Cutting for Stone

by Abraham Verghese

Disappearing bookstores notwithstanding, contemporary novels are a dime-a-dozen.  Most, in my opinion, are not worth your time; but every year a handful of truly great works of fiction rises – like cream – to the top.  Cutting for Stone, published in 2009, is one such book.   To summarize in one sentence: it is about becoming a whole person by embracing every aspect of one’s self.  A powerful quote from the book explains that “[t]he key to your happiness is to … own who you are, own how you look, own your family, own the talents you have, and own the ones you don’t.”   To develop this idea of owning one’s self, Abraham Verghese takes the reader on a journey through the life of an Anglo-Indian man, born and raised in Ethiopia, who eventually becomes a trauma surgeon in New York City.  There is so much information, insight, and wisdom in this book that it gets better with each reading.

A good book, in my opinion, is one that forces me to consult my dictionary throughout the reading.  If I need to consult a globe and a world almanac, the book rises even higher in my estimation.  Finally, what lifts a book into the category of literature is how it references great works which have come before.  Quotes from Shakespeare are easy to spot, but there are other great thinkers and writers – representing the accumulation of human civilization – whose influence we are less aware of and to whom a great writer pays homage. 

In addition to telling a good story, Abraham Verghese uses the English language to give depth and significance to themes and motifs used throughout Cutting for Stone.  To begin with, the author assigns several meanings to the title:  the last name of the main character and his twin is Stone.  Bernini, one of the world’s greatest stone cutters, has a part in the book, too.  The main character and his twin represent duality as well as cohesion:  they start out conjoined, are surgically divided,  then emotionally separated, and finally reconnected in a profoundly spiritual way.  Parenthood is another theme which Abraham Verghese explores in depth.  The boys’ adoptive parents create a beautiful and loving family which their birth parents could never have provided.  Despite being identical twins, Marion and Shiva are opposites, or mirror images of each other.  Where Marion is curious, sensitive, and ethical, Shiva is experimental, analytical, and mechanical in their respective approaches to life. Surgery, i.e., cutting people open, is one of the main themes.   Verghese uses holes as a metaphor for openings, injuries, losses, and areas of potential growth.  The creation and repair of different types of holes, through surgery and other means, occupy each of the main characters throughout the book.  

Cutting for Stone is initially set in Ethiopia, a nation with an interesting history going back some 400,000 years – to the dawn of man.  Modern Ethiopia, as we recognize it today, became a monarchy in the late 1800s under the rule of Emperor Abeto Menelik.  To strengthen his imperialist aims, this emperor entered into a treaty with Italy which permitted Italy to occupy Eretria in exchange for the Italians’ recognition of Ethiopia as a sovereign nation as well as to provide Menelik with arms and security forces to quash any threats to his power.  Before the treaty could be ratified, the Italians quickly took advantage of their military position in Eretria and began encroaching into Ethiopian territory.  Despite having lost 30 per cent of its population due to the Great Ethiopian Famine (1888-1892), Ethiopia handily routed the Italians in what is still considered their finest hour.  In 1935, Italy invaded Ethiopia again and this hostile action elevated then emperor, Haile Selassie, to the world stage where he successfully asked the League of Nations to intervene.  By 1941, the Italian occupiers were gone.  Eretria, however, remained a British Protectorate until 1951, and then it was policed by Ethiopian troops in a caretaking role.  

Eretrians bitterly opposed Ethiopian rule but were so divided by their religious alliances that they had no ability to unify and fight for independence.  When the warring factions began attacking the Ethiopian occupiers in 1962 – the year that Marion and Shiva were born – Haile Selassie shuttered the Eretrian parliament and seized control of the region.  From inside the sanctuary of the mission hospital, the boys witnessed Haile Selassie devolve from hero to despot.  In 1974, a Soviet-backed coup ousted Haile Selassie and replaced him with the brutal dictator, Mengistu Haile Mariam, who cracked down hard on Eretrian separatists and anyone remotely associated with them.   Ragtag insurgent groups formed and hid out in unpopulated mountain ranges in order to commit terrorist acts against Ethiopia.  A climate of suspicion and paranoia permeated Addis Ababa during this time, when friendships and political alliances could be beneficial one day and grounds for execution by hanging the next. 

The story of Marion and Shiva begins when a young Carmelite nun leaves India to spread Christianity in Yemen.  She endures this harrowing ocean voyage – from Madras to Aden – through stormy seas by nursing a young doctor back to health from debilitating seasickness so that he can treat the other passengers, who have contracted typhoid fever.  Doctor and nun work tirelessly to save their patients and discover that together they accomplish more than they could as individuals (the whole being greater than the sum of the parts).  At the end of the sea voyage, the doctor expresses a wish that Sister would be his operating room assistant in Addis Ababa, but she has orders to stay in Yemen and so they part ways. 

This doctor, Thomas Stone, left India for Ethiopia after Indian Independence limited the potential for a white Englishman to pursue a medical career and live in the country safely.  Sister Mary Joseph Praise, an Indian by birth, wanted to stay but was ordered by her Mother Superior to save Arabic souls through medicine.  When she arrived at the mission hospital in Addis Ababa, many months later, she had been through a trauma about which she could not and would not speak.  Sister Mary Joseph Praise found peace in the operating room of the mission hospital assisting Dr. Thomas Stone and serving him so perfectly that she was essentially his right hand.  On the day she failed to show up for work, Dr. Stone fell apart and his patient died as a result.

The title, “Cutting for Stone” comes from the original Hippocratic Oath that physicians – as opposed to surgeons – took in ancient Greece.  Physicians swore to heal patients through nourishment and medicine and to leave surgery – i.e., cutting for kidney stones – to the surgeons (whose patients usually died the same day).  No one at the mission hospital had noticed that Sister Mary Joseph Praise was pregnant until she went into labor.  The resident obstetrician, Dr. Kalpana Hemlatha, was traveling on the day of the twins’ birth, so the caesarean section fell to Dr. Stone to perform, except that he was constrained by his own rule not to operate on the day of the patient’s death.  Rather, he thought to abort what he assumed was a single baby in an effort to save the mother, his implicit other half.  Fortunately, Dr. Hema returned in time to stop the abortion but not the death of the mother.   Devastated, Dr. Stone fled Ethiopia leaving his sons orphans.  The gaping hole in their world needed to be filled:  Hema became a wife and mother and Dr. Abhi Ghosh, who had long dreamed of marrying Hema, had his dearest wish fulfilled.  Two people left, two new people arrived, and a family was formed,  all in an instant.  

Hema easily cut Marion and Shiva’s physical connection, barely more than a membrane;  even so, for years they would sleep with their heads touching.  The boys seemed to share a spiritual connection as if the two together made a single complete person.  In their late teens, however, Shiva hurt Marion so deeply that he tried to eliminate his twin from his life and the two lives diverged.  Their adoptive parents recognized that the boys had some bad blood between them concerning their “sister” Genet, an Eritrean girl whose mother worked for the family, but blamed Marion for the trouble that eventually befell the young Muslim girl. 

While Marion excelled at scholarship, Shiva was unable to tolerate academia and dropped out of school. He learned the intricacies of female anatomy in order to repair obstetric fistulae by working with Hema as she delivered babies and performed gynecological surgeries.  In countries such as Ethiopia, where female circumcision and young brides are common, prenatal care is rare; and obstetric fistulae are a frequent and devastating problem.  The unfortunate women suffering from this condition leak urine and feces continually.  They become pariahs whose husbands reject them and whose families of origin refuse to take them back.  Shiva witnessed a young girl with this condition and it set the course of his life.

Cutting for Stone is an ambitious novel which allows Abraham Verghese  to show his virtuosic ability to weave history, geography, medicine, religion, and politics together with family relationships, friendships, ethics, humanity, and spirituality.   It is a beautiful story, beautifully crafted, and definitely worth your time.  Don’t be intimidated by words you cannot pronounce and facts you do not know.  Own these holes in your education and fill them with knowledge, because “the greatest sin is not finding … what God made possible in you.” 

Copyright 2012 Teresa Friedlander, all rights reserved

Siddhartha

Siddhartha by Hermann Hesse

Book review by Teresa Friedlander, copyright 2010


There has never been a point in history when the “human condition” was universally good. Whether the enemy is our environment, each other, or ourselves, human beings haven’t found a way to eliminate suffering in the 20,000 or so years we have been on earth. Even at the height of the Renaissance, the plague swept through Europe while monarchs and bishops practiced politics by arranging for heads to be separated from bodies, villages to be sacked, and the poor to starve. And yet, there have always been a few beautiful souls who recognized that our species could be so much better than we are by being better to each other. Jesus, Mohammad, and the Buddha taught (and continue to teach) how we can find the good within ourselves, so that we might transcend the suffering and baseness of our earthly lives. The world’s great religions – Christianity, Islam, Buddhism, and Judaism – promise salvation, eternal rest, paradise, or enlightenment as a reward for rising above greed, hatred, vanity, lust, gluttony, and envy.

Siddhartha is the wealthy scion of an important Indian family who dutifully learns his lessons and religious practices in order that he continue his family’s Brahmin legacy. The young man typifies the person who “has it all” but one day realizes that he feels empty inside. Rather than attempt to fill his emptiness with pleasures of the body, Siddhartha decides to quit his family and his caste to go searching for a path to enlightenment. At first Siddhartha believes that ascetism will make him more holy, but after a time he realizes that denying the body is itself a form of vanity. He leaves the ascetics and joins up with followers of the Buddha. Buddhists are more accepting of the body’s physical needs, but Siddhartha finds irreconcilable logic problems in their belief system. Weary of his quest, Siddhartha succumbs to the attraction of a beautiful and demanding woman. In order to win her, Siddhartha learns how to amass riches by apprenticing himself to a successful merchant. He becomes quite wealthy and after several years of hedonism, Siddhartha realizes that he can have anything he wants and he can make others do his bidding: his life has become a game. Once again, he walks away. At the end of the story, after following a zig-zag path from one extreme to the other, Siddhartha discovers that the secret to enlightenment is within himself and that only by letting go of people, possessions, and expectations can he get there.

Hermann Hesse (1877-1962), best known for Steppenwolf, published Siddhartha in 1922. As a boy, Hermann was psychologically troubled, prone to tantrums and oppositional behavior, and at times suicidal. He bridled under his parents’ strict upbringing and did not share their Lutheran faith. Hermann sought better answers to life’s mysteries and paradoxes by reading the works of great European thinkers including Arthur Schopenhauer, Johann Wolfgang von Goethe, Gotthold Ephraim Lessing, and Friedrich Schiller. Because of his parents’ missionary work in India, Hermann had access to Indian artifacts, literature, and art. This fueled a fascination with that culture and an interest in Buddhism.

In 1894, at age seventeen, Hermann Hesse became an apprentice mechanic; work he found so soul-killing that he began studying spiritualism in earnest. After completing his apprenticeship, Mr. Hesse supported himself by working for a series of book stores, and began writing in his free time. His first book, Peter Carmenzind, published in 1904, was so successful that Mr. Hesse was able to live off the proceeds. In that same year, he married Maria Bernoulli and they settled in a small German town on the shores of Lake Constance.

Mrs. Hesse bore three sons while Mr. Hesse continued to write. It was during this time that Mr. Hesse began reading Schopenhauer’s works on Theosophy (religious philosophy and studies of the unknown and unknowable) which were influenced by Buddhism. As his thinking evolved, his marriage fell apart and Mr. Hesse embarked on a spiritual quest to Sri Lanka and Indonesia. While he found no answers to his questions, Hermann Hesse did find inspiration for his writing, and published Rosshalde in 1914.

During the build-up to World War I, Mr. Hesse became troubled by a growing movement of fanatic patriotism in Germany, but voluntarily enlisted in the Imperial Army out of a sense of duty. Due to poor eyesight, he was not allowed to fight and instead was assigned to look after prisoners of war. Shortly thereafter, Mr. Hesse published an essay entitled “O Freunde, nicht diese Töne” (Oh Friends, Not These Tones), decrying the nationalistic patriotism which preached German superiority and hatred of non-Germans. This essay, while important, made Mr. Hesse a pariah; he began receiving hate mail and found himself - unhappily - in the public eye. During the same period, his father died and his wife became schizophrenic. The pressure was too much and Hermann Hesse, himself, suffered a psychiatric breakdown.

Mr. Hesse’s breakdown and institutionalization coincided with the advent of psychology and psychoanalysis, and he became acquainted with Carl Jung, a contemporary of Sigmund Freud. Jung believed that within each human psyche there are echoes of a collective consciousness which make certain symbols universally meaningful and explain common thought patterns across cultures. It is as if each of us is born with memories created by our ancestors which replay in our dreams. Mr. Hesse’s experience with Jungian psychoanalysis enabled his spiritual beliefs and his quest for self-actualization to coalesce. Siddhartha and Steppenwolf, his two most famous books, describe respectively, a spiritual quest and a semi-autobiographical examination of a disintegrated personality. Hermann Hesse found the world of humans to be complex and frustrating and had difficulty making sense of life. While he felt alone in his struggles, his writing reflected the zeitgeist (spirit of the time) which had undercurrents of confusion, depression, and fear. Mr. Hesse believed that enlightenment would change the zeitgeist and thereby enable humanity to advance.

Enlightenment, according to Buddhism, is to be free from greed, hatred, and delusion, and only by achieving enlightenment can one find pure peace and happiness. But what would happen if everyone on earth suddenly achieved enlightenment? Thieves would stop stealing, wars and feuds would cease, and we would accept ourselves as we truly are. We might all join hands and celebrate our collective bliss by chanting “Om”. So far, so good. However, without greed, no one would want to work; without hatred, no one would have passion; and without delusion, there would be no art, literature, or fashion. The world of humans would grind to a halt and we would starve or freeze to death. We would, however, be experiencing a state of bliss. And then what?

There is something very satisfying about the daily struggles we must all endure, whether it is to get a bite of food, to stay warm (or cool), to find comfort, to finish a job, to make something, to sell something or simply get through another day. If we were all perfectly content in our present moment, doing nothing but being, life would be meaningless. And so, we must go on loving/hating, giving/taking, laughing/crying, birthing/dying. As long as we retain our living bodies, we are bound to life on earth and all that entails. What awaits us after death is unknown and unknowable, but most of us believe that how we conduct our lives will send our souls in one direction or another. To reach heaven or to achieve enlightenment requires giving up wealth, comfort, competition, vanity, and social hierarchies. That is a tall order for most of us.

Siddhartha spent a lifetime trying to become enlightened, learning important lessons each step of the way. It was only when he stopped trying and let go of everything that he finally understood the simple, pure beauty of enlightenment. Most of us go through life moment to moment – growing up, having children, trying to grab the brass ring, growing old, and dying. Some of us achieve a degree of wisdom, but most of us live lives “of quiet desperation”. What Hermann Hesse understood and communicated through his most important books, especially Siddhartha, was that in order to improve the “human condition” we need to act collectively to reduce suffering, and that requires that the human species become more enlightened. Whether we can, or will, depends on each and every one of us. Om.