Review: Cutting for Stone

Cover image of "Cutting for Stone" by Abraham Verghese.

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.

The Weekly Wrap: May 25-31

woman in white crew neck t shirt in a bookstore wrapping books
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The Weekly Wrap: May 25-31

AI Laziness

A romantic novel in which the AI prompt was never edited out. A White House report on health citing non-existent sources. An article with summer book recommendations in which some of the authors existed but not the books attributed to them.

One might argue that each of these expose the flaws of AI. I suspect what they really expose is the flaws of the particular humans using this tool. Laziness that doesn’t carefully line edit, that doesn’t verify sources, and that doesn’t confirm the existence and availability of books. Similar to computer programming, AI is only as good as the prompts given it. “Garbage in, garbage out.”

Actually, AI has become quite good. A college professor friend now considers AI capable of writing at a professorial level. He shared examples of using AI in various forms of analysis of large amounts of material.

But one thing both of us are agreed upon is that AI offers a dangerous temptation to let it do our thinking for us. It may be a student writing a paper or an author cranking out a steamy novel. What we are doing when we let AI think for us is denying the intrinsic worth of thinking. For many of us, hammering out our ideas in writing serves to clarify thought.

Lest you think I am an AI Luddite, I do believe AI may be a helpful interlocutor in the process. I might ask AI to evaluate an argument for weaknesses or to raise counter arguments. It strikes me that when the chance to do this with real people is unavailable, this could be quite helpful. However, I am still thinking, and indeed, am forced to think harder and better.

I guess what it comes down to is that the ability to think and reason and create from our thoughts is one of the things that makes us human. I’m just not willing to give that up. I’m not ready to slack on the hard work of being a thinking human.

Five Articles Worth Reading

Alasdair MacIntyre, the philosopher, died recently. Charles Matthewes reviews his life and work in “Remembering Alasdair MacIntyre.”

“In a nation known for its relatively poor health, nearly everybody seems to be thinking about how to be healthy….” This line in “The Perilous Spread of the Wellness Craze” captured my attention. Sheila McClear explores the connection between our health care inequalities and the explosion of the wellness industry.

Nick Ripatrazone explores the decline of literary criticism in “The Art of the Critic.” Specifically, he argues for the importance of criticism as a benefit not only to audiences but to writers.

Geraldine Brooks is popular with many readers. Her husband died in 2019. In this interview, “Geraldine Brooks Is a Widow Now,” she talks about loss, grief, writing, and her Jewish faith.

Finally, the summer can be a great time to break out of our reading ruts. The New York Times Book Review has published a “Summer Reading Bucket List” of ten literary “to-do’s,” challenging us to see if we can check off five. The even include a copiable checklist!

…And a Video Worth Watching

The Covenant of Water was one of my favorite books of 2024. I have Cutting for Stone on my reading stack. On Thursday, physician and author Abraham Verghese gave the commencement address at Harvard. One of his pieces of advice for students was to commend the importance of reading novels. As an immigrant to the U.S., he also had some thoughtful and challenging critiques of our current political scene. In case you haven’t seen the video, it is worth watching, especially if you appreciate his writing.

Quote of the Week

G. K. Chesterton was born May 29, 1874. I’ve often appreciated his wit and turn of phrase. This one has some good advice:

“Don’t ever take a fence down until you know why it was put up.”

Miscellaneous Musings

Regular followers of this blog may have noticed that I have been posting two reviews a day this week. One of these has been of a children’s book published by IVP Kids. What a joy. I’ve loved the combination of brilliant illustration, good writing, and especially the inclusive character of these books. The first book I reviewed, Jesus Loves the Little Children, typified this approach showing pictures of children from every culture as well as children with disabilities. The reason for the extra reviews? I wanted to review these books, compliments of IVP Kids, before passing them along to our church’s Little Free Library, which we’ve just set up.

I was thrilled to visit the new Barnes & Noble store in Dublin, Ohio. When I walked in, it took my breath away–it was huge and overwhelming at first. And it was packed. But I like how the different sections were set apart from each other, many with comfortable seating. Not only that, the cafe was huge. But there was one drawback: the checkout and service counter was smaller than in the old store. And the lines were long.

I like the writing of Amor Towles. And I love bookstores, in case you haven’t noticed. I enjoyed this brief video clip of Towles supporting BINC, a national foundation supporting independent booksellers.

Next Week’s Reviews

Monday: The Month in Reviews: May 2025

Tuesday: Ian Harber, Walking Through Deconstructioin

Wednesday: Josephine Quinn, How the World Made the West

Thursday: Brian Goldstone, There is No Place For Us

Friday: Terence Halliday and K.K. Yeo, eds., Justice and Rights

So, that’s The Weekly Wrap for May 25-31, 2025!

Find past editions of The Weekly Wrap under The Weekly Wrap heading on this page

Review: The Covenant of Water

The Covenant of Water, Abraham Verghese. New York: The Grove Press, 2023.

Summary: The story of three generations of the family of Big Ammachi of Parambil, the ever present reality of “the Condition” resulting in a drowning in every generation, a story both of love and the hope in advances in medicine.

Twelve year old Mariamma has been engaged in a brokered marriage to a forty year old widow, the owner of a 500 acre estate near the town of Parambil. Her mother tells her, “The saddest day of a girl’s life is the day of her wedding….After that, God willing, it gets better.” I began reading with a sense of foreboding of what would happen to this girl in the house of this man. And I was surprised. At the wedding, he runs away, mortified that she is a mere child. But they wed. And he leaves her to her own room, and lets her learn the management of the household, lets her mature, lets her bond with his son, JoJo, and lets her realize that he has loved her by providing her time to come to love him. And so begins this incredible story spanning three generations within the Mar Thoma Christian community of South India.

When JoJo falls into what is little more than a puddle and drowns, she learns of “The Condition.” It explains the distance of the house from the river, the fact that her husband will not travel on the water. She is shown a genealogy. Every generation has a death from drowning. And JoJo’s name is added. Eventually Mariamma, who has become Big Ammachi, a capable manager of her household, bears another child, a girl with a developmental difficulty leaving her a perpetual child. Baby Mol brings perpetual love and an uncanny prescience about events. Fifteen years pass, and at a point of giving up hope, Big Ammachi has a son, named Philipose.

Philipose has the condition. Sent to college in Madras, he soon quits due to deafness that impedes his ability to follow the lectures. On the carriage home, he meets Elsie Chandy, an artist, and is smitten. They’d had a brief encounter when Philipose risked his life carrying a dying child on a river barge during floods to the nearest hospital, and was given a ride home by Elsie and her father. He strives to educate himself and becomes a writer, producing a column, “The Ordinary Man” widely followed throughout the country. Eventually, through a broker, Elsie’s family agrees to the marriage. It seems like a beautiful love affair, that sadly ends with the tragic death of their child Ninan. They blame each other and Philipose, injured trying to rescue Ninan, falls into opium addiction. Elsie leaves but returns when she learns Baby Mol is pining for her, and in failing health. Philipose and Elsie are intimate once and it is soon evident that Elsie is pregnant. As she approaches delivery, she has a seizure. Big Ammachi assists in a difficult breech birth, nearly costing the mother her life.

The baby is named Mariamma, after her grandmother. Soon after her recovery, Elsie disappears after going to the river to bathe, her body never found. Philipose sorts out his life, becomes an exemplary father, and continues his writing work, turning over his estate to Shamuel, and eventually, Shamuel’s son Joppan, to operate. Big Ammachi has dreamed of both a hospital in Parambil, and that her grand-daughter would become a doctor and find the cause of “The Condition” that plagues her family.

The book also involves a parallel plot line in which a young Scottish doctor, Digby Kilgour, goes to India to acquire surgical experience. Working for an incompetent superior, he has an affair with the superior’s wife, ending in a tragic fire that only he survives, with his right hand badly burned. A couple, grateful for an earlier medical intervention on his part, shelter him and connect him with a doctor working with lepers, who operates on his hand. He is helped by a young girl who helps him recover fine movements in the hand through drawing. Through much of the novel, we wonder what the what the connection of this plotline is with the main plotline of Big Ammachi and her family. Hang in there. There is one.

The story spans the period from 1900 to 1977. India goes through huge transformations through this time that serve as a backdrop for the novel, from a British colony par excellence to an independent country, seeking to modernize amid political ferment, with the electrification of the countryside and advances in medicine and modern technology. We get some sense in the novel of how this presses against traditional caste divisions, particularly in the relations between the family of Big Ammachi and Shamuel and his son Joppan.

I found the writing particularly engaging. It felt to me that Abraham Verghese writes with the same reverence for his characters that he has for his patients (he is a Professor and Vice Chair of the Department of Medicine at Stanford). One senses a deep sympathy for his characters, even as they struggle with tragedy, estrangement, and the vicissitudes of life and death. He portrays a community shaped by faith, love, and purpose. And he conveys the noble possibilities of the medical profession, evident in Rune Orquist, the doctor of a leper mission who operates on Kilgour’s hand, and in Mariamma, and the professors who train her. To read Verghese is to read a consummate story weaver who has thought deeply about the human condition in its frailty and fallibility, in the powerful bonds upon which our lives and loves depend, and in the hopes and holy aspirations that represent the best in human striving.