literary awards

A reader from India has picked his Man Booker shortlist before the jury does

No, Arundhati Roy’s novel is not in there.

On September 13, the 13-book longlist for the Man Booker Prize will be whittled down to six by the five-member jury chaired by Baroness Lola Young. But before that, a reader decided to read all 13 titles on the longlist and pick his own shortlist. Over to our one-person jury:

I endeavoured to read the Man Booker longlist in its entirety in 2016. By the time the winner – Paul Beatty’s The Sellout was announced, I had read nine books out of the 13. This year I finished reading the longlist a fortnight before the shortlist is to be announced.

This is my 2017 Man Booker shortlist:

Kamila Shamsie’s Home Fire is a modernist retelling of the Greek Tragedy Antigone. The story is set in Massachusetts, London, Syria, and Karachi, and is about five principal characters, siblings Isma, Aneeka, and Parvaiz, and father and son Karamat and Eamonn Lone. Aneeka’s twin brother Parvaiz has joined the media wing of ISIS. Karamat Lone is the Home Secretary in Londonn. The story unfolds like an impending disaster. Shamsie’s writing is sharp, assured and evocative.

The novel weaves a complex thread of family, loyalty, faith, and society. Home Fire takes a few chances with the structure of Antigone, for there is no incest or fratricide here, but these risks make this novel tighter in both plot and structure. This, along with Ali Smith’s Autumn, is a very current novel.

An ode to Irish pastoral life, Mike McCormack’s Solar Bones is elegiac, and structurally confident. The novel starts on November 2, 2008, All Souls’ Day. This is contextually important, with the Angelus bell tolling, signifying the ascension of souls to heaven. The narrator is Marcus Conway, a civil engineer who works for the local council and lives in Louisburgh, County Mayo, Ireland.

The entire novel is one single sentence, broken up in paragraphs. McCormack writes with verve. His voice is poetic, and he uses it to reminisce about many things – the life of his parents, meeting his wife, their life together, his children growing up, and his career. As you start reading Solar Bones, you quickly forget the narrative quirk and get immersed in the story. The prose has an immediacy and a poignancy that is haunting.

A daring entry to the longlist is Fiona Mozley’s Elmet. The story is narrated by Daniel, an effeminate teenage boy who is on the run. The two other main characters are his father John, a giant of a man, a bareknuckle fighter, and his sister Cathy. John builds a house in a copse. The family hunts and largely live off the land. The land owner is Price, and the confrontation that is built up is both brutal and explosive.

The novel grapples with themes of rural exploitation and creeping poverty in a working-class neighbourhood in an area where coal mining has run aground. The language of the narrator sticks to a rural, Yorkshire dialect. The tone of the novel is modern Gothic and this lends the narrative a savage beauty.

Jon McGregor’s Reservoir 13 is ostensibly about a 13-year-old girl named Rebecca Shaw. Rebecca’s family is holidaying in a village in the Peak District for the New Year when she goes missing. The novel takes us on a cyclical, circuitous path through changing seasons, weather, flora and fauna. We are meant to see the effects of Rebecca’s disappearance on the evolution of lives of the villagers.

McGregor has a panoramic eye for nature and its rhythms. He writes about rural life in an unfussy manner. The effect of this prismatic, cyclical change is spellbinding as it keeps the readers focussed. The novel may be termed “plotless” by some, but its narrative journey is the true reward.

Sebastian Barry’s Days Without End is the story of Thomas McNulty, a young lad who flees poverty and hunger in Ireland and ends up enlisting in the US Army of the 1850s. With his friend and lover, John Cole, Thomas fights in both the Indian Wars and the Civil War. The men endure terrible hardships and suffering during their tumultuous lives.

The tone of the novel is moving and despite the horrors of war, the writing remains remarkably fluid and beautiful. It confronts issues of cruelty, justice, identity, and belonging in a remarkably non-judgemental vein.

Ali Smith’s Autumn is the first of a series of seasonal novels she plans to write. Autumn is a novel on pop art and friendship, set firmly in the aftermath of the Brexit vote. Elizabeth is a 32-year-old contractual junior lecturer at a London University, and the novel is about her relationship with Daniel, a 101-year-old man, now in a care home. Smith cleverly juxtaposes the current political climate with the Profumo scandal of 1963 and the pop art of Pauline Boty. Autumn is often wry, absurdist and melancholic.

The other two novels that were contenders on my list were Arundhati Roy’s The Ministry of Utmost Happiness and Colson Whitehead’s The Underground Railroad. The Ministry of Utmost Happiness fuses fluid writing with politics and modern Indian history. The two halves of the novel never really come together.

Colson Whitehead’s The Underground Railroad is a powerful narrative. The understated writing shines a light on slavery in the South. But it unravels towards the end, bringing it to an unsatisfactory conclusion.

The novels included in my shortlist showcase themes of identity, loss, community, politics, indigenous Indians and their sacred land, faith, and loyalty. All the six novels are beautifully written and are a rare combination of art and craft. This is a shortlist which chooses itself.

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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 marketing team and not by the editorial staff.