Cover image for Book Club kit : Cutting for stone
Title:
Book Club kit : Cutting for stone
Edition:
1st ed.
Publication Information:
New York : Alfred A. Knopf, 2009.
ISBN:
9780375414497
Physical Description:
8 books (x, 541 p.) ; 24 cm. + 1 discussion guide
Language:
English
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Book Club Kit BOOK CLUB 1 .CIRCNOTE. *****8 BOOKS, 1 CD BOOK, 1 DISCUSSION GUIDE*****
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Summary

Summary

A sweeping, emotionally riveting first novel--an enthralling family saga of Africa and America, doctors and patients, exile and home.

Marion and Shiva Stone are twin brothers born of a secret union between a beautiful Indian nun and a brash British surgeon at a mission hospital in Addis Ababa. Orphaned by their mother's death in childbirth and their father's disappearance, bound together by a preternatural connection and a shared fascination with medicine, the twins come of age as Ethiopia hovers on the brink of revolution. Yet it will be love, not politics--their passion for the same woman--that will tear them apart and force Marion, fresh out of medical school, to flee his homeland. He makes his way to America, finding refuge in his work as an intern at an underfunded, overcrowded New York City hospital. When the past catches up to him--nearly destroying him--Marion must entrust his life to the two men he thought he trusted least in the world: the surgeon father who abandoned him and the brother who betrayed him.

An unforgettable journey into one man's remarkable life, and an epic story about the power, intimacy, and curious beauty of the work of healing others.


Reviews 5

Publisher's Weekly Review

Lauded for his sensitive memoir (My Own Country) about his time as a doctor in eastern Tennessee at the onset of the AIDS epidemic in the '80s, Verghese 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. Sister Mary Joseph Praise, a devout young nun, leaves the south Indian state of Kerala in 1947 for a missionary post in Yemen. During the arduous sea voyage, she saves the life of an English doctor bound for Ethiopia, Thomas Stone, who becomes a key player in her destiny when they meet up again at Missing Hospital in Addis Ababa. Seven years later, Sister Praise dies birthing twin boys: Shiva and Marion, the latter narrating his own and his brother's long, dramatic, biblical story set against the backdrop of political turmoil in Ethiopia, the life of the hospital compound in which they grow up and the love story of their adopted parents, both doctors at Missing. 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 and coincidences of the best 19th-century novel. (Feb.) (c) Copyright PWxyz, LLC. All rights reserved


New York Review of Books Review

"I WILL not cut for stone," runs the text of the Hippocratic oath, "even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art." Those words provide an epigraph partway through Abraham Verghese's first novel, "Cutting for Stone," and also explain the surname of its narrator, Marion Stone, along with his twin brother, Shiva, and their father, the almost entirely absent surgeon Thomas Stone. Absent in body only: in spirit, Thomas's disappearance after their birth haunts and drives this book. Yet until the reader comes across the oath, well into the novel, the title may seem pleasing to the ear but puzzling to the mind: it tries to do too many jobs at once. It neither suggests the book's action - as, say, "Digging to America" does - nor evokes its mood, as "Bleak House" does. Still, Verghese strives for the empathy of Anne Tyler and the scope of Dickens. If he doesn't quite manage either, he is to be admired for his ambition. Verghese is a physician and an already accomplished author. His two nonfiction books, "My Own Country," about AIDS in rural Tennessee, and "The Tennis Partner," a moving and honest memoir of a difficult, intimate friendship, are justly celebrated. His commitment to both his professions is admirable : currently a professor at the Stanford University School of Medicine, he also holds an M.F.A. from the Iowa Writers' Workshop. But why mention qualifications? What do qualifications matter where fine writing is concerned? Not at all, is the correct answer, and yet qualifications like Verghese's are tribute, at the very least, to his stalwart effort. This effort is both the making and the unmaking of "Cutting for Stone." The plot of this big, dense book is fairly straightforward. Marion and Shiva Stone are born one dramatic afternoon in 1954 in Addis Ababa, the same day their mother - a nun, Sister Mary Joseph Praise dies of complications from her hidden pregnancy. The boys are conjoined at the skull, yet separated at birth; they are raised by Dr. Kalpana Hemlatha, a forceful woman known as Hema, and Dr. Abhi Ghosh, both immigrants from Madras and both doctors at the hospital where the boys' natural parents also worked. Missing Hospital, it's called: "Missing was really Mission Hospital, a word that on the Ethiopian tongue came out with a hiss so it sounded like 'Missing.' " They grow up amid the political turmoil of Ethiopia (its actual chronology altered slightly by Verghese to suit his fictional purposes), and in 1979 Marion flees, first to Nairobi and finally to New York, where he qualifies as a surgeon. Shiva, too, goes into medicine, specializing in treating vaginal fistula, for which work he is acclaimed in this very newspaper, a sure sign of his renown. Almost supernaturally close as children, the brothers become more and more distant as the novel progresses; they are dramatically reunited at its end - through the mysterious agency of the long-vanished Thomas Stone. AS 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. (The brothers' being joined - but only briefly - at the head is an example of this slightly half-hearted effort.) Much more forceful are his vivid descriptions of surgery, vivid enough that those with weaker stomachs may find them disturbing. One would, I suppose, be ill advised to use this novel as a textbook for liver transplantation or bowel surgery, but it might almost be possible. The trouble is that for all the author's passion, this kind of writing periodically stops the book in its tracks: "Hema smiled, as if to say, Very little escapes me, my dear man. And then she was thinking of . . . rugaeform folds, of the median raphe that separated one bollock from the other, of the dartos muscle, the cells of Sertoli." Hema's mind, as the author then says, is racing: but the reader's goes into a stall. The novel is crippled, too, by the use of back story. There is a feeling of Greek drama about the narrative: a lot of the real action happens offstage. We finally learn, toward the end of the novel, what made Thomas Stone the man he is, with all his strengths and deficits, yet by then the tale seems curiously belated and less than fully integrated into the novel. The same is true for the later events in the life of Genet, Marion's childhood sweetheart, the daughter of his nanny, who joins a band of Eritrean guerrillas but reappears fleetingly in Marion's life to devastating effect. 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. Great novels are not built merely on the agglomeration of detail. This is a first novel that reveals the author's willingness to show the souls, as well as the bodies, of his characters. In Verghese's second profession, a great surgeon is called an editor. Here's hoping that in the future the author finds stronger medicine in that line. The twins' father is absent in body only. In spirit, his disappearance haunts and drives Verghese's narrative. Erica Wagner is the literary editor of The Times of London and the author, most recently, of the novel "Seizure."


Guardian Review

Abraham Verghese, an Indian, grew up in Addis Ababa, has lived in Madras and various cities in America, and thus, regardless of temperament, would always have felt something of a watchful outsider. This first novel was preceded by two non-fiction books: The Tennis Partner , about his distressing friendship with a drug addict and fellow doctor, and My Own Country , a memoir of working with Aids patients in a conservative southern US town. Some of the best passages in all three 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. Cutting for Stone - the phrase is from the Hippocratic oath - is about twins born joined at the head, in a mission hospital in Addis Ababa half a century ago. Their mother, a nun from Madras, does not survive the birth. Their father, a British surgeon called Thomas Stone, cannot bear the loss and flees, so Marion and Shiva are raised by two Indian doctors in the hospital where their parents worked; both become surgeons. Verghese carefully (and sometimes rather unbelievably - he is unapologetic about coincidences) interweaves their story with that of Ethiopia's past half-century. About three-quarters of the way through, the book moves to the US - as many Ethiopians did, after the revolution that replaced the emperor with a Marxist/military regime. 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. Only occasionally is there a wrong note or mis-transcription from Amharic. In fact, when I worried about anything it was for the opposite reason: when one twin becomes famous abroad for his fistula operations, it felt rather too much of an appropriation of the achievements of Reginald and Catherine Hamlin, the latter of whom was nominated for a Nobel peace prize. Surely there were other procedures to choose from? It is a little strange to move major revolutions by a year or two, just to suit your plot. And there is too unquestioning a reliance on Ryszard Kapuscinski's The Emperor ; Kapuscinski was himself an observer from another land, and he had his own agenda. (As, apparently, did whoever designed the cover: it's the worst kind of laziness to depict an "African coastline" as if everything on that continent were interchangeable - never mind that it's a book set in cities. What coast there was, until Eritrea gained independence in 1991, consisted of desert and volcanic rock rather than lush palm trees; Ethiopia no longer has a coast at all.) But all the rich detail in the world is as nothing if you don't have command of emotion and narrative. One could argue, given everything from ER to House , that medicine cannot help but be dramatic, but that isn't necessarily true: Verghese's achievement is to make the reader feel there really is something at stake - birth, love, death, war, loyalty. There's no smug postmodern self-undermining (otherwise known as irony) here: the mythic arises seamlessly from the quotidian; telepathy or saintly intercessions are simply accepted - as they often are in Ethiopian life. You conserve pages because you don't want it to end. But irony is a useful thing, too, when considered as an ability to hold contradictory meanings in suspension. Richard Eyre compared this book to Chekhov and Shakespeare, an enthusiasm presumably prompted by the variety and colour of Verghese's world, its earthiness and drama, its concreteness of detail and unselfconscious swing. And this, often accompanied by a real delicacy and honesty, is pleasing, but there was an extra element I missed: a serious playfulness of meaning, a compassion arising from an understanding of perspective and of all that cannot be controlled. This is a book narrated by a surgeon, and structured as a surgeon might structure it: after the body has been cut open and explored everything is returned to its place and carefully sutured up - which is not, in the end, how life actually works. And, like surgery, there's a certain brutality involved, particularly evident in the novel's gender politics. Of course the narrator arises from a patriarchal society, but it is difficult not to feel discomfited by the fact that the virgin/whore/mother/passive sufferer roles of the women (particularly the Ethiopian women, who are prostitutes, or servants, or simply available and, if not, righteously punished for their wilfulness) are so unquestioned. A major strand of the plot is the love that one twin, Marion, has for a girl he knows from childhood, Genet; but there is surprisingly little imaginative projection of what Genet might feel. Which of course is a character's prerogative - except that it was a niggle I had with The Tennis Partner as well: Verghese was recklessly honest about his feelings and vulnerabilities, but there might have been a bit more sympathy for what his friend was suffering. Perhaps this is a function of the detachment of observation and, specifically, a medical manifestation of it: a doctor must be the most attentive observer, but also, ultimately, a judge as well. And that is a tricky place for a novelist to occupy. Caption: article-fictionbootom.1 While I don't know [Abraham Verghese] personally, I know the streets and shops he evokes, the hospitals; I know that his setting, seemingly so rich and strange, is real. Only occasionally is there a wrong note or mis-transcription from Amharic. In fact, when I worried about anything it was for the opposite reason: when one twin becomes famous abroad for his fistula operations, it felt rather too much of an appropriation of the achievements of Reginald and Catherine Hamlin, the latter of whom was nominated for a Nobel peace prize. Surely there were other procedures to choose from? It is a little strange to move major revolutions by a year or two, just to suit your plot. And there is too unquestioning a reliance on Ryszard Kapuscinski's The Emperor ; Kapuscinski was himself an observer from another land, and he had his own agenda. (As, apparently, did whoever designed the cover: it's the worst kind of laziness to depict an "African coastline" as if everything on that continent were interchangeable - never mind that it's a book set in cities. What coast there was, until Eritrea gained independence in 1991, consisted of desert and volcanic rock rather than lush palm trees; Ethiopia no longer has a coast at all.) - Aida Edemariam.


Kirkus Review

There's a mystery, a coming-of-age, abundant melodrama and even more abundant medical lore in this idiosyncratic first novel from a doctor best known for the memoir My Own Country (1994). The nun is struggling to give birth in the hospital. The surgeon (is he also the father?) dithers. The late-arriving OB-GYN takes charge, losing the mother but saving her babies, identical twins. We are in Addis Ababa, Ethiopia, in 1954. The Indian nun, Sister Mary Joseph Praise, was a trained nurse who had met the British surgeon Thomas Stone on a sea voyage ministering to passengers dying of typhus. She then served as his assistant for seven years. The emotionally repressed Stone never declared his love for her; had they really done the deed? After the delivery, Stone rejects the babies and leaves Ethiopia. This is good news for Hema (Dr. Hemalatha, the Indian gynecologist), who becomes their surrogate mother and names them Shiva and Marion. When Shiva stops breathing, Dr. Ghosh (another Indian) diagnoses his apnea; again, a medical emergency throws two characters together. Ghosh and Hema marry and make a happy family of four. Marion eventually emerges as narrator. "Where but in medicine," he asks, "might our conjoined, matricidal, patrifugal, twisted fate be explained?" The question is key, revealing Verghese's intent: a family saga in the context of medicine. The ambition is laudable, but too often accounts of operationsa bowel obstruction here, a vasectomy thereoverwhelm the narrative. Characterization suffers. The boys' Ethiopian identity goes unexplored. Shiva is an enigma, though it's no surprise he'll have a medical career, like his brother, though far less orthodox. They become estranged over a girl, and eventually Marion leaves for America and an internship in the Bronx (the final, most suspenseful section). Once again a medical emergency defines the characters, though they are not large enough to fill the positively operatic roles Verghese has ordained for them. A bold but flawed debut novel. Copyright Kirkus Reviews, used with permission.


Library Journal Review

Focusing on the world of medicine, this epic first novel by well-known doctor/author Verghese (My Own Country) follows a man on a mythic quest to find his father. It begins with the dramatic birth of twins slightly joined at the skull, their father serving as surgeon and their mother dying on the table. The 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, with Marion the more studious one and Shiva a moody genius and loner. Also living on the hospital grounds is Genet, daughter of one of the maids, who grows up to be a beautiful and mysterious young woman and a source of ruinous competition between the brothers. After Marion 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. [See Prepub Alert, LJ 10/1/08.]-Jim Coan, SUNY Coll. at Oneonta (c) Copyright 2010. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.


Excerpts

Excerpts

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 Bernin Excerpted from Cutting for Stone: A Novel by Abraham Verghese, A. Verghese All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.