Fiction Prescription

Dr. Abraham Verghese injects humanity into his debut novel about a pair of physicians, “Cutting for Stone.”

by Joseph Kleinschmidt

What: Talking Volumes: Abraham Verghese hosted by Kerri Miller

Where: The Fitzgerald Theater, 10 E. Exchange St., St. Paul

When: 7 p.m., Wednesday


Dr. Abraham Verghese speaks about his initial foray into medicine in surprisingly mystical terms. He remembers scouring his uncles’ anatomy textbooks as a child, entranced by the eerie images he saw.

“Their books seemed like some kind of sorcery,” Verghese said. “I’d pick up these books and see these pictures of human beings in conditions that I never knew they could be in.”

Verghese’s childhood wonder fills his debut best-selling novel, “Cutting for Stone.” Using both biblical imagery and vivid surgical procedures, the author and professor at the Stanford University School of Medicine reminds his audiences — readers and residents alike — of the limits to a doctor’s knowledge.

“I think physicians, as much as they know, are even aware of what they don’t know about what’s going on, about death and the outcome of things,” Verghese said. “I think in that sense it’s all witchcraft.”

Embracing the unknown in both his literature and medicine, Verghese’s writing represents an attempt to chronicle the emotional undertaking for doctors. The author weaves his intimate knowledge of medicine with an epic family saga set in Africa and the U.S. in “Cutting for Stone,” following two brothers who share a passion for medicine and a mission to reconcile their family’s history.

“I think I’ve always been intrigued by the process of studying medicine, a sort of a romantic and an adventurous quest,” Verghese said.

The story’s grand scale follows the journey of Dr. Marion Stone — estranged from his once conjoined twin — from Addis Ababa to Nairobi to New York. Amid political turmoil in Ethiopia, Stone flees. Verghese takes details of Stone’s story from his own experiences leaving Ethiopia with his family during the country’s coup in the 1970s.

“It’s really never quite recovered from the kind of devastation and impoverishment that the dictator brought about,” Verghese said.

At the heart of “Cutting for Stone” lies Verghese’s true-to-life conviction that the patient-doctor relationship remains the key to quality healthcare. What may seem obvious actually represents a fundamental problem in the U.S. healthcare system, he explained.

“All of our money is going not to that kind of care, but to poorly thought-out reimbursement that usually revolves around giving something to a person rather than doing something for a person,” Verghese said.

The doctor’s first novel works as therapy for the ailing healthcare industry in the U.S., one he terms a “dysfunctional system.” In Addis Ababa, Verghese learned the art of medicine in absence of expensive technology and machinery. Verghese humanizes medicine through the narrative of “Cutting for Stone,” something he also teaches without the metaphors to med students at Stanford.

“Illness is a personal experience,” Verghese said. “I think too often in medicine we tend to see illness as some sort of scientific process that’s easy quantified and analyzed and pieced apart and understood using the lens of science.”

The common thread in Verghese’s work unites art and medicine by unmasking the impersonal interface a doctor’s white smock might present. “Cutting for Stone” exposes both the internal and interpersonal conflicts of a doctor’s experiences. Verghese confronts the limits of science and feels a physician’s duty lies beyond doling out a prescription.

“The art of medicine as opposed to the science of medicine,” Verghese said, “begins at the threshold of our incompetence, of our incompleteness.”