The Hippocratic Oath states, “I will not cut for stone, even for patients in whom the disease is manifest.” Stone is also the surname of a trio of surgeons in Abraham Verghese’s first novel, Cutting for Stone.

Marion and Shiva Stone are born in 1954 in Addis Ababa, the same day their mother, the nun, Sister Mary Joseph Praise, dies of complications from her hidden pregnancy. The boys are conjoined at the skull, yet separated at birth. They are then raised by Dr. Kalpana Hemlatha, a forceful woman known as Hema, and Dr. Abhi Ghosh, both immigrants from Madras and both doctors at the hospital where the boys’ natural parents also worked.

This first portion of the book proved to be a chore to work through but I promise readers that once the foundation was laid, the story was a beautiful and poignant testimony to love, family, immigration, and the pursuit of medicine.

The boys grow up amid the political turmoil of Ethiopia and Marion must flee to New York where he pursues his career as a surgeon.  His brother Shiva, to whom he has grown distant as the years passed, stayed in Ethiopia becoming a world renowned doctor specializing in women’s medicine.

The climax of the story results when the boys become reunited with one another and their father at the end of the book with a startling conclusion that forever alters the lives of all the characters.

The novel does not shy away from reaching for epic stature.  There are elements that came late in the story causing disruption in the narration and therefore having less impact.  One instance is the back story of their father Thomas Stone.  He departs in part one with no explanation and as a reader, I found myself having dealt with it long before the author chose too.  It made the revelations no less illuminating but less integrated in the story.  And as the reader, I didn’t choose to abandon my own conclusions and feelings of the character and story even after reading his revelations.

In an interview, Verghese clarifies, “There is a line in the Hippocratic Oath that says: ‘I will not cut for stone, even for patients in whom the disease is manifest.’ It stems from the days when bladder stones were epidemic, a cause of great suffering, probably from bad water and who knows what else. […] There were itinerant stonecutters—lithologists—who could cut either into the bladder or the perineum and get the stone out, but because they cleaned the knife by wiping it on their blood-stiffened surgical aprons, patients usually died of infection the next day. Hence the proscription ‘Thou shall not cut for stone.’ […] It isn’t just that the main characters have the surname Stone; I was hoping the phrase would resonate for the reader just as it does for me, and that it would have several levels of meaning in the context of the narrative.”

The theme of things missing from the story is prevalent throughout the novel, where things happen offstage like in Greek tragedy, which many reviewers and critics have compared this story to. Three chapter titles are dedicated to absence: Missing Fingers, Missing People, and Missing Letters. Not to mention, the small hospital where the boys were born and grew up was called Missing.

Author Verghese is a physician and an already accomplished author. His two nonfiction books, My Own Country about AIDS in rural Tennessee, and The Tennis Partner, a moving and honest memoir of a difficult, intimate friendship have been well received.

I enjoyed the history and culture of this novel.  The vivid and explicit surgery scenes intrigued me rather than turned me off.  And the characters were richly drawn, each one with his or her own back-story and place in the landscape. It was a story I was sad to see end.

GENRE: Historical Fiction

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