Ethiopia, 1954. Twin boys conjoined at the head survive a surgical separation and a gruesome C-section delivery. Their mother, Sister Mary Joseph Praise, does not. The Carmelite nun, a native of India, dies in the same place where she worked as a nurse - the operating room of a small hospital in Addis Ababa. The facility is dubbed Missing Hospital, and it is staffed by some remarkable people.

Thomas Stone is a British general surgeon. The only thing that he loves more than medicine is Sister Praise. When she dies during childbirth, he has a meltdown - abruptly fleeing the hospital and leaving Africa. Although Thomas Stone is the father of the twins, he blames the babies for the nun's death. Decades later, he is working at a prestigious medical center in Boston where he specializes in hepatic surgery and research on liver transplantation. The twins are raised by two physicians at Missing Hospital - Dr. Ghosh and Dr. Hemlatha (Hema) - who get married. Hema is an obstetrician-gynecologist. Ghosh is an internist who becomes the hospital's surgeon by necessity after Thomas Stone departs.

The fate of the twin boys, Marion Stone and Shiva Stone, is sculpted by their experiences at Missing Hospital and the growing pains of Ethiopia. The African nation is full of possibilities and mayhem. Both boys are highly intelligent and unusually bonded. Shiva is eccentric and empathic. Although he never attends medical school, Ghosh and Hema train him. Shiva becomes a world authority on treating vaginal fistulas. Marion narrates the story. He is repeatedly hurt by love. The girl of his dreams, Genet, opts to have her first sexual encounter with Shiva. Genet plays a role in hijacking an airplane and rebels against the Ethiopian government. Although innocent, Marion comes under suspicion because of her actions. He escapes the country for his own safety.

Like his father, Marion lands in America. He completes his residency training as a trauma surgeon in New York. He locates his biological father but reconciliation is difficult for both men. Genet has also come to America. She shows up at Marion's apartment, and they have sexual intercourse. Genet exposes him to tuberculosis and Hepatitis B. Marion delevelops liver failure due to hepatitis. He is going to die. Shiva and Hema travel to New York to be with Marion. Shiva proposes an experimental treatment for his brother - a living donor liver transplantation. After all, there is no better organ donor than an identical twin. Thomas Stone performs the operation along with one of Marion's coleagues. The surgery is successful. Then Shiva has bleeding in his brain and dies. Marion returns to Ethiopia and Missing Hospital. Half a century removed from his birth, Marion is back at home and still conected to his twin brother. The lobe of liver donated by Shiva is functioning perfectly.


For the most part, the doctors in Cutting for Stone are heroes - compassionate, dedicated - although flawed. Their heroism comes with a hefty price. The practice of medicine runs their life and sometimes ruins it too. Often these physicians are imprisoned by their profession. The novel is filled with insights about being a doctor. Ghosh speaks for all doctors when he remarks that "the uneventful day was a precious gift" (p 258). Marion Stone confesses that "I don't think you can be a physician and not see yourself reflected in your patient's illness" (p 397).

Foreign lands, immigration, and new homes are central to the story. What do we owe our birthplace? What does it mean to be a foreigner? Where do we truly belong? Perhaps "home" is not a place of origin but rather a location where an individual is most wanted.

The novel takes a long look at fatherhood - particularly lost and absent fathers. What are the minimum requirements of fatherhood? What makes a man an exceptional father instead of just a decent dad? Beyond nurturing, the story zooms in on the nature of healing. Life comes with pain. Those we love can hurt us. Those who love us can sustain us. How we handle wounds and repair what is broken define our lives. The story details what it means to heal - patients, family, self, and the world.

Cutting for Stone is imbued with grace and wisdom. Readers will be hard-pressed to recall any other medically-themed novel that is the equal of this gem. Doctors ply their trade cognizant that they don't have all the answers. Writers work that way also. Cutting for Stone is proof that medicine and great literature actually have the answers to many perplexing problems not the least of which is an explanation for good and evil.

Primary Source

Cutting for Stone


Alfred A. Knopf

Place Published

New York



Page Count