Cutting for Stone

“As she bent over the child she realized that the tragedy of death had to do entirely with what was left unfulfilled. She was ashamed that such a simple insight should have eluded her all these years. Make something beautiful of your life. Wasn’t that the adage Sister Mary Joseph Praise lived by?”

Hema is flying home to Ethiopia after visiting her family in India when her plane seems as if it is going to crash. A child breaks his leg as a result of the plane’s steep dive, and she is caring for him. During this near-death experience, Hema reevaluates her life, including her relationship with Ghosh, using Sister Mary Joseph’s philosophy as a guiding principle. Throughout the novel, Sister’s influence is felt long after her death by all the members of the Missing community.

“Daring operations performed in darkest Africa—that was how the publisher had described the book on the back cover. The reader, knowing nothing about the ‘dark continent,’ filled in the blanks, pictured Stone in a tent, a kerosene lamp held up by a Hottentot providing the only light, elephants stampeding outside while the good doctor recited Cicero and excised a part of himself as blithely as if he were cutting for stone on the body of another.”

Thomas Stone’s book is the accumulated wisdom from his practice in India and Africa, including his experience amputating his own finger. The publisher’s description, however, shows the perception of Africa as dangerous and primitive, and it romanticizes the white author’s actions and perceived superiority. Marion’s interpretation of the publisher’s text shows his understanding of outside perspectives on Africa and his disdain of the ignorance exposed therein.

“In that gesture she slipped off the mantle of the traveler and put on that of the obstetrician. The task ahead, however difficult, dangerous, or unpleasant, was hers and hers alone.”

Hema returns to Missing and is immediately faced with Sister’s difficult birth. Her expertise is reflected in her ability to compartmentalize at a moment’s notice. She accepts not only the task but also the responsibility for the outcome. This ritual might be one that Hema engages in every time she performs surgery.

“Prisoners they all were, Matron thought, smiling despite herself; Missing People who could hardly choose their cellmates.”

At the beginning of the novel, Verghese introduces the Missing community through Matron’s perspective. She has built Missing up from nothing and loves every member of the community. At the same time, she sees them all as having exiled themselves from the rest of the world. This realization is tempered by humor and the understanding of the “Missing People” as a family.

“He had negotiated his way through life by work, and work, and more work. It was the only arena in which he felt complete and the only thing he had to give Sister Mary Joseph Praise. But at this moment work had failed him.”

Thomas Stone fails to save Sister Mary Joseph, and in the process, he nearly kills the twins as well. Throughout his life, he has placed his faith in medicine; in this case, medicine has failed him. This results in a crisis of faith that prompts Thomas to disappear from Missing and from the children’s lives.

“From her lips had come the kind of fundamental truth which, because of its simplicity, was unspoken in a church like Harris’s where internecine squabbling seemed to be the purpose for the committee’s existence, as well as a manifestation of faith.”

Eli Harris, a visiting donor from Houston, Texas, has failed to establish a mission in Oromo, which Matron warned him against. When he attempts to justify his church’s actions, Matron peels back the politics of the religion that his church espouses to get to what matters. Harris realizes that Matron’s religion is practical, whereas his is mainly theoretical, and he is ashamed.

“What we are fighting isn’t godlessness—this is the most godly country on earth. We aren’t even fighting disease. It’s poverty. Money for food, medicines…that helps. When we cannot cure or save a life, our patients can at least feel cared for. It should be a basic human right.”

Matron receives funding from several sources for Missing Hospital, including a Baptist group in Houston, Texas. When Eli Harris arrives, Matron reprimands him and his well-meaning congregation, revealing the gap between what outsiders think Ethiopia needs and what Ethiopia truly needs. Their fundamental misunderstanding of the country is highlighted by Eli’s ignorance about Ethiopia’s Christian tradition being hundreds of years older than his own.

“In that fugue state between wakefulness and dreaming, the song I hear is not Rosina’s. It is ‘Tizita,’ which Almaz sang when I held her breast.”

“Tizita,” a popular Ethiopian song, is a motif that runs throughout Marion’s life, beginning with these earliest memories of Almaz. When Marion leaves Addis Ababa, the song becomes a touchstone for him, reminding him of home. In addition, he uses “Tizita” to connect with other Ethiopians while living in America.

“I became the first to breathe—senior by a few seconds. I also became spokesperson for ShivaMarion.”

Throughout the novel, Marion and Shiva gradually separate and then become one again. At the beginning of their lives, they are viewed as one entity by everyone around them, and Marion dubs that entity ShivaMarion. As the novel continues, ShivaMarion begins to separate and is torn apart, only to be brought back together at the end of the story.

“The unexpected clubbing of the old woman, seconds after the Emperor had greeted us so warmly, felt like a betrayal, and with it came the shock of knowing that Hema and Ghosh were powerless to help [...] From that day forth I had a new perception of the Emperor, and of Lulu.”

When an elderly woman throws a shoe at the Emperor’s car, the police beat her mercilessly. Marion and his family witness the beating, and afterward, Marion’s perception of the Emperor changes. His view becomes less childlike and more nuanced. In addition, he recognizes that his parents’ power is limited—the realization of a child becoming an adult.

“How exciting to be able to touch a human being with one’s fingertips and know all these things about them. I said as much to Ghosh, and from his expression you would think I’d said something profound.”

When he first begins following and observing Ghosh at Missing Hospital, Marion is stunned by Ghosh’s knowledge and diagnostic ability. With this quote, the reader sees the true beginning of Marion’s fascination with medicine. His comment is made in wonder, and Ghosh is able to see the powers of medicine anew through Marion’s eyes.

“General Mebratu was our hero, a dashing figure who could do no wrong. The Emperor had lost some of his glow for us. But I never expected this of the General—was this a betrayal, a dark side of his that had emerged? Or was he doing the right thing?”

When Marion hears news of the coup, he is confused by the complexity of what is happening. He meditates on the complicated issue of right and wrong. Mebratu is leading the coup, which seems like the action of a bad man. However, he also has a new perspective on the Emperor, who he is not sure is a good man. Marion also knows Mebratu personally and likes him, as does Ghosh, whose opinion he greatly respects.

“Later we found out that similar scenes were playing out all over the city. It was an early lesson in medicine. Sometimes, if you think you’re sick, you will be.”

When Hema hears that the water supply is poisoned, she becomes violently ill after drinking a glass. This leads to an important lesson for Marion about the power of the mind over the body, and the psychosomatic symptoms that can result from fear.

“This was my country they were talking about, the land of my birth. True, its potential for violence and mayhem had been proved. But it was still home. How much worse would it be to be tortured in a land that wasn’t your own?”

Marion overhears Hema and Ghosh talking about leaving Ethiopia in light of the political unrest. He realizes that although Ethiopia is his homeland, it is not Hema’s or Ghosh’s. Marion also realizes that Ghosh was tortured in a foreign country and cannot hold much love for Ethiopia as a result.

“Rain was familiar. But this balancing on the edge of feelings so powerful they seemed capable of making me fly, this was a revelation.”

Marion has just been offered sex by the probationer, and he refuses her. After leaving, he wonders at the tumult of emotions he is experiencing. Marion is determined to wait to have sex with Genet and yet is drawn by the probationer’s offer. He is just becoming interested in sex, and he is naive about it.

“The passing years hadn’t taken away from me the weight of what had happened at this spot; but the fear had become familiar. I understood what made people confess to murder years after the fact; they believed that it was the only way to cease tormenting themselves.”

During the confusing time of the coup, Marion accidentally kills a man. Because it happens near his home, he is constantly reminded of his guilt and cannot tell anyone. Verghese examines the weight of guilt here, as well as the healing powers of absolution.

“At the moment he died I felt the mantle of responsibility pass from him to me. He’d anticipated that. I remembered his advice to wear that mantle lightly. He’d handed me the professional baton, wanted me to be the kind of doctor who would surpass him, and then pass on that same knowledge to my children and to their children, a chain.”

Marion feels that he must carry on with Ghosh’s responsibilities after his death. Ghosh’s anticipation of this obligation shows what a good father he was, encouraging Marion to make his own way in the world. In the novel, Ghosh is truly Marion’s father, supporting, encouraging, and educating him while allowing him to make his own decisions and mistakes.

“We were both exhausted, dazed, unprepared for the sea of faces scrutinizing us. We stood there, manila X-ray folders (a requirement for immigration which no one checked) clutched awkwardly, baggage straps crisscrossing our chests, wide-eyes like animals coming off the Ark.”

Marion arrives in America and is waiting in customs with another woman from his flight. Verghese illustrates the shock and disorientation of arriving in US Customs. The comment about the unchecked X-rays offers a perspective on the endless bureaucracy and requirements involved in immigrating to America.

“You can be a cretin, but if you have the Queen’s accent, next thing you know you are on Johnny Carson and he’ll laugh at anything you say.”

One of Marion’s colleagues, B.C. Gandhi, states a truth he has come to understand after living in America for a while. Although he is Indian, he is accorded more respect than many of his fellow doctors because of his British accent. This is just one example of the injustice that Marion and his colleagues, who are all highly qualified, experience when they practice in America.

“I’d discovered Thomas Stone in the text, just as he must have discovered himself in the discipline of making notes in a landscape of disease and poverty, overcoming his fatigue to fill exercise books with his observations. I was convinced that it was the accumulation of these journals that he pulled together to form a textbook. In doing so, he made his knowledge incarnate.”

Marion first gets to know his father through Thomas’s book, which Shiva gives to him. By studying Thomas’s progress, Marion learns about his father as well. He realizes that by documenting his learning, discoveries, and progress, Thomas has externalized his knowledge, separated it from himself, and turned it into an educational tool.

“He believes the only virtues passed down to him were the virtues of his profession, and they came through books and by apprenticeship. The only suffering that interested him was that of the flesh. For the heartache and the grief of his own loss, he had found the cure and he’d found it by himself. Ross had it wrong, or so Thomas thought: perfection of the life came from perfection of the work.”

When Marion and Thomas finally talk, Thomas tells the story of his life. Marion realizes that Thomas, at a young age, decided that his life would revolve around work, an attitude that resulted in great skill and discoveries in his field. After hearing his story, Marion begins to feel compassion for Thomas, which allows him to eventually have a relationship with him, however distant.

“This was a Pyrrhic victory. A pyrexic victory—the thermometer I slid under her armpit read one hundred three degrees.”

When Genet shows up on Marion’s doorstep, he at last sees an opportunity to vent his anger. But she is ill, and he ends up caring for her. A “Pyrrhic victory” is one in which the losses outweigh the gains, and victory becomes defeat. Marion realizes that while he wished Genet would be punished, he never wanted her to be in such a state. “Pyrexic,” on the other hand, means feverish, a literal translation of Genet’s condition.

“‘I realized that if something happens to him, it happens to me, too. If I love myself, I love him, for we are one. That makes it a risk worth taking for me—it wouldn’t be for anyone else, unless they loved him.”

Shiva has decided to donate part of his liver to Marion and is explaining his reasoning: He is acting as Marion would. He finally understands the connection that they have always had. Throughout their lives, Shiva has held himself apart, but with this operation, he is reaching out to mend the rift between himself and Marion.