publishing trends

Should an author’s unfinished work be completed by someone else after their death?

Terry Pratchett made sure that his unfinished work was destroyed after he died.

The scene: a field in southwest England. The sun is shining for a quintessentially British event, the Great Dorset Steam Fair. A six-and-a-half tonne steamroller takes centre stage. This, the Lord Jericho, goes head-to-head with a computer hard drive, and in a battle of old and new technologies, rolls over it several times. Then, just to be on the safe side, the hard drive is placed in a steam-powered stone crusher.

A scene from a fantasy novel? No. The hard drive was from the late author Sir Terry Pratchett’s computer, and it contained the files of, it is thought, 10 unfinished novels.

Pratchett, author of the much-loved Discworld series, wrote more than 60 books in his lifetime. But it was his wish that any unfinished works remained unpublished, and so he instructed that the hard drive containing his remaining works be crushed by a steamroller.

Raising Steam

Commenting on BBC Radio Four’s Today programme, authors Patrick Ness and Samantha Norman asserted Pratchett’s absolute right to determine the future of his unfinished work. In recent years, though, both authors have completed unfinished novels by other writers. In Norman’s case, it was The Siege Winter, a book by her late mother, Ariana Franklin. For Ness, it was Siobhan Dowd’s A Monster Calls, now adapted into a hit film.

Unfinished work abounds in literary history, from Jane Austen’s Sanditon and Charles Dickens’s The Mystery of Edwin Drood to F Scott Fitzgerald’s The Last Tycoon.

For each of these canonical authors, their unfinished texts add to our accumulated knowledge of their writing, their rich imagination, and the development of their thinking. After completing Dorothy L Sayers’ last novel, Jill Paton Walsh went on to create warmly regarded new novels featuring Lord Peter Wimsey and Harriet Vane. JRR Tolkien’s son Christopher likewise has worked painstakingly on unfinished works by his father, including The Children of Hurin.

Unlike Pratchett, the strict instructions left by some authors about their legacy have been ignored, sometimes to the reader’s benefit. Max Brod’s decision to counter Franz Kafka’s wish for destruction is to literary history’s benefit, as it led to the publication of The Trial, The Castle, and Amerika. Emily Dickinson left no instructions on what to do with the approximately 1,800 unpublished poems she wrote before her death in 1886. Fortunately, her sister Lavinia took it on as her mission to see them made public.

When Swedish crime novelist Stieg Larsson died suddenly, unmarried and with no will, his estate came under the control of his father and brother. They commissioned ghostwriter David Largenrcrantz to create new works using Larsson’s characters, with the latest, The Girl Who Takes an Eye for an Eye due in September 2017. Larsson’s bereaved long-term partner is in possession of the author’s laptop which is believed to hold Larsson’s last unfinished novel, but she has refused to turn it over to his family.

Reaper Man

The biographical figure of the author has, despite Roland Barthes’ critical articulation of “The Death of the Author” in 1967, never been more present. Now, readers have unprecedented access to the names on the spines of their books, thanks to festivals, talks and social media.

While some authors may not want to show the struggle of their early drafts to the world, there is both an industry (famous authors’ manuscripts can sell for high figures) and scholarship attached to them. Formal archives of Pratchett’s work exist in Senate House in London, for example – including some tantalising glimpses replete with coffee stains and notes to the publisher. Salman Rushdie has even given a desktop computer and several laptops to Emory University in the US.

There is no doubt that Pratchett was within his rights to deprive readers of these last rough-hewn gems, though understandably fans may be disappointed with his choice. However, the rumours swirling around the appearance of Go Set a Watchman – the original version of Harper Lee’s To Kill a Mocking Bird – suggest that elderly and infirm authors can potentially be preyed upon. Pratchett’s wish to control his literary legacy was consonant with his advocacy for assisted dying. He, more than anyone else, understood the power of letting things come to an end.

As an author who had “Death” as one of his major recurring characters, Pratchett had thoroughly tested its presence in human life. But now, even knowing that Pratchett’s crushed hard drive will soon feature in an exhibition, we can’t but regret the loss of these early, unfinished drafts, which contained the very last doorway into the Discworld.

Claire Squires, Professor in Publishing Studies, University of Stirling.

This article first appeared on The Conversation.

We welcome your comments at letters@scroll.in.
Sponsored Content BY 

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.