Cutting for Stone Hardcover - 2009

Summary

Excerpt

The Coming

After eight months spent in the obscurity of our mother’s womb, my brother, Shiva, and I came into the world in the late afternoon of the twentieth of September in the year of grace 1954. We took our first breaths at an elevation of eight thousand feet in the thin air of Addis Ababa, capital city of Ethiopia. The miracle of our birth took place in Missing Hospital’s Operating Theater 3, the very room where our mother, Sister Mary Joseph Praise, spent most of her working hours, and in which she had been most fulfilled.

When our mother, a nun of the Diocesan Carmelite Order of Madras, unexpectedly went into labor that September morning, the big rain in Ethiopia had ended, its rattle on the corrugated tin roofs of Missing ceasing abruptly like a chatterbox cut off in midsentence. Over night, in that hushed silence, the meskel flowers bloomed, turning the hillsides of Addis Ababa into gold. In the meadows around Missing the sedge won its battle over mud, and a brilliant carpet now swept right up to the paved threshold of the hospital, holding forth the promise of something more substantial than cricket, croquet, or shuttlecock.

Missing sat on a verdant rise, the irregular cluster of whitewashed one- and two-story buildings looking as if they were pushed up from the ground in the same geologic rumble that created the Entoto Mountains. Troughlike flower beds, fed by the runoff from the roof gutters, surrounded the squat buildings like a moat. Matron Hirst’s roses overtook the walls, the crimson blooms framing every window and reaching to the roof. So fertile was that loamy soil that Matron—Missing Hospital’s wise and sensible leader—cautioned us against stepping into it barefoot lest we sprout new toes.

Five trails flanked by shoulder-high bushes ran away from the main hospital buildings like spokes of a wheel, leading to five thatched-roof bungalows that were all but hidden by copse, by hedgerows, by wild eucalyptus and pine. It was Matron’s intent that Missing resemble an arboretum, or a corner of Kensington Gardens (where, before she came to Africa, she used to walk as a young nun), or Eden before the Fall.

Missing was really Mission Hospital, a word that on the Ethiopian tongue came out with a hiss so it sounded like “Missing.” A clerk in the Ministry of Health who was a fresh high-school graduate had typed out the missing hospital on the license, a phonetically correct spelling as far as he was concerned. A reporter for the Ethiopian Herald perpetuated this misspelling. When Matron Hirst had approached the clerk in the ministry to correct this, he pulled out his original typescript. “See for yourself, madam. Quod erat demonstrandum it is Missing,” he said, as if he’d proved Pythagoras’s theorem, the sun’s central position in the solar system, the roundness of the earth, and Missing’s precise location at its imagined corner. And so Missing it was.


Not a cry or a groan escaped from Sister Mary Joseph Praise while in the throes of her cataclysmic labor. But just beyond the swinging door in the room adjoining Operating Theater 3, the oversize autoclave (donated by the Lutheran church in Zurich) bellowed and wept for my mother while its scalding steam sterilized the surgical instruments and towels that would be used on her. After all, it was in the corner of the autoclave room, right next to that stainless-steel behemoth, that my mother kept a sanctuary for herself during the seven years she spent at Missing before our rude arrival. Her one-piece desk-and-chair, rescued from a defunct mission school, and bearing the gouged frustration of many a pupil, faced the wall. Her white cardigan, which I am told she often slipped over her shoulders when she was between operations, lay over the back of the chair.

On the plaster above the desk my mother had tacked up a calendar print of Bernini’s famous sculpture of St. Teresa of Avila. The figure of St. Teresa lies limp, as if in a faint, her lips parted in ecstasy, her eyes unfocused, lids half closed. On either side of her, a voyeuristic chorus peers down from the prie-dieux. With a faint smile and a body more muscular than befits his youthful face, a boy angel stands over the saintly, voluptuous sister. The fingertips of his left hand lift the edge of the cloth covering her bosom. In his right hand he holds an arrow as delicately as a violinist holds a bow.

Why this picture? Why St. Teresa, Mother?

As a little boy of four, I took myself away to this windowless room to study the image. Courage alone could not get me past that heavy door, but my sense that she was there, my obsession to know the nun who was my mother, gave me strength. I sat next to the autoclave which rumbled and hissed like a waking dragon, as if the hammering of my heart had roused the beast. Gradually, as I sat at my mother’s desk, a peace would come over me, a sense of communion with her.

I learned later that no one had dared remove her cardigan from where it sat draped on the chair. It was a sacred object. But for a four-yearold, everything is sacred and ordinary. I pulled that Cuticura-scented garment around my shoulders. I rimmed the dried-out inkpot with my nail, tracing a path her fingers had taken. Gazing up at the calendar print just as she must have while sitting there in that windowless room, I was transfixed by that image. Years later, I learned that St. Teresa’s recurrent vision of the angel was called the transverberation, which the dictionary said was the soul “inflamed” by the love of God, and the heart “pierced” by divine love; the metaphors of her faith were also the metaphors of medicine. At four years of age, I didn’t need words like “transverberation” to feel reverence for that image. Without photographs of her to go by, I couldn’t help but imagine that the woman in the picture was my mother, threatened and about to be ravished by the spear-wielding boy-angel. “When are you coming, Mama?” I would ask, my small voice echoing off the cold tile. When are you coming?

I would whisper my answer: “By God!” That was all I had to go by: Dr. Ghosh’s declaration the time I’d first wandered in there and he’d come looking for me and had stared at the picture of St. Teresa over my shoulders; he lifted me in his strong arms and said in that voice of his that was every bit a match for the autoclave: “She is CUM-MING, by God!”



Forty-six and four years have passed since my birth, and miraculously I have the opportunity to return to that room. I find I am too large for that chair now, and the cardigan sits atop my shoulders like the lace amice of a priest. But chair, cardigan, and calendar print of transverberation are still there. I, Marion Stone, have changed, but little else has. Being in that unaltered room propels a thumbing back through time and memory. The unfading print of Bernini’s statue of St. Teresa (now framed and under glass to preserve what my mother tacked up) seems to demand this. I am forced to render some order to the events of my life, to say it began here, and then because of this, that happened, and this is how the end connects to the beginning, and so here I am.



We come unbidden into this life, and if we are lucky we find a purpose beyond starvation, misery, and early death which, lest we forget, is the common lot. I grew up and I found my purpose and it was to become a physician. My intent wasn’t to save the world as much as to heal myself.
Few doctors will admit this, certainly not young ones, but subconsciously, in entering the profession, we must believe that ministering to others will heal our woundedness. And it can. But it can also deepen the wound.

I chose the specialty of surgery because of Matron, that steady presence during my boyhood and adolescence. “What is the hardest thing you can possibly do?” she said when I went to her for advice on the darkest day of the first half of my life. I squirmed. How easily Matron probed the gap between ambition and expediency. “Why must I do what is hardest?”

“Because, Marion, you are an instrument of God. Don’t leave the instrument sitting in its case, my son. Play! Leave no part of your instrument unexplored. Why settle for ‘Three Blind Mice’ when you can play the ‘Gloria’?”

How unfair of Matron to evoke that soaring chorale which always made me feel that I stood with every mortal creature looking up to the heavens in dumb wonder. She understood my unformed character.

“But, Matron, I can’t dream of playing Bach, the ‘Gloria’ . . . ,” I said under my breath. I’d never played a string or wind instrument. I couldn’t read music.

“No, Marion,” she said, her gaze soft, reaching for me, her gnarled hands rough on my cheeks. “No, not Bach’s ‘Gloria.’ Yours! Your ‘Gloria’ lives within you. The greatest sin is not finding it, ignoring what God made possible in you.”

I was temperamentally better suited to a cognitive discipline, to an introspective field—internal medicine, or perhaps psychiatry. The sight of the operating theater made me sweat. The idea of holding a scalpel caused coils to form in my belly. (It still does.) Surgery was the most difficult thing I could imagine.

And so I became a surgeon.

Thirty years later, I am not known for speed, or daring, or technical genius. Call me steady, call me plodding; say I adopt the style and technique that suits the patient and the particular situation and I’ll consider that high praise. I take heart from my fellow physicians who come to me when they themselves must suffer the knife. They know that Marion Stone will be as involved after the surgery as before and during. They know I have no use for surgical aphorisms such as “When in doubt, cut it out” or “Why wait when you can operate” other than for how reliably they reveal the shallowest intellects in our field. My father, for whose skills as a surgeon I have the deepest respect, says, “The operation with the best outcome is the one you decide not to do.” Knowing when not to operate, knowing when I am in over my head, knowing when to call for the assistance of a surgeon of my father’s caliber—that kind of talent, that kind of “brilliance,” goes unheralded.

On one occasion with a patient in grave peril, I begged my father to operate. He stood silent at the bedside, his fingers lingering on the patient’s pulse long after he had registered the heart rate, as if he needed the touch of skin, the thready signal in the radial artery to catalyze his decision. In his taut expression I saw complete concentration. I imagined I could see the cogs turning in his head; I imagined I saw the shimmer of tears in his eyes. With utmost care he weighed one option against another. At last, he shook his head, and turned away.

I followed. “Dr. Stone,” I said, using his title though I longed to cry out, Father! “An operation is his only chance,” I said. In my heart I knew the chance was infinitesimally small, and the first whiff of anesthesia might end it all. My father put his hand on my shoulder. He spoke to me gently, as if to a junior colleague rather than his son. “Marion, remember the Eleventh Commandment,” he said. “Thou shall not operate on the day of a patient’s death.”

I remember his words on full-moon nights in Addis Ababa when knives are flashing and rocks and bullets are flying, and when I feel as if I am standing in an abattoir and not in Operating Theater 3, my skin flecked with the grist and blood of strangers. I remember. But you don’t always know the answers before you operate. One operates in the now. Later, the retrospectoscope, that handy tool of the wags and pundits, the conveners of the farce we call M&M—morbidity and mortality conference—will pronounce your decision right or wrong. 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.

Now, in my fiftieth year, I venerate the sight of the abdomen or chest laid open. 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. 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. Is there a greater privilege on earth?

At such moments I remember to thank my twin brother, Shiva—Dr. Shiva Praise Stone—to seek him out, to find his reflection in the glass panel that separates the two operating theaters, and to nod my thanks because he allows me to be what I am today. A surgeon. 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.

Born in Africa, living in exile in America, then returning at last to Africa, I am proof that geography is destiny. Destiny has brought me back to the precise coordinates of my birth, to the very same operating theater where I was born. My gloved hands share the space above the table in Operating Theater 3 that my mother and father’s hands once occupied.

Some nights the crickets cry zaa-zee, zaa-zee, thousands of them drowning out the coughs and grunts of the hyenas in the hillsides. Suddenly, nature turns quiet. It is as if roll call is over and it is time now in the darkness to find your mate and retreat. In the ensuing vacuum of silence, I hear the high-pitched humming of the stars and I feel exultant, thankful for my insignificant place in the galaxy. It is at such times that I feel my indebtedness to Shiva.

Twin brothers, we slept in the same bed till our teens, our heads touching, our legs and torsos angled away. We outgrew that intimacy, but I still long for it, for the proximity of his skull. When I wake to the gift of yet another sunrise, my first thought is to rouse him and say, I owe you the sight of morning.

What I owe Shiva most is this: to tell the story. It is one my mother, Sister Mary Joseph Praise, did not reveal and my fearless father, Thomas Stone, ran from, and which I had to piece together. Only the telling can heal the rift that separates my brother and me. Yes, I have infinite faith in the craft of surgery, but no surgeon can heal the kind of wound that divides two brothers. Where silk and steel fail, story must succeed. To begin at the beginning . . .

Media reviews

“Abraham Verghese is a doctor, an accomplished memoirist and, as he proves in Cutting for Stone, something of a magician as a novelist. This sprawling, 50-year epic begins with a touch of alchemy: the birth of conjoined twins to an Indian nun in an Ethiopian hospital in 1954. The likely father, a British surgeon, flees upon the mother’s death, and the (now separated) baby boys are adopted by a loving Indian couple who run the hospital. Filled with mystical scenes and deeply felt characters–and opening a fascinating window onto the Third World–Cutting for Stone is an underdog and a winner. Shades of Slumdog Millionaire.”

–Jocelyn McClurg, USA Today

“A novel set in Africa bears a heavy burden. The author must bring the continent home to help the reader sit in a chair and imagine vast, ancient, sorrowful, beautiful Africa. In the last decade I’ve read books narrated by characters homesick for Africa; books by or about child soldiers; books about politics; books full of splintering history. Cutting for Stone is the first straightforward novel set in and largely about Africa that I’ve read in a good long time–the kind Richard Russo or Cormac McCarthy might write, the kind that shows how history and landscape and accidents of birth and death conspire to create the story of a single life. Perhaps it is because the narrator is a doctor that you know there will be pain, healing, distance, perspective and a phoenix rising from the ashes of human error. Marion Stone reconstructs his half-century with a child’s wonder . . . Verghese knows that beauty is the best way to draw us in . . . The landscape and the characters who live and work [at Missing Hospital] create something greater than a community, more like an organism. The intimacy of the twins . . . the ghostly purity of their mother and the daily rhythms of the hospital create an inhabitable, safe place, on and off the page. In lesser hands, melodrama would be irresistible . . . but Verghese has created characters with integrity that will not be shattered by any event. . . . Verghese makes the point in his gentle way that violence begets violence; that fanaticism is born from pain. . . . Cutting for Stone owes its goodness to something greater than plot. It would not be possible to give away the story by simply telling you what happens. Verghese creates this story so lovingly that it is actually possible to live within it for the brief time one spends with this book. You may never leave the chair. . . Lush and exotic . . . richly written.”

–Susan Salter Reynolds, Los Angeles Times

“Any doubts you might harbor about a 534-page first novel by a physician in his 50s will be allayed in the first few pages of this marvelous book. Abraham Verghese has written two graceful memoirs, but Cutting for Stone, his wildly imaginative fictional debut, is looser, bigger, even better. The narrative begins as a nun of staff at a charity hospital in Ethiopia dies giving birth to twin boys. No one on staff had known she was pregnant, least of all her surgeon lover, who promptly decamps. Just when you think you’re holding a grim epic of abandonment, Verghese changes keys, launching a buoyant tale of family happiness. [The] newborns are adopted by Hema, the hospital’s gynecologist, and her physician husband Ghosh. Introduced as a cheerful buffoon, Ghosh emerges as Verghese’s most achingly soulful creation, man as wise as he is tender. Verghese has the rare gift of showing his characters in different lights as the story evolves, from tragedy to comedy to melodrama, with an ending that is part Dickens, part Grey’s Anatomy. The novel works as a family saga, but it is also something more, a lovely ode to the medical profession. Verghese can write about the repair of a twisted bowel with the precision and poetry usually reserved for love scenes. The doctor in him sees the luminous beauty of the physician’s calling; the artist recognizes that there remain wounds no surgeon can men. ‘Where silk and steel fail, story must succeed,’ Marion muses. This one does.”

–Jennifer Reese, Entertainment Weekly; Grade: A

“An epic tale about love, abandonment, betrayal and redemption, Verghese’s first novel is a masterpiece of traditional storytelling. Not a word is wasted in this larger-than-life saga that spans three countries and six decades. . . . So adept at keeping his readers engaged, Verghese (a doctor himself, as well as a professor at Stanford) is able to relate technically detailed accounts of medical procedures without ever slowing the pace of the narrative. Detail, in fact, is Verghese’s forte. Every character has a history–and Verghese expertly weaves the threads of numerous story lines into one cohesive opus. The writing is graceful, the characters compassionate and the story full of nuggets of wisdom. Verghese’s august talent for storytelling is apparent in the dramatic arc of every chapter, but it is his handling of the human condition, of sins and salvation, of flaws and forgiveness, that makes this work particularly moving. From [Marion and Shiva Stone’s] dramatic upbringing in a politically unstable nation to their heartbreaks and humiliations, Verghese’s prose is teeming with memorable dialogue and description. Marion’s arrival in New York City captures the wonderment of an immigrant . . . Although Verghese’s nonfiction works exemplify the sensitivity and awareness evident in Cutting for Stone, neither achieves the depth or breadth of this fictional tour de force. With all the traits of a great 19th century novel–a personal and intense narrative with coincidences and an unexpected denouement–Cutting for Stone is destined for success.”

–Meghan Ward, San Francisco Chronicle

“Blood is thicker than water, and more copious, in this expansive novel about identical twin boys born in Addis Ababa in 1954 and instantly orphaned–their mother dies, their father flees. Raised by doctors at the hospital, Shiva and Marion soon begin practicing medicine themselves, but their lives unhappily diverge. The twins have a telepathic connection, and Marion, the narrator, believes he can recall their relationship in the womb. Verghese, a doctor, has an affinity for unstinting detail and unscientific intuition. The exhaustive gore of the medical procedures is matched by a poetic perception of the outside world–arriving in New York, Marion misses the cacophony of Addis Ababa’s roads, observing that in America ‘the cars were near silent, like a school of fish.’ Verghese bends history and coincidence to his narrative needs–characters cross paths when they should and find the information they seek–creating a story much like the human bodies Marion painstakingly describes: beautiful [and] amazing.”

–The New Yorker

“Masterful . . . Verghese’s gripping narrative moves over decades and generations from India to Ethiopia to an inner-city hospital in New York, describing the cultural and spiritual pull of these places. . . . Even with its many stories and layers, Cutting for Stone remains clear and concise. Verghese paints a vivid picture of these settings, the practice of medicine (he is also a physician) and the characters’ inner conflicts. I felt as though I were with these people, eating dinner with them even, feeling the hot spongy injera on my fingers as they dipped it into a spicy wot. In The Interior Castle, Saint Teresa’s work on mystical theology, she wrote, ‘I began to think of the soul as if it were a castle made of a single diamond or of very clear crystal, in which there are many rooms, just as in Heaven there are many mansions.’ Cutting for Stone shines like that place.”

–W. Ralph Eubanks, The Washington Post Book World

“Stupendous . . . The best novel to come along so far this year. [Cutting for Stone] doesn’t really belong to any familiar genre. Rather, it has invented its own: the epic medical romance, surgery meets history. [Verghese is] an original talent; a writing that can deliver with both pen and scalpel. . . . Verghese’s eye is acutely diagnostic. Like Tolstoy (the comparison is not completely far-fetched), he spots the symptomatic, involuntary tics and twitches of body language and nails something bigger: the rough force of politics with which the twins Shiva and Marion . . . have to deal as they grow to maturity in embattled Ethiopia. . . . In War and Peace, the field hospital was a place of last resort for Tolstoy’s antagonists to discover the point of the life from which they are about to exit. For Verghese, the hospital is the world itself, laid out in a state of extreme emotional exposure–for Cutting for Stone is also, at its core, a story of erotic upheavals and familial betrayals. Its action takes place within the arc of the two terrifying procedures that form its beginning and end, and in this sense it reaches for the ambitions of Greek tragedy. . . . Beautiful and deeply affecting.”

–Simon Schama, Financial Times

“Three and a half stars. Conjoined twins, Shiva and Marion Stone are separated by the doctor whose Caesarean fails to save their mother. Raised near the Ethiopian hospital where they were born, the brothers lock into a struggle that mirrors the country’s political tension: Their family is touched by murder, a coup, betrayal. Verghese plays straight to the heart in his first novel, which will keep you in its thrall.”

–Michelle Green, People

“Engrossing . . . Endearing . . . A passionate, vivid, and informative novel . . . [Verghese] paints a colorful, fact-filled, and loving portrait . . . Verghese is at his best describing the landscape, the genial wisdom of the man who raises [twin brothers Marion and Shiva], the political upheavals that rupture the land he loves, and . . . the medical and surgical challenges that confront this family of doctors. . . . Cutting for Stone is worth reading. Verghese is clearly a compassionate man in love with words and the subject matter to which he applies them.”

–Julie Wittes Schlack, The Boston Globe

“[An] astonishing, breath-taking and heartrending human epic about two little boys who become enamored of medicine, but whose paths violently diverge . . . A perfectly pitched, endlessly rewarding symphony of a debut novel. If you have time to read only one novel this year, make it this one.”

–Sheila Anne Feeney, Newark Star-Ledger

“Absorbing, exhilarating . . . Rich . . . Worthy of ‘Once-upon-a-time’ status. . . . If you’re hungry for an epic that begins in 1940s Madras, sails through a typhoid outbreak, stumbles through a sordid khat den in Yemen, lingers in a plucky mission clinic in Addis Ababa and climaxes in a gritty New York City hospital before alighting, for a mystical moment, in a small Italian chapel graced by Bernini’s sculpture of St. Teresa, then open the covers of Cutting for Stone, [then] don’t expect to do much else. . . . [Verghese] skillfully captures the tensions and insights triggered by cultural crosscurrents. [He] details with equal adroitness the thrashing of 10,000 Italian soldiers by barefoot Ethiopian fighters in 1896; the patois of frankincense-scented brothels; a vasectomy performed with the aid of space heater and Johnnie Walker Red–the description of the latter so charming and surgically precise, it could serve, in a pinch, as how-to manual. Verghese’s love of medicine is palpable. He’s equally passionate about narrative. . . . He sprinkles medical nuggets throughout his novel to reveal the raw complexity of life . . . His intimate depiction of humanity makes your pulse race, your eyes tear, and your lungs exhale a satisfied sigh.”

–Paula Bock, The Seattle Times

“Compelling . . . A story [that] refuses to let go of the readers. . . . Cutting for Stone [is] a coming-of-age novel. But it’s also a novel about doctors and nurses living amid the rich contradictions of Ethiopia. Then again, it’s a novel about the making of a surgeon, an expatriate who leaves Ethiopia to learn the art in a not-so-nice neighborhood in the Bronx. On another level, it’s a surgical thriller. Finally, Cutting for Stone is a novel of character–of a family held together by love and split by betrayal. . . . Readers will put this novel down at book’s end knowing that it will stick with them for a long time to come. . . . Unlike many doctors, Verghese can write. . . . And, unlike so many doctors, Verghese (or at least the surgeon in this novel, his first) insists on seeing patients as humans. . . . Somehow, even using the jargon that surgeons use, Verghese makes the process clear to readers. So, read it for the medical education. Or for the characters. Or for the action, or for the dynamics of an unhappy family. But do yourself a favor. Read it.”

–Harry Levins, St. Louis Post-Dispatch

“Gripping . . . Admirably accessible, Verghese takes every opportunity to make the language of medicine fascinating to the outsider. . . . His novel has more in common with the large, ambitious, action-packed novels of the 19th century than with any more recent models. References to George Eliot’s Middlemarch are layered into the book, perhaps as an indicator of the kind of sweeping social novel Verghese is attempting. What’s most memorable about Cutting for Stone is Verghese’s compassionate authorial generosity toward his characters, particularly in his medical scenes. Verghese’s doctors never forget that they are operating on human beings. . . . Refreshing.”

–Laura C. J. Owen, Minneapolis Star Tribune

“Epic/intimate storytelling in the tradition of Forster, Conrad, Dinesen, Maugham, Naipaul. . . . All signs point in the affirmative that Verghese has succeeded in his ambition to write ‘the great medical novel.’”

–Steve Bennett, San Antonio Express-News

“The novel is full of compassion and wise vision. . . . I feel I changed forever after reading this book, as if an entire universe had been illuminated for me. It’s an astonishing accomplishment to make such a foreign world familiar to a reader by the book’s end.”

–Sandra Cisneros, San Antonio Express-News

“Dr. Marion Praise Stone, the narrator of Cutting for Stone, [holds] his audience spellbound. Call him a little miracle, a fictional character so richly imagined and situated that neither he nor the book he lives in will ever be forgotten. Verghese’s first novel is a whopper, illuminating the magic and the tragedy of our lives, brimming with wisdom about the human condition. Such fun to read, too–with a huge cast, a sweeping multi-continental plot arc, a zillion lovely moments along the way: sharp descriptions, recurrent jokes, cultural observations and medical asides both witty and profound. (Wait till you get to the vasectomy.) In charting the destiny of this family–twins born attached at the head, adoptive parents whose devotion is a force of nature, biological parents whose absence is a wound, a servant’s daughter who becomes a semi-sibling, Verghese tells the brightest and darkest truths of what it means to be connected to another human. . . In Cutting for Stone, we get all we were promised and then some. Verghese’s previous two books established [him] as a gifted memoirist, a devoted doctor whose skillful storytelling transformed sad stories into fine reading. Yet these books gave no hint of the incredible imaginative power found in this first novel, a power that recalls contemporary fabulists like Salman Rushdie and John Irving. Like Rushdie, Verghese takes us wholly away to a foreign place, culture and history. Like John Irving, he invents characters whose eccentricities are both mythic and adorable. To these achievements, Verghese adds his ability to dramatize matters of biology, medicine and surgery, allowing him to get to the heart, the brain, [and] the liver as few other writers can.”

–Marion Winik, Newsday

“At its best, the first novel from physician Verghese displays the virtues so evident in his bestselling and much-lauded memoirs. He has a knack for well-structured scenes, a passion for medicine and a gift for communicating that passion. He gives readers clear, sensory and intricately detailed description, and he uncovers the unexpected significance of mundane actions and objects. Cutting for Stone is the saga of Marion Stone, son a brilliant, though psychologically damaged British surgeon and a nun who dies giving birth to Marion and his twin, Shiva. Drawn to a life in medicine, Marion narrates a childhood full of incident and atmosphere, culminating in his estrangement from Shiva and his eventual escape from Addis during the 1960s struggle for Eritrean independence. After a harrowing journey, he finds a second home as a surgical resident at a cash-strapped hospital in [America].”

–John Repp, Cleveland Plain-Dealer

“After two highly successful nonfiction books, Verghese has written an enthralling debut novel set largely in Ethiopia, the country where he grew up. Verghese creates a saga grand enough for the movies, yet sensitive in its explorations of character, purpose and place. Cutting for Stone tells the story of twin boys born to an Indian nun mother and a British surgeon father. The mother dies in childbirth and the father leaves the country, abandoning the twin boys, Marion and Shiva Stone. They grow up in the household of two dedicated physicians, [and] Verghese creates in the adoptive parents, Hema and Ghosh, marvelous characters that readers come to know well. Ghosh may be the book’s best creation. His robust affection for life fills the page, even as he deals day to day with death. Ghosh sees his patients as people, not just problems to be solved. Marion, the twin who narrates the novel, will grow up to be such a doctor himself. Fascinating in its detailed depiction of the sights and sounds of its Ethiopian setting, the novel holds your attention throughout, for you care about the characters, both male and female, young and old. Plus, Verghese writes beautifully…A great, sweeping novel.”

–Anne Morris, Dallas Morning News

“To exhilarate you . . . A saga about love, medicine, and exile, this debut reads like a modern Odyssey as it follows twin boys born in an Ethiopian mission hospital as they search for the man presumed to be their father.”

–Good Housekeeping

“Magical . . . Vivid . . . Cutting for Stone kept me absorbed and enthralled all the way to India . . . A big, sweeping family saga about twin brothers born of the secret union between a formidable, aloof surgeon and a nun at a mission hospital in Addis Ababa during the reign of Emperor Haile Selassie. . . . Some of the most gripping writing in the novel is [Verghese’s] evocation of the power, mastery, and process of surgery. . . . It’s the perfect read to escape the recession. . . . I don’t think I’ve read a novel with this kind of depth and sweep and character and sort of vividness for such a long time. It’s just what we need at this moment to disappear into and flee.”

–Tina Brown, The Daily Beast

“Like [John] Irving, like Dickens, Verghese in this book refers to an older model of fiction, prior to the distinction between high and low culture. The novel intends to say something serious about callings, in love and in work, and along the way to provide insights into the histories of medicine and of East Africa, but Cutting for Stone is [also] an airport read, with cliff-hanger plot points at the end of each chapter. For a taste, [just] read the opening. . . . A book that’s unashamedly a page-turner.”

–Peter D. Kramer, PsychologyToday.com

“[A] fantastic evocation of the life of a pair of twins whose mother was a nun and father an English surgeon. The twins both grow up to be doctors and become patients in a ground-breaking organ transplant which is both the tragic and triumphant end of the novel. Verghese’s medical expertise informs and enlivens much of this story. He describes the death of Sister Mary Joseph Praise while giving birth to the twins in lavish detail. . . . [Verghese] is a particular hybrid creature, both novelist and physician, and has a style and magic all his own. Written with a lyrical flair, told through a compassionate first-person point of view, and rich with medical insight and information, [Cutting for Stone] makes for a memorable read.

–William J. Cobb, Houston Chronicle

“Sparkling . . . Epic . . . . Verghese has made a seamless transition from best-selling memoirist to novelist. His plotting is subtle–clues planted in chapter 1 blossom with meaning in chapter 53–and the Stone circle of characters is unforgettable. Cutting for Stone is as wise and worldly as it is gritty and unpretentious.”

–Mike Shea, Texas Monthly

“The best novel I’ve read this year . . . Like Chekhov, Verghese is a doctor and is as authoritative about the workings of the human heart as he is of the human body. The novel moves from birth to death over several continents and decades and if comparisons with another writer have to be made, its blend of intensely realized detail, adventure, myth, wit, drama and poetry reminded me of Shakespeare.”

–Richard Eyre, The Sunday Telegraph (UK)

“Verghese is a novelist revealing extraordinary skill. With Cutting for Stone, [he] proves his gift [and] shares with us a story that cuts into our hearts and burns into our minds. . . . This epic of family and love is told largely from the operating theater as surgeon and soul become one. Each story of lives saved and lost is lovingly and graphically told. Were this to be yet another television-esque medical drama, or if it played out like a simple metaphoric Jacob and Esau tale, it would not be such a remarkable work. It is set apart from pedestrian stories by its international and universal story of love found in brotherhood, medicine, patriotism and family and of a faith that transcends any named religion. It is epic in every sense of the word. . . . Deeply affecting, cuts deep and heals broadly for all who willingly place themselves in its grasp.”

–Adera Causey, Chattanooga Free Press

“An enormously impressive first novel. . . . Many physicians write eloquently about their work–Atul Gawande and Oliver Sacks come readily to mind–but Abraham Verghese may be the first to use his medical expertise to reconfigure a hallowed literary genre: the epic novel. [He] has written a riveting tale . . . while interweaving graphic physiological details and lots of shoptalk. . . . A powerful story of abandonment, betrayal, and redemptive (and destructive) love. . . . Page-turning. A-.”

–Nan Wiener, San Francisco Magazine

“Following in the footsteps of Sacred Games by Vikram Chandra and Cavedweller by Dorothy Allison, Verghese skillfully captures a spectrum of history and culture with a particular voice. . . . The ties and hierarchies of the unconventional ‘family’ at Missing Hospital are intriguing and accessible. One of the novel’s most interesting conflicts lies in how [twins] Shiva and Marion [Stone] struggle to uncover their own personalities despite the tendency of others to see them as one. . . . Verghese excels at establishing the world of the twins . . . A welcome addition to Verghese’s works. He continues to beautifully trace the ambiguities of the human heart.”

–Elizabeth Rabin, Fredericksburg Free Lance-Star

“Required Reading: Marion Stone, the hero/narrator of Verghese’s epic debut novel, is an Indian raised in Ethiopia–as is the author . . . The story of Marion and his twin brother Shiva takes readers from India to Yemen, Addis Ababa to the Bronx.”

–Billy Heller, New York Post

“Some of the best passages in [all of Verghese’s books] are those in which he reads the language of the body–its colours and betraying odours, its telltale pulses–and the emotions that obscure and interrupt that language. . . . While I don’t know Verghese personally, I know the streets and shops he evokes, the hospitals; I know that his setting, seemingly so rich and strange, is real. . . . Verghese’s achievement is to make the reader feel there really is something at stake–birth, love, death, war, loyalty. . . . The mythic arises seamlessly from the quotidian . . . You conserve pages because you don’t want [the book] to end.”

–Aida Edemariam, The Guardian (UK)

“A good writer can open the boundaries of geography, education, religion and ethnicity. We vicariously experience life in all its diversity through the best storytellers. Abraham Verghese is this kind of writer. . . . This is the best novel I have read in a long time, maybe since my favorite John Irving novel, A Prayer for Owen Meany. Verghese’s attention to detail is phenomenal, but never tiresome. He is a storyteller of the first magnitude.”

–Beth Pratt, Lubbock Avalanche Journal (TX)

“Lauded for his sensitive memoir My Own Country, Verghese [now] turns his formidable talents to fiction, mining his own life and experiences in a magnificent, sweeping novel that moves from India to Ethiopia to an inner-city hospital in New York City over decades and generations. During an arduous sea voyage, Sister Mary Joseph Praise, a devout young nun, saves the life of an English doctor bound for Ethiopia, Thomas Stone . . . Seven years later, Sister Praise dies birthing twin boys: Shiva and Marion, the latter narrating his own and his brother’s dramatic, biblical story set against the backdrop of political turmoil in Ethiopia, the hospital compound in which they grow up, and the love story of their adopted parents, both doctors. The boys become doctors as well, and Verghese’s weaving of the practice of medicine into the narrative is fascinating even as the story bobs and weaves with the power of the best 19th-century novels.”
–Publishers Weekly (starred, boxed review)

“This epic first novel by well-known doctor/author Verghese follows a man on a mythic quest to find his father. It begins with the dramatic birth of twins, their father serving as surgeon and their mother dying on the table. Their horrorstruck father vanishes, and the now separated boys are raised by two Indian doctors living on the grounds of a mission hospital in early 1950s Ethiopia. The boys both gravitate toward medical practice . . . After Marion, [one of the twins,] is forced to flee the country for political reasons, he begins his medical residency at a poor hospital in New York City, and the past catches up with him. The medical background is fascinating as the author delves into fairly technical areas of human anatomy and surgical procedure. This novel succeeds on many levels and is recommended for all collections.”
–Jim Coan, Library Journal

“Abraham Verghese has always written with grace, precision and feeling [but] he’s topped himself with Cutting for Stone. . . . A vastly entertaining and enlightening book.”
–Tracy Kidder
 
“Absolutely fantastic! Holy cow, this book should be a huge success. It has everything: nuns, conjoined twins, civil war, and medicine–I was thinking that if Vikram Seth and Oliver Sacks were to collaborate on a four-hour episode of Grey’s Anatomy set in Africa, they could only hope to come up with something this moving and entertaining. . . . A marvelous novel!”
–Mark Salzman
 
“A marvelous novel. To read the first page of Cutting for Stone is to fall hopelessly under the spell of a masterful storyteller; and to try to close the book thereafter is to tear oneself away from the most vivid of dreams. Cutting for Stone is a gorgeous epic tale, suffused with unforgettable grace, humanity and compassion. Verghese breathes such life into his characters that there is a poignant familiarity to them, one that lingers and haunts long after the dream is over. Verghese has once again set the bar and re-defined great medical literature–great literature period–for the rest of us.”
–Pauline W. Chen, author of Final Exam

“Abraham Verghese has long been one of my favorite authors. Yet, much as I admire his abundant gifts as both writer and physician, nothing could have prepared me for the great achievement of his first novel. Here is an extraordinary imagination, artfully shaped and forcefully developed, wholly given in service to a human story that is deeply moving, utterly gripping, and, indeed, unforgettable. Cutting for Stone is a work of literature as noble and dramatic as that ancient practice–medicine–that lies at the heart of this magnificent novel.”
–John Burnham Schwartz, author of The Commoner and Reservation Road

“A marvel of a first novel. Verghese’s generosity of spirit is beautifully embodied in this gripping family saga that brings mid-century Ethiopia to vivid life. The practice of medicine is like a spiritual calling in this book, and the unforgettable people at its center bring passion and nobility–not to mention humor and humility–to the ancient art, while living an unforgettable story of love and betrayal and forgiveness. It’s wonderful.”
–Ann Packer

“Cutting for Stone is a tremendous accomplishment. The writing is vivid and thrilling, and the story completely absorbing, with its pregnant Indian nun, demon-ridden British surgeon, Siamese twins orphaned and severed at birth, and narrative strands stretching across four continents. A tale this wild is perilous, but there is not a false step anywhere. Accomplished non-fiction writers do not necessarily make accomplished novelists, but with Cutting for Stone, Abraham Verghese has become both. This is a novel sure to receive a great amount of critical attention–and attention from readers, too. I feel lucky to have gotten to read it.”
 –Atul Gawande
 
“One of the best novels I’ve read in a long time.”
–Robert Bly

“The admixture of the generally unfamiliar but colorful venues of northeastern Africa and a distinctly different yet subtly similar part of the Bronx; a cast of complex but thoroughly conceivable characters; an intriguing medical drama of the highest intensity without deviation from scientific truth–in sum–leads to the diagnosis of an exciting novel and the assured prognosis of a memorable read! I’d prescribe Cutting for Stone not just for every surgeon and surgeon-in-training, but for any reader in search of an awesome tale.”
–Seymour I. Schwartz, Distinguished Alumni Professor of Surgery, University of Rochester Medical Center, editor-in-chief of Principles of Surgery, and author of Surgical Reflections and Gifted Hands


“Prepare to be transported entirely by one of the finest writers of our time. Cutting for Stone by the astonishingly gifted, deeply compassionate writer Abraham Verghese will wrap around you from the very first page and will not let you go.”
–Naomi Shihab Nye, author of Habibi
 
“Empathy for our frail human condition resonates throughout Abraham Verghese’s Cutting for Stone.  By tracing the development of a narrator unlike any other in our literature–from his nearly mythic beginnings in Ethiopia to his immigrant life in contemporary America–Verghese demonstrates that the supreme skill of a physician lies not in his hands but in his heart. No contemporary novelist has written so well about the human body.  Cutting for Stone is an amazing and moving achievement which reminds us of the miracle of being alive.”
–Tom Grimes, author of A Stone of the Heart
 
“Cutting for Stone is nothing short of masterful–a riveting tale of love, medicine, and the complex dynamic of twin brothers. It is beautifully conceived and written. The settings are wonderfully pictorial. There is no doubt in my mind that Cutting for Stone will endure in the permanent literature of our time.”
–Richard Selzer, surgeon and author of Letters to a Young Doctor

“Cutting the Stone is astonishing–the best book I have read in years. Verghese has a profound love and empathy for his characters and an extraordinary ability to bring his readers to worlds they could never imagine. Here at last is an epic–a great yarn of a novel–as ambitious in its reach as if from another century. Fathers, mothers, sons, children, love: what emotion is not examined? So many of us have been operating as if a sweeping narrative were as quaint as the buggy whip, and yet here comes Verghese to turn that assumption inside out. I wept through parts of this novel, as much for how we live lives of blindness, to ourselves and to others, until we are set on a course that cannot be altered, but just lived and then reconsidered. Bravo to Abraham Verghese!”  
–Marie Brenner, author of Apples & Oranges

“A grand, exquisitely drawn story of twin brothers that ranges from birth to death, and from Ethiopia to America. In Cutting for Stone, Abraham Verghese shows us with brilliance and passion where healing comes from, and how we move through suffering to embrace life. In the hands of this compassionate doctor/writer, the details are indelible: A wonderful book.”
–Samuel Shem, author of The House of God and The Spirit of the Place