Read this book: Cutting for Stone

Sept. 23, 2014, 3:32 p.m.

Interdisciplinary is a term that gets tossed around a lot these days, a sought after label whose true meaning sometimes gets lost in the academic rhetoric. Not so with Abraham Verghese, a professor and vice chair for the Theory and Practice of Medicine at the School of Medicine at Stanford University. Verghese juggles the titles of doctor, professor and best selling author so effortlessly and fluidly you would think he somehow found a way to avoid the necessity of sleep, teaching medical students by day and then cranking out elegant prose by night.

Verghese’s third and most recent novel, “Cutting for Stone” (a best-seller on The New York Times list for more than two years) is a testament to his truly unique ability to combine his knowledge of medicine and surgery with his gift for story telling. “Cutting for Stone” is fiction but borrows liberally from Verghese’s life experiences. It tells the story of twin brothers who are born in Missing, an Ethiopian hospital, into shocking and tragic circumstances. The twins, Shiva and Marion, are born attached at the head and though they were successfully separated by surgery they maintain an intricate and somewhat miraculous connection. Both brothers choose medical careers, but that is where the similarities end. Their training, approach to patients and view of their own roles as medical practitioners is vastly different. Shiva is self-taught, focused and often emotionless. Marion is acutely aware of his environment and affected by it as he interns in a hospital in the Bronx.

So what kind of doctor is Verghese? “Cutting for Stone” clearly demonstrates Verghese’s ability to understand human interaction and emotion on a very real world level. Not only does he include realistic details of illness and surgeries in his novel, but he brings his sense of spirit and rich emotional landscape into the practice of medicine, allowing him to reinstate the doctor-patient relationship (medicine the way it used to be before technology). In a TED talk at TEDGlobal 2011, Verghese emphasized the importance of the physical examination, a practice which today is mostly neglected in favor of technology but which Verghese claims is indispensable for the sake of ritual, connection and comfort. Verghese’s philosophy of synthesizing science with the human experience is unique and unfortunately under appreciated in today’s digitalized, paper-work laden, efficiency-consumed practice of medicine.

The historical and cultural aspects of Cutting for Stone are so natural that it is no surprise that the story bears a resemblance to Verghese’s personal background. Like the twins in his novel, Marian and Shiva, Verghese was born in Addis Ababa, Ethiopia, to Indian parents. His own training in Ethiopia was interrupted by civil unrest. He eventually completed his medical studies at Madras Medical College in India and completed a medical residency in the United States, but, like many foreign medical graduates, he was welcomed by only the less prestigious less popular hospitals. Verghese practiced in Tennessee and then at the Boston City Hospital, where he first encountered the beginning of the HIV epidemic. Upon his return to Tennessee he encountered the second epidemic, “rural AIDS,” and he embarked upon the work for which he is now best know — caring for young AIDS patients before today’s medical advancements, a time when nothing could be done for them but provide palliative care. The deep relationships Verghese formed through his work with AIDS patients and the physical and emotional suffering he witnessed gave way to his current holistic medical philosophy, as well as his interest in writing. He earned a Master of Fine Arts degree in 1991 from the prestigious Iowa Writers Workshop and then it was back to medicine again. In 2002, Verghese became the founding director of the Center for Medical Humanities and Ethics at the University of Texas Health Center San Antonio, carrying with him the mission of “imagining the patient’s experience,” instead of just viewing patients as medical problems. Concerning “Cutting for Stone,” Verghese writes, “My ambition as a writer was to tell a great story, an old fashioned, truth-telling story. But, beyond that, my single goal was to portray an aspect of medicine that gets buried in the way television depicts the practice: I wanted the reader to see how entering medicine was a passionate quest, a romantic pursuit, a spiritual calling, a privileged yet hazardous undertaking.”

Through his novel, Cutting for Stone, Verghese makes it clear that when it comes to the art of healing the physical and metaphorical heart are inextricably intertwined.



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