Tuesday, June 11, 2013

Cutting for Stone ~ Abraham Verghese

"Tell us, please, what treatment in an emergency is administered by ear?" ... "Words of comfort." (520-521)

Cutting for Stone is one of those books that I've been meaning to read for a long time, years maybe.  I first heard of it on a non-book blog and picked up a copy at a library book sale soon after.  It's been sitting on my shelf ever since.  Perhaps this latent anticipation raised it up in my expectations, for I certainly heard no hype about it, but it fell short of my expectations.  I liked it, but I did not love it, and found more problems in it than I found answers.

The novel is epic in scope, spanning continents, from Addis Ababa, Ethiopia to New York and back again, with stops in India, Britain, and Italy.  It starts decades before the birth of the narrator, centuries if one considers the impact of colonialism, and stretches to the present day.  It is narrated by Dr. Marion Stone, son of an Indian nun and a white doctor who was born in India, though it is in their passage from India to Africa and in Ethiopia that the two come together.  Marion and his mirror-image twin brother, who heads were connected in the womb, are raised at Missing Hospital (a mis-transcription of "Mission") by two of the doctors there, after the death of their saint-like mother and abandonment by their surgeon father.

From the very beginning of this novel, I sensed that Verghese was emulating the form of epic novels that preceded his; I was put in mind particularly of Middlemarch and Anna Karenina, which was unfortunate as I did not particularly enjoy either novel.  Sure enough...
It's fuzzy, but the first word of the third line is "Middlemarch."
Before I get into what I didn't like about this novel, let's start with what I did like.  Similar to my favorite part of Middlemarch, the medical talk was probably my favorite part - it was interesting and I felt like I learned a lot.  Verghese's main career, as a doctor, really shone through.  You could tell that not only did he know his stuff, but he made it accessible as well.  Yes, there were some obscure Latin terms, but he explained what we needed to know and a little bit of mystery makes sense in the context of a time when a lot less was known about medicine and the human body.  I personally find surgery scenes in TV show revolting (perversely, I'd rather watch someone's head get blown up) but in this novel those scenes were fascinating, a puzzle.

There was one scene in the operating theater that was positively funny, despite how horrific it really was.  Marion's mother, the nun, is dead on the operating table and her twins are being resuscitated by the gynecologist.  Everyone else in the room is frozen, inert, as opposed to their normal bustling efficiency, all except for Marion's father, who will be fleeing the hospital and his sons shortly.  He is frantically and unadvisedly attempting to restart the nun's heart, his hands literally sunk into her chest cavity.  Disturbing, but it makes sense given the terror of the moment and his desperation (and his personal history, which we learn later).  Then, suddenly, another person enters the operating room and the perspective shifts and we see Sister Mary Joseph Praise opened like a sacrificial lamb with Stone's hand in her chest (123).  I don't think this is supposed to be funny, but I found myself laughing and the change, how different things look from a different perspective.  Oddly, that scene has stuck with me since.

There are two main things that bothered me about this novel and unfortunately, they are big things.  The first is that the novel was clearly written with Western readers in mind.  Nearly all of the cultural references are Western, with the exception of a few Indian references and a single Ethiopian song and Ethiopian food.  On one level, this makes sense - while Verghese was born in Ethiopia, it was to Indian parents and he has spent his adult life in the United States, where he writes.  However, it does not make sense in the context of the novel.  Marion is also born in Ethiopia and raised by Indians and moves to the United States...but then he returns to Ethiopia at the end of the novel (which is revealed at the beginning, so I'm not spoiling anything).  Yes, his parents read him some Western novels but still, his frame of reference for Western culture would be pretty small.  While these references and allusions make the novel more accessible to me as a reader, they are also alienating because they don't make sense to me.  Related to this is who Verghese talks about Ethiopia - he idealizes it in a mythical sort of way.  This makes sense for an expatriate, which he is, but not for the narrator, Marion, who returns to Ethiopia after a relatively short absence.

My other major issue is the character and relationship development.  I found most of the characters hard to believe, and the women in particular.  Female characters tended to be ALL good or ALL bad and the only "complex ones" (Rosina and Genet) just start off good and then turn bad.  There's no ambiguity.  Likewise, the nun who mothers Marion and Shiva is seen as saint-like but we're never given any indication of why, or shown the relationship between her and those who so effusively mourn her loss.  Marion's longing and grief for her are understandable - his birth was her death and they are forever linked.  But why was Hema so ready to raise her children, why was the Matron so cut up by her loss?  We never find out.  Shiva's character development was strange, until I realized that he was probably autistic and that made sense - until the end when he abruptly develops insight and totally changes his perspective.  Even Marion I didn't understand all too well - his characters changes abruptly many times throughout the novel and for no apparent reason.  Also, why do two much older women repeatedly offer their bodies up to him?  Maybe it's an Ethiopian thing, but I couldn't help associating this with his seeming lack of respect for women.  His rape of a woman at the end of the novel is totally unremarked upon and he repeatedly makes comments about how the woman he loves should exist just for him.  This isn't actually a character development issue (he was actually very inconsistent in his flawed, simplistic view of women) but just something that made me personally dislike the novel's narrator.

The end irked me too.  Again, this is a personal preference, but I just don't like novels that tie up too neatly.  I have in the past expressed my dislike for epilogues that do this and this was another one of those instances, except there was no "epilogue" chapter heading to warn me!  We can't always know how each and everything turns out for every character (or, for that matter, the people we encounter in our real lives) and I personally prefer some ambiguity in this matter.  Again, this is a personal preference - I know many readers want to know just what happens to every beloved character, and that's fine too.

Despite my dislike of the main character, who from what I can tell is largely based on the author, both the novel and the biography of Verghese from his website gave me respect for him as a doctor.  It sounds as though he has done a lot of work promoting the importance of the patient/physician relationship and respecting the dignity of patients.  Having been manhandled by doctors myself and being a social worker who highly values this sort of relationship, I do have to applaud the man for his work in this area, which was reflected in this novel.  I may not love the book (though I certainly didn't hate it either) but I do respect the man who wrote it.


  1. I've been meaning to read this one for years too. It's a shame it didn't work out for you - I think the Western cultural references would irritate me as well.

    I will moderate my expectations for when I finally read this book.

  2. It must feel like I'm stalking your blog tonight, with as many comments as I'm leaving, but I promise I"m not being creepy--I'm just catching up on some really great posts of yours that I somehow missed at the time of posting.

    I actually loved this book, but I'm so far removed from my reading of it that I couldn't possibly be critical of it now in a meaningful way. I've had the biggest readerly crush on Dr. Verghese, whom I've met twice now, and I admit that probably influences the way I view the book. He is charm personified.

    I will bow to your more recent reading re: the lack of character development and/or lack of nuance in the portrayal of the women in this novel, but I have to wonder about the cultural references. I'm not up on the colonial history of Ethiopia in particular, but having just re-read Bill Bryson's In a Sunburned Country, I know that it was up until relatively recently that Australians learned British history, not Australian history, and I wonder if it could have been a similar situation with the way Verghese grew up, as the child of Indian parents living in Ethiopia. No doubt much of his parents' lives were spent under British rule...

    1. Lol, blog stalking is totally acceptable - no worries!

      That's a really good point about how the character's education could affect his cultural references - he did go to a British school, albeit a crappy one, so that would influence him, though it doesn't really account for American references (of which I believe there were also many). I would be interested in meeting Verghese, as I do have a lot of respect for what I've read about him.