Cutting for Stone

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Overview

Marion and Shiva Stone are twin brothers born of a secret union between a beautiful Indian nun and a brash British surgeon. Orphaned by their mother’s death 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.
 
Moving from Addis Ababa to New York City and back again, Cutting for Stone is an unforgettable ...

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Cutting for Stone

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Overview

Marion and Shiva Stone are twin brothers born of a secret union between a beautiful Indian nun and a brash British surgeon. Orphaned by their mother’s death 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.
 
Moving from Addis Ababa to New York City and back again, Cutting for Stone is an unforgettable story of love and betrayal, medicine and ordinary miracles—and two brothers whose fates are forever intertwined.

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  • Abraham Verghese
    Abraham Verghese  

Editorial Reviews

From the Publisher
“A winner. . . . Filled with mystical scenes and deeply felt characters. . . . Verghese is something of a magician as a novelist.”
USA Today
 
“A masterpiece. . . . Not a word is wasted in this larger-than-life saga. . . . Verghese expertly weaves the threads of numerous story lines into one cohesive opus. The writing is graceful, the characters compassionate and the story full of nuggets of wisdom.”
San Francisco Chronicle
 
“Lush and exotic. . . . The kind [of novel] Richard Russo or Cormac McCarthy might write. . . . Shows how history and landscape and accidents of birth conspire to create the story of a single life. . . . Verghese creates this story so lovingly that it is actually possible to live within it for the brief time one spends with this book. You may never leave the chair.”
Los Angeles Times
 
“Vivid. . . . Cutting for Stone shines.”
The Washington Post Book World
 
“Absorbing, exhilarating. . . . If you’re hungry for an epic . . . open the covers of Cutting for Stone, [then] don’t expect to do much else.”
The Seattle Times
 
“Wildly imaginative. . . . Verghese has the rare gift of showing his characters in different lights as the story evolves, from tragedy to comedy to melodrama, with an ending that is part Dickens, part Grey’s Anatomy. The novel works as a family saga, but it is also something more, a lovely ode to the medical profession.”
Entertainment Weekly
 
“Engrossing. . . . Endearing. . . . A passionate, vivid, and informative novel.”
The Boston Globe
 
“Here is an extraordinary imagination, artfully shaped and forcefully developed, wholly given in service to a human story that is deeply moving, utterly gripping, and, indeed, unforgettable. . . . As noble and dramatic as that ancient practice—medicine—that lies at the heart of this magnificent novel.”
—John Burnham Schwartz
 
“Grand enough for the movies. . . . Fascinating.”
Dallas Morning News
 
“Stupendous. . . . An epic romance, surgery meets history. Beautiful and deeply affecting.”
—Simon Schama, Financial Times
 
“Verghese plays straight to the heart in his first novel, which will keep you in its thrall.”
People
 
“A marvel of a first novel. Verghese’s generosity of spirit is beautifully embodied in this gripping family saga that brings mid-century Ethiopia to vivid life. The practice of medicine is like a spiritual calling in this book, and the unforgettable people at its center bring passion and nobility—not to mention humor and humility—to the ancient art, while living an unforgettable story of love and betrayal and forgiveness. It’s wonderful.”
—Ann Packer
 
“Like Chekhov, Verghese is a doctor and is as authoritative about the workings of the human heart as he is of the human body. . . . 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.”
—Richard Eyre, The Sunday Telegraph (UK)
 
“Compelling. . . . Readers will put this novel down at book’s end knowing that it will stick with them for a long time to come.”
St. Louis Post-Dispatch
 
“The novel is full of compassion and wise vision. . . . I feel I changed forever after reading this book, as if an entire universe had been illuminated for me. It’s an astonishing accomplishment to make such a foreign world familiar to a reader by the book’s end.”
—Sandra Cisneros, San Antonio Express-News
 
“Verghese’s first novel is a whopper, illuminating the magic and the tragedy of our lives, brimming with wisdom about the human condition. Such fun to read, too. . . . In Cutting for Stone, we get all we were promised and then some. . . . Like Rushdie, Verghese takes us wholly away to a foreign place, culture and history.”
Newsday
 
“Tremendous. . . . Vivid and thrilling. . . . I feel lucky to have gotten to read it.”
—Atul Gawande
 
“The first novel from physician Verghese displays the virtues so evident in his bestselling and much-lauded memoirs. He has a knack for well-structured scenes, a passion for medicine and a gift for communicating that passion.”
Cleveland Plain-Dealer
 
“Fantastic. . . . Written with a lyrical flair, told through a compassionate first-person point of view, and rich with medical insight and information, [Cutting for Stone] makes for a memorable read.”
Houston Chronicle
 
“Vastly entertaining and enlightening.”
—Tracy Kidder
 
“Ambitious. . . . Sprawling. . . . A synthesis of the everyday and the extraordinary [written] in a style that could be called ecstatic realism.”
The Oregonian
 
“[An] astonishing, breath-taking and heartrending human epic. . . . A perfectly pitched, endlessly rewarding symphony of a debut novel. If you have time to read only one novel this year, make it this one.”
—Newark Star-Ledger
 
“Verghese’s achievement is to make the reader feel there really is something at stake—birth, love, death, war, loyalty. . . . You conserve pages because you don’t want [the book] to end.”
The Guardian (UK)
 
“Richly entertaining. . . . A narrative that ranges as skillfully through the emotional register as it does across time and space. . . . Cutting for Stone honors the extraordinary, complex work of surgeons and physicians, but it also allows us to see them as ordinary men and women.”
The Sunday Times (London)

“Absolutely fantastic! If Vikram Seth and Oliver Sacks were to collaborate on a four-hour episode of Grey’s Anatomy set in Africa, they could only hope to come up with something this moving and entertaining.”
—Mark Salzman

“Tremendous, compassionate, technically exuberant. . . . This is a big book and, along with Naipaul and Waugh and Dickens, there is also a strong flavour of William Boyd. . . . We can only stand back awestruck at [Verghese’s] energy.”
The Independent (UK)
 
“Breathtaking. . . . A global story about medicine and family relationships that achieves the literary heights of A Thousand Splendid Suns by Khaled Hosseini. . . . A masterful read.”
The Missourian
 
“Gripping. . . . What’s most memorable about Cutting for Stone is Verghese’s compassionate authorial generosity toward his characters, particularly in his medical scenes. Verghese’s doctors never forget that they are operating on human beings. . . . Refreshing.”
—Minneapolis Star Tribune
 
“Magical. . . . A big, sweeping family saga. . . . I don’t think I’ve read a novel with this kind of depth and sweep and character and sort of vividness for such a long time.”
—Tina Brown, The Daily Beast
 
“A saga about love, medicine, and exile, this debut reads like a modern Odyssey.”
Good Housekeeping
 
“To read the first page of Cutting for Stone is to fall hopelessly under the spell of a masterful storyteller; and to try to close the book thereafter is to tear oneself away from the most vivid of dreams. . . . Verghese has once again set the bar and re-defined great medical literature—great literature period—for the rest of us.”
—Pauline W. Chen, author of Final Exam

W. Ralph Eubanks
Even with its many stories and layers, Cutting for Stone remains clear and concise. Verghese paints a vivid picture of these settings, the practice of medicine (he is also a physician) and the characters' inner conflicts. 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.
—The Washington Post
Publishers Weekly

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.)

Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
Library Journal

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, LJ10/1/08.]
—Jim Coan

Kirkus Reviews
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 operations-a bowel obstruction here, a vasectomy there-overwhelm 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 overa 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. First printing of 150,000. Author tour to Austin, Boston, Dallas, Denver, Iowa City, Los Angeles, New York, Portland, Ore., Raleigh/Durham, San Antonio, San Francisco, Seattle, Toronto, Washington, D.C.
The Barnes & Noble Review
Abraham Verghese's My Own Country, an incandescent memoir of the author's early years as a doctor caring for HIV patients in rural Tennessee, was one of those books that seemed to make an indelible impression on everyone who read it. His next work, The Tennis Partner -- the tale of a friend's struggle with drug addiction -- was also nonfiction, but his storytelling gifts were clearly so outstanding that it could only have been a matter of time before he turned to fiction.

Written 14 years after his auspicious literary debut, Cutting for Stone is Verghese's first novel, and it shows him not entirely in control of his new medium. But for all the book's faults, it is vastly preferable to most recent fiction and wonderfully refreshing in its utter lack of irony, cynicism, self-involvement, or hipness. Verghese puts his artistry at the service of his all-embracing humanism, rather in the manner of 19th-century social realist novelists like George Eliot. In fact Somerset Maugham, also a medical doctor, provided an early inspiration for Verghese, especially in his comparison of the physician's vocation with that of the artist in his classic novel Of Human Bondage (1915). Verghese sees his dual callings in a similar light. "My ambition as a writer," he says of Cutting for Stone, "was to tell a great story, an old-fashioned, truth-telling story. But beyond that, my single goal was to portray an aspect of medicine that gets buried in the way television depicts the practice: I wanted the reader to see how entering medicine was a passionate quest, a romantic pursuit, a spiritual calling, a privileged yet hazardous undertaking."

Verghese has lived and practiced in the United States for many years but fears that in American hospitals "the patient is becoming invisible.... It is as if the patient in the bed is merely an icon for the real patient, who exists in the computer." He felt that the kind of medical story he wanted to tell needed to be set in Ethiopia, where he was born (of Indian parents) in the 1950s and lived until his family had to flee after General Mengistu's 1974 military coup. In Cutting for Stone, he says, "I wanted to portray a place so basic, so unadorned, that nothing separates doctor and patient, no layers of paperwork, no technology or specialists, no disguising of the nature of the patient's experience or the raw physician experience. It's a setting where the nature of the suffering, the fiduciary responsibility and moral obligation to the patient and to society, are no longer abstract terms."

This is the rationale for the novel's Missing (a local mispronunciation of "Mission") Hospital in Addis Ababa, where early in the 1950s a forbidden and scarcely acknowledged love between an Indian nursing sister and a British surgeon produces identical twin boys: Marion, the narrator, and the brilliant, enigmatic Shiva. The mother, Sister Mary Joseph Praise, dies in childbirth; the father, Dr. Thomas Stone, fails to save her and is so grief-stricken that he flees the country, abandoning the two boys whom he vigorously denies are his. The boys are adopted by Missing's Indian gynecologist, Dr. Kalpana Hemlatha, familiarly known as Hema, who subsequently marries a genial colleague, Dr. Ghosh. The courtship between Hema and Ghosh is depicted with earthy charm, in contrast with the unearthly, almost mystical bond between Stone and Sister Mary.

Verghese follows the makeshift family's progress through several decades. Ethiopian by birth, the two boys are nevertheless perpetual foreigners, ferengi; their relationship with their housekeeper's beautiful and provocative daughter, Genet -- almost but never quite a sister -- underlines that fact. In accordance with their status as ferengi, they attend a rather pretentious British school rather than the perfectly adequate state one. ("I am convinced," Marion says, "that one can buy in Harrods of London a kit that allows an enterprising Englishman to create a British school anywhere in the third world. It comes with black robes, preprinted report cards for Michaelmas, Lent, and Easter terms, as well as hymnals, Prefect Badges, and a syllabus. Assembly required. ") Hema and Ghosh train the boys for medical careers as a matter of course, proudly initiating them into what Ghosh celebrates as his "romantic and passionate pursuit." Eventually, Marion is hounded out of Ethiopia for political reasons and goes to New York, where he joins the stream of young Indian doctors invited to America to staff rural or inner-city hospitals -- places where few American physicians want to work.

The medical scenes, whether at Missing or at Our Lady of Perpetual Succour in the Bronx, are uniformly well done, but Verghese is not always as successful in other areas: he succumbs to crass melodrama, for example, in his treatment of Genet, who is not so much a character as a vehicle for many contradictory veins of Ethiopan history and culture: tribal pride, female circumcision, militarism, Eritrean separatism, etc. Verghese has tried to squeeze too much material into his plot, linking personal tales with historical forces in the manner of the 19th-century novelists he admires, but he hasn't quite pulled it off. He is at his best when most personal, most earthbound.

His love for Ethiopia is palpable. "The fragrance of eucalyptus stoking a home fire, the smell of wet grass, of dung fuel, of tobacco, of swamp air, and of the perfume of hundreds of roses -- this was the scent of Missing. No, it was the scent of a continent." His evocations of the taste of injera bread soaked up with fiery wot, of the sound of a cow calling its calf with "soothing and auspicious sounds," of "the great banks of clouds that spilled over the Entoto Mountains" enrich his story at every turn. He is equally adept at making us see our own country through the eyes of a foreigner. Marion's first impressions of New York City are brilliantly realized; so are his reflections on the differences between the kind of medicine practiced back in Africa and "the artful, lavish, disposable-everything, lucrative, and incredibly effective American brand of medicine," and his thoughts on the two cultures' opposing attitudes toward death. "It was as if in Ethiopia, and even in Nairobi, people assumed that all illness -- even a trivial or imagined one -- was fatal; they expected death. The news to convey in Africa was that you'd kept death at bay.... In America, my initial impression was that death or the possibility of it always seemed to come as a surprise, as if we took it for granted that we were immortal."

Verghese's great strength as a novelist is his ability to speak straight from the heart -- indeed, he seems unwilling to speak any other way, and is possibly incapable of doing so. His weakness is his uncertainty with the genre, and in Cutting for Stone he has made artistic choices that lend an unfortunate note of artificiality to parts of his tale. The first hundred pages or so make the book look almost like a Rushdie-esque magic realist novel, complete with mystically communicating twins, an apparent virgin birth, divine intervention, and other anti-realist devices. Soon, though, the author settles into the more or less realistic mode that seems to come more naturally to him. His novel is often awkward but nearly always affecting, for aside from being an engaging tale in its own right it comprises a moral self-portrait and a valuable philosophical statement. --Brooke Allen

Brooke Allen is the author of Twentieth-Century Attitudes; Artistic License; and Moral Minority. She is a contributor to The New York Times Book Review, The New Criterion, The New Leader, The Hudson Review, and The Nation, among others. She was named a finalist for the 2007 Nona Balakian Citation for Excellence in Reviewing from the National Book Critics Circle.

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Product Details

  • ISBN-13: 9780375714368
  • Publisher: Knopf Doubleday Publishing Group
  • Publication date: 1/26/2010
  • Series: Vintage Series
  • Pages: 688
  • Sales rank: 23,387
  • Product dimensions: 5.20 (w) x 7.90 (h) x 1.40 (d)

Meet the Author

Abraham Verghese is Professor and Senior Associate Chair for the Theory and Practice of Medicine at the Stanford University School of Medicine. He was the founding director of the Center for Medical Humanities & Ethics at the University of Texas Health Science Center, San Antonio, where he is now an adjunct professor. He is the author of My Own Country, a 1994 NBCC Finalist and a Time Best Book of the Year, and The Tennis Partner, a New York Times Notable Book. A graduate of the Iowa Writers’ Workshop, he has published essays and short stories that have appeared in The New Yorker, The New York Times, The Atlantic Monthly, Esquire, Granta, The Wall Street Journal, and elsewhere. He lives in Palo Alto, California.

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Read an Excerpt

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 Bernini’s famous sculpture of St. Teresa of Avila. The figure of St. Teresa lies limp, as if in a faint, her lips parted in ecstasy, her eyes unfocused, lids half closed. On either side of her, a voyeuristic chorus peers down from the prie-dieux. With a faint smile and a body more muscular than befits his youthful face, a boy angel stands over the saintly, voluptuous sister. The fingertips of his left hand lift the edge of the cloth covering her bosom. In his right hand he holds an arrow as delicately as a violinist holds a bow.

Why this picture? Why St. Teresa, Mother?

As a little boy of four, I took myself away to this windowless room to study the image. Courage alone could not get me past that heavy door, but my sense that she was there, my obsession to know the nun who was my mother, gave me strength. I sat next to the autoclave which rumbled and hissed like a waking dragon, as if the hammering of my heart had roused the beast. Gradually, as I sat at my mother’s desk, a peace would come over me, a sense of communion with her.

I learned later that no one had dared remove her cardigan from where it sat draped on the chair. It was a sacred object. But for a four-yearold, everything is sacred and ordinary. I pulled that Cuticura-scented garment around my shoulders. I rimmed the dried-out inkpot with my nail, tracing a path her fingers had taken. Gazing up at the calendar print just as she must have while sitting there in that windowless room, I was transfixed by that image. Years later, I learned that St. Teresa’s recurrent vision of the angel was called the transverberation, which the dictionary said was the soul “inflamed” by the love of God, and the heart “pierced” by divine love; the metaphors of her faith were also the metaphors of medicine. At four years of age, I didn’t need words like “transverberation” to feel reverence for that image. Without photographs of her to go by, I couldn’t help but imagine that the woman in the picture was my mother, threatened and about to be ravished by the spear-wielding boy-angel. “When are you coming, Mama?” I would ask, my small voice echoing off the cold tile. When are you coming?

I would whisper my answer: “By God!” That was all I had to go by: Dr. Ghosh’s declaration the time I’d first wandered in there and he’d come looking for me and had stared at the picture of St. Teresa over my shoulders; he lifted me in his strong arms and said in that voice of his that was every bit a match for the autoclave: “She is CUM-MING, by God!”

Forty-six and four years have passed since my birth, and miraculously I have the opportunity to return to that room. I find I am too large for that chair now, and the cardigan sits atop my shoulders like the lace amice of a priest. But chair, cardigan, and calendar print of transverberation are still there. I, Marion Stone, have changed, but little else has. Being in that unaltered room propels a thumbing back through time and memory. The unfading print of Bernini’s statue of St. Teresa (now framed and under glass to preserve what my mother tacked up) seems to demand this. I am forced to render some order to the events of my life, to say it began here, and then because of this, that happened, and this is how the end connects to the beginning, and so here I am.

We come unbidden into this life, and if we are lucky we find a purpose beyond starvation, misery, and early death which, lest we forget, is the common lot. I grew up and I found my purpose and it was to become a physician. My intent wasn’t to save the world as much as to heal myself.
Few doctors will admit this, certainly not young ones, but subconsciously, in entering the profession, we must believe that ministering to others will heal our woundedness. And it can. But it can also deepen the wound.

I chose the specialty of surgery because of Matron, that steady presence during my boyhood and adolescence. “What is the hardest thing you can possibly do?” she said when I went to her for advice on the darkest day of the first half of my life. I squirmed. How easily Matron probed the gap between ambition and expediency. “Why must I do what is hardest?”

“Because, Marion, you are an instrument of God. Don’t leave the instrument sitting in its case, my son. Play! Leave no part of your instrument unexplored. Why settle for ‘Three Blind Mice’ when you can play the ‘Gloria’?”

How unfair of Matron to evoke that soaring chorale which always made me feel that I stood with every mortal creature looking up to the heavens in dumb wonder. She understood my unformed character.

“But, Matron, I can’t dream of playing Bach, the ‘Gloria’ . . . ,” I said under my breath. I’d never played a string or wind instrument. I couldn’t read music.

“No, Marion,” she said, her gaze soft, reaching for me, her gnarled hands rough on my cheeks. “No, not Bach’s ‘Gloria.’ Yours! Your ‘Gloria’ lives within you. The greatest sin is not finding it, ignoring what God made possible in you.”

I was temperamentally better suited to a cognitive discipline, to an introspective field—internal medicine, or perhaps psychiatry. The sight of the operating theater made me sweat. The idea of holding a scalpel caused coils to form in my belly. (It still does.) Surgery was the most difficult thing I could imagine.

And so I became a surgeon.

Thirty years later, I am not known for speed, or daring, or technical genius. Call me steady, call me plodding; say I adopt the style and technique that suits the patient and the particular situation and I’ll consider that high praise. I take heart from my fellow physicians who come to me when they themselves must suffer the knife. They know that Marion Stone will be as involved after the surgery as before and during. They know I have no use for surgical aphorisms such as “When in doubt, cut it out” or “Why wait when you can operate” other than for how reliably they reveal the shallowest intellects in our field. My father, for whose skills as a surgeon I have the deepest respect, says, “The operation with the best outcome is the one you decide not to do.” Knowing when not to operate, knowing when I am in over my head, knowing when to call for the assistance of a surgeon of my father’s caliber—that kind of talent, that kind of “brilliance,” goes unheralded.

On one occasion with a patient in grave peril, I begged my father to operate. He stood silent at the bedside, his fingers lingering on the patient’s pulse long after he had registered the heart rate, as if he needed the touch of skin, the thready signal in the radial artery to catalyze his decision. In his taut expression I saw complete concentration. I imagined I could see the cogs turning in his head; I imagined I saw the shimmer of tears in his eyes. With utmost care he weighed one option against another. At last, he shook his head, and turned away.

I followed. “Dr. Stone,” I said, using his title though I longed to cry out, Father! “An operation is his only chance,” I said. In my heart I knew the chance was infinitesimally small, and the first whiff of anesthesia might end it all. My father put his hand on my shoulder. He spoke to me gently, as if to a junior colleague rather than his son. “Marion, remember the Eleventh Commandment,” he said. “Thou shall not operate on the day of a patient’s death.”

I remember his words on full-moon nights in Addis Ababa when knives are flashing and rocks and bullets are flying, and when I feel as if I am standing in an abattoir and not in Operating Theater 3, my skin flecked with the grist and blood of strangers. I remember. But you don’t always know the answers before you operate. One operates in the now. Later, the retrospectoscope, that handy tool of the wags and pundits, the conveners of the farce we call M&M—morbidity and mortality conference—will pronounce your decision right or wrong. Life, too, is like that. You live it forward, but understand it backward. It is only when you stop and look to the rear that you see the corpse caught under your wheel.

Now, in my fiftieth year, I venerate the sight of the abdomen or chest laid open. I’m ashamed of our human capacity to hurt and maim one another, to desecrate the body. Yet it allows me to see the cabalistic harmony of heart peeking out behind lung, of liver and spleen consulting each other under the dome of the diaphragm—these things leave me speechless. My fingers “run the bowel” looking for holes that a blade or bullet might have created, coil after glistening coil, twenty-three feet of it compacted into such a small space. The gut that has slithered past my fingers like this in the African night would by now reach the Cape of Good Hope, and I have yet to see the serpent’s head. But I do see the ordinary miracles under skin and rib and muscle, visions concealed from their owner. Is there a greater privilege on earth?

At such moments I remember to thank my twin brother, Shiva—Dr. Shiva Praise Stone—to seek him out, to find his reflection in the glass panel that separates the two operating theaters, and to nod my thanks because he allows me to be what I am today. A surgeon. According to Shiva, life is in the end about fixing holes. Shiva didn’t speak in metaphors. Fixing holes is precisely what he did. Still, it’s an apt metaphor for our profession. But there’s another kind of hole, and that is the wound that divides family. Sometimes this wound occurs at the moment of birth, sometimes it happens later. We are all fixing what is broken. It is the task of a lifetime. We’ll leave much unfinished for the next generation.

Born in Africa, living in exile in America, then returning at last to Africa, I am proof that geography is destiny. Destiny has brought me back to the precise coordinates of my birth, to the very same operating theater where I was born. My gloved hands share the space above the table in Operating Theater 3 that my mother and father’s hands once occupied.

Some nights the crickets cry zaa-zee, zaa-zee, thousands of them drowning out the coughs and grunts of the hyenas in the hillsides. Suddenly, nature turns quiet. It is as if roll call is over and it is time now in the darkness to find your mate and retreat. In the ensuing vacuum of silence, I hear the high-pitched humming of the stars and I feel exultant, thankful for my insignificant place in the galaxy. It is at such times that I feel my indebtedness to Shiva.

Twin brothers, we slept in the same bed till our teens, our heads touching, our legs and torsos angled away. We outgrew that intimacy, but I still long for it, for the proximity of his skull. When I wake to the gift of yet another sunrise, my first thought is to rouse him and say, I owe you the sight of morning.

What I owe Shiva most is this: to tell the story. It is one my mother, Sister Mary Joseph Praise, did not reveal and my fearless father, Thomas Stone, ran from, and which I had to piece together. Only the telling can heal the rift that separates my brother and me. Yes, I have infinite faith in the craft of surgery, but no surgeon can heal the kind of wound that divides two brothers. Where silk and steel fail, story must succeed. To begin at the beginning . . .

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Interviews & Essays

LOVE AND MEDICINE by Abraham Verghese.

Someone once told me, or perhaps I read this, that stories with a dog and a doctor in them are universally appealing because we are fascinated by the doings of both creatures-it's in our genes. That aphorism had nothing to do with my choice of subjects for my novel CUTTING FOR STONE, even though my book has both doctors (many) and dogs (one named, and several nameless) within its pages.

Instead, my goal was simply to tell an epic tale steeped in medicine and medical lore, and to convey the unabashed love I feel for medicine, for the way I see it is to this day as a romantic and passionate pursuit just as it was the first day I stepped on the ward, a love affair that can save you and kill you, complete your character or exaggerate your deficiencies. Call me mad, but it's a madness I won't trade for a life in any other world. And so I'll confess I wanted every page of CUTTING FOR STONE to be true to that sentiment, to be redolent of medicine, to give off the very hospital fumes on which I cut my teeth and which I now need to breathe, just the way Zola's novel PARIS seems on every page to emanate the scents and sounds of the street. So you can imagine what a happy, unexpected surprise it is to find readers telling me they think of my book not as a medical story, but as a love story.

Medicine and love seems worlds apart at first blush, but really they are not. Love that may be hidden outside becomes very visible in the hospital, popping out like the rabbit out of a hat. I don't mean just the falling-off-a-cliff , can't-get-you-out-of-my-mind madness of blooming love, (which is as common in the hospital as out and can get you into just as much trouble in no time, ask anybody); I'm talking about the love of parents caring for a child with fatal illness; or adult children expressing love for a sick and aging parent, or the love that keeps one spouse caring for a partner who has lost the very mental faculties that made the person they once were. And let's include love of a needle, or the bottle, or of the crack pipe, or meth-costly love, the pursuit of which often kills the body. Then there's love of career, money, reputation-each comes with its own hazards. It's a cliché I suppose, but God, so true, that you don't know what love means till you lose it or are about to lose it. The emptiness, the hollowness defines it better than its presence: think Auden in STOP ALL THE CLOCKS:

"The stars are not wanted now: put out every one;
Pack up the moon and dismantle the sun;
Pour away the ocean and sweep up the wood.
For nothing now can ever come to any good."

Paradoxically hospitals are places to loose and to rediscover love. Wallace Stevens has a line, "The body dies; the body's beauty lives." You can meditate on a line like that for ever. To me it has come to mean that we live in those who survive us, we live in their love which is the central theme I suppose of my book. So maybe that is why my novel turned out to be a love story at heart, at least in the eyes of many readers who have done me the honor of not just reading the book but communicating their thoughts; because what makes life poignant, incredibly poignant, is that we are all going to die. Roses would be mere weeds if they didn't bloom and fade and stuck around forever. We humans are the only species that is aware of our own mortality (so a scientist friend told me). Other animals are oblivious and if they were aware, they'd go nuts-who could blame them? But we humans, we the living, we who find love, lose love, plod on, despite the knowledge that it all ends, perhaps denying that knowledge even though it is all around us. And we plod on because it doesn't end. Not really.

The body dies, the body's beauty lives.

Love dies. Love never dies.

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Reading Group Guide

“A winner. . . . Filled with mystical scenes and deeply felt characters. . . . Verghese is something of a magician as a novelist.” —USA Today

The introduction, questions, and suggestions for further reading that follow are designed to enhance your group's discussion of Abraham Verghese's acclaimed novel, Cutting for Stone.

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Customer Reviews

Average Rating 4
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See All Sort by: Showing 1 – 20 of 2192 Customer Reviews
  • Anonymous

    Posted May 4, 2009

    A Master Craftsman

    Don't miss this incredible novel -- one of the finest books I've read in many years. It's an amazing story of fact and fiction, man and medicine, faith and doubt, hope and dreams, and the incredible courage to survive and achieve. It is so well written you become part of the story, cannot put the book down, and are disappointed when there is no more to read. But I immediately bought the author's two non-fiction books, which are like sequels to the novel, and was equally impressed with them. Presuming he's as good a doctor as he is a writer, he's an amazing man!

    63 out of 65 people found this review helpful.

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  • Posted September 2, 2010

    Disappointing at Best

    Having read Dr. Verghese's two works of non-fiction, which are both highly recommended, I could not wait to purchase this book. Unfortunately, I was completely disappointed. The story line while interesting digresses far too often into long, tedious descriptions of medical procedures that leave one wondering if Dr. Verghese's editor ever actually read this work. Several of my friends who are also fans of Dr. Verghese's previous books all commented that they "labored" through this work, and each felt that it was very poorly edited. I suggest you skip this book. However, if you have not read Dr. Verghese's two previous efforts, My Own Country and The Tennis Partner, I urge you to do so. Both of those books are exceptionally well written, moving, and very memorable pieces of literature.

    30 out of 45 people found this review helpful.

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  • Posted March 14, 2010

    I loved this book!

    I picked up this book without really thinking about it or employing my usual habit of reading at least the first 8 to 10 pages to see if I would like it. After a bit of a slow start, I could not put this book down. The character development was wonderful. By the end of the book, I felt sad that these characters I had gotten to know so well would no longer be a part of my life. The story also takes the reader through several years and many continents making the story even more enjoyable and educational.
    I enjoyed this book so much that I gave my Kindle to my eldest daughter so that she could read it, and bought a hardback copy so that my youngest daughter and husband could read and enjoy it also. I am now considering reading the book again - just for my own enjoyment. Don't miss this wonderful book! I have recommended it to many of my friends and I am now recommending it to you!

    30 out of 31 people found this review helpful.

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  • Posted February 26, 2010

    Perfection!

    This is absolutely one of my all-time favorite reads! I found myself slowing down at the end because I didn't want the story to come to an end. And when I did finish, I just wanted to hug the book. The characters were so real and richly developed. I was transported to another time and place and didn't want to leave. And the way the compassion and love of medicine was woven into the story was pure genius. Abraham Verghese is not only a talented writer, but the doctor that all patients wish to find.

    23 out of 26 people found this review helpful.

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  • Posted September 16, 2010

    I Also Recommend:

    Savor the written word, enjoy the experience! I recommend!

    This high caliber, moving novel begins and ends with very difficult surgeries. While very technical, this beautifully written story of family, love, life, loyalties and compassion is rich in detail, huge in heart, and very insightful. The story shows different perspectives of cultural diversity and moves from India to Ethiopia to a hospital in New York City over decades and generations. Savor the written word, enjoy the experience! I recommend!

    19 out of 22 people found this review helpful.

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  • Anonymous

    Posted April 14, 2010

    HUH?

    OK, help me here...help me to understand what these reviewers are talking about. I am SOOOOOOOOOOOOOOOOOO bored with this book! I keep trying to read it because of all the great reviews but in my opinion, the book is very boring. Who cares about the ENTIRE LIFE STORY/HISTORY of certain characters when it seems to not have anything to do with the rest of the book?! I got about half-way through it....scanned a lot....and I just can't force myself to pick it up.

    17 out of 36 people found this review helpful.

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  • Posted July 6, 2010

    One of My All-Time Favorites

    "Cutting for Stone" is now on my all-time favorites list, right up there with "Water for Elephants," "Pillars of the Earth," "The Help" and "The Great Santini." I am dying for some of my physician friends to read it so I will have someone to enter into deep discussions with. You will learn about Africa in the same way that you learned about the Middle East through "Kite Runner." This is a beautifully written story of love and loss, but mostly, it is a story of passion - for one's children, for one's career (medicine, in this case), and for a life of service. I was sorry when I read the last page. Verghese is a great writer.

    11 out of 12 people found this review helpful.

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  • Anonymous

    Posted May 14, 2010

    Cutting for Stone

    I read seven pages of this book before I rushed out and purchased three more for gifts. My Mom and three sisters are reading or rereading this book. A story unlike any other I have every read, it is entertaining and yet very intellectual. The author paints a picture of Addis Ababa and Asmara, where most of the book takes place - the colors and smells of Africa, its culture, history, become vivid and alive, all the while teaching the reader of medical practices, surgery and those who have served there. In the end, it is about forgiveness and redemption, which only begs the reader to read it again. I have recommended this book to my friends, colleagues, scholars, my doctor and I highly recommend to viewers.

    11 out of 11 people found this review helpful.

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  • Anonymous

    Posted February 1, 2010

    Moving and Inspiring

    Not in twenty years have I read a book that I will likely read again. Dr Verghese's style is economical but complete capturing the essence of his characters. An unbelievable story that is woven so tightly without becoming surreal. It speaks to human nature at its best and worst and the backdrops are so descriptive, we are inspired to experience Ethiopia. As a physician myself, I was inspired by the spirit of compassion, caring and competence particularly of Ghosh. He is the quintessential role model.

    10 out of 10 people found this review helpful.

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  • Anonymous

    Posted February 26, 2010

    I Also Recommend:

    Amazing book.

    I have to admit...I almost gave up on this one. However, by page 100 there was no putting it down. This book has characters that are so believable and real you can't help but love them. What an amazing story this turned out to be. Thank you SOOO much Abraham Verghese!! I can't wait to read the next one!

    9 out of 10 people found this review helpful.

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  • Posted June 14, 2010

    more from this reviewer

    Compelling!

    This was a very different book. I wasn't sure that I was going to understand all of the medical terms and diagnosis..but this author made it easy to stick with and comprehend. I learned about medicine, geography, friendships, betrayal, loyalty, family and forgiveness. I couldn't put it down! A great read from beginning to end! I never thought that this would be a "subject" that I would read, but am really glad that I did!

    7 out of 7 people found this review helpful.

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  • Posted December 4, 2008

    more from this reviewer

    This is a terrific twenty century epic

    In 1947 dedicated to the Lord Sister Mary Joseph Praise leaves Kerala, India for a missionary assignment in Yemen. The voyage mostly by sea is grueling, but Sister Mary has the Lord accompanying her so has no ill affects. She saves the life of Dr. Thomas Stone who is heading to Ethiopia.<BR/><BR/>Sister Mary and Dr. Stone meet for the first time since their sea trek at Missing Hospital in Addis Ababa and she provides him comfort. Sister Mary dies during child birth, but her twin sons Shiva and Marion survive; Thomas never knew although she wrote him a letter explaining all. Adopted by physicians at Missing Hospital, who hide Mary¿s letter, the brothers thrive over the decades until each becomes a doctor.<BR/><BR/>This is a terrific twenty century epic that wonderfully blends a family drama and medical practices into an Ethiopian political thriller. The well written story line is told by one of the siblings, who vividly explains, the love he and his twin received from his adopted parents, his discovery of the letter, and especially medicine in war torn Ethiopia and in the battle zone of the New York City slums. Although coincidence allows the major early events to occur the way the do, fans will relish this deep tale of two adopted brothers becoming doctors just like their parents and the biological father they do not know.<BR/><BR/>Harriet Klausner

    7 out of 8 people found this review helpful.

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  • Posted July 9, 2010

    BUY THIS BOOK

    This book is now on my "Top 10 of All Time" list. After having it suggested to me over and over I finally bought it. The synopsis does not do justice to this expertly written novel. The language was lovely and I'm so glad I had my e-book for definitions. This is one of those books you say to yourself, "I wish I could write like that". Very engaging. I was sad it ended and am looking very forward to his next novel.

    6 out of 7 people found this review helpful.

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  • Anonymous

    Posted January 23, 2010

    Best book I've read in a very long while

    I found this book on a library shelf and took it on the chance it might be interesting. Imagine my joy when I discovered I couldn't put it down. I carried this book everywhere until I read the last page and realized how disappointed I was that it had ended.
    I've ordered several copies in paperback to give as gifts, and I will keep one in my permanent library so I can reread it whenever I choose. My book club will read it this month and I hope to gain additional insights when we discuss it.

    6 out of 6 people found this review helpful.

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  • Anonymous

    Posted July 22, 2010

    A great read

    The story was complete and clearly written, including the medical descriptions. The ending of the story was both a shock and initially quite sad, but could not have left the reader more pleased with the final outcome. All books should be so enjoyable to read. I loved it.

    5 out of 7 people found this review helpful.

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  • Anonymous

    Posted May 5, 2010

    Unforgettable

    Verghese's novel is amazing. Though I sometimes wondered where the narrative was heading, I was always completely involved in the story line. The characters are both archetypal and original. This book should be at the top of the "you must read this" list.

    5 out of 5 people found this review helpful.

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  • Anonymous

    Posted February 22, 2010

    EXCELLENT!

    Overall, just an absolutely beautifully written novel - writing, plot, characters, everything worked together. I think of it as an epic - the story encompasses fifty years and crosses the globe. I couldn't put this book down!

    5 out of 5 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted January 25, 2010

    I Also Recommend:

    GOOD BOOK

    This story is complex and is well written. The characters are so real and powerful. I loved this book. I'm suprised that not many people I talk to (also book-a-holics like myself) haven't heard of it. I truly hope to hear that more people have found it and read it. It is an excellent read.

    4 out of 5 people found this review helpful.

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  • Anonymous

    Posted January 2, 2010

    I Also Recommend:

    Loved this book

    I've read another book by this author years ago about a doctor in an AIDS hospital in the Carolinas & loved it so I thought I'd give this one a try.
    Even though this is a book over 500 pages I almost wished it was longer. I enjoy fiction but if I can learn something too....BONUS

    4 out of 4 people found this review helpful.

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  • Posted May 5, 2009

    more from this reviewer

    Disappointing

    I did not care for this book. In the beginning I thought I would , but it just got way too far fetched for this reader.

    4 out of 16 people found this review helpful.

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