A vivid slice of Ethiopian life and history
A famed doctor and accomplished medical writer spins out a novel about Ethiopia. This graphic page-turner runs more than 500 pages, but a Peace Corps doctor who worked the wards in Dessie’s hospital says it’s relentlessly authentic
Cutting for Stone
by Abraham Verghese
Knopf hardback $26.95
Vintage paperback $15.95
Reviewed by Robert Mayer, Peace Corps Physician 65–67
Dr. Abraham Verghese is neither Ethiopian nor part of the Peace Corps family. Even so, this bulky first novel verbally displays wonderful images of the country, especially of Addis in the ‘60s and ‘70s. The author modifies some of the chronology of events of that period but many of the events are true and provide context for this readable and moving book. For those of you who have a weakness for medical novels, a strong stomach, and an interest in obsessively chronicled medical detail this book should interest you.
As a writer, Verghese was acclaimed for his first nonfiction book, “My Own Country”, which has become a must-read for medical students seeking to understand the AIDS plague of the ‘80s; his other career is as a specialist in infectious diseases at Stanford Medical School. In this book he takes full advantage of Ethiopia’s fertile environment for such maladies, and he covers the ground from the familiar hepatitis and dysentery to the less common typhus and relapsing fever, finishing with a treatise on the ravages of untreated syphilis. I admit this medical review brought back vivid memories of trying, often without success, to identify and treat the many severe systemic infections I saw daily during a three-month stint at the Dessie Hospital in 1965.
The book takes its title from an obscure proscription in the Hippocratic oath (“I will not cut for stone…”), but also plays on the novel’s penetration into the history of three generations of the Stone family. The protagonist, Marion Stone, is born to an Indian Catholic nun in a mission hospital in Addis (called “Missing” in the novel, a distortion of the Amharic tongue) and becomes an instant orphan when his mother dies in childbirth and his presumed father, super-surgeon Thomas Stone, goes missing himself. In one of Verghese’s less successful flights of fancy, Marion is born conjoined to his twin brother through a narrow bridge of skin connecting them head to head, a harmless anomaly for the twins but a major contributor to their mother’s death from complications of delivery. In fact less than a quarter of conjoined twins survive, and the novelist’s contrivance, with which he plays throughout the book to emphasize the interconnectedness of the siblings, would be an extreme rarity in an already very rare condition.
Although the book is not identified as autobiographical, Marion Stone follows a route similar to that traveled by the author in becoming a physician. Verghese was born in Ethiopia of Indian parents and attended Addis Ababa Medical School briefly before being forced to leave the country in 1973 due to political chaos. He worked in menial jobs in a hospital near New York City and began to settle into a routine when he found himself drawn back to his interest in becoming a doctor.
Because our medical establishment would not recognize his partial training in Ethiopia, he went to his ethnic country of origin and completed medical school in India, then took a residency position in a small hospital in Tennessee. This is where he became immersed in the AIDS epidemic, which in turn started him off on his writing career. Verghese is credentialed in both medicine (his unique professorship at Stanford permits him to write whatever he wishes on “company time” beyond his teaching and clinical responsibilities) and literature (M.F.A. from the Iowa Writers’ Workshop), according to a feature article about Verghese published in the Washington Post last year.
As in most good novels, romance is sparsely but passionately portrayed in this book, often with wrenching effect on familial bonds. Shiva, the protagonist’s brother, registers an Apgar score (medicine’s initial rating of quality of life) of close to zero at birth but somehow survives and becomes the more successful twin professionally. He develops pioneering approaches to the surgical treatment of vaginal fistula, the tragic outcome of prolonged unsuccessful delivery in countries without adequate obstetrical care. He remains in the shadow of his brother interpersonally, with social skills suggesting Asperger’s syndrome.
The brothers are raised by a peculiar but kind expatriate medical pair who work at Missing and do their best to fill the void created by the death of Sister Mary Joseph Praise and the flight of Dr. Stone. The twins share their childhood with Genet, an Eritrean girl who charms Marion as an adolescent but, as she reaches for adulthood, wreaks havoc on the boys’ attachment. Genet eventually forces Marion’s abrupt exile from the kingdom through her involvement in the Eritrean People’s Liberation Front. In the end, and on a different continent, father and sons reunite, and, in another twist of medical fancy, the twins again share tissue through the actions of their father. This “re-union” has its unfortunate downside however.
For me at least this novel became a page-turner not only because of its often captivating if sometimes fantastic story line but also by necessity to push through the heavy doses of medical jargon and sometimes overdone literary flourishes:
He took a leak by the roadside. A hyena laughed, whether
at his action or his equipment he couldn’t be sure.
In the Washington Post article referred to above, Verghese calls the novel a medical epic, saying “It’s all there. I left nothing out”. This is indeed both the draw and the curse of the book. Nonetheless, I enjoyed the read and will keep my eyes open for Verghese’s next work, hoping that either he or his editor will apply a more forceful hand to the literary scalpel before final closure.