Yael Inokai: Ein Simpler Eingriff

Inokai, Yael (2022), Ein Simpler Eingriff, Hanser
ISBN 978-3-446-27231-6

In an overall not great year for German-language literary fiction, Swiss novelist Yael Inokai’s third novel, Ein Simpler Eingriff (“a simple procedure”) was among the better entries. Like many of its contemporaries, Inokai opts for a simple, poetically weighed language that often veers close to schmaltz, but never quite tips over. In this short novel, Inokai tells us about a nurse at a hospital where a new procedure has been invented and is being used on unsuspecting patients – an operation that will remove your feelings of anger and your impulses to be criminal and generally bad. It’s set in a vague past, anchored by old technology, and a kind of operation that we would not do to mentally ill people today. Inokai’s protagonist develops feelings for one of her patients, and, more importantly, falls in love with a fellow nurse. The novel is not very interested in the nuts and bolts of the treatment or the specific details of the hospital structure. Inokai instead gives us a story that is primarily about vibes – and about relationships: between the protagonist and the other nurse, between the protagonist and her own family, between the protagonist and the physician, who invented the procedure, and finally, between the protagonist and the patient.

Despite reviews (and the book cover) focusing on power structures, and on the budding lesbian relationship, it is the latter relationship, between Meret, the nurse, and Marianne, the patient, that is actually structuring the book and its ideas. In order for us to understand the impact of the procedure, we are given two distinct periods in this relationship: the time before the operation, when we see Meret interact with the patient at length, and the time after the operation. It should be, if you have read any novels dealing with this sort of topos, no surprise or spoiler, that the operation does not result in a well-adjusted patient. Instead, Marianne has lost most of her memory and all of her personality. It is an invasive and damaging procedure. Inokai is not, as I said, extremely interested in the procedure itself, and the way she tells us of its effects relies heavily on the literary history of the topos. This is a very 1960s kind of operation, with the obvious literary antecedent in Ken Kesey’s classic novel of mental ward mayhem, One Flew Over the Cuckoo’s Nest. There are no surprises here, as in a tale of psychological horror, the reader follows the text along to its horrifying conclusion. At no point during the times when Meret and Marianne play cards, read books, discuss childhoods, are we ever expecting anything less than the utter catastrophe we are given. And when we find Marianne after the operation, changed, bland, with empty eyes, it does not come as a surprise, but as the expected result of 1960s psychiatry.

I say 1960s psychiatry – but there’s an intentional vagueness. Inokai mixes two tropes. Kesey’s novel and others like it often focused on all genders – the treatment of depression, “criminality” and schizophrenia was liberally applied to people regardless of gender. That said, there is a second literary tradition: that women who are prone to anger, prone to resistance and general societal strangeness are easily medicated, hurt and subjected to exactly the kinds of operations depicted in Inokai’s novel. That’s why Kesey, despite the book being the standard reference in reviews of Ein Simpler Eingriff, isn’t the right reference point at all: it is the history of medicating women. From the Yellow Wall-Paper, to the Bell Jar and Susanna Kaysen’s celebrated memoir, there is a long track record in writing of the many attempts by men to control the emotions of women, ideally by cutting out some wayward part of them. This explains why, despite review after review suggesting that Inokai writes about hospital hierarchies, she at no point does any such thing. We know what a novel dealing with hierarchies in mental health looks like – this is not it. She is talking about misogynist violence. The three examples offered in the novel is a woman treated for being a petty criminal, a woman treated for being irascible, and, finally, a treatment is explicitly sugested to the protagonist as well: for being a lesbian.

Gendered violence in health care is a long and widely explored topic, and Inokai does not add anything specific to it; instead, she offers a meditation on what it feels like to be at the intersection of the various ways to inflict mental health treatment on women. Meret works within the system, observes the elements happening in it, and through her own personal relationship also understands what it would mean to be subjected to it. In the end she breaks out of the system, galvanized both by her partner Sarah, as well as by her transformative experience of accompanying Marianne through the procedure. The book is written with clarity of language, even though the descriptive aspects are all intentionally vague. Inokai loves one-sentence paragraphs, short descriptions. There are entire paragraphs like this “I was thirsty. I grabbed my cup, it made a noise. I retracted my hand.” Or the following two consecutive sentences, each given its own line: “So that was the history of shame. // There was also a history without.” Inokai’s simple but very stylistically controlled language does not employ reduction to open interpretative holes in the story, open emotional gaps. Instead, she elides descriptions and details, and focuses on emotional phrasing above all else. Inokai’s control of language is excellent.

What’s disappointing is that Inokai, while shining a light on a past practice, is using the harm done to a maybe mentally ill person to help the protagonist to grow. It is tempting to make her partner’s influence the deciding factor behind Meret’s changes – but that is wrong. In fact it is watching Marianne vanish after the operation and only surface in bits and pieces, as well as an encounter with a different woman, who, after the operation, seems devoid of personality. Meret specifically notes the strange smell emanating from the woman. Honestly, I did not expect that a novel in 2022 would use someone else’s illness to help build character for a person unaffected by the issue. In this light, even the late suggestion that Meret could also be affected by the mindset behind the operation, seems slightly unpleasant, given that she, factually, is not yet. Meret (and her partner Sarah) never lose control of their agency, never have to fight for their mental state against a family and medical apparatus that is predisposed to harm them. It is true that potentially, they could both be subject to the problem, but within the novel they are not. And their agency is essential for the denouement of the novel. It is watching people harmed by the system that build Meret’s character, dealing with a, at the end, mentally disabled woman, that changes Meret’s mind – Marianne is a mere object to move Meret from point a in the book to point b.

This is also the biggest difference between the Kaysers and Bell Jars of the world. That we are observing Marianne from two angles: from the point of view of her family, who is very happy to cut her out of their lives, and from the point of view of Meret, who is a significant part of the system that physically harmed her, is, in some ways, not an improvement on the mindset that created the “simple procedure” in the first place. There is no inside view, there is just another gaze from within the medical system on someone trapped in it. I have attempted and failed to write about Donald Antrim’s recent excellent memoir of receiving electro shock treatment – the difference between Antrim discussing his feelings, fears and results, to a potential book written by someone unaffected, offering the point of view of someone sympathetic but unaffected, is stark. And this closes the circle to my slight misgivings about the pathos. I have friends who are critical of pathos when it comes to people with mental illness discussing their situation, but surely, pathos by an outsider, who is moved into emotionality by a patient that she helped treat, is worse?

Despite these misgivings, Ein Simpler Eingriff is a very good novel and among the best published last year. The criticism of gendered violence, of the connection between patriarchy and mental health treatment, the way, Inokai offers us a debate on self-actualization on multiple levels is impressive, and what’s more, unlike many of her contemporaries, she’s in complete stylistic control from the word go the last line of the novel. She mirrors themes of the book in the way she deals with metaphors and observations, it’s just a very impressive performance and a book worth reading and translating.