“We are all fixing what is broken. It is the task of a lifetime.” —Verghese
By chance, when I was a boy searching for rocks to add to my growing collection, I found my first piece of pyrite — “fool’s gold.” This particular nugget was big, certainly much bigger than any crystalline mineral I had previously encountered. As I turned it over in my hand, it reflected a tarnished brassy light.
This treasure turned out to be nothing next to the tiny flakes of real gold that later, as an adolescent, I panned from the mountain streams of New Mexico. That brilliant yellow sparkle was unmistakable. Once you encounter the real thing, you never forget; it burns itself into your memory and you guard its image forever.
For me, now a seasoned clinician, Abraham Verghese’s 2009 novel Cutting for Stone is the real thing.
Against the backdrop of Ethiopia, a country so beautifully depicted that his descriptions can hurt, Verghese crafts the timeless narrative of two brothers, twins joined at the head by a mysterious cord identified at birth. In an emergency caesarean section the obstetrician who will become their surrogate mother clamps and divides this tube, uncertain if it contains meninges, gray matter or aberrant blood vessels. Thus separated at birth, the twins retain a mysterious bond between them throughout the rest of their lives.
Thomas Stone, their surgeon father, normally level-headed and dexterous in the operating theater, flounders on how to proceed with the delivery. Because of his lack of timely intervention, the mother exsanguinates on the table. Unable to cope with his perceived incompetence, Stone flees the hospital, the country, and, as we later learn, the continent. He appears again in the final section of the book where he will be called upon in his brokenness to perform a surgical miracle.
Meantime, the boys are adopted and reared by Hema, the obstetrician gynecologist, and Ghosh, the internist, at Missing (a mispronunciation of “Mission”) Hospital in Addis. Both boys are introduced to the practice of medicine at an early age. Each pursues it in his own fashion. Marion, the first-born, blossoms under the tutelage of Ghosh, the competent and kind clinician; while Shiva, his mother’s favorite, blazes his own unique path, pioneering and perfecting the techniques of fistula surgery that will save thousands of ill-fated young women.
Estranged from Shiva over a fiery young woman, Marion is forced to flee Ethiopia for political asylum. The paths of the brothers will converge seven years later in America, where, in a manner of speaking, they become reunited again.
In Cutting for Stone, Verghese gives us his best, exploring how the sins of fathers are visited upon subsequent generations, the intricate relationships between broken people, the history of modern medicine from clinical practice to the art of transplantation, the interrelatedness of human existence on this planet. The narrative is chocked full of medical aphorisms and old saws, a well-stocked larder for the practicing clinician.
Cutting for Stone was placed in my hands by a good friend who thought I might enjoy it. He and his wife had read it over the course of their recent two-month trek through Australia and New Zealand. I discovered a bookmark sandwiched between two pages — a dog-eared boarding pass from one of their intercontinental flights.
The read itself turned out to be a fascinating journey, one enriched by precious stone.