Having picked over the details of his real life in two acclaimed memoirs (My Own Country and The Tennis Partner), Dr. Abraham Verghese approaches his first work of fiction like an Amish kid on rumspringa. Verghese’s Cutting For Stone is a sprawling, undisciplined book, spanning decades and continents, and encompassing a multitude of genres. In telling the story of a pair of identical twins growing up in Ethiopia, Verghese cycles through tragedy, historical romance, political thriller, and clinical neo-realism, all in a prose style that’s laudable in its poetic exactitude, but frustrating in its bulk. Given the chance to invent, Verghese apparently can’t stop himself from piling on.
Yet Cutting For Stone is so involving that it’s hard to fault Verghese too much. The book is narrated by Marion Stone, one of a pair of twins born in the early ’60s to an aloof British surgeon and a secretive Indian nun. The nun dies in childbirth; the surgeon promptly flees. Born conjoined, the boys are separated, but they share an almost telepathic bond throughout a childhood spent in and around a low-tech African hospital. They both grow up to be doctors, although Marion’s brother Shiva—who has a not-quite-in-sync-with-humanity condition akin to Asperger’s—never formalizes his studies. Both also share a romantic interest in their maid’s daughter Genet, who grows up alongside them and eventually drives the brothers apart, prompting Marion to move to New York.
At several points during Cutting For Stone, Marion describes complicated operations in gruesome detail. Verghese includes these scenes because he knows about such things firsthand, but also because they promote the book’s main theme. Verghese is interested in connectivity and fate: how the actions of one person have an impact on other people’s lives, much as a tumor in one part of the body can generate symptoms elsewhere. Verghese’s meticulousness in exploring Marion’s story requires digressions to cover Ethiopian politics and American internship programs, as well as multiple subplots that affect the main narrative only tangentially. Finally, in the final 100 pages, Verghese runs Marion and his family through the wringer, with one crisis and emotional climax after another. It’s all too much, yet even as an author, Verghese holds to his Hippocratic Oath. He will not cut for stone, even for patients in whom the disease is manifest.