(Blogger Note: This review was published in the January, 2012 edition of LAMLight, the physician newsletter of the Lynchburg Academy of Medicine.)
This could be
the very shortest book review which I have ever written. It would read: Buy, borrow or steal a copy of this book immediately
and read it. It is fantastic. That brevity would not, however, do this book
justice or fill up the page, so here goes:
Cutting for Stone is the first novel by
author Abraham Verghese, an internist and infectious disease specialist. He has written two previous non-fiction
books. The first, published in 1995 is
titled My Own Country: A Doctor’s Story
of a Town and Its People in the Age of AIDS.
He was practicing at the time in Johnson City, Tennessee. The second, The Tennis Partner was published in 1999 and told of the author’s
relationship with a colleague who had an unfortunate addiction problem. At that time, Dr. Verghese was a Professor of
Medicine and Chief of the Infectious Disease Division at the Texas Health
Sciences Center in El Paso, Texas. Dr.
Verghese is now on the faculty at Stanford University as a Professor and Senior
Associate Chair for the Theory and Practice of Medicine. He also has received an MFA in Creative
Writing from the prestigious Iowa Writers Workshop.
Cutting for Stone is a 657 page
tour-de-force novel packed with history, unforgettable characters and
descriptions of medicine practiced without any of the modern diagnostic
tools. The story starts in the early
1950s in Addis Ababa, the capital of Ethiopia. Ethiopia is located on the Horn
of Africa and has Middle Eastern, Muslim, Christian and Jewish heritages. Marion
Stone and his twin brother Shiva are born in chaotic fashion. They are delivered from a Carmelite nun by
emergency C-section after attempts to deliver them vaginally by the mission
hospital’s surgeon nearly killed them.
Sister Mary Joseph Praise was a dedicated surgical nurse and had kept
the pregnancy a secret until she was found in the late stages of arrested labor
in her room. She had worked diligently
for years in the operating theater with Dr. Thomas Stone who was presumed by
all to be the babies’ father. The
secrets of the babies’ conception are hidden from the reader until nearly the
entire book has transpired. Sister Mary
Joseph Praise dies on the operating table and Dr. Stone disappears. The hospital is left in a state of turmoil,
having lost their most talented physician and their most respected nurse in one
day. The twin boys are adopted by the hospital’s
obstetrician and her husband, an internist who takes over surgical
responsibilities in the absence of Dr. Stone.
The story then
follows the childhood and early adulthood of both boys. They are raised on the hospital grounds and
attend local schools. They are literally
raised by a village, including servants, hospital workers and even some of the
patients. The author reveals the stories
of Thomas Stone and Sister Mary Joseph Praise in flashback chapters. They both were born and raised in India and
each arrived at Missing Hospital in Addis Ababa for different reasons. These stories are very compelling in their
own rights. Dr. Stone became an expert
tropical surgeon and wrote an internationally recognized
text book on the subject. Marion and
Shiva develop quite different personalities despite being identical twins. Marion is the serious student and romantic,
Shiva is rebellious and more irresponsible.
This inevitably causes friction and the boys become estranged after a
fight over a local girl, a love interest for Marion and a conquest for Shiva.
As a physician
reading this novel, it was refreshing to read of doctors using history taking
and basic physical diagnosis skills to solve medical puzzles and not only make
correct diagnoses but prescribe the appropriate treatments. They accomplish this without MRI or CT scans
or reams of laboratory data. They use
their medical knowledge, their physical examination skills and their insights
as diagnosticians to practice their art.
This author is
able to weave the history of modern Ethiopia into the fabric of the novel, much
like Khaled Hosseini did for Afghanistan in A
Thousand Splendid Suns. The author
describes the impact of Italian occupation on the local culture and, in
particular, the architecture. He
narrates the rise to power of the diminutive Emperor Haile Selassie and
multiple attempts to dethrone him. The
hospital is geographically caught in the middle of several coup attempts and
the twins’ adopted father is imprisoned at one point for operating emergently
on one of the resistance leaders.
Political unrest eventually leads Marion to immigrate to America to
complete surgical residency.
In another
comparison to Hosseini, Abraham Verghese does a terrific job of describing the
plight of women in third world countries.
The female characters in Cutting
for Stone are subjected to unbelievable prejudices and sufferings. There is one chapter which graphically
describes a female circumcision and its horrible aftermath which is as riveting
as it is revolting. Even the crude
health care system discriminates and women are often left with the natural
consequences of their diseases. Shiva
uses his precocious fascination for repairing things and anatomical knowledge
that he gleans by observing surgeries performed by his adopted mother
gynecologist to devise a surgical repair for vaginal fistulae. These are an all too common occurrence in
Ethiopia because of early teen and multiple pregnancies combined with
inadequate gynecological care. Because
of incontinence these women become outcasts, much like lepers in previous
centuries. Shiva's notoriety becomes yet another
source of irritation for Marion who has worked tirelessly for years to become
an accomplished surgeon, only to have his formally untrained twin receive
notoriety for his surgical innovations.
The latter
portion of the book details Marion’s life as a surgical house officer in a
depressed hospital in New York City.
This hospital is in such a blighted area that it is completely staffed
by foreign medical grads. It is a
virtual United Nations with Pakistani, Indian and Ethiopian physicians. The combination and clash of cultures in the
house staff living quarters is entertaining. Marion inevitably comes into contact with his
biological father who has by now reinvented himself as a renowned Boston academic
transplant surgeon. After expressing his
great anger, Marion more or less makes amends with Thomas Stone. Marion becomes seriously ill which precipitates
a reunion of the brothers, their biological father and their adopted
mother. The book ends with the
exposition of the many secrets and fears which all of the characters had held
in their hearts for thirty years.
One of the more
pleasant surprises in this book is the author’s description of the foods of his
native land. His descriptions almost
make the aromas of lamb, lentils and chicken waft off of the page:
“Mustard seeds
explode in the hot oil. She holds a lid
over the pan to fend off the missiles.
Rat-a-tat-tat! Like hail on a tin roof.
She adds the cumin seeds, which sizzle, darken, and crackle. A dry, fragrant smoke chases out the mustard
scent. Only then are the onions added, handfuls
of them, and now the sound is that of life being spawned in a primordial fire.”
(Side
note: If you would like to try amazing and
authentic Ethiopian food, try Zed’s Ethiopian Cuisine at 1201 28th
Street, N.W, in the Georgetown section of Washington, D.C. Their chicken doro watt is superb and they
have great vegetarian entrees as well, such as Split Pea Kik Alicha. We discovered this restaurant a few years ago
when it was recommended to us by an Ethiopian cab driver.)
This is a
wonderful book which is extraordinarily well written. The words flow and the paragraphs glide and
the entire book is a mesmerizing and fantastic reading experience. The characters are so vivid you feel like you
have known them your whole life. The
emotions are conveyed in a sincere way and all of the melancholy, fear,
desperation, hope and even happiness are felt deeply by the reader. Cutting
for Stone is also a novel of redemption, forgiveness, sacrifice and triumph
over adversity. As I said earlier, get a copy of this book,
read it and savor it. You will be glad
that you did.
