Set mainly in Ethiopia from the 1950s into the 1980s, Cutting for Stone
by Abraham Verghese is the story of twin brothers, Marion and Shiva, whose biological parents were an Indian nun and an English surgeon who worked together at Missing Hospital. When mom dies in birth and dad flees, the boys are raised by two Indian doctors at the hospital, Hema and Ghosh, and follow their own distinct paths in the field of medicine.
I really enjoyed reading this novel. The characters, including Ethiopia itself, are beautifully drawn and complicated, capable of making you both admire them and become exasperated by them. The title Cutting for Stone comes from the Hippocratic oath and refers to performing an operation for which you are not trained (doctors take an oath not to cut for stone). At the “Missing Hospital” (which was really named the Mission Hospital, but local pronunciation made it sound like “missing” and so “missing” it became), there are only a handful of qualified doctors on staff, and Dr. Stone is the only surgeon. He and the other doctors frequently must “cut for stone” because there is no other option for the poor in Addis Ababa. If they don’t try to perform some sort of operation, the patients will die anyway.
The words “stone” and “missing” have much meaning throughout this novel. Stone is the surname of three characters, all surgeons, and is a medical term (as in gall stone, kidney stone), but stone also carries certain connotations — hardness, lack of feeling or sympathy. The characters named Stone can be rather hard and stony. And at Missing Hospital, much is indeed missing: adequate supplies, trained personnel, fathers. The main characters in this book all seem to be fatherless.
This brings us to a theme running throughout the novel — what is a family? How is it defined? In Cutting for Stone, the real family is not necessarily the biological family. Often it’s the members of ones biological family who let one down, who betray and disappoint, while those who choose to become family are most true. For example, Hema and Ghosh (my two favorite characters in the book) are wonderful adoptive parents to Marion and Shiva, Matron is a surrogate grandmother, and Gebrew and Almaz are like a doting aunt and uncle. I must add that the scene on the airplane where Hema is introduced is my favorite scene in the book. It is hilarious and gives you a heads up as to what kind of woman Hema is — one who just isn’t going to put up with any nonsense.
The characters who exasperated me the most were Shiva, Marion (who narrates the story) and Genet — the daughter of Shiva/Marion’s nanny who becomes a revolutionary. Each of these characters annoyed me at times and did distinctly unlikable things. The relationship among the three is complicated and is what drives much of the plot, so I don’t want to give it away, but Marion and Shiva are twins who were conjoined at birth and had to be surgically separated. They seem to share a mystical bond that becomes broken and must be healed. I found that aspect of the plot to be powerful and moving.
One final observation: one of the characters has autism. If you know anything about autism, you will know who I mean and why. I “liked” Abraham Verghese on Facebook and posted a question about this on his wall. I later saw that NPR had a discussion wall on Cutting for Stone where readers could post questions, and someone else had asked my question. Verghese replied in the affirmative — the character is an Aspie even though this is never said in the book. It’s a minor part of the story, but for those of us living with autism, it really sticks out!