Verghese
says about his book: “My ambition as a writer 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”.
Cutting
for Stone
is
an ambitious work about a small, intimate group of people living and
working at a hospital called Missing
in
Addis
Ababa, Ethiopia. Although only two
of
them are biologically connected, and the group is racially divergent (Ethiopians, Indians, Eritreans and British Indians), these
people constitute what could be called a family, and the novel traces
their lives from the 1940s through to the early 2000s.
The
title can refer to a phrase taken from the Hippocratic Oath: "I
will not cut for stone, even for patients in whom the disease is
manifest; I will leave this operation to be performed by
practitioners, specialists in this art… " a phrase which
refers to the travelling stone cutters of earlier centuries
who
cut out kidney and bladder stones, using unsanitary tools; it can
also refer
to
the two sons of the story, cutting for their father, Thomas Stone.
At
the centre of the novel are Marion and Shiva Stone, the twin sons of
a British surgeon and an Indian nun working at Missing hospital. Fate
decrees, however, that the boys should be brought up by others (also
doctors at the hospital), and it is not surprising that both boys
choose medical careers. Much of the story is played out against a
background of political unrest in Ethiopia, an unrest that eventually
sees the twenty-five-year-old Marion move to USA. Marion grows up
hating the father who abandoned him as a baby, and after an
unfortunate episode when he is in his teens he also bears a grudge
against the brother who he actually loves more than anyone else in
the world. While he is in USA, circumstances force him to come to
terms with both his hate and his grudge.
Abraham
Verghese is a Professor of Medicine at Stanford, USA, and he is,
therefore, qualified to write about ailments, operations and
everything medical. I found the amount of medical jargon and
reference to medical procedures – especially in the beginning of
the novel – to be a little overwhelming, but as the book proceeds
the medical aspects of the story become so integrated with the
characters that the novel would probably seem lopsided without them.
This is, after all, a story about doctors.
Even
though the novel is basically fiction, it was interesting reading
about Ethiopia, particularly from the point of view of health care,
and, later in the book, it was equally interesting to look at the
two-tiered approach to health care in USA and the gulf between
well-equipped university hospitals and hospitals set up to care for
poorer patients.
The
story, though interesting, is not of the page-turning variety (not
until the final thirty pages of its five hundred and thirty-four
pages), and, at times, I found it slightly tedious. Certain episodes
lack credibility: for example, the promiscuous activities and
thoughts of thirteen-year-old children and the relationship between
the surgeon and the nun, which, although it is at the centre of the
novel, remains both surreal and nebulous.
Nevertheless,
I enjoyed the novel, and I respected what Verghese was trying to do –
even more so after reading the following comments of his
from
an interview:
“As
we’ve gotten very fancy in technology and the incredible detail
with which we can see the body, we sometimes lose sight of how much
we can see about the body just from examining the patient. The
physical exam really allows you to order tests more judiciously and
to ask better questions of the test” (...)
“… We’re all intrinsically prone to allowing
technology to take the place of common sense and I think that’s a
danger. … The tests have become an easy shortcut. They’re an
efficient, quick way to get information. But the great danger I see
is this: I think that people fail to really connect with patients
when they don’t examine them. I think the carefully done physical
is a wonderful way to convey your attentiveness to the patient”.
