Book review

With these short stories, Akhil Sharma adds funny and gentle variations to a familiar theme

These tales of Indian lives in America get to the core with quiet prose that shows, not tells.

An obvious trap when reviewing a short-story collection is to obsessively trace common themes and links between pieces that might represent very different aspects of a writer’s creative life. But the characters and predicaments in Akhil Sharma’s A Life of Adventure and Delight often lend themselves to such analysis. Reading one of my favourite stories in this book, it struck me that its title – the deceptively simple “You are Happy?” – would work just as well for most of the other pieces.

In one passage in this story about a boy watching his mother fall into alcoholism and desolation, Sharma’s quiet, no-frills prose builds a litany of horrors. Lakshman’s mother must be taken to a detox centre after a nightmarish few days where she stayed in bed with her liquor and refused to get up even to go to the toilet, using a bucket next to the bed instead. Vomit lines her chin; she is led, dazed and half-dressed, to the bathroom. This is a very bleak day for the family, yet the paragraph about the drive to the centre begins “It was a bright Sunday morning” and goes on to describe Lakshman’s relief when he sees sunlight reflecting off the glass windows of the shops they pass.

“The flashes of light were like blasts of music. The occasional person walking across a road seemed like life going on, like life was always going to go on and so somewhere there was the possibility of things being different and happiness existing.”

The possibility of things being different, of happiness existing not too far out of reach… these words are reminiscent of a scene from another story, “If You Sing Like That for Me”, where a woman named Anita who stumbled into an arranged marriage – before she fully realised what was happening – mulls her discontent with her husband. He is a good man, but “what I wanted was to be with someone who could make me different, someone other than the person I was”. Someone like her sister, perhaps, who seems to have become a gentler, happier person after her own wedding.

Who are these people?

Many of these pieces are about people who are either trapped in difficult situations or at an important crossroads. In “Cosmopolitan”, the middle-aged Gopal is adrift – minus the safety nets of work or steady relationships – after his wife leaves him. On the verge of becoming a sociopathic recluse who stays permanently at home, watching TV and bursting into giggles when he hears news of bombings in far-off countries, his senses are reawakened by the possibility of a relationship with his American neighbour. And in Sharma’s hands, what might have been an unremarkable little tale grows into a comedy of sexual etiquette and the expectations game. It is never too late to learn new things, Gopal finds, but it is also very easy to misread other people – or to deceive yourself.

Again, in keeping with the small ways in which these characters seem to call out to each from within the confines of their separate stories, Gopal put me in mind of the narrator-protagonist of “If You Sing Like That for Me” – telling us her story at a point where she has already been in a loveless marriage for decades, seemingly resigned that this is all her life amounted to. But what if Anita were to get another, unexpected chance? How would her response compare to Gopal’s, and would society afford her the same freedoms?

Frequently, we meet characters who are tied to traditional ways even as they try to be citizens of a changing world. (Some of the protagonists are Indians living in America.) In “A Heart is Such a Heavy Thing”, a woman is startled when her new daughter-in-law boldly asks for shampoo when there is only soap in the house; she recalls her own days as a compliant bride and wonders if something is wrong with the girl’s mind. Later, though, she reflects that what she had thought was insanity might just be candour, and a small shift occurs in the terms of engagement. In “The Well”, the protagonist’s cultural references are mostly non-Indian (as a boy he has a crush on Lynda Carter’s Wonder Woman and Mrs Muir in The Ghost and Mrs Muir), but when his girlfriend gets pregnant, he self-consciously tries to do the “right thing” (even though the girl has no wish to get married), and tells his mother “I love her” in a Hindi conversation that sounds fake and melodramatic to his own ears.

Darker and deeper

Sharma is very good at unexpected little touches that creep up on the reader: a seemingly normal encounter giving way to something darker, patches of humour in a situation that is far from inherently funny. In “Surrounded by Sleep”, the life of 10-year-old Ajay and his family abruptly changes when his elder brother has a swimming-pool accident and is rendered vegetative. In one passage that is both comical and poignant, the efforts of Ajay’s mother to please god are likened to the boy performing somersaults to amuse his aunt; while the mother prays to more conventional gods, Ajay turns to Superman. But droll as these scenes are, they don’t detract from the basic sadness of the situation: not just the tragedy of a family having lost a healthy child to a freak accident, but also the tragedy of a younger child – naturally self-centred and restless – whose life has come to a standstill; who must feel like he himself is living at the bottom of the pool where his brother spent three minutes, in a place where everything happens in slow motion.

I particularly liked the little asides and detours, such as the coda that closes “A Heart is Such a Heavy Thing”, where a middle-aged man – whose son has just got married – watches a young boy singing on a bus. Passages like these prioritise the creation of mood over plot, and there are many quietly observant moments in this vein. A couple who have just started dating negotiate some awkwardness while dining at a restaurant that is temporarily allowing customers to pay whatever they think is fair (while the manager keeps a suspicious eye on the opportunistic Indian diners). During a fight between his parents, a boy starts hopping about and acting like a cartoon character, “as if we were on a TV show and people were laughing at my cuteness”. When Anita’s sister says of their father, “If he wants to die, wonderful […] but why is he making it difficult for us?”, Anita is shocked – not by the apparent callousness but by the directness and honesty, which makes her realise that her own sentimentality may have been a lie.

The minor weaknesses

Given that these stories mainly follow the “show, don’t tell” mode – allowing the gradual accumulation of events to reveal things about the characters and their inner worlds – the weaker bits are the ones where information is explicitly provided or underlined. And some of this may have to do with the need to spell things out about a culture that isn’t familiar to the readership. (These pieces were originally published in The New Yorker, The Atlantic and The Paris Review.)

I’m usually wary of the allegations of “exoticising” that get directed at non-resident Indian authors – too often, these are built on defensiveness and hurt feelings rather than an engagement with the actual writing or an attempt to understand another perspective. But it still feels heavy-handed when the omniscient narrator of “You are Happy?” informs us that “In India, on farms, pretty young women are as common as rabbits. It is easy to have sex with girls who are fifteen, sixteen, seventeen.” Or when the otherwise subtle “A Life of Adventure and Delight” throws in this bit of exposition:

“Gautam was an ordinary middle-class boy. He knew he would have to get married one day, and he hoped to have as much sex as possible before then, but he also believed that any Indian girl who had sex before marriage had something wrong with her, was in some way depraved and foul and also unintelligent. He wished he could have sex with Sunny Leone.”

In a more minor key, why spell “Defence Colony” (the south Delhi neighbourhood, and a proper noun) as “Defense Colony”? Or repeatedly use “lentils” when “daal” would have done perfectly well? (Especially given that the author uses “roti” in a similar context, and even has a woman address her father as “Pitaji” in a sentence that must have been spoken in Hindi but is conveyed to us in English.)

These are small irritants, though, and they don’t take much away from the universal appeal of these stories, full of attention to detail, gentle humour, and insights into how strangely people might behave when circumstances overwhelm them. And when happiness becomes hard to grasp or define.

A Life of Adventure and Delight, Akhil Sharma, Hamish Hamilton.

An excerpt from “Cosmopolitan”

They went to the garage. The warm sun on the back of his neck made Gopal hopeful. He believed that something would soon be said or done to delay Mrs Shaw’s departure, for certainly god could not leave him alone again. The garage smelled of must and gasoline. The lawn mower was in a shadowy corner with an aluminium ladder resting on it. “I haven’t used it in a while,” Gopal said, placing the ladder on the ground and smiling at Mrs Shaw beside him. “But it should be fine.” As he stood up, he suddenly felt aroused by Mrs Shaw’s large breasts, boy’s haircut, and little-girl sneakers. Even her nostrils suggested a frank sexuality. Gopal wanted to put his hands on her waist and pull her toward him. And then he realised that he had.

“No. No,” Mrs Shaw said, laughing and putting her palms at against his chest. “Not now.” She pushed him away gently.

Gopal did not try kissing her again, but he was excited. Not now, he thought. He carefully poured gasoline into the lawn mower, wanting to appear calm, as if the two of them had already made some commitment and there was no need for nervousness. He pushed the lawn mower out onto the gravel driveway and jerked the cord to test the engine. Not now, not now, he thought, each time he tugged. He let the engine run for a minute. Mrs Shaw stood silent beside him. Gopal felt like smiling, but wanted to make everything appear casual. “You can have it for as long as you need,” he said.

“Thank you,” Mrs Shaw replied, and smiled. They looked at each other for a moment without saying anything. Then she rolled the lawn mower down the driveway and onto the road. She stopped, turned to look at him, and said, “I’ll call.”

“Good,” Gopal answered, and watched her push the lawn mower down the road and up her driveway into the tin shack that huddled at its end. The driveway was separated from her ranch-style house by ten or fifteen feet of grass, and they were connected by a trampled path. Before she entered her house, Mrs. Shaw turned and looked at him as he stood at the top of his driveway. She smiled and waved.

When he went back into his house, Gopal was too excited to sleep. Before Mrs. Shaw, the only woman he had ever embraced was his wife, and a part of him assumed that it was now only a matter of time before he and Mrs Shaw fell in love and his life resumed its normalcy. Oh, to live again as he had for nearly thirty years! Gopal thought, with such force that he shocked himself. Unable to sit, unable even to think coherently, he walked around his house.

His daughter’s departure had made Gopal sick at heart for two or three weeks, but then she sank so completely from his thoughts that he questioned whether his pain had been hurt pride rather than grief. Gitu had been a graduate student and spent only a few weeks with them each year, so it was understandable that he would not miss her for long. But the swift- ness with which the dense absence on the other side of his bed unknotted and evaporated made him wonder whether he had ever loved his wife. It made him think that his wife’s abrupt decision never to return from her visit to India was as much his fault as God’s. Anita, he thought, must have decided upon seeing Gitu leave that there was no more reason to stay, and that perhaps, after all, it was not too late to start again. Anita had gone to India at the end of November – a month after Gitu got on a Lufthansa flight to go live with her boyfriend in Germany – and a week later, over an echoing phone line, she told him of the guru and her enlightenment.

Perhaps if Gopal had not retired early from AT&T, he could have worked long hours and his wife’s and daughter’s slipping from his thoughts might have been mistaken for healing. But he had nothing to do. Most of his acquaintances had come by way of his wife, and when she left, Gopal did not call them, both because they had always been more Anita’s friends than his and because he felt ashamed, as if his wife’s departure revealed his inability to love her. At one point, around Christmas, he went to a dinner party, but he did not enjoy it. He found that he was not curious about other people’s lives and did not want to talk about his own.

A month after Anita’s departure a letter from her arrived – a blue aerogram, telling of the ashram, and of sweeping the courtyard, and of the daily prayers. Gopal responded immediately, but she never wrote again. His pride prevented him from trying to continue the correspondence, though he read her one letter so many times that he inadvertently memorised the Pune address. His brothers sent a flurry of long missives from India, on paper so thin that it was almost translucent, but his contact with them over the decades had been minimal, and the tragedy pushed them apart instead of pulling them closer.

Gitu sent a picture of herself wearing a yellow-and-blue ski jacket in the Swiss Alps. Gopal wrote her back in a stiff, formal way, and she responded with a breezy postcard to which he replied only after a long wait.

Other than this, Gopal had had little personal contact with the world. He was accustomed to getting up early and going to bed late, but now, since he had no work and no friends, after he spent the morning reading The New York Times and The Home News & Tribune front to back, Gopal felt adrift through the after- noon and evening. For a few weeks he tried to fill his days by showering and shaving twice daily, brushing his teeth after every snack and meal. But the purposelessness of this made him despair, and he stopped bathing altogether and instead began sleeping more and more, sometimes sixteen hours a day. He slept in the living room, long and narrow with high rectangular windows blocked by trees. At some point, in a burst of self-hate, Gopal moved his clothes from the bedroom closet to a corner of the living room, wanting to avoid comforting himself with any illusions that his life was normal.

But he yearned for his old life, the life of a clean kitchen, of a bedroom, of going out into the sun, and on a half-conscious level that morning Gopal decided to use the excitement of clasping Mrs Shaw to change himself back to the man he had been. She might be spending time at his house, he thought, so he mopped the kitchen oor, moved back into his bedroom, vacuumed and dusted all the rooms. He spent most of the afternoon doing this, aware always of his humming lawn mower in the background. He had only to focus on it to make his heart race. Every now and then he would stop working and go to his bedroom window, where, from behind the curtains, he would stare at Mrs Shaw. She had a red bandanna tied around her forehead, and he somehow found this appealing. That night he made himself an elaborate dinner with three dishes and a mango shake. For the rst time in months Gopal watched the eleven o’clock news. He had the lights o and his feet up on a low table. Lebanon was being bombed again, and Gopal kept bursting into giggles for no reason. He tried to think of what he would do tomorrow. Gopal knew that he was happy and that to avoid depression he must keep himself busy until Mrs Shaw called. He suddenly realised that he did not know Mrs Shaw’s first name. He padded into the darkened kitchen and looked at the phone diary. “Helen Shaw” was written in the big, loopy handwriting of his wife. Having his wife help him in this way did not bother him at all, and then he felt ashamed that it didn’t.

The next day was Sunday, and Gopal anticipated it cheerfully, for the Sunday Times was frequently so thick that he could spend the whole day reading it. But this time he did not read it all the way through. He left the Book Review and the other features sections to fill time over the next few days. After eating a large breakfast – the idea of preparing elaborate meals had begun to appeal to him – he went for a haircut. Gopal had not left his house in several days. He rolled down the window of his blue Honda Civic and took the long way, past the lake, to the mall. Instead of going to his usual barber, he went to a hair stylist, where a woman with long nails and large, contented breasts shampooed his hair before cutting it. Then Gopal wandered around the mall, savoring its buttered-popcorn smell and enjoying the sight of the girls with their sometimes odd-coloured hair. He went into some of the small shops and looked at clothes, and considered buying a half pound of cocoa amaretto coffee beans, although he had never cared much for coffee. After walking for nearly two hours, Gopal sat on a bench and ate an ice cream cone while reading an article in Cosmopolitan about what makes a good lover. He had seen the magazine in CVS and, noting the article mentioned on the cover, had been reminded how easily one can learn anything in America. Because Mrs Shaw was an American, Gopal thought, he needed to do research into what might be expected of him. Although the article was about what makes a woman a good lover, it offered clues for men as well. Gopal felt confident that given time, Mrs Shaw would love him. The article made attachment appear effortless. All you had to do was listen closely and speak honestly.

He returned home around five, and Mrs. Shaw called soon after. “If you want, you can come over now.”

“All right,” Gopal answered. He was calm. He showered and put on a blue cotton shirt and khaki slacks. When he stepped outside, the sky was turning pink and the air smelled of wet earth. He felt young, as if he had just arrived in America and the huge scale of things had made him a giant as well.

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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.

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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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  • 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.