrity breakups being bundled alongside proclamations of the world ending by climatologists in your Facebook feed.

It’s easy to forget that we’re living in some of the most disorienting years in any century. And what’s more unsettling than all of these things is how we’re taking it all in our collective stride. How do you write a realist novel that can genuinely unsettle you amidst everything else that’s vying for your attention?

JM Coetzee’s answer, if The Schooldays of Jesus is anything to go by, is that you don’t. Not write a “realist’ novel anyway, or at least, not in the sense we understand "realism". Coetzee seems to be suggesting, and very slyly at that, that we leave behind such demarcations and come with an open mind to savour what a master of the craft has to offer us when he really does not have anything left to prove; when he is free to indulge himself a little.

It’s useless reducing this novel to one primary theme; there’s simply too much happening, pared down as it is with immense authorial discipline and brevity. But, in keeping with the theme of strangeness, we can certainly ask this question of it: how do you write an allegory for an age with no use for allegories?

The Jesus trail

Coetzee’s “Jesus” novels follow the adventures of David, a strange, gifted child who arrives on the shores of Novilla, (which means “heifer” in English) with his caretaker Simón, from an unspecified camp called Belstar. As people make the journey across the oceans to Novilla, they lose their memory of a previous life, and essentially start from scratch. What led to such an immigration is never made clear, and it’s one of the many conditions the novel requests that the reader blindly accept.

The two of them try to settle down in this new city, with Simón convinced for some reason that he will identify David’s mother the minute he sees her, in spite of never having met her before. Ultimately, they do find David’s “mother”, Inés, who after an initial bout of uncertainty, decides to adopt David. The first book was essentially the story of their meeting, and their encounter with the insipid, bland existence that Novilla had in store for them. In Novilla, no one goes hungry, but there is little aside from bread to be had, for the most part.

People lead a peculiarly unimaginative existence, and seem quite content with a lack of sensation in their lives. However, several philosophical discussions and minor incidents later, the three characters are forced to flee this life again, as David proves to be too different for the city authorities to handle. The “parents” are asked to enter David in a boarding school of sorts as a means of checking his reckless bouts of reasoning, but David escapes, and the three of them soon flee Novilla for Estrella.

How to be different

It is in Estrella that our novel begins. David’s difficult nature has blossomed further: he is not a “bad” kid, by any means, but he is certainly odd. David questions everything unceasingly, to Simón’s exasperation. He does not seem too convinced by human morality and reasoning, choosing instead to surrender to wild flights of fancy. He keeps putting new spins on facts of life that we seem to take for granted, and these make for some of the most interesting parts of the book.

In one chapter, Simón and David discuss one of Coetzee’s pet themes, the ethics of eating meat. David, in what is almost a parody of the Socratic dialogue, asks Simón: “Why do they have to die to give us their meat?” One is instantly reminded of Margaret Atwood’s Oryx and Crake, where a giant, headless chicken developed by one of the numerous laboratories of the future, provides an endless supply of meat without dying. The question, reformulated through a child’s eye, becomes a profound one: are we aware of the death that we participate in every day when we eat meat, or has the notion of the living, breathing animal come untethered from the idea of food?

There are only two schools of note in Estrella: one specialising in dancing and the other in song, and David is enrolled in the former. Soon he finds himself surrounded with arcane theories that link numbers with the stars, both of which are “brought down” to Earth through the human appropriation of dance.

Through it all, there is that need among David’s instructors to have him transcend and become something more; much of the insipid and somewhat bland nature of Novilla’s citizens stemmed from a similar belief in Platonic ideals, and work for work’s sake, beliefs which never sat well with Simón. It does not here, either; Simón, David’s protector and in a sense the classical Utopian traveller, always at several removes from the new reality around him, is unconvinced, but not immune to persuasion. He struggles to understand how grown men and women could subscribe to dancing as a way of life, and what numbers have to do with anything.

David, strangely enough, is right at home in all of this: he is at his best in the world of abstractions. It is in such a space that he can let loose his brand of childlike logic, which some in Estrella recognise to be wisdom manifesting prematurely in the child.

The meaningless crime

There is a semblance of plot in all of this, especially surrounding a heinous crime of passion committed by a worker called Dmitri, whom David becomes quite fond of. But the larger question that Coetzee seems to be asking is: how do we treat difference in a land which has more or less achieved the ideals it had set out to achieve; where there is little need for food or money among its people, but where passions are also kept in check at all times?

The perpetrator, Dmitri, who plays a large role in the proceedings, is like Albert Camus’s Meursault: he is not insane, and his crime seemingly has no motive behind it. How does a utopian society such as Estrella deal with a crime that has no philosophical or logical grounding? David, who defies human reasoning in his impulsive behaviour and stubbornness, takes a liking for Dmitri. Dmitri is not looking to escape the consequences of his crime; indeed, he wants to suffer and yet he is not allowed to, his prosecutors choosing to explain away his crime as the result of a deranged mind.

It is disturbing, but perhaps no wonder that David relates to Dmitri on some level, even though the latter's crime is an act of sheer depravity: neither of them is deranged, and yet their actions cannot be perceived as anything else in Estrella. But in David’s case, madness cannot be conveniently gendered or otherwise appropriated as a result of a specific social strain. The figure of the child enjoys a certain immunity when it comes to prejudiced opinion.

The “Jesus” in the novel’s title could then refer to the strangeness with which figures such as David are perceived by a society with no clear labels to pigeonhole them with. True, uninhibited human expression of the sort that David exhibits often flies in the face of human morality and rationality, but our appreciation for such expressivity is always deferred. Rarely are we comfortable with difference when it stares us in the face, be it in the form of someone defying gender norms, the mentally challenged, the physically disabled, or even the animal.

Coetzee’s great achievement in this and the previous novel, however, is not to generalise difference, or to suggest that society should reconcile itself to the many kinds of differences that are possible in the same way, but to demonstrate the pitfalls of not acknowledging difference at all in a misplaced scramble for rationality, lucidity and transparency.

Perhaps he greatest irony of the novel, aside from its setting, is the fact that it’s written in the most beautifully lucid and transparent style imaginable, by a superb prose stylist. In the end, call Coetzee’s latest what you will, but it is always a joy to read.

The Schooldays of Jesus, JM Coetzee, Random House.

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

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Getting the best from collaborations

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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:

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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.