John Coyne recently published an interview with Abraham Verghese, whose first novel, Cutting For Stone, was published this past winter. [http://peacecorpsworldwide.org/writing/2009/07/13/verghese/]

 A well-regarded author of nonfiction and a graduate of the Iowa Writer’s Workshop, Verghese has a day job as a physician and a professor at Stanford University’s medical school. 

Much of Cutting For Stone takes place in Addis Ababa, the capital of Ethiopia, a rare setting for fiction. Verghese brings the unusual perspective of having been born, raised and educated in Addis, even starting his medical training there. He uses his familiarity with Addis life, but it is a rather precious slice of that life.  Verghese was born to Indian parents who taught in the private schools for the prosperous middle class and above, who lived nicely in a city where the vast majority struggled in poverty.  Verghese’s fictional Addis suggests that he didn’t often venture much beyond the circle of expatriates and the small Ethiopian elite. Even so, he would have experienced the close personal relationships that developed with household servants - more substantial than one might expect - where he learned to speak Amharic and was exposed to the public events of those years, including a failed coup against Emperor Haile Selassie (the history a bit manipulated in time to fit his story) and knew the hit songs, popular cafes and the like.  His lovely riff on the classic song ‘Tizita’ and the expressive power of the word was an inside job.   

The novel, however, is not about Addis Ababa or Ethiopia.  The city is a backdrop, lightly but nicely sketched by a sharp observer. He revived memories of my five years in Addis in the middle of his period - the mid 1950s to the late 1970s.  

 What the novel is about is harder to say, and it isn’t clear who Verghese is writing for. These liabilities reflect a weakness in telling the story, though the novel has some fine scenes. Much of the action takes place in the hospital where the adoptive parents of Marion Stone, the main character, are doctors and where he and his twin brother were born to a nurse who died there in childbirth. Joined at the head at birth and surgically separated - a gimmick, in my opinion - the boys go on to very different medical careers. 

Ethiopia surrounds the hospital compound but we get only glimpses of the city and none of the rest of the country. Marion and his brother are raised by the doctors, both of whom are expatriate MDs from India. Lesser characters include household helpers and hospital staff who are the vehicle for bringing Ethiopia’s human face into the story. They are nicely drawn and the relationships with the principle characters ring true, but they are not representative of the majority of Ethiopians because most would find such intimacy with expatriates impossible. Ethiopia, never colonized and only briefly occupied during World War II, never incorporated the presence of foreigners in its psyche the way colonies had to do.  Foreigners were distant objects of curiosity and mystery to most Ethiopians, not  targets for resentment or hate. Varghese’s Ethiopia is credible, but it is the Ethiopia of very few. 

The real Ethiopia arrives daily at ‘Missing Hospital’ in a steady flow of anonymous women and children suffering unimaginable misery from conditions rarely known in richer countries and too often untreatable by the time they arrive.  Pain and death surround these encounters, described in overwhelming detail for which only prepared readers will be able to grasp.    

It is no surprise that Dr. Verghese presents Ethiopia from a doctor’s perspective, and creates adult characters who are also MDs.  Even a layperson can find some of that interesting, but the volume of detail interfered with the dramatic flow.  The loving Indian couple (the boys’ mother was also Indian, their father was an American surgeon at the hospital who helped deliver them and disappeared from the story until late) were not merely doctors, but admirable, honorable, devoted, committed widely respected and admired doctors. They were, in fact, too admirable to be fully credible.    

Verghese’s bits of Ethiopian history were not as reliable as his nice touches of Addis detail, even allowing for his admitted tampering with chronology. Ethiopian Airlines was not founded to transport khat, the stimulant leaf so popular in the region. The airline always did good business transporting khat and still does, but to make drug trafficking its founding principle is a bit sensational, a cheap shot. His throwaway comments about Eritrea and Ethiopia reflect a weak understanding of a enduring problem and were in any case irrelevant and unnecessary. Fortunately, such stumbles are rare. 

More serious is the uncertain narrative that fails to build. The characters don’t come to life consistently. Improbable coincidences are increasingly hard to accept. And again, the recurring deluge of medical detail was a burden to a non-medical reader.     

The story ends in the United States, where Marion has fled to escape dangerous politics at home. His brother shows up, as do several Ethiopian women who played small roles back home. Their surgeon father also reappears.  The window into medical politics, not nearly as technical as physical medicine, was more interesting and accessible but still distracted from the narrative that should have been reaching a climax.  Instead, the novel comes to an unsatisfying end.

Despite its weaknesses, two groups of readers may enjoy this book more than might seem likely.  Those with strong memories of Addis Ababa or another Third World city in those years can enjoy Verghese’s sensitive evocation of relationships and of a time and place.  Addis is now a city of 5 million and the sparkling high altitude air he writes about is now gray with pollution, the streets jammed. But my recent visits confirm that the people have not changed and Verghese’s touch is light but impressive, capturing relationships between the Indian doctors and the boys on one hand, and the Ethiopian household help and hospital workers who became, as they so often  did in Ethiopia members of an extended family while never forgetting their respective roles, on the other. They shared great intimacy while still living completely separate lives. 

Readers with a medical interest may also find much to interest them.  Of course I trust Verghese here. In particular, his descriptions of backstage life in US training hospitals were revealing, even if they didn’t do much for the novel.      

Here is the review of Cutting for Stone published by the New York Times on February 6, 2009:  http://www.nytimes.com/2009/02/08/books/review/Wagner-t.html.

Shlomo Bachrach, an authority on the recent history of Ethiopia, was on the Peace Corps Staff in Addis Ababa from 1966 to 1968. He worked on Peace Corps Training Program in Ethiopia beginning in 1964 until 1970. Shlomo has a BA in English and a Masters in Linguistics, both from UCLA. From 1964 to 1966 he was a lecturer at Haile Selassie I University. He also conducted regular seminars and workshops for teachers throughout Ethiopia for Ethiopians, Peace Corps Volunteers and contract teachers. He is the author of an English text adopted by the Ministry of Education in 1967. It has been a standard text book for the last fifteen years. He has also done development work for USAID and World Ban in other African countries and his most recent project in Ethiopia was the Ethiopian Coffee Trademark Initiative that began in 2004.