In Janice Pariat’s new novel, a woman’s story is told by nine different characters from her life

An excerpt from the Sahitya Akademi award winning author’s new novel ‘The Nine Chambered Heart’.

All through that winter, I spend more time at the apartment than at home. It’s cold in the city without a river. The days brief, the nights long. I bring along shawls and blankets, and we sit like children around the radiator, begging to be kept warm. I haven’t, in a long while, known such...informality. You place your socked feet on my chest, between my legs, on my back. While I do my best to undress you. I want not just to see your skin, but also to see whether you’re intact, that the red beauty spot on your stomach, to the right side, is still there, that the one on your back, perfectly placed between your shoulder blades, hasn’t shifted.

“It’s freezing...what are you doing?” you’ll ask, half laughing.

“Checking to see it’s still you.”

And you’ll be perfectly serious when you say, “It’s always me, you fool.”

How can anyone, I think, when I look down at you, lying under me, be so young?

No, that isn’t the word. Youthful. Yes, youthful.

I suppose all I’ve noticed for years now is the human body in need of repair.

And you, you are perfect.

“Have you ever had an operation?” I ask you once.

You shake your head.

“Nothing? Not an appendectomy...tonsils?”

On your body, you say, not a stitch. You’ve scraped and hurt yourself, of course – on your palm, the scar from the tender bite of a pet dog, on your knee, an old wound that had become infected – but you’ve never been sliced by a scalpel. Never needed a threaded needle to hold flesh together. Silently, I hope you’ll always stay this way, that you will remain intact.

One late afternoon, I find you wandering the street outside the apartment.

“China,” you say, “China’s gone.”

It takes me a moment to recollect that that’s what you’ve named the ginger cat. (The tiger-stripe is India.) China clambered out to the balcony, spotted a bird and, unable to resist, leapt over the gap, fell to the balcony below, and dashed back out again on to the road in fright. You watched all this happen, helpless, and then rushed downstairs, calling out his name. When I find you, you’ve taken about twenty turns. China is still nowhere in sight. You aren’t, as one might expect, apoplectic or hysterical, just deeply restless, unable to sit or stand still. I join you on the search. The two of us, to anyone watching, a father and daughter looking for our lost pet.

“He must be frightened and hiding,” I tell you. “He’ll come back later.”

But he doesn’t, not that night or the next.

You leave the windows open; the apartment grows so cold we sleep with our jackets on. You put out plates of cat food on the balcony. “But how will he climb up?” you agonise. And you want to take to the streets again. At first, I accompany you, exhausted, in the middle of the night. Then I try to make you see that there’s no point. When China disappears, I realise there doesn’t exist a body with no scars.

You stop going out to look for him but still keep the windows open. One morning, we wake to find India gone too. We’d left the bedroom door ajar, and he must’ve slipped out silently while we slept.

Then you weep, and don’t stop. I’ve only seen such grief at funerals.

After that, I sense a retreat, as though you hold me responsible. I knew this was bound to happen, inevitable really, if you look at our situation. There is nothing I can do. There is nothing I can do enough.

‘Why don’t we get another cat?’ I ask once, and you look at me as though I’m mad.

Before the disappearance of China and India, you would allow me to hold you when I spent the night. Now, there is a space between us on the bed, seldom bridged. When it is, I stroke your hair. Your sides, curving like hills. One night, I say that you will get over these abandonments, and then, because I feel compelled to be honest, that they may happen again.

“What do you mean?” you ask, your breath warm on my neck.


“‘Tell me.”

I regret it already. Who am I to warn you about these things? Can anyone ever be warned?

Just that, I reiterate, it might happen again, and that you’d be surprised at the lengths people would go to not to feel abandoned, or to abandon.

For a long while, you are silent. Then you say, “I know.”

I want to laugh and say, aren’t you too young to know, but there’s a look on your face that stops me. I wait for you to speak, and you do, slowly, haltingly. “I was with this guy once...and it was horrible at the end...”


“We fought...all the time...but we stayed together in spite of everything...probably because of this reason...”

“It’s the hardest thing,’ I say, “to bring things to a close.”

“And you?’”

We’ve never spoken of my marriage before.
 “Even though you’ve been with other people, why do you still stay married?”

I have nothing to say but this pitiful thing. “I’m not the kind of person to leave.”

And you lie back, staring at the white ceiling, and say you understand. I’m silent for a while, and then ask, “Because you stayed with this...guy...even though you weren’t happy?”

You nod. He wasn’t either, you explain, but at least he knew when it was enough, when the unhappiness was too much, had gone on too long. “I don’t,” you say. “I never seem to know.”

And I long to say that you will learn, but how can I, when I know nothing of it either.

Excerpted with permission from The Nine Chambered Heart, Janice Pariat, HarperCollins India.

We welcome your comments at
Sponsored Content BY 

Putting the patient first - insights for hospitals to meet customer service expectations

These emerging solutions are a fine balance between technology and the human touch.

As customers become more vocal and assertive of their needs, their expectations are changing across industries. Consequently, customer service has gone from being a hygiene factor to actively influencing the customer’s choice of product or service. This trend is also being seen in the healthcare segment. Today good healthcare service is no longer defined by just qualified doctors and the quality of medical treatment offered. The overall ambience, convenience, hospitality and the warmth and friendliness of staff is becoming a crucial way for hospitals to differentiate themselves.

A study by the Deloitte Centre for Health Solutions in fact indicates that good patient experience is also excellent from a profitability point of view. The study, conducted in the US, analyzed the impact of hospital ratings by patients on overall margins and return on assets. It revealed that hospitals with high patient-reported experience scores have higher profitability. For instance, hospitals with ‘excellent’ consumer assessment scores between 2008 and 2014 had a net margin of 4.7 percent, on average, as compared to just 1.8 percent for hospitals with ‘low’ scores.

This clearly indicates that good customer service in hospitals boosts loyalty and goodwill as well as financial performance. Many healthcare service providers are thus putting their efforts behind: understanding constantly evolving customer expectations, solving long-standing problems in hospital management (such as long check-out times) and proactively offering a better experience by leveraging technology and human interface.

The evolving patient

Healthcare service customers, who comprise both the patient and his or her family and friends, are more exposed today to high standards of service across industries. As a result, hospitals are putting patient care right on top of their priorities. An example of this in action can be seen in the Sir Ganga Ram Hospital. In July 2015, the hospital launched a ‘Smart OPD’ system — an integrated mobile health system under which the entire medical ecosystem of the hospital was brought together on a digital app. Patients could use the app to book/reschedule doctor’s appointments and doctors could use it to access a patient’s medical history, write prescriptions and schedule appointments. To further aid the process, IT assistants were provided to help those uncomfortable with technology.

The need for such initiatives and the evolving nature of patient care were among the central themes of the recently concluded Abbott Hospital Leadership Summit. The speakers included pundits from marketing and customer relations along with leaders in the healthcare space.

Among them was the illustrious speaker Larry Hochman, a globally recognised name in customer service. According to Mr. Hochman, who has worked with British Airways and Air Miles, patients are rapidly evolving from passive recipients of treatment to active consumers who are evaluating their overall experience with a hospital on social media and creating a ‘word-of-mouth’ economy. He talks about this in the video below.


As the video says, with social media and other public platforms being available today to share experiences, hospitals need to ensure that every customer walks away with a good experience.

The promise gap

In his address, Mr. Hochman also spoke at length about the ‘promise gap’ — the difference between what a company promises to deliver and what it actually delivers. In the video given below, he explains the concept in detail. As the gap grows wider, the potential for customer dissatisfaction increases.


So how do hospitals differentiate themselves with this evolved set of customers? How do they ensure that the promise gap remains small? “You can create a unique value only through relationships, because that is something that is not manufactured. It is about people, it’s a human thing,” says Mr. Hochman in the video below.


As Mr. Hochman and others in the discussion panel point out, the key to delivering a good customer experience is to instil a culture of empathy and hospitality across the organisation. Whether it is small things like smiling at patients, educating them at every step about their illness or listening to them to understand their fears, every action needs to be geared towards making the customer feel that they made the correct decision by getting treated at that hospital. This is also why, Dr. Nandkumar Jairam, Chairman and Group Medical Director, Columbia Asia, talked about the need for hospitals to train and hire people with soft skills and qualities such as empathy and the ability to listen.

Striking the balance

Bridging the promise gap also involves a balance between technology and the human touch. Dr. Robert Pearl, Executive Director and CEO of The Permanente Medical Group, who also spoke at the event, wrote about the example of Dr. Devi Shetty’s Narayana Health Hospitals. He writes that their team of surgeons typically performs about 900 procedures a month which is equivalent to what most U.S. university hospitals do in a year. The hospitals employ cutting edge technology and other simple innovations to improve efficiency and patient care.

The insights gained from Narayana’s model show that while technology increases efficiency of processes, what really makes a difference to customers are the human touch-points. As Mr. Hochman says, “Human touch points matter more because there are less and less of them today and are therefore crucial to the whole customer experience.”


By putting customers at the core of their thinking, many hospitals have been able to apply innovative solutions to solve age old problems. For example, Max Healthcare, introduced paramedics on motorcycles to circumvent heavy traffic and respond faster to critical emergencies. While ambulances reach 30 minutes after a call, the motorcycles reach in just 17 minutes. In the first three months, two lives were saved because of this customer-centric innovation.

Hospitals are also looking at data and consumer research to identify consumer pain points. Rajit Mehta, the MD and CEO of Max Healthcare Institute, who was a panelist at the summit, spoke of the importance of data to understand patient needs. His organisation used consumer research to identify three critical areas that needed work - discharge and admission processes for IPD patients and wait-time for OPD patients. To improve wait-time, they incentivised people to book appointments online. They also installed digital kiosks where customers could punch in their details to get an appointment quickly.

These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott 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.