BOOK REVIEW (Cutting for Stone) By Solomon Gebre-Selassie
Cutting for Stone
By Abraham Verghese
Alfred Knopf Publishers
This is a first novel written by an Indian surgeon who was born and went to school in Ethiopia with a fluent knowledge of Amharic. Besides getting his medical degree from Ethiopia’s medical school, Dr. Verghese also got a Master of Writing degree from the famous Iowa University Writers’ Workshop. He is currently a professor and surgeon at Stanford’s medical school. Dr. Verghese left Ethiopia as the Dirgue regime came to power and threw the nation into a tailspin. His book had been reviewed by the book critics of major US newspapers, such as the New York Times and the Washington Post. I have not come across any review of the book by an Ethiopian, and I thought I should introduce the book to an Ethiopian audience by highlighting some of the novel’s salient points.
The title for the novel is taken from the Hippocratic oath that in part says “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 novel unfolds at a hospital in Addis run by missionaries that provides service to the Ethiopian indigent and officialdom alike. The hospital is called “Mission”, but Addis Abeba’s poor call it just “Missing”. The famous foreign characters in the story are two volunteer South Indian doctors, the woman and gynecologist Dr. Hema and her colleague and eventual husband Dr. Ghosh. Also, the British nun Matron serves as the hospital’s administrator and fund raiser. However, the drivers of the story are a Dr. Thomas Stone, a scrawny British volunteer surgeon and a young Indian nun nurse Sister Mary Joseph Praise. Coming to Ethiopia from India in a ship, and originally assigned to a hospital in Aden, Yemen, the nurse enjoys the companionship of the British doctor, and later joined him in Addis at Missing. She was his assistant at Missing while he performed operations, and the relationship grows and results in the nun bearing twins and dies due to complications of their birth. This tragedy must have driven the British doctor intensely guilty and sorrowful and he disappears from sight.
The twins, Marion and Shiva, are adopted by Dr. Hema who was mad as hell with Dr. Stone and wishes he would never come back to claim the children. Dr. Ghosh was in love with Dr. Hema, but she has consistently spurned him, and bored of the single life in Addis and at Missing, he had his visa ready to leave within a few months. But the birth of the twins changed all that. Dr. Ghosh also served as their surrogate father, and that led to Hema and Ghosh falling in love and fully adopting and parenting the twins. Ghosh loved Stone as his brother and never entertained ill feelings about his friend, an issue that did not sit well with his now wife Dr. Hema.
On the Ethiopian side, the main characters in the novel are Gebrew, guard, gardner and priest, Rosina (and her daughter Genet) and Alamz, maids to Dr. Hema and Dr. Ghosh, who now make one big family. Rosina is an Eritrean who lives with her daughter in a small house just behind her Indian employer’s house. The three kids -Genet, Marion and Shiva, grow up together, going to the same school, and being one happy family until puberty sets in.
Genet’s father Zemui does not seem to be formally married to Rosina, but comes occasionally and spends nights with her (he was in the army and later part of the generals coup against the Emperor and was executed). As the three kids grow together, the Indian family treated Genet with the same love as they treated their twins. Shiva started talking late, and was usually focused on a single task, while his identical twin was an all-academic youth with a flair for social activities. Marion gradually started getting attracted to the beautiful Genet as the shapely Genet matures into a young woman. One day they were playing naked in a room when Rosina stumbled upon them and, shocked, put a piece of cloth on her daughter and pulled her into their house. From that day on, she started suspecting that her daughter might be exposed to some horse playing. She took her to vacation to Asmara so that Genet could meet her relatives, and while she was away, Marion was burning with love and missing her a lot. In the meantime, Shiva was visiting prostitutes in Addis and becoming a typical teenager.
When Genet came back from Asmara, the three got together and started talking among other things about sex. Genet was also in heat and intensely desiring to experience it. Shiva started telling them in intimate details his sexual experiences. Marion was a bit shy and excused himself and left the room. Genet seduces Shiva to have her first sexual experience, and Rosina was heart- broken to find blood and semen in her daughter’s underwear. Fuming and suspecting Marion as the culprit, she barricaded her door and tried to mutilate Genet’s genitals by way of sewing her. This intensely painful and dangerous act ended in Genet being hospitalized and operated by the Indian doctors.
Marion was devastated at the betrayal of his brother, and his goddess Genet. He was never the same again, and this gulf endured for long between the brothers until later in life. Genet and Marion go to medical school, and Genet slowly loses interest and, once a brilliant student, starts failing classes. When Marion talked to her about what it was that was holding her back, he was talking to a different Genet who was political and caught in the Eritrean secessionist movement.
Soon after, Genet hijacked an Ethiopian Airlines plane along with her comrades and left the country. The Ethiopian intelligence agency was hot on Marion’s trail as a close confidant of Genet. He was forced to flee the country to Sudan through Asmara and EPLF’s field where he met medical school classmates now fighting as guerrillas and field medics. From Sudan to Kenya, and eventually settles in the USA as a medical intern at one of New York’s inner city hospitals.
Another Ethiopian character in the novel is the beautiful Tsigie. A young bar maid/bar owner she brought her sick child to Missing where the young Marion was helping his parents as he took his initial interest in the study and practice of medical science.
Marion empathized with the poor Tsigie whose child was coughing hard and seemed close to death. Marion arranged for her to see his doctor parents, but unfortunately they could not revive the child. Marion held Tsigie’s hand and comforted her, a kind act she never forgot. Tsigie was later to see Marion when he came to Boston and came to an Ethiopian restaurant to eat. Tsigie had emigrated to the US and was now an owner of the restaurant and an activist in the Ethiopian community there. Tsigie with the shapely legs brought back some love nostalgia, and both were not sure whether or not to rekindle the flame of love. In fact, when he was tempted to make the move, Tsigie advised the young doctor to go back to his home in New York and think hard about their relationship, and if he decided to come back to her she would be honored.
The subject of Genet was also discussed. To his utter surprise, Tsigie tells Marion that Genet was in the US, and that she had a child but she was now in jail. He could not believe what he was hearing. Tsigie said she helped Genet for some time, but lost track of her until she recently heard that Genet was in jail.
Back in New York lying on his bed in his single apartment, one day there was a knock on his door. When he opened the door, a disheveled woman was at his door. It was Genet. He was shocked, let her in, bathed and changed her clothes. She was coughing hard, and spitting blood. He tried to help her with home medication, and discussed how she got to this stage of her life. She told him that she married an Eritrean, had a son, but the husband was unfaithful to her and she killed him one day for which she served jail time. He felt sorry for her, and tenderly holding her body, made love to her…an act that almost cost his life, but in a twist of fate, cost the life of his twin brother who had deflowered Marion’s love in an earlier life.
The reason Marion went to Boston and met Tsigie at an Ethiopian restaurant was to attend a conference where a famous surgeon, Dr. Thomas Stone (his real father) was giving a speech. He confronted his father eventually, and shamed the British doctor who abandoned Marion and his twin brother in their infancy.
After Marion’s misadventure with Genet, she left and went away. But he became seriously ill. It was diagnosed by his father and doctor friends as hepatic coma – a life-threatening hepatitis. The ammonia level was very high and the liver hardly functioning. His adoptive mother (Ghosh was dead 2 years before Marion left Ethiopia) Hema and his twin brother Shiva came from Ethiopia to see the ill Marion. Hema was so terribly distraught. The doctors concluded that a liver transplant has to be done…but that was full of risks the least of which being the patient’s rejection of a foreign organ. Shiva volunteered to donate, and the operation was done by none other than his real father, Dr. Thomas Stone. The transplant was successful, and initially both donor and recipient fared well. But later, Shiva died.
Dr. Verghese has sprinkled a heavy dose of medical procedures and operations in his novel, thus Ethiopian medical doctors and medical practitioners would find in the book an appealing perspective. Shiva gives Marion as a gift when Marion left Ethiopia his dear and beloved possession, “Gray’s Anatomy”. Dr. Verghese has incorporated in his novel the fine fistula work the Hamlins have been doing in Ethiopia. Dr. Verghese has an eye for the suffering of the poor and the class basis of medical care, discussing the various ailments Ethiopia’s poor suffer from to the lack of staffing and equipment at inner city hospitals in New York and major US cities.
The 11th Commandment for Republicans in the US is “Thou shalt not badmouth another Republican”, an aphorism attributed to Ronald Reagan. For surgeons, Dr. Verghese tells us it is “Thou shalt not operate on a man in death”. Professor Asrat, who is mentioned in the novel, and most likely taught Dr. Verghese in medical school, also says something similar :” injuries to the vena cava behind the liver are when the surgeon sees God”.
The Amharic words Dr. Verghese used show his fluency in Amharic, and for possibly one error where he called the sticks the priests use for support at church mekuteriya, instead of mekuamiya.
Dr. Verghese loves Ethiopia dearly. Of Ethiopian Airlines, he says “the heroism of the security crew and the incredible skill of the pilots are very real (in the novel). He adds “Ethiopian Airlines remains, in my opinion, the safest and best international airline I have flown, with the most hospitable and dedicated flight attendants”.
His attribution of references is exceptional. Lest he be accused of plagiarism it seems, he even references sayings used in the novel; e.g., in the acknowledgments at page 536, Dr. Verghese says “her nose was sharp as a pen” is from Henry V, part II, and relates to belief that it represents Shakespeare’s astute clinical observation”.
By writing this novel, the good doctor has blended very well his South Indian heritage, his Ethiopian upbringing, and his love for medical science in a smartly written prose.