Abraham Verghese's first novel takes too long to get going, but once it does, it grips. It's the saga of twins Marion and Shiva Stone, pulled from the womb of the nun Sister Mary Joseph Praise and immediately abandoned by their father, surgeon Thomas Stone. Stone is so disturbed by the boys' arrival that he leaves the delivery to his assistants at Missing, the Ethiopian hospital at the heart of this sprawling book.
Eventually, the various meanings of the title, including its link to the defaulting surgeon, come together. So do various members of a family stretched across continents. The first work of fiction by Verghese, a physician who has written two acclaimed memoirs, is ambitious, if occasionally underwritten and underdeveloped.
It does have problems. Why is Marion such a prude and why does he keep himself "pure" for so long? Why is Genet, whom Marion loves and who betrays him, so coldly portrayed? The symbolism can be heavy-handed, particularly toward the end, when the estranged brothers rejoin in a medical crisis.
Still, the book's strengths — generosity of spirit, political insight, acute analysis of a hospital caste system (particularly in the United States) and generally well-rounded, warmhearted characterizations — outweigh its weaknesses. I ended up caring deeply for Hema and Ghosh, the Indian emigres who effectively became the twins' parents; Ghosh, in particular, is wonderfully realized, as is Stone, a shadow at first but ultimately a credible, even admirable, presence.
The characterizations are bound up with many procedures Verghese takes us through, and he's extraordinarily talented at giving language to medicine, a field that can seem inscrutable. Effortlessly blending fictional and historical characters, like various Ethiopian rulers, pioneering liver specialist Thomas Starzl and his fictional doppelganger Thomas Stone, Cutting for Stone deals with contemporary problems in an old-fashioned, thorough way.
Carlo Wolff is a freelance writer from Cleveland.