Children s Neurological Development Of Schizophrenia

The goal of this case study is to provide a basis on children s neurological development of schizophrenia including family history, genetics, environment and culture to determine the major biomedical aspects of the etiology of schizophrenia in young to middle adulthood. The study addresses the debilitating positive and negative symptoms of schizophrenics plus presenting problems, such as living life according to unacceptable social norms, and caring for one’s basic needs, while including assessment tools and diagnostic scales of childhood schizophrenia in Jack according to the American Psychiatric Association’s Diagnostic Manual of Mental Disorders, Fifth Edition. A comprehensive treatment plan assesses the outcomes of the most successful†¦show more content†¦Keywords: Early on-set schizophrenia, childhood schizophrenia, positive symptoms, negative symptoms, cognitive deficits, restricted affect, hallucinations, delusions, cognitive-behavioral therapy, Clorazi l, antipsychotics, case study The Case Study of Jack: Early On-set Schizophrenia Schizophrenia is a form of psychosis, which are mental illnesses that are characterized as unusual behaviors exhibited as out of touch with reality. Schizophrenia is characterized by positive symptoms such as delusions, hallucinations, disorganized thoughts or speech, and catatonic behavior. While negative symptoms range from cognitive deficits to restricted emotional affect. According to the Harvard Mental Health Letter (2009), there are five stages of progression of schizophrenia: premorbid, prodromal, psychotic, transitional, and chronic. Early on-set schizophrenia develops in children who experience odd or unusual auditory hallucinations and olfactory delusions in the prodromal stage. It is thought that schizophrenia is fully developed at the psychotic level, once an individual has reached their first psychotic episode. However researchers suggest looking into the prodromal stage through assessment and diagnosis to learn more about the etiologies of schizophrenia, and therefore c ontribute further research into preventative methods. According to the National Institute of Mental Health, childhood-onset schizophrenia is a rare form of schizophrenia which has its onset before

Writing Analysis My Writing - 950 Words

My Writing Wall Writing isn’t for everyone, yet the number of people writing in this exact moment is pretty monstrous if you google it. Writing has basically been there for me since I was born, it was there when they wrote my birth certificate, when i was learning how to write my name, when i wrote my first essay, taking the STAAR tests, practicing for the AP test, to my first writing assignment for college. People are gifted with creating such rich, breathtaking, emotional, and deep work that last for generations and generations (not me), but writing has not always been a friend to me. The process of writing is not just write and your done, no you need to take time and let your ideas gush out (duh you already knew that) but also to edit and revise to make those final drafts. Writing can be a huge pain in the buttocks (ass), but it isn t that bad. Here are some of my issues and strengths about writing and my take on it. Now it just hit me that this exact moment I m a freshman in college. I am a writer the time my pencil touches that paper and when I put my name on something I sure hell want to be proud of it. Every time I write I want to make a personal connection, so it can be painless for me to get ideas and to relate. In my opinion, disregard that, I am a disgrace in how I can t spell, like I am a joke. Sometimes I feel I have dyslexia, I think about writing â€Å"how†and I end up writing â€Å"who†; I flip letters around and confuse myself. I can t spell February, avocado,Show MoreRelatedThe Rhetorical Analysis Of My Writing1443 Words   |  6 Pagesblood. I ve always liked writing. Even before I knew how to write I would make up stories and pretend to write them down. Each year in high school I ve written a multitude of essays on varying topics. I have selected three of these writings from each of my years in high school to examine as part of this rhetorical analysis of my writing history. As I ve grown older, my writing style has changed and I ve learned more about the world and developed my own personal writing voice more and more. LikeRead MoreRhetorical Analysis : My Writing Skills894 Words   |  4 Pagesam tearing my hair to squeeze every single word from my poor mind to finish this letter. Yet deep in my frontal cortex, there is no part of mechanisms that is designed for writing a self-analyzing letter to my instructors. However, it has been ten weeks I studied in this course, and all my favorite works in these ten weeks are gathering in this tiny portfolio. I have wrote a several rhetorical practices that taught me basic rules of rhetorical essays. I have wrote a rhetorical analysis, which explainedRead MoreAnalysis Of The Writing And Performance Of My Town Hall Speech1570 Words   |  7 PagesInterpretation of Survey Results The results of this survey provide critical information for the writing and performance of my town hall speech, including both which arguments will be most effective in persuading my audience as well as the persuasive methods that will be of most use to me. Questions 1, 18, and 20 provide information about the audience’s knowledge of the current state of debt in Ohio, as well as allowing the audience the opportunity to contribute information about any debts thatRead MoreWriting A Rhetorical Analysis On My Service Learning s Organization Website853 Words   |  4 Pagesoutcome is to develop flexible strategies for revising, editing, and proofreading writing. I believe that my first and third short assignment, and the second major paper will be able to demonstrate my ability to pull from given feedback by instructor and peers to successfully revise in order to produce effective works. 1. The writing demonstrates substantial and successful revision. After receiving the feedback for my first short assignment, I realized that were a lot of revision that needed to beRead MoreProcess Analysis Reflection1066 Words   |  5 Pagesgood writing. Little did I know everyone’s writing style is good in its own way. This academic writing class proved to me that no writing style is right or wrong, but instead all writing styles have their own uniqueness and character to them. After reading the assigned articles and analyzing the writing process and other topics discussed in this class, I now see writing as an extraordinary process that is different for everyone. After writing papers and getting feedback, I saw where my writing lackedRead MoreHow I Am A Writer Essay1112 Words   |  5 Pageswriter. When it comes to writing or having different writing assignments, I have to write everything down on a piece of paper to get my thoughts out and just let my pen flow. I tend to write essays only when I am assigned, but for the most part, I write everyday. I personally like to write about me in particular but mainly I enjoy writing about overcoming different obstacles people face in life or about the future. As a writer, you will have different weaknesses and strengths. My weakness is sometimesRead MoreHow Can I Write An Essay Essay1285 Words   |  6 PagesFor as long as I can remember, I began writing in Nursery School what is Pre K in the U.S. These moments in kindergarten I was focusing on drawing perfect circles, squares , tracing letters and writing my name so I can begin to writing clearly. This was not to test my ability on how effectively I can write but how I can look at things and make my writing similar to someone else s. As i progressed to a higher grade I focused more on effectively my writing can become by using punctuation. In GradesRead MoreThe Literacy Narrative, A Discourse Community Analysis, And A Writing Research Essay1180 Words   |  5 PagesIn my English 1010 class, I have learned to do a n umber of things through writing essays. I have written a Literacy Narrative, a Discourse Community Analysis, and a Writing Research essay. Firstly, I have learned to identify how an author’s purpose, audience, genre, and context determine effective writing. The purpose of the literacy narrative was to help me understand myself better as a writer (Jones 1). My teacher was the intended audience of the narrative. The genre of the narrative was non-fictionRead MoreCritical Thinking Skill At Me My Professor948 Words   |  4 Pagesopportunity to explore my imagination; everything that I learn is factual and unquestionable. Having the opportunity to take an advanced course such as English 1301, opened the window to a world of imagination, information, and wisdom. Prior to taking this course I struggled with different writing skills such as, understanding the process of writing, analyzing reading selection and applying basic critical thinking skill in an argumentative essay. I also struggled with the analysis of specific contentRead MoreAnalysis Of The Poem I Was The Hardest Paper For Me 899 Words   |  4 Pagesto have another situation like in my literary analysis. I found that I often discouraged myself several times why writing. The paper I want to focus on in this reflection is my Analysis paper. The analysis paper was by far the hardest paper for me. Not because I did not know how to do it or even for the simple fact that I did not want to do it. I was hard because I could not figure out which way I wanted to portray the poem I decided to work with. During the writing I found myself starting over many

Colonial Architecture Essay Example For Students

Colonial Architecture Essay By Mason ForandoAll the colonial houses are alike. From the least important placeslike farms to places like Monticello all the houses were built in thefederal style. The federal style just means that the house would bebilaterally symmetrical. If there was five windows on the top half, thenthere would be five on the lower half (same on the left and right side). When the plantation owners were in the heat of summer they would cometo these houses in Beaufort. Inside these houses, an arch would separatethe public and private side. On the public side there would be rooms likea dining room, an office, a ballroom, and a living room. On the privateside there was the bedroom and kitchen. The public side it was generallyfancier and had the expensive things in it. Also inside these houses was a natural wind flow. They accomplishedthis by having two doors in every room so when they opened all the doorsthe wind would flow throughout the house. The doors look like closets butthere is no real closets in the house. The colonists would party a lot. They had a ballroom on the secondfloor for two reasons. To have a good view, and to keep away the flies. There was a ladys ballroom ( a present from the husband) coming off fromthe ballroom so the women could leave the party and just chat about thecurrent events. The houses had no plumbing, and no heating so the colonists neededfireplaces and outhouses. The fire places on the public side were Adamsfireplaces (expensive) and was elaborately decorated. They were made ofmarble. The ones on the public side were just there for heating purposes,not decoration.

Obsessions and the Downfall It Brings Upon Life Essay Example

Obsessions and the Downfall It Brings Upon Life Essay Obsessions and the Downfall it Brings Upon Life What is the first thing that comes to mind when someone speaks of obsession? For most people it is the obsession with media or someone with no life, or maybe both. Inside almost every single person’s mind is someone or something they are passionate about. Not only are they passionate about it, they are obsessed. So much that they are unconscious that their obsession be dangerous to themselves as well as others. In Lolita by Vladimir Nabokov, Perfume by Patrick Suskind and Obsession by DaMoyre, they all express different stories of obsession, but they all mainly have the same concept. Their obsession is what brings the downfall of themselves, as well as the surrounded environment they are in. For example, in Lolita the downfall is that Humbert does not know that he is being taken advantage of when Lolita asks for his money, same with Obsession, the young girl in the story is too naive to even care or know that she is being taken advantage for her body, not her feelings or personality. Finally in Perfume, it is evident that society would view Grenouille as someone with no life. His life and perfume are all that he cares for and surrounds himself with. We will write a custom essay sample on Obsessions and the Downfall It Brings Upon Life specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Obsessions and the Downfall It Brings Upon Life specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Obsessions and the Downfall It Brings Upon Life specifically for you FOR ONLY $16.38 $13.9/page Hire Writer For example, if Grenouille smelt a desirable scent on someone, he would do anything to get that scent even if he had to harm that person. This demonstrates that he is so tormented with his obsession that he has no care or sympathy for anyone. The protagonists in Lolita, Perfume and Obsession are unaware that their obsession is not only hurting themselves, but hurting others too. They may interpret the obsession as a sign of love, but society views it differently. What does society view it as? Society has a book of rules, and being overly obsessed is viewed negatively and as a huge problem. Also, since obsession can often be mistaken as love, it is easy for people to fall into that trap and become victims to that problem. In the three literatures, Lolita, Perfume and Obsession, they all surround on the theme of obsession. In Lolita, it is a story of a man Humbert Humbert, who develops a strong interest in young girls or in his words, â€Å"nymphetsâ€Å". He started having a fixation with young girls ever since his love as a young teenager left him. From there his obsession with nymphets continued, until his one love Lolita completely took over his life. At this point, Humbert Humbert was willing to give her all she wanted, whether it was material things or money. In Perfume, a different kind of obsession kicked in. As a young boy, Jean-Baptiste Grenouille did not have a scent; this alone had the biggest impact on his life. As he grew older it was something he desperately longed for, as a lack of scent was found odd and unusual in his society. He was abandoned many times when he was a child, not due to his attitude or his behaviour, but due to his lack of smell. Through this experience, he developed a strong obsession of getting certain scents and perfumes. Eventually he learned the art of perfumery and mastered techniques that no one had done before. However, what was unexpected was the limits he was willing to cross to reach his goal even limits like murder. Finally, in Obsession, the story is about a girl who is completely in love with her man, again willing to do anything for him. She in ways many may not understand; the words she uses are almost abstract in art. Her obsession is her weakness, even her man knows it and this is what leads to her downfall. He uses her weakness as an advantage and uses it for his own wants and desires, mainly his sexual desires. When something is unnatural, it means it is altered with. For example, when we pose for a photo it is unnatural thus making the picture look a bit odd to how one sees the world. In Lolita, what is so unnatural about the obsession of the protagonist, Humbert, is the huge age gap between Lolita and him. The cause for Humbert’s obsession is one of his earlier lovers Annabel. She died from a disease called Typhus, which made him long for that feeling of love again. He attempts to experience that kind of love again and as he grows older, however his mentality and maturity still remained the same. Unlike most people, Humbert does not move on to the future. Instead he makes himself believe he is staying exactly where he used to be emotionally. But physically, he is a man of old age, which makes his want for nymphets really disturbing to society. Then, when Humbert met Lolita, he felt like he had found true love again and was willing to do anything to be with her. For example, when Lolita’s mother Charlotte Haze threatens Humbert with marriage or the consequence is that he has to leave their house, Humbert ultimately sacrifices his own freedom to be with Lolita. [Mrs. Haze] had left half an hour before, and getting Lo instead, I told her I was going to marry her mother. I had to repeat it twice because something was preventing her from giving me her attention† (Nabokov 72). Humbert tells Lolita that he is going to tie the knot with her mother. He is not only doing this to prevent himself from being kicked out, but because he wanted to be able to see Lolita everyday. Not only are his actions sacrificial, they also cause Humbert to lose his liberty, dignity and most importantly himself. Losing freedom could be compared to being locked in a prison – reason being is that both result in lost of free will or choice. From Lolita’s end, it is very obvious she does not seem to care at all about the marriage. Humbert says, â€Å"I had to repeat it twice because something was preventing her from giving me her attention† (Nabokov 72). Marriage was, is and always will be a special event in everybody’s life. However it seems like Lolita was purposely not paying attention and not caring, which gives a clue that she may not feel the same way as Humbert does about her. Near the end of the novel, Humbert due to his unnatural obsession goes insane when he finds out that Lolita had another lover behind his back. â€Å"On his way to kill Quilty he puts on black clothes, ‘I was wearing a black suit, a black shirt, no tie’, the classic western villain† (Quin 1998). Humbert was willing to murder for the love of his life, which society would regard as disgust. Though his love was strong for her, his actions went too far. Murder is a sin and an illicit action that is strongly condemned. In Perfume, what is so odd about Grenouille’s obsession is that he is fixated with something he longs for. Just like Humbert longed for the feeling of young love, Grenouille longed for the scent he never had. His childhood memories consisted of being passed along and abandoned because he lacked something essential that everyone else in society had. Because of this, he developed a twisted obsession with scents. Also, it encouraged him to strive towards making the ultimate perfume to satisfy and try to fit in society. Just like Humbert, there was nothing anyone could do to stop him – even murder. Although Humbert, Grenouille and Anonymous’ stories have the same concept of â€Å"unnatural obsession†, they all have perspectives of different kinds of obsessions. For Humbert, his story may be disturbing due to the age gap, Grenouille’s is disturbing because he is obsessed with a chemical, and finally Anonymous’ is disturbing because she represents someone with no future and life. Life is a big part of us, and that is why these characters are considered abnormal in society. â€Å"Grenouille never again departed from what he believed was the direction fate had pointed him. It was clear to him why he had clung to life so tenaciously, so savagely. He must become a creator of scents. And not just an average one. But, rather, the greatest perfumer of all time† (Suskind 44). It is evident that Grenouille is committed to his life goal. He wanted to be the God of scents, the creator, and the boss. He did not want anything else in life, which to society may seem odd. For example, since people are so used to seeing what is normal/typical, when they see a person with a disability they often stare at what is out of the norm. The same thing applies for people with and without unnatural obsessions. Society would treat people with obsessions like they are odd, and even outcast them. But what is the definition of normal and does it apply to everyone? The truth is that the definition of normal differs for everyone. Once again, society has a book of rules and the predetermined definition of normal is a person who has all their body parts, no disabilities, and strives for similar goals in life like success in areas of love, school, work, and their social life. However, Grenouille’s actions do not fall in the category of normal, therefore regarding him as unnatural and irregular. If Grenouille is the hero of the novel, his obsessions are also its informing presence† (Ackroyd 1986). Grenouille’s obsession is so strong, that it could be considered as another person, another living thing, but of course that is what makes it so unnatural. In Obsession, the protagonist who might as well be Anonymous is a young girl who is naive and clueless around the nature of love, t herefore she falls in love with the wrong guy. In return, he does nothing but secretly use her for his own sexual desires, showing a very selfish act. She never realizes the truth about his feelings and continues to mourn for him even after he leaves her. â€Å"An obsessive mind, a morbid romantic, struggling between fantasy and reality I dreamed of love† (DaMoyre). The protagonist is aware of her state of tormented mind, but she is unaware of the fact that it is unhealthy for her to keep thinking about him. There are more important things for her to worry about such as work, her social life and school. Her love for her boyfriend is so deep but the problem is that he does not feel the same way. When their relationship does end, the boyfriend moves on but she stays in the same spot, looking for her next prey. Her obsessive mind does not cure, she just longs for more love, passion and inevitably pain. Although her obsession may not be as odd as Humbert’s or Grenouille’s, it is still considered an unnatural obsession to society. â€Å"The term obsession refers to images, ideas, or words that force themselves into the subjects consciousness against their will, and which momentarily deprive them of the ability to think and sometimes even to act† (Hayat 2005). The word obsessed is something we use in our everyday vocabulary especially in the teenage community. What we do not realize is that the word means much more than intended, just like the word â€Å"gay† is. These words have become trends, but they should be taken more seriously because true obsessions can be a disorder. People who are overly obsessed, especially with unordinary things should not be ignored, as it can be a serious problem. For example, Anonymous is unaware that her obsession is hurting anybody, therefore she continues and lets other take advantage of her. All three literature works are based around an obsession we do not usually encounter or hear about and because of that, the protagonists do not notice that they are harming themselves physically, emotionally, and also the people around them. In today’s world, being isolated is the worst thing because we are educated that isolation causes us to be narrow-minded and not see the other side of the world. In Lolita, Humbert isolates himself from society, especially when he meets young Lolita. He thinks old women are disgusting hags, even if in reality they are beautiful women. He isolates himself from other things in society that he should be doing. For example, most thirty year old men are trying to fulfill their goals in work or family, but Humbert’s only goal and focus is unlike others around his age – a young innocent girl. â€Å"I think I had better describe her right away, to get it over with. The poor lady was in her middle thirties, she has a shiny forehead, plucked eyebrows and quite simple but not attractive features of a type that may be defined as a weak solution of Marlene Dietrich† (Nabokov 37). From what Humbert speaks of, it is fair to draw the conclusion that he is turned off by older woman. The reason being is since his first young love, he has isolated himself from other selections that may suit him better. For example, if a child had a choice of chocolate, vanilla and strawberry ice cream, but could only choose vanilla because he believed chocolate and strawberry were poisonous, he is then isolating himself from something he could potentially be enjoying. The same concept goes for Humbert, since isolation is consuming his life, he does not see the enjoyment in life that others in society may. And because of that, he is unaware that he is isolating himself and also Lolita along with him. Lolita is all he ever thinks about which would prevent other thoughts that he could be thinking about, such as â€Å"What do I want to become? † or â€Å"Do I love Lolita, or the childhood memories of Annabel? † However, Humbert does not realize this and goes on being blind to what is happening to him. â€Å"Lolita, on the other hand, is all colour. Humbert thinks of her as ‘a little ghost in natural colours and as ‘the beautiful warm coloured prey’ (Quin 1998). As already stated, it is obvious Humbert spends a little too much time thinking about Lolita, and making her thousands of different meaningful poems about her. In Perfume, it is even more obvious than Humbert that he isolates himself. In Grenouille’s case, he has to work hard to get to his goal. At first when he is learning to incorporate different ingredients and natural scents into his perfume experiments, he discloses himself from anyone and everyone. He concentrates and focuses on the perfumes and nothing else, thus hiding himself from society. â€Å"After a few weeks Grenouille had mastered not only the names of all the odours in Baldini’s laboratory, but he was also able to record the formulas for his perfumes and other scented products. And not merely that! Once he learned to express his fragrant ideas in drops and drams, he no longer needed the intermediate step of experimentation† (Suskind 92). All the skills and methods he learned and mastered in perfumery took him a lot of time, which resulted in isolation once again. He isolates himself in the laboratory to test his experiments, discover new methods to preserve scents, and come up with new aromas to put on himself. To skip an intermediate step in experimentation is probably Grenouille’s biggest achievement, and if one were to predict how long he spent doing so, it would be days after days of isolation from society. Of course, society does not view this as normal behavioural traits. Nonetheless what does the society book of rules say about isolation? For one it states that one needs their own time alone, but only briefly. If isolation happens, there is definitely a problem developing. â€Å"You cannot have both love and life; to demand both is to come to a grisly end† (Prescott 1986). In Grenouille’s case, this is what he thinks but is reality like that? Many successful people out there have both a life and love; it is not a big deal to balance the essentials in your life. For example Hilary Duff is now known as a worldwide singer and actress, she gets along with her family fine and although she just broke up with a long time boyfriend, she is not sad about it she does not isolate herself because she has a job to do – make music for the world to hear. In Obsession, Anonymous isolates herself thinking about her lover, just like Humbert does. All throughout the poem, instead of expressing her feelings of the world around her, she talks constantly about her lover and how she misses him. â€Å"A trap, a cage, prison of death underground† (DaMoyre). She expresses herself trapped in a cage just like being in a prison of death underground. She is being suffocated like a prison underneath his love and she pulls him with her. She is isolated from society, and as a teenager she is supposed to have a future for herself, but apparently does not seem to have one. Again, she is aware of herself being isolated and isolating her lover, but what she is unaware of is that it is unhealthy to both her and her lover. Instead of keeping him by her side, knowing he is not cheating or whatever she is trying to prevent, she is making their relationship go downhill. What is the difference between love and obsession? Love is when you are passionate about something or someone and appreciate them for what they are. Obsession on the other hand is love except it is on an extreme level in which that something or someone is the only though in your mind, the only thing in your life. There is a thin line between love and obsession, and it is very easy to mix the two around and maybe possibly mistaken one for the other. Humbert thinks of Lolita as a lover, and would probably never classify himself of having an obsession with her. Most people are unaware that they are crossing the line just because it is hard for them to distinguish the difference. Humbert has been a person trapped in an obsessed world all his life, even with his first love Annabel. They were young and naive and therefore experimenting with young love, but even when she died he had memories of her. He never threw away those memories until he met Lolita. For most people, although it is painful to have someone you loved pass away, but one would mourn over it, and then move on because there are bigger things out there in this world. However Humbert did not seem to believe this. Lolita, light of my life, fire of my loins. My sin, my soul. Lo-lee-ta† (Nabokov 9). Among the first few lines of the book, it feels like Humbert just stepped over the line to obsession because books usually start pleasantly setting the image for the reader. However he displays a selfish impression and talks about his love without being kind to the reader and explain ing what is going on. Oftentimes, people would say, â€Å"I love ice cream† or â€Å"I really love this song†, but do we really mean it? Do we really love that song? Sometimes it so happens we do, but people are misusing the word love. What does love mean by the society’s book of rules? Well for one, it is a word that is mainly used for a person that you have been in a relationship for some time. It only makes sense to use it for someone you truly care about, not something that is just going to be another phase in life. But that is when obsession kicks in, once you truly love someone it is really close to becoming that obsession you never wanted to encounter. The definition of obsession is just a step higher than love; it is not that far away which is why obsession is taking over the protagonists in the three literature works so easily. Humbert refers to Lolita’s â€Å"tender, mysterious, impure, indifferent, twilight eyes† and to the â€Å"smoother, tender bloom† of her (Pifer 1999). It is obvious that as lovers, it is nice when one compliments another to make them feel better and have a day full of enjoyment. But Humber again goes far out on it, and describes her like she’s a fl ower or animal that he uses for pleasure. He describes Lolita as the love of his life, but does he really love her or is it more than that? He does not just love her, he is obsessed and it is evident that not even he can stop himself. But because he is so obsessed, he is treating Lolita in a way that a young girl should not be treated like, he is making her experience things she should not be experiencing until she is a fully grown adult. Of course due to his desire to satisfy his sexual wants, he does not care about anything else, just Lolita and her tender young body. Instead of relationship, Grenouille in Perfume has a strong passion to search for the perfect scent since he was deprived of a human odour. It is true that most people have a strong passion for something. For example Craig Kielburger had a passion for helping others, which is why when he was only at the age of ten saw a newspaper about poor families in Africa, and desperately wanting to help, created a well-known organization â€Å"Free the Children†. When one is passionate about something, they will do whatever it takes to reach their goal. This is what Grenouille is like, but instead of being just passionate about something, he becomes obsessed which is how he brings the downfall upon himself as well as others. As his obsession grew deeper and developed stronger, he brought the downfall of others by murdering them one by one for their odour. When he was born and knew he was different from what the rest of society was like, he stepped over the line to obsession. He spent a majority of his life in the lab just trying to reach his ultimate goal, was creating the perfect scent doable? What does society view the word â€Å"perfect† as? The word perfect is used in our everyday vocabulary, but again it is misused as the word â€Å"love† is misused. â€Å"Nobody is perfect† is the famous phrase you hear, because it is true, we were created as human beings to sin and make mistakes, so knowing this, it is true Grenouille’s goal is unreachable. As he came out onto the street, he was suddenly afraid, for he knew that for the first time in his life he was giving off a human odor† (Suskind 151). He creates a human odour for himself so he can finally fit into society and be a normal person, but is that what he is? Throughout the whole book he seemed so desperate to find that scent that he was obsessed and over driven about it, that in the end trying to be normal is not normal. â€Å"It was the fresh odor of the approaching day, of the first daybreak that he had ever known in freedom. That odor had been the pledge of freedom. It had been the pledge of a different life. The odor of that morning was for Grenouille the door of hope. He guarded it carefully. And he drank it daily† (Suskind 129). Grenouille now was so in love, so obsessed with odours and scents that he guarded it like it was money. In every society, money seems to be the base of everything, it meant power and high status, however, Grenouille does not care. In his world it seems that perfume is everything, scent is everything and having an odour is everything. He is so unaware that he does whatever it takes to fit in society, even committing the act of murder. Does Grenouille just love his job as a perfumer or is he infatuated to believe that he had to prove to everyone that he is just like everyone else? As Perfume continues, a story of a murderer, he becomes insanely obsessed, crazy and mad to murder every woman who had the scent he was looking for that instead of working hard to be successful, he murders to come to his success. Throughout the whole story of the poem Obsession, the protagonist thinks she is in love with her lover and that she cannot live without him because she loves him so much. What she may not realize is that she has crossed the border of love and into her obsession. Her unawareness makes he think that it is a norm for over love for another in a relationship. The truth is love is a complex thing, but not as complex as she depicts it as. â€Å"And thought, ‘His face shall be my last vision when I die’† (DaMoyre). She pictures her future but not about how happy she will be and how successful she will be, but that the image of her lover’s face will be her last vision. If anything is obsessive, this statement she makes wins it all. Anonymous is young and she is inexperienced, because of that she has no idea what she is doing, and all the things she does not notice herself doing. However the things she does not notice such as her unawareness of obsession seems all a little unrealistic although it does happen. A love relationship is something that should not be complex especially at a young age, because it takes away from the important things such as family, friends and school. In the poem, it does not mention anything about her family, friends or education; her world only consists of herself and her lover. As the definition of obsession was stated before, her life fits exactly into the definition. She is not exposed to society but since her lover does not even love her, he might tell his friends about the story, and his friends posing as society would look at her an insane and mad human being since she is again viewed as someone who is not normal. Instead of making her boyfriend love her, she makes him dislike her more and more which will hurt herself in return because she suffocates him emotionally so much. Unawareness is not only causing one’s emotional distress over the differences between love and obsession, it causes them to not even realize the condition they are in such as isolation and a strong unnatural love. Humbert’s unnatural love in Lolita is finding girls too young for him, he works hard detaching himself from society thinking about Lolita and not conscious that he is possessed by thoughts about her. A similar thing happens to Grenouille in Perfume, he detaches once again himself from society for society, in other words his aim to reach the goal of the perfect scent is to satisfy society’s outlook on him and to fit in it as well. He becomes obsessed unknowingly, but because his obsession is so twisted and odd, society views him as someone who is different. Finally in Obsession, Anonymous is unaware that her love for her lover is pushing him farther instead of closer. In all these literature works, one thing they have in common is that their obsession hurts others as well as themselves physically and emotionally and they are unconscious of it happening. Because of that, the characters suffer thinking that they are satisfying others but in reality, they are just hurting them which is opposite of what they wanted to do in the first place. Thus being unaware of the problem is worse than being conscious of it. In terms of obsession vs. ove, there isn’t a major difference in the three characters because they all cannot distinguish between the two. However there is some kind of difference to when readers discover their unawareness. For example, Humbert only had obsession in his life since his first love in his life, and for Grenouille, it started when he realized people were abandoning him due to his lack of smell. Finally, for Anonymo us, it all starts when her boyfriend leads her on and she falls for the trap of his invisible love. Obsession does not only exist in storybooks, but they also exist in the real world. It’s happened to young kids, teenagers and adults. Let’s face it, it has happened to the vast majority of everyone. First, learning that your inspiration is a person or object, and then loving them so much, one would do anything to fulfill their desire associated with them. Finally, obsession rises and nothing can stop their love for that person or object. For example, a Chinese actor named Andy Lau had an obsessive fan. It seems nothing out of the ordinary but this particular obsessive fan had a father as a reporter and demanded to get a signature and photo from her favourite actor. However, when the father failed to do so, not only was he disappointed, but he was so disappointed and did not want to disappoint her daughter he committed suicide. The moral of the story: the media brain washes us into thinking that being the rich and the famous is the only goal in life thus why obsession exists today. Humbert, Grenouille and Anonymous are just like the daughter and father have an unawareness of their obsession with something or someone leads them to their downfall. The story also proves that an obsession of one person does not just affect themselves, it affects the people they care for and the people that they influence everyday. Works Cited Ackroyd, Peter. Patrick Suskind. Contemporary Literary Criticism. 1986. Adams, Robert M. Patrick Suskind. Contemporary Literary Criticism. 1986. Barber, Charles. The brain: a mindless obsession. The Wilson Quarterly 32. 1 (Wntr 2008): 32(13). General OneFile. Gale. Markham Public Libraries (CELPLO). 26 May 2008 . Hayat, Marc. Psychoanalysis: Obsession. Large Print Press 24 May 2008 . Pifer, Ellen. His monster, his nymphet: Nabokov and Mary Shelley. New York: Cambridge University Press , 1999. Prescott, Peter S. Patrick Suskind. Contemporary Literary Criticism. 1986. Simon, Schama. Patrick Suskind. Contemporary Literary Criticism. 1986. Quin, John D.. Nabokovs World. New York: Penguin Books, 1998. Updike, John. Patrick Suskind. Contemporary Literary Criticism. 1986. Annotated Bibliography Ackroyd, Peter. Patrick Suskind. Contemporary Literary Criticism. 1986. This author writes his opinion on Patrick Suskind’s novel, Perfume. It is written in an encyclopedia format where they critique an author’s works. In this critique he describes the setting and idea of Perfume that it’s a story about odour and the whole surprising fact that Jean-Baptiste Grenouille does not have a scent at all. I took a quote from this author’s critique and it helped proved my point which was that Grenouille’s obsession is so strong that it has a separate presence. It is relevant to my essay because my thesis is to prove that they are unaware of the character’s obsessions. Hayat, Marc. Psychoanalysis: Obsession. Large Print Press 24 May 2008 . The author is writing what the definition of obsession is in an online journal and article. Many people are not aware of what obsession is because everyone may have a different definition. However, society will always portray one definition of obsession so I took a quote that defined the way society viewed obsession. It is relevant to my essay because one of my arguments is obsession vs. love. Lehmann-Haupt, Christopher. Nabokovs World. New York: Penguin Books, 1998. Christopher Lehmann-Haupt wrote a very long and intriguing critique on Perfume, however I found no use for it. It talked a lot about how we feel sympathy for Grenouille’s character because he was born destined to have no scent and to ultimately be a killer. It didn’t really help me because it didn’t support my thesis nor any of my arguments. Pifer, Ellen. His monster, his nymphet: Nabokov and Mary Shelley. New York: Cambridge University Press , 1999. This author compares the monster in Mary Shelley’s book Frankenstein to Vladimir Nabokov’s novel Lolita. In the comparison, she describes Humbert indirectly as a person who may be questionable about his love for Lolita. He almost describes her like an object or animal in the quote I found. It is relevant to my essay because it fits right in to my argument of obsession vs. love and whether or not he knows the line between it. Quin, John D.. Nabokovs World. New York: Penguin Books, 1998. This author talked a lot about Humbert’s obsession with nymphets. He talked about Humbert’s feelings when he went and decided to kill Lolita’s other lover. I took a quote from it which described how far Humbert was willing to go for love. This source is relevant to my essay because it shows the unnatural obsession o Obsessions and the Downfall It Brings Upon Life Essay Example Obsessions and the Downfall It Brings Upon Life Essay Obsessions and the Downfall it Brings Upon Life What is the first thing that comes to mind when someone speaks of obsession? For most people it is the obsession with media or someone with no life, or maybe both. Inside almost every single person’s mind is someone or something they are passionate about. Not only are they passionate about it, they are obsessed. So much that they are unconscious that their obsession be dangerous to themselves as well as others. In Lolita by Vladimir Nabokov, Perfume by Patrick Suskind and Obsession by DaMoyre, they all express different stories of obsession, but they all mainly have the same concept. Their obsession is what brings the downfall of themselves, as well as the surrounded environment they are in. For example, in Lolita the downfall is that Humbert does not know that he is being taken advantage of when Lolita asks for his money, same with Obsession, the young girl in the story is too naive to even care or know that she is being taken advantage for her body, not her feelings or personality. Finally in Perfume, it is evident that society would view Grenouille as someone with no life. His life and perfume are all that he cares for and surrounds himself with. We will write a custom essay sample on Obsessions and the Downfall It Brings Upon Life specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Obsessions and the Downfall It Brings Upon Life specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Obsessions and the Downfall It Brings Upon Life specifically for you FOR ONLY $16.38 $13.9/page Hire Writer For example, if Grenouille smelt a desirable scent on someone, he would do anything to get that scent even if he had to harm that person. This demonstrates that he is so tormented with his obsession that he has no care or sympathy for anyone. The protagonists in Lolita, Perfume and Obsession are unaware that their obsession is not only hurting themselves, but hurting others too. They may interpret the obsession as a sign of love, but society views it differently. What does society view it as? Society has a book of rules, and being overly obsessed is viewed negatively and as a huge problem. Also, since obsession can often be mistaken as love, it is easy for people to fall into that trap and become victims to that problem. In the three literatures, Lolita, Perfume and Obsession, they all surround on the theme of obsession. In Lolita, it is a story of a man Humbert Humbert, who develops a strong interest in young girls or in his words, â€Å"nymphetsâ€Å". He started having a fixation with young girls ever since his love as a young teenager left him. From there his obsession with nymphets continued, until his one love Lolita completely took over his life. At this point, Humbert Humbert was willing to give her all she wanted, whether it was material things or money. In Perfume, a different kind of obsession kicked in. As a young boy, Jean-Baptiste Grenouille did not have a scent; this alone had the biggest impact on his life. As he grew older it was something he desperately longed for, as a lack of scent was found odd and unusual in his society. He was abandoned many times when he was a child, not due to his attitude or his behaviour, but due to his lack of smell. Through this experience, he developed a strong obsession of getting certain scents and perfumes. Eventually he learned the art of perfumery and mastered techniques that no one had done before. However, what was unexpected was the limits he was willing to cross to reach his goal even limits like murder. Finally, in Obsession, the story is about a girl who is completely in love with her man, again willing to do anything for him. She in ways many may not understand; the words she uses are almost abstract in art. Her obsession is her weakness, even her man knows it and this is what leads to her downfall. He uses her weakness as an advantage and uses it for his own wants and desires, mainly his sexual desires. When something is unnatural, it means it is altered with. For example, when we pose for a photo it is unnatural thus making the picture look a bit odd to how one sees the world. In Lolita, what is so unnatural about the obsession of the protagonist, Humbert, is the huge age gap between Lolita and him. The cause for Humbert’s obsession is one of his earlier lovers Annabel. She died from a disease called Typhus, which made him long for that feeling of love again. He attempts to experience that kind of love again and as he grows older, however his mentality and maturity still remained the same. Unlike most people, Humbert does not move on to the future. Instead he makes himself believe he is staying exactly where he used to be emotionally. But physically, he is a man of old age, which makes his want for nymphets really disturbing to society. Then, when Humbert met Lolita, he felt like he had found true love again and was willing to do anything to be with her. For example, when Lolita’s mother Charlotte Haze threatens Humbert with marriage or the consequence is that he has to leave their house, Humbert ultimately sacrifices his own freedom to be with Lolita. [Mrs. Haze] had left half an hour before, and getting Lo instead, I told her I was going to marry her mother. I had to repeat it twice because something was preventing her from giving me her attention† (Nabokov 72). Humbert tells Lolita that he is going to tie the knot with her mother. He is not only doing this to prevent himself from being kicked out, but because he wanted to be able to see Lolita everyday. Not only are his actions sacrificial, they also cause Humbert to lose his liberty, dignity and most importantly himself. Losing freedom could be compared to being locked in a prison – reason being is that both result in lost of free will or choice. From Lolita’s end, it is very obvious she does not seem to care at all about the marriage. Humbert says, â€Å"I had to repeat it twice because something was preventing her from giving me her attention† (Nabokov 72). Marriage was, is and always will be a special event in everybody’s life. However it seems like Lolita was purposely not paying attention and not caring, which gives a clue that she may not feel the same way as Humbert does about her. Near the end of the novel, Humbert due to his unnatural obsession goes insane when he finds out that Lolita had another lover behind his back. â€Å"On his way to kill Quilty he puts on black clothes, ‘I was wearing a black suit, a black shirt, no tie’, the classic western villain† (Quin 1998). Humbert was willing to murder for the love of his life, which society would regard as disgust. Though his love was strong for her, his actions went too far. Murder is a sin and an illicit action that is strongly condemned. In Perfume, what is so odd about Grenouille’s obsession is that he is fixated with something he longs for. Just like Humbert longed for the feeling of young love, Grenouille longed for the scent he never had. His childhood memories consisted of being passed along and abandoned because he lacked something essential that everyone else in society had. Because of this, he developed a twisted obsession with scents. Also, it encouraged him to strive towards making the ultimate perfume to satisfy and try to fit in society. Just like Humbert, there was nothing anyone could do to stop him – even murder. Although Humbert, Grenouille and Anonymous’ stories have the same concept of â€Å"unnatural obsession†, they all have perspectives of different kinds of obsessions. For Humbert, his story may be disturbing due to the age gap, Grenouille’s is disturbing because he is obsessed with a chemical, and finally Anonymous’ is disturbing because she represents someone with no future and life. Life is a big part of us, and that is why these characters are considered abnormal in society. â€Å"Grenouille never again departed from what he believed was the direction fate had pointed him. It was clear to him why he had clung to life so tenaciously, so savagely. He must become a creator of scents. And not just an average one. But, rather, the greatest perfumer of all time† (Suskind 44). It is evident that Grenouille is committed to his life goal. He wanted to be the God of scents, the creator, and the boss. He did not want anything else in life, which to society may seem odd. For example, since people are so used to seeing what is normal/typical, when they see a person with a disability they often stare at what is out of the norm. The same thing applies for people with and without unnatural obsessions. Society would treat people with obsessions like they are odd, and even outcast them. But what is the definition of normal and does it apply to everyone? The truth is that the definition of normal differs for everyone. Once again, society has a book of rules and the predetermined definition of normal is a person who has all their body parts, no disabilities, and strives for similar goals in life like success in areas of love, school, work, and their social life. However, Grenouille’s actions do not fall in the category of normal, therefore regarding him as unnatural and irregular. If Grenouille is the hero of the novel, his obsessions are also its informing presence† (Ackroyd 1986). Grenouille’s obsession is so strong, that it could be considered as another person, another living thing, but of course that is what makes it so unnatural. In Obsession, the protagonist who might as well be Anonymous is a young girl who is naive and clueless around the nature of love, t herefore she falls in love with the wrong guy. In return, he does nothing but secretly use her for his own sexual desires, showing a very selfish act. She never realizes the truth about his feelings and continues to mourn for him even after he leaves her. â€Å"An obsessive mind, a morbid romantic, struggling between fantasy and reality I dreamed of love† (DaMoyre). The protagonist is aware of her state of tormented mind, but she is unaware of the fact that it is unhealthy for her to keep thinking about him. There are more important things for her to worry about such as work, her social life and school. Her love for her boyfriend is so deep but the problem is that he does not feel the same way. When their relationship does end, the boyfriend moves on but she stays in the same spot, looking for her next prey. Her obsessive mind does not cure, she just longs for more love, passion and inevitably pain. Although her obsession may not be as odd as Humbert’s or Grenouille’s, it is still considered an unnatural obsession to society. â€Å"The term obsession refers to images, ideas, or words that force themselves into the subjects consciousness against their will, and which momentarily deprive them of the ability to think and sometimes even to act† (Hayat 2005). The word obsessed is something we use in our everyday vocabulary especially in the teenage community. What we do not realize is that the word means much more than intended, just like the word â€Å"gay† is. These words have become trends, but they should be taken more seriously because true obsessions can be a disorder. People who are overly obsessed, especially with unordinary things should not be ignored, as it can be a serious problem. For example, Anonymous is unaware that her obsession is hurting anybody, therefore she continues and lets other take advantage of her. All three literature works are based around an obsession we do not usually encounter or hear about and because of that, the protagonists do not notice that they are harming themselves physically, emotionally, and also the people around them. In today’s world, being isolated is the worst thing because we are educated that isolation causes us to be narrow-minded and not see the other side of the world. In Lolita, Humbert isolates himself from society, especially when he meets young Lolita. He thinks old women are disgusting hags, even if in reality they are beautiful women. He isolates himself from other things in society that he should be doing. For example, most thirty year old men are trying to fulfill their goals in work or family, but Humbert’s only goal and focus is unlike others around his age – a young innocent girl. â€Å"I think I had better describe her right away, to get it over with. The poor lady was in her middle thirties, she has a shiny forehead, plucked eyebrows and quite simple but not attractive features of a type that may be defined as a weak solution of Marlene Dietrich† (Nabokov 37). From what Humbert speaks of, it is fair to draw the conclusion that he is turned off by older woman. The reason being is since his first young love, he has isolated himself from other selections that may suit him better. For example, if a child had a choice of chocolate, vanilla and strawberry ice cream, but could only choose vanilla because he believed chocolate and strawberry were poisonous, he is then isolating himself from something he could potentially be enjoying. The same concept goes for Humbert, since isolation is consuming his life, he does not see the enjoyment in life that others in society may. And because of that, he is unaware that he is isolating himself and also Lolita along with him. Lolita is all he ever thinks about which would prevent other thoughts that he could be thinking about, such as â€Å"What do I want to become? † or â€Å"Do I love Lolita, or the childhood memories of Annabel? † However, Humbert does not realize this and goes on being blind to what is happening to him. â€Å"Lolita, on the other hand, is all colour. Humbert thinks of her as ‘a little ghost in natural colours and as ‘the beautiful warm coloured prey’ (Quin 1998). As already stated, it is obvious Humbert spends a little too much time thinking about Lolita, and making her thousands of different meaningful poems about her. In Perfume, it is even more obvious than Humbert that he isolates himself. In Grenouille’s case, he has to work hard to get to his goal. At first when he is learning to incorporate different ingredients and natural scents into his perfume experiments, he discloses himself from anyone and everyone. He concentrates and focuses on the perfumes and nothing else, thus hiding himself from society. â€Å"After a few weeks Grenouille had mastered not only the names of all the odours in Baldini’s laboratory, but he was also able to record the formulas for his perfumes and other scented products. And not merely that! Once he learned to express his fragrant ideas in drops and drams, he no longer needed the intermediate step of experimentation† (Suskind 92). All the skills and methods he learned and mastered in perfumery took him a lot of time, which resulted in isolation once again. He isolates himself in the laboratory to test his experiments, discover new methods to preserve scents, and come up with new aromas to put on himself. To skip an intermediate step in experimentation is probably Grenouille’s biggest achievement, and if one were to predict how long he spent doing so, it would be days after days of isolation from society. Of course, society does not view this as normal behavioural traits. Nonetheless what does the society book of rules say about isolation? For one it states that one needs their own time alone, but only briefly. If isolation happens, there is definitely a problem developing. â€Å"You cannot have both love and life; to demand both is to come to a grisly end† (Prescott 1986). In Grenouille’s case, this is what he thinks but is reality like that? Many successful people out there have both a life and love; it is not a big deal to balance the essentials in your life. For example Hilary Duff is now known as a worldwide singer and actress, she gets along with her family fine and although she just broke up with a long time boyfriend, she is not sad about it she does not isolate herself because she has a job to do – make music for the world to hear. In Obsession, Anonymous isolates herself thinking about her lover, just like Humbert does. All throughout the poem, instead of expressing her feelings of the world around her, she talks constantly about her lover and how she misses him. â€Å"A trap, a cage, prison of death underground† (DaMoyre). She expresses herself trapped in a cage just like being in a prison of death underground. She is being suffocated like a prison underneath his love and she pulls him with her. She is isolated from society, and as a teenager she is supposed to have a future for herself, but apparently does not seem to have one. Again, she is aware of herself being isolated and isolating her lover, but what she is unaware of is that it is unhealthy to both her and her lover. Instead of keeping him by her side, knowing he is not cheating or whatever she is trying to prevent, she is making their relationship go downhill. What is the difference between love and obsession? Love is when you are passionate about something or someone and appreciate them for what they are. Obsession on the other hand is love except it is on an extreme level in which that something or someone is the only though in your mind, the only thing in your life. There is a thin line between love and obsession, and it is very easy to mix the two around and maybe possibly mistaken one for the other. Humbert thinks of Lolita as a lover, and would probably never classify himself of having an obsession with her. Most people are unaware that they are crossing the line just because it is hard for them to distinguish the difference. Humbert has been a person trapped in an obsessed world all his life, even with his first love Annabel. They were young and naive and therefore experimenting with young love, but even when she died he had memories of her. He never threw away those memories until he met Lolita. For most people, although it is painful to have someone you loved pass away, but one would mourn over it, and then move on because there are bigger things out there in this world. However Humbert did not seem to believe this. Lolita, light of my life, fire of my loins. My sin, my soul. Lo-lee-ta† (Nabokov 9). Among the first few lines of the book, it feels like Humbert just stepped over the line to obsession because books usually start pleasantly setting the image for the reader. However he displays a selfish impression and talks about his love without being kind to the reader and explain ing what is going on. Oftentimes, people would say, â€Å"I love ice cream† or â€Å"I really love this song†, but do we really mean it? Do we really love that song? Sometimes it so happens we do, but people are misusing the word love. What does love mean by the society’s book of rules? Well for one, it is a word that is mainly used for a person that you have been in a relationship for some time. It only makes sense to use it for someone you truly care about, not something that is just going to be another phase in life. But that is when obsession kicks in, once you truly love someone it is really close to becoming that obsession you never wanted to encounter. The definition of obsession is just a step higher than love; it is not that far away which is why obsession is taking over the protagonists in the three literature works so easily. Humbert refers to Lolita’s â€Å"tender, mysterious, impure, indifferent, twilight eyes† and to the â€Å"smoother, tender bloom† of her (Pifer 1999). It is obvious that as lovers, it is nice when one compliments another to make them feel better and have a day full of enjoyment. But Humber again goes far out on it, and describes her like she’s a fl ower or animal that he uses for pleasure. He describes Lolita as the love of his life, but does he really love her or is it more than that? He does not just love her, he is obsessed and it is evident that not even he can stop himself. But because he is so obsessed, he is treating Lolita in a way that a young girl should not be treated like, he is making her experience things she should not be experiencing until she is a fully grown adult. Of course due to his desire to satisfy his sexual wants, he does not care about anything else, just Lolita and her tender young body. Instead of relationship, Grenouille in Perfume has a strong passion to search for the perfect scent since he was deprived of a human odour. It is true that most people have a strong passion for something. For example Craig Kielburger had a passion for helping others, which is why when he was only at the age of ten saw a newspaper about poor families in Africa, and desperately wanting to help, created a well-known organization â€Å"Free the Children†. When one is passionate about something, they will do whatever it takes to reach their goal. This is what Grenouille is like, but instead of being just passionate about something, he becomes obsessed which is how he brings the downfall upon himself as well as others. As his obsession grew deeper and developed stronger, he brought the downfall of others by murdering them one by one for their odour. When he was born and knew he was different from what the rest of society was like, he stepped over the line to obsession. He spent a majority of his life in the lab just trying to reach his ultimate goal, was creating the perfect scent doable? What does society view the word â€Å"perfect† as? The word perfect is used in our everyday vocabulary, but again it is misused as the word â€Å"love† is misused. â€Å"Nobody is perfect† is the famous phrase you hear, because it is true, we were created as human beings to sin and make mistakes, so knowing this, it is true Grenouille’s goal is unreachable. As he came out onto the street, he was suddenly afraid, for he knew that for the first time in his life he was giving off a human odor† (Suskind 151). He creates a human odour for himself so he can finally fit into society and be a normal person, but is that what he is? Throughout the whole book he seemed so desperate to find that scent that he was obsessed and over driven about it, that in the end trying to be normal is not normal. â€Å"It was the fresh odor of the approaching day, of the first daybreak that he had ever known in freedom. That odor had been the pledge of freedom. It had been the pledge of a different life. The odor of that morning was for Grenouille the door of hope. He guarded it carefully. And he drank it daily† (Suskind 129). Grenouille now was so in love, so obsessed with odours and scents that he guarded it like it was money. In every society, money seems to be the base of everything, it meant power and high status, however, Grenouille does not care. In his world it seems that perfume is everything, scent is everything and having an odour is everything. He is so unaware that he does whatever it takes to fit in society, even committing the act of murder. Does Grenouille just love his job as a perfumer or is he infatuated to believe that he had to prove to everyone that he is just like everyone else? As Perfume continues, a story of a murderer, he becomes insanely obsessed, crazy and mad to murder every woman who had the scent he was looking for that instead of working hard to be successful, he murders to come to his success. Throughout the whole story of the poem Obsession, the protagonist thinks she is in love with her lover and that she cannot live without him because she loves him so much. What she may not realize is that she has crossed the border of love and into her obsession. Her unawareness makes he think that it is a norm for over love for another in a relationship. The truth is love is a complex thing, but not as complex as she depicts it as. â€Å"And thought, ‘His face shall be my last vision when I die’† (DaMoyre). She pictures her future but not about how happy she will be and how successful she will be, but that the image of her lover’s face will be her last vision. If anything is obsessive, this statement she makes wins it all. Anonymous is young and she is inexperienced, because of that she has no idea what she is doing, and all the things she does not notice herself doing. However the things she does not notice such as her unawareness of obsession seems all a little unrealistic although it does happen. A love relationship is something that should not be complex especially at a young age, because it takes away from the important things such as family, friends and school. In the poem, it does not mention anything about her family, friends or education; her world only consists of herself and her lover. As the definition of obsession was stated before, her life fits exactly into the definition. She is not exposed to society but since her lover does not even love her, he might tell his friends about the story, and his friends posing as society would look at her an insane and mad human being since she is again viewed as someone who is not normal. Instead of making her boyfriend love her, she makes him dislike her more and more which will hurt herself in return because she suffocates him emotionally so much. Unawareness is not only causing one’s emotional distress over the differences between love and obsession, it causes them to not even realize the condition they are in such as isolation and a strong unnatural love. Humbert’s unnatural love in Lolita is finding girls too young for him, he works hard detaching himself from society thinking about Lolita and not conscious that he is possessed by thoughts about her. A similar thing happens to Grenouille in Perfume, he detaches once again himself from society for society, in other words his aim to reach the goal of the perfect scent is to satisfy society’s outlook on him and to fit in it as well. He becomes obsessed unknowingly, but because his obsession is so twisted and odd, society views him as someone who is different. Finally in Obsession, Anonymous is unaware that her love for her lover is pushing him farther instead of closer. In all these literature works, one thing they have in common is that their obsession hurts others as well as themselves physically and emotionally and they are unconscious of it happening. Because of that, the characters suffer thinking that they are satisfying others but in reality, they are just hurting them which is opposite of what they wanted to do in the first place. Thus being unaware of the problem is worse than being conscious of it. In terms of obsession vs. ove, there isn’t a major difference in the three characters because they all cannot distinguish between the two. However there is some kind of difference to when readers discover their unawareness. For example, Humbert only had obsession in his life since his first love in his life, and for Grenouille, it started when he realized people were abandoning him due to his lack of smell. Finally, for Anonymo us, it all starts when her boyfriend leads her on and she falls for the trap of his invisible love. Obsession does not only exist in storybooks, but they also exist in the real world. It’s happened to young kids, teenagers and adults. Let’s face it, it has happened to the vast majority of everyone. First, learning that your inspiration is a person or object, and then loving them so much, one would do anything to fulfill their desire associated with them. Finally, obsession rises and nothing can stop their love for that person or object. For example, a Chinese actor named Andy Lau had an obsessive fan. It seems nothing out of the ordinary but this particular obsessive fan had a father as a reporter and demanded to get a signature and photo from her favourite actor. However, when the father failed to do so, not only was he disappointed, but he was so disappointed and did not want to disappoint her daughter he committed suicide. The moral of the story: the media brain washes us into thinking that being the rich and the famous is the only goal in life thus why obsession exists today. Humbert, Grenouille and Anonymous are just like the daughter and father have an unawareness of their obsession with something or someone leads them to their downfall. The story also proves that an obsession of one person does not just affect themselves, it affects the people they care for and the people that they influence everyday. Works Cited Ackroyd, Peter. Patrick Suskind. Contemporary Literary Criticism. 1986. Adams, Robert M. Patrick Suskind. Contemporary Literary Criticism. 1986. Barber, Charles. The brain: a mindless obsession. The Wilson Quarterly 32. 1 (Wntr 2008): 32(13). General OneFile. Gale. Markham Public Libraries (CELPLO). 26 May 2008 . Hayat, Marc. Psychoanalysis: Obsession. Large Print Press 24 May 2008 . Pifer, Ellen. His monster, his nymphet: Nabokov and Mary Shelley. New York: Cambridge University Press , 1999. Prescott, Peter S. Patrick Suskind. Contemporary Literary Criticism. 1986. Simon, Schama. Patrick Suskind. Contemporary Literary Criticism. 1986. Quin, John D.. Nabokovs World. New York: Penguin Books, 1998. Updike, John. Patrick Suskind. Contemporary Literary Criticism. 1986. Annotated Bibliography Ackroyd, Peter. Patrick Suskind. Contemporary Literary Criticism. 1986. This author writes his opinion on Patrick Suskind’s novel, Perfume. It is written in an encyclopedia format where they critique an author’s works. In this critique he describes the setting and idea of Perfume that it’s a story about odour and the whole surprising fact that Jean-Baptiste Grenouille does not have a scent at all. I took a quote from this author’s critique and it helped proved my point which was that Grenouille’s obsession is so strong that it has a separate presence. It is relevant to my essay because my thesis is to prove that they are unaware of the character’s obsessions. Hayat, Marc. Psychoanalysis: Obsession. Large Print Press 24 May 2008 . The author is writing what the definition of obsession is in an online journal and article. Many people are not aware of what obsession is because everyone may have a different definition. However, society will always portray one definition of obsession so I took a quote that defined the way society viewed obsession. It is relevant to my essay because one of my arguments is obsession vs. love. Lehmann-Haupt, Christopher. Nabokovs World. New York: Penguin Books, 1998. Christopher Lehmann-Haupt wrote a very long and intriguing critique on Perfume, however I found no use for it. It talked a lot about how we feel sympathy for Grenouille’s character because he was born destined to have no scent and to ultimately be a killer. It didn’t really help me because it didn’t support my thesis nor any of my arguments. Pifer, Ellen. His monster, his nymphet: Nabokov and Mary Shelley. New York: Cambridge University Press , 1999. This author compares the monster in Mary Shelley’s book Frankenstein to Vladimir Nabokov’s novel Lolita. In the comparison, she describes Humbert indirectly as a person who may be questionable about his love for Lolita. He almost describes her like an object or animal in the quote I found. It is relevant to my essay because it fits right in to my argument of obsession vs. love and whether or not he knows the line between it. Quin, John D.. Nabokovs World. New York: Penguin Books, 1998. This author talked a lot about Humbert’s obsession with nymphets. He talked about Humbert’s feelings when he went and decided to kill Lolita’s other lover. I took a quote from it which described how far Humbert was willing to go for love. This source is relevant to my essay because it shows the unnatural obsession of Humbert which is again one of my arguments.

Models for Learning and Development The WritePass Journal

Models for Learning and Development WRITEPASS BUSINESS MANAGEMENT DISSERTATION TOPICS CUSTOM ESSAY WRITING Models for Learning and Development /07/70-20-10-Where-Is-the-Evidence [Accessed 17 Mar. 2017]. Td.org. (2017).  70:20:10: Where Is the Evidence?. [online] Available at: https://www.td.org/Publications/Blogs/Science-of-Learning-Blog/2014/07/70-20-10-Where-Is-the-Evidence [Accessed 24 Mar. 2017]. Training Magazine. (2017).  Fear Not the 70-20-10. [online] Available at: https://trainingmag.com/content/fear-not-70-20-10 [Accessed 24 Mar. 2017]. Trainingindustry.com. (2017).  The 70:20:10 Model for Learning and Development | Training Industry. [online] Available at: https://www.trainingindustry.com/wiki/entries/the-702010-model-for-learning-and-development.aspx [Accessed 24 Mar. 2017]. Watkins, K. and Marsick, V. (1992). Towards a theory of informal and incidental learning in organizationsâˆâ€".  International Journal of Lifelong Education, 11(4), pp.287-300.

Apollo Hospital Essay Example

Apollo Hospital Essay Example Apollo Hospital Essay Apollo Hospital Essay The ‘‘wow’’ factor in service relies on constant innovation and demands continuous and sensitive focus on all issues that may affect the patient’s stay in a hospital. Every touch point of the hospital needs to be ‘‘alive’’ and the client must be able to feel the warmth offered. The culture of service is imperative in today’s scenario, where the differentiators could just be the manner in which services are offered. All the major players could replicate infrastructure within a short span of time, but not the service culture. Dr. Umapathy Panyala, Chief Executive Officer, Apollo Hospitals, Bangalore (March 2013) Dr. Panyala, CEO, Apollo Hospitals, Bangalore believed that in the future, the hospitality aspect of hospitals- the service provided to patients- would differentiate Apollo Hospitals from a large number of equally competent competitors in the growing Indian healthcare industry. He had set up a quality department at the Apollo Hospital in Bangalore, headed by Dr. Ananth Rao. Apart from being an expert on Metabolic Diseases and Biochemistry, Dr. Rao was also a Lean Six-Sigma black belt from the Indian Statistical Institute, Chennai. You can’t manage what you don’t measure- although this may sound cliched; I am still a firm believer of this philosophy and want to apply this, especially in the hospitality part of hospitals. Clinical benchmarking is a compulsory requirement and is taken care of; however, patients have so many other touch points in their stay at hospitals- the hospitality part. Some of the world-class hotels (such as the Ritz–Carlton) have performed benchmarking to standardise their hospitality offerings; at the same time, its employees are allowed to use their judgment to provide whatever delights the customer in every visit. 1 We want to internalise this in our culture as well. – Dr. Ananth Rao, Head–Quality Department, Apollo Hospital, Bangalore (March 2013) Dr. Rao also believed that the hospitality aspect would differentiate Apollo Hospitals from its competitors. Patient cure and care played very important roles in hospitals. Many patients were generally anxious when in a hospital and the sense of disservice increased their anxiety level very easily. Integrating healthcare and hospitality was essential for creating patient-focused care. Hospitality aspects included a smooth admission procedure, friendly medical and non-medical staff, comfortable furniture, varied choices on the food menu, attractive surroundings, recreational facilities, privacy, clear signposting, adequate provisions for visitors, and so on. 2 Important aspects of hospitality were managed by the nursing staff and other non-medical staff, which meant inherent variability of service owingto human interventions. Dr. Panyala and Dr. Rao wanted to measure the hospitality aspects at Apollo Hospitals and improve hospitality to create a world-class hospital. Dr. Rao and his team collected feedback every day from the patients and received a number of complaints, ranging from not having a TV remote to long response time on the part of nursing staff in attending to requests from patients. For Apollo Hospitals, it was important that the patients’ experience in the hospital was not compromised, since it could have a significant financial impact. Managing the hospitality elements of the hospital was as important as managing the clinical aspects. Apollo Hospitals had a stringent process in place to take care of clinical aspects. Dr. Rao wanted to improve the hospitality at Apollo Hospitals by reducing the 1 Hall, J. M. and Johnson, M. E. , When should a process be art, not science, Harvard Business Review, 2009, 1–9. Hepple, J. ,Kipps, M. and Thomson, J. , The concept of hospitality and an evaluation of its applicability to the experience of hospital patients, International Journal of Hospitality Management, 1990, 9(4),305–318. 2 Suhruta Kulkarni, Kripa Makhija and U Dinesh Kumar, Professor of Quantitative Methods and Information Systems, prepared this case for classroom discussion. V Sandeep assisted in data collection and analysis. This case is not intended to serve as an endorsement or source of primary data, or to show effective or inefficient handling of decision or business processes. Copyright  © 2013 by the Indian Institute of Management Bangalore. No part of the publication may be reproduced or transmitted in any form or by any means – electronic, mechanical, photocopying, recording, or otherwise (including internet) – without the permission of Indian Institute of Management Bangalore. This document is authorized for use only by NIKITA VAIDYA in Nutrition 346 taught by Carol Blindauer, at Dominican University Illinois from January 2015 to May 2015. For the exclusive use of N. VAIDYA, 2015. Apollo Hospitals: Differentiation through Hospitality Page 2 of 20 number of complaints from patients; he also wanted to achieve significant improvement in sigma levels measured through the Six Sigma performance scale. According to Dr. Ananth Rao: The immediate challenge is to understand the patients’ sentiment towards the hospitality provided and to design a process improvement plan that is affordable. Apollo takes feedback from patients every day and the quality department staff interviews many patients every week to understand their needs. Dr. Rao was aware that improving hospitality at Apollo Hospitals was going to be a continuous exercise in improvement; collecting feedback was one way of approaching the process of continuous improvement. He treated every complaint as a â€Å"defect† and planned to use lean Six Sigma concepts to eliminate defects. Implementing Six Sigma in all departments was likely to be a challenge since departments such as housekeeping faced high attrition rates. His immediate objective was to introduce a system where future complaints related to hospitality could be reduced. Also, how much importance should be given to hospitality by Apollo Hospital was one of the dilemmas faced by Dr Rao and he wanted to set a realistic target for Sigma level in hospitality at Apollo. APOLLO HOSPITALS: THE TRENDSETTER Dr. Prathap C. Reddy, founder of Apollo Hospital Enterprises Ltd. (AHEL) had accomplished a successful medical career in the United States. He returned to India in 1972 to contribute to the healthcare system in India. Health infrastructure in India was very poorly developed in the 1970s. In 1971, there were 3,862 hospitals and 12,180 dispensaries with a total of 348,6553 beds for a population of 548,159,6524- a ratio of 6. 36 beds per 10,000 people as against the ratio of 9 beds per 10,000 people in 2011. 5 India’s first National Health Policy was declared in 1983,6 almost 36 years after independence, which was an indication of the neglect faced by the health sector in the country since independence. Dr. Reddy had set up a good medical practice in India and used to send patients outside the country for specific treatments. However, in 1979, a young patient died as he could not arrange the money for treatment in the United States. Dr. Reddy then decided to provide the best of medical treatment from the West to patients in India with an emotional touch, calling it â€Å"High Tech with High Touch. † Apollo was a doctor-promoted enterprise- 10,000 Indian doctors, 4,700 U. S. -based doctors, and 60 doctors from the United Kingdom invested approximately USD 5,000 to start the venture. Dr. Reddy selected the best of the talent available to ensure the best possible service and care. He also ensured that a clear distinction was maintained between business management and clinical management. 7Apollo pioneered world-class healthcare in India, which was later emulated by several other hospitals. Apollo focused on technological excellence and garnered many firsts to its credit in the country. Apollo was the first not only in India but also in South Asia to launch Oncological Robotic Surgery, G4 Cyberknife Robotic Radiosurgery System, 320-slice computed tomography scanner, 64-slice positron emission tomography-computed scan system, full-field digital mammography with tomosynthesis, and many such technologies. 8 According to Dr. Rao, Apollo intended to carry forward technological excellence in hospitality to provide patients with the best cure and care services. Dr Preetha Reddy, Managing Director, Apollo Hospitals Enterprises Limited has been the pioneer and chief architect of the tender loving care –TLC ‘‘mantra’’, a pillar of the Apollo way, which is affectionately applied to every patient at Apollo Hospitals. â€Å"The patients and staff comprehend this language better,† she points out. The concept of TLC integrates service delivery with clinical outcomes resulting in exceptional patient experiences9,10. 3 Background Papers: Financing and Delivery of Healthcare Services in India, National Commission on Macroeconomics and Health, Ministry of Health and Family Welfare Government of India, 2005, p. 47. 4 Source: http://cyberjournalist. org. in/census/cenpop. html, accessed on March11, 2013. 5 Source: globalhealthfacts. org/data/topic/map. aspx? ind=78, accessed on March11, 2013. 6 Health Research Policy, Indian Council of Medical Research, New Delhi, (October 2007). 7 Mitra, M. , The Apollo Mission, Corporate Dossier with The Economic Times, June 1, 2012. 8 Apollo Investor Presentation, www. apollohospitals. com, accessed in January 2013. 9 N Amarnath, and D Ghosh, The Voyage to Excellence: The Ascent of 21 Women Leaders of India Inc. , Pustak Mahal, pp. 80-95. 10 apollohospitals. com/apollo_pdf/dr_preetha_reddy_managing_director. pdf This document is authorized for use only by NIKITA VAIDYA in Nutrition 346 taught by Carol Blindauer, at Dominican University Illinois from January 2015 to May 2015. For the exclusive use of N. VAIDYA, 2015. Apollo Hospitals: Differentiation through Hospitality Page 3 of 20. CLINICAL BENCHMARKING Apollo Hospitals had been using a clinical score card called [emailprotected] (Apollo Clinical Excellence), which measured and monitored clinical excellence among the group’s hospitals. [emailprotected] measured 25 clinical parameters (Exhibit 1) every month, which were benchmarked against global standards. [emailprotected] was launched on September18, 2008 and used across 32 hospitals of the group. Clinical benchmarks were published by various institutions and bodies such as Cleveland Clinic, Mayo Clinic, and National Healthcare Safety Network (NHSN), among others. Hospitals were grouped according to their bed strengths, locations, services offered, and so on. Group A hospitals had to report 25 parameters- 23 were common parameters, while two were location-specific. Group B and Group C hospitals had to report 15 and 10 parameters, respectively, out of which two were location-specific. [emailprotected] was an internally developed clinical scorecard, created by drawing upon the wealth of expertise available within Apollo. An audit committee at the corporate level was set up to validate the data, methodology, and definitions followed at each location. According to Sangita Reddy, Executive Director, Apollo Hospitals Group: We needed a yardstick like [emailprotected] that would pit us against international institutes like Cleveland Clinic, Mayo Clinic, and others, and position us on the global healthcare firmament for excellence in clinical quality. This also enables us to assess where we stand and where we need to 11 be, while pursuing excellence in clinical quality. Apart from this internal benchmarking exercise, seven of Apollo’s hospitals were accredited by the Joint Commission International (JCI); and it was the largest group in South Asia to be accredited by the JCI. The JCI was a U. S. -based accreditation body dedicated to improving healthcare quality and safety around the world and recognized as the gold standard for hospitals. Apollo was also accorded the Superbrand status by the Indian Consumer Superbrands Council, which recognised that the best practices were used in the brand. Apollo was the 12 only hospital that was accorded the Superbrand status in India. There were other accreditations that several Apollo hospitals had achieved (Exhibit 2). According to Dr. Panyala, Living the brand should be our focus in every initiative or activity we perform. Apollo Hospitals has been one of the consistent names among the Superbrands. The perceived value of a brand like Apollo Hospitals is set very high in the backdrop of the decades of service and excellence it has offered. Clients need to see and experience that value, and the gap between perceived value and obtained value must be zero at best or at a bare minimum. PATIENTS’ FEEDBACK AND REAL-TIME ACTION On average, a patient spends 80% of the time in hospital for the care part rather than the cure, and we need to focus on care to ensure speedy recovery and maximum satisfaction. Hospitality is critical in healthcare as the patient and his/her attendants are already distraught and highly anxious. Hospitality is driven mainly by human interventions- in nursing, housekeeping, as well as food and beverages. It is very difficult to ensure consistency of quality and hence, we want to benchmark these to ensure we provide the best quality of hospitality all the time. –Dr. Ananth Rao, Head–Quality Department, Apollo Hospital, Bangalore (December 2012) Dr. Rao believed that although clinical services formed the core of Apollo’s services and brand image, hospitality would support the brand, and in the long run, both would merge to form the Apollo brand (as shown in Exhibit 3). All services that did not require core clinical expertise were classified as hospitality services, including services such as billing, dietician service, food beverages, facility, housekeeping, nursing, facility, and overall operations. Each service was executed through a variety of processes. All the processes included in each service were identified and defined with regard to the procedure, timelines, required output, and so on. All the processes were mapped and the quality measures defined; these would be used as Sigma metrics. 11 12 Express Healthcare, (2010), http://healthcare. financialexpress. com/201009/strategy01. shtml Source: http://kolkata. apollohospitals. com/newsroom/271-apollo-hospitals-only-healthcare-super-brand-in-india. html This document is authorized for use only by NIKITA VAIDYA in Nutrition 346 taught by Carol Blindauer, at Dominican University Illinois from January 2015 to May 2015. For the exclusive use of N. VAIDYA, 2015. Apollo Hospitals: Differentiation through Hospitality Page 4 of 20 The Quality Department, established under the leadership of Dr. Rao, comprised two dedicated staff- Soumi Dutta and Nisha Maria- who looked after a variety of quality-related issues. Soumi and Nisha collected feedback from the patients between March 2011 and December 2012using the form presented in Exhibit 4. Patients were asked to rate each department on a scale of 1 to 10. Additionally, open-ended feedback such as patients’ comments, opinions, or suggestions was also collected. A schedule was developed for collecting feedback, which ensured that Soumi and Nisha collected feedback from a cross-section of patients; this also ensured that no biases crept into the feedback. The feedback collection methodology is shown in Exhibit 5. Soumi and Nisha were trained to collect frank, free-flowing feedback from the patients. If they received complaints while collecting feedback, they would immediately inform the department concerned and get the errors rectified, whenever possible; or ensure that the complaints were addressed to the patient’s satisfaction in real time. One of them recollected the following anecdote: A patient had complained that the door was not getting locked properly. I got in touch with the facility personnel and they worked on the door and the lock and fixed the problem- all in a matter of 25 minutes from the moment it was brought to my attention. The patient was satisfied with the immediate solution. However, we did not stop there. We teamed up with the facility team and checked every door of the hospital and repaired them if required. We wanted to ensure that such complaints were not repeated. The feedback collection process served multiple objectives such as collecting open-ended feedback from patients, resolving the issues in real time, and further auditing the actions of the service departments. The real-time escalation flowchart is shown in Exhibit 6. The feedback was saved on an MS Excel spread sheet, and stored on a monthly basis for easy retrieval. The data was then analyzed using various parameters and trends were plotted for each service. At Apollo, each service was related to a department; hence, it was easier to deal with the complaints and determine monthly improvements. FEEDBACK ANALYSIS From March 2011 to December 2012, 1,434 complaints were received from among the 1,38,600 in-patients treated during that period (approximately 1. 03%). A Pareto chart was plotted for these complaints (as shown in Exhibit 7). The housekeeping department received the maximum number of complaints, while the dietary service had the least number of complaints. The department-wise spread of complaints is shown in Exhibit 7. Some of the complaints were genuine concerns while some were related to minor discomfort. A few of the complaints were very specific, while some were generic. All of these were analyzed, which would enable the hospital to work towards reducing the overall number of complaints. Some of the sample complaints from each department are provided in Exhibit 8. According to Dr. Rao, Every complaint is an opportunity to improve. We keep looking for the smallest of the complaints, which will help us in improving our quality by several levels. Sometimes it is difficult to interpret the complaints and it is even more complex to develop strategies that will enable a better patient experience. The complete data set was analyzed to determine the word frequency count in the complaints section. The significant words with their frequencies are shown in Exhibit 9. This analysis was used to focus on specific tasks to ensure reduction in the number of complaints. For example, the most significant word was â€Å"time† and it was associated with delays in response time for the various services. The twenty-fourth most frequent word was â€Å"late,† which is again related to response time. Thus, the word frequency technique helped in focusing on problem areas. Based on the results of the analysis, benchmarks were set in consultation with the respective department for the response time of each service as shown in Exhibit 10. Apart from this quantitative analysis, another approach was used to analyze the feedback and obtain deeper insights for quality improvements. Dr. Rao used the term â€Å"defect-defective† from the Six Sigma methodology- one â€Å"defective† product/service could be caused by one or several â€Å"defects†. According to Dr. Rao, This document is authorized for use only by NIKITA VAIDYA in Nutrition 346 taught by Carol Blindauer, at Dominican University Illinois from January 2015 to May 2015. For the exclusive use of N. VAIDYA, 2015. Apollo Hospitals: Differentiation through Hospitality. Page 5 of 20 Any complaint from a patient is considered as a ‘‘defective’’. For example, consider the complaint: ‘‘Food is not served on time’’. This complaint may arise due to several reasons such as food not being prepared in time, food not being delivered on time, patient changing his/her order, etc. It is essential to identify these defects in order to eliminate the defective. On receiving a complaint from the patient, which was termed as â€Å"defective,† defects that led to the defective (complaint) were identified. Root-cause analysis was performed on all the processes of the identified defects. The processes were re-engineered to eliminate all the defects and a pilot study was conducted using the â€Å"Define Measure Analyse Improve Control† (DMAIC) cycle. Once the process was found acceptable, it was then deployed across locations. This was followed by routine and surprise audits to ensure that the process was being followed as defined to ensure customer satisfaction. The flowchart is shown in Exhibit 11a and b. All feedback related to medical services was escalated to the Medical Director’s office. In addition to this, the Quality Department at Apollo Bangalore developed a methodology called the Daily Point Average © or DPA ©. The ratings provided by patients for different departments were used to calculate the DPA ©. The departments had to improve these ratings over a period of time. The DPA © effectively captured the â€Å"mind of the customers† since the feedback was collected during the patients’ stay and not at the time of discharge. BENCHMARKING OF HOSPITALITY Hospitality required high human involvement and was very specific not only to local cultures but also to each individual. Since a patient had to stay in a hospital to get cured, hospitality automatically came into the picture. Hospitality in various hospitals was very different owing to the surroundings and differences in customer (patient) requirements. Patients did not walk into a hospital out of volition- they came in only because there was some problem. Under such conditions, the patient would be very agitated and any small thing that was out of place would become a big issue. Any kind of delay would be extremely intolerable and all the services had to be perfect all the time. Even in the hotel industry, hospitality was not standardized and benchmarks were not available. The Ritz–Carlton hotels, which are considered the gold standard in the hospitality industry, had used Six Sigma and benchmarking for their hospitality business. 13 Although benchmarks for clinical services were well-established, those for hospitality in hospitals were yet to be established. Apollo Bangalore developed benchmarks for several common complaints with three levels of services (as shown in Exhibit 10) by adopting the Kano model, which was developed by Noriaki Kano (Exhibit 12). This model was used across service industries and it helped in understanding customer expectations from any product or service. The threshold or the basic quality was the minimum requirement of the customer, which would be taken for granted even if it were present; however, if it were not there, the customer would complain about its absence. Normal or performance quality was something that the customer would expect because these were stated either by the product/service provider or by the customer as a requirement. This quality was observed by the customer and its absence would cause discomfort and disappointment. Exciting quality of the service or product was something that would not disappoint the customer; the presence of this would delight the customer, since the customer did not expect this quality. With time, the exciting quality would become performance quality and the performance quality would become a basic quality. Hence, the manufacturer or the service provider should always strive to provide new exciting qualities. Accordingly, several metrics were defined for benchmarking. For example, patients were informed that routine hospital-provided meals would be served within 10 to 20 minutes of every mealtime. This became a performance attribute. The threshold requirement of the patient would be that meals should be served within 20 minutes after placing the order. If the meal was served within 10 minutes, the patient would be delighted. However, if this customer (patient) were to come to the hospital again, she/he would expect the meal to be delivered within 10 minutes; this then would become a performance quality for her/him. 13 Source: qfdi. org/newsletters/six_sigma_qfd_hotel_application. html This document is authorized for use only by NIKITA VAIDYA in Nutrition 346 taught by Carol Blindauer, at Dominican University Illinois from January 2015 to May 2015. For the exclusive use of N. VAIDYA, 2015. Apollo Hospitals: Differentiation through Hospitality Page 6 of 20 FINANCIAL IMPLICATIONS The Quality Department required funding for data collection, analysis, and other related activities. These expenses affected the bottom line of the hospital. However, from March 2011 to December 2012, the number of re-visits increased, which implied that customer loyalty had increased. There was a 15% increase in the number of inpatients. Earlier, high discounts had been offered to dissatisfied patients owing to errors in service or poor quality of service. Gradually, there was a reduction in the discounts provided, which was a direct result of better satisfied patients. Additionally, owing to better processes, cost of quality (in terms of re-work and consumable wastage) had reduced, which helped in improving the bottom line. Further, owing to better service and higher levels of satisfaction, the patients acted as brand ambassadors for Apollo and provided word-of-mouth publicity, which improved the top line. Another example of decreased turnaround time and a resultant increase in profitability was seen in the Biochemistry Lab at the Apollo Bangalore Hospital. Dr. Rao headed this lab and he understood the patients’ requirement of receiving diagnostics reports in two hours instead of three. Dr. Rao and his team redesigned the process using 5S and lean concepts and managed to reach a turnaround time of two hours. Profits from the Biochemistry Lab nearly doubled after the decrease in turnaround time; while the cost of consumables increased by only 11%. Even though the Apollo team was trying to improve customer satisfaction, it still faced the question of how much satisfaction could be actually provided to the customer considering the room tariffs that were charged. As seen from Exhibit 13, the charges at the Apollo Bangalore Hospital ranged from USD 25 for a basic room to USD 120 for the Platinum Suite. A Ritz–Carlton basic room would cost USD 799 at Washington, U. S. A. and USD 165 at Kuala Lumpur, Malaysia (per person, per night). 14 The Apollo team might be able to provide high quality hospitality to patients in the Platinum Suites. However, the aspiration to provide the same service to patients in other rooms might not be financially feasible. The team was trying to build high levels of service for the Platinum Suites. However, the volumes in the other rooms were too high to be ignored, especially in the Indian context. Additionally, customer loyalty was extremely important to Apollo; in Dr. Panyala’s words, Customer loyalty and not mere retention is what we need to focus on. It is important to think ahead of the customer to identify issues that may compromise the experience. QUANTIFYING HOSPITALITY ACROSS APOLLO According to Dr. Rao, Once, we develop the benchmarks and the Sigma metrics, we want to replicate the system across all Apollo hospitals in the country. Each hospital will have to devise its own benchmark and Sigma metrics. However, we want to provide a framework for developing these and then measuring the outcomes. All the hospitals would then be compared by equalisation of scores and would benefit from one another’s learning†. After collecting the feedback and attempting to set benchmarks, Dr. Rao knew that he needed to go deeper and analyze each service through the complaints, set up relevant benchmarks, and target certain Sigma levels for each benchmark. He wondered whether they could collect and analyze data in a better manner. He wanted to arrive at the basis for the cost-benefit analysis of this activity. Looking at the complaints and the analysis, Dr. Rao had two major questions on his mind: 1. 2. 14 What strategy should be used to reduce the number of complaints and sustain the culture of excellence at Apollo Hospitals, Bangalore under the leadership of Dr. Panyala? Given the manual intensive processes involved in addressing the hospitality issues, what is a good Sigma level? Could Apollo set a target for Sigma level in hospitality? Source: www. ritzcarlton. com, accessed on April 15, 2013. This document is authorized for use only by NIKITA VAIDYA in Nutrition 346 taught by Carol Blindauer, at Dominican University Illinois from January 2015 to May 2015. For the exclusive use of N. VAIDYA, 2015. Apollo Hospitals: Differentiation through Hospitality Page 7 of 20 Exhibit 1 [emailprotected] parameters Sl. Parameter No. 1 Coronary artery bypass grafting (CABG) mortality rate. 2 Complication rate post coronary intervention(percutaneous transluminal coronary angioplasty; PTCA) 3 Average length of stay (ALOS) post angioplasty 4 Average length of stay (ALOS) post total hip replacement (THR) 5 Average length of stay (ALOS) post total knee replacement (TKR) 6 Complication rate for total knee replacement (TKR) 7 Average length of stay (ALOS) post renal transplant 8 Average turnaround per dialysis chair per day 9 Average length of stay (ALOS) post transurethral resection of the prostate(TURP) 10 Complication rate transurethral resection of the prostate(TURP) 11 Endoscopy complication rate. 12 Patient satisfaction with pain management 13 Door to thrombolysis time in ischemic stroke in emergency room (ER) 14 Percentage conversion of coronary angiographies to coronary artery bypass grafting (CABG) 15 Catheter-related blood stream infection (CR-BSI) 16 Ventilator associated pneumonia (VAP) 17 Catheter-related urinary tract infection (CR-UTI) 18 Average length of stay (ALOS) in hospital 19 Average length of stay (ALOS) in intensive care unit (ICU) 20 Door to CT time in stroke cases in emergency room (ER) 21 Surgical site infection (SSI – Clean wound) 22 Medication errors. 23 Average length of stay (ALOS) post modified radical mastectomy (MRM) 24 Average length of stay (ALOS) post microdisectomy 25 Average urea reduction ratio* 26 Percentage of patients achieving/maintaining haemoglobin level of 11gram or higher after 3 months of dialysis in end stage renal disease (ESRD) *Optional This document is authorized for use only by NIKITA VAIDYA in Nutrition 346 taught by Carol Blindauer, at Dominican University Illinois from January 2015 to May 2015. For the exclusive use of N. VAIDYA, 2015. Apollo Hospitals: Differentiation through Hospitality. Page 8 of 20 Exhibit 2 Accreditation of Apollo Hospitals Accreditation Joint Commission International (JCI) Delhi, Apollo Hospital Location Chennai, Hyderabad, Ludhiana, Bangalore, Kolkata, Dhaka National Accreditation Board for Hospitals Madurai, Chennai Healthcare Providers (NABH) National Accreditation Board for Laboratories (NABL) Chennai ISO 9002 Chennai Source: Apollo Investor Presentation (retrieved from www. apollohospitals. com in January 2013) Exhibit 3 Apollo Brand–Clinical and Hospitality Services Core Clinical Services Hospitality Source: Interview with Dr. Ananth Rao. This document is authorized for use only by NIKITA VAIDYA in Nutrition 346 taught by Carol Blindauer, at Dominican University Illinois from January 2015 to May 2015. For the exclusive use of N. VAIDYA, 2015. Apollo Hospitals: Differentiation through Hospitality Page 9 of 20 Exhibit 4 Feedback Form YOUR FEEDBACK Thank you for choosing Apollo Hospitals for your healthcare needs. As a quality improvement initiative, we are looking for improvements in parameters towards ‘‘Service Excellence’’ of our hospital. Please provide a few minutes of your valuable time for a personal interaction. How satisfied are you with your experience and the services provided by our hospital on a scale of 1 to 10? 1. MEDICAL SERVICES 1 2 3 4 5 6 Poor 2. NURSING SERVICES 1 2 3 7 8 Good 4 5 6 3. OPERATIONS ADMINISTRATION 1 2 3 8 5 6 7 1 2 3 1 2 4 3 5 6 7 1 2 3 10 Excellent 8 9 10 Good 4 5 6 Poor 6. FACILITY MAINTENANCE 9 Good Poor 5. HOUSEKEEPING SERVICES 10 Excellent 8 Poor 4. FOOD BEVERAGES 9 Good 4 7 Excellent 8 9 Good 4 Poor 5 6 10 Excellent 7 Poor 9 7 10 Excellent 8 Good 9 10 Excellent COMMENTS (OVERALL): Patient Name (Optional): UHID: Date of Admission: Room No: Signature: Date: This document is authorized for use only by NIKITA VAIDYA in Nutrition 346 taught by Carol Blindauer, at Dominican University Illinois from January 2015 to May 2015. For the exclusive use of N. VAIDYA, 2015. Apollo Hospitals: Differentiation through Hospitality Page 10 of 20 Exhibit 5 Feedback collection methodology A Typical Process Map: DPA Daily Data Collection Method 1:00pm–2:30pm Data consolidated; DPA Score developed* 11:00am–1:00pm Survey conducted Point of Data Colle ction Score given to IT Dept. disseminated to individual stakeholders via.