Cutting for Stone, this intriguing first novel by Dr. Abraham Verghese pulls
the reader into the story at once. His characters are people you want to know more
about. The story takes place in countries scattered over three continents and involves a variety of
ethnic and religious groups: Indians,
British, Ethiopians, Eritreans, Americans, and more. People worship one or many gods. All struggle.
Some win, some lose, some find
peace.
Young, beautiful Sister Mary Joseph Praise from
India is the operating room nurse assisting a brilliant British surgeon Dr.
Stone at a mission hospital in Addis Ababa in Ethiopia. She learned to know him on the ship coming
from India, nursing him to health when he became deathly ill. He may be a great surgeon but is a flawed
human being. Personal relationships are not his strength.
The unexpected premature birth of the twins Marion and Shiva to this nun is the setting for this novel of passion, personal
and political trauma, and family rifts,
and a resolution that leaves one wondering – and yet content.
The question I am asked is the meaning of the title “cutting
for stone.” The Internet informs me
that the phrase derives from the Hippocratic Oath that doctors swear on graduation
from medical school. No surgeon cuts for
stone (kidney?) if there is someone better equipped to that.
This theme of cutting is introduced early in the
novel at the impending birth of the twin boys, the main characters. The Matron of Missing Hospital stands helplessly over Sister Mary Joseph’s dying body. She says to Stone,
a skilled surgeon: “Your patient, Dr. Stone.”
She wants him to cut, to do a C-section, but he is helpless, unable to
function because he loved the woman dying before him. He
attempts an abortion with an anatomy book propped in front of him, planning to crush the skull and pull the infant out.
Fortunately, Dr. Hemalatha, gynecologist, arrives to “cut,”
perform a C-section, only to discover
that there are two babies waiting to be born. She names them
Marion and Shiva. The babies are joined
at the head by a shaft, which she cuts not knowing whether that will start a
massive bleed or be the babies’ salvation.
That mashing of one baby’s head is key to later events. Her cut saves
their lives.
Both boys become surgeons and Marion, who should
have been born second in a normal birth, is the first to see the light of day
in a C-section. I am reminded of the
story of Jacob and Esau, sons of the patriarch Isaac, who all their lives vied
with one another for their father’s affection, with firstborn Esau selling his
birthright to his brother.
The author enjoys double meanings, so “cutting for
stone” as well as other terms and events
have more than one meaning that weave in
and out of the action. The setting for
the book is Missing Hospital, yet
the original name for this institution is Mission Hospital. Because it was
often misspoken by native speakers, some clerk registered it as Missing
Hospital, and that’s what it became. People
and objects are often missing in this novel. Yet missing does not mean the matter is ended.
Missing
is a finger of Dr. Stone’s hand which he
self-amputated when it became infected.
Because he only has four fingers on that hand he is able to poke into
body cavities with greater facility than someone with five. The finger shows up later in a bottle of
formaldehyde and becomes a symbol of something bigger than a mere digit.
Missing
also is the doctor’s memory of how he impregnated this young
nun. It is a mystery to him although he knows he was deeply in love with
her.
Missing
also is a letter the desperate young nun wrote to her
lover, Dr. Stone, before her death. It
doesn’t show up until the end in the “afterbird,” the Amharic mispronunciation of “afterbirth.”
It reveals the events leading up to the conception.
Missing
is Stone as the father of these boys during their growing up and development.
But
back to “cutting for stone.” The twin boys are
brought up by Hema and Ghosh, surgeons at Missing Hospital, in a loving home. Both boys become
surgeons, Marion through formal education, Shiva through self-education. Shiva becomes a surgeon of women with fistula, a tragic condition that
afflicted countless African women
because they were married too
young, received nonexistent prenatal care and came too late for help after
the baby was already jammed down the birth canal and hospitals where C-sections
could be performed too distant. The result was a fistula, or tear between
bladder and vagina, causing persistent dribbling of urine. Such women soon reeked and were ostracized by
husband, family and community. Shiva becomes
the world’s expert on fistula surgery and leading advocate for women in Third World countries for better care of
women.
Women with fistula found their way to Shiva by bus,
foot, and donkey. They often came with a piece of paper in their hand that
simply said in Amharic “Cutting for
Stone.” Shiva Stone was the expert
without having taken the Hippocratic oath.
This is a great novel because, first of all, it is a
good story. It makes the reader want to
know what’s coming next. What will
happen to the twins? Will they ever be united with their absentee father? The reader soon begins to care for them and
their generous caretakers Hema and Ghosh and about the conflicts in their
lives, which, though in a different culture, are not so different from ours –
family tensions, personal traumas, political turmoil.
The novel is also gripping because the actions of the
main characters move them ahead—or backwards. There is clear cause and effect. The
twins, their father, their adoptive parents,
and other characters in the story live out their lives using their
strengths and weaknesses, but not
without consequences.
I recommend the book. I understand it has already
sold millions.
