Cutting for Stone, Abraham Verghese. Vintage Books (ISBN: 9780375714368) 2010.

Summary: Twins Marion and Shiva were born amidst tragedy involving their mother’s death and father’s flight.

Marion Stone, the narrative voice of this work, and his twin brother Shiva were born amidst a tragedy. Their mother was Sister Mary Joseph Praise. Gifted surgeon Thomas Stone is their father. Both the Sister and Stone had arrived in Ethiopia seven years earlier, meeting on a boat from India. They worked together at “Missing” (actually Mission) Hospital in Addis Ababa. They were as one in the surgery theatre. She helped illustrate a textbook on surgery. And, mysteriously, they had become lovers (we only learn the circumstances at the close of the novel).

When the time of delivery was at hand, the babies can’t make it through the birth canal. The obstetrics doctor, Hema was away. Stone first attempts a botched abortion procedure. He freezes and can’t perform the needed Caesarian. Hema arrives in time to deliver the babies, who were attached at the head. Miraculously, they both live. But the mother dies and the father flees. Marion does not hear from him until he is an adult in America. However, Hema decides to raise the boys. And the one remaining staff doctor. Ghosh, takes over surgery in addition to general care. He also marries Hema and joins her in raising the boys. Clearly, they are better off than they would have been with Stone.

Ghosh mentors Marion in surgery. And Hema mentors Shiva in obstetrics and gynecology. He eventually develops an innovative procedure to treat women with fistulas. The boys are close, having been connected at birth. Yet their lives take unique courses. Eventually Shiva betrays Marion. Marion loved the daughter of the housekeeper and hoped to marry Genet. But Shiva slept with her. Betrayed by both, he is deeply depressed.

All this occurs against the backdrop of a turbulent period in Ethiopian history, first a failed coup attempt, and later, the Eritrean revolt, in which Genet plays a prominent role. Because of her tie with Marion, Marion flees Ethiopia to train as a trauma surgeon in a poor, New York hospital. It is here that he reconnects with Thomas Stone, a liver transplant specialist in Boston. Marion’s hospital is a source of many of those livers. The climax of the novel brings Marion together with the three people who had betrayed him. But will they find the reconciliation Ghosh, his step-father hoped for before he died?

Behind this theme lies another that I suspect is dear to Verghese–the calling of a doctor, and particularly a surgeon. The title, “cutting for stone” comes from the Hippocratic Oath as well as playing on Marion’s father’s name. Physicians swear not to operate for kidney stones, unless a specialist. Too many died at the hands of “lithologists” whose unsterile practices often killed their patients. In a scene during a conference, Thomas Stone asks,  “What treatment in an emergency is administered by ear?” Marion, not yet known to him answers correctly, “Words of comfort.” Marion and Shiva’s step parents imparted this care for patients to the twins even as they emulated their father’s skill.

Last year, I read Verghese’s The Covenant of Water. His voice and storytelling capacity enthralled me. And so I sought out his earlier work. The same qualities are evident here. Verghese spins a compelling story. At the same time, he offers us layers of meaning and insight into the human experience. I look forward to his next work, which I suspect will be at least several years coming given the careful writing and length of his stories.