Cutting for Stone by Abraham Verghese

6599486Fiction — audiobook. Read by Sunil Malhotra. Random House Audio, 2009. 23 hours, 44 minutes. Library copy.

Orphaned at birth by the death of their mother, an Indian Carmelite nun, and the subsequent disappearance of their father, a British surgeon, Marion and Shiva Stone grow up at a mission hospital in Addis Ababa, the capital of Ethiopia, during the overthrow of the emperor. Raised by an Indian obstetrician and an Indian general surgeon along with the Mother Superior of the mission, the twins grow to love medicine and are given a largely idyllic lifestyle until the revolution begins.

Shiva eventually decides not to attend medical school yet still become a pioneer in the surgical correction of vesicovaginal fistulas while Marion throws himself into an intern at an underfunded hospital in the Bronx. The internship was not Marion’s original plan; Marion is forced to leave due to his brother’s betrayal with the woman Marion loves, who positions him as an enemy of the state, but coincidence leads him to finally meet the man who abandoned him at birth.

I attempted to read Verghese’s novel in June 2011, but could not lose myself into the story or follow the prose of the narrator. I set the book aside about 25 percent of the way through intending to abandon the novel for good. Yet the image of conjoined twins separated at birth from each other and their biological parents in Ethiopia during the 1960s never let me, and three years after my first attempt I plucked the audiobook version of the novel off the library shelf and tried for a second time.

Although I was familiar with the beginning of the novel, I still had to adjust to the style of the narration. Marion is an adult reflecting on his life, and he utilized adult prose and medical jargon to explain his thoughts and feelings at every age and stage of his life, including in utero and during a lengthy coma. He narrates events to which he is not privy — namely, how his parents met and Hema’s time in India before his birth — and often interrupts the most emotionally intense moments of the story to provide a back story for a secondary character. That said, I began to lose myself in the story once I grew accustomed to Marion’s use of language and suspended my disbelief that he would not know the details of others’ lives to the degree he presumes.

At the heart of this story exists a critique of the medical system in America and the donations used to keep the mission hospital open as well as an introduction into the history and culture of Ethiopia. During his internship, Marion learns about the differences in the quality of care between “Mecca” hospitals where the wealthy are cared for and hospitals like his own where money is tight and organs are harvested for patients at “Mecca” hospitals. In the days following Marion’s birth, the reader learns about the misguided donation of Bibles and nameplates over antibiotics and medical supplies by religious people in the United States. It is surprisingly easy to follow and understand the medical jargon, which becomes a character in its own right, as the novel progresses.

And throughout the novel, Marion and the reader learn about how Ethiopia was the only country not colonized by the Europeans, how the emperor attempted to thwart a revolution by encouraging infighting amongst the military, how the doctors and the people they serve fine the fine line between advocacy and treason. Verghese does an amazing job of conveying the passion his characters have for their country to the reader, possibly because this aspect of the novel is autobiographical in nature, and understanding this passion and the history of Ethiopia was easily my favorite aspect of the novel.

The narration of the audiobook by Sunil Malhotra was, quite simply, amazing. He manages to maintain a distinct accent for all the characters indicative of where they were born, including a Texas twang for a Baptist visitor to the mission, without the trace of an underlying accent. I know I would not have been able to finish this book without Malhotra’s excellent narration.

My singular uneasiness about the novel — the reason why I’m not shouting praises from the rooftop — is the treatment of Genet, the supposed love of Marion’s life. The child of a married general and the domestic help of the Stone family, Genet struggles to find an identity for herself and a place in a world where she is educated as though she is Marion and Shiva’s sister but treated with disdain for her illegitimacy and, later, her father’s participation in the revolution. Her mother, Rosina, desperately attempts to hold onto Genet’s paternal ancestry allowing her daughter’s face to be cut so Genet will bare the marks of her father’s people over Hema’s objections. Meanwhile, Marion attempts to cast her as the mother of his future children clinging to the idea that they are soulmates with the rights to each other’s virginity.

When Genet has sex for the first time with someone other than Marion, he throws Genet out of his life and Rosina hires a woman to perform genital mutational on her daughter . Marion’s reaction to Genet, particularly during their reunion later in the novel, is difficult to understand or tolerate, and I am terribly troubled by the implication for the reader that Genet caused the ending of the novel.

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