BOOK EXCERPT

Five poems by Perumal Murugan from his days in exile

A selection from the poems that the Tamil writer wrote after being persecuted by caste and religious groups for his fiction.

Never have I not been engaged in the act of writing.

Of course, the pressures of material life have kept me from writing now and then. But even then my mind was always ticking with ideas. I don’t know whether I had the ability to stem the flow of my thoughts and to exert control over them. But I know I never felt any desire to rein them in. Many of those thoughts just ran away and never came back. There have also been those that only appeared to run away but actually stayed buried inside and later expressed themselves when I put pen to paper. Writing to me is a habit of the mind. And poetry is my ideal. It is close to my inner being. Right or wrong, it allows me to give vent to my feelings and emotions.

Poetry, to me, is a vehicle to recover from anything. No matter how stressful the situation, I have been able to endure it, hanging on to the tip of the one word that takes shape in my mind. This habit of talking to myself sometimes even manifests in the movement of my lips, when my thoughts are given shape as spoken words. That has caused some amount of trouble in the outside world. And there are many lone words and phrases that have never got written down. While it is true that I cannot take pride in every such word that takes shape in my mind, I had always thought of this mental habit as a boon.

But there came a moment when I realised this boon was a curse, and I stifled it. I thought I was done with it, that I could perform the final rites for it and get on with my life. But I couldn’t. I felt like a dead man walking, though there was nothing I could do about it. I had throttled the voice, killed it. I hoped that I’d soon stop grieving. But that did not happen either. Perhaps I was not strong enough to kill. Thus, for a long while my mental habit lay ailing. But finally it rose with a roar and possessed me again – words, thoughts, poetry. And then it seeped in all directions like an unstoppable spring.

When I found an opportunity, I set the words down on paper. They kept coming forth like never before. Poetry is a great medicine, a rare herb. It was poetry that revived me.


A Great Stream

Nameless, endless
impassable forest

Alone, a lamb bounds about
making new pathways
as it runs

As it runs
it leaps
to cross a great stream
that has appeared suddenly

It is possible
that it would cross the stream and look back in wonder
It is possible
that it would falter in its leap and fall in and die

May the wide-mouthed stream do right
by the lamb

~ 22 February, 2015


A Strange Beast

My very existence becomes a threat to anyone I meet

As soon as I enter
they close doors and windows
As soon as they see me
they hurriedly send away their guests
They drift away from my words
and look anxiously around
They fall silent
They make plans to send me away quickly

They text from their cell phones under the table
informing god knows who about my visit
They take photos with me
and leave
They try to make a rare wonder of my voice

Someone has painted over my head
a pair of horns everyone can see
Someone has turned me
into a strange beast

~ 22 February, 2015


Names of Days

Names of days
have become ruins of antiquity
We can give them new names
by flinging up new words
from the warehouse of language

Week, month, year
all such calculations too will go obsolete
Even day

Instead
We shall name a day Cuckoo’s Call
We shall name a day Scattering of Snow
We shall name a day Stone’s Softening
We shall name a day Mountain Peak
We shall name a day Crescent Moon

Each unlike the other, each unlike the other
So many days

We shall name some days
Devil’s Scream
Fool’s Grunt
Corpse’s Stench
And get past them easily

~ 23 February, 2015


A Language Without Nouns

All that get caught like cobwebs in the broom
of the man who set out to cleanse language
are nouns

He keeps clearing away
at the reeking mass
that are the names of people
Trash piles up high

Names of places go into the pile
along with names of people

Nouns for things, nouns for time
Nouns for qualities, nouns for body parts
Nothing survives

Now
only verbs leap about
all over the dictionary

Conceding to the pleadings
of the language-mother who stands frozen
he magnanimously allows some nouns
but not the ones for people
and the places they live in

Unable to bear the sting of her entreaties
he allows pronouns too
and sets the broom down
in a corner.

~ 23 February, 2015


A Divine Tongue

I am angry enough
to sing a song of curses at all of you

I am angry enough to curse
that the hands that burnt my effigy
shall char in the same fire
That the words that flew at me
like poison-soaked arrows
shall turn back to go
and wound and kill
the stone hearts that sent them

I am angry enough to sing
Oh you guardians of morals
May the screens part
and expose your truths
May the lord of cremation grounds
dance, smearing the ashes
from your powdered bones

I am angry enough to sing
a song of curses
That lips that spout lies shall burn and wither
That crowds that gather quickly shall die

But my divine tongue has no words
for curses
Go away, live!

~ 26 March, 2015

Excerpted with permission from Songs of a Coward: Poems of Exile, Perumal Murugan, translated from Tamil by Aniruddhan Vasudevan, Penguin India.

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.