The title Cutting for Stone is a pretty on the nose, but it can take a while to figure it out if you're not a doctor who's memorized the Hippocratic oath. That's the professional promise that doctors make ("first do no harm") when they first become legit doctors, and one of its vows goes a little like this:
"I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art…" (Part 3, epigraph)
Wait, what? Okay, let's slow down. According to the author, this refers to back in the day when people got lots of bladder stones, and so there were lots of dudes who went around cutting them out. Problem was, these dudes didn't know much of anything about germs and bacteria and things like that, so lots of people got infected. This promise is basically a repetition of "do no harm"—it's just more specific.
It also fits handily in with the surname of many of the characters: Stone. Dr. Thomas Stone, Shiva and Marion Stone's biological father, abandons them on the day that they're born. They spend their lives wondering about him; his memory, or lack thereof, bugs them. When Marion finally gets the chance to find him he digs in, almost surgically extracting an apology from his dad. Get it? Deep, right?
The very last scene in the novel has Marion, now a middle-aged man, calling up his father, Dr. Thomas Stone. Marion is in Ethiopia, and Stone in Boston. Marion has finally found the mysterious missing letter written by Sister Mary Joseph Praise the day before he was born, and he wants to tell Stone. The last line reads: "'Stone here,' he said, his voice sounding so very close, as if he were there with me, as if nothing at all separated our two worlds.'" (4.55.13). So what's up with that?
The phone call crosses the Atlantic, from one continent to another, and also crosses generations, from son to father. The miracle of the telephone might be the only thing making Stone's voice sound "so very close," but we think it's more that the two men have finally, after many years of being estranged, come together. Sister Mary Joseph Praise's love for and forgiveness of Stone allow Marion to forgive him as well. There's no more anger and hate between their hearts.
Almost all of the action of Cutting for Stone takes place within one of two hospitals. The characters live apart from the societies that their hospitals serve. While outside there is chaos, danger, and poverty, inside of both Missing and Our Lady, the world is regulated by science and medicine.
Even so, the majority of the characters are considered ferengi, foreigners, and that's because most of them were either born elsewhere or were born to immigrant parents. So it's fitting that they all take refuge in the hospital they call "Missing." The name seems strange, because it's "really Mission Hospital, a word that on the Ethiopian tongue came out with a hiss so it sounded like 'Missing'" (P.6).
Translation: the novel's setting is an unpronounceable hospital filled with foreigners.
Besides the corruption of Mission to Missing, the hospital's name also constantly reminds us that, error or not, everyone there is "missing" someone or someplace. The loneliness of the foreigners is part of the setting.
Missing, according to Marion, is a fertile place, a sort of paradise:
"Missing sat on a verdant rise, the irregular cluster of whitewashed one- and two-story buildings looking as if they were pushed up from the ground in the same geologic rumble that created the Entoto Mountains. Troughlike flower beds, fed by the runoff from the roof gutters, surrounded the squat buildings like a moat. Matron Hirst's roses overtook the walls, the crimson blooms framing every window and reaching to the roof." (P.4)
Marion sees Missing as an organic, natural thing, not an artificial building. It seems to grow up out of the ground, and it supports the plants that grow on its territory with plenty of fertile soil. It's also a good place for the narrator to grow up; it's his paradise. It's almost as if because Marion has been out of place his whole life, being "missing" just feels natural to him.
In comparison to Missing, Our Lady of Perpetual Succor hospital in New York is not quite the Eden that Marion might have expected. He notices how rundown his new home is as soon as he arrives:
"We rounded a dry fountain, streaked with pigeon droppings. It resembled the magnificent one depicted in the brochure, but the bronze monsignor who was the centerpiece leaned precariously forward. The monsignor's features were worn down like the sphinx's. Also not in the brochure was the iron rod wedged between the rim of the fountain and the monsignor's waist to keep him from falling over." (4.38.64)
The description contrasts greatly with Missing: dry, precarious, worn down, falling over. Our Lady is in bad shape, and this is a disappointment to Marion because the brochure showed a much rosier picture.
This disappointment is shared by all of the hopeful doctors who come to Our Lady hoping for a bright future. Lou, the caretaker, calls them "Perpetual Suckers" (4.38.84), a play on the word "succor," as in the consolation that the Virgin Mary gives to faithful believers, and "sucker," meaning someone who has been conned.
Even if it's not all it's cracked up to be, Our Lady is, like Missing, a hospital that is sheltered from the violence outside. While in Ethiopia, Missing battened down the hatches against revolution, in New York, Our Lady shuts the gates against the gun violence that accompanies the drug trade in the surrounding neighborhood. Either way, the novel's characters find a shelter from the storm.
Cutting for Stone is divided into four parts, each part with its own epigraph… or three. So hold on tight, Shmoopers; time to go epigraph hunting.
. . . for the secret of the care of the patient is in caring for the patient. – Francis W. Peabody, October 21, 1925
Might sound like Dr. Peabody got mixed up there, but we think he's playing with the word "care." There's medical care, which can be a little impersonal, and there's caring for someone, which is more intimate. This epigraph means that it's not just book learning, but also genuine love that makes a doctor great.
When a pole goes into a hole
it creates another soul
which is either a pole
or a hole — Newton's Fourth Law of Motion (as taught by the Mighty Senior Sirs of Madras Christian College during the initiation/ragging of A. Ghosh, Junior Pisser Kataan, Batch of 1938, St. Thomas Hall, D Block, Tambaram, Madras)
So, you're smart Shmoopers: we don't have to explain to you that this is a dirty joke. The poem is talking about sex and reproduction, and that's a big part of Part II of the book, which is all about Hema and Ghosh finally falling in love and getting married. They do become parents, of course, though it's not because of any pole-and-hole play: they adopt the twins.
I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art… — Hippocratic oath
See "What's Up with the Title?" for our discussion of this epigraph!
Theirs is the stoneless fruit of love
Whose love is returned. – Tiruvalluvar, The Kural
This line from a classical poem written in Tamil, a South Asian language, also talks about stones, just like the Hippocratic oath and the title. In this case, though, the stone refers to the pit of a fruit, like a peach. You know how pesky it is to always be picking the pits out of cherries? Wouldn't it be nice if they were all sweet, squishy goodness with nothing to break your teeth on?
According to this epigraph, loving and being loved in return is the squishy goodness of a seedless fruit. Not sounding romantic to you? Well, it goes along with the theme of stones, so cut an epigraph some slack, will you?
The intellect of man is forced to choose
the perfection of the life, or of the work,
And if it take the second must refuse
A heavenly mansion, raging in the dark. — William Yeats, "The Choice"
Our buddy Yeats has it figured out. Why work? Live your life, man! This part of the novel is about Marion's coming to terms with Thomas, who left his family and his life behind in order to dedicate himself to the work of being a surgeon. He is extremely successful, but he's all alone. That's why he's given up the "heavenly mansion" in the dark: because he's a workaholic, he has no love and nobody to call his own.
Cutting for Stone isn't too hard. It's straightforward and action-driven, it'll keep your feet moving one in front of the other, and it'll entertain you along the way. You may even be delighted by the Ethiopian terms, which are all clearly explained, and you may feel like you've learned a lot after you finish this climb.
"Tizita" is a traditional Ethiopian tune that crops up over and over again in Cutting for Stone, holding the storyline together. It first shows up when Ghosh is visiting a prostitute:
"On the radio the muffled twang of a krar repeated a six-note riff from a pentatonic scale that seemed common to all Ethiopian music, fast or slow. Ghosh recognized the song, a very popular one. It was called 'Tizita'; there was no single equivalent English word. Tizita meant 'memory tinged with regret.' Was there any other kind, Ghosh wondered." (2.11.85)
The title of the song—"memory tinged with regret"—reflects that fact that memory is one of the book's major themes. For Ghosh, memory will always carry regret; perhaps the fact that the past is unchangeable makes it always a little bit sad. The song is mentioned at various points in the novel to reflect the impossibility of going back and making wrongs right.
Later, there's an entire chapter called "Tizita," in which Marion describes his very first memories, those he had as a baby. Almaz, his nanny, sings the song to him as she gives him her breast to play with as a pacifier. This early connection to the maternal and to birth is what Marion brings with him to America later on, when he meets Ethiopians in exile.
The Ethiopians in exile share their memories of their homeland by sharing their recordings of the song: "They are eager to share, to thrust that song in my hands, as if only 'Tizita' explains the strange inertia that overcomes them" (3.17.25). The song represents Ethiopia for the exiled people, so it's clear that these people's memories of Ethiopia are "tinged with regret." They can't go back, and they can't change what's done—but they can remember.