Medicine as Art: A Few Thoughts on Cutting for Stone by Abraham Verghase

No spoiler information is contained in this post.

A good book. A page turner. I love when I get my hands on one. But I must admit, I am the type of person who can put a good book down. It is always with guilt and regret, but I get distracted by other books, spend too much blogging instead of reading, or just fiddle around with my kids. Sometimes it can take me months to read books that are compelling and I never make it through books that do not grab me.

So, I must admit that I was a little surprised when I read the 658 page novel Cutting for Stone by Abraham Verghese in three days. To say this spellbinding, captivating novel is a page tuner is a crude understatement. Cutting for Stone is a gripping epic that sweeps through six decades and three continents, making the reader part of the powerful and heartrending journey.

Verghese’s debut work of literary fiction is so far-reaching in scope and depth that it cannot be pigeonholed into one genre. There is a touch a mystery, much romance, tons of action, many thrills, a tremendous amount of humor, a plethora of heartbreak, a multitude of surgical drama and most importantly, luminous storytelling.

Despite the high page count and larger-than-life story, the plot of the novel is really quite simple. A beautiful Indian nun who works in a hospital in Ethiopia conceals her pregnancy for nearly nine months, suddenly goes into labor, and gives birth to twins in the middle of night. She dies immediately following the birth which results in the twins’ distraught father (a brilliant British surgeon who was unaware of the pregnancy) to flee the country minutes after the birth. Left behind are twin boys, Marion and Shiva who both eventually embark on careers in medicine after being raised by two kindhearted, loving, compassionate doctors and their zany support staff --a bunch of madcap, doting characters similar to those found in a Dickens novel.

Unlike a Dickens novel, Verghese writes fully developed character histories that are meticulously recounted by Marion, the biological son of surgeon Thomas Stone and Sister Mary Joseph Praise and the adopted son of Hema and Gosh. With meticulous detail, Marion reveals what he knows about the mystery surrounding the twins' conception, their birth, their mother’s death and the disappearance of their father, which propels the action of the novel that unfolds into a saga about family, coming of age, betrayal, love, loss, social unrest, medicine, forgiveness and redemption.

If Stone’s abandonment and betrayal is the stimulus of the first portion of the novel, Shiva’s betrayal of Marion and all the events that spiral out of control after the betrayal drives the latter part of the novel. Secrets, lies, impulsiveness, insensitivity, and selfishness run as rampant in this novel as does kindness, compassion, healing, tenderness, passion and love. Just about every human emotion is rendered eloquently and believably. Verghase is a master at capturing the human spirit without relying on clichés and sappiness. He successfully manages to balance good and evil; life and death; mysticism and realism; and medical care and human acts of comfort.

Balance is a trick that Verghase seems to know well since by profession he is both a doctor and a writer (published two memoirs prior to his work of fiction). It is through his fiction writing that he is able to offer profound observations about and scathing accusations towards the field of medicine. Throughout the novel, he takes a strong line that doctors need to see patients as humans with one doctor asking: “What treatment in an emergency is administered by ear?” After a long silence in a room filled with medical practitioners, another doctor responds, “Words of comfort.”

Comfort -- this is precisely what Verghase offers his readers although he gives a lot of discomfort, upheaval, distress and agony too. But no matter if he is providing details on a bowel removal, discussing the foul smell associated with young women with fistula or explaining the motivation of Eritrean guerrilla fighters, Verghase wastes no words, finds beauty in grotesqueness and makes art out of science.

Verghase is a truly masterful novelist who pulls his readers into a lush and thrilling world where emotions and empiricism commingle beautifully to make a whirlwind saga that holds the reader captive until the end. Cutting for Stone is truly a marvel of a novel.

Is It a Good Book or Just Good for Me?

For librarians and readers with advanced degrees in English, literary fiction is like porn; you know it when you see it. For folks who have lives outside the pages of books, literary fiction is not as easily recognizable. Unlike genres such as mystery, science fiction, romance and chick lit., there are no specific techniques that govern and easily distinguish it.

At its best, literary fiction makes you grow smart exponentially with its big words and deeper psychological, sociological, or historical context. But at its worse, literary fiction feels like school and is just plain boring.

Here are some basic guidelines to help you determine if it is literary fiction:

· Beach Read – NO

· Anything with a pink or mint green cover -- NO

· Award Winner – YES (except for the genre awards in mystery, horror and western writing)

· You need to have a dictionary nearby to understand what you are reading -- YES

· The sentences are long and fluid with advanced punctuation techniques like semi-colons and ellipses – YES

· A New Times Best Seller – Typically NO, Occasionally YES

· A book sold at the check-out counter at Wal-Mart – NO

· A book for adults that your third grader can read with ease -- NO

· Novels about vampires – Typically NO for Contemporary Works Maybe YES for Gothic Novels

· James Patterson – HELL NO