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Abraham Verghese: Cutting for Stone

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Abraham Verghese Cutting for Stone

Cutting for Stone: краткое содержание, описание и аннотация

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Marion and Shiva Stone are twin brothers born of a secret union between a beautiful Indian nun and a brash British surgeon at a mission hospital in Addis Ababa. Orphaned by their mother’s death in childbirth and their father’s disappearance, bound together by a preternatural connection and a shared fascination with medicine, the twins come of age as Ethiopia hovers on the brink of revolution. Yet it will be love, not politics—their passion for the same woman—that will tear them apart and force Marion, fresh out of medical school, to flee his homeland. He makes his way to America, finding refuge in his work as an intern at an underfunded, overcrowded New York City hospital. When the past catches up to him—nearly destroying him—Marion must entrust his life to the two men he thought he trusted least in the world: the surgeon father who abandoned him and the brother who betrayed him.

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Eventually she found a clean undershirt and shorts. What did it say when a man had fewer clothes than books? Turning him first this way and then that, she changed the sheets beneath him and then dressed him.

She knew his name was Thomas Stone because it was inscribed inside the surgical textbook hed placed at his bedside. In the book she found little about fever with rash, and nothing about seasickness.

That night Sister Mary Joseph Praise negotiated the heaving passageways, hurrying from one sickbed to the next. The mound where the deck had buckled resembled a shrouded figure and she averted her eyes. Once she saw a black mountain of a wave, several stories high, and the Calangute looked poised to fall into a hole. Sheets of water smashed over the bow, the noise more terrifying than the sight.

In the middle of the tempestuous ocean, groggy from lack of sleep, facing a terrible medical crisis, her world had become simplified. It was divided into those with fever, those with seasickness, and those without. And it was possible that none of these distinctions mattered, for very soon they might all drown.

She awoke from where she must have drifted off next to Anjali. In what seemed like the next instant she awoke again, but this time in the Englishman's cabin where she'd fallen asleep kneeling by his bed, her head lolling on his chest, his arm resting on her shoulder. In the time it took her to recognize this, she was asleep again, waking at daybreak finding herself on the bunk, but on its very edge, pressed against Thomas Stone. She hurried back to Anjali to find her worse, her respirations now sighing and rapid. There were large confluent purple patches showing on Anjali's skin.

The anxious faces of the sleepless crew and the fact that one fellow had knelt before her and said “Sister, forgive my sins!” told her that the ship was still in danger. The crew ignored her pleas for help.

Frantic and frustrated, Sister Mary Joseph Praise retrieved a hammock from the common room because of a vision she had in that fugue state between wakefulness and sleep. She strung it in his cabin between porthole and bedpost.

Dr. Stone was a dead weight and only the intercession of St. Catherine allowed her to drag him from bunk to floor, then feed him, one body part at a time, onto the hammock. Answering more to gravity than to the roll of the ship, the hammock found the true horizontal. She knelt beside him and prayed, pouring her heart out to Jesus, completing the Magnificat which had been interrupted the night the deck had buckled.

Color returned first to Stone's neck, then his cheeks. She fed him teaspoons of water. In an hour he held down broth. His eyes were open now, the light coming back into them, and the eyeballs tracking her every movement. Then, when she brought the spoon up, sturdy fingers encircled her wrist to guide the food to his mouth. She remembered the line shed sung moments before: “He hath filled the hungry with good things, and the rich He hath sent empty away.”

God had heard her prayers.

A pale and unsteady Thomas Stone came with Sister Mary Joseph Praise to where Sister Anjali lay. He gasped at the sight of the wide-eyed and delirious nun, her face pinched and anxious, her nose sharp as a pen, the nostrils flaring with each breath, seemingly awake and yet completely oblivious to her visitors.

He knelt over her, but Anjali's glassy gaze passed right through him. Sister Mary Joseph Praise watched the practiced way he pulled down Anjali's lids to examine her conjunctivae, and the way he swung the flashlight in front of her pupils. His movements were smooth and flowing as he bent Anjali's head toward her chest to check for neck stiffness, as he felt for lymph nodes, moved her limbs, and as he tapped her patel-lar tendon using his cocked finger in lieu of a reflex hammer. The awkwardness Sister Mary Joseph Praise had sensed in him when she had seen him as a passenger and then as a patient was gone.

He stripped off Anjali's clothes, unaware of Sister Mary Joseph Praise's assistance as he dispassionately studied the patient's back, thighs, and buttocks. The long sculpted fingers that probed Anjali's belly for the spleen and liver seemed to have been created for this purpose— she couldn't imagine them doing anything else. Not having his stethoscope, he applied his ear to Sister Anjali's heart, then her belly. Then he turned her to one side and pressed his ear against her ribs to listen to the lungs. He took stock, then muttered, “Breath sounds are diminished on the right … parotids enlarged … she has neck glands—why? … Pulse is feeble and rapid—”

“It was a slow pulse when the fever started,” Sister Mary Joseph Praise offered.

“So you mentioned,” he said sharply. “How slow?” He didn't look up.

“Forty-five to fifty, Doctor.”

She felt he had forgotten his illness, forgotten even that he was on a ship. He had become one with Sister Anjali's body, it was his text, and he sounded it for the enemy within. She felt such confidence in his being that her fear for Anjali vanished. Kneeling by his side, she was euphoric, as if she had only at that moment come of age as a nurse because this was the first time she had encountered a physician like him. She bit her tongue because she wanted so much to say all this and more to him.

“Coma vigil,” he said, and Sister Mary Joseph Praise assumed he was instructing her. “See how her eyes keep roving as if she's waiting for something? A grave sign. And look at the way she picks at the bedclothes—that's called carphology and those little muscle twitches are subsultus tendinum. This is the ‘typhoid state.’ You'll see it in the late stages of many kinds of blood poisoning, not just typhoid … But mind you”—and he looked up at her with a little smile that belied what he said next—”I am a surgeon, not a medical man. What do I know of medical matters? Except to know that this is not a surgical illness.”

His presence had done more than reassure Sister Mary Joseph Praise; it calmed the seas. The sun, which had been hiding, was suddenly at their back. The crew's drunken celebration indicated how grave the situation had been just hours before.

But though Sister Mary Joseph Praise did not want to believe this, there was little Stone could do for Sister Anjali, and in any case, nothing to do it with. The first-aid box in the galley held a desiccated cockroach— its contents had been pawned by one of the crew at the last port. The medicine chest which the captain used as a seat in his cabin seemed to have been left over from the Dark Ages. A pair of scissors, a bone knife, and crude forceps were the only things of use within that ornate box. What was a surgeon like Stone to do with poultices, or tiny containers of wormwood, thyme, and sage? Stone laughed at the label of something called oleum philosophorum (and this was the first time Sister Mary Joseph Praise heard that happy sound even if in its dying echo there was something hard-edged). “Listen to this,” he said, reading: “ ‘containing old tilestones and brickebats for chronic costiveness’!” That done, he heaved the box overboard. He'd removed only the dull instruments and an amber bottle of laudanum opiatum paracelsi. A spoonful of that ancient remedy seemed to ease Sister Anjali's terrible air hunger, to “disconnect her lungs from her brain,” as Thomas Stone explained to Sister Mary Joseph Praise.

The captain came by, sleepless, apoplectic, spraying saliva and brandy as he spoke: “How dare you dispose of shipboard property?”

Stone leaped to his feet, and at that moment he reminded Sister Mary Joseph Praise of a schoolboy spoiling for a fight. Stone fixed the captain with a glare that made the man swallow and take a step back. “Tossing that box was better for mankind and worse for the fish. One more word out of you and I'll report you for taking on passengers without any medical supplies.”

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