"Cutting for Stone": Verghese's epic of Ethiopia

"Cutting for Stone"

by Abraham Verghese

Knopf, 560 pp., $26.95

If you're hungry for an epic that begins in 1940s Madras, sails through a typhoid outbreak, stumbles through a sordid khat den in Yemen, lingers in a plucky mission clinic in Addis Ababa and climaxes in a gritty New York City hospital before alighting, for a mystical moment, in a small Italian chapel graced by Bernini's sculpture of St. Teresa, then open the covers of "Cutting for Stone."

For the next 560 pages (spanning five decades), don't expect to do much else.

Like many tales worthy of "Once-upon-a-time" status, this one starts with a mother's death. Sister Mary Joseph Praise, a beautiful young Carmelite nun and scrub nurse from India, fatally hemorrhages giving birth to twin sons in the humble Ethiopian mission hospital where she works. The infants' father, a brilliant and maladjusted British surgeon, promptly flees.

That leaves Marion, our narrator, and his twin, Shiva, an emotionally remote genius, in the hands of ballsy obstetrician Hema and her affable doctor husband, Ghosh. The adoptive parents are Indian expatriates called to work in Africa for personal, rather than religious, reasons.

Verghese's rich cast also includes General Mebratu, an excellent bridge player who eventually attempts to depose Emperor Haile Selassie; Genet, a servant's siren daughter whose adolescent lust causes a rift between the twin brothers; a mama mutt named Koochooloo, who shuns people after watching clinic staff asphyxiate her puppies — a scene that seems to condemn mankind for tolerating violence. Marion, as a young boy: "After the killings, I saw in Koochooloo's eyes her disappointment in us as a race. She sought out places where she could curl up and not run into humans. We left food out for her, and if she ate, it was not when we were around."

Verghese grew up in Ethiopia, the middle son of Indian expats, and he skillfully captures the tensions and insights triggered by cultural crosscurrents.

Here's Hema, after stumbling upon a street gallows where a reluctant executioner bows to the condemned before hanging him. ... "Yes, it might be the era of the kidney transplant in America and a vaccine for polio due to arrive even in India, but here Hema felt she'd tricked time; with her twentieth-century knowledge, she had traveled back to an earlier epoch ... Her skills were so rare, so needed ... Wasn't that the definition of home? Not where you are from, but where you are wanted?"

"Cutting for Stone" is absorbing, exhilarating and exhausting. Verghese details with equal adroitness the thrashing of 10,000 Italian soldiers by barefoot Ethiopian fighters in 1896; the patois of frankincense-scented brothels; a vasectomy performed with the aid of space heater and Johnny Walker Red — the description of the latter so charming and surgically precise, it could serve, in a pinch, as how-to manual.

Verghese's love of medicine is palpable. He's equally passionate about narrative. A professor at Stanford University, Verghese uses Tolstoy to help medical students understand end-of-life issues. He sprinkles medical nuggets throughout his novel to reveal the raw complexity of life (or perhaps he finds medicine so comforting, so fascinating, he can't hold back).

Almost always, it works.

A few surgical scenes in "Cutting for Stone" are a tad clinical, but the physician (board-certified in three specialties!) should be forgiven; ultimately, his intimate depiction of humanity makes your pulse race, your eyes tear, and your lungs exhale a satisfied sigh.