Cutting for Stone: Twins, intertwined at birth and through difficulty and betrayal

Cutting for Stone, by Abraham Verghese
My rating: 4 out of 5 stars

It always amazes me when someone whose primary profession is not writing manages to write a highly ambitious, sweeping saga of a novel like Cutting for Stone.

Abraham Verghese is a surgeon by trade, and it shows in this book. It's full of painstakingly detailed, sometimes graphic medical procedures. Fortunately, they are written in a way that a layperson can understand. It's not a book for the squeamish, which you will realize once you get into the first couple of chapters.

Cutting for Stone is about twin boys, Marion and Shiva, who are born to an Indian nun and a British surgeon. After their mother dies and their father runs off in grief, they are raised by two other doctors (Ghosh and Hema) at "Missing Hospital" in Addis Adaba, Ethiopia. Extremely different from one another but bound together from birth through blood and an invisible line between their heads, the brothers experience loss, betrayal, and distance.

Other reviewers were troubled by the narrator perspective of Marion, and I agree that at times it was jarring (especially when Marion was unconscious at one point!). Shiva in particular is very difficult to fathom at times, because of the singular perspective of his twin brother.

Marion has an obsessive love for Genet, his nanny's daughter, although it's difficult to understand why at times. She takes his affection for granted, and in one troubling scene, he has violent sex with her, I suppose as his way of getting even with her.

Verghese is an excellent descriptive writer--he's able to paint a canvas full of interesting, colorful locations--India, Ethiopia, the sea, New York, Boston--in addition to his ability to place you right in the operating room.

The book dragged for me at times, and I found the beginning and the end to be the most gripping.
As the aunt of twin boys and the friend of someone who bore twin girls and lost one on the day of her birth, I have seen twin kinship in action. I wonder whether Verghese is a twin or is close to twins. He seems to have a genuine understanding of the invisible bond between people who shared their mother's womb. When Marion fell ill, Shiva could sense it from a world away, in spite of the fact that they were somewhat estranged. This did not surprise me.

Even though this book took me awhile to finish (because of its length and at-times slow pace), I thought about it when I was not reading it--always a good sign.

As someone who has experienced the unique agony of having a loved one be medically fragile and close to death, I appreciated Verghese's efforts to express this perspective.

At one point, Thomas Stone (father of the twins) shares a letter from her mother about her son dying in surgery, and no one offered him any words of comfort--"Before I was asked to leave the room in a very rough manner, I must tell you that I saw my son was terrified and there was no one who addressed his fear...I saw no sign of the slightest bit of human kindness. My son and I were irritants. Your team would have preferred for me to be gone and for him to be quiet....My son's last conscious memory will be of people ignoring him. My last memory of him will be of my little boy, watching in terror as his mother is escorted out of the room. It is the graven image I will carry to my own deathbed. The fact that people were attentive to his body does not compensate for them ignoring his being." This so perfectly captures the feeling of desperation felt by a parent whose child is not being cared for with compassion, respect, and understanding.

Later when Marion was deathly ill, Shiva lay down next to him on his hospital bed, head to head, as they lay in the womb and during childhood...and Marion's intracranial pressure went down immediately. This is akin to those times when we would visit our premature son in the NICU and he would feel our presence--his oxygen saturation would go up.

Even during the times when Thomas Stone and his son, Marion, led solitary, reserved private lives, they displayed the kinder, more human side of medicine.