Abraham Verghese’s first novel, Cutting for Stone, with its huge cast of characters and exotic locales—including the Bronx—has a richness that recalls Conrad or Forster. Set mostly in and around Addis Ababa and New York, the story follows the life of Marion Praise Stone. His mother, a nun, died giving birth to Marion and his twin Shiva, and their Anglo-Indian father fled the country after the catastrophe. As a result, the twins are cared for by Hema, an irascible but hugely loving Indian born-doctor, and the saintly Ghosh, another Indian-born physician who spends years pining for Hema even as they raise the twins together. Rosina is the boys’ nanny and her daughter Genet is their playmate and “sister,” while Matron is the stern but loving head of both the family and the “Missing” (the Ethiopian mispronunciation of Mission) hospital where the family lives and ministers to the needs of the poor.

Marion, the narrator, shares a nearly mystical connection with his twin: in fact, they were born joined at the head. Though both boys are handsome and intelligent, Shiva is an oddity; one is tempted to describe him as a high-functioning autistic savant. Both brothers, predictably, go into medicine. Marion becomes an excellent if unheralded surgeon, but Shiva, with no formal medical training, becomes a pioneer in fistula repair, a skill desperately needed Ethiopia. Yet Shiva’s inability to read social cues leads to a long estrangement between the brothers and eventual disaster for not only the two of them but also for Genet, whom Marion grows to love.

Such is Verghese’s talent that minor characters like patients, interns, Ethiopian soldiers and even the emperor’s spoiled little dog are compelling. Trained as a doctor (his memoir about working with AIDS patients garnered considerable acclaim), his depictions of surgery are graphic without being macabre, and he’s also excellent at juxtaposing the intimate life of a family with the larger crises happening in the outside world. Cutting for Stone is a brilliantly realized book that the reader wants to live in, if only for a while.

Arlene McKanic writes from Jamaica, New York.

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