A Simple Intervention by Yael Inokai: Review by Niall Harrison
A Simple Intervention, Yael Inokai (Peirene 978-1-90867-087-8, 187pp, £12.99, pb). October 2024. Cover by Tessa Mackenzie.
There are different ways of writing medical SF. One, as in the case of Rajaniemi above, or Greg Egan occasionally, is to crank up the verisimilitude and extrapolate specific diseases or treatments in the best net-up hard-SF fashion; another is to lean into medicine as a system rather than a science and build something metaphorical or even allegorical. This is a tradition that can be elaborate and fantastical, as in Han Song’s recent Hospital (2016, trans. 2023) and its sequels, or it can be restrained to the point of austere, as in a book like Kazuo Ishiguro’s Never Let Me Go (2006); and it is the latter that came to mind reading A Simple Intervention.
Yael Inokai’s third novel is her first to be published in English and, at least in Marielle Sutherland’s translation, is a work of elegant restraint, but with great unease thrumming beneath the surface. Our viewpoint character is Meret, a nurse whose role is to assist a doctor with a surgical procedure that can free people from psychological disorders. That is more or less all the detail we get about the procedure: Meret doesn’t know how it works. Her role is to keep the patient company, since the procedure is carried out while the patient is awake, as a way of making sure no healthy tissue is damaged. To the extent that Meret thinks about what is being done, she thinks of the brain as a map, on which diseases have locations. We can cut out tumours, she reasons: “Why should it be any different with psychological disorders?”
This does not make her a very realistic nurse, but it does make her an effective narrator for the story Inokai seems to be telling, which is about trust, and how it is lost and gained. Meret writes in recollection of her youth. “I see myself in the mirror as a young woman again,” she tells us at the start of the book. “I’m in my mid-twenties, and I understand the world.” So she does not think about the history of interventions such as lobotomy and trepanation, and their disproportionate uses on women and ethnic minorities, and probably would not be much troubled if she did: The new procedure works, after all. Everything we see of Meret in those early chapters speaks to a woman who has been raised in, and believes in, a world of order. “I was proud of who I was when I wore the uniform,” she thinks, “The version of myself I liked most.” Which is, of course, in many ways what you would hope for a healthcare professional. The uniform is also a form of escape, from a claustrophobic family life which she explains as too many personalities in too small a space, but which seems to revolve around her father’s anger in particular.
So you can understand Meret’s investment in her work, her commitment to rules that resolve problems, her belief that the intervention offers people hope, if it can quieten the rage of people like her father. And you can understand how, even as she professes to particularly like the “nuances” of working with patients, she also sometimes seems oblivious to them, as in the case of Marianne, another person afflicted by rages, perhaps not as unrelated to her position as the youngest daughter of a wealthy family as Meret might think. And most of all you can understand how she is ambushed by her feelings for Sarah, a nurse who is assigned as her roommate. Their relationship is almost comic, initially: Sarah works the night shift, while Meret works the day shift, so for weeks they cohabit without seeing each other, only their traces. It quickly becomes tender, and then intense, and the trigger for Meret to question her profession. Sarah is warier of doctors, warier of treatments that may “fix” people: She knows what people with power might decide needs fixing.
To this point, for all its poise, it is true to say that A Simple Intervention feels familiar. We know the game, both because of its proximity to actual historical situations and its similarity to numerous dystopian narratives; we can see the pieces on the board, we recognise the doctor, we recognise Meret, we recognise Sarah. And the last third of the novel doesn’t bring many surprising moves. But what it does do is make the game matter. What it does do is unpack Meret’s emotional journey from belief to doubt with piercing clarity, through conversations with the doctor, with Sarah, and with patients for whom the treatment has worked, as well as those for whom it hasn’t. Hope remains Meret’s keystone. “Most of the people I cared for shared the same conviction: I used to be whole,” she reflects. “You couldn’t just abandon them to hopelessness.” It’s that determination that leads her to the real questions, about where and when and how hope should be invested, in systems, in procedures, or in people. And with the ending that follows, Inokai says everything that needs to be said.
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In Niall Harrison‘s spare time, he writes reviews and essays about sf. He is a former editor of Vector (2006-2010) and Strange Horizons (2010-2017), as well as a former Arthur C. Clarke Award judge and various other things.
This review and more like it in the November 2024 issue of Locus.
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