Cutting the Stone
Abraham Verghese
(Alfred A. Knopf)
The hospital's name there in Addis Ababa is "Missing." It was supposed to be Mission, but the clerk in the Ethiopian Ministry of Health had trouble writing the English word so it came out "Missing." And so it would always be the "Missing Hospital."

Back at the beginning, in 1955, it had three doctors, Dr. Ghosh, an expert on Venereal Disease; the OB/GYN specialist, Hema, from Madras; and Thomas Stone, a crack surgeon. Dr. Stone's assistant was Sister Mary Joseph Praise, and the surgeon somehow got her with twins: Shiva and Marion, both boys, both destined to become doctors themselves (the last named after Dr. Marion Sims, of Montgomery, Alabama, 1849 ... the inventor of a procedure for repairing "vaginal fistula.")

If you don't like medicine, you'll love Cutting for Stone. It is, for the most part, about being a doctor during the life and times of dictator Haile Selassie. It's crammed with odd lore about Ethiopia, medicine, diseases, third-world practice, and the various looks and stinks of sickness:

    The musty ammoniacal reek of liver failure came with yellow eyes and in the rainy season; the freshly baked bread scent of typhoid fever was year-round and then the eyes were anxious, porcelain white. The sewer breath of lung abscess, the grapelike odor of a Pseudomonas-infected burn, the stale urine scent of kidney failure, the old beer smell of scrofula --- the list was huge.

Verghese is expert with the sounds and hues of disease and dying. A patient in a diabetic coma? "His breathing was deep, loud, and sighing, like an overworked locomotive. With every exhalation he gave off that sweet emanation --- it even had a color: red."

When Hema goes for emergencies at night, she mutters cryptic phrases to the boys, "eclampsia" or "post-partum hemorrhage" or, "that most chilling term of all, the 'Delayed Afterbird.' That one wasn't even in the medical dictionary."

§     §     §

This is compelling writing, but odd. Odd because one could hardly expect an author to become involved with such rare subjects as the invention of coffee, the roiled politics of mid-century Ethiopia, the god Ramakrishna, or the physical surroundings of Addis Ababa.

Part has to do with Verghese's ability with mere words, to pull off the telling of such exotic subjects: sailing across the stormy Indian sea; the structure of a third-world hospital in a capital city; how to perform a vasectomy ("If you don't want the scrotum to shrivel up, and the balls to retreat to the armpit, the room has to be really warm ... I recommend an ounce of Johnny Walker Red or Black.")

    A wonderful relaxant. And yes, you might give one to the patient, too.

But it's not all prolapse and life-saving. Cutting for Stone goes into hypotension at the mid-point. Dr. Marion goes to practice medicine in New York City, and we are told that he is still a virgin all though medical school and ten years in Manhattan.

Verghese says so, and he's the boss, but the key love interest, his half-sister Genet (turned twiggy, addicted to heroin) hardly seems worth the candle to the rest of us. Marion's naggy passion during a chance meeting with her in Gotham, turns feral:

    It was good she didn't look, because if she'd so much as blinked, I would have bit into her jugular, I would have consumed her, bones, teeth, and hair, leaving nothing of her on the street.

Some can make do with love, passion, obsession; some can't. But just as the story starts to fold, the old medical lore pops up and you are tempted to ring up Verghese there in Stanford to seek a quick consultation: "should I do something about the tingling in the toes, the ringing in the ears?" He's that good.

Here he is on boozers: "A drunk named Jones looked eerily like his father; Thomas realized it was the waxy complexion, the swollen parotids, the loss of the outer third of the eyebrows, and the puffy eyelids of alcoholism that gave both men a leonine appearance ... red palms, the starburst of capillaries on cheek and neck, the womanly breasts, and the absence of armpit hair."

The title of this novel is a character, and a warning from Hippocrates: "I will not cut for stone."

It is, too, the name of a flawed but fascinating read.

--- Lolita Lark
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