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Cutting for Stone

4.24 of 5 stars 4.24 · rating details · 128,083 ratings · 16,586 reviews

Marion and Shiva Stone are twin brothers born of a secret union between a beautiful Indian nun and a brash British surgeon. Orphaned by their mother’s death and their father’s disappearance, bound together by a preternatural connection and a shared fascination with medicine, the twins come of age as Ethiopia hovers on the brink of revolution.

Moving from Addis Ababa to New...more

ebook, 600 pages

Published February 3rd 2009 by Vintage (first published 2009)

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Jan 24, 2012 Jason rated it 5 of 5 stars · review of another edition

Shelves: for-kindle, 2012, reviewed, thrill-me-chill-me-fulfill-me

The world turns on our every action, and our every omission, whether we know it or not.

It is statistically improbable that I will read a book as good as this one anytime soon. Although I’ll admit it starts off slowly, I found that the depths of this novel are revealed as the protagonist’s life unfolds. Something of a bildungsroman, Cutting for Stone focuses on a pair of twin boys who are born and raised in an African missionary hospital. Their story combines elements of Indian and Ethiopian lang...more

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Oct 27, 2012 Nataliya rated it 3 of 5 stars · review of another edition

Shelves: medicine, 2011-reads, doctor-wrote-it

My favorite parts of this sizable tome were, of course, the medical jargon and the lyrically gory descriptions of diseases and surgeries.

I guess, by now I have finally and irreversibly crossed that thin line between sanity and medicine.

Yes, all the descriptions of diseases and surgeries, and the handy medical mneumonics were like music to my ears. Really. Reading Verghese's Cutting for Stone reminded me of the conversations that I tend to have with my friends in the medical field - they inevita...more
My favorite parts of this sizable tome were, of course, the medical jargon and the lyrically gory descriptions of diseases and surgeries.

I guess, by now I have finally and irreversibly crossed that thin line between sanity and medicine.

Yes, all the descriptions of diseases and surgeries, and the handy medical mneumonics were like music to my ears. Really. Reading Verghese's Cutting for Stone reminded me of the conversations that I tend to have with my friends in the medical field - they inevitably will deteriorate into the full-on medical jargon-fest. And they will become hard (and boring) to follow for the 'outsiders'. And I love it in a strange way. Insanity, like I said.

Tell me, in what other fiction book can you read about surgery for volvulus, vaginal fistula repairs, detailed C-section and transplant surgery description, and medical conditions that are becoming increasingly rare in the US and therefore are fascinating? Where else in fiction do you get a crash review course on different kinds of cardiac murmurs or vesicovaginal fistulae and the history of their repair? Right, I thought so. Medicine is so seamlessly integrated in the very structure of this novel that it becomes a character in its own right. Nicely done, Dr. Verghese.

“I'm ashamed of our human capacity to hurt and maim one another, to desecrate the body. Yet it allows me to see the cabalistic harmony of heart peeking out behind lung, of liver and spleen consulting each other under the dome of the diaphragm -- these things leave me speechless.”

Oh, but I guess you also care about the story, and not just about my dithyrambs about the medical jargon? Okay, okay. Here is the brief synopsis of 600-plus pages:

“Wasn't that the definition of home? Not where you are from, but where you are wanted.”

Twin boys Shiva and Marion (*) are born in a poor 'Missing' Hospital in Ethiopia to an Indian nun (who died in childbirth status post a horrific and vividly described Cesarean section) and a socially inept but talented British surgeon (who promptly exits the twins' lives mere minutes after their birth, having almost crushed their initially conjoined heads

(*) Marion is named after Marion Sims, the "father of American gynecology", who in the 19th century pioneered the operation for repair of vesicovaginal fistula (the abnormal communication between urethra and vagina with all the unpleasant and horrific consequences) - the operation that Shiva performs in this book.
Marion Sims' work became a subject of much controversy in the 20th century since he practiced his craft without anesthesia on slave women, with unknown consent of his subjects on some of whom he operated about 30 times.
The past of medicine is very often a very scary and cruel place.

The boys are adopted and raised by an eccentric couple of Indian doctors at Missing - Hema and Ghosh, who in an adorable and sweet way 'renew' their marriage each year. We witness them growing up around the hospital, learning medicine from a very tender age, living through periods of Ethiopian civil unrest, and, of course, girl troubles (Genet - the tragic girl who always tragically plays the tragic role in the brothers' tragic lives). Both brothers decide to pursue medicine - self-taught Shiva is a gynecologist while Marion (view spoiler). More tragedy ensues, forever changing the lives of the twins, and everyone learns the value of love and family through much sadness. And it's both a bit cheesy and melodramatic and touching.

“What we are fighting isn't godlessness--this is the most godly country on earth. We aren't even fighting disease. Its poverty. Money for food, medicines... that helps. When we cannot cure or save a life, our patients can at least feel cared for. It should be a basic human right.”

I also rather enjoyed the descriptions of practice of medicine in a poor Ethiopian society. You can't help but sadly laugh reading about money spent by the donors on sending Bibles to the hospital while the cash-strapped hospital desperately needs equipment and medications. The lack of resources leading to the necessity of excellent physical exam skills combined with some ingenuity was really interesting. And the stark contrasts between medicine in the US and Ethiopia were fascinating as well, reminding me of the stories I hear from the physicians who go to practice medicine in Africa for a while - surreal and fascinating and yet painfully real, with stark realities of poverty dictating medical care.

“God will judge us, Mr. Harris, by--by what we did to relieve the suffering of our fellow human beings. I don't think God cares what doctrine we embrace.”

Now, when stripped from the medicine component, the story itself did not fascinate me much. Mainly - because I did not care much for Marion, the narrator. His narrative voice is very monotone, as well as quite judgmental and, frankly, quite irritating. After hundreds and hundreds of pages listening to his voice, I still did not feel that I knew the character much. His neverending obsession with Genet was bordering on unhealthy and frightening. The subtle mystical elements of the connection between the twins Shiva and Marion are hinted at but never really followed through; we never really get to see much of it but are told without showing. Finally (view spoiler) did not have the expected emotional effect, either.

The pacing was uneven as well, with the story dragging through the long sections of the narrative. And a word of warning - the description of a certain intercourse in this book is one of the most nausea-inducing things that I've ever read. Way too many bodily fluids are involved for my comfort level - and I HAVE been on the receiving end of way too many bodily fluids as a work hazard. So yeah. Be warned.

The female characters were not very well-developed and weak. Genet felt caricaturish at times. Hema had potential, but did not quite live up to it. The rest of female characters are kinda just there. But in all honesty, male characters were not that much better. Marion and Shiva's surrogate father, Ghosh, is the only character who I felt actually came to life in this book. He is shown as intelligent, kind, and compassionate, and yet still flawed. He is the only character for whom I actually cared at all.

“Life, too, is like that. You live it forward, but understand it backward. It is only when you stop and look to the rear that you see the corpse caught under your wheel.”

--------------------------------------------
The verdict: 3 stars for the beautiful descriptions of medicine and a notable quotability factor, but not as much for the story itself. I am not sure whether it will appeal to a non-medical person - maybe if you have more of sentimentality than I do.

“According to Shiva, life is in the end about fixing holes. Shiva didn't speak in metaphors. fixing holes is precisely what he did. Still, it's an apt metaphor for our profession. But there's another kind of hole, and that is the wound that divides family. Sometimes this wound occurs at the moment of birth, sometimes it happens later. We are all fixing what is broken. It is the task of a lifetime. We'll leave much unfinished for the next generation.”

(less)

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Nov 04, 2011 Judy rated it 4 of 5 stars · review of another edition Recommends it for: readers with medical knowledge

Shelves: fiction, ethiopia, chunksters, 2011-reads

I'm going to start this review doing something I've never done before and that is tell what I didn't like right away. The reason for this is because I want to spend the rest of the time enumerating many of the good points. Believe me, there are a lot of those!

The only two faults I see in Cutting for Stone is that there is a lot of medical jargon. I'm surprised at the number of people who have read the book and liked it considering the length. Fortunately, my ten years of working in the medical f...more

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Jan 31, 2009 Kate Merriman rated it 5 of 5 stars · review of another edition

Shelves: advanced-reader-copy, favorites, winter-day, fave-21st-century-fiction, around-the-world, ethiopia

Beautifully written, engrossing novel plants you deeply in the passion of practicing medicine, winds you intimately into the cloth of Ethiopia. Verghese uses language so elegantly and paces his story so perfectly that I was totally transported.

I finished the book feeling homesick for Addis Ababa, although I have never been there.

When I signed up (in several places) to review early editions of books on my blog and in other viral / social media places (like Facebook), I had that little hope that I...more

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Oct 11, 2012 Quinn Barrett rated it 4 of 5 stars · review of another edition

Cutting for Stone was like a challenging round of golf for me.

Sorry for the analogy, but here goes for anyone who has never played the most enjoyable, yet frustrating sport ever invented. I grew up playing all sorts of sports: tennis, softball, volleyball, etc. With most sports you can have a great game, but one error can ruin your enjoyment and subsequent memory of that experience.

Conversely, most of us suck big time at golf. We hook, we slice, we lose ball after ball and yet if all we have is...more

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Sep 20, 2011 Annalisa rated it 3 of 5 stars · review of another edition

Recommended to Annalisa by: amy gretchen

Shelves: book-club, historical-fiction, literary

This had the potential to be amazing, a sweeping epic history of Ethiopia ala The Poisonwood Bible, but for all of Verghese's description, he failed to paint a powerful picture of Ethiopia. I expected so much more from him. He wastes 20% of the book describing the first day, but most of it I found pointless to the novel. I would much rather all that description give me something of the setting, of the characters, something powerful and enduring. Either that or cut it by a good 200 pages. But I w...more This had the potential to be amazing, a sweeping epic history of Ethiopia ala The Poisonwood Bible, but for all of Verghese's description, he failed to paint a powerful picture of Ethiopia. I expected so much more from him. He wastes 20% of the book describing the first day, but most of it I found pointless to the novel. I would much rather all that description give me something of the setting, of the characters, something powerful and enduring. Either that or cut it by a good 200 pages. But I wouldn't cut the medical procedures. They gave me the setting Ethiopia did not. They also painted a picture of the characters. The coldness of Thomas Stone, the dedication of Sister Mary Joseph Praise, the drive for Hema, the heart of Ghosh, the genius of Shiva, and the preciseness of Marion. All of it can be described by the medical fields they practiced.

I think Ghosh was my favorite character. I can picture his hearty laugh now. I enjoyed Marion's relationship with Shiva and in the end that's what's fundamental to the book, their love, their distance, their painful understanding of each other. I liked Marion as a protagonist. I connected with his methodical and inactive responses. Genet was the character I struggled with the most. Of all the characters, she was the least fleshed out for so long, and yet, the most important to Marion, our protagonist. I struggled with the scene of her getting all hot and bothered by Shiva talking about sex. Only a man would write that and I didn't believe it. A lot of what she did was a little too convenient to maximum Marion's story and she didn't feel organic to me. Every time she showed up in the book, I knew something tragic was going to happen that didn't feel right for the story.

In the end, I liked the book. Somewhere around 400 pages I didn't want to put the book down. But it shouldn't have taken me 400 pages to get there. I should have been drawn in by the first 50, or the very least the first 100. The characters should have been stronger, the setting, the fake history (I would much rather real events had been intertwined with the story). None of it was as strong as the medicine.(less)

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Feb 03, 2012 Wicked Incognito Now rated it 3 of 5 stars · review of another edition

I just can't listen to this anymore. I ONLY ever listen to audiobooks while exercising, and this one makes me want to lay down and take a nap.

I think audiobooks and I were just not made for each other. I can't listen to something and think about DOING anything at the same time. I can't drive and listen, I can't exercise and listen....I'm just too easily distracted. So...I give up.

Now, I'd like to say that this has no reflection on this book, but I'm afraid it does. The author goes off on tangen...more

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Jul 18, 2011 Barbara rated it 4 of 5 stars · review of another edition

Shelves: health-medicine

As usual, I will not summarize the plot here, merely comment on my reaction to this book. The essences of the story are many- love/lust, heartbreak and humiliation,the ability to forgive and the trials and tribulations of life and death. It is difficult to know where to start with all of these complex, interwoven themes.

Verghese has undertaken a novel which is very broad and ambitious in scope. His geographic sweep travels from Asia, to Africa, to America, with the major part in Ethiopia. The la...more As usual, I will not summarize the plot here, merely comment on my reaction to this book. The essences of the story are many- love/lust, heartbreak and humiliation,the ability to forgive and the trials and tribulations of life and death. It is difficult to know where to start with all of these complex, interwoven themes.

Verghese has undertaken a novel which is very broad and ambitious in scope. His geographic sweep travels from Asia, to Africa, to America, with the major part in Ethiopia. The landscape and the people are portrayed realistically and with clarity. In Addis Ababa, one can clearly envision the poverty and the discrepancies between the classes that existed there. Although the chronology of the political turmoil in Ethiopia is altered for the purposes of the story, it is evident how the populace was efected.

An interesting feature is the title, Cutting for Stone , itself. I spent much time thinking about this through most of my reading. There are references to this term in several areas of the narrative, one most clearly in the latter part of the story. One could conjecture that it alludes to Dr. Stone, a surgeon. The Hippocratic Oath includes, "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." The practise of "cutting for stone" was also employed at one time to root out mental illness with cranial trephination.

My medical experience served me well while reading. For the most part,Verghese's profession as a physician and author was well blended with his accuracy and extensive descriptions of medical conditions and procedures. Although I found these factors stimulating and enjoyable, I wondered how those less immersed in medicine might react. There were a few occasions where I thought certain surgical procedures strained credibility. In particular, the conjoining of the twins was a half-hearted effort.

The last part of the book seemed to disintegrate with many coincidences occuring. The use of the backstory was also disturbing. Many events seemed to have happened previously so that when the reader becomes fully informed, the information seems belated and less well integrated into the novel.

Despite any negative criticisms I appreciated Verghese's ambitious eforts and enjoyed reading this novel.(less)

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Jan 26, 2009 warren Cassell rated it 5 of 5 stars · review of another edition Recommends it for: All of you

Recommended to warren by: Random House sales rep

This is the one that started me. I read a galley and it will be published February 2. It was a sublime reading experience, the best novel I have read in several years. Back in the old days of Just Books, I probably would not have let a customer out of the store without the book in hand. In some places that might be considered pushy. In Greenwich, it was a gushing "Thanks Warren for putting this book in my hands."

Anyway, this is the story of twin doctors separated at their birth in a hospital in...more

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Nov 01, 2010 Alex rated it 3 of 5 stars · review of another edition

Shelves: africa, 2010

But it was only now, near the end, and far too late, that the pieces suddenly - dreadfully - clicked into place. Like a long Tetris piece slamming down, making a whole block of mystery blink and vanish. Only now did he realize what suddenly seemed so obvious: everyone who had suggested this book to him – every single one – was a middle-aged woman. This book…it was about the importance of family.

A wave of cold horror washed over him.

It would take months of porn and comic books to counteract this...more

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Feb 15, 2012 Joy H. rated it 5 of 5 stars · review of another edition

Shelves: fiction, selection-of-library-bk-group, sampled-at-my-ebooks, e-book-google, medical-content

_Cutting for Stone_ by Abraham Verghese (first published 2009)
Added 4/13/11:
NOTE ABOUT THE TITLE: For an explanation of the title of this book, see the end of this review.

4/13/11: I recently read a sample of this book at:
http://books.google.com/ebooks/reader... and now I can't wait to read the rest of it.

5/12/11: The book has finally come in at the library. What a wonderful writer Verghese is! The lyricism of his writing is compelling. I'm up to Chapter 5. The map in the book helps a lot since...more

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Dec 02, 2012 Kalliope rated it 5 of 5 stars · review of another edition

Shelves: fiction-english

Some books have a hypnotic effect and they leave you in a state of haziness when you finish them. Cutting for Stone has been such a book for me.

It is a beautiful novel because it succeeds in creating endearing personalities.

Apart from this, there is very little I can add to the very many reviews in GR, or to what the author has presented in the “Stanford Book Salon”. He acted as the Faculty Host when they chose this book in their monthly reading.

As I do not belong to the medical community, I fo...more

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Feb 10, 2009 Sara rated it 5 of 5 stars · review of another edition

Many readers will tell you that Cutting for Stone is the epic story of two conjoined twins fathered by a brilliant British Surgeon and an Indian Nun. And it technically is. Narrated by Marion the first born twin we are told of every influence on his and his brother’s existence. More than the story being told however, the novel is an accurate portrayal of life in all it’s cruelty and wonder.

The twin’s mother dies in childbirth and their father abandons them minutes later. They are raised in a mi...more

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Mar 29, 2013 Kelly rated it 5 of 5 stars · review of another edition

Shelves: favorites, historical-fiction, epic-sagas

After reading this epic medical saga I am confident that I can now fix a bowel obstruction, do a vasectomy, perform a liver transplant or repair a burst uterus on the fly. It makes me feel very useful hahaha!

The writing in this book is beautiful and mesmerized me. I absolutely loved Ghosh, Hema, Almaz, Stone, Marion, Tsige but hated other characters. This is always the calling card of books I passionately love. Acts of heroism and love by Almaz, Ghosh, Marion and Hema moved me so much. All of t...more

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May 31, 2012 Kim rated it 5 of 5 stars · review of another edition

Recommended to Kim by: Jill Mcdougall

Shelves: cry-havoc, holy-shit

I’m not feeling that well today. I don’t know if it’s from yesterday’s chicken or the fact that I cried copious amounts of tears finishing up this book. I even got the paper wet and if you know me… you know what that means. (view spoiler)

I wouldn’t have picked up this book on my own. I had to be led to it, and that’s okay because sometimes I can walk in circles and create a rut and start to write about nasty fan-fiction that isn’t worth a tinker’s curse.

The stor...more
I’m not feeling that well today. I don’t know if it’s from yesterday’s chicken or the fact that I cried copious amounts of tears finishing up this book. I even got the paper wet and if you know me… you know what that means. (view spoiler)

I wouldn’t have picked up this book on my own. I had to be led to it, and that’s okay because sometimes I can walk in circles and create a rut and start to write about nasty fan-fiction that isn’t worth a tinker’s curse.

The story is set in Ethiopia during the reign of Haile Selassie. It tells of two brothers, born conjoined at the head (not for long, forceps and a big ol’ knife took care of that) to a nun and a drunk, anxiety ridden surgeon. Both parents abandon their children (one via death, the other via drink and an exit visa). The boys are raised by two other doctors at hospital appropriately misnamed Missing.

The story is a tender one. By which I mean that it bruises. It gives us love and takes it away, it shows us our faults and how we can so easily take simple beautiful acts for granted. It’s about growing up and falling down. It’s earnest and in that, I find it so beautiful.

There is one passage that held me:

“It was a tale well known to children all over Africa: Abu Kassem, a miserly Baghdad merchant, had held on to his battered, much repaired pair of slippers even though they were objects of derision. At last, even he couldn't stomach the sight of them. But his every attempt to get rid of his slippers ended in disaster: when he tossed them out of his window they landed on the head of a pregnant woman who miscarried, and Abu Kassem was thrown in jail; when he dropped them in the canal, the slippers choked off the main drain and caused flooding, and off Abu Kassem went to jail...

'One night when Tawfiq finished, another prisoner, a quiet dignified old man, said, 'Abu Kassem might as well build a special room for his slippers. Why try to lose them? He'll never escape.' The old man laughed, and he seemed happy when he said that. That night the old man died in his sleep.

We all saw it the same way. the old man was right. The slippers in the story mean that everything you see and do and touch, every seed you sow, or don't sow, becomes part of your destiny...

In order to start to get rid of your slippers, you have to admit they are yours, and if you do, then they will get rid of themselves.

Ghosh sighed. 'I hope one day you see this as clearly as I did in Kerchele. The key to your happiness is to own your slippers, own who you are, own how you look, own your family, own the talents you have, and own the ones you don't. If you keep saying your slippers aren't yours, then you'll die searching, you'll die bitter, always feeling you were promised more. Not only our actions, but also our omissions, become our destiny.”

I am still learning to walk on my own, I think I just discovered my slippers and they still feel too big and a bit scratchy. I’m afraid I won’t have a destiny and that sends me headlong into a panic attack. How vain is that?

I have to remember…. Own It.
(less)

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Mar 19, 2011 Ayaz rated it 2 of 5 stars · review of another edition

“My VIP patients often regret so many things on their deathbeds. They regret the bitterness they’ll leave in people’s hearts. They realize that no money, no church service, no eulogy, no funeral procession no matter how elaborate can remove the legacy of a mean spirit.” (Cutting for Stone, pg 434)

More than a few people who’ve read the novel mentioned to me that they wanted to discontinue reading the novel. And I understood what they meant, when I finished reading Cutting for Stone this last week...more “My VIP patients often regret so many things on their deathbeds. They regret the bitterness they’ll leave in people’s hearts. They realize that no money, no church service, no eulogy, no funeral procession no matter how elaborate can remove the legacy of a mean spirit.” (Cutting for Stone, pg 434)

More than a few people who’ve read the novel mentioned to me that they wanted to discontinue reading the novel. And I understood what they meant, when I finished reading Cutting for Stone this last weekend.

I had trouble with the point of view. Unlike Frankie in Angela’s Ashes, Marion, the protagonist, is an adult all along, and mono-tonal. Mr. Verghese doesn’t give Marion the privilege of his own voice. Marion is smothered by adult language, betrayed by the medical jargon, which is overbearing ultimately, as well as weak writing—this last piece was a surprise to me. The idiom in some places puts me right in 2011 America, when in fact, we’re in Ethiopia for most part of the novel—mid 1900’s onward. Also, an overuse of similes was irritating, and kept dragging the writing down, but most importantly, the reader can’t get to Marion’s soul, because weak language confounds the reader. Moreover, the shifting points of view are shoddy, and in fact, weaken the intensity of emotion that existed briefly when Dr. Thomas Stone is trying to deliver the twins. By the way, this was the most poignant scene of the novel, and then the novel degenerates slowly and painfully for the 100’s of pages to come.

Probably the lowest point of the novel is the coincidence (you’ll find far too many coincidental meetings and appearances etc) of Genet and Marion meeting in the US. Marion is set up to be a romantic by the author, and had saved his virginity for Genet. But then enjoys a grotesque intercourse, which involves urine, blood and vaginal fluids. Marion is so turned on that he goes at it again. If I didn’t feel terrible for Genet by then, I certainly did at that point. I am not sure that Mr. Verghese wanted Marion to be narcissistic and sadistic (“I grabbed her shoulder and pulled her to me hard. I smelled her fever, and the scent of blood and sex and urine. I came again, pg.598)—but Mr. Verghese came pretty close here.

But the novel had unraveled for me earlier. Mr.Verghese simply has the hardest time developing female characters. They play stereotypical roles, except for Marion’s mother, who had the potential to be very interesting as a developed character, but the author, again “uses” her as a plot device (wish not to reveal how for those who’ve not read the novel yet). Hema, his adopted mother also has wonderful potential of becoming an interesting character, but remains flat throughout. The male characters dialogue is a notch better, but the dialogue throughout the novel is tiresome, and most characters sound like each other. There is some good dialogue from Marion’s adopted father, Ghosh and Dr. Deepak, but not enough to save the novel.

And poor Marion, remains a prisoner to a very brilliant individual as a novelist in Mr. Verghese, who tries desperately but fails to develop a nuanced protagonist--maybe the reason people wanted to put the novel down. I think if the novel was cut into half, it may have worked for me, given the good writing would have blossomed and caught the attention of the reader. Here’s one other passage I liked:

“ In America, my initial impression was that death or the possibility of it always seemed to come as a surprise, as if we took it for granted that we were immortal and that death was just an option.” (Cutting for Stone, pg 486)
(less)

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Nov 02, 2010 Karla rated it 5 of 5 stars · review of another edition

Shelves: ethiopia, twins, mourning, tear-jerkers, 2010, favorites

Narrated by Marion the first born of conjoined twin brothers. Fathered by a brilliant British surgeon and an Indian nun. The twins mother dies in childbirth and their father abandons them almost instantly after birth. Left to be raised in a missionary hospital in Ethiopia by Loving skilled doctors of the hospital Ghosh and Hema.

The medical jargon is very detailed and descriptions of Ethiopian cuture and history are richly described. The twins Marion and Shiva's lifes are riden with tragedy, Alth...more

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Aug 14, 2011 Juanita Rice rated it 4 of 5 stars · review of another edition

Cutting for Stone by Abraham Verghese
4 stars

Verghese is a new author to me; he has, understandably, only two previous books, for besides being a writer, he is a physician who also holds two appointments at distinguished medical centers in Stanford and San Antonio. This book only just misses my 5-star superlative rating, but it was compelling, intelligent and intricate, reflective and shot through with symbolism and analogy. Cutting for Stone is set primarily in Ethiopia, with India as the backg...more Cutting for Stone by Abraham Verghese
4 stars

Verghese is a new author to me; he has, understandably, only two previous books, for besides being a writer, he is a physician who also holds two appointments at distinguished medical centers in Stanford and San Antonio. This book only just misses my 5-star superlative rating, but it was compelling, intelligent and intricate, reflective and shot through with symbolism and analogy. Cutting for Stone is set primarily in Ethiopia, with India as the background, and the US—New York and Boston--as a third setting. It takes place in a panoramic twenty-five years of Ethiopian life, rich with detailed understanding of the people and culture and its geopolitical history. It is an intensely sensual novel—the smells, tastes, flowers, seasons and skies of Ethiopia especially. The narrator Marion Stone, one of two identical boy twins, even begins his distinction in medicine by his sensitivity to the smells of different medical conditions, a talent he shares with his obstetrician mother Hema.
The story proper begins when four people from India come separately to a medical clinic in Addis Ababa at a key moment in history: "It was 1947, and the British were finally leaving India; the Quit India Movement had made the impossible come about. Saintly Amma slowly let the air out of her lungs. It was a new world, and bold action was called for, or so she believed. "
In 1954 at the clinic are born identical twin boys and their lives become inextricably interwoven with the politics and history of Ethiopia, including a tragic failed coup against Emperor Haile Selassie, the struggles of the Eritrean people, a successful but disastrous military uprising and dictatorship, and finally a more stable and humane revolution. The novel is well worth reading if only for the vivid realities of Ethiopian life conveyed through its intersection with an understaffed and underfunded medical clinic run by a Christian matron who sets her jaw against the endless donation of Bibles and religious material, believing that their patients need medicine, not missionary zeal.
The people of Ethiopia themselves figure not just as exotic or pitiful "natives" but as complex characters, their humanity more fully realized than in most stories set in Africa and written by non-Africans. Verghese shows Emperor Haile Selassie as a dictator responsible for the country's poverty. His caprice and paranoia and resplendent lifestyle (20 are Rolls Royces among his 26 cars) are set against the results of his rule: rickets, malnutrition, joblessness, prostitution, and untreated diseases. Nor does Verghese spare some of the country's customs like genital mutilation ("female circumcision"), and the too-frequent tragedy of girls in labor too young, resulting in sometimes immediate death of baby and mother, or sometimes a lingering hideous condition leading more slowly to the same conclusion: a condition called "fistula," where a baby's head being ground against an immature pelvis in impossible labor destroys vaginal tissue, leading to ulcerations where the bladder leaks constantly into the diseased remains of a stinking vagina.
This introduces the second unique beauty of the book, although the word "beauty" may seem a strange word to use after a description of "fistulas," but what distinguishes the book above all, I think, is something which online reader chat cites as obstacle. It is what definitively rescues the story from being romantic or exotic: the intense language of physiology, details of medical procedures, of colon surgery, liver transplants, disastrous labors, babies dying, twisted colons, "Version" clinic in which women from the country are taught how to reposition breech babies. In these scenes, the body glistens and throbs, or it dries and fades, it leaks, it smells, while human language and skills survey, senses alert, and then intervene, cutting, clamping, removing, replacing, resectioning. In a brief prologue the narrator, Dr. Marion Stone speaks from Ethiopia of his career at age fifty: "I venerate the sight of the abdomen and chest laid open. I'm ashamed of our human capacity to hurt and maim one another, to desecrate the body." His language is that of reverence:
My fingers "run the bowel" looking for holes that a blade or bullet
might have created, coil after glistening coil, twenty-three feet of it compacted into such a small space. The gut that has slithered past my fingers like this in the African night would by now reach the Cape of Good Hope, and I have yet to see the serpent's head. But I do see the ordinary miracles under skin and rib and muscle, visions concealed from their owner.
The intense scenes of medical engagement function almost as a counter-narrative. Although often suspenseful and dramatic, they are written in the language of a densely precise science, arcane and esoteric to the layperson. It is also a historical language, recording the conquests of human anatomical challenges like the marking of ascents of Everest, and also ignoring the Sherpas:
There is a Chvostek's sign, a Bos's sign, a Courvoisier's sign, a Quincke's sign— no limit it seems to white men naming things after themselves. Surely, the world is ready for an eponym honoring a humble compounder [Adam, an untrained Ethiopian] who has seen more relapsing fever with one eye than you or I will ever see with two."
So writes Ghosh, the male third doctor at the Addis clinic, in a struggle from Ethiopia to have an article published in the New England Journal of Medicine.
The third great beauty of Cutting for Stone is a deeply lodged poetic imagery, a resonance of sensuality and intelligence, of sympathy and anger. The title itself comes from the Hippocratic oath "I will not cut for stone," an enigmatic phrase, and "cutting for stone" continually unfolds new levels of resonance. One of the four expatriates of India is the Anglo-Indian surgeon Thomas Stone, a hidden character, self-withheld. The twin boys will be given his surname, and the middle name derived from their dead birthmother: they are thus named Marion Praise Stone and Shiva Praise Stone. One, Marion, will become a surgeon also, thus someone who lives "cutting," while the other is a savant who never completes schooling but nevertheless revolutionizes treatment of "fistulas," another kind of "cutting edge." The twins are physically linked in utero, but an instant decision to separate them—to cut them apart--in an emergency Caesarean section, has a long psychologically symbolic, and mortal, aftermath. They will search history for their antecedents, "cutting" to the bone.
The book is not short on humor, either: a panicked nursing attendant at the birth which sets the plot going cries out, "Japanese twins! Japanese twins!"—the hapless girl thus begins her role in the story getting things not quite right, always. But even she develops, grows, changes, plays her part. There are no caricatures here. Attitudes toward sexuality are consistent with the no-nonsense vision of the human body, its miracles, mysteries and its misfunctions, its dominant role in determining our lives.
It's a wildly adventurous story, but the adventures are never gratuitous. Ghosh is at one point arrested as an "acquaintance" of the first coup's leader, General Mebratu, who is based on a historical figure. Marion Stone has to flee Ethiopia through the underground of the Eritrean People's Liberation Front. After a wild near-disastrous flight in a cargo plane, Hema applies a coercive maneuver to the pilot's testicles. Her move is not a crude self-defensive reflex: "she was thinking of the Frenchman's balls, of rugaeform folds, of the median raphe that separated one bollock from the other, of the dartos muscle, the cells of Sertoli."
She succeeds in immobilizing and overpowering him (she is equally tall). "The Frenchman, his eyeballs sinking in their sockets, nodded mutely. France had colonized Djibouti and parts of Somalia, and they had even jockeyed with the English in India before settling for a foothold in Pondicherry. But on this steamy afternoon, one brown soul who would never be the same again, and who had Malayalis, Armenians, Greeks, and Yemenis backing her, showed that she was free."
There is not very much anti-colonial talk in the book; there doesn't have to be, for the very heart of the book is Post-Colonial in flavor, philosophy, realism and determination. It was a grand experience to be taken into this world in which the US is a strange and dispiriting place of great wealth and great inequality and injustice. In a particularly moving scene, the mission Matron explodes at a Houston church visitor who is concerned that the mission should "teach Christianity." She points out the window: "When you look around Addis and see children barefoot and shivering in the rain, when you see the lepers begging for their next morsel, does any of that [sectarian] nonsense matter the least bit?" "God will judge us, Mr. Harris, by—by what we did to relieve the suffering of our fellow human beings. I don't think God cares what doctrine we embrace." The book also takes that view: Hema's pantheism, Ghosh's pragmatism, the Christianity of Sister Mary Joseph Praise, the Ethiopian Christianity of Gebrew the watchman, cheerful atheism: there are no doctrines that matter besides dedication to relieve suffering.
So why not five stars in my opinion? I don't really know. I think it's because almost all the main characters, and especially the ones we get to know best, are men. I'm a woman; I don't like to live in a world where one of the women characters is
a beautiful dead girl, and one (an Eritrean named Genet) is always incomprehensible, her motivations and emotions unexamined, and she acts throughout as a kind of doom for the main characters, a constant irritation and emptiness and erotic stimulant who almost kills Marion. Hema, the strongest woman character, is eventually swallowed up in mothering, and Matron is a minor character. Maybe that was the small disappointment that haunted my reading.
I still plan to reread it, however, and I do strongly recommend it.

(less)

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Nov 08, 2012 Karen rated it 5 of 5 stars · review of another edition

Shelves: africa, death-and-dying, health, non-western-culture, us-multicultural

A heart-breaking and thought-provoking novel, set primarily in Ethiopia and featuring health care workers and those they work with, love and live with. I got to watch the impossible task of running a hospital in a developing nation and see the various paths that doctors with Indian ancestry take as they move from India to Africa or from these countries to the US.

We meet Sister Mary Praise, a nurse from India who has dedicated her life to making something beautiful; Dr. Thomas Stone, a surgeon f...more A heart-breaking and thought-provoking novel, set primarily in Ethiopia and featuring health care workers and those they work with, love and live with. I got to watch the impossible task of running a hospital in a developing nation and see the various paths that doctors with Indian ancestry take as they move from India to Africa or from these countries to the US.

We meet Sister Mary Praise, a nurse from India who has dedicated her life to making something beautiful; Dr. Thomas Stone, a surgeon from the UK, who is socially awkward but brilliant in the operating room; Hema and Gosh, who also practice medicine at the same hospital; and the twins Marion and Shiva who come into the world in an unexpected and horrible manner and grow up to work in health care as well. Marion serves as the primary narrator, but the novel employs an ensemble cast.

It makes sense that Marion narrates the novel since he presents as a left-brain dominant person: he is verbal, analytic, goal oriented, and self-disciplined. Shiva is his mirror image as a right-brain dominant person: physical, emotional, impulsive, and living in the here-and-now. They complement and vex each other because of these differences. More accurately, Marion is vexed because Shiva exhibits a more carefree attitude. I think this left-brain/right-brain distinction is no accident since Verghese has these two come into the world as conjoined twins--with their heads attached at birth.

However, Verghese brings so much more than his medical training and his life in Ethiopia to this novel. He creates characters who are at once extreme in their behaviors yet realistic in their motives and actions. He convinced me to fall in love with a variety of people despite their flaws, excesses and misbehaviors--or maybe because of them. Within the pages of this novel we see people experience loss, regret, violence and betrayal but we also see them love, serve, nurture and forgive one another.

Yes, the novel is a hefty 660 pages, but I enjoyed moving through the decades with Marion Stone showing me the various characters' histories and hardships and the outcomes of choices made years ago coming to fruition in a future that no one could predict. (less)

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Jul 13, 2012 Jennuineglass rated it 4 of 5 stars · review of another edition

Coming off of The Historian I was a bit nervous to jump right into another long, multi generational, around the world kind of book by a first time author. The trepidation was entirely unfounded because this is an amazing read.

A fictional story based in actual history is fascinating to me, even more so if its a history that I was only peripherally aware of because I was a small child. The timing of this book spans roughly 1940-1990, splashed across the globe in Ethiopia, India, and good ol' New Y...more Coming off of The Historian I was a bit nervous to jump right into another long, multi generational, around the world kind of book by a first time author. The trepidation was entirely unfounded because this is an amazing read.

A fictional story based in actual history is fascinating to me, even more so if its a history that I was only peripherally aware of because I was a small child. The timing of this book spans roughly 1940-1990, splashed across the globe in Ethiopia, India, and good ol' New York City.

This book, narrated from the POV of a twin named Marion (boy), is symphonic in tone. Though the book starts before the birth of Marion he is our guide from the very first page. It gives the book an ethreal feeling as, in utero, he ushers us through the story of his parents and how he came to be. Then, bursting into the world, on the story goes still with Marion's voice leading us along till the very last page. (Note this is not a spoiler as Marion spoke to us before life. His narration is not dependent on his existance) The delicate opening notes of a simple story become more complex, layering on characters until Marion is (figurately) conducting a full orchestra without missing a beat. Mr. Verghese has given us what I often describe as a "beautiful read" where the pages zoom by and you are fully immersed in the story, feeling and seeing everything in your cranial cinema.

Books like this are hard to summarize (the summary/review on Goodreads is entirely adequate) without giving things away. When I love a book...I hate to give anything away. I want you to have the full joy of experiencing every twist, every betrayal, every tender moment of quiet stoicism that lies within these pages.

So with that said, if two or more of these apply to you, I would recommend this book whole heartedly:
1) Aren't afraid of hefty books
2) Aren't bored by (well written) story lines dealing with the emotions of family ties and responsibility that come with them
3) Have an affinity for medical themes (one of the books centralizing themes is the constant presence of some doctor/clinic/medical setting)
4) Have an affinity for foreign locations/cultures and their politics

Happy reading my friends!(less)

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May 30, 2009 Kasa Cotugno rated it 5 of 5 stars · review of another edition

Shelves: awards-winners, subject-immigration-experience, location-africa

Recently in San Francisco I attended a reading by Abraham Verghese, who has written my favorite book of the year: CUTTING FOR STONE. I'd gotten it from the library, and after @150 pages was so in love with it that when I heard he was going to be at the store, I returned the library copy (there's a huge line waiting for it), and bought a copy just to have the pleasure of his signature. We actually had a little chat after the reading, while he happened by on his way to his car. He asked why I'd ch...more

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Apr 10, 2013 John Vibber rated it 5 of 5 stars · review of another edition

I won’t debase “Cutting for Stone” with superlatives. It’s a coming-of-age story that has magic in its setting, character, and plot development, and prominence in its wisdom and humanity. If you need relief from some recent addictive, yet pointless best-seller, here is a book to savor. I think you will find each chapter a vignette designed to make you contemplate the power and beauty of language.

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Nov 24, 2008 Katie rated it 3 of 5 stars · review of another edition

I liked CUTTING FOR STONE, but ultimately, it disappointed. I'd heard such glowing reviews, perhaps I was setting my self up to be underwhelmed. Still, I found Marion, the narrator, very distant and was not able to engage with his character at all.

The books contains some interesting detail about the advent of several medical procedures, and I did find the end of the book much more emotionally satisfying than the beginning and middle, but in the end, it wasn't enough. Verghese is a wonderful des...more

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Aug 10, 2009 Wanda rated it 5 of 5 stars · review of another edition Recommends it for: Everyone

Shelves: 2009, fiction-and-literature, ebooks

Any superlative which I could use to describe this book would pale in comparison to your own experience of reading it. You simply MUST read this book and experience the lives of the characters and how a family is defined.

I will definitely read other books by this author. The author is a master at descriptive writing and so many times while reading this book, I felt as if I were right there with the characters sharing their experiences.

I cannot adequately describe the feeling you will have once...more

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Apr 28, 2013 Sheila Callahan rated it 5 of 5 stars · review of another edition

Shelves: 2013-reads

I've been waiting two years to read this book. The school library's copy went missing for nearly a year and I finally managed to check it out last week. "Wow," is all I can say. This book is so good it makes me want to stop everything and try a write a novel myself. I read in the acknowledgements section that the author, Abraham Verghese, is friends with fellow novelist John Irving. I can see that in the writing.

To the few who have not already consumed this tasty treat: Run, run, run, to get a c...more

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Dec 31, 2012 Lori rated it 5 of 5 stars · review of another edition

Wow. Tough to know what I could possibly say to do justice to this book. The story was completely engrossing. Twins born under tragic and mysterious circumstances in mid-20th century Ethiopia. So much to embrace in this book: the art of medicine and the men and women committed to it, the tumultuous history of Ethiopia, the love between families (even those that don't meet the conventional definition of family) and the amazing and indescribable bond that can exist between twins. Tragic and redeem...more

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Aug 25, 2009 Marge rated it 5 of 5 stars · review of another edition

I took time finishing this book. Although it is an easy read, the writing is so good that some of the lines warranted second, even third, reading. It is also the second book I read this year that has a protagonist with a twin brother. Pure coincidence.

When I finished a really good book, it's hard for me to shake the feeling of loss. This is an excellent read and I am highly recommending it to friends. You will not be disappointed.

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Aug 29, 2009 Trish rated it 4 of 5 stars · review of another edition

Shelves: africa, fiction, literature

Unequivocably fine. The authorial control over the number of carefully- drawn characters, the time-span, the continental shift, the depth of medical knowledge, the sheer size of the story--all these inspire awe. The novel also inspired gratitude in me--that the author shared his story with us, taught us things about medicine we didn't, couldn't know, and for trusting us to rejoice in the differentness of his construction. And for the time. I hope he got as much out of the telling as we have gott...more

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Apr 23, 2012 Hayes rated it 4 of 5 stars · review of another edition

Shelves: tbr-challenge-2012, read-in-2012, favorites

Almost 5 stars. I suppose this could be considered a sweeping family saga, although the family in question is highly unusual. India, Ethiopia, Italy, and America are also major "characters". It's incredibly difficult to say what this book is about; it is about everything, really. It is about survival.

I loved all of it, even (especially!) the surgical descriptions. A Gorgeous Book.

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Jul 15, 2011 Katie rated it 5 of 5 stars · review of another edition

Shelves: good-writing, asia-india-middle-east

I wish I still had this book in my future. I wish it were tucked away in a stack of books on my nightstand, waiting patiently for its turn to be read. I wish I were going home tonight to curl up in a chair with nothing to do but pick up this book and slowly -- savoringly, if that's a word* -- take it in, one page at a time.

There's a lot to say about this book, but I'll simplify what could otherwise become a lengthy review (Me? Verbose? Nevah!) and say this: Cutting for Stone is a beautifully wr...more

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About Abraham Verghese

Abraham Verghese, MD, MACP, is Professor for the Theory and Practice of Medicine at the Stanford University School of Medicine and Senior Associate Chair of the Department of Internal Medicine.

Born of Indian parents who were teachers in Ethiopia, he grew up near Addis Ababa and began his medical training there. When Emperor Haile Selassie was deposed, he completed his training at Madras Medical Co...more Abraham Verghese, MD, MACP, is Professor for the Theory and Practice of Medicine at the Stanford University School of Medicine and Senior Associate Chair of the Department of Internal Medicine.

Born of Indian parents who were teachers in Ethiopia, he grew up near Addis Ababa and began his medical training there. When Emperor Haile Selassie was deposed, he completed his training at Madras Medical College and went to the United States for his residency as one of many foreign medical graduates. Like many others, he found only the less popular hospitals and communities open to him, an experience he described in one of his early New Yorker articles, The Cowpath to America.

From Johnson City, Tennessee, where he was a resident from 1980 to 1983, he did his fellowship at Boston University School of Medicine, working at Boston City Hospital for two years. It was here that he first saw the early signs of the HIV epidemic and later, when he returned to Johnson City as an assistant professor of medicine, he saw the second epidemic, rural AIDS, and his life took the turn for which he is most well known ? his caring for numerous AIDS patients in an era when little could be done and helping them through their early and painful deaths was often the most a physician could do.

His work with terminal patients and the insights he gained from the deep relationships he formed and the suffering he saw were intensely transformative; they became the basis for his first book, My Own Country : A Doctor's Story, written later during his years in El Paso, Texas. Such was his interest in writing that he decided to take some time away from medicine to study at the Iowa Writers Workshop at the University of Iowa, where he earned a Master of Fine Arts degree in 1991. Since then, his writing has appeared in The New Yorker, Texas Monthly, Atlantic, The New York Times, The New York Times Magazine, Granta, Forbes.com, and The Wall Street Journal, among others.

Following Iowa, he became professor of medicine and chief of the Division of Infectious Diseases at Texas Tech Health Sciences Center in El Paso, Texas, where he lived for the next 11 years. In addition to writing his first book, which was one of five chosen as Best Book of the Year by Time magazine and later made into a Mira Nair movie, he also wrote a second best-selling book, The Tennis Partner : A Story of Friendship and Loss, about his friend and tennis partner?s struggle with addiction. This was a New York Times' Notable Book.(less)

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Quotes from Cutting for Stone

“The key to your happiness is to own your slippers, own who you are, own how you look, own your family, own the talents you have, and own the ones you don't. If you keep saying your slippers aren't yours, then you'll die searching, you'll die bitter, always feeling you were promised more. Not only our actions, but also our omissions, become our destiny.” — 247 people liked it

“You live it forward, but understand it backward.” — 145 people liked it

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