A Simple Intervention by Yael Inokai, translated by Marielle Sutherland, Peire Press, London 2024.

A Simple Intervention begins with a brief retrospective as Meret, the main character and narrator, reflects on the novel to come “I see myself in the mirror as a young woman again. Conviction in my eyes. Unclouded by doubt. I’m in my mid-twenties, and I understand the world”. While the opening retrospective is a common literary technique, in this context, it works well to create the context in which the rest of the novel plays out.

Meret has worked as a nurse in a surgical ward of a major hospital for eight years. She is dedicated to her work and views the hospital and the nurses’ accommodation as her home. There is a sense of safety and certainty in the her routine which is in contrast to her past growing up in a largely dysfunctional family.

Meret’s reliability and loyalty is rewarded when she is chosen to assist one of the doctors in a new procedure, the ‘intervention’. It appears that the process is basically a lobotomy performed while the patient is conscious, and Meret’s job is to engage the patient while the doctor preforms the operation. The procedure appears to be performed primarily on women and, more precisely, on women how don’t quite fit society’s expectations. While at first proud of her role in assisting the doctor, Meret gradually becomes more concerned about the why the procedure is being performed and its outcomes.

These concerns increase when Marianne, a patient Meret has made some connection with, has complications during the procedure. As she plays cards with Marianne during the operation, Meret realises that “Something died in her eyes”. Marianne survives but is little more than a shell. When Meret warns the family of another potential patient of the possible risk she is relieved of her role in assisting in the procedure.

There are some interesting parallels between Marianne and the case of Rosemary Kennedy, sister to John F and Bobby Kennedy. Rosemary was a difficult child and suffered learning difficulties, probably as a result of oxygen deprivation during birth. By 1940 she had become “increasingly irritable and difficult” and there were concerns about her sexual activity. Her father was concerned that her behaviour could embarrass the family and impact her brother’s political careers. As a result her father arranged for her to be lobotomised in November 1941. The actual procedure sounds very similar to the one in A Simple Intervention:

After Rosemary was mildly sedated, “We went through the top of the head,” … “I think she was awake. She had a mild tranquilizer. I made a surgical incision in the brain through the skull. It was near the front. It was on both sides. We just made a small incision, no more than an inch.” The instrument Dr. Watts used looked like a butter knife. He swung it up and down to cut brain tissue. …. As Dr. Watts cut, Dr. Freeman asked Rosemary some questions. For example, he asked her to recite the Lord’s Prayer or sing “God Bless America” or count backward … “We made an estimate on how far to cut based on how she responded.” When Rosemary began to become incoherent, they stopped.¹

Meret’s job during the ‘procedure’ is talk to the patient, to keep them occupied — “as long as they stayed awake, we knew the doctor and his instruments had found the right place”.

Once the connections are made between the novel’s intervention and the history of real world lobotomies it becomes clear that this is far more than just a story of a single nurse’s disillusionment with the system. Well over 60% of all lobotomies ever performed were on women, most commonly to ‘correct’ emotional disturbances or failure to conform to social norms. A high proportion of patients targeted were also LGBTQ, or thought to be ‘at risk’ of being gay.

Indeed the society that Meret finds herself in is inherently a patriarchal one. She grew up in a family dominated by a verbal and physically abusive father and her life as a nurse is controlled by the male medical hierarchy and, in particular, the male doctor who conducts the ‘interventions’. The women, who are the objects of the procedure, are largely there because the controlling males in there lives, husbands, fathers and brothers, are ‘uncomfortable’ with aspects of their behaviour. Meanwhile, the nurses are housed in a hall of residence, separate from the hospital and separate from the town. They have their routines and expected behaviours designed to ensure the system keeps functioning.

Inokai skillfully builds the imagery surrounding Meret and her role in the hospital. In many ways it is a very filmic imagery. Much of it takes place inside, the interior of Meret’s room in the residence and the wards and offices of the hospital. It is a very monochrome existence and one can imagine it captured on black and white film. This only serves to reinforce the conformity and structure Meret and the other nurses endue.

As the novel progresses, however, chinks appear in this imagery – hints of colour start to appear. Meret forms a deep friendship with her new room-mate, Sarah, which evolves into a physical relationship, the timing of which corresponds to her increasing unease about the intervention. There are simple acts of rebellions, the two women cycle to a restaurant and then make their way to the roof to talk free from the restrictions of hospital and work. They place a plant on a stool in the middle of their sparse room and they agree not to visit their families at Christmas in order to spend more time together.

Increasingly the world of the hospital and the nurses residence becomes restrictive to Meret and Sarah. The colours are threatening to swamp the monochrome world which has seemed so safe for so long. The novel concludes with an escape and new a new beginning.

A simple Intervention is a powerful allegory of obedience and coercion and the ability to push back. The narrative is sparse and simple yet driven by a strong filmic imagery which suggests that this novel could be easily adapted to the screen. As A Simple Intervention was originally published in German a special mention must be made to the translator, Marielle Sutherland, who must claim part of the credit for the success of this Peirene Press edition.

 – Mark Roberts

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Mark Roberts is a writer, critic and publisher living on unceded Darug and Gundungurra land. He is co-editor, along with Linda Adair, of Rochford Street Review. His latest poetry collection, The Office of Literary Endeavours, was published by 5 Islands Press in May 2025. Mark’s writing on poetry and culture can be found at https://printedshadows.com/

A Simple Intervention by Yael Inokai, translated by Marielle Sutherland is available from https://www.peirenepress.com/shop/books/a-simple-intervention/

 

1. Kessler, Ronald (1996). The Sins of the Father: Joseph P. Kennedy and the Dynasty He Founded. Warner Books. [↩]