Not a cry or a groan escaped from Sister Mary Joseph Praise while in the throes of her cataclysmic labor. (P.7)
As a nun, we can expect that Sister Mary Joseph Praise is pretty much in control of her emotions and actions. But it's pretty incredible that she never even makes a peep when she's suffering what will end up being her doom. The novel makes her seem almost superhuman.
We come unbidden into this life, and if we are lucky we find a purpose beyond starvation, misery, and early death which, lest we forget, is the common lot. (P.14)
Okay, we don't need to ask Abraham Verghese whether the glass is half full or half empty; we think we know what he's going to say. This pessimistic view of life focuses on the fact that for the majority of humans, health and basic necessities are difficult to come by.
The black-and-red floating packet of misery that called itself a ship steamed across the Indian Ocean toward its destination, Aden. […] The ship wasn't meant to carry passengers, but the Greek captain did just that by housing 'paying guests.'" (1.1.8)
Whoa. Calm yourself, Verghese. What did that ship ever do to you? Marion comes in strong with a metaphor comparing the ship that carried his parents (before they were his parents) to Africa from India to a "floating packet of misery." Then he quickly links that misery to the ship captain's corruption, which is where the real blame lies.
On the ninth night, four of the sixteen passengers and one of the crew came down with a fever whose flesh signs were rose spots that appeared on the second febrile day and that arranged themselves like a Chinese puzzle on the chest and abdomen. (1.1.14)
This is one of our first tastes of the medical language that Marion will use throughout the novel. He reads the "flesh signs" like we read his metaphors. In case you're wondering, "febrile," means having to do with a fever. Look how the illness becomes an image: the spots are "rose" and "arrange themselves," as though they had powers.
Sister Mary Joseph Praise lay in agony on her narrow cot. Her lips were blue. Her lusterless eyes were focused beyond his face. She was deathly pale. He reached for her pulse, which was rapid and feeble. (1.2.29)
Up until now, most of the suffering described in the novel has been on a collective level: all of the ship's passengers, for example, were suffering the same thing. Now, Sister Mary Joseph Praise is going it alone. Her "agony" in this case means that her suffering probably won't ease until she buys the farm, if we read the signs like blue lips, dull eyes, and a weak pulse.
A herd of mules overladen with firewood trotted along, their expressions docile and angelic in the face of the whipping they were getting from the barefoot owner who ran with them. (1.6.42)
When Hema comes back to Addis Ababa, she takes in the familiar sights that she might have missed while she was in India. Mostly, she notices human beings, some suffering, and some happiness, but this image of the mules being whipped and overworked reminds us that humans can make each other suffer pretty easily—but we're also good at spreading it around to the rest of the animals.
Matron offered the history that Sister Mary Joseph Praise had been in severe pain, great spasms of it, and then the pains had suddenly ceased and she'd seemed almost lucid, talking…but now she had deteriorated again.
"My God," Hema said, knowing that in nature pains don't cease until a baby is out, "it sounds like a uterine rupture." It would explain all the blood on the floor. (1.7.33-34)
The first paragraph of this quotation gives the rundown of Sister Mary Joseph Praise's suffering, with Matron listing all of her symptoms. It's Hema who really makes the connection between the suffering and the baby. Everyone has been focused on saving Sister Mary Joseph Praise, but Hema knows that the nun's body is committed to giving birth.
This man she thought she knew well, seven years a colleague, now stood bent as if he'd been gutted.
That, she said to herself, is visceral pain. As angry as she'd been with him, the depth of his grief and his shame moved her. (1.10.37-38)
When Dr. Thomas Stone, who up until now has been mostly a rational guy, has finally been brought down by his emotions. Hema is furious with him not only for having gotten Sister Mary Joseph Praise pregnant and causing the situation, but also for having totally botched the operation. She can see that he is not a doctor in this moment; he's a suffering man.
"I tell you, I have never hurt like this." He grinned from ear to ear as if to say, A man is going along when out of the blue comes a banana peel, a cosmic joke that leaves you upended and clutching your belly. A wave of pain made him wince.
I can't possibly see you today. Beloved Sister has died […]. That was what Ghosh wanted to say, but in the face of such suffering he waited. (2.13.6-7)
When Mebratu comes into the hospital to get his stomach looked at, he acts very differently from someone like Sister Mary Joseph Praise in the face of his suffering. Whereas she is an angelic, stoic sufferer, he takes it as a joke. But the joke is a painful one: Mebratu is seeing things on the grand scale, as a "cosmic joke," which brings Ghosh out of his personal tragedy and forces him to perform his duties.
"[…] The pain was… I knew whatever this was would get worse, would kill me. But I had options. I came to you. When you told me that for my fellow countrymen, if they have to suffer this, they simply die…" The Colonel's face turned hard, and Ghosh could not be sure if it was anger or if he was holding back tears. He cleared his throat. "It was a crime to close my brother's health care center." (2.1.31)
The suffering that Mebratu feels with his stomach problem is intense. But, again, he's able to understand that suffering and recognize that even though he was in great pain, he still had the option to get good treatment for it; the majority of Ethiopians, without adequate care, would have just died in that situation. Through suffering he finds solidarity, which inspires him to revolt against the emperor.
I grew up and I found my purpose and it was to become a physician. (P.14)
Marion sees his profession as his entire reason for being. It's not surprising that he would be interested in medicine, having been raised in a hospital by doctors, but the use of the word "purpose" gives his chosen profession a nobler aura, as though he were called by a supernatural power to develop medical skills.
I chose the specialty of surgery because of Matron, that steady presence during my boyhood and adolescence. "What is the hardest thing you can possibly do?" she said when I went to her for advice on the darkest day of the first half of my life. (P.15)
Can you identify with Marion's desire to do the most difficult thing possible? Some people might cruise along, taking the path of least resistance or just letting the universe show them the way. Marion seems to believe that he is purifying himself by choosing a difficult career path.
"Because, Marion, you are an instrument of God. Don't leave the instrument sitting in its case, my son. Play! Leave no part of your instrument unexplored. Why settle for 'Three Blind Mice' when you can play the 'Gloria'?" (P.17)
Matron compares the art of surgery to the art of music. The "instrument" she talks about is Marion himself at first: "you are an instrument of God." But then the metaphor shifts, and she seems to be referring to Marion's potential: he should practice and work to improve so that instead of just being mediocre, he can be a great doctor.
Surgery was the most difficult thing I could imagine.
And so I became a surgeon.
Thirty years later, I am not known for speed, or daring, or technical genius. (P.21-23)
When Marion comes back to Ethiopia after his exile in the United States, he has received an education in surgery and passed the very difficult board exams. But all of that comes after this moment of resolution, where he imagines something difficult and then chooses to accomplish it.
The apparition was painfully thin, swaying, but resolute, and it seemed a miracle that it was capable of speech, when it said in a voice heavy with fatigue and sadness: "I desire to begin the time of discernment, the time of listening to God as He speaks in and through the Community. I ask for your prayers that I may spend the rest of my life in His Eucharistic Presence and prepare my soul for the great day of union between bride and Bridegroom." (1.1.77)
While everyone in Missing is dedicated to the practice of medicine, Sister Mary Joseph Praise first shows up begging to have the chance to improve her skills as a nun. Of course, part of her service as a nun is to be a nurse, but at this moment, when she appears before Matron for the first time, she is asking for the time to study, contemplate, and really focus on the skill required to be a follower of God.
As a surgeon, Stone was famous for his speed, his courage, his daring, his boldness, his inventiveness, the economy of his movements, and his calmness under duress. […] But when Sister Mary Joseph Praise, his assistant for seven years, went into labor, all these qualities vanished. (1.2.2)
Remember when Marion said that he is not known for his speed, daring, or technical genius? Well, now we know why he chose to include that information: his father is known just for those things. But there's a catch. Marion may not be a show-off doctor, but he is steady. Dr. Stone, on the other hand, was a superstar, but he choked when it really mattered.
Stone didn't believe in glorifying surgeons or operations. "Surgery is surgery is surgery," he liked to say, and on principle he would no more look up to a neurosurgeon than down on a podiatrist. (1.4.15)
It's funny, after our discussion of the differences between Marion's and Stone's skills, that here Marion claims that Stone didn't differentiate between the medical specialties. Stone might not think surgeons are any better than podiatrists, but Marion's decision to choose surgery because it's difficult might hint that he thinks differently.
A Cesarean section was technically not beyond Stone's abilities. But on that fateful day, the thought of taking scalpel to Sister Mary Joseph Praise—his surgical assistant, his closest confidante, his typist, his muse, and the woman he realized he loved—terrified him. (1.4.16)
For Dr. Stone, surgery has always been his wheelhouse. He knows what he's doing; he even wrote a book on it. But this time, the act of operating isn't just part of his job—it has become personal. Maybe the reason Stone is such a good doctor is that he doesn't see his patients as people and can therefore focus on the task at hand.
Hema's hands were like extensions of her eyes as she explored the space that she thought of as the portal to her work; fingers inside took their soundings, helped by the hand on the outside. (1.7.41)
We don't get to see much of Hema in action, but here's a rare peek. Whereas Stone is pretty showy with his skills, Hema is more organic. She feels rather than looks, and, funnily enough, she's able to separate the fact that the person on the table is her dear friend, even though you'd think this is a more intimate approach.
[The newborns] were obstetric miracles for surviving [Stone's] assault. Hema decided to name the first twin to breathe Marion. Marion Sims, she would tell me later, was a simple practitioner in Alabama, USA, who had revolutionized women's surgery. He was considered the father of obstetrics and gynecology, the patron saint; in naming me for him, she was both honoring him and giving thanks. (1.10.77)
The assault that this quote is talking about is the procedure that Stone attempted. He wanted to get the baby out of the birth canal, where it was stuck, because it was killing Sister Mary Joseph Praise. And so, well, the plan Stone came up with was to crush the baby's head and just pull it out. This brutal attack is stopped by Hema, and she names the untouched baby after the father of her field, the person who developed the skills that helped her save the twins.
"Marion, remember the Eleventh Commandment," he said. "Thou shall not operate on the day of a patient's death." (P.25)
Stone's advice to Marion is an allusion to the Bible's Ten Commandments. It's as though doctors have their own set of God-given rules, and this one is more about saving the doctor than saving the patient. It's about knowing when to give up and when to recognize that the doctor's powers are limited.
As she bent over the child she realized that the tragedy of death had to do entirely with what was left unfulfilled. (1.3.54)
Hema has an epiphany on the airplane heading back to Addis Ababa after her vacation in India. She realizes that she does, after many years without knowing it, want to have a child. For her, it's about cheating death: if she were to die in a plane crash with no descendants, her life would not go on in the form of her children.
She was already in appalling shape, pale and clammy, her pulse so thready that he believed anything he did would send her over the precipice. (1.4.16)
In this quote, life and death are given a spatial dimension. The precipice (which is a steep cliff) is a metaphor for the division between the two states, and Sister Mary Joseph Praise is teetering on the edge of it like a boulder hanging over Wile E. Coyote's head.
The passengers' relief turned to bewilderment and embarrassment, for the most godless among them had prayed for divine intervention. (1.5.4)
This is basically the Cutting for Stone version of "there are no atheists in foxholes." Basically, everyone can act like they're all tough and like they don't believe in God when they're just walking down the street playing with a yo-yo, but when they're looking mortality in the face, it's a different story.
"Perhaps she felt she deserved to die," Matron said, guessing at my mother's thoughts. (1.7.19)
Why would Sister Mary Joseph Praise feel she deserved to die? Well, go back and reread her name. Her parents didn't name her "sister"; the Church did. She's a nun, which is code for celibate, which is code for never getting it on. Ever. And we're pretty sure you all know where babies come from, so… you do the math.
Matron wondered if it scared my mother that she might die in Africa, a continent away from her birthplace. Perhaps deep in her—perhaps deep in every being—there lingers a desire to bring the circle of life back to its starting point, which in her case was Cochin. (1.7.20)
Death is final, as far as we know, so we can kind of see what Matron is getting at when she wonders about Sister Mary's feelings about dying far from home. Going back to where you started, to your birthplace, gives your life a feeling of being a never-ending cycle rather than a line that just drops off abruptly.
Matron, Gebrew, the nurse anesthetist, and others who had gathered were weeping around Sister's body. Word had spread to the maids and housekeepers. Now a funeral wail, a piercing lululululululu ripped through the heart of Missing. The ululations would continue for the next few hours. (1.10.66)
When Sister Mary Joseph Praise finally dies, it's like a public spectacle. There are so many people in the room where she lies naked, bloodied, and cut open by more than one surgeon that death is not a neat, tidy thing that they can just sweep under the rug. The lululu is a noise made to mark an important event, happy or sad, and it sounds like this.
"Lord help us all, but she is dead." Almaz was sobbing now. "She died giving birth to twins. Dr. Hema arrived but could not save her. Dr. Hema saved the twins."
Ghosh stopped hearing after her first mention of Sister and death. He had to have her repeat everything she said, and then repeat again everything that she knew, but each time it came down to Sister being dead. And something about twins. (2.11.103)
Death can be such a surprise, and it's not fixable. Ghosh has missed his chance to say goodbye to his friend, to understand what has happened, and to help. It's all over. Maybe that's why he "stops hearing." It's as though the finality of death were unacceptable to his brain: it does not compute.
Farther down were the graves of young Italian soldiers: NATO À ROMA, or NATO À NAPOLI, but no matter where they were born they were DECEDUTO AD ADDIS ABABA. Matron's vision turned misty as she thought of them having died so very far from home. (2.12.38)
Remember Matron's musing about dying far from home? The cemetery in Addis Ababa is filled with the bodies of soldiers who did just that fighting for Italy. "Nato à" means "born in," so the stones say "BORN IN ROME" and "BORN IN NAPLES." But all of them say DIED IN (DECEDUTO IN) ADDIS ABABA."
"Ghosh, if you bury me in Gulele, I'll never forgive you," she said. Ghosh decided silence was the best strategy. "We Christians believe that in the Lord's Second Coming the dead will be raised from the grave." (2.12.53)
Even though Matron is worried about Sister Mary Joseph Praise dying far from her birthplace, we see now that she doesn't actually believe that death is the end. Her belief isn't in reincarnation, exactly, but more in resurrection. The difference is that reincarnation involves being born again as a new being, whereas resurrection means being raised from the dead as the same person.
I remember his words on full-moon nights in Addis Ababa when knives are flashing and rocks and bullets are flying, and when I feel as if I am standing in an abattoir and not in Operating Theater 3, my skin flecked with the grist and blood of strangers. I remember. (P.26)
The prologue has Marion explaining where he is now (Addis Ababa, clearly in a war zone) but also letting us know what the novel is going to be about: it's going to be all about his memory. Even while he's dodging bullets in the present, Marion is actually reliving the past, over and over again.
At such moments I remember to thank my twin brother, Shiva—Dr. Shiva Praise Stone—to seek him out, to find his reflection in the glass panel that separates the two operating theaters, and to nod my thanks because he allows me to be what I am today. (P.28)
Marion's brother is a memory because he died. We don't know yet how or why, but this mention shows us that the twins have split. The reflection probably looks just like Shiva, since Marion and Shiva were identical twins, but it's still just a piece of glass. Marion can't get to his reflection, just like he can't go back in time to get to Shiva.
In the ensuing seven years that she lived and worked at Missing Hospital, Sister Mary Joseph Praise rarely spoke about her voyage and never about her time in Aden. (1.1.83)
Whereas Marion has decided to sit down and write his entire past, including memories that don't even belong to him, his mother had a different approach. She experienced a terrible trauma in Aden, probably rape and kidnapping, and decided to bury her memories of the past, never looking back.
Such a crucial gap in the history, especially that of a short life, calls attention to itself. A biographer, or a son, must dig deep. Perhaps she knew that the side effect of such a quest was that I'd learn medicine, or that I would find Thomas Stone. (1.1.84)
Marion never got to know his mother, so he has no memories of her. This "gap" must gnaw at him, because he decides to fill it up with information he gathers from a historical investigation. What he hasn't experienced he wants to learn by reading and talking to others who did.
As abruptly as it started, in two days, no more than three, the spell would be over, and after a very long sleep Stone would be back at work as if nothing had happened, never making any reference to how he'd inconvenienced the hospital, the memory of it erased. (1.2.42)
Whereas Sister Mary Joseph Praise forgets her past because it is so painful to her, Dr. Stone forgets his past because it is so painful to others. His drunken binges cause considerable damage to the hospital and its staff, but he never even acknowledges them.
When, years later, she'd look back at this moment of change, look at it clinically ("Milk the history! Exactly when and exactly how did it start? Onset is everything! In the anamnesis is the diagnosis!" as her professor would say), she would see that her transformation actually took place over many months. However, it was only as she was falling out of the sky over the Bab al-Mandab that she understood that change had come. (1.3.44)
The word anamnesis comes from Greek and means remembrance or reminiscence. In this case, however, it refers to a medical history. The doctor's job isn't just to work with the body in front of her, but also to ask the patient for memories of symptoms and pain in order to fit the past into the present and make a diagnosis.
Perhaps it was because the emperor was still on her mind, and because her taxi was at the intersection where, in place of the string of shops, there once stood a gallows, but suddenly Hema was thinking about a scene that haunted her. (1.6.50)
Isn't it funny when space and time kind of implode, like in this scene? Hema has lived in Addis Ababa for years, but for some reason, today, when she drives past a certain spot, she is transported back in time to the memory of that spot several years ago. Of course, it's a traumatic memory of a hanging, so it's not such a surprise that it could creep up, but it's still interesting how place triggers memory.
He turned to leave again, glancing around as if to seal in his memory this place in which he'd polished and elevated his art, this place that he'd furnished to suit his needs and that he thought was his real home. He took it all in because he knew he'd never ever return. (1.10.49)
We don't often get the chance to know that an experience is our last one. Stone is making the decision to leave Missing (and the pain of losing Sister Mary Joseph Praise) behind him, and so he's able to program his own memories of the place. This vision of the place will haunt him for years to come.
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)
Many cultures have words for nostalgia, but the word tizita has a special hint of remorse or regret in it. Even though Ghosh is not Ethiopian, he seems to have adopted its attitude toward the past, in which all memories must have regrets.
She was mourning […] the passage of the years. She'd come to Addis Ababa from England after getting restless teaching in a convent school and running the student infirmary; she'd accepted a post with Sudan Interior Mission to work in Harrar, Ethiopia. In Addis, she found her orders were canceled because the Italians had attacked, and so she had simply attached herself to a small hospital all but abandoned by the American Protestants. (2.12.48)
Matron, like Stone on his way out of the hospital, is very conscious of the way the past is building up behind her, pressing in on her and stealing her attention from the present. It must be strange to look back on events that, at the time, couldn't have the weight they do now that they are in the past.
At such moments I remember to thank my twin brother, Shiva—Dr. Shiva Praise Stone—to seek him out, to find his reflection in the glass panel that separates the two operating theaters, and to nod my thanks because he allows me to be what I am today. (P.28)
Though we can't know it when we first read the prologue, we know now that Marion feels that he and his once-conjoined identical twin Shiva have been reunited in the flesh. Shiva "allows" Marion to be what he is because he donated part of his liver to him, saving his life. The brothers' identities fuse by means of this transplant.
Born in Africa, living in exile in America, then returning at last to Africa, I am proof that geography is destiny. Destiny has brought me back to the precise coordinates of my birth, to the very same operating theater where I was born. (P.30)
Matron mourned the fact that many people who die in Ethiopia (like Sister Mary Joseph Praise or the Italian soldiers) are not actually from Ethiopia. Marion is one of the few characters we get to know who was actually born there and who gets to live out his adulthood there. He is Ethiopian, though his parents are not.
Twin brothers, we slept in the same bed till our teens, our heads touching, our legs and torsos angled away. We outgrew that intimacy, but I still long for it, for the proximity of his skull. (P.32)
The boys build up their identity as a collective. They are "the twins," and this position that they sleep in at night reinforces the togetherness that they experienced when they were joined at the head in the womb. Even after the stump that connects them is cut, they continue to feel as though they are a unit.
We two unnamed babies, newly arrived, were without breath. If most newborns meet life outside the womb with a shrill, piercing wail, ours was the saddest of all songs: the stillborn's song of silence. (1.10.1)
The boys don't have names because one of their parents is dying and the other is busy falling apart. Their lack of names means they don't have an identity—no one has claimed them, no one will take care of them, and no one even realizes they are alive. And so they don't speak, or cry, either.
Why had Hema taken on the naming of the babies? It felt premature. He couldn't get his lips around the names. Were the names negotiable? What if Thomas Stone showed up? And why name the child of a nun and an Englishman after a Hindu god? And for the other twin, also a boy, why Marion? Surely it was temporary, until Stone came to his senses, or the British Embassy or someone made arrangements. Hema was acting as if the kids were hers. (2.15.18)
This paragraph is just packed with thoughts about how identity is constructed. First up, Hema names the babies, which is sort of like claiming them as her own kids. Would changing parents change the twins' identities?
No matter how far apart Hema put [the twins], when she came to them again, they would be in a V, their heads touching, facing each other, just as they had been in the womb. (2.15.55)
There's a strong argument for nature over nurture going on here. Whereas everyone treats the boys as though they were two separate people (because they are, physically), they remember where they came from. They share an identity as the conjoined twins, one and the same.
"Look," Hema hissed, embarrassed by his behavior, "the father is supposed to whisper the child's name into its ear. If you don't want to do it, I'll call someone else."
That word—"father"—changed everything. He felt a thrill. He quickly whispered "Marion" and then "Shiva" into each tiny ear, kissed each child, then kissed Hema on the cheek before he could pull away, saying "Bye, Mama" [...]. (2.16.30-31)
Just as Ghosh realizes that Hema has become a mother when she names the babies, he gets that he must be her partner if she's calling him their father. The way that a person reacts to being identified as a certain role is very telling. It's as though Ghosh were waiting to be called a father all of his life, and he rises to the challenge.
The twins weren't easy to tell apart but for the anklet which Hema had kept on Shiva as a talisman. (2.16.32)
The difference between Shiva and Marion is artificial, just like the surgeon's slice that separated them from one another just after they were born. Here, rather than having a birthmark or a tic that identifies them, Shiva is marked by Hema. She has him wear bells that let her know which one he is.
If they didn't show awareness of each other, Hema believed it was because they thought they were one. When they were bottle-fed, one in Rosina's arms, the other in Hema's or Ghosh's, it helped greatly for them to be within earshot, heads or limbs touching; if they took one twin to another room, they both became fussy. (2.16.34)
It takes a while for the babies to realize that they are two separate people. Psychologists say this is a normal part of development, but usually the baby believes it is merged with its mother. Shiva and Marion have lost their mother, so they become all things to one another.
Had ShivaMarion been delivered vaginally (impossible, given how our heads were connected), Shiva, presenting skull first, would have been the firstborn, the older twin. But when the Cesarean section reversed the natural birth order, I became the first to breathe—senior by a few seconds. I also became spokesperson for ShivaMarion.
Here's another way in which the twins' separate identities are actually inseparable. Usually, siblings (even twins) identify by birth order, but Shiva and Marion can't even differentiate in that way. Shiva was the first to start on his way out, but Marion was the first to be pulled out. They are the same.
She rinsed out the bucket and put it back within his reach. She mopped up the mess on the floor with a towel, then she rinsed the towel out and hung it up to dry. She brought water to his side. She withdrew, wondering how many days it had been since he'd eaten anything. (1.1.20)
When Sister Mary Joseph Praise first meets Dr. Thomas Stone, he's in really bad shape. Most people would run for their lives once they smelled the state of his ship cabin (think your worst flu on steroids), but Sister Mary Joseph Praise is such a compassionate person that she only thinks of how she can help.
"You did more than any human being could do," she said and took his hand in both of hers and held it. She looked into his eyes. "God be with you and bless you." (1.1.62)
Dr. Stone is worried that Sister Mary Joseph Praise will be unhappy with him because he is unable to save her friend, but she forgives him. That forgiveness is what he can't give himself years later when he's unable to save Sister Mary Joseph Praise herself. It will be many decades before he finds a letter that shows that she forgave him for getting her pregnant.
Every maternal instinct in Matron came alive, and she kept vigil. She was there when the young nun woke up in the night, terrified, delirious, clinging to Matron once she knew she was in a safe place. "Child, child, what happened to you? It is all right. You are safe now." With such soothing words, Matron comforted her, but it was a week before the young nun slept alone and another week before the color returned to her face. (1.1.80)
In Cutting for Stone, there is a strong connection between motherhood and compassion, even when we're not talking about technical mother-and-child relationships. Sister Mary Joseph Praise is far from her home, and Matron has no children of her own, but her "maternal instinct" perks up, and she treats Sister Mary with the compassion of a mother. Hey, she's called Matron, after all.
At the time of our birth the probationer was not yet eighteen, with a tendency to confuse penmanship and keeping a neat medical record (and thereby pleasing Matron) with the actual care of patients. (1.2.12)
The idea of compassion in medical care is an important one in Cutting for Stone. The probationer is probably the person who is most responsible for Sister Mary Joseph Praise's death, since she was more worried about following rules than about seeing what was in front of her and feeling any compassion.
There was a question the chief examiner had posed to him when he appeared for the Royal College of Surgeons viva voce after passing his written examinations in Edinburgh: "What first-aid treatment in shock is administered by ear?" His answer "Words of comfort!" had won the day. (1.2.37)
This is the lesson that the probationer needed to have learned before she ignored Sister Mary Joseph Praise's pain. She doesn't understand that being a nurse doesn't mean being inhuman. Dr. Stone seems to have learned the lesson on paper, but we're not sure he has figured out how to apply it.
As angry as she'd been with him, the depth of his grief and his shame moved her. (1.10.38)
Hema is the person in the novel who shows the greatest extremes of emotion. She is so furious with Dr. Stone that she could kill him, but at the same time, she's able to put herself in his shoes and feel compassion, forgiving him for the pain he's caused because he's experiencing so much pain himself.
Even the probationer began to show the first inkling of Sound Nursing Sense. Instead of struggling to appear to be something she was not, she wept for Sister, who was the only nurse who really understood her. For the first time the probationer saw the children not as "fetuses" or "neonates" but instead as motherless children, like herself, to be pitied. Her tears poured out. (1.10.67)
Finally, the probationer starts to understand what everyone has been calling "sound nursing sense." She thinks it's something she can gain by memorizing the words in her textbooks, but really she needs to feel it in her bones. For some good students, that's the hardest lesson of all.
"My journey, my pain, my operation…," the Colonel went on, "God was showing me the suffering of my people. It was a message. How we treat the least of our brethren, how we treat the peasant suffering with volvulus, that's the measure of this country. Not our fighter planes or tanks, or how big the Emperor's palace happens to be. I think God put you in my path." (2.14.33)
Colonel Mebratu will go on to lead a coup against the emperor in an attempt to free his people from the injustice and poverty they experience under his rule. An important factor in making the decision to fight is the compassion he feels for his fellow Ethiopians, who live in terrible conditions.
"When you look around Addis and see children barefoot and shivering in the rain, when you see the lepers begging for their next morsel, does any of that Monophysitic nonsense matter the least bit?"
Matron leaned her head on the windowpane.
"God will judge us [...] by what we did to relieve the suffering of our fellow human beings." (2.14.54-56)
Monophysitic is a term that refers to someone who believes that Jesus was totally divine. It's opposed to the idea that Jesus had two natures, divine and human. What's the big deal, you ask? Well, Matron asks the same thing. Some people are more worried about philosophical debates than about basic needs being met, and Matron wants to teach them some compassion.
"I'll confess, Mr. Harris, that as I get older, my prayers aren't about forgiveness. My prayers are for money to do His work." (2.14.79)
It's interesting that Matron associates prayers for forgiveness with her youth. We might think that the older people get, the more they've done that requires forgiveness, but it seems Matron has come to believe that God is more compassionate than she thought, so she spends her time trying to be compassionate, too.
"Dr. Stone. Your patient," she said to the man who everyone believed to be my father, putting in his hands not only the life of a woman that he chose to love, but our two lives—mine and my brother's—which he chose to hate. (1.2.65)
When Matron she sees what's going on between Sister Mary's legs she abandons ship, handing over the wheel to Dr. Stone, who is not quite the captain she hoped for. Not that we blame her, really—she's way out of her league here.
Hemlatha had established that the boys could move their limbs, neither of them was cockeyed, and they seemed to hear and to see. "Thomas," she said, approaching, but he cringed. He turned away. He would not look. (1.10.36)
Stone seems to feel a physical repulsion to the babies, though they're his own flesh and blood. He "cringes," "turns away," and "won't look." It's like people who are afraid to watch a horror movie and won't peek at the screen even though their friends beg them to. Is Stone afraid of the children and what they represent?
Stone thrust his chin at her, as if to say she could name them whatever she wanted. "Please get them out of my sight," he said very softly. (1.10.43)
What a juxtaposition: the man's body language (chin jutting out) and words ("get them out of my sight") clash wildly with his tone (very soft). Why? How could he so calmly choose to abandon his children? The chin-jut, though, indicates that he's leaving Hema in charge, so maybe the knowledge that she'll care for them makes it easier for him to leave.
He kept his back turned on the infants to gaze once more at Sister Mary Joseph Praise. (1.10.45)
Aha! Now we're starting to peel back some of the layers of the onion that is Dr. Thomas Stone. It's not necessarily that he's abandoning his children (okay, yes, it is) but that he can't abandon Sister Mary. He can't accept her death, and that she, in a sense, has abandoned him.
Stone wanted to run away, but not from the children or from responsibility. It was the mystery, the impossibility of their existence that made him turn his back on the infants. (1.10.45)
Here we get some more clarification as to Stone's motivations for abandoning Shiva and Marion. He doesn't know how Sister Mary Joseph Praise got pregnant, though he's a doctor, so we're pretty sure he knows where babies come from. It turns out he and Sister Mary Joseph Praise had sex while he was in a drunken fever dream, so he didn't even realize that it had really happened. So romantic.
Sister Mary Joseph Praise lay lifeless and unburdened of the two lives she carried, as if that had been her sole earthly purpose. (1.10.46)
Sister Mary Joseph Praise dies on the operating table, just after her children have been delivered. She abandons her physical body and her babies all in one fell swoop. The description of her as "unburdened" makes her seem like a beast of burden, like a donkey or a mule, something meant only to carry things. The narrator even says that bringing the boys to earth was her only purpose.
"Stone, think about this," Hema said. "Turn your back on me if you want, because I'll have no use for you. But don't turn your back on these children. I won't ask you again."
[…] What she didn't see was any recognition of the infants as being connected to him. He spoke like a man who'd just been hit on the head. "Hema, I don't understand who… why they are here… why Mary is dead." (1.10.50-51)
Hema seems to think that all Stone wants is to abandon someone, and he'll be satisfied—so she offers up herself in exchange for the boys, who need their father. But Stone still doesn't know how Sister Mary Joseph Praise got pregnant; he might be thinking that she had a secret boyfriend (besides him). That makes it easier for him to abandon the babies.
At last he met her gaze, refusing to look down at the infants, and what he said wasn't what she wanted to hear. "Hema, I don't want to set eyes on them, ever." (1.10.53)
Good thing destiny had other plans for Thomas Stone, or we wouldn't have a novel to read. At this moment, Stone truly does reject the children and abandon them, knowingly. By stating that he doesn't ever want them in his sight, he is banishing them from his life. But they'll be back. Oh, they'll be back.
"You heard me, Stone, you killed her," Hema said, raising her voice so that she drowned out every other sound. He flinched as the words lashed into him. It pleased her. She felt no pity. Not for a man who wouldn't claim his children. He pushed the swinging door so hard it shrieked in protest.
"Stone, you killed her," she shouted after him. "These are your children." (1.10.61-62)
Hema doesn't even seem to be trying to bring Stone back at this point. Now she's just punishing him for abandoning his poor, defenseless sons just after their mother abandoned them by dying. Even the door seems to judge him, shrieking in protest as he walks out of the hospital, never to return.
And finally, reluctantly, almost as an afterthought, but because you cannot escape your destiny, and so that he wouldn't walk away scot-free, she added our surname, the name of the man who had left the room: Stone. (1.10.81)
It's a funny twist on Hema's part. She doesn't want Stone to come back for the babies, but she also wants to mark him as their father. She doesn't want to let him get away with abandoning them, because it was the wrong thing to do. It's also a sort of favor to the babies, connecting them to their father by name if by nothing else.
The oldest profession in the world raised no eyebrows, even with Hema. She'd learned it was futile to object—it would have been like taking exception to oxygen. But the consequences of such tolerance were evident to her: tubal and ovarian abscesses, infertility from gonorrhea, stillbirths, and babies with congenital syphilis. (1.6.47)
In case you're wondering, "the oldest profession in the world" is a euphemism for prostitution. Hema has seen so much of the practice in her life as a doctor that she doesn't really have a moral opinion. And why, you might ask, would a doctor need to know about prostitution? Just read the list of conditions that result in unsafe sex, and you'll get the point.
"What gives you the right to address me this way?" he said, though he didn't really feel the anger his voice carried. He was about to add, Are you my wife?—but choked those words off. To his perpetual shame, he and Almaz had been intimate twice over the years, both times when he was drunk. She'd lain down, lifted, and spread, grumbling even as her hips fell into rhythm with his, but no more than she grumbled about the coffee or hot water. (2.11.21)
Sex is basically shameful for Ghosh, because he's always doing it with women he doesn't love. But here it's especially shameful because with Almaz, he has abused his power as her employer and has taken advantage of her. Think about it—what would be the consequences of her saying no? Possibly losing her job and her income.
In the bathroom Ghosh felt a sharp pain as he peed and was forced to cut off his stream. "Like sliding down the edge of a razor blade using my balls as brakes," he muttered, his eyes tearing. What did the French call it? Chaude pisse, but that didn't come close to describing his symptoms.
Was the mysterious irritation from lack of use? (2.11.27-28)
Ghosh pays for his shameful ways, though, just like pretty much every character in Cutting for Stone. Sex leads to no good, and in Ghosh's case, this takes the form of the famous burning urination: chaude pisse means "hot piss" in French, and it's a colloquial term for gonorrhea.
After his first liaison in Ethiopia (and the only time he'd not used a condom), he had relied on the Allied Army Field Method for "post-exposure prophylaxis," as it was called in the books: wash with soap and mercuric chloride, then squeeze silver proteinate ointment into the urethra and milk it down the length of his shaft. It felt like a penance invented by the Jesuits. (2.11.29)
Once again, sex is super dangerous in this novel. Ghosh has sex only once in Ethiopia, and he's immediately infected. He practices prophylaxis, which is basically preventive care, but it's kind of a scary treatment, and it might be doing more harm than the disease he's trying to prevent. Message: SEX = PAIN.
High heels to show off her calves. Dark polish on her toenails. Very pretty, he thought. [...] The land of milk and honey, Ghosh thought. Milk and honey, and love for money. (2.11.64-65)
The signs might seem subtle to us, because high heels and nail polish are pretty commonplace. But Ghosh reads the barkeeper's accessories as signs that she is willing to have sex for money. Ethiopia is associated with the biblical Promised Land, a land of milk and honey, and Ghosh associates it also with an abundance of prostitutes.
Much, much later, they retired to the back room; he closed his eyes and pretended, as he always did, that she was Hema. A most willing Hema. (2.11.92)
And there it is. Ghosh is so concerned about getting infections because he is actually not happy with the sex he's having. And why isn't he happy? Because he's not having it with Hema, his secret crush. So instead of just talking to her about how he feels, he fantasizes that every other woman is Hema. It doesn't really work.
She pulled him in, welcomed him—colleague, fellow physician, stranger, friend, and lover. She gasped in regret for all the evenings they'd sat across from each other, baiting each other and throwing barbs (though, now that she thought about it, she did most of the baiting and throwing) when they could have been engaged in this astonishing congress. (2.16.82)
Finally! Hema and Ghosh get together, and we have the one positive sex scene in the entire book. Seriously. So it seems that Cutting for Stone only advocates for sex between old friends, and all others will end in unwanted pregnancies, which in turn end in death, or in disease. Be warned.
What I felt with the probationer, I never wanted to feel with anyone but Genet. There were too many temptations out there, great forces ready to shake me free of my avowed intent. I wanted to succumb to temptation. But with just one woman, and that was Genet. (3.31.59)
The probationer awakens Marion's sexual feelings when he's hit puberty, but he doesn't feel like exploring them with her. He's in love with Genet and wants sex and love to be all part of the same thing. Unlike Shiva, he is unable to separate sex from love, and so he only wants sex with the woman he loves.
"You want proof? Is that it?" she yelled. "She reached to her waist and drew something out and flung it at me. A pair of women's panties. "Her blood… and your seed." I picked the garment off my face. In the dark I could see nothing. But I could smell blood, the scent of Genet… and I could smell semen. It was mine. I recognized my starchy scent. No one else shared that odor. No one but my twin brother. (3.34.67-68)
Poor Marion. Even though he would like to have been the one to sleep with Genet for the first time, Shiva got there first—and Marion is blamed for it, anyway. The fact that his twin brother would sleep with the girl he loves is a major betrayal at first glance, but maybe it happens because Shiva doesn't really see himself as separate from Marion.
I grabbed her shoulders and pulled her to me hard. I smelled her fever, and the scent of blood and sex and urine. I came again. (4.50.90)
When Marion finally loses his virginity, it is to Genet, but not in the jungle-fantasy honeymoon suite he'd dreamed about. Instead, it's after she's been sick and in jail, and the sex is painful for her. She asks him to stop, and he ignores her. There doesn't seem to be any responsibility for what amounts to sexual assault here, but Marion certainly grows to hate Genet when he contracts her illness.