A writer speaks

When a writer reads another, it can sometimes be love (and envy) at first sight

Hansda Sowvendra Shekhar on the moving experience of reading Easterine Kiré’s new novel.

I do not know if it was a sadness closed up within me or if it was something written in the book, but just nine pages before Son Of The Thundercloud, the new novel by Easterine Kire, came to an end, I found myself bawling. I closed the book; assured in the knowledge that no one was hearing me, I bawled my heart out; then resumed reading.

This part of the book is about a character being killed out of jealousy by someone he had trusted and thought of as his friend. A simple enough plot element, but when I look back at the suddenness with which I felt like crying, I am surprised. I am surprised by the fact that I cried, and I wonder if any other story or any other writer dealing with the same themes – of trust and betrayal – would have made me cry. Making a reader cry is not exactly an easy job for a writer. A reader needs to fully engage with the character they cry for, to cohabit that particular space that the character is living in, to adequately share the experience.

Normally, such an engagement might need words and pages. In Kire’s novel, a slim volume of barely 150 pages, though, there are no lengthy descriptions of the crises faced by the characters, who are described in only as many words as a reader needs to understand what is being said. Yet, the engagement I speak of is palpable. The magic in this novel kept me spellbound. Despite the sparseness of words and pages, not a single character seemed incomplete, and the scenes seemed to take place right before my eyes. No wonder I felt for the character who was killed and cried for him.

The difficulties of writing tales we have heard

I have read three books by Easterine Kire: her novels, Bitter Wormwood, When The River Sleeps, and this one. The first was a juxtaposition of Nagaland’s history and present – a political and social story rather than one based on the myths of Nagaland. That showed in the book’s girth. At nearly 300 pages, Bitter Wormwood was a novel-like novel. With When The River Sleeps, the novel which won The Hindu Prize 2015, Kire seemed to return entirely to her roots, telling stories that she must have heard from her family, her ancestors – stories that were told down the generations.

Kire belongs to the Angami community, which is indigenous to Nagaland. Like Kire, I too have an Adivasi background – I am a Santhal, from Jharkhand. Like Kire, I too have grown up with myths and legends that I heard from my family, whose members had heard those stories from our ancestors, dead and gone decades before I was even born. At times, I have tried writing those stories down in my own words in an attempt to develop them into longer works. I failed each time. The reason: I heard those stories, I did not read them.

The stories were rendered orally, and every person who knew a particular story had their own version to tell. And every version, irrespective of length or whether it was taken from real life, was either quite short or did not have a proper ending, an ending that could enhance it in terms of structure and narration. And so writing those stories was difficult unless I added my own imagination. But how much could I imagine? At one point, I feared that I might mar the original oral version if I added too much of my own to fit the demands of paper.

So, I know the limitations of basing a longer work on oral legends. But Kire seems to have mastered this art. She takes the traditional stories, folklore and myths of her community, and uses her imagination to create a work that is as magical in the written form as the original story, I am sure, is in the oral form. Her books based on these stories might not have too many words or pages or plot elements, but the description of a Naga landscape and village, of spirits and magical beings, of Naga customs and traditions, are so lively that the reader feels at home even during that brief journey.

When The River Sleeps is shorter and simpler than Bitter Wormwood, and Son Of The Thundercloud is far shorter and simpler than When The River Sleeps. The increasing simplicity of Kire’s books is their strength.

Angami tribe, Nagaland. Image credit: Yves Picq (Wikimedia Commons)
Angami tribe, Nagaland. Image credit: Yves Picq (Wikimedia Commons)

What the spirits do

In When The River Sleeps, the journey of the protagonist Vilie, who is in search of the “heart stone” from a river, comes alive as Kire brings in creatures from the spirit world, nasty spirits of river widows, and a forest of spectres – among other things – into the narration. Magic and simplicity travel along with Vilie in When The River Sleeps’.

Son of The Thundercloud is even simpler. Like When The River Sleeps, Son Of The Thundercloud too has a traveller. His name is Pele (short for Pelevotso), though he is not the hero. Pele here is the narrator-like character through whose eyes, and in the third person, we see the life of the eponymous Son of the Thundercloud.

The hero is a young boy named Rhalie (short for Rhalietuo), who was born after his mother, Mesanuo, is impregnated by a single drop of rain that fell on her body from a thundercloud. Mesanuo is the tiger-widow, whose husband and seven sons were killed by a tiger. This is no ordinary tiger, though, it is a spirit. Afraid of it, the people of the village in which Mesanuo lives – the Village of Weavers – have started offering sacrifices to the spirit tiger. But a prophecy has it that Mesanuo will be impregnated by a thundercloud and bear the Son of the Thundercloud, and this Son of the Thundercloud will slay the spirit tiger. Awaiting the fulfilment of the prophecy, Mesanuo has lived for more than three hundred years.

Pele is led to the Village of Weavers by Mesanuo’s sisters, Kethonuo and Siedze, each of them, like Mesanuo, having lived for over three hundred years.

The hugely intriguing plot – I was really drawn by the sisters having lived for more than three-hundred years – is held together by Kire’s terrific narration. She establishes the plot and moves forward with a pace that grabbed my attention. Concise and engrossing, every scene and chapter is only as long as it needs to be. There are no superfluous lines, nothing to hinder the reader’s attention.

I was already acquainted with the spirits and the things they are capable of doing from When The River Sleeps. Here, too, the spirits use a force of nature – heavy rains – to thwart the journey that Pele, Mesanuo and Rhalie make. But despite the return of the spirits, Son Of The Thundercloud does not seem repetitive. On the other hand, there are new magical elements: a famine that lasts four centuries, the earth shifting its position because of the movement of stars, and many others.

What’s also vital here is the coming together of modern life with the traditional. There are women who have lived for more than three centuries and are dissolving into their spirit forms, and yet the roof of their house has been built with tin.

The birth of Rhalie could find a parallel in the birth of Christ. This is a beautiful coming together of a Christian myth and Naga legends. Human nature, love, friendship, trust, fear, envy, and betrayal have been explored through the magical events in the novel. At one point, I even felt there’s a message about preservation of natural resources. And all of it has been written in Kire’s beautiful, almost touching prose. Sample these two passages:

“…I’m talking about the famine of stories and songs. They killed all the storytellers who tried to tell them about the Son of the Thundercloud. They killed hope…”

and

“Because the people sought to be free whenever they heard the stories. Free of fear, free of shame and constant desire. Without the stories, people believed they were destined to suffer, and allowed the dark ones to enslave their minds and fill them with fear and sorrow and despair until they died.”

For me, a novel that relates stories and storytellers to hope can never be wrong. I am in love with Son Of The Thundercloud.

Son Of The Thundercloud, Easterine Kire, Speaking Tiger Books.

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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 Scroll.in marketing team and not by the Scroll.in editorial staff.