Synopses & Reviews
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.
"An enormously impressive first novel. . . . Many physicians write eloquently about their work — Atul Gawande and Oliver Sacks come readily to mind — but Abraham Verghese may be the first to use his medical expertise to reconfigure a hallowed literary genre: the epic novel. [He] has written a riveting tale . . . while interweaving graphic physiological details and lots of shoptalk. . . . A powerful story of abandonment, betrayal, and redemptive (and destructive) love. . . . Page-turning." Nan Wiener, San Francisco Magazine
"Cutting for Stone is nothing short of masterful — a riveting tale of love, medicine, and the complex dynamic of twin brothers. It is beautifully conceived and written. The settings are wonderfully pictorial. There is no doubt in my mind that Cutting for Stone will endure in the permanent literature of our time." Richard Selzer, surgeon and author of Letters to a Young Doctor
"A grand, exquisitely drawn story of twin brothers that ranges from birth to death, and from Ethiopia to America. In Cutting for Stone, Abraham Verghese shows us with brilliance and passion where healing comes from, and how we move through suffering to embrace life. In the hands of this compassionate doctor/writer, the details are indelible: A wonderful book." Samuel Shem, author of The House of God and The Spirit of the Place
"A winner. . . . Filled with mystical scenes and deeply felt characters. . . . Verghese is something of a magician as a novelist." USA Today
"His intimate depiction of humanity makes your pulse race, your eyes tear, and your lungs exhale a satisfied sigh." Paula Bock, The Seattle Times
"[R]ead it for the medical education. Or for the characters. Or for the action, or for the dynamics of an unhappy family. But do yourself a favor. Read it." Harry Levins, St. Louis Post-Dispatch
"At its best, the first novel from physician Verghese displays the virtues so evident in his bestselling and much-lauded memoirs." John Repp, Cleveland Plain-Dealer
"Verghese writes beautifully. A great, sweeping novel." Anne Morris, Dallas Morning News
"Magical . . . Vivid . . . Cutting for Stone kept me absorbed and enthralled all the way to India." Tina Brown, The Daily Beast
"[A] fantastic evocation of the life of a pair of twins whose mother was a nun and father an English surgeon." William J. Cobb, Houston Chronicle
"Verghese is a novelist revealing extraordinary skill. With Cutting for Stone, [he] proves his gift [and] shares with us a story that cuts into our hearts and burns into our minds. . . . This epic of family and love is told largely from the operating theater as surgeon and soul become one." Adera Causey, Chattanooga Free Press
About 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.
Reading Group Guide
1. Abraham Verghese has said that his ambition in writing Cutting for Stone
was to “tell a great story, an old-fashioned, truth-telling story.” In what ways is Cutting for Stone
an old-fashioned story—and what does it share with the great novels of the nineteenth century? What essential human truths does it convey?
2. What does Cutting for Stone reveal about the emotional lives of doctors? Contrast the attitudes of Hema, Ghosh, Marion, Shiva, and Thomas Stone toward their work. What draws each of them to the practice of medicine? How are they affected, emotionally and otherwise, by the work they do?
3. Marion observes that in Ethiopia, patients assume that all illnesses are fatal and that death is expected, but in America, news of having a fatal illness “always seemed to come as a surprise, as if we took it for granted that we were immortal” [p. 486]. What other important differences does Cutting for Stone reveal about the way illness is viewed and treated in Ethiopia and in the United States? To what extent are these differences reflected in the split between poor hospitals, like the one in the Bronx where Marion works, and rich hospitals like the one in Boston where his father works?
4. In the novel, Thomas Stone asks, “What treatment in an emergency is administered by ear?” The correct answer is “Words of comfort.” How does this moment encapsulate the book's surprising take on medicine? Have your experiences with doctors and hospitals held this to be true? Why or why not? What doesCutting for Stone tell us about the roles of compassion, faith, and hope in medicine?
5. There are a number of dramatic scenes on operating tables in Cutting for Stone: the twins' births, Thomas Stone amputating his own finger, Ghosh untwisting Colonel Mebratu's volvulus, the liver transplant, etc. How does Verghese use medical detail to create tension and surprise? What do his depictions of dramatic surgeries share with film and television hospital dramas—and yet how are they different?
6. Marion suffers a series of painful betrayals—by his father, by Shiva, and by Genet. To what degree is he able, by the end of the novel, to forgive them?
7. To what extent does the story of Thomas Stone's childhood soften Marion's judgment of him? How does Thomas's suffering as a child, the illness of his parents, and his own illness help to explain why he abandons Shiva and Marion at their birth? How should Thomas finally be judged?
8. In what important ways does Marion come to resemble his father, although he grows up without him? How does Marion grow and change over the course of the novel?
9. A passionate, unique love affair sets Cutting for Stone in motion, and yet this romance remains a mystery—even to the key players—until the very conclusion of the novel. How does the relationship between Sister Mary Joseph Praise and Thomas Stone affect the lives of Shiva and Marion, Hema and Ghosh, Matron and everyone else at Missing? What do you think Verghese is trying to say about the nature of love and loss?
10. What do Hema, Matron, Rosina, Sister Mary Joseph Praise, Genet, and Tsige—as well as the many women who come to Missing seeking medical treatment—reveal about what life is like for women in Ethiopia?
11. Addis Ababa is at once a cosmopolitan city thrumming with life and the center of a dictatorship rife with conflict. How do the influences of Ethiopia's various rulers—England, Italy, Emperor Selassie—reveal themselves in day-to-day life? How does growing up there affect Marion's and Shiva's worldviews?
12. As Ghosh nears death, Marion comments that the man who raised him had no worries or regrets, that “there was no restitution he needed to make, no moment he failed to seize” [p. 424]. What is the key to Ghosh's contentment? What makes him such a good father, doctor, and teacher? What wisdom does he impart to Marion?
13. Although it's also a play on the surname of the characters, the title Cutting for Stone comes from a line in 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.” Verghese has said that this line comes from ancient times, when bladder stones were epidemic and painful: “There were itinerant stone cutters—lithologists—who could cut into either the bladder or the perineum and get the stone out, but because they cleaned the knife by wiping their blood-stiffened surgical aprons, patients usually died of infection the next day.” How does this line resonate for the doctors in the novel?
14. Almost all of the characters in Cutting for Stone are living in some sort of exile, self-imposed or forced, from their home country—Hema and Ghosh from India, Marion from Ethiopia, Thomas from India and then Ethiopia. Verghese is of Indian descent but was born and raised in Ethiopia, went to medical school in India, and has lived and worked in the United States for many years. What do you think this novel says about exile and the immigrant experience? How does exile change these characters, and what do they find themselves missing the most about home?
(For a complete list of available reading group guides, and to sign up for the Reading Group Center enewsletter, visit www.readinggroupcenter.com)
“A winner. . . . Filled with mystical scenes and deeply felt characters. . . . Verghese is something of a magician as a novelist.”
“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.”
“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.”
“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.”
“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.”
“Tremendous. . . . Vivid and thrilling. . . . I feel lucky to have gotten to read it.”
“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.”
“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.”
“Vastly entertaining and enlightening.”
“Ambitious. . . . Sprawling. . . . A synthesis of the everyday and the extraordinary [written] in a style that could be called ecstatic realism.”
“[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.”
“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.”
“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.”
“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.”
“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
Q: Your previous two books are non-fiction, but you’ve said that you have always thought of
yourself as a fiction writer first. How so?
A: Fiction is truly my first love. To paraphrase Dorothy Allison, fiction is the great lie that tells the
truth about how the world really lives. It is why in teaching medical students I use Tolstoy’s The
Death of Ivan Ilych to teach about end-of-life, and Bastard out of Carolina to help students really understand child abuse. A textbook rarely gives them the kind of truth or understanding achieved in
the best fiction.
One of my first published short stories was “Lilacs,” in which the protagonist has HIV. Its
appearance in The New Yorker in 1991 was a part of what led to my contract to write My Own Country,
a memoir of my years of caring for persons with HIV in rural Tennessee. While writing that book
I found myself living through an intense personal story of friendship and loss that led to a second
non-fiction book, The Tennis Partner. But after that, I passed up on an offer to write a third non-fiction
book. I was keen to get back to fiction, to explore that kind of truth.
Q: In 1990, while practicing medicine, you decided to attend the Iowa Writers’ Workshop and obtain a degree in Fine Arts. What led you to go back to school—particularly for creative writing—while you were in the middle of a successful career as a doctor?
A: At the time I was living in Johnson City, Tennessee, working at a small medical school as an internist
and infectious diseases specialist. Between ‘85 and ‘90, we began to see many HIV-infected
persons at a time when the pundits said AIDS was a big-city disease, and we’d never see it in our
small communities. Soon we had close to 100 patients in a town of 50,000, a mystery I explained in
My Own Country. It was an intense, sad, heartbreaking period because we had no real therapy and
lots of prejudice and hatred, but also lots of courage and heroism. Not having anything by way of
medicine to offer my patients, I began to visit with them at times in their homes. That is when I
found that even when I had nothing to offer, I had everything to offer: It was the distinction between
healing and curing (and the cure was what all of us in Western medicine were obsessed with). I realized
that I could heal when I could not cure, meaning that my presence, my interest and support,
could help the patient and the family come to terms with the illness, come to terms with death.
But by the fifth year of this practice, with little in the way of help, I was getting burned out.
If I wanted to stay in the war against AIDS—and I did—I needed to pace myself, to take a break. I
had been writing short stories and essays as a way of keeping sane during those intense days. So I
decided I would apply to the Iowa Writers’ Workshop, send in my two stories, and if they took me,
I would go. If they didn’t take me, I was still determined to take a break and support my family by
working in emergency rooms.
Well, Iowa took me, and I wound up cashing in my 401K plan and giving up my tenured position to drive out there with my wife and two young children. As I look back, I think it was a very selfish thing to put my family through, but it was an act of self-preservation, too—I felt I would implode if I didn’t take a break.
In Iowa, I worked in the University HIV clinic once a week. Other than that and the workshop
that met weekly, my time was gloriously free to read and write. Given my background, this was precious
time—I didn’t think I would ever get time like that again (and I haven’t)—so I worked very hard
for the year and a half it took me to finish. The bills piled up, and when I was done, I needed to get a
regular job again, which is how I landed up in El Paso at Texas Tech’s teaching hospital there. I chose
a place well off the main academic trail because I thought that my nights and weekends would be
mine, no grants to write. That turned out to be true and my first two books were written there.
Q: Was there a single idea behind or genesis for Cutting for Stone?
A: 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. It’s a view of medicine I don’t think too many young people see in the West because, frankly, in the sterile hallways of modern medical-industrial complexes where physicians and nurses are hunkered down behind computer monitors, and patients are whisked off here and there for this and that test, that side of medicine gets lost.
So I began with the image of a mission hospital in Africa, redolent with Dettol, the antiseptic of choice of the tropics; I wanted to portray a place so basic, so unadorned, that nothing separates doctor and patient, no layers of paperwork, 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 society are no longer abstract terms. In that setting I wanted to put very human, fallible characters—people like Sister Mary Joseph Praise and Thomas Stone. I wanted the whole novel to be of medicine, populated by people in medicine, the way Zola’s novels are of Paris.
Q: Where does the title “Cutting for Stone” come from?
A: There is a line in the Hippocratic Oath that says: . . . I will not cut for stone, even for patients in whom
the disease is manifest . . . It stems from the days when bladder stones were epidemic, a cause of great
suffering, probably from bad water and who knows what else. Adults and children suffered so much
with these—and died prematurely of infection and kidney failure. There were itinerant stone cutters—
lithologists—who could cut either into the bladder or the perineum and get the stone out, but
because they cleaned the knife by wiping it on their blood-stiffened surgical aprons, patients usually
died of infection the next day. Hence the proscription, “thou shall not cut for stone.”
It has always seemed to me a curious thing to say when we recite the oath in this day and age.
But I love the Hippocratic Oath (or oaths, because its origins and authorship are far from clear), and
always try to attend medical school commencement. When the new graduates stand and take the
oath, all the physicians in the room are invited to rise and retake the oath. You see many physician
parents and physician siblings standing as their son or daughter or brother or sister takes the oath. It
chokes me up every time. Not only am I renewing my faith, but I am bursting with pride in seeing my
students graduate—another part of the oath is “to teach them this art, if they desire to learn it; to give
a share of precepts and oral instruction and all the other learning to my children and to the children
of those who instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law.”
How does all this relate to my novel? It isn’t just that the main characters have the surname ‘Stone’; I was hoping the phrase would resonate for the reader just as it does for me, and that it would have several levels of meaning in the context of the narrative.
Q: Each of the characters in this novel is drawn to medicine in different ways and for different
personal reasons. What drew you to medicine?
A: I was the middle of three sons of Indian parents who taught college physics. My brothers had a precocious ability with numbers, while I had no head for math—or much else in the curriculum. For middle-class Indian parents only three professions exist: medicine, engineering, and law. My older brother announced he was going to be an engineer, which delighted my parents. I felt obliged to proclaim that I intended to be a doctor. I figured that my propensity to fall and bleed, my unseemly interest in witnessing chickens and sheep being slaughtered for the kitchen, and my fascination with watch