Cutting for Stone by Abraham Verghese was published in 2009. Verghese, an Indian American doctor born in Ethiopia, interrupted his medical career to attend the University of Iowa’s Writing Workshop and wrote two memoirs before publishing this novel. The book is notable for its incorporation of medical knowledge and its intimate portrayal of the lives of medical doctors. The novel spans several decades, weaving a deeply personal story with the complex 20th-century history of Ethiopia.

Cutting for Stone was widely praised by critics, was on the New York Times bestseller list for two years, and was included on Barack Obama’s 2011 summer reading list. It was shortlisted for the 2009 Wellcome Trust Book Prize and longlisted for the 2011 International Dublin Literary Award. In 2015, Verghese received a National Humanities Medal for his work.

This guide refers to the eBook edition of this text, published in 2009 by Vintage Books.

Content Warning: The source text contains descriptions of murder, death by suicide, animal abuse, maternal death, traumatic childbirth, sexual assault, and female genital mutilation.

Plot Summary

Cutting for Stone is the story of Marion Praise Stone and his twin brother, Shiva Praise Stone. The novel begins much earlier, with their parents, Sister Mary Joseph Praise (referred to as Sister) and Thomas Stone, meeting on a ship traveling from India to Yemen. When they arrive, Thomas asks Sister, a Carmelite nun, to come with him to Missing Hospital in Addis Ababa, Ethiopia. Although Sister initially declines, her mission in Aden comes to a terrible end, and so she travels to Missing to find Thomas. For the next seven years, they perform surgery together, Thomas operating and Sister assisting.

One day, although no one knew she was pregnant, Sister goes into labor. The labor is difficult, and Thomas, assuming the babies are dead, attempts to save her by removing them. In the end, Hema, the obstetrician, arrives and performs a Cesarean section, saving the twin boys, but Sister dies. The twins are conjoined but are successfully separated at birth. Thomas disappears, and Hema takes charge of the twins, naming them Marion and Shiva.

Hema and another doctor, Ghosh, adopt the twins. Marion and Shiva are never apart when they are young, but as they get older, they develop separate interests: Marion follows and observes Ghosh at the hospital, and Shiva observes Hema, learning dance from her as well. Marion falls in love with his friend Genet and plans for a future with her. However, Genet and Shiva have sex, which breaks Marion’s heart. He physically separates himself from Shiva for the first time, moving into separate quarters. Rosina, Genet’s mother, arranges for Genet’s genital mutilation, which almost kills her. Rosina then dies by suicide, and Genet moves in with Hema, Ghosh, and the twins.

Meanwhile, Ethiopia is in turmoil. A close friend of Ghosh’s, General Mebratu, stages a coup to depose Emperor Haile Selassie, which is ultimately unsuccessful. Ghosh is arrested because of his association with Mebratu and held for weeks. Later, Genet participates in the hijacking of an Ethiopian Airlines plane as a part of the Eritrean movement. A friend of hers identifies Marion as an associate, and Marion is forced to leave the country immediately. He is smuggled to Kenya, where he studies and readies himself to move to America and begin medical training there.

When he arrives in America, Marion has an internship at a Bronx hospital that is fully staffed by fellow immigrants who are working to become doctors in America. While he is assisting a surgery one day, his father, Thomas Stone, appears in the operating room but does not know who Marion is. Marion travels to Boston to attend a conference in which Thomas is participating, and Thomas recognizes Marion, who looks very much like himself. Marion vandalizes Thomas’s apartment and leaves a message from Sister on his desk. A few weeks later, Thomas and Marion warily reconnect. After he hears Thomas’s story, Marion feels more compassion for his father, and later in the book, he is able to finally forgive him. Marion also finds a woman he knew in Ethiopia living in Boston, and she tells him that Genet is in America, too.

Marion settles into his work as a trauma surgeon and buys a home in New York. One day, Genet shows up at his door and apologizes. She is very ill, so he cares for her. Then they have sex, and she disappears. At the hospital, they discover that Genet has given Marion hepatitis, and his liver is failing. Thomas contacts Hema, and she and Shiva come to New York, where Shiva offers to donate part of his liver to Marion. The operation is successful, but Shiva dies. Marion grieves deeply, but he also understands that a part of Shiva is in him, and he is now both Marion and Shiva, or ShivaMarion, again. He returns to Ethiopia with Hema and becomes a surgeon at Missing Hospital.