Book Club Discussion Questions
Please be aware that this discussion guide will contain spoilers!
About This Guide
The introduction, discussion questions, and suggested further reading that
follow are designed to enhance your group's discussion of Abraham Verghese's
acclaimed first novel,
Cutting for Stone.
About This Book
An epic novel that spans continents and generations,
Cutting for Stone
is an unforgettable story of love and betrayal, compassion and redemption, exile
An epic novel that spans continents and generations,
Cutting for Stone is
an unforgettable story of love and betrayal, compassion and redemption, exile
and home that unfolds across five decades in India, Ethiopia, and America.
Narrated by Marion Stone, the story begins even before Marion and his twin
brother, Shiva, are born in Addis Ababa's Missing Hospital (a mispronunciation
of "Mission Hospital"), with the illicit, years-in-the-making romance between
their parents, Sister Mary Joseph Praise, a beautiful Indian nun, and Thomas
Stone, a brash, brilliant British surgeon. Mary and Thomas meet on a boat out of
Madras in 1947; she follows him to Ethiopia and to Missing, where they work side
by side for seven years as nurse and doctor. After Mary dies while giving birth
to the twins-a harrowing, traumatic scene on the operating table-Thomas
vanishes, and Marion and Shiva grow up with only a dim sense of who he was, and
with a deep hostility toward him for what they see as an act of betrayal and
cowardice.
The twins are raised by Hema and Ghosh, two Indian doctors who also work at
Missing, and who shower Marion and Shiva with love and nurture their interest in
medicine-part of the deep, almost preternatural connection the brothers share.
They are so close that Marion, as a boy, thinks of them as a single entity:
ShivaMarion.
Marion and Shiva come of age as Ethiopia hovers on the brink of revolution, and
their lives become intertwined with the nation's politics. Addis Ababa is a
colorful, cosmopolitan city: the Italians have left behind cappuccino machines,
Campari umbrellas, and a vibrant expat community. But they've also left a nation
crippled by poverty, hunger, and authoritarian rule: Ethiopia in the 1960s and
1970s is both bolstered and trapped by its notorious emperor, Haile Selassie,
and rocked by violence and civil war.
Yet it is not politics but love that tears the brothers apart: Shiva sleeps with
Genet-the daughter of their housekeeper and the girl Marion has always loved.
This second betrayal, now by the two people this sensitive young man loves most,
sends Marion into a deep depression. And when Genet joins a radical political
group fighting for the independence of Eritrea, Marion's connection to her
forces him into exile: he sneaks out of Ethiopia and makes his way to America.
Marion interns at a hospital in the Bronx, an underfunded, chaotic place where
the patients are nearly as poor and desperate as those he had seen at Missing.
It is here that Marion comes to maturity as a doctor and as a man. It is here,
too, that he meets his father and takes his first steps toward reconciling with
him. But when the past catches up to Marion-nearly destroying him-he must
entrust his life to the two men he thought he trusted least in the world: the
father who abandoned him and the brother who betrayed him. The surprising,
stunning denouement both arises from and reenacts the major themes of
Cutting
for Stone: love and betrayal, forgiveness and self-sacrifice, and the
inextricable union of life and death.
In
Cutting for Stone, renowned physician Abraham Verghese has given us a
remarkable reading experience that explores the lives of a memorable cast of
characters, many of them doctors; the insight the novel offers into the world of
medicine, along with its wealth of precise detail about how doctors work, is
unparalleled in American fiction. Verghese is so attuned to the movements of the
heart and of the mind, so adept at dramatizing the great themes of human
existence, and he has filled this world with such richly drawn, fascinating
characters, that
Cutting for Stone becomes one of those rare books one
wishes would never end, an alternate reality that both rivals and illuminates
the real world readers must return to when the book is closed.
and home that unfolds across five decades in India, Ethiopia, and America.
Narrated by Marion Stone, the story begins even before Marion and his twin
brother, Shiva, are born in Addis Ababa's Missing Hospital (a mispronunciation
of "Mission Hospital"), with the illicit, years-in-the-making romance between
their parents, Sister Mary Joseph Praise, a beautiful Indian nun, and Thomas
Stone, a brash, brilliant British surgeon. Mary and Thomas meet on a boat out of
Madras in 1947; she follows him to Ethiopia and to Missing, where they work side
by side for seven years as nurse and doctor. After Mary dies while giving birth
to the twins-a harrowing, traumatic scene on the operating table-Thomas
vanishes, and Marion and Shiva grow up with only a dim sense of who he was, and
with a deep hostility toward him for what they see as an act of betrayal and
cowardice.
The twins are raised by Hema and Ghosh, two Indian doctors who also work at
Missing, and who shower Marion and Shiva with love and nurture their interest in
medicine-part of the deep, almost preternatural connection the brothers share.
They are so close that Marion, as a boy, thinks of them as a single entity:
ShivaMarion.
Marion and Shiva come of age as Ethiopia hovers on the brink of revolution, and
their lives become intertwined with the nation's politics. Addis Ababa is a
colorful, cosmopolitan city: the Italians have left behind cappuccino machines,
Campari umbrellas, and a vibrant expat community. But they've also left a nation
crippled by poverty, hunger, and authoritarian rule: Ethiopia in the 1960s and
1970s is both bolstered and trapped by its notorious emperor, Haile Selassie,
and rocked by violence and civil war.
Yet it is not politics but love that tears the brothers apart: Shiva sleeps with
Genet-the daughter of their housekeeper and the girl Marion has always loved.
This second betrayal, now by the two people this sensitive young man loves most,
sends Marion into a deep depression. And when Genet joins a radical political
group fighting for the independence of Eritrea, Marion's connection to her
forces him into exile: he sneaks out of Ethiopia and makes his way to America.
Marion interns at a hospital in the Bronx, an underfunded, chaotic place where
the patients are nearly as poor and desperate as those he had seen at Missing.
It is here that Marion comes to maturity as a doctor and as a man. It is here,
too, that he meets his father and takes his first steps toward reconciling with
him. But when the past catches up to Marion-nearly destroying him-he must
entrust his life to the two men he thought he trusted least in the world: the
father who abandoned him and the brother who betrayed him. The surprising,
stunning denouement both arises from and reenacts the major themes of
Cutting
for Stone: love and betrayal, forgiveness and self-sacrifice, and the
inextricable union of life and death.
In
Cutting for Stone, renowned physician Abraham Verghese has given us a
remarkable reading experience that explores the lives of a memorable cast of
characters, many of them doctors; the insight the novel offers into the world of
medicine, along with its wealth of precise detail about how doctors work, is
unparalleled in American fiction. Verghese is so attuned to the movements of the
heart and of the mind, so adept at dramatizing the great themes of human
existence, and he has filled this world with such richly drawn, fascinating
characters, that
Cutting for Stone becomes one of those rare books one
wishes would never end, an alternate reality that both rivals and illuminates
the real world readers must return to when the book is closed.
Reader's Guide
- Abraham Verghese has said that his ambition in writing Cutting for
Stone was to "tell a great story, an old-fashioned, truth-telling story." In
what ways is Cutting for Stone an old-fashioned story-and what does it
share with the great novels of the nineteenth century? What essential human
truths does it convey?
- What does Cutting for Stone reveal about the emotional lives of
doctors? Contrast the attitudes of Hema, Ghosh, Marion, Shiva, and Thomas Stone
toward their work. What draws each of them to the practice of medicine? How are
they affected, emotionally and otherwise, by the work they do?
- Marion observes that in Ethiopia, patients assume that all
illnesses are fatal and that death is expected, but in America, news of having a
fatal illness "always seemed to come as a surprise, as if we took it for granted
that we were immortal" (p. 396). What other important differences does Cutting for Stone reveal about the way illness is viewed and treated in
Ethiopia and in the United States? To what extent are these differences
reflected in the split between poor hospitals, like the one in the Bronx where
Marion works, and rich hospitals like the one in Boston where his father works?
- In the novel, Thomas Stone asks, "What treatment in an emergency is
administered by ear?" The correct answer is "Words of comfort." How does this
moment encapsulate the book's surprising take on medicine? Have your experiences
with doctors and hospitals held this to be true? Why or why not? What does Cutting for Stone
tell us about the roles of compassion, faith, and hope in
medicine?
- There are a number of dramatic scenes on operating tables in Cutting
for Stone: the twins' births, Thomas Stone amputating his own finger, Ghosh
untwisting Colonel Mebratu's volvulus, the liver transplant, etc. How does
Verghese use medical detail to create tension and surprise? What do his
depictions of dramatic surgeries share with film and television hospital
dramas-and yet how are they different?
- Marion suffers a series of painful betrayals-by his father, by Shiva, and
by Genet. To what degree is he able, by the end of the novel, to forgive them?
- To what extent does the story of Thomas Stone's childhood soften Marion's
judgment of him? How does Thomas's suffering as a child, the illness of his
parents, and his own illness help to explain why he abandons Shiva and Marion at
their birth? How should Thomas finally be judged?
- In what important ways does Marion come to resemble his father, although
he grows up without him? How does Marion grow and change over the course of the
novel?
- A passionate, unique love affair sets Cutting for Stone in motion,
and yet this romance remains a mystery-even to the key players-until the very
conclusion of the novel. How does the relationship between Sister Mary Joseph
Praise and Thomas Stone affect the lives of Shiva and Marion, Hema and Ghosh,
Matron and everyone else at Missing? What do you think Verghese is trying to say
about the nature of love and loss?
- What do Hema, Matron, Rosina, Sister Mary Joseph Praise, Genet, and
Tsige-as well as the many women who come to Missing seeking medical
treatment-reveal about what life is like for women in Ethiopia?
- Addis Ababa is at once a cosmopolitan city thrumming with life and the
center of a dictatorship rife with conflict. How do the influences of Ethiopia's
various rulers-England, Italy, Emperor Selassie-reveal themselves in day-to-day
life? How does growing up there affect Marion's and Shiva's worldviews?
- As Ghosh nears death, Marion comments that the man who raised him had no
worries or regrets, that "there was no restitution he needed to make, no moment
he failed to seize" (p. 346). What is the key to Ghosh's contentment? What makes
him such a good father, doctor, and teacher? What wisdom does he impart to
Marion?
- Although it's also a play on the surname of the characters, the title Cutting for Stone comes from a line in the Hippocratic Oath:
"I will not cut
for stone, even for patients in whom the disease is manifest; I will leave this
operation to be performed by practitioners, specialists in this art." Verghese
has said that this line comes from ancient times, when bladder stones were
epidemic and painful: "There were itinerant stone cutters-lithologists-who could
cut into either the bladder or the perineum and get the stone out, but because
they cleaned the knife by wiping their blood-stiffened surgical aprons, patients
usually died of infection the next day." How does this line resonate for the
doctors in the novel?
- Almost all of the characters in Cutting for Stone are living in
some sort of exile, self-imposed or forced, from their home country-Hema and
Ghosh from India, Marion from Ethiopia, Thomas from India and then Ethiopia.
Verghese is of Indian descent but was born and raised in Ethiopia, went to
medical school in India, and has lived and worked in the United States for many
years. What do you think this novel says about exile and the immigrant
experience? How does exile change these characters, and what do they find
themselves missing the most about home?
Suggested Reading
Chinua Achebe, Girls at War;
Andre Brink, A Dry White Season;
Pauline Chen, Final Exam;
Dave Eggers, What Is the What;
Tracy
Kidder, Old Friends;
John Irving, The Cider House Rules;
Ryszard Kapuscinski, The Emperor;
Barbara Kingsolver, The Poisonwood
Bible;
Somerset Maugham, Of Human Bondage;
Samuel Shem, The House
of God;
William Carlos Williams, The Doctor Stories.
Unless otherwise stated, this discussion guide is reprinted with the permission of Vintage.
Any page references refer to a USA edition of the book, usually the trade paperback version, and may vary in other editions.
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