Foreigners, whose only image of Ethiopia was that of starving people sitting in blinding dust, were disbelieving when they landed in the mist and chill of Addis Ababa at night and saw the boulevards and tram-track lights of Churchill Road.
Terrible jokes:Q: Have you ever tasted Ethiopian food? A: Neither have they. Q: What do you call a 65 pound Ethiopian? A: A cannibal. Q: How do Ethiopians camouflage themselves? A: They stand sideways. Q: What do you call an Ethiopian with a bag of rice? A: Set for life.Abraham Verghese was born in Ethiopia to Indian parents and became a doctor, eventually moving to the United States to complete his training, and he loosely uses this narrative for the main character of Cutting for Stone, Marion, and, other than the move to the U.S., for Marion's conjoined twin, Shiva (okay, the twins are half Indian and half colonial-Brit-from-India, and are raised by adoptive Indian parents -- but it's pretty much the same thing.) Like a typical foreigner, I suppose, I too think of Ethiopia as a famine-ravaged wasteland instead of the misty mountain-top metropolis of Addis Ababa, and where Verghese most succeeds in this book is in bringing the actual Ethiopia to life. The setting and history and politics of Ethiopia was an enjoyable education for me, but so far as Cutting for Stone is a work of fiction, I found it lacking in art. As a surgeon and a graduate of the Iowa Writers Workshop, Verghese writes like -- a surgeon: He surveyed his subject and slit open its belly, allowing the 7 or 8 meters of bowels to spill out onto the table. After examining its length and taking copious and jargon-filled notes, the slippery tube was crammed back into its host and the various enclosing layers were stitched up, one at a time, neatly using two-handed stitches and carefully rotating the scissors to forty-five degrees to snip each knot, keeping everything nice and tidy.
Even the title was not nearly as profound as I think it's meant to be. The Hippocratic Oath includes, "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." So, GPs shouldn't attempt surgery (specifically to remove gall or kidney stones) but rather leave these matters to specialists -- yet nearly every doctor in Cutting for Stone becomes a specialist of some sort because they experiment and push the boundaries of their knowledge, whether it's Shiva with his Fistula repairs, Ghosh becoming Missing's surgeon without specialised training and by default, or Thomas pioneering the field of liver transplants (and if the ultimate lesson is that Thomas shouldn't have "cut for stone" because it cost Shiva's life, that's not really fair because, not only did Shiva have a specific and undetected flaw that put him at risk, but the techniques Thomas developed went on to save hundreds or thousands of other lives). And the fact that Thomas and his sons had the surname Stone didn't make it more meaningful -- this felt forced and blunt. By the by, also forced was the notion of a "Missing" hospital -- a clerical error become fact based on the Ethiopian lisping of the intended "Mission" hospital's name -- that led to the very unsubtle "Missing Finger" and "Missing Letters" and "Missing People" and even "Missing is missing"
As for fact-cramming, I have some longish quotes here that hopefully approximate what I mean -- I had a constant awareness of information being listed off to me but I wasn't marking passages at the time and these were the best I could find after the fact:
Bachelli was lost in the memory of boarding his troop ship in Naples in 1934; he was a young officer again in the 230th legion of the national Fascist Militia, off to fight for Il Duce, off to capture Abyssinia, off to expunge the shame of being defeated at the battle of Adowa by Emperor Menelik in 1896. At Adowa, ten thousand Italian soldiers, with as many of their Eritrean askaris, poured down from their colony to invade and take Ethiopia. They were defeated by Emperor Menelik's barefoot Ethiopian fighters armed with spears and Remingtons (sold to them by none other than Rimbaud). No European army had ever been so thoroughly thrashed in Africa. It stuck in the Italian craw, so that even men who weren't born at the time of Adowa, like Bachelli, grew up wanting vengeance.^ That didn't feel to me like the natural or organic thoughts of someone sitting in a bar, and the following is typical of the way we are introduced to new settings:
Ghosh didn't understand any of this till he came to Africa. He hadn't realised that Menelik's victory had inspired Marcus Garvey's Back to Africa Movement, and that it had awakened Pan-African consciousness in Kenya, the Sudan, and the Congo.
The Avakians were locking up their bottled-gas store, and beyond their shop the lights of the Piazza, the transitory illusions of Roma, came to an end. Now it was all darkness, and the road ran past the long, gloomy, fortresslike stone wall that held up the hillside. A gash in the moss-covered stones was Saba Dereja -- Seventy Steps -- a pedestrian shortcut to the roundabout at Sidist Kilo, though the steps were so worn down that it was more a ramp than stairs, treacherous when it rained. He drove past the Armenian church, then around the obelisk at Arat Kilo -- another war monument at a roundabout -- past the Gothic spires and domes of the Trinity Cathedral and then the Parliament Building, which took its inspiration from the one on the banks of the Thames. At the Old Palace, because he was not quite ready to go home, he turned down to Casa INCES, a neighborhood of pretty villas.^ That bit didn't bring Addis Ababa to life for me, but Verghese was more successful when he populated the city with people, and especially the students and revolutionaries and the Emperor Haile Selassie himself. (Although if he had to fudge the dates of the various revolutions and counter-revolutions to fit his storyline, I don't know why he didn't just amend his storyline…) I thought that many of the operations and clinic visits were very interesting, the jargon was necessary and not too hard to understand, but the following (and there were more such passages) was hopelessly arcane:
Braithwaite pointed to a vein coursing over the pylorus. He asked Thomas what it was.Some characters were interesting, like Hema and Ghosh, and I would have liked to have known them better; some characters remained flat and undeveloped throughout, like Marion and Shiva and Genet -- which is really curious since they are the main characters; and some were veiled in mystery, like Thomas and Sister Mary Joseph Praise, who, when their full back stories were finally revealed near the end, evoked from me a weak and dejected, "Meh". If I was meant to think that Marion was a complex and tragic figure, the following rape scene killed all empathy I had for him (and most especially because the character and I both know that Genet had been the victim of female genital mutilation as a child; that he was raping her through her scars):
"The pyloric vein of Mayo, sir…" Thomas said, and appeared about to add something. Braithwaite waited, but Thomas was done.
"Yes, that's what it's called, though I think that vein was there long before Mayo spotted it, don't you think? Why do you think he took the trouble to name it?"
"I believe it was a useful landmark to identify the prepyloric from the pyloric area when operating on an infant with pyloric stenosis."
"That's right," Braithwaite said. "They should really call it the prepyloric vein."
"That would be better, sir. Because the right gastric vein is also referred to in some books as the 'pyloric vein'. Which is very confusing."
"Indeed, it is, Stone," Braithwaite said, surprised that this student had picked up on something that even surgeons with a special interest in the stomach might not know. "If we have to give it an eponym, maybe call it the vein of Mayo if we must, or even the vein of Laterjet, which seems to me much the same thing. Just don't call it pyloric."
Suddenly I was on top of her, tearing away the sheet, tearing away her towel, clumsy but determined. She was startled, the muscles of her neck taut like cables. I grabbed her head and kissed her.
"Wait", she whispered, "shouldn't you…"
But I was already inside her.
She winced.
…break to explain that this was Marion's first time because he's the good guy…
She wept under me. After a long time, she gently caressed my head, tried to kiss me. She said, "I need to go to the bathroom."
I ignored her. I was aroused again. I began to move inside her once more.
"Please, Marion," she said.
Without removing myself from within her, I rolled onto my back, holding her, flipping her, and setting her on top of me, her breasts hovering over me.
"You need to pee? Go ahead," I said, my breath coming quick. "You've done that before, too."
I grabbed her shoulders and pulled her to me hard. I smelled her fever, and the scent of blood and sex and urine. I came again.
Then I let go. I let her slide off.When we later learn that Marion contracted Hepatitis from this assault, I could only think, "Good". And as an aside -- the incident referred to here, where as a child Genet had spread-eagled herself over Marion and peed on him as a warning, was, I thought, one of the most memorable events in the book. I was really disappointed, therefore, to read in the Acknowledgements that this was based on a scene in some book the author once read but can't recall. Also, many of his best aphorisms ("A rich man's faults are covered with money, but a surgeon's faults are covered with earth" or "Call no man happy until he dies") were taken from other works.
And so, to return to my metaphor, Verghese the surgeon lays bare the guts of his storyline and then crams them back in, checking off each step on the blackboard in his operating room as he goes along (Betrayal that leads to estrangement? Check. Tragedy that leads to reconciliation? Check. Coincidental meetings that lead to confrontation and resolution? Check, check and check) and then, with the help of a few more coincidences and a final catharsis, all loose ends are tied up and the storyline is sent off, healthy and whole. Parts of this book are very good (I really did like the adventurous bits like Thomas and Sister Mary Joseph Praise on their boat voyage or Marion's escape through Eritrea or Hema's encounter with the pilot of her plane), and Verghese assembles them together with a cool and clinical eye, but the overall effect for me lacked heart and depth. I suspect a reader will like Cutting for Stone in direct proportion to the profundity read into this conclusion:
According to Shiva, life is in the end about fixing holes. Shiva didn't speak in metaphor, 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.
I remember last Christmas (2012) that my sister-in-law's mother asked me if I had read Cutting for Stone, and when I admitted that I hadn't, she recommended it highly, based on her book club's enjoyment of it. Barb is a nurse and I wonder if that's why she thought it was so profound -- if it felt like it was somehow telling her story, so I'll forgive the recommendation. (Cutting for Stone also has a very high goodreads rating -- 4.25 as of now -- so it seemed like a safe bet in any case.)
As I was just talking about Barb and my aunt Judi after my last review, I thought maybe I'd talk just a bit more about Judi and her nursing career here.
Judi and Barb were nurses together at an Ottawa hospital and Barb told Laura once that all of the nurses marvelled at how money-hungry my aunt was -- always volunteering for overtime and stat holidays, and especially Christmas which Judi worked every year, despite having three kids at home. When we occasionally went up to visit them, it certainly was impressive how they lived -- first in a big fancy house with a pool and furnished with beautiful antiques (even in the kids' rooms) and later in a log home they had custom-made in the country. Judi was also notoriously cheap -- from serving powdered milk to buying all of my uncle's clothes at Value Village (which was only embarrassing the one time a coworker remarked that Dennis' sweater looked just like the one of his that his wife had recently donated).
As I've stated here before, if something wasn't any of our goddamn business, my brothers and I were unlikely to be told much of anything, so I can only piece the following together from conversations overheard over the years (also note that google isn't coming up with any results for me even though I know this once made the papers):
Apparently one time, as was very customary at the hospital where she worked, when Judi couldn't find a doctor to order the meds that she was certain a patient needed, my aunt just went ahead and administered them. And the patient died. The lovely teenaged girl died and her parents demanded answers and the rolling of heads (and what parent wouldn't?) Even though any nurse in her position, apparently, would have done the same, the College of Nurses had to make an example of Judi and she was stripped of her license, fired, and she may have even lost her pension over it.
However badly she felt about the young girl dying, and of course she must have felt terrible, Judi was also devastated by the loss of income -- this really messed with my aunt and uncle's retirement plans (she would have been in her early 50s at the time). And so she did what she had to do -- Judi hired herself out as a housecleaner. (She has delighted in telling me a couple of times about the one client who couldn't help but remark how weird it was to see Judi pull her mop and bucket out of the trunk of a convertible Mercedes, har har.) She did what she had to do until my uncle retired and they could build a modest (it's really quite beautiful) home back in the small community they both came from; they had adjusted their plans and knew they would have enough.
Meanwhile, my cousin Shelley, their daughter, had a baby, and being on her own, moved out to be close to them. Soon enough, with a different deadbeat guy, she had another baby, a boy with special needs, and still being a single parent, and either with grave medical conditions or a penchant for faking them (as the doctors suggest), Shelley has not worked and has been on social assistance since they were born. (Oh, she did work for a bit at first, but being a Practical Nurse who visited patients' homes and a drug addict, Shelley soon stole enough meds to get blackballed from the profession.) Living in social housing, Shelley repeatedly had neighbours call Child Social Services on her for the way she screamed at her kids, and eventually my aunt and uncle bought her her own house. I could only imagine how that impacted their retirement plans.
A few years ago I attended a wedding for another one of my cousins down there and I thought I knew everything I needed to know about these people -- my uncle in particular is a creepy piece of work who always seemed to put himself first and was prone to telling inappropriate jokes and obsessed with asking people how much money they make. It was, therefore, a gentle surprise for me to see Dennis with his grandson, the boy with special needs. Dennis called the boy over to him and sat him on his lap and patiently explained what he was doing as he tied the boy's shoelace. After the boy raced back to the dancefloor, Dennis said to me, "He's going to need a lot of help from us, for his whole life. Thank God we've got the energy and the money to make that happen."
I don't know what the lesson is from all of this -- did Judi and Dennis learn what was really important in the end? Were they subconsciously compelled to make as much money as possible because they would eventually need more than they ever could have imagined -- or was the boy sent by the fates to punish their hubris? Isn't there a strange symmetry between my aunt killing a girl with unauthorised meds and my cousin first stealing and then malingering to obtain unauthorised meds? If it was a work of fiction, would it all come off as too neat and tidy?
And while I'm thinking of Shelley: When I was 13 or 14 (and Shelley 1 year younger than I am), my family went to Ottawa for Christmas, and as an added bonus, my mother's youngest brother Mike was also there. We didn't see him often but we assumed he was incredibly cool since he is only 8 years older than my big brother, Ken, and he had long hippy hair and a biker moustache. As always happened when we visited there, I shared Shelley's bed with her and one night she asked, "Don't you think Mike is really good looking?" I slapped her playfully and said, "Ew gross. He's our uncle." But she insisted, "That doesn't mean you can't tell if he's good looking or not." And I insisted: "No. He's our uncle. I could never think of him that way."
The next day we went somewhere in the car, me and Shelley in the backseat, and my Mom and Mike up front, and when we stopped and my mother got out, Shelley said, "Know what Uncle Mike? Last night Krista said you're sooo good looking and she wants to make out with you."
Mike never even turned around, pretended not to hear, and I was trapped between protesting and knowing that protesting would do me no good, I gabbled something like, "No I...but you...I didn't..."
And as Shelley grinned evilly at me, no doubt her revenge for me not playing along the night before, all I could do was shut up and turn to the window, very careful not to look anywhere near the front seat.
And while I'm remembering that visit: At a different time, Mike showed us all the engagement ring he was going to give his girlfriend, Carlene, when he returned to Calgary. Now, Carlene was a tiny, tiny woman -- she complained to me once that the only clothes that really fit her were from the kids' department and it was impossible to put together a sexy look from the kids' department, haha -- so the ring was incredibly tiny around. I was overwhelmed by the romanticism of it all, like any young girl would be, and I gushed, "It's just so little." Mike blushed and mumbled something about it being all that he could afford, and I marvelled at how romantic that was -- wanting to buy a ring but not being able to afford all the gold required to go around her tiny finger. Of course, I realised my mistake in a flash of memory years later -- Mike must have thought I was calling the diamond little and he was probably really embarrassed by my statement.
Maybe he thought I was a social freak after that visit, but at least I was spared the consciousnesses of that second humiliation, lol.
