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Cutting for Stone
By Abraham Verghese

By jonMon, 02/02/2009 - 16:32

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40-May-June-2009
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Abraham Verghese
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A-Cutting for StoneAbraham Verghese, a graduate of the Iowa Writers’ Workshop and a professor at the Stanford University School of Medicine, is the author of two acclaimed collections of nonfiction, My Own Country: A Doctor’s Story and The Tennis Partner. Cutting for Stone is his first novel.

The Story: Marion and Shiva Stone are twins born to an Indian nun and a British surgeon in 1954. After the boys’ mother dies in childbirth and their father disappears, the boys fend for themselves in an Addis Ababa hospital compound. When love for the same woman drives a wedge between the brothers, Marion, now a doctor, emigrates to America, where he practices at a New York City hospital. Then an event from Marion’s past returns to haunt him, and he must rely on his father and his brother, the two people he has come to resent. Cutting for Stone—the title is taken from the Hippocratic oath—is not only about the wounds that tear families apart but also about suffering and healing, love and hatred, and life and death.
Knopf. 534 pages. $26.95. ISBN: 0375414495

Rocky Mountain News 4.5 of 5 Stars
"[The author] weaves the threads of the story together with incredible skill, resulting in a novel that is beautifully written, complex and satisfying. Verghese is a master storyteller, and Cutting for Stone is a brilliant first novel." Ashley Simpson Shires

San Francisco Chronicle 4.5 of 5 Stars
"An epic tale bout love, abandonment, betrayal and redemption, Abraham Verghese’s first novel, Cutting for Stone, is a masterpiece of traditional storytelling. … 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

Washington Post 4.5 of 5 Stars
"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

Denver Post 4 of 5 Stars
"There are many reasons to read Cutting for Stone; it is a door into a number of foreign experiences. But the best reason to pick it up, perhaps, is that it is simply a good story, peopled by imperfect characters the reader comes to care about greatly." Robin Vidimos

Providence Journal 4 of 5 Stars
"In his superb first novel, Cutting for Stone, Abraham Verghese stitches together a poignant tale featuring a pregnant nun, twin brothers, three continents, five decades and the practice of medicine. … Verghese’s writing infuses both surprise and humor as political and moral crises emerge at the hospital and within his characters." Lisa Palmer

Chicago Tribune 3.5 of 5 Stars
"Cutting for Stone is a big, wandering, novel that moves from childhood and adolescence in Ethiopia forward to America for a few of the characters. … Suffering, in medical and psychological senses, is the armature of much of the action and character in Cutting for Stone, but there is heroism as well, some of it steady forbearance, some of it carried out as specific acts." Art Winslow

Dallas Morning News 3.5 of 5 Stars
"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, old and young. … [One] problem with the book is the large number of coincidences that bring characters together against heavy odds." Anne Morris

Boston Globe 3 of 5 Stars
"Cutting for Stone is certainly a long book, and a generally engrossing one; not a great work of fiction but an interesting one. … [Verghese is] not a bad novelist, but I suspect he’s a better doctor, and while this book is not the one I’d turn to in times of illness or pain, its author is." Julie Wittes Schlack

NY Times Book Review 2.5 of 5 Stars
"As a novelist, Verghese looks to models like Salman Rushdie and John Irving: the novel is capacious, not to say baggy, in the way those writers’ novels can be, and it is tinged, albeit lightly, with a sense of magic, though one senses that Verghese in his soul is too much a realist ever to be quite convinced of his own attempts in this department. … Verghese’s weakness is the weakness of a writer with too much heart: it’s clear he loves his characters and he just wants to cram in every last fact about them, somehow." Erica Wagner

Critical Summary

One might envy Abraham Verghese, who makes the transition from essayist to novelist look easier than it should be. Cutting for Stone will remind readers of the fiction of Salman Rushdie, John Irving (The Cider House Rules), and Ha Jin (A Free Life); it seems likely that the author knows the work of doctor and essayist Richard Selzer (Letters to a Young Doctor) as well. Verghese’s first novel is an expansive story well told. If he has a weakness as a novelist, though, as the New York Times Book Review points out, it is a surplus of passion for his characters and an unwillingness to let the smallest detail go unremarked. ("Only the telling can heal the rift that separates my brother and me," Marion writes, and that single sentence justifies Verghese’s motivation.) Would that all writers suffered for paying the same attention to their craft.

Reading Guide

POTENTIAL SPOILER ALERT!

The Reading Guide below is supplied by the book's publisher, and plot points may be revealed. We recommend that read the book before reading the guide.

1. Abraham Verghese has said that his ambition in writing Cutting for Stone was to “tell a great story, an old-fashioned, truth-telling story.” In what ways is Cutting for Stone an old-fashioned story-and what does it share with the great novels of the nineteenth century? What essential human truths does it convey?

2. What does Cutting for Stone reveal about the emotional lives of doctors? Contrast the attitudes of Hema, Ghosh, Marion, Shiva, and Thomas Stone toward their work. What draws each of them to the practice of medicine? How are they affected, emotionally and otherwise, by the work they do?

3. Marion observes that in Ethiopia, patients assume that all illnesses are fatal and that death is expected, but in America, news of having a fatal illness “always seemed to come as a surprise, as if we took it for granted that we were immortal” (p. 396). What other important differences does Cutting for Stone reveal about the way illness is viewed and treated in Ethiopia and in the United States? To what extent are these differences reflected in the split between poor hospitals, like the one in the Bronx where Marion works, and rich hospitals like the one in Boston where his father works?

4. In the novel, Thomas Stone asks, “What treatment in an emergency is administered by ear?” The correct answer is “Words of comfort.” How does this moment encapsulate the book's surprising take on medicine? Have your experiences with doctors and hospitals held this to be true? Why or why not? What does Cutting for Stone tell us about the roles of compassion, faith, and hope in medicine?

5. There are a number of dramatic scenes on operating tables in Cutting for Stone: the twins' births, Thomas Stone amputating his own finger, Ghosh untwisting Colonel Mebratu's volvulus, the liver transplant, etc. How does Verghese use medical detail to create tension and surprise? What do his depictions of dramatic surgeries share with film and television hospital dramas-and yet how are they different?

6. Marion suffers a series of painful betrayals-by his father, by Shiva, and by Genet. To what degree is he able, by the end of the novel, to forgive them?

7. To what extent does the story of Thomas Stone's childhood soften Marion's judgment of him? How does Thomas's suffering as a child, the illness of his parents, and his own illness help to explain why he abandons Shiva and Marion at their birth? How should Thomas finally be judged?

8. In what important ways does Marion come to resemble his father, although he grows up without him? How does Marion grow and change over the course of the novel?

9. A passionate, unique love affair sets Cutting for Stone in motion, and yet this romance remains a mystery-even to the key players-until the very conclusion of the novel. How does the relationship between Sister Mary Joseph Praise and Thomas Stone affect the lives of Shiva and Marion, Hema and Ghosh, Matron and everyone else at Missing? What do you think Verghese is trying to say about the nature of love and loss?

10. What do Hema, Matron, Rosina, Sister Mary Joseph Praise, Genet, and Tsige-as well as the many women who come to Missing seeking medical treatment-reveal about what life is like for women in Ethiopia?

11. Addis Ababa is at once a cosmopolitan city thrumming with life and the center of a dictatorship rife with conflict. How do the influences of Ethiopia's various rulers-England, Italy, Emperor Selassie-reveal themselves in day-to-day life? How does growing up there affect Marion's and Shiva's worldviews?

12. As Ghosh nears death, Marion comments that the man who raised him had no worries or regrets, that “there was no restitution he needed to make, no moment he failed to seize” (p. 346). What is the key to Ghosh's contentment? What makes him such a good father, doctor, and teacher? What wisdom does he impart to Marion?

13. Although it's also a play on the surname of the characters, the title Cutting for Stone comes from a line in 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.” Verghese has said that this line comes from ancient times, when bladder stones were epidemic and painful: “There were itinerant stone cutters-lithologists-who could cut into either the bladder or the perineum and get the stone out, but because they cleaned the knife by wiping their blood-stiffened surgical aprons, patients usually died of infection the next day.” How does this line resonate for the doctors in the novel?

14. Almost all of the characters in Cutting for Stone are living in some sort of exile, self-imposed or forced, from their home country-Hema and Ghosh from India, Marion from Ethiopia, Thomas from India and then Ethiopia. Verghese is of Indian descent but was born and raised in Ethiopia, went to medical school in India, and has lived and worked in the United States for many years. What do you think this novel says about exile and the immigrant experience? How does exile change these characters, and what do they find themselves missing the most about home?

SUGGESTED READING
Chinua Achebe, Girls at War; Andre Brink, A Dry White Season; Pauline Chen, Final Exam; Dave Eggers, What Is the What; Tracy Kidder, Old Friends; John Irving, The Cider House Rules; Ryszard Kapuscinski, The Emperor; Barbara Kingsolver, The Poisonwood Bible; Somerset Maugham, Of Human Bondage; Samuel Shem, The House of God; William Carlos Williams, The Doctor Stories.

ABOUT THE AUTHOR
Abraham Verghese is Professor and Senior Associate Chair for the Theory and Practice of Medicine at the Stanford University School of Medicine. He was the founding director of the Center for Medical Humanities & Ethics at the University of Texas Health Science Center, San Antonio, where he is now an adjunct professor. He is the author of My Own Country, a 1994 NBCC Finalist and a Time Best Book of the Year, and The Tennis Partner, a New York Times Notable Book. A graduate of the Iowa Writers' Workshop, he has published essays and short stories that have appeared in The New Yorker, The New York Times, The Atlantic Monthly, and Granta. He lives in Palo Alto, California.

Unless otherwise stated, this discussion guide is reprinted with the permission of Knopf. Any page references refer to a USA edition of the book, usually the trade paperback version, and may vary in other editions.