Cutting For Stone

Elly Bray, Gabrielle Barbour, and Alberta Engelman

Context: When and Where?

Setting: 1954 Missing Hospital, in Addis Ababa, Ethiopia.

Characterization: protagonist-Marion, antagonist-in the beginning, Shiva plays this role, foil-Shiva contrasts with Marion and this highlights characteristics of both of them, character development

Point of View: 1st person-Marion

Tone: lost, confused, wanting to find a place to fit in

Atmosphere (mood): on edge, emotional, and engaging.

Dramatic Structure:

Exposition: The background of their birth and time leading up to young adulthood

Conflict: Shiva sleeps with the love of Marion’s life

Complications: The love of Marion’s life, Genet, gets involved in the civil war and it forces Marion to flee Ethiopia and go to America where he meets his father for the first time Climax: Marion contracts Hepatitis B and is forced to make some difficult decisions

Resolution: Shiva risks his life to save Marion


Throughout the book they explain all the medical procedures vividly. They also use imagery to explain the setting, “From the waiting room window the earth looked as if it were mostly sky and concrete- no real earth to speak of, no manifestation of nature on the ground other than the sun setting in that direction.”


  • The boys being conjoined at the head- symbolizes their connection throughout life, and is symbolic for their careers because they both grew up to be very brilliant

  • The conjunction being severed- symbolic for their break away from each other but they still have a connection even though it wasn’t physical

  • Title Cutting for Stone: “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, specialist in this art”- Hippocratic Oath. The title is symbolic because to become a doctor to have to say this and it is exactly what Thomas, Shiva, and Marion lived by.

Social Context

A novel about Ethiopia, Africa. This novel is set in the 20th century when Ethiopia was under the reign of Emperor Haile Selassie who led a nationwide modernization campaign. As the nation developed, it was also in a constant stream of violence. Life there was hard and chaotic but the citizens had a strong connection and love for the nation.

Political Context

The Ethiopian Civil War began on September 12th, 1974 and did not reach a conclusion until U.S. intervention in 1991, at which point over 1.4 million people had already died. After the civil war concluded, the government was no longer under communist control. Previous to the civil war, Africa was held as colonies by much of Europe in an attempt to stop global conflict in the aftermath of World War I. The area consisting of and surrounding today’s Ethiopia was controlled by Britain and Italy. Ethiopia did not become an independent country until 1945. Today, after gaining its independence from Europe and Communism, the Ethiopian government functions as a Parliamentary Republic. It is a coming of age story not only for Marion but also for Ethiopia.

Modern Context: Text-to-World

  • Love and betrayal: a problem that people face everyday. Times have changed but this theme is a universal struggle in everyday life

  • Forgiveness: everyone has to deal with their individual problems and the battle to forgive and forget what has wronged them

  • Life and death: “in 2013 an estimated 56 million people died worldwide.”

  • War: Even in more modern times there is still war going on and the world still feels the effects of the war

  • After the Civil War, Ethiopia was converted to a Parliamentary Republic from a communist country.

Literary Value: Text-to-Text

  • Common themes: Self-sacrifice, sibling conflict- The hunger games: katniss volunteers for her sister, Romulus and Remus, My Sister’s Keeper

  • Come back together- family bond

  • Medical value- All of the main characters are doctors, learn more about medicine

  • Religious- born from a nun, Hema’s payers kept Marion alive. “Hema fell to her knees, the flame throwing a flickering light on her face. Her lips moved, She believed in every kind of deity, and in reincarnation and resurrection- she knew no contradiction in these areas. How I admired her faith, her lack of self-consciousness- a Hindu lighting candles to a Carmelite nun in a Catholic church.” Paige 526

  • Future goals- follow your parents or choose your own path and your own career?

Significance to Peers: Text-to-Self

The significance of this book to the modern adult world is to demonstrate the need for family and support. Sacrifice is a major motif in this story and though a large sacrifice is made in the story, it illuminates the meanings of smaller sacrifices made everyday. If the reader has siblings, the connection can be made to the eternal bond made with a family member. There can also be connections made to the medical aspect of the story because it a prominent aspect in the plot.

Books like Cutting For Stone

The Hunger Games by Suzanne Collins

My Sister's Keeper by Jodi Picoult

The Secret Life of Bees by Sue Monk Kidd


Cutting for Stone, a novel written by Abraham Verghese, primarily takes place in Civil War ridden Ethiopia and follows the journey of self-discovery between two previously conjoined twins, Marion and Shiva, whose bond was never really broken. Verghese uses his medical knowledge as a Chairman at Stanford School of Medicine to detail the journey of joining the medical profession in mid to late 1900s. The story of a broken family and the dream of two brothers morphs into a tale of an incredible bond and an irreversible sacrifice that can never be forgotten. Abraham Verghese illuminates the importance of family and freedom in a crumbling world of unfair events.

Marion and Shiva are identical from their birthday right down to their to their taste in women. After unnecessary details and comments on their mother’s past, the reader is finally exposed to the life of the actual main characters. After being adopted by doctors and with half of their chromosomes being from a doctor, the twins indulge into a life of medicine and a career track to accentuate it. Growing up, the brothers are closer than they were as conjoined infants and share their experiences, interests, and wait for it...a girl. Nothing wedges its way between love like love itself and Genet is swinging that axe. Trust is severed as Shiva has a meaningless affair with Marion’s girlfriend and the bond between them is stretched thin; and stretched even thinner when Marion moves across seas to protect Genet and continue his medical career. Verghese found the move to New York a perfect time to bring to light an old character whom holds resolution for his own children. Marion and Shiva’s British, biological father surprises Marion revealing he was being searched for while he felt the most alone. Marion’s life is soon in the hands of his father and brother whom abandoned and betrayed him and the sacrifice of a lifetime is made...literally.

Family is a common cure and provides support in many cultures. The love and connection of a family is the same in any language. Although missing for most of Marion’s life, his father brings ideas necessary for Marion to resolve his troubles. Even after Shiva’s actions wear thin the bond he shares with his brother, the bond is never gone and only returns stronger. The importance of freedom is blended throughout the story but becomes apparent at the end; creating your own path is the easiest way to find yourself.

The strength of the plot and surprising decisions is enough to leave any reader intrigued. By incorporating various themes, Verghese allows many interpretations and connections to be made uniquely by every audience member. Is it really sacrifice if you would do it all over again?