Coincidence, Karma or Providence?

Rarely in recent memory has a novel so captivated me—even hooked me—as Abraham Verghese’s Cutting for Stone. I knew the book was getting to me when I began to violate my almost stereotypical routine for reading novels. Normally, I read a novel, each day, seriatim, for thirty minutes on the stationary bike. Unusually, if ever, do I break this pattern to pursue the novel at other times. Even novels that I have much enjoyed, like Colm Toibin’s Brooklyn and Doris Lessing’s The Sweetest Dream, never really enticed me to interrupt this daily ritual. But Cutting for Stone lured me to read it into the solitary depths of the night, so enamored was I by its story and characters. I also can count on one hand the times I have literally cried over the death of a beloved character in a novel. Cutting for Stone brought tears to my eyes at the death of Dr. Abhi Ghosh, the beloved, wise and humane foster-father of the novel’s main narrator.

Perhaps, it is a bit much, as Simon Schama does in his review of the novel in The Financial Times, to compare Verghese to Tolstoy (although Schama hardly thought it   stretching too much to do so). Yet in his review for The Sunday Telegraph, Richard Eyre ups the ante by saying: “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.”


The novel recounts the life and the coming of age as a surgeon of Marion Stone, the narrator. He was born, in unusual, even scandalous, circumstances, as a breech birth to a Carmelite Indian nursing nun and a British physician father. Conjoined at the head, in birth, with an identical twin brother (Shiva), Marion and Shiva are lovingly raised by two surrogate parents, Hema and Ghosh, both Indian doctors working in a Catholic hospital in Addis Ababa. The hospital is called “Missing,” representing a typical Ethiopian hissing mispronunciation of “mission.” The novel also involves a missing father, Thomas Stone, who bolts in shame and consternation at the death of the nun, Sister Mary Joseph Praise. At the time of the twins’ birth, Stone appears, surprisingly, unaware that he is their father and that, in a reckless, if partially unconscious, act during his own convalescence from a mental breakdown, he has perpetrated what eventually caused the ultimate death of the lovely nursing nun.

The novel is also a story of place. We catch glimpses of India (Madras) where the main characters originate before migrating to Missing Hospital. I have never been to Ethiopia but Addis Ababa is vividly portrayed: its souks, markets, geography, sounds and  people. Set first in 1954 (the date of the birth of the twins), the novel—best described as a wondrously sprawling saga—carries on to the fall of Haile Selassee and the rise of General Mengistu’s military dictatorship and its eventual overthrow. Later the novel shifts us to the South Bronx where Marion Stone takes up a residency in another Catholic hospital in the middle of a poor neighborhood, rife with crime and guns. As Verghese has elsewhere noted, such poor hospitals in America have typically depended on imported foreign doctors for their sustenance.

The novel teems with interesting characters. Matron Hirst, the nun who runs Missing hospital, is sensible, jovial and humane—in the very best sense a matron. Gebrew, an illiterate handyman and guard at the hospital, is also a pious priest of the Ethiopian church. Rosina and Almaz watch over the twins as nannies. Tsige, a bar girl who works near Missing, ultimately reinvents and saves herself in America where Marion, fatefully, re-encounters her. Genet, Rosina’s daughter and the great love of Marion’s life, eventually becomes a rebel against the Mengistu regime, endangering Marion’s life as her known close friend.

Most of all, Cutting for Stone is a spiritual novel. I mean that in several senses. It captures the sense of a young man’s lure to become a doctor as a true spiritual calling as a healer. In one place, Marion says he became a surgeon less with the intent “to save the world as much as to heal myself.” Brought up at the Addis Ababa compound of Missing, parented by two doctors, Marion’s boyhood “imparted lessons about resilience, about fortitude and about the fragility of life. I knew better than most children how little separated the world of health is from that of disease, living flesh from the icy touch of the dead.” He learns that lesson personally from his mother’s untimely death and from his own near scrape with death, when, by an unexpected fate, he falls into the saving hands of the father who abandoned him and a selfless act of his brother Shiva from whom he had become estranged.

Many sections of the novel describe, often in great, even gory, detail, surgical operations. The particular brutalities of the twin’s breech birth and their mother’s death are especially graphic. Some readers and reviewers have complained that the technicalities about operations on livers or the removal of fistulas from women’s wombs turned them off. In an interview with Tina Brown, Verghese, himself a doctor who teaches at Stanford’s School of Medicine, explains his reason for such technical detail: “I think it is risky but one of my favorite series of novels is C.S. Forester’s Hornblower series… The details are so dense. I’m not a sailor and I don’t know what he’s saying fully most of the time, but it did not matter because there was an authority to that detail that allowed me to really feel I was on that ship and I was fighting the French. So I think readers enjoy details even when they don’t completely understand them.” Verghese’s great achievement in this novel is to make the reader feel there is really something at stake in the lives of these surgeons: birth, love, death, war and loyalty.

Verghese has long championed doctors’ seeing their patients as individuals and profoundly human, not just symptoms. Otherwise, as his fictional physician says: “The patients become ‘ the diabetic in bed two’ or ‘ the myocardial infarction in bed three.’” One of the novel’s physicians insists on asking: “ What treatment is offered by ear in an emergency? Words of comfort!” Cutting for Stone honors the extraordinary, complex work of surgeons while, all the while, allowing us to see them as still ordinary men and women.

Cutting for Stone is spiritual in a deeper sense. Marion comes to see what seem to be mere coincidences as both connected and pregnant with meaning. He realizes that passing through one door rather than another has consequences. Here, too, some reviewers reacted negatively. I rather thought, that like Augustine in The Confessions, Marion Stone, at fifty, came to see a meaningful pattern to what, earlier, seemed mere happenstance. Perhaps, as a son of a Hindu foster mother, Hema, Marion was steeped in some sense of karma. More likely, he presents a vivid sense of providence—God acting and leaving his traces in the sins, choices and directions of a life.

Throughout the novel, a recurrent object of attention is a reproduction, in Sister Mary Joseph Praise’s room, of the famous Bernini “Ecstasy of Saint Teresa”. At one key point it becomes an object for the possible redemption of Marion’s father, containing behind its picture frame a final letter of Marion’s mother to his father. In the end, Cutting for Stone is profoundly a novel of redemption and forgiveness. In that sense, I found apt the remarks of W. Ralph Eubanks in his review in The Washington Post: “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.”

John Coleman, S.J.

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8 years 6 months ago
It's a terrific read - I hate to put it down each night.  In some ways, this book could have been set anywhere, it's the characters that make it.  And tipped off, I've enjoyed encountering St. Theresa at various turns.  Thanks!


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