Abraham Verghese - Cutting for Stone

I thought of the surgical anatomy atlas I had seen in his condominium, a big folio book, and next to it an operative anatomy atlas, both open on his desk as if they were the last things he looked at before he left his apartment.

“What about the day I … the day of your morbidity and mortality conference?”

“Exactly. Early that morning I had to do a simple breast lump excision, and if the biopsy was positive, then a mastectomy and auxiliary node dissection. I've done hundreds of them. Maybe more. But this was one of our nurses. Someone putting faith in me.”

“So what happened?”

“I walked into the theater, feeling as if I were about to faint. No one knows, of course. The mask helps. But as soon as I make the incision, it all vanishes. Then it feels silly to have been so anxious. Ridiculous. It'll never happen again, I tell myself. But it does.”

“Did it ever happen in Ethiopia?”

He shook his head. “I think it was because I knew I was the only choice the patient had. There were no other options. Two other surgeons in the whole city. Here there are so many surgeons.”

“Or maybe those lives weren't as valuable. Natives, right? Who cares? The alternative was death anyway, so why worry? Just like you come and take organs from our patients at Our Lady.”

He flinched. I sensed that no one ever talked to him in this manner. We hadn't agreed to any rules. If he didn't like it, he could just leave. He had come to Our Lady. This wasn't Mecca.

He clamped his lips together. “I don't expect you to understand,” he said.

I knew he wasn't talking about his surgical anxieties.

He patted his pockets. He didn't find what he was looking for. So he just sat there and blinked, waiting for more punishment.

He slumped down in the chair. He had crossed his legs, and hooked his free foot under the calf of the other, like a twisted vine. “You see … Mar-ion —” He wasn't used to saying my name. “I … It is not as if everything can be explained by logic.”

Now he uncrossed his legs and leaned forward. “I can't give you a neat explanation about why … I did what I did, because I don't understand it myself. Even after all these years …”

Which “it” was he talking about? I had my daggers lined up, and my lances and mace ready just behind them. I thought of all kinds of clever things to say: Save your breath. Or, I understand all'right. You took the path less traveled. You bailed out. What else is there to understand? But perhaps he meant the “it” of impregnating my mother.

“Ghosh said you didn't know how it happened. That it was a mystery to you.”

“Yes!” he said, relieved, but then I sensed he was blushing. “He said that? Yes, it was.”

“Like Joseph? Clueless about Mary and the baby? Babies, in your case.”

“… Yes.” He crossed his legs.

“Maybe you don't think you are my father.”

“No, it's not that. I am your father. I—”

“No, you're not! Ghosh was my father. He raised me. He taught me everything from riding a bike to hitting a square drive off the back foot. He gave me my love for medicine. He raised me and Shiva. I am here because of Ghosh. A greater man never lived.”

I had baited the trap, lured him in. But I was the one who snapped.

“ ‘Lived’ … ?” he said, leaning forward, the foot no longer wagging.

“Ghosh is dead.”

His features turned leaden, then pale.

I let him ruminate on that. I'm sure he wanted to know how, why, but he couldn't ask. The news had stopped him cold, saddened him, I could see. Good. I was touched. But I wasn't done kicking him. I was impressed that he took it, waited for more.

“So you are off the hook,” I said. “I had a father.”

He sighed. “I don't expect you to understand,” he said again.

“Tell me anyway.”

“Where shall I start?”

“ ‘Begin at the beginning and go on until you come to the end,’ the King said, very gravely, ‘then stop.’ Do you know who said that?”

I was enjoying myself. The famous Thomas Stone being grilled, getting screwed, getting a dose of his own medicine. Sure, he could rattle off the branches of the external carotid artery, or the boundaries of the foramen of Winslow, but did he know his Lewis Carroll? Did he know his Alice in Wonderland?

He surprised me with his answer. It was wrong but it was right.

“Ghosh,” he said, and the air went out of his lungs.

WHEN THOMAS STONE WAS A CHILD, he asked the—the gardener—where little boys came from. The ma-alt, a dark man with muddy eyes and acid breath from the previous night's arrack, said, “You came with the evening tide, of course! I found you. You were succulent and pink with one long fin and no scales. Such fish they say only exist in Ceylon, but there you were. I almost ate you, but I wasn't hungry. I cut off the fin with this very sickle and brought you to your mother.”

“I don't believe you. My mother and I must have washed in from the sea together. We were one large fish. I was in her belly and came out,” the little boy said, walking away. The maali could coax roses out of the earth where their neighbors failed. But Hilda Stone would have fired him for telling such tales to her only child.

The little boy's home was just outside the rock walls of Fort St. George in Madras, India. The spire of St. Mary's poked up from behind the incomplete battlements. Its quaint, well-tended cemetery was his playground, a place where more than five generations of English men, women, and babies were buried, taken by typhoid, malaria, kala azar, and rarely old age.

Fort St. George was the first home of the East India Company. St. Mary's, built in 1680, was the first Anglican church in India (but by no means the first church, that being the one built in A.D. 54 by St. Thomas the Apostle, who landed on the Kerala coast). A plaque inside St. Mary's commemorated the marriage of Lord Clive, and another that of Governor Elihu Yale, who later founded a university in America. But the little boy saw no plaque to commemorate the marriage of Hilda Masters of Fife, tutor and governess, to Justifus Stone, civil servant in the British Raj and almost two decades her senior.

Thomas thought every child grew up as he did—in sight of the Indian Ocean, hearing the fearsome-sounding waves crashing around Fort St. George. And he assumed that all fathers were like his, crashing into furniture and making alarming sounds at night.

Justifus Kaye Stone's voice rumbled down from a height, and his bottle-brush mustache kept little boys at bay. District collectors in the Indian Civil Service were demigods, with secretaries and peons hovering around them like flies around overripe mangoes. Collectors went on tours for weeks at a time, holding court in each city. When Justifus Stone was home, despite his noisy presence, he was somehow not there. Thomas understood (in that way that children do, even though they lack words to express themselves) that Justifus was a self-centered man and neglectful of his wife. Perhaps this was why Hilda turned to religion. To imagine Christ's suffering allowed her to live with hers.

Blessed are the meek.

Blessed are the peacemakers.

Blessed the young governess who marries a DC hoping to clear his yellow-tinged skin of quinine and cure his taste for gin and native women, for hers is the kingdom of heaven.

Hilda's blessing came in the form of her blue-eyed, towheaded boy whose feet she hardly let touch the ground, even when he was old enough to walk.

The little boy's ayah, Sebestie, had nothing to do other than join in the play since it was Hilda who let him ride on her back pretending he was Jim Corbett, the big-game hunter, and she the elephant carrying him to the tiger blind. Hilda drew red-chalk wickets on the whitewashed walls and bowled to him with a tennis ball. She sang hymns to him, and fanned him when it was too humid to fall asleep. The bell-like clarity of her voice caused somnolent lizards on the wall to snap to attention. Her brown hair, parted in the center, fell from a steepled head. Regardless of how she restrained it, a frizzy halo framed her face.