Book review

The Man Booker International prize-winner is a brilliant, tragic story full of jokes

A stand-up comedian’s life unravels in full view of his audience.

Last summer, everyone was reading Elena Ferrante. There were think pieces and analyses, dissections of female friendships and artfully crafted Instagram posts. The tweets were almost relentless: “Reading Elena Ferrante!” “Can’t believe it’s taken me so long!” And there, out in the cold, sat I – with both the time and inclination to read five books in one day if I so choose – who couldn’t for the life of me get into it.

I tried over and over again, three times returning to the “Look Inside!” button on Amazon, clicking through the pages to see if it hooked me this time, so that I could join the club I so desperately wanted to join. How often is all the social media furore over a book? But no. Ferrante’s slippery pose, her Italian girls, they evaded the click I wait for in my brain, sometimes as soft as a door opening, sometimes as hard as a match striking a box, and left me not able to enter the biggest book club I had seen in ages.

Maybe it’s translated books. I’ve never been much good with them. Somehow I can always see the translator lurking between me and the author, a sort of edgy English, stilted sometimes, not as easy as having a conversation. Maybe it’s me: I see myself reading a translated book as though I’m watching a story through glass, I know it’s there, and it’s technically sound, and a lovely story by all accounts, but all I can see is my own reflected face, not hearing the characters at all.

A few exceptions, Murakami among them, but it is my biggest shame as a reader that I can’t delve as joyfully and easily into the world of books that didn’t begin as my language. English is the only language I speak (with a smattering of Hindi, which is so poor it’s laughable), and it could be why I’m so wary of books that bring other languages into English’s less-than-loving fold, they feel third hand. Like the joke goes: you had to be there.

Reader walks into a book

Which explains how I began by plodding through the most recent Man Booker International Award winner David Grossman’s book A Horse Walks Into A Bar. This is not the Booker, but as the years have gone on, they’ve picked some stand-out titles, often translated from other languages in the past, and since 2016, only translated books.

Do you know how many prizes 63-year-old Israeli author Grossman has won? Sixteen. It’s lucky I didn’t know that before I picked up A Horse Walks Into A Bar, or I might have been too intimidated to notice that I wanted to abandon it almost as soon as I started.

It’s a book that starts slowly, almost painfully, and then suddenly picks up speed. It’s a book that makes you wonder if the author is going to do everything in the irritating voice of the stand-up comedian. And then, just as you begin to collect your things and leave, as his audience is doing, he hits you with a story which makes you want to stay.

The comedian as hero

I wasn’t a huge fan of stand-up either, not until I watched Hasan Minhaj’s Homecoming on Netflix recently. Minhaj teeters between sadness and punchlines so often that the whole audience seemed to be holding its breath for him, and all the time he gazed out from the stage with an expression part happy part appealing, that you wanted to pat him on the head and buy him a drink. Stand-up comedians, the best of them anyway, have a way of revealing so much while all the time inviting you to laugh at their troubles. They are the circus clowns of our new era.

Dovaleh Greenstein, Grossman’s comic protagonist, is a bit like that. Desperately needy, and also just desperate. Several times during the course of the novel – which unfolds over a period of two hours at a comedy club – Dovaleh punches himself in the face, hard enough to double over. There are several moments where you are so actively put off by this narrator that you want to avert your eyes and turn to the nearest PG Wodehouse to soothe yourself.

But then, like the judge friend Dovaleh invites to watch him – the present day “I” narrator, who is a foil for Dovaleh’s story of his past – you’re drawn in almost against your wishes. That is the trick to this novel, something Grossman does so cleverly, that it wasn’t till I rushed breathlessly to the end that I realised that it was all part of his structure. His plan. And this from a book I had been dying to leave unread only a few hours ago!


Laugh lines

To tell the truth, a lot of the political jokes went over my head. I know that in real life Grossman is a “left wing peace activist” to quote straight from his Wikipedia page. A lot of that is reflected in Dovaleh’s story, not to give too much away, but let’s just say there’s a war and the story of a little boy lost.

Then too there is the feeling of being in a comedy club, which Grossman does so artfully, you could swear you were there yourself, that you are the audience to whom Dovaleh is speaking. Every now and then when the story gets too heavy, he throws in a little joke, almost off the cuff: a man had a swearing parrot, three men talk about how they get women to orgasm, amateur stuff, but enough to lighten the mood so when you next encounter the tension of the narrative, your defences are down.

A word about the translation (from Hebrew), since it’s come up. Jessica Cohen, the translator of this, and several other of Grossman’s books, split the prize with him, something that is well deserved, I think, because Cohen brings to life perfectly the fractured energy that all the characters have, an almost imperceptible feeling that they are all twitching in their seats, while retaining the staccato of Dovaleh’s stream-of-conciousness story, and at the same time, turning the view on the judge – who is basically us, the reader, but with a dark secret – without losing any of the focus.

A Horse Walks Into A Bar could be described as all Israel. You’re sitting there in this small town , surrounded by people who range from a biker couple to a midget medium, but I also saw shades of every comic I have ever seen. The need to please, the need to stretch out humour from wherever they can find it. And you know? Once I was third of a way through, the glass disappeared and it was just me and the words, no barriers at all.

A Horse Walks Into A Bar, David Grossman translated by Jessica Cohen, Vintage.

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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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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:

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  • 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.