I have maintained a longtime appreciation for historical fiction novels, particularly those which capture characters’ evolving lives against the backdrop of historically significant events. While my mom recommended this coming-of-age story to me a long time ago (exclaiming in the middle of a thrift store that she had to buy me my own copy), it took me a couple of years to begin working my way through all 657 pages of it. I am so glad I finally did.
In Cutting for Stone, a pair of identical twins—abandoned after their mother dies in childbirth and their father, a surgeon, flees the country—grow up in Ethiopia amidst dangerous and transformative political changes. Adopted by a practitioner of general medicine and a gynecologist, they grow up learning to care for patients at the very hospital where their biological parents once worked. Marion and Shiva each become enamored with medicine, destined to follow the profession that led to their parents’ undoing.
A timeline of destruction and rebirth
The summary of the book I glanced at on the back cover was a bit like the paragraph written above in that it portrays the twins, Marion and Shiva, as the only protagonists. I did not realize until I began the book that the timeline of events begins before the twins even enter the world, describing how the biological parents (Sister Mary Joseph Praise and Thomas Stone) and the adoptive parents (Hema and Ghosh) make their way to “Missing Hospital” in Ethiopia. I was surprised by this decision on the author’s part, as it’s challenging to write in this many characters, but starting the timeline of events this early gives the reader essential information about the adults who laid the foundation for the twins’ hopes, dreams, and struggles.
What all of the characters share in common, from the blunt Thomas Stone to the sensitive Shiva, is that their lives revolve around cycles of destruction and rebirth; they each suffer and proceed to alter the course of their lives as a result of this suffering. Take Hema, for instance, who finds herself struggling with her childlessness; the twins’ birth, despite leading to a tragic death, makes Hema a mother. While they are haunted by the specter of their vanished father, Shiva and Marion become immersed in the medical field, transforming and refashioning his legacy.
The country of Ethiopia, with its coups and dictatorships, progresses through the same cycles in the book. Hema makes note of this after witnessing a political execution:
“Maybe this is what keeps me in Addis all these years, Hema thought, this juxtaposition of culture and brutality, this molding of the new out of the crucible of primeval mud. The city is evolving, and I feel part of that evolution”
p. 94
The transformation of characters and setting across many decades is the most exceptional aspect of this book. I found complexity in each character and nuance in each situation they encountered, both inside and outside the white walls of the hospital.
The order and chaos of medicine
I also ought to mention that Cutting for Stone is certainly not for the faint of heart. The author, being a surgeon himself, captures the high stakes of surgery in vivid (often gruesome) detail. At several points over the last few weeks, I wondered to myself whether the nightmares I was having resulted from reading about a patient’s abdomen being sliced open before bed!
With that said, the in-depth descriptions of surgical procedures help the reader develop a closer relationship with the main characters. For example, the violent death of Sister Mary Joseph Praise in childbirth is the catalyst for Thomas Stone’s abandonment of his children and his emotional reunion with them decades later. The tragic image of a father dragging his wounded daughter up a hill to Missing Hospital, a pungent odor surrounding them, prompts Shiva to enter the gynecological profession and revolutionize the treatment of vaginal fistulas. While the medical scenes may make a reader squirm with discomfort, they show how the characters’ lives are linked to the medical field in powerful ways.
Marion, Shiva and their adoptive parents demonstrate that medicine is messy and brutal, yet also orderly and beautiful. One of my favorite passages in the book captures Shiva’s fascination with the medical vocabulary Ghosh teaches him:
“I loved those Latin words for their dignity, their foreignness, and the way my tongue had to warp around them. I felt that in learning the special language of a scholarly order, I was amassing a kind of force. This was the pure and noble side of the world, uncorrupted by secrets and trickery.”
p. 274
This profession is a source of pain and longing for the twins, given that their absent father is a surgeon; yet it becomes a source of power and connectivity, enabling them to find organization in a tumultuous environment and deepen their connections to their adoptive parents. A reader doesn’t have to be a surgeon to understand how the twins’ knowledge of medicine changes their view of the world in fundamental ways.
A beautiful and tragic book
As this review makes clear, Cutting for Stone is a novel full of juxtapositions and contradictions—order and chaos, destruction and rebirth, hope and despair. Abraham Verghese has such talent as an author that he sends each of his characters through these many extremes while ensuring that their lives remain connected along the same timeline. I consider Cutting for Stone to be an absolute masterpiece of historical fiction and am finishing it with a newfound appreciation for medicine.
