CUTTING FOR STONE: ABRAHAM VERGHESE

There is a line in the Hippocratic Oath that says: ‘I will not cut for stone, even for patients in whom the disease is manifest.’ It stems from the days when bladder stones were epidemic, a cause of great suffering, probably from bad water and who knows what else. […] There were itinerant stonecutters—lithologists—who could cut either into the bladder or the perineum and get the stone out, but because they cleaned the knife by wiping it on their blood-stiffened surgical aprons, patients usually died of infection the next day. Hence the proscription ‘Thou shall not cut for stone.’ […] It isn’t just that the main characters have the surname Stone; I was hoping the phrase would resonate for the reader just as it does for me, and that it would have several levels of meaning in the context of the narrative. A. Verghese

CUTTING FOR STONE immediately grabs the reader and never lets go till the final page.  Verghese has made the jump from non fiction to fiction, effortlessly, and combines the world of medicine with the 'other', immigrants from India, to both Africa and the United States.  As a reader, we get immersed in the  various cultures, Ethiopia and medicine, to be more specific.

The novel, told from the point of view of Marion Stone a twin, born mysteriously along with his brother Shiva to Sister Mary Joseph Praise, a nun from India, in a hospital in Addis Abba, Ethiopia, where she has worked for a number of years.  The mystery of the father, lies with Thomas Stone, surgeon, who has worked at the hospital for years.  With the birth of the twins and Sister Mary's death, Stone disappears, and the twins are taken in and raised by Hema, a gynecologist and her friend and husband Ghosh, a general surgeon at the Mission Hospital in Addis Abba.  The first third of the novel chronicles the early lives of the twins, their differences, Shiva brilliant but silent, Marion, outgoing and hardworking, and Genet, the daughter of their nanny.  The three are inseparable in the early years until they reach their teens, when Marion discovers he loves Genet.  His struggles with his feelings for her, his distancing himself from Shiva, his brother, the increasingly radicalization of Genet, after the brutal death of her father, as well as the lives of his parents and their patients, take up most of the second third of the novel.

The context for much of the above is the political changing world of politics in Africa, in this case Ethiopia, where Haile Selassie, the Emperor for close to fifty years is  overthrown by a Marxists, whose  goal is to destroy all the institutions that have held this poor country together, including those who supported Selassie, like the doctors and their families who have worked at the hospital.  Genet gets involved in a hijacking, further involving her family and friends, and Marion is forced to flee the country, ending up in NYC, working at a charity hospital, as he gets his medical degree.

The final third of the book gives the reader a clear look at what it's like to be a resident at a hospital for the poor in NYC, the arduous work, the impossible hours, but also the sense of 'doing good' that all those who work there feel.  Eventually, Marion finds his father, Thomas Stone, a famous liver transplant surgeon, confronts him with his abandonment of his sons.  Slowly, the two mend their relationship until Marion comes down with severe, life threatening hepatitis, a result of his final encounter with his first love Genet, just released from prison and obviously sick.  As Marion lies on his death bed, his brother Shiva, offers to give him a part of his liver, hoping that it will regenerate and save Marion's life.  With the acquiescence of his step mother, Hema, his father, and Marion, the operation takes place, saving Marion's life but through fate, Shiva dies of a aneurysm, something unrelated with the transplant.

Marion recovers, leaves NYC, to return to Addis Abba with Hema, eventually settles in at the hospital and though he vowed to return to the States, he finds his meaning in Africa.  The novel ends with a phone call to his father, Thomas Stone, to read him a lost letter from Sister Mary Joseph Praise to Thomas, freeing him of his guilt for her death and espousing her love.

The novel makes you admire the skill and courage of surgeons, makes you even want to become one, if you had the chops.  And it also makes clear how lucky Americans are to have doctors and hospitals and the facilities, so different from those in a third world country.  Here, we expect to get better, to live; there, most of the sick expect to die.  Quite a difference.