Wednesday, June 24, 2009

Book Review: Cutting for Stone

I have to start by clearing up the confusion I had with Abraham Verghese's title, Cutting for Stone. As the book mentions several times but never precisely explains, the reference is to the Hippocratic Oath, "I will not cut for stone." However I had to look it up in Wikipedia to find the meaning, which is probably apparent to medical professionals. It was a prohibition from operating on stones, or calcified deposits, in the kidney or bladder. The ancient Greeks apparently thought surgeons should leave this menial procedure to barbers. The modern meaning seems to be that doctors should recognize they can't specialize in all areas. But I'd say closer to the original intent, and perhaps more relevant to today's medicine, would be: "I won't perform treatments just for the sake of making money."

Okay, I got that off my chest!

The title has at least a double meaning. The story flows from the unlikely and surprising conception of a pair of twins by an English surgeon, Thomas Stone, and an Indian-born nun, Sister Mary Praise, in Ethiopia in the mid-twentieth century. The story is narrated by one of the twins, Marion, who eventually becomes a surgeon himself.

Verghese is likewise a practicing surgeon, now living in the U.S., who grew up in Ethiopia. His account seems autobiographical, but much of it is invented, as he explains in detail in his Acknowledgments.

If I say too much about this book, I'll have to throw in a lot of spoilers, and suspense has its delicious rewards in this leisurely paced plot. So I won't. Suffice it to say, I believe your patience with Verghese will be rewarded.

I heard him speak at a book signing at an Ethiopian restaurant in Los Angeles, and he mentioned that he admired W. Somerset Maugham. This book does remind me of Cakes and Ale, in more ways than one, including the crafting of its sentences. (Maugham also studied medicine.) It's not the page-turning, plain-vanilla, cliffhanger prose of Tom Clancy or Dan Brown. It's thoughtful, colorful, and literary. Slow down and enjoy it.

This novel is about family, community, betrayal, parental love and estrangement, sibling bonding and rivalry, personal bravery, not-so-uncommon acts of kindness, the heroic practice of medicine, suffering and compassion--and irony.

Lots of irony.

Cutting for Stone is selling well, so lots of other people must think it's worthwhile. The story doesn't read like a movie plot, but neither does The English Patient. Yes, this book is that big--in its scope and its ambitions, and in the magnitude of its achievement.