Monday, April 12, 2010
23. CUTTING for STONE
Abraham Verghese 2009
The Book Blurb:
Marion and Shiva Stone are twin brothers born of a secret union between a beautiful Indian nun and a brash British surgeon. Orphaned by their mother's death and their father's disappearance, bound together by a preternatural connection and a shared fascination with medicine, the twins come of age as Ethiopia hovers on the brink of revolution.
Moving from Addis Ababa to New York City and back again, Cutting for Stone is an unforgettable story of love and betrayal, medicine and ordinary miracles -- and two brothers whose fates are forever intertwined.
What Hooked Me:
One of the best books I have read in 2010, this is a fantastic book that has what I most love in a book: it makes me care for almost ALL of the characters in the book, even if they seemingly appear secondary or inconsequential to the novel. The two characters that I care most about are Ghosh and Thomas, the two fathers who are tied by friendship and genuinely good hearts. I also love that the novel emphasizes that a thorough history and physical examination are the key to properly diagnosing a patient. And most of all, I love its compassionate and refreshing depiction of physicians and surgeons.
'After eight months spent in the obscurity of our mother's womb, my brother, Shiva and I came into the world in the late afternoon of the twentieth of September in the year of grace 1954. We took our first breaths at an elevation of eight thousand feet in the thin air of Addis Abab, capital city of Ethiopia.'(opening lines)
'We come unbidden into this life, and if we are lucky we find a purpose beyond starvation, misery, and early death which, lest we forget, is the common lot. I grew up and I found my purpose and it was to become a physician. My intent wasn't to save the world as much as to heal myself. Few doctors will admit this, certainly not young ones, but subconsciously, in entering the profession, we must believe that ministering to others will heal our woundedness. And it can. But it can also deepen the wound.'(6-7)
'My father, for whose skills as a surgeon I have the deepest respect, says, "The operation with the best outcome is the one you decide not to do." Knowing when not to operate, knowing when I am in over in my head, knowing when to call for the assistance, of a surgeon of my father's caliber -- that kind of talent, that kind of "brilliance," goes unheralded.' (8)
"Marion, remember the Eleventh commandment," he said. "thou shall not operate on the day of a patient's death."
I remember his words on full-moon nights in Addis Ababa when knives are flashing and rocks and bullets are flying, and when I feel as if I am standing in the abattoir and not in Operating Theater 3, my skin flecked with the grist and blood of strangers. I remember. But you don't always know the answers before you operate. One operates in the now. Later, the retrospectoscope, that handy tool of the wags and pundits, the conveners of the farce we call M&M -- morbidity and mortality conference -- will pronounce your decision right or wrong. Life too, is like that. You live it forward, but understand it backward. It is only when you stop and look to the rear that you see the corpse caught under your wheel.'(8-9)
'According to Shiva, life is in the end about fixing holes. Shiva didn't speak in metaphors. Fixing holes is precisely what he did. Still, it's an apt metaphor for our profession. But there's another kind of hole, and that is the wound that divides family. Sometimes this wound occurs at the moment of birth, sometimes it happens later. We are all fixing what is broken. It is the task of a lifetime. We'll leave much unfinished for the next generation.'(9)
'Sound Nursing Sense is more important that knowledge, though knowledge only enhances it. Sound Nursing Sense is a quality that cannot be defined, yet it is invaluable when present and noticeable when absent.'(41)
'Ghosh had introduced her to jazz and to "take the 'A Train." "Wait... watch! See?" he said, the first time she heard the melody after the chords. "You have to smile. You can't help it!" And he was right, the tune was so catchy and upbeat -- how fortunate she was that her first introduction to serious Western music should be that tune. Still she'd come to think of it as her song, her invention, and it annoyed her that he'd been the one to bring her to it. She laughed at the strangeness of liking Ghosh so much, when she had wanted to dislike him.'(62)
'... the tragedy of death had to do entirely with what was left unfulfilled.'(64)
'The twin lay swaddled next to each other like larvae, sharing the incubator, their skulls covered with monkey caps and only their wizened, newborn faces showing. No matter how far apart Hema put them, when she came to them again, they would be in a V, their heads touching, facing each other, just as they had been in the womb.'(200)
'Indian classical music with a snappy tabla beat marked time. Hema had tucked her sari so that one loop ran between her legs, creating what looked like pantaloons. She'd taught Shiva and Genet a complex series of steps and poses in the the time I'd been out. Arms in, arms out, arms together, pointing, dipping, drawing a bow, firing an imaginary arrow, the eyes looking this way and that, the feet sliding, a cymbal clash of anklets every time their heels thumped the floor.'(239)
"Yes! A treasure trove of words! That's what you find in medicine. Take the food metaphors we use to describe disease: the nutmeg liver, the sago spleen, the anchovy sauce sputum, or currant jelly stools. Why, if you consider just fruits alone you have the strawberry tongue of scarlet fever, which the next day becomes the raspberry tongue. Or how the strawberry angioma, the watermelon stomach, the apple core lesion of cancer, the peau d'orange appearance of breast cancer ... and that's just fruits! Don't get me started on the nonvegetarian stuff!"(274)
'Looking back, I realize Ghosh saved me when he called me to feel Demisses's pulse. My mother was dead, and my father a ghost; increasingly I felt disconnected from Shiva and Hema, and guilty for feeling that way. Ghosh in giving me the stethoscope, was saying, Marion, you can be you. It's okay. He invited me to a world that wasn't secret, but it was well hidden. You needed a guide. You had to know what to look for, but also how to look. You had to exert yourself to see this world. But if you did, if you had that kind of curiosity, if you had an innate interest in the welfare of your fellow human beings, and if you went through that door, a strange thing happened: you left your petty troubles on the threshold.'(275)
'The key to your happiness is to own your slippers, own who you are, own how you look, own your family, own the talents you have, and own the ones you don't. If you keep saying your slippers aren't yours, then you'll die searching, you'll die bitter, always feeling you were promised more. Not only our actions, but also our omissions, become our destiny.'(351)
'Tell us please, what treatment in an emergency is administered by ear?"....I met his gaze and I did not blink. "Words of comfort," I said to my father.' (520-521)
'Don't leave the instrument sitting in its case, my son. Play! Leave no part of your instrument unexplored. Why settle for 'Three Blind Mice' when you can play the 'Gloria'?'
'Life is full of signs. The trick is to know how to read them. Ghosh called this heuristics, a method for solving a problem for which no formula exists.'
'I believe in black holes. I believe that as the universe empties into nothingness, past and future will smack together in the last swirl around the drain.'
First Vintage Books Edition January 2010
Post updated and edited December 18, 2011