Saturday, March 24, 2012

Cutting for Stone by Abraham Verghese

In this sweeping novel that takes the reader from India to Aden, to Ethiopia, to New York, Boston and back to Ethiopia, Abraham Vergehese fills the pages with love, politics, medical procedures, and relationships. At some times it is tedious and overwhelms, at others, it leaves us wanting more.

Sister Mary Jane Praise, a Carmelite nun, leaves India and on a very rough voyage to Aden, loses a friend and nurses Dr. Thomas Stone through a typhoid epidemic on the ship. One senses the romantic tension between the two and knows that at some point their love will be consummated. They both end their journey at Missing Missionary Hospital outside Addis Ababa. It is there that the story continues with Sister Mary Jane giving birth to conjoined twins, Marion and Shiva, after a pregnancy that had been hidden from all under the folds of her habit. It was a difficult birth that ended in her death. With no parents to raise the boys, Dr. Hemlatha, "Hema" and obstetrician, and Dr. Abhi Ghosh, assume the roles. The boys grow up in the culture of the hospital and the ever-changing political unrest in Ethiopia. They are nurtured by the love of Hema and Ghosh and an entourage of servants. The novel is replete with childhood memories, graphic medical procedures, the blossoming of love and the violence of a revolution.

Both Marion and Shiva enter the medical field with diverse political and philosophical principles guiding their lives. It is, however, love of a woman, Genet, the daughter Dr. Stone's housekeeper, that creates a chasm between them. In another consequence of his association with her, it is one that forces Marion to move to the United States to further his medical practice. He lands in an inner city hospital in the Bronx it is there he begins his real contribution to medicine. In a twist, the past catches up to him and he is confronted by two people who will change his world.

The novel is full of very quotable lines that show the craft of Verghese. His love is medicine, but he is adept at the written word also. Verghese did leave his practice of medicine at one point to study at the Iowa's Writers Workshop at the University of Iowa. The book's title is taken from 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.
“The eleventh commandment... never operate on a patient on the last day of their life.”
Marion attends a lecture in Boston and as a result of reading Dr. Thomas Stone's book, is able to answer the question:
 “What treatment is offered by ear in an emergency?”  "Words of comfort. "he answers. 
This statement is at the heart of the book and Verghese's practice of medicine. Throughout the novel his words reverberate with the need for more art and less business in today's health care. 

Dr. Verghese signing a copy of Cuttng for Stone, 19 March 2012
Cutting for Stone  is not an easy book to read, but in the end and upon reflection, it is a completely satisfying one. I finished the book about two weeks ago and have thought about it for  periods of time since then trying to make up my mind if I really liked it or not. There were some situations that I thought were quite contrived and I struggled at times with the change of voice. However, after hearing Dr. Verghese speak, I recognize more fully his purpose in writing the book and can appreciate the message that he was delivering. It WAS a good read.

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