cutting for stone

Trigger warning: The book and this post, albeit briefly, explore the subject of sexual violence, which may be upsetting to survivors.

Each summer, my family rents a beach house in Atlantic Beach, N.C., and we spend a week together in what is always for me the most relaxing vacation of the year. I’m generally able to read four or five books — and everyone else passes the time the same way, often swapping books. Usually there’s at least one that forms a line: from the past couple of years, it’s been the latest in the Harry Potter series, Little Bee, and Water for Elephants.

Abraham Verghese’s Cutting for Stone was last year’s beach book, but vacation ended before the book was passed to me. I didn’t pick it up until recently, but apparently I’m on a kick of novels that take place during mid-20th-century upheaval in African countries. However, I think the book would have benefited more in terms of my review if I had read it last summer rather than when I did read it, which was mostly during Passover last week: my husband’s family is a little less used to me buried in a book than my family is. Some of the difficulty I had in concentrating may have spilled over into my opinion of the book.

Overall, I enjoyed the book — although I don’t think I liked it as much as my family did, or as much as the gushing reviews on the back cover. The story of extraordinary identical twins born under even more extraordinary circumstances, the novel takes the reader from India to Ethiopia, then to the U.S. and back, delving into the lives of a half a dozen medical professionals, most of whom are related.

The title is a play on words that the book unfortunately doesn’t do much to explain. “Stone” is the surname of the twins, given to them in honor of their absent biological father. But it’s also a reference to a portion of the Hippocratic Oath: “I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art.” In this case, “stone[s]” refer to those of the kidney, bladder, and gallbladder, which must be removed via surgery — the distinction between physicians and surgeons an important one in 5th century BCE Greece. More generally, it’s a promise to do what is best for a patient — what is within the doctor’s skills — and not to overreach. It’s a lesson that the book illustrates, if not elucidates, well.

Born in the oddly-named Missing Hospital in Addis Ababa, Shiva and Marion are the improbable progeny of the hospital’s main surgeon and his surgical assistant, Sister Mary Joseph Praise. Their nun mother dies in childbirth, and their father leaves the country in grief, leaving the boys to be raised by two of the hospital’s other doctors. They grow up against the background of (historical) political turmoil in Ethiopia, which eventually forces Marion to flee to the U.S., where he pursues his medical studies, reunites with Thomas Stone, and finally decides to return to the land of his birth.

Verghese is a doctor, but he’s also a talented writer who is able to make compelling the intricacies of surgery (much like one of my favorite authors, Atul Gawande, who provided one of the adulatory blurbs). He weaves a beautiful story, told through the voice of Marion, an extremely earnest narrator. Marion is buffeted more than most by forces beyond his control, and my heart broke for him on more than one occasion (I was even in tears at the end of the novel). I was, however, not so sympathetic, when fueled by anger, he forces himself more than once on a vulnerable childhood friend. Verghese even has him use the phrase “took her” in describing one of the encounters, and the thrust of this part of the plot (excuse the terrible pun) is that Marion is justified in his behavior — although he certainly comes to to regret his actions (but for different reasons). It was a disappointing part of a story that otherwise treats relationships, not to mention the importance of humanity in practice of medicine, with sensitivity and wisdom.