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OHT Unprescribed Stories Kick Off: Session Recap and The Immortal King of Rao Book Review
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- 2 days ago
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Updated: 14 hours ago
The Unprescribed Stories Club is our new space for people to reflect on healthtech using ‘unprescribed stories’ like fiction books, films, music, TV shows, and art. Whilst these materials are not strictly ‘about’ healthtech, the Unprescribed Stories Club prompts us to think about the world in which we’re building healthtech and lowers the barriers to having honest, speculative conversations about what equity means in this space.
The Unprescribed Stories Club meets bi-monthly to discuss one story to interrupt the prescribed ways we think about healthtech. In November, One HealthTech had its first Unprescribed Stories Club to discuss, dissect, and debate the book The Immortal King of Rao by Vauhini Vara… and Friday evenings have never looked so good.
The Immortal King of Rao was voted by our community as the first book to kick off the inaugural Unprescribed Stories Club. In this blog post, fellow Zoya Yasmine (from OHT Oxford) provides a summary of the first session and a review of the book through the lens of OHT.
It was Friday the 14th…
Friday 14th is typically considered an unlucky day. But any fears about the Western superstition bringing bad fortune were dispelled when OHT community members, Kate, Mary, Steven, Charly, Aamani, and Zoya were brought together virtually to discuss The Immortal King of Rao.
Everyone had just over a month to read it, or at least engage with it in some shape or form). We all did a pretty good job and shoutout to Mary (OHT Fellow) for consuming all 374 pages within just 1 week, averaging 50+ pages per day.
During the session, our conversations not only touched on explicit connections between the book and healthtech, but we also stumbled into conversations about the book’s relations to synthetic data in health research, Elon Musk’s Neuralink, and even Margaret Thatcher’s ‘erotic power’ – admittedly, this last one was very Unprescribed. Because of the way the session is structured, even if you hadn’t managed to read the book at all, you could still quite easily engage in the conversations because the book isn’t the main focus but a platform for speculative and critical discussions about healthtech.
A brief summary of the book: spoilers alert!
The Immortal King of Rao is centred around the main protagonist, King Rao, and his journey from an Indian coconut plantation in the 1950s to Silicon Valley’s most successful tech company, the Coconut Computer Corporation. The Coconut Computer Corporation grows to become a global, corporate-led government where citizens (referred to as Shareholders) are controlled by an ‘Algo’ and decisions about society are made by Coconut’s Board. The book is very much a commentary on contemporary times, with several nods to real-world companies and tech founders such as Steve Jobs and Bill Gates – likely influenced by the author’s previous role as a technology reporter at the Wall Street Journal and business editor of the New Yorker.
King Rao began his entrepreneurial career by building a microcomputer called the Coconut (named in homage to his origins) as a student in his future wife’s (Margie) dad’s lab. He then goes onto inventing the Harmonica (a technology of resemblance to Musk’s Neuralink) to finally, the most controversial, the Clarinet – a memory uploading technology. King Rao becomes father to Athena through a surrogacy arrangement after Margie passes away. Athena was modified at embryo stage with the Clarinet technology, so her brain is connected to her father’s memories. The story is told from Athena’s perspective, which is possible because of the Clarinet which enables her to recount her father’s past alongside her own perceptions of reality.
Athena’s entire young life is spent growing up in isolation on an island with King Rao, away from the world controlled by the Coconut Computer Corporation (to which Rao is no longer CEO because of failings of the Clarinet technology which killed 63 individuals). One central plot in the story follows Athena as she leaves the island and befriends the growing anarchist collective, called the ‘exes’, who have rejected the system run by the Coconut to live in autonomous island zones.
The book is told by Athena through a dual timeline which each operates through the conventions of different genres and focuses on the different stages of King Rao’s life:
The first is King Rao’s origins and childhood on an Indian coconut plantation known as the Garden
The second was his arrival in American and rise to CEO of the Coconut Computer Corporation
And the third, was the aftermath of his demise, where he lives his life hiding on a deserted island with Athena surrounded by vegetable and fruit plants reminiscent of the Garden
Our thoughts on The Immortal King of Rao
The first half of the session featured a quick attempt at a summary of the book by me and then we chatted about our thoughts on the book itself. Generally, we all liked the book but some of us found the first half a bit tricky to get into. As you’ll see from the summary of the plot above (which is only a high-level overview) Vara packs a lot into her first novel. Since the book is told through three different narrative strands, each with their own plots, characters, genres, and meta commentaries on contemporary times, there is a lot to remember and understand. But it got easier to piece things together as the book went on. We did find that some of the stories, such as those in the Garden tracing King Rao’s childhood in the Dalit community, felt underdeveloped as a result of this.
Another point raised was that we were unsure what audience the book was aimed at, it felt semi sci-fi because some of the dystopian elements, but told from the point of view of young Athena it had a young adult feel, but then the references to the technology industry felt detached or may have been unfamiliar with this audience. Nevertheless, we appreciated Vera’s ambitions with the book and desire to subvert typical genre binaries and narrative structures. It also made for a great Unprescribed Stories Club choice since there was just so much to unpack!
A breakdown on the things we liked:
The Algo, privatisation of government, and brain interface technology, while feeling very dystopian, all felt very familiar and relevant to current day. This weird speculative fiction, but oddly non-fictional aspect made the book thought-provoking (and also quite scary). Being addressed as ‘Dear Shareholder’ was also ironic and on the nose in a good way.
The author, Vauhini Vara, was a technology reporter at the Wall Street Journal. The book was clearly influenced by her experiences and was very much a critique of all the ‘technos’ (technofeudalism/technopolies/technocracy).
The book's characters King Rao and Margie were reminiscent of Bill and Melinda Gates. The Coconut Computer Corporation was also homage (we believe) to Apple and there were also some subtle Steve Jobs references made.
The book’s title, The Immortal King Rao, is clever. King Rao, although not a king, possesses this royalty-like position in society in his ‘rein’ to power as CEO of Coconut, becoming leader of the world as part of the Coconut’s Board. Due to the Harmonica too, King Rao becomes somewhat immortal in a sense as his memories are trapped within the brain of his daughter Athena who recounts his life after his death.
The book’s descriptions of India and the Garden were beautiful, and the adjacent descriptions of the US were wonderfully bleak. The book ends on the sentiment to challenge why King Rao felt the need to move to the US to pursue his ambitions and throughout there are criticisms of the falsities of the American Dream. We liked that the book did not play into the typical ‘poor Indian poverty porn’, and directly relates to the problem of ‘Indian brain drain’ to the US.
Linked to the above, the book also references the caste system in India, as King Rao is born and grows up in a Dalit village. The book grapples with the tensions between the Dalit community's aspirations to remain as a community supported by their own farming industry and ways of living, as well as King Rao’s desperation to leave (alongside other members of the Rao family) and immerse himself in the American landscape.
The Immortal King of Rao, through the lens of healthtech
The second half of the Unprescribed Stories club was centred on its connections to healthtech and things we as a community were currently thinking about when we were reading the book. The speculative nature of the The Immortal King od Rao provided a platform to think about the implications of our current approach to building healthtech and how things could be done differently, for instance, the “exes” provided an alternative decentralised system of living away from digitalisation and commodification of our bodies and health. Below are some of the discussions inspired by the story.
One of the main conversations we had was around technology founders and their desire to make society better which often ends up causing harm and being misguided. In the book, we observed how lonely King Rao must have been in his life: his mother died while giving birth to him after being raped by his father. Growing up as part of the Dalit community, he felt outcast in India and the family farm was run by the patriarch Grandfather Rao who placed pressure on him to succeed and look after the family. This could be the reason for his fascination in technology’s ability to connect brains and memories, a way to feel closer to his daughter, his dead wife Margie, and his own upbringing and family in India which he undoubtedly now felt detached from. Indeed, the tagline of the Coconut, is even: the goal of Coconut is even to bring people together in harmony.
However, King Rao’s response to these social problems of loneliness was technology. This leads us to question why we always turn to technology to solve problems which are often always rooted in other issues which are better addressed through non-technical means. One example that came to mind from me was the interest in synthetic data for mitigating biases in health datasets. Broadly, synthetic data is data created using algorithms to mimic the statistical properties of real-world data, doing this makes it possible to process datasets that can have the same function of real data but with a greatly reduced risk of identifying individuals. There is research exploring how synthetic data can be used to ‘boost’ the presence of patient groups who are underrepresented in the datasets. Yet, again like King Rao, while possibly with good intentions, does this not miss the deeper question of why these patients are underrepresented in the datasets in the first place? Should we instead find ways to make health systems more equitable so these communities do not continue to be misrepresented or artificially represented in medical research?
Another potentially misaligned healthtech intervention that was mentioned were GP appointment booking technologies. While convenient in theory, calling up your GP first thing in the morning to get an appointment is riddled with issues (namely, routinely being caller number 8728372 even when you’re on the line bang on 9AM). It also excludes those who have working or family commitments at those times who cannot call, as well as those without access to the phone. Another example mentioned was the recent deployment of ambient voice technologies (AI Scribes) which are used to transcribe GP consultations. While intended to enhance the doctor-patient interaction by saving time, AI scribes have actually led to the opposite results for some. Eccles and others argue in the BMJ that by cognitively offloading the transcribing role, doctors miss out on essential critical thought and reflection which may compromise clinical expertise. The technology is also mainly tested on patients whose first language is English, meaning that it could be less accurate for patients whose first language is not English.
Another conversation we had was on sexism and women in healthtech. We had a long discussion about Margie (King Rao’s wife) and her role in the success of Coconut which was downplayed by King Rao’s technical skills. Margie notes that her father would have never allowed her to be involved with Coconut, which is precisely why she needed to involve him. At the time, through Athena’s narration, Margie is positioned as a young woman showing romantic interest in King Rao. But the deeper truth is that her closeness to him was at least in part strategic: she was pursuing her own ambitions to build a tech company in a world structured to deny her that possibility. The book makes reference to Margaret Thatcher (yes, this is how we got onto this) and Eleanor Roosevelt who “were powerful enough to render beauty beside the point” (though, Fellow Kate shared THIS which slightly challenges this point). It led us to reflect on how women may sometimes feel the need to take on patriarchal forms to be accepted as authoritative, worthy, and credible in the healthtech industry. A point we could reflect on here is how we can make meaningful differences to change the perceptions of women in the healthtech industry. Moving beyond initiatives that risk “othering women” – showcasing them as exceptional despite (and excusing) the patriarchal system rather than changing it.
We also spoke about couples in the biotech space, such as Elisabeth Holmes and Sunny Balwani secret romance (Theranos), and the delicate balance of interests in companies led by people who are romantically involved. On the one hand we felt that this provided them with a mutual passion for the company (so much so that in the book King Rao and Margie spend their wedding day in the office…) but also, how companies can become corrupt without independent checks and balances in the decision-making processes which can become clouded behind closed doors. This conversation made me think about the importance of having a diversity of views and people within your business, especially at the start-up level, where it is essential to have truck loads of ambition and perseverance, but also should have people around you that can keep you accountable, honest, and realistic.
On a final note, we pondered on how technological advancement was framed in the book – serving as both a hope and as a warning. Since we were receiving the narration from King Rao’s own nostalgic memories, we see how inventions can show signs of promise and the potential for greater connectivity (although, preface with our earlier discussion). However, we also touched on the consequences of an unchecked, race to the bottom, approach to technology regulation. Chaley chimed in with some excellent insights about the EU AI Act here and the responsibilities that technology providers have for high-risk AI systems, contrasting with the UK’s own “pro-innovation approach to AI regulation”.
The group’s rating of The Immortal King Rao
All in all, our first Unprescribed Stories Club was jam packed with various musings about the book and our own interests in healthtech. On average, we (those who had finished it) rated the book a solid 3.5/5 – not bad for our first choice!
The next Unprescribed Stories Club?
Dearest Shareholder, if this all sounded very fun and you’re feeling the FOMO, never fear. The Unprescribed Stories Club runs bi-monthly so our next session will be in January (23rd @ 5pm). This time we will be watching a film: Barbie! The aim of the Unprescribed Stories Club is to use unprescribed materials which are not “about” healthtech, but nevertheless can help us think differently about the world we’re building it in. We’re hoping that Barbie and all the feminist commentary that flowed following its release will provide us with some great conversations about power structures, women’s health, and care in medicine. You can take this as an opportunity over the Christmas break to subject your family and friends to a bit of sparkle, pinkness, and Dua Lipa – you’ll thank us later :)
If you’re interested in joining the session, please join the Unprescribed Stories Slack Channel where you can keep up to date with all the Club’s happenings. If you do end up reading The Immortal King of Rao, do pop any of your reflections or thoughts of the book onto the channel too – we’d love to hear them!
Unprescribed Stories Club x The Immortal King of Rao questions
Below are some additional healthtech questions related to The Immortal King of Rao which you can think about yourself if you have read the book.
From the opening of the book, King Rao states, as he is talking about the beauty of writing code: “there was no mystery in it. It was not like understanding another human, or for that matter, oneself. It was instead a puzzle, which is to say, it could be solved”.
Do you think that the academic culture of STEM subjects, especially computer science and maths, is harmful in the world of healthtech? Many healthtech founders are from a STEM background which is so often based on abstract concepts (taught not in relation to their real world implications), quantifiable answers, and little room for ambiguity. In contrast the culture of the humanities prompts us to ‘question the question’ and engage in critical theories where puzzles are not easily solved.
In the world run by the Coconut Computer Corporation, on the island there is a super yacht (called the Cha Cha) where citizens party. Sometimes, the “exes” go there on a mission to convert citizens who are under the obedience of the Coconut. However, on the Cha Cha, instead of sex work or drinking, people follow each other into backrooms to inject each other experimental drugs in the form of underground clinical trials. We see that experimental drugs in uncontrolled environments are the new currency of pleasure and status and how the tech-elite culture enjoys treating human bodies as playgrounds for untested science in a culture addicted to novelty.
How does this relate to today when we see people taking Ozempic and Mounjaro and other anti-aging or cosmetic injectables? What are our thoughts on this, and how can we, or should we even, discuss this alongside colonial clinical trial practices where individuals from the Majority World are often forced to be test subjects without consent and often causing injury and death?
In the book, Coconut faces an intellectual property infringement lawsuit as it is claimed that Coconut’s invention is based on other people’s ideas (not King Rao’s). King Rao openly and proudly admits to using other people's ideas learnt from scientific papers. In one respect, King Rao’s attitude is reflective of the culture of innovation, whereby we build upon, develop, and improve other people’s ideas (the Creative Commons community and Open Source movement reflects this idea).
We’ve recently seen lots of intellectual property challenges in the AI field, especially whereby large language model companies have trained their models on other creatives’ work. In particular, despite making aggressive assertions that its AI models were not infringing copyright and could rely on the legal exception of ‘fair use’ in the US, OpenAI began investigations into DeepSeek after it believed that it used the outputs of ChatGPT to train its own models.
What do you think about intellectual property in the healthtech industry? Have you ever encountered issues, do you think intellectual property laws support smaller companies to protect their inventions and work, or does its current operation only protect big companies to grow and monopolise?
Unprescribed Stories Club: book suggestions
Here is the original list of books that we had if you’re looking for some fictional books with some loose healthtech-y vibes:
Automatic Noodle: A cozy near-future novella about a crew of leftover robots opening their very own noodle shop.
The Immortal King Rao: The novel follows the legacy of King Rao, a tech CEO who motioned the world toward corporatocracy, as his daughter pens a letter about his rise to power.
Klara and the Sun: Klara and the Sun explores the uncharted implications of AI to human relationships and the abiding question of what it means to love.
Do Androids Dream Of Electric Sheep?: Set in a post-apocalyptic San Francisco, where Earth's life has been greatly damaged by a nuclear global war.