A Simple Procedure

Author: Yael Inokai
Translator: Helen Nurse

Translator’s preface
A Simple Procedure is set in an unspecified time and place in a hospital that has recently introduced a radical new procedure to cure mental illness. The nature of the procedure is never explained, although it is clear to the reader that a form of lobotomy is being practiced.

At the hospital, three women’s lives intertwine. Meret is a psychiatric nurse. She is proud of her role and hopes to give her patients a better life. Growing up with an abusive father, she has learned to be watchful, cautious and restrained. Meret’s new roommate is a breath of fresh air – warm, messy and rebellious, Sarah works on a different ward as a maternity nurse. Through meeting Sarah and a new patient Marianne (the third important figure in the novel), it slowly dawns on Meret that not everything is as it should be at the clinic and we develop a creeping sense of dread for the safety of the three women. They seek to break free from the rigid hierarchies and male power structures that contain them.

In this extract, Meret meets Sarah properly for the first time. Although they have been sharing a room for weeks, their shift patterns have meant they kept missing one another.


A shoe lay on the floor. A single shoe, lying on its side, like in a bad play. That was the sight that met me when I came back to our room after a long shift. The shock made my cup slip from my grasp. It smashed to pieces on the floor.

“Hello,” said the head, emerging from under the covers. “There was no need for that.”

I froze. And stood there whilst Sarah studied my face, waiting for me to identify myself. “It’s me,” she said after a while. She pointed at herself. “Your roommate. Sarah. We met recently, for … two minutes, if memory serves. Remember?”

Sarah. I repeated her name in my head. Where it had often been in the past few weeks. After we last met, I’d felt sure I’d just have to get used to her absence again. I tried to comfort myself by thinking of how exciting our work at the hospital was right now. That we were looking at a future full of hope. So really, it was good that I would be left to my own devices in this room, alone with the day and the procedures.

“I know,” I said hesitantly, “I know who you are. Of course I do.”

She threw back the covers. Without taking her eyes off me, she got up, came towards me and knelt on the floor to pick up the pieces of the cup.

“No!” I cried out.

“Yes,” she said, “It was me who made you jump.”

“Your shoe.” She was too close. I wanted to give her a hand, but she was too close. “Your shoe made me jump.”

She looked around until she found it. “Oh, I see. Sorry, I just had to throw something.”


“Don’t you ever have the urge to throw something?”

Good question. “Sometimes I do,” I admitted. Then I thought of how I punched my pillow instead, bit into it, screaming. I wasn’t a shoe thrower. If I needed to, I let my frustration out on a pillow. Like the small child I once was.

“I’m just going to get something to wipe this up.”

She left the room and I stood there, just stood there, rooted to the spot, like a pillar of salt. I’d often felt like that at the beginning, at the hospital: frozen into a pillar of salt when I experienced people in their helplessness. I hadn’t realised how ugly helplessness could be. When the older nurses hissed in my ear, snatching things from me that I was busy with. Wasn’t all that far in the past now though?

Sarah returned. Her smile brushed me as she passed. She wiped up the spilled liquid with a cloth, then left the room again. I managed to shake off my frozenness. I took a few steps to my bed, where I sat down and stared at the shoe. For a moment, I was in a daze, like after a dream.

“You wanted tea, didn’t you?” Sarah came in and opened the drawer of her bedside table, a few small bottles clinking together. “Maybe you fancy something a bit stronger though? We haven’t had a toast yet, to us living together.”

“We’ve only met twice.”

“True.” She got one of the bottles out of the drawer, took out two shot glasses and filled them to the brim. She handed one of them to me.

“To us,” she said and raised her glass to me.

“To us,” I said and tipped the schnapps down in one go to stop myself spilling it. The alcohol burnt my throat. We sat there for a while, twisting the tiny glasses round and round in our hands.

“I’m going to be here more often from now on.” She poured two more shots. “Mind you, more often is kind of relative when you’re on nights. What about you? Always on days? On the fifth floor, right?”

I nodded. She must have heard stuff about me. Complaints from the others probably; that I was never up for a laugh, that I never wiped my shoes properly, that I let my sister ring me at all hours but never woke up when the phone rang. If you’d been living in halls long enough, people only mentioned your name when there was something to complain about.

“Don’t worry.” She downed her schnapps in one. “I’m not interested in talking about work the whole time. Listening to the others here, you’d think that’s all there is to life.”

“What else is going on in your life?”

“Well …” She smiled, caught out. “Work, mainly.”

“Are you on the third floor?”

She nodded.

“And? What’s it like?”

“It’s …” She looked past me out of the window. “I’m still getting used to it.”

“Are things not so great with the older nurses?”

“No. It’s not that. It was just different before. More relaxed. I used to go to women’s homes and help them deliver their babies safely. It was so … intimate. Now the hospital always stands between me and the patients.”

“Why did you leave?”

She looked at me again. “Why do you ask so many questions?”

I fell silent all of a sudden.

“I’d rather hear about you.”

“I like it on my ward. It’s …”

“About you!” she cried out laughing, “Tell me about you, not about the hospital!”

“Oh.” But all of a sudden, I couldn’t think of anything to say.

“We haven’t seen each other for weeks,” I said instead. I didn’t say, I thought you’d been avoiding me. We’d managed to keep missing one another so reliably. I thought, you’re not like us, you don’t sleep, one life isn’t enough for you, you’re leading dozens.

“I know.” The smile disappeared from her face. “I just couldn’t …” She looked down at her hands. “I just didn’t want to come back to an empty room. The past few months have been tough.” She poured herself another schnapps, forgetting to pour me one. “I saved up my days off so I could go to my mum’s. Sometimes … I stayed over at the other night nurses’. But it’s better now. From now on I’ll be a better roommate.”

I thought back to our last meeting. She’d closed the door behind her and something fell from her. Her composure. Maybe she hadn’t been coming back from the hospital then.

She had a broken heart. I could see that now. She drank a third schnapps, downing it with her eyes closed.

I didn’t want to feel surprised. The nurses met up with men, I knew that. If they didn’t have any free time, they snatched a few free minutes, relaying things they’d heard in the immediate vicinity of the halls or creeping off to a quiet corner of the hospital, where they couldn’t be seen. Some nurses left their jobs for men. Went away, just like my old roommate. Yet I still thought some of them were above all that. The older nurses, who lived here in halls or shared small flats in town. Those old spinsters who sat reading the paper in the evenings, causing the younger ones to announce: “I’m never going to turn out like them!” But their lives didn’t seem all that bad to me.

“What happened?” It was none of my business. I wanted to know everything. I would empathize, smile, say comforting things, like a good roommate. I wouldn’t be disappointed that Sarah was as ordinary as everyone else when it came to affairs of the heart.

“Decisions were made. For a different life.” She put her glass down, shaking her head, wanting to change the subject. “Read me something?”

“Out loud?” She’d said it as if it were a routine thing between us.

“Anything. No sad stuff though. I’m not in the mood for it.”

I looked at the pile of books she had. “No, none of those.” She swept the books off the bedside table onto the floor. “Load of depressing rubbish.”

I thought about Bibi’s book. That was no good. The schnapps, and therefore my courage, was out of reach.

“I just want a story. Don’t stress over it. Or don’t you have any books with you?”

“I’ve got a children’s book.”

“A kid’s book?” She got back under the covers. I bit my lip. She’s going to laugh at me any minute, I thought.

“Perfect.” She stretched. “One of your old books?”

“My sister’s.”

I got up and went to the cupboard. I pulled Bibi’s favourite book out from under a pile of folded clothes, the one about Mrs Fox who travelled the world in a hot air balloon. “She wanted to hear it over and over again. She’s five years younger than me.” My tongue started to loosen. “When she was younger, she used to sleepwalk. My sister, she … I thought she was afraid of sleeping. Later, she couldn’t remember that she’d been walking around our apartment, but afterwards she was completely exhausted. Well, maybe on one level she did realise that she hadn’t been lying there asleep like everyone else and she did somehow know she’d been off on her travels, climbing stairs. This book was the only thing that we could get her back with. A secret weapon. Our secret weapon.”

Sarah put out her hand. “Show me,” she said. Whilst the waterfall of words echoed in my head, she ran her finger across the old pages, along the bits of sticky tape that held the book together.
“What’s your sister called?”

“Bibiana. Bibi. I’ve got a brother too, Wilm.”

“There’s only my mum and me.” Sarah shut the book again. She handed it to me and closed her eyes, folding her hands over her stomach.

“Right. I’m ready.”

When I woke up, the book lay open at my side. The day awaited me. Sarah was still sleeping deeply. Or had she just fallen asleep? She was a night owl after all, the morning usually signalled the end of her working day. How could I have missed these last few hours with her?
Then I remembered, her broken heart. That she wasn’t above all that. Instead of feeling disappointed, I felt intensely angry with the unknown individual responsible for it all.
I took the book and put it on her bedside table. Then I picked up all the books she’d knocked off the night before. I wasn’t going to touch the shoe. It could wait for me until I got back. Or stay there forever as far as I was concerned.

I stood next to her for a minute. I had a minute to spare. I would have to hurry afterwards, but I wanted to look at her, watch her for a moment whilst she was breathing, dreaming, maybe; her eyelids were flickering.

Mrs Fox will keep you company, I wrote on a torn piece of paper and tucked it in the book as a bookmark, putting it on her bedside table.

When I came home, there was a book on my pillow. The cover told the story of a young man who liked walking around and thinking about the world. Next to it, a folded note.

Here’s what people do when they’re not working all the time. S.

Sarah was right. We bumped into each other in our room at least once a week now, but it still startled me a bit every time we met. Like on that day in December when she suddenly stood in the doorway. I was in the middle of packing to go home.

“What time does your train leave?” she asked, without saying hello.

My heart did a little jump. “In two hours.” I was always a bit surprised when I saw her face, because it looked different to how it was in my imagination. Not the details. I knew those so well. I could even correctly place the small birthmark under her left eye. But she, as she stood there opposite me, was not the same girl as the one in my head.

“Mine’s going in half an hour.”

Sarah came in and closed the door behind her. Her suitcase was ready to go on the chair, its contents bulging. Like me, she would soon turn into a daughter again too.

Every other year, we were allowed to go and see our families over the Christmas holidays. The thought of it didn’t fill me with any joy. I imagined the kitchen table, the place not set for Bibi. I remembered the silence and the eruptions which broke it. In our family, nothing cried out more for a row than a festive season where everyone was supposed to come in peace. Our neighbours were the only people who could keep us in check. Once we heard them arguing through the thin walls, we quietened down. After all, we weren’t like them.

“I’d hoped I would have to work,” Sarah said. She’d sat on the bed and talked to my back.
“Me too.”

That seemed to surprise her. “Really?”

She had the ability to make me feel like that. She hesitated as if she doubted that I was telling the truth. And I began to doubt if I was telling the truth as well. Perhaps I just wanted to make her like me.

“Do I look like the others, walking happily around the place?”

“From behind, you always look very happy.”

That made me laugh.

We nurses had been seized by a great sense of haste in the past few weeks, propelling us through the hospital and our halls of residence. But there were a few upbeat types who remained unfazed by the relentless slog to the year’s end. In their first few months here, those from happy families still read their letters out at supper, constantly on the phone, talking proudly of how homesick they were. That wore off, bit by bit. But their old habits could be depended on to rematerialize before the holidays.

“Lots of arguing?” she asked.

I nodded. I thought about the peace, the actual, inexplicable peace that sometimes descended on the ward over the holidays.

“We argue too, mum and I. We argue from dawn to dusk. In between we carry out these weird rituals, cooking together, praying, lighting candles because … I don’t know why we do that, to be honest. During the holidays I never really know why.”

“Because it is the clay from which we are formed.”

I glanced quickly at her over my shoulder. She smiled. “It’s easier here,” she said. “When the others have gone, I can work. Then there’s no-one in the way between me and the job.”

“Is that why you always work nights?”

“One of the reasons, yes. I like the night.”

“I don’t. It scares me.”

“The day scares me.”

My suitcase had been packed ages ago, so I just rearranged my things. I moved my washbag from one side to the other. I rolled my socks together, then unrolled them again, wanting to keep my hands occupied.

She scuffed her feet on the floor. I thought briefly that she was anxious too, that her body felt as strange and awkward in my presence as mine in hers.

“I want to ask you something,” she said. I unpacked my two cardigans, refolded them, put the edges together so that they fitted perfectly. It was ridiculous, I thought. Any minute now, she was going to notice how ridiculous I was.

“Can I?” she asked again, insistently.

I realised I was supposed to answer. “Of course.”

But she didn’t ask me anything. The room stayed silent, so I turned round to face her. She had lowered her head.

Any minute now, she’s going to tell me she’s leaving, I suddenly thought. Like my other roommate, she’s going to say that she is off to start a new life. And there’s nothing I can do to persuade her to stay.

“Will you stay here with me?” She said it so quietly that I nearly didn’t hear her. “Shall we stay here?” she said again when I didn’t answer, this time more loudly. “We’ll unpack our stuff. We’ll ring home and say we have to work.”

Impossible, I thought. Her suggestion was impossible. To let the train go without me, and the next one and the one after that, until there were no more trains left. To hear the others set off to their families or to work, one after the other, until the halls were completely empty.
Only we didn’t have to go anywhere, nobody was waiting for us, we didn’t have to do anything.
“We can’t,” I said.

“OK.” She came over to me, opened the wardrobe and took her coat off the hanger. “You’re right.” She pulled it on. “It was a stupid idea, right? After all, we’ve got …” She tried to find the right word.


She picked up her case. “Take care, Meret. See you soon.”

“See you.”

And she would have left if I hadn’t started to laugh. As she turned her back on me without a parting glance, the laughter burst right out of me. At that moment it seemed so absurd that we were both going home, even though we had the option of staying put. How could it be harder to stay than to go?

“Are you alright?” She frowned.

“Stay.” I was laughing so hard I could barely get the words out. “Please. Stay.”

From Yael Inokai,  Ein simpler Eingriff, Hanser Berlin, 2022.