Marion and Shiva Stone are twin brothers born of a secret union between a beautiful Indian nun and a brash British surgeon at a mission hospital in Addis Ababa. Orphaned by their mother's death in childbirth 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. Yet it will be love, not politics -- their passion for the same woman -- that will tear them apart and force Marion, fresh out of medical school, to flee his homeland. He makes his way to America, finding refuge in his work as an intern at an underfunded, overcrowded New York City hospital. When the past catches up to him -- nearly destroying him -- Marion must entrust his life to the two men he thought he trusted least in the world: the surgeon father who abandoned him and the brother who betrayed him.
The orphaned twins were adopted and raised by two doctors at the hospital, Hema (the obstetrician) and Ghosh (the internist turned surgeon). There was an entire staff of surrogate parents to help in raising the boys. Medicine and its practice, including surgery was normal dinner conversation in the household. It was small wonder both grew to become doctors.
We are involved in the coups and political unrest in Ethiopia during the second half of the 20th century including the arrest and imprisonment of Ghosh, and the twins' later dealings with a rogue army bandit who threatens to kill them; we watch as the humble hospital in Addis Ababa continues to care for a diverse group of patrons, from the emperor's family to the poorest of the poor, with little funding and often crudely fashioned homemade instruments. We are given broad but specific (and sometimes gory) details of medical procedures in language the layman can understand, even though the amount of detail sometimes slows down the story. We watch as the boys mature, learn to dance, quote Shakespeare, and learn the art as well as the science of medicine from their parents. We see one of them fall hopelessly in love and then see one betray the other.
When Marion leaves to go to America, we are made brutally aware of the differences in medical practice in the two countries. It's not that the two countries have doctors of different abilities making the difference, rather it is the difference in resources and expectations that is vibrantly portrayed. Marion's residency in surgery at a hospital in New York eventually brings him face to face with his biological father and ultimately leads to history making and life changing experiences for all the family.
This book is long. It is 18 discs on audio (almost 24 hours of extremely well narrated story read by Sunil Malhotra) and 688 pages in print. It is difficult to do it justice in a review because, although written as a fictional narrative memoir, it is a novel with a spectacular ending that deserves not to be spoiled.
It is a story that is engrossing, exciting, appealing, easy to read and extremely difficult to put down. It is also one that I will want to read again and again. In both its print and its audio versions it is a story not soon to be forgotten. It is simply one of the best books I've ever read.
Both boys become surgeons, but Marion is forced to flee to New York while Shiva stays at the mission hospital in Addis Ababa. After years of separation, both are successful, but one more fateful encounter leads to the final, unexpected set of events.
There are numerous medical and surgical terms and techniques in the book. However, I found it enjoyable and instructive.
It is obvious that this novel involved an extensive amount of research into the political and cultural history of Ethiopia after WWII, the practice of modern medicine in a major African city, the sexual oppression of women in Africa and its consequences, including female genital mutilation and vaginal fistulas, and longstanding and modern surgical techniques. Dr. Verghese was trained as an infectious disease specialist, yet it was easy for me to envision the operations taking place. However, I think I am most impressed with the Dr. Verghese's storytelling ability, especially given all of the topics he covers in this book.
While I was immediately and irresistibly pulled into the story and fell in love with the beautiful writing, I balked at the frequent graphic descriptions of medical conditions and procedures, though could well understand how a novel with medicine and surgery as one of it's main themes must be so, and also came to see toward the end of the novel that these were essential in the telling of the story. I loved that the events were rooted in a solid historical, social and political context, and the perspective of a native Ethiopian describing both his own country and his perspective on life in America. I found the strong love and bond between the twins and their adoptive parents—who were both wonderfully well drawn and well-rounded characters—both moving and lovely to read about. The relationships seemed absolutely real, and were peppered with the kinds of unique moments a family shares and which could only be so well described by a very talented author. Surprisingly, the only character in the story that remained a mystery to me was that of Shiva, and while this was something I found fault with at first, thinking back on it, I came to understand that this was entirely in keeping with the mystery he constitutes even to his own twin, and made perfect sense when one considers all that he eventually comes to embody in this unforgettable novel. Definitely recommended. I listened to the audio version which is also excellently narrated by Sunil Malhotra.
The novel gives fascinating insights into the cultural and political situation in Ethiopia, as well as developing unforgettable characters and unforgettable but believable relationships that move across time and space. If I had to make one criticism, it would be that Verghese, a doctor himself, sometimes get a bit too caught up in the details of diagnosis and surgery; these sections can drag for the non-medical expert reader. But this is a very small flaw in an otherwise fine novel.
A wave of cold horror washed over him.
It would take months of porn and comic books to counteract this book’s effect. Months.
“I laugh uncontrollably in anticipation, tuck my chin into my body, because I know Rosina’s fingers, which are like icicles, will soon stroke my cheek. The first time she did this, I was startled into laughter instead of tears, a mistake, because it has encouraged this ritual that I dread and anticipate every day.”
Cutting for Stone is a story of hospitals and medicine. Verghese is a doctor himself, so the book is filled with detailed descriptions of medical conditions and procedures. The book gives us snapshots of life in Ethiopia, successful and attempted coups, and the Eritrean struggle for independence. It is also the story of family. When Marion’s mother dies during childbirth, his father abandons him and his brother. The novel is partly the story of Marion’s longing to fill the gaping hole created by his parents. It is a story of the close-knit family created by the people who raised him. Perhaps most importantly, it is the story of twins, and the ties that bind them. This is a book that I read slowly because I didn’t want it to end. It is a dazzling fictional debut that deeply moved me. Highly recommended.
Marion and Shiva are twin brothers, connected to each other at birth, but then quickly separated. Their mother, Sister Mary Joseph Praise, was a nun and nurse from India; their father, Thomas Stone, was an English surgeon who also had lived in India at one time. Both ended up at Missing Hospital in Addis Ababa, Ethiopia, where their devotion and camaraderie with each other suddenly came apart as Sister Mary Joseph Praise died in childbirth, and Thomas Stone fled the country.
The story begins well before the birth of the twins and continues far beyond their childhood years. The reader will learn about Ethiopia, Eritrea, medical procedures, family relationships, deep love, betrayal, and sacrifice.
I liked that this novel was well researched (just look at the acknowledgements and bibliography that follow the story) and that it dealt with the practice of medicine on a very high level (the author is a surgeon). My favorite snippet of this book came in one part that talked about "common nursing sense". As a nurse myself, I do respect this attribute and fear its absence.
When I felt that the book was growing a bit long, I never had the feeling of wanting to put it aside. I think that was because the characters were so believable and interesting. When I thought I could figure out where the author was taking me, I was constantly surprised. By the time I reach the story's conclusion, I realized what a treat this author had created for me (and others).
Recommended for: everyone but me? I seem to be one of the few people so underwhelmed with this novel. I only got through it because my book club is meeting on it next week.
We follow Marion and Shiva as they mature and make sense of the changes happening all around them. Step by step we see the twins both develop a love for medicine that will take them in very different directions when they both fall in love with the same woman. Marion flees to New York, but his past catches up with him and causes his life to be placed in the hands of those he trusts the least.
This book is about healing others with the power of medicine but also is very involved with love, betrayal, fate and honor. We become intimately connected with all the characters in this story and the emotions are powerful. I caught myself on the edge of my seat and reading until my eyes were burning. I also wanted to throw the book because I would get so mad at certain characters.
I unequivocally loved this book and it is one of the best I’ve read this year. I wanted to turn right around and read it again. I would certainly recommend it to others as being a book that goes the distance.
So begins Abraham Verghese's wonderful sweeping novel that takes us from India to Ethiopa to New York City and covers the years 1954 until 1986. The story is told by Marion Stone, twin brother of Shiva, son of Sister Mary Joseph Praise, a Catholic nun, and Dr. Thomas Stone, noted surgeon. The circumstances of this birth are not the strangest things to occur in this saga but with a beginning like that, you get the idea. You also know, after reading the first page, that you are in the hands of a master and that thought does not diminish over the next 533 pages. Verghese, a physician and professor at the Stanford University School of Medicine, wields the pen just as he probably wields the scalpel. His writing is poetic and flows eloquently.
The story itself follows the lives of the twins; their mother dies in childbirth, their father so traumatized by the event (no one was aware that she was pregnant)that he abandons his children. The obstetrician who delivers them, raises them along with another doctor, whom she eventually marries. It's essentially a story of love, abandonment, bonding, coming of age and redemption.
Medicine plays as big a role in the novel as any of the forgoing themes and is the medium that propels the narrative forward. We learn a lot about medical practices carried on in the backward areas of Africa, as well as pioneering practices of great sophistication for the time.
Africa, and all the political upheaval transpiring at that time,provides another backdrop for the story. It's all wonderfully done by the author and you are carried along as Verghese allows you to unfold the many layers of narrative.
Something must be said about the intriguing title. The author explained in an interview that 'cutting for stone' refers to a part of the Hippocratic Oath that says "I will not cut for stone" referring to ancient problems with gallstones, where practitioners actually tried to cut them out, with no care for sanitation so the patient usually died a few days later. But the main character is named Stone, and he, his brother and his father are all surgeons, so there is that connection that cannot be ignored and provides food for thought. Highly recommended.
The central characters of the tale are Marion and Shiva, twin boys born in the most unlikely of circumstances in a mission hospital in Addis Ababa and raised by an Indian gynecologist and her internist-turned-surgeon husband following the tragic and shocking death of their birth mother. Their childhood years are punctuated by civil wars and attempted coups. Their surrogate father is imprisoned because of his suspected involvement in a plot to overthrow Emperor Haile Selassie.
Despite an almost mystical emotional bond, Marion and Shiva are polar opposites: One is studious, the other intuitively gifted; one passionately loves their nanny's daughter while the other is incurably carnal - a conflict that leads to estrangement and suffering. In the end, however, the disparate threads combine to produce an ending almost as shocking as the beginning, and sacrifice leads to an unimagined kind of wholeness. If all this seems vague, it is deliberately so: I don't want to deprive readers of the wonderful discoveries that come along the way.
Whatever the appeal that has earned Cutting for Stone its rave reviews, it escaped me.
Although skillfully interwoven, I feel as though Cutting for Stone is really two stories. One is the touching coming of age story of twin boys growing up in Ethiopia, and the other is the surgical development and journey of a doctor. I cannot recall reading any other medical fiction of this type, i.e. not biomedical suspense. Because it is so well-written, either strand of the book would have caught my attention, and together I felt as though I had found something new.
On the day of their birth, Marion and Shiva Stone lose their mother and are abandoned by their father. One of the twins is driven to try and learn their parents' stories, the other is content to live in the now of their happy life with their adopted extended family. These motivations help drive the plot. It is a fairly typical coming of age story: happy childhood, then growing awareness of sexuality, politics, and the emotional lives of others. Well told and set within the beauty and strife of Ethiopia.
That alone would have made a good story. But interwoven with this plot line are the stories of medical personnel, specifically surgeons. The nature of each doctor is revealed, not only by their role in the larger plot, but also by their work. Operations are described in detail, and the motivations and attitudes of the surgeons as surgeons are explored. Being a doctor is a large part of each one's identity, and Verghese is able to portray them so convincingly because he is a doctor himself, born in Ethiopia of Indian parents, and later practicing in the United States.
Verghese writes on his website:
I wanted the reader to see how entering medicine was a passionate quest, a romantic pursuit, a spiritual calling, a privileged yet hazardous undertaking. It's a view of medicine I don't think too many young people see in the West because, frankly, in the sterile hallways of modern medical-industrial complexes, where physicians and nurses are hunkered down behind computer monitors, and patients are whisked off here and there for this and that test, that side of medicine gets lost.
In the guise of a compelling fictional story, Verghese is able to bring his message of compassionate medical care, a glimpse into his personal life, and a portrayal of the impact of poverty on medicine to a much larger audience than the readers of the New England Journal of Medicine.
When Sister Mary Joseph Praise gives birth to twin boys, no one is more surprised than the people trying to save her life - even Dr. Thomas Stone, the man suspected of being the father of the babies cannot believe what he is seeing. Stone feels such shock and dismay at his failure to save the nun that he walks out of the lives of his sons even as they are struggling to draw their first breaths.
Right up to the moment of her tragic death, Sister Mary Joseph Praise and Dr. Stone have been integral parts of the Missing Hospital community (called "Missing" only because native speakers have difficulty pronouncing the word "Mission"). Now, Hema, the mission's obstetrician, decides that she needs to devote herself to raising the twins, and Ghosh, the only other doctor, has to transform himself into a confident surgeon. Marion and Shiva Stone will grow into young men surrounded by loving and supportive people but, to say the least, they live in interesting times.
The boys will prove to be good students and, with the encouragement of Hema and Ghosh, both develop the interest in medicine that will define their lives. What better place can there be than Missing Hospital for would-be medical doctors to gain countless hours of hands-on experience other medical students can only dream about.? Unfortunately, politics, in the form of military coups and Eritrean separatist rebels, will have tragic consequences for some of those closest to Marion and Shiva, even to the point that Marion is forced to leave Missing Hospital for work in a New York ghetto hospital. But that is far from the end of Marion and Shiva Stone's story.
Readers will be totally immersed in the world and characters Abraham Verghese has created in "Cutting for Stone," and will find that Marion and Shiva Stone soon become believable characters despite their rather mythical entry into the world. Their relationship suffers over the years but, despite everything that happens between them, the pair shares the kind of bond only experienced by identical twins. They are so close, in fact, that Marion often feels they should be called MarionShiva rather than by their individual names. The reader will also come to love most of the supporting cast, despite the fatal flaws exhibited by a few of them, with which Verghese surrounds the Stone brothers.
I do have one warning about "Cutting for Stone" (and I say this with a smile): Keep in mind that Abraham Verghese is a doctor and that he uses surgical detail and medical condition descriptions to add authenticity and passion to his prose. This is not a book to be read during lunch or dinner by anyone with a "weak stomach." Those who have read the book will know what I mean; those who have not should consider themselves warned.
Rated at: 5.0
We first meet the narrator, Marion Stone, as he (yes, he has a girl’s name) and his twin brother, Shiva, are about to be pried from the dying body of their mother, Sister Mary Joseph Praise, an Indian nun working at Missing (a mispronunciation of Mission) Hospital in Ethiopia. With this enticing start the story retains a sense of wonder and uniqueness throughout as we follow the twins through their eventful lives, learning both about love and medicine as they grow up under the protective wings of Missing doctors Hema and Ghosh who rear them as their own after their mother’s death and their father, Dr. Thomas Stone’s, untimely departure. Politics, poverty, cunning, revolution, education, love, and surgery envelope the characters as they mature. Since childhood Marion has loved Genet, the daughter of the family cook, but it is Shiva, with his clinical distraction, that sets the ball of betrayal and escape in motion. Marion finally ends up in New York where he finds deep satisfaction in become an adept surgeon, but it is not until his reunion with his father, and a self-sacrificing gift from Shiva, that Marion truly begins to understand life and love.
Being a professor of medicine, Verghese includes many medical details in the story, but he also creates unique and memorable characters and settings based on his own Indian heritage and his life in Ethiopia for this epic family saga.
That said, I was hooked to the larger story and overall enjoyed it. The descriptions of surgeries, hospitals and sickness are written by and for those who have experienced them, and it's hard for me to imagine people outside of medicine/nursing not getting lost in these. The epic description of a postpartum hemorrhage brought back intense memories of my clinical rotation in obstetrics, so much that I recalled vividly the smell of childbirth and blood. This evocation is what hooked me to the story. Are there more books that fit into the genre of third world medical drama? I'm hungry for more.
Verghese brings the sights and sounds of Ethiopia to life beautifully. If I had one complaint, and this is being quite picky, it was that the final Third of the book seemed a tad contrived. In saying that I was happy how the book finished.
There is so much that I could talk about in my review, so I'll discuss what stood out for me the most and has stayed with me the longest - the similarities between members of the Stone family and the Holy Family.
It was no coincidence that Marion and Shiva's mother's name was Mary and that she, as a nun, was a bride of Christ.
Although we get to know her a little bit while she’s traveling to Africa, she’s shrouded in mystery nearly from the moment she lands there until the day she delivers the twins. After death, she becomes mythical. Her presence is never far from the Theater in which she died.
It is also significant to me that Sr. Mary Jospeh Praise was an indispensable assistant to Missing’s lone surgeon, Dr. Stone. In that position, he wasn’t far removed from a god there. Then, to have him attempt to destroy his own creation in order to save his helpmate was shocking, especially when he fails on all accounts. Is it no wonder that he deserts his people at Missing and runs away from his failure? It’s both Adam and God fleeing Eden.
I could not help but associate Ghosh to Joseph. After so long, he finally realizes that he loves Hema, only to find that she’s adopted Marion and Shiva. While he may not have chosen fatherhood in this manner any more than he chose to become a surgeon, he was a model father. Instead of cursing events beyond his control that change the course of his life, he accepts his fate with peace and love.
Likewise, there are parallels that could be made between Jesus and Marion. He may have been named after a famous gynecological surgeon, but his name always reminded me of Mary. Shiva was not as obviously connected to me, but there were glimpses within his character as well. I do not wish to mention specific scenes, but there are times when I was reminded of Jesus as he draws in the dirt while being asked the fate of the adulterer, of Jesus and the women in his life, and of Jesus dealing with the money lenders in the temple.
Cutting for Stone paints a vivid picture of life in Ethiopia leading up to and including the Ethiopian Revolution. The story’s undercurrents and religious parallels have kept me thinking from the moment I first picked up the book. Could I have read this book from cover to cover if I had had the time? I most certainly could have and would have. In the end, I’m thankful that I couldn’t. This novel was worth every moment of the month I spent with it.
3 setting where the book took place or characters I met
* Setting: Missing Hospital in Addis Ababa, Ethiopia and New York City
* Marion Stone is our narrator and one of the twin boys born to Sister Mary Joseph Praise during a tragic birth scene that will leave you breathless. With no one aware that she was pregnant, Sister’s labor is unexpected, bloody and emotional. The apparent father—Dr. Thomas Stone—falls apart and abandons his sons, leaving them to be raised by the staff of Missing Hospital where they both worked. Trying to make sense of his heritage and his parents, Marion seeks to find out the history of his family and what the future will hold for him and his twin brother Shiva.
* Ghosh and Hema are two doctors at Missing Hospital who worked with Sister and Dr. Stone. They take on the raising of the brothers and influence them in their career paths—with Shiva being mentored by Hema and Marion being mentored by Ghosh. These two were my favorite characters in the whole book, and I actually missed them when the narrative didn’t have them as a focus.
4 things I liked or disliked about the book
* I read that Vergheses is a physician himself, and it shows throughout the book. I don’t think I’ve ever read a book that brought to life the feel and stresses of medicine (particularly surgery) in quite the way this book did. Verghese brings you right into the operating room with his characters and exposes you to the life of a physician in a way I haven’t ever seen before. It is obvious that Verghese is passionate about his profession, and that passion is apparent throughout this novel.
* Verghese brings to life the Addis Ababa where the Stone boys were born and grew up. He also deftly weaves in the story of the overthrow of Emperor Halie Selassie and the subsequent civil unrest that rocked the country, including the country’s ongoing dispute with Eritrea. I thought Verghese did a wonderful job of bringing the beauties and turmoil of Ethiopia to life and weaving them into his story in a way that felt natural and realistic.
* Verghese has an almost poetic writing style that resulted in many eloquent turns of phrase. In the Kindle version I was reading, I was able to see quotes that other readers had highlighted (with the new “Popular Highlights” feature), and I kept thinking “Wow … that is some lovely writing.” Here are a few examples:
EXCERPT: 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.
EXCERPT: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.
EXCERPT: Wasn’t that the definition of home? Not where you are from, but where you are wanted?
EXCERPT: We are all fixing what is broken. It is the task of a lifetime. We’ll leave much unfinished for the next generation.
* Although the novel seemed very grounded in reality and history while still having a “magical realism” feel to it, I had some trouble with some of the plotting, which seemed to rely a bit too much on coincidence and “convenient” happenings. One part that particularly bothered me was when Marion meets up again with Thomas Stone. It didn’t feel right to me at all and rankled me quite a bit. I also felt that Verghese didn’t quite know what to do with the character of Genet, a troubled girl who grows up with the twins.
5 stars or less for my rating:
I’m giving the book 4 stars. This is an impressive piece of literary fiction that brings surgery and medicine to life in a way I’ve never seen before. Although I had some issues with the plotting, I was willing to overlook them for Vergheses’s strong writing and ability to weave history and a family’s personal story into a narrative that will stay with you for some time afterward.
Of all the blurbs praising the book, I think Simon Schama's describes it best: the book is indeed an "epic medical romance," celebrating the vocation of medicine and the sometimes visionary courage of those who practice it. It is not, alas, a compelling piece of fiction.