Set primarily in Addis Ababa, Ethiopia, during the mid–twentieth century, Cutting for Stone opens at the Missing Hospital with the unexpected and miraculous birth of Marion and Shiva to Sister Mary Joseph Praise. Marion narrates the story and says that all stories must begin at the beginning, at which point the narrative flashes back to Sister Mary Joseph Praise’s journey to Ethiopia.
Sent on a mission to bring enlightenment to Africa, Sister Mary and her friend Sister Anjali begin their voyage from India onboard the Calangute. Before reaching their destination, a severe case of typhus takes over the ship, and Sister Anjali falls gravely ill. Sister Mary attempts to secure the services of the doctor onboard, yet she finds that Dr. Thomas Stone is ill, himself, with a strange fever. Sister Mary nurses him back to health, but Sister Anjali succumbs to the disease. Upon arriving at port, Thomas clumsily attempts to persuade Sister Mary to accompany him to the Mission Hospital (pronounced “Missing” by the local Ethiopians), but she refuses, saying that her mission will have her go to Aden, Yemen. However, Aden is far from a paradise, and Sister Mary flees the country and goes to Addis Ababa in Ethiopia, where Matron Hirst receives her in a pitiful state. After she rests and recovers, Sister Mary accompanies Thomas in surgery and serves as his nurse.
Sister Mary’s assistance ends abruptly when she goes into labor in her bedroom. Thomas is shocked by her pallid face and the endless blood coming from her pubic area. He falls to his knees and realizes that for the past seven years, he has been in love with the nun. He awkwardly takes her in his arms and rushes to Operating Theatre 3 with Matron Hirst close behind. Dr. Stone, normally adept, freezes in the operating room. Matron, knowing but not wanting to admit that the nun is pregnant, tries to take over the procedure. Just then the hospital’s gynecologist, Dr. Kalpana Hemlatha, returns from her trip to Djibouti. She runs to the operating room and performs a Cesarean section to birth the twins and discovers a lacerated uterus and a tube connecting the twins by the head. Frightened but feeling that there is no other choice, Hema separates the twins, and Sister Mary dies in the matron’s arms. Thomas is destroyed by the death of the woman he loves. He refuses to look at the boys, and he leaves the hospital for good. Having felt a loss at not having her own...
(The entire section is 1880 words.)
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Prologue and Chapter 1 Summary
On September 20, 1954, twins were born in Addis Ababa, the capital city of Ethiopia. Shiva and Marion were born a month early in the very operating room in Missing Hospital in which their mother, Sister Mary Joseph Praise, a nun of the Diocesan Carmelite Order of Madras, spent most of her working hours. The big rain in Ethiopia had ended and everything was lush and verdant. Not one groan of pain, not one sound, escaped her lips as she gave birth to her twins, while just outside the door, the autoclave (sterilizing machine) “bellowed and wept.” Behind the great, noisy machine was the small sanctuary Sister Mary Joseph Praise built for herself during her seven years at Missing Hospital. It has become a shrine no one has touched since she died. On the wall hangs a calendar picture of Bernini’s famous sculpture of St. Teresa of Avila. When Marion was four he often went to this area and found peace, despite the noisy autoclave and his obsession to know the nun who gave birth to him. He would often ask, “When are you coming, Mama?” His only answer was the echo of his question on the bare walls and his own small answer, “By God!” It was a phrase spoken by Dr. Ghosh the first time he found Marion in this room and told him in a rumbling voice, “She is coming, by God!”
Forty-six years have passed, and Marion Stone finds himself again in his mother’s sanctuary. He has changed, but nothing else in this preserved shrine has done so except the print of Bernini’s Statue of St. Teresa, which is now framed under glass. Marion is here to put some order to his life, to say it began here, and from this time and place the next thing happened, and so on until he arrives at today.
As a young boy, Marion discovered his purpose in life—to be a physician. When he asked Matron, Missing Hospital’s “wise and sensible leader,” for advice, she asked him what is the hardest thing he could possibly do and told him he must do that because he is “an instrument of God” and should play to his full potential. Although the operating theater still makes him sweat and the idea of holding a scalpel causes his stomach to knot, he is a surgeon. Years later he is not a surgical genius, but he is the surgeon his colleagues call on because they know he is cautious, willing to ask for help, and eager to avoid surgery when possible. He follows the pattern set by his father, who believes the most...
(The entire section is 2332 words.)
Chapter 2 Summary
Thomas Stone is often considered mysterious, though it is likely he is even more of a mystery to himself than to others. Dr. Stone is painfully shy everywhere else, but he feels at home in the operating theater, as if it is the one place where his body and soul are at peace. As a surgeon he is known for being precise and bold, inventive and courageous, calm despite every pressure. However, when his long-time assistant, Sister Mary Joseph Praise, goes into labor, he is none of these things.
He is about to do surgery on a young boy and expects the proper instrument to be placed in his hand, as it has for the past seven years. Instead, he discovers a young probationer timidly telling him that Sister Mary Joseph Praise is indisposed. Dr. Stone begins the surgery, though without his usual confidence, and asks the frightened girl to tell his usual assistant that there is no time to be sick in the operating room and remind her that he returned to surgery the day after he amputated his own finger (a surgery so masterful that few people noticed he was missing an appendage), never thinking his message could be hurtful or rude. The probationer is an excellent memorizer of facts but a poor student of human nature. She walks into the darkened room of Sister Mary Joseph Praise, finds her huddled under a blanket, and does not get a response from her. The probationer delivers the message into the air and leaves. She goes to class and does not return to Operating Theater 3.
It is afternoon (following nine surgeries) before Thomas Stone impatiently checks on his assistant. He has never been to her room before; when she typed his manuscripts or drew illustrations for his book, it was in his office or his quarters. When he steps in he is struck by a “miasma at once familiar and alarming” but cannot immediately place it. As he opens the windows to allow fresh air and sunlight into the room, he sees his finger suspended in a sealed jar of preserving fluid. He feels a pang of nostalgia for the lost appendage until he sees Sister Mary Joseph Praise in agony on her narrow cot. He is reminded of Sister Anjali, whom he could not save, and falls to his knees at her side. Her name, Mary, escapes his lips first as an expression of fear and finally as a confession of love. She does not, cannot answer.
Thomas Stone knows now he has always loved her, almost from their first meeting, but never told her. His love has become almost invisible...
(The entire section is 855 words.)
Chapter 3 Summary
Dr. Kalpana Hemlatha, Hema, is the woman Marion comes to call his mother. At the time of Sister Mary Joseph Praise’s labor, she is five hundred miles away, flying over the Gate of Tears dividing Yemen from Africa. Hema later tells the boys that as she flew over the Gate of Tears, she heard a call she now knows was them; they always thought it was a strange place for an epiphany.
After boarding the plane as she returns a visit to her home in India, Hema thinks about her colleague, Dr. Ghosh. He is an odd-looking man with a teasing manner. Hema spoke of him so often that her mother wondered if he could be her future son-in-law. Hema quickly dismissed the idea, particularly since her mother would be so unhappy that he is not of her faith, but she does enjoy working with Ghosh. Hema also remembers her school-girl self attending an exclusive private school with a British headmistress, where she was an outstanding student, athlete, and leader. In medical school she felt “neither an obligation to join the herd nor any urge to try to stand out from it.” She chose gynecology and obstetrics because it had some boundaries and the possibility for a mechanical component—operations—but soon discovered she had a gift for divining how a baby is sitting in its mother’s womb.
Hema settled in Ethiopia on a whim, but Missing Hospital seemed familiar from the moment she arrived there eight years ago. It was a busy place, and the busyness kept her from thinking too much about anything but survival. Lately, though, she is feeling quite removed from any advancements in science and medicine. By the time anything reaches Missing Hospital, it is old news. If anyone had asked, she would have told them she was content and doing what she was intended to do; however, she knows her work is disconnected from the rest of the medical world.
The plane begins to rattle and the cargo, stored behind netting to protect the passengers, begins to shift. She worries about her extravagant purchase, a Grundig “radio-cum record player,” and even in the trembling plane she smiles at the thought of the jazz music to which Ghosh introduced her. Just then the plane begins to shudder “as if mortally wounded.” Passengers are screaming as the plane begins a steep descent. Years later, looking back on this pivotal moment, she would see that the change had been happening over many months. It is only as she is falling from the sky over Bab...
(The entire section is 577 words.)
Chapter 4 Summary
Matron steps away from Sister Mary Joseph Praise and hands her off to a speechless Thomas Stone. He feels helpless and even afraid; this is unfamiliar to him, but the families of his patients must often feel thus. When he finally speaks, in a rare act of humility he says they need Dr. Hemlatha. A Cesarean section is one of the only surgeries Thomas Stone has never performed, and that is because of his aversion to anything obstetrical. In medical school he had purchased his own cadaver, a middle-aged woman. As he wielded his scalpel and exposed the intricacies of the human anatomy, he felt quite comfortable with her. When his studies took him to the pelvis and he sliced open the uterus, a tiny fetus fell out, still connected to its umbilical cord. A cervical infection had poisoned the woman’s body and eventually killed her. Thomas got rid of the cadaver immediately.
At Missing, any injuries to or near the uterus were handled by both Hema and Thomas Stone, who are both meticulous surgeons in their own ways. A Cesarean section is not technically above Dr. Stone’s abilities, but on this day the thought of taking a scalpel and cutting the woman he loves is terrifying. For the third time, Matron tells Dr. Stone that Sister Mary Joseph Praise is his patient, and this time he sits where Matron had been sitting, an unfamiliar position for a surgeon. When he finally looks at his patient, Thomas Stone turns pale at the sight of a baby’s head clearly desperate for release. At that moment, something that had been dormant rises up in him, and Dr. Stone takes over.
The sight of the baby’s head makes the doctor angry: how dare this child threaten the life of the woman he loves? He feels no tenderness or compassion for the child; instead he realizes he has found the enemy and can now combat it. He recites what he calls the Five-F Rule: “Flatus, Fluid, Feces, Foreign body, and Fetus feel better out than in.” He makes the terrible decision to drill a hole in the skull of the creature (he no longer thinks of it as a baby), crush it, and pull it from Sister Mary Joseph Praise’s body rather than experiment with a C-section; he is not familiar with Cesarean sections and does not believe she would live through one anyway. His decision seems purely rational to him.
As Matron looks at him, she does not see a composed and competent surgeon; she sees a “desperate, agitated fellow...consumed by a sense of mission.” Thomas...
(The entire section is 660 words.)
Chapter 5 Summary
At the very last second, the water below the plane turns to land, and Dr. Hemlatha sees “dry scrubland” below them as the plan swoops into a landing on the asphalt. The passengers are first relieved; then some are embarrassed because out of fear even the godless had prayed for divine intervention. The plane finally stops, but the pilot is conducting an argument over the phone with the control tower. In the meantime, Hema places a splint (made from a cane procured by the Armenian man) on the young boy’s leg. With a smirk on his face, the pilot finally looks around the silent plane. Almost as an afterthought he announces they are in Djibouti and will be picking up some baggage and some very important people. Because the authorities here would not let him land except in an emergency, he had created his own “engine failure”—and he is proud of it.
Hema is furious and shatters the silence with an angry diatribe about mistreating his passengers for his own gain. The repulsive French pilot is somewhat amused by her woman’s anger until she calls him a “bloody mercenary.” He raises his hand to her, incensed at her use of “bloody” rather than being called a mercenary, a label he is undoubtedly proud to claim. Later he will say he had no intention of hitting her, but his hand is in the air when Hema reacts. She has changed since the flight began and is no longer willing to be pushed around by any man. When she sees his hand move, she reaches under his shorts and locks her fingers around his testicles. The pilot is afraid; Hema’s eyes burn “like a martyr’s.” His hand lowers to settle onto her forearm as she tries to inflict on him the same level of distress and fear the pilot had caused the passengers.
Now that she has his full attention, Hema tells the Frenchman that he caused a little boy to break his leg and demands the pilot not only pay his family—in cash—for medical expenses but also reimburse them for the cost of their flight. The frightened man tries to justify his actions but Hema is relentless. Other passengers express their anger at the man until they hear noise near the cargo door. As the door opens, Hema removes her hand from under the man’s shorts. She stifles her laughter as she goes outside to wash her hands.
(The entire section is 415 words.)
Chapter 6 Summary
Dr. Hemlatha looks out the plane’s window and cannot wait to see the familiar sights of Ethiopia, though she prefers its more romantic name—Abyssinia. Some passengers joined them during their unscheduled stop, along with a huge cargo of fresh khat, which is needed at a wedding and must be chewed within a day or two of being picked. The rest of the ride is uneventful. Hema takes the time to think about her parents and the renovations she insisted they make and which she paid for because they had not spent any of the money she has been sending them regularly. The Western-style commode will be much easier on her mother’s bad hips.
One of the passengers is Adid, a man who brought his young wife to Missing Hospital when she was having difficulty with her first pregnancy. As Hema performed a Cesarean section on her, Adid left and returned to the hospital with an older wife who delivered outside the operating room. Hema reached the second wife just in time to cut the umbilical cord; when she pushed down on the woman’s belly, out popped a twin instead of the afterbirth. Adid was a proud father. Today he is traveling with another pregnant wife and has another child expected back at home. He reminds Hema that a man is only as rich as the number of children he fathers, and Hema teases that he must be a millionaire. By that yardstick, Hema knows she is a pauper.
When they land, the khat is unloaded into vans and cars and driven away with a police escort. Finally the passengers are allowed to disembark, and Hema is hit by a wave of nostalgia for this place; she almost forgets she is two days late in arriving. As she rides in a taxi through the market area, she is struck by the familiar sights, smells, and sounds, experiencing them all as if they were new although her absence was relatively short. Suddenly she sees children everywhere she looks, as if they had been invisible for the eight years she has lived here. She also sees a prostitute; Hema makes no moral judgment but is all too aware of the consequences of such practices. At Missing Hospital she sees tubal and ovarian abscesses, infertility caused by gonorrhea, stillbirths, and babies born with syphilis.
This taxi ride reminds Hema of another drive through the city. She was riding in Dr. Ghosh’s Volkswagen when they saw a crudely constructed wooden frame from which hung three nooses. A military truck pulled up to the structure and three men were positioned...
(The entire section is 828 words.)
Chapter 7 Summary
When the doors to Operating Theater 3 burst open, no one in the room knows whether it is really Dr. Hemlatha or an apparition. She looks fierce and is practically breathing fire; only when she demands to know what nonsense Gebrew is talking do they realize it is, indeed, their Hema. Matron and others see her arrival as a miracle; Dr. Stone sees it as a lifeline thrown to him in the deep crevasse in which he finds himself. Many years later Hema will describe that moment to Marion, telling him she knew the problem as soon as she walked into the room because of the smell. No one writes about it in textbooks, but it is the smell of what she calls fetor terribilis. It is both sweet and astringent, and it always means a “labor room catastrophe. Dead mothers, or dead babies, or homicidal husbands. Or all the above.”
Hema breaks out in a cold sweat despite the warmth of the room and is stunned at the amount of blood she sees on the floor. The sight of so many awful instruments strewn about is not as shocking as the sight of sweet Sister Mary Joseph Praise lying nearly lifeless on the table; she should have been assisting, in her capable way, with this procedure on someone else. The Sister’s hand captures Hema’s attention. Her fingers are curled, though her index finger is more open, as if she had been pointing when she lost consciousness. It is an image Hema will be drawn to many times over the next hour; but it is the sight of Thomas Stone settled between the woman’s legs that prompts her to act. That is her position, her domain, and she shoves him aside as he tries to explain all that has happened. Hema cuts him off, infuriated that he has been using books to determine what to do. The probationer nurse is more aware than ever that she lacks the essential thing to be a successful nurse: what Matron calls Sound Nursing Sense. She had not realized the seriousness of Sister Mary Joseph Praise’s condition and assumed others would check on her; however, no one but the probationer realized the sister was ill, and no one had told Matron.
Sister Mary Joseph Praise moves her head, and Matron thinks the younger woman is at least partially aware that she is holding her hand. Her pain is obviously severe, and she is mumbling what Matron believes are words from St. Teresa about pain, the soul, and God. The pain suddenly seems to loosen its grip on her and Sister says, quite clearly, “I marvel, Lord, at your mercy. It is not...
(The entire section is 968 words.)
Chapter 8 Summary
Matron remains unconscious for only a few seconds, and when others want her to leave the room she is adamant that she will stay. She takes a position near Sister Mary Joseph Praise’s head and massages her fingers as blood is being transfused into her arm. She looks at the hands of the younger woman and knows they had been used as “instruments of God.” In contrast to Sister’s long, slender fingers, Matron’s are rough and have clearly been used in much more physical labor. Tears track down Matron’s face as she prays for this daughter she could never have and wonders why the Lord did not spare all of them this agony. Matron feels her body shaking and tells the Lord He can take her any time, but she hopes it will not be right now because she does not want to be a distraction from the work at hand.
As her thoughts wander, Matron wonders what prompted this woman on the table to always try to hide herself, her body, beneath a nun’s habit or scrub suit and mask. Whatever part of her was exposed shone with her beauty, even if her face was surrounded by a wimple. There was a time when the Ethiopian government was persecuting anyone caught proselytizing, and Matron wondered then if she and Sister Mary Joseph Praise should discontinue wearing their habits. But when she saw the younger sister in a skirt and blouse and the reaction men had to her, Matron determined that habits would be better for everyone. The Sister was a beautiful, sensual woman, and even her habit did not hide that. She was a woman at peace with God, and her equanimity is what undoubtedly equipped her to work with the rather stern and uncommunicative Thomas Stone. This hospital is where Matron finds her identity—in this place and in this position. She has a maternal affection for those who work here, even the irascible doctor of internal medicine, Ghosh.
A sudden exclamation by one of them, Dr. Hemlatha or Dr. Stone, captures Matron’s attention. She is still feeling woozy and has tried not to look at the bloody work happening at the other end of the table. Now, though, she looks in that direction and what she sees will change her life forever. The doctors and others are gathered around the gaping uterus like “hyenas over carrion.” The rays of the sun are poking through the gaps in arms and hips, directing themselves, it seems to her, directly onto the bloody opening; the uterus rose and glowed in the light as if it were in the very presence of...
(The entire section is 520 words.)
Chapter 9 Summary
Hema makes her incision and has no time to think about tying off bleeders; there is very little bleeding, in any case, and that is not a positive sign. She positions the retractors to hold the wound open. Then something amazing happens: the abdomen seems to expand and glow with a heavenly luminescence. She is stunned and puzzled at the sight until she realizes it is simply the sunlight coming through the frosted operating theater window. Nevertheless, Hema cannot remember such a thing happening before now. She sees the worst of her fears and knows she will have to perform a hysterectomy once the twins have been removed. There is so much blood, including a massive blood clot practically surging up at her, and there has been so much trauma. Hema knows all her familiar landmarks and guidelines for such a procedure will be nonexistent.
Numerology is important to Hema; she quickly tries to ascertain the bad luck of this day’s numbers. She recalls having to repair a child’s broken leg and gripping the testicles of a crazy Frenchman earlier in the day, and she wonders what is next. Thomas Stone is fumbling around with an oozing vessel. Hema gets his attention back to the more important work ahead of them. After she incises the uterus, she reaches for the baby located at the top of the uterus. He is head down and upside down, and he would have been the second child delivered in a natural birth. Now, though, he will be the firstborn. This twin has his hand jammed against his cheek, however, and he will not move. Hema extends the cut and suctions the infant’s mouth, but he will still not move. Then she sees the problem: the twins are joined at the head.
The connection is not complete; a small tube of flesh, darker than an umbilical cord, tethers them together. Blood is flowing from the tube, probably caused by one of the probes made by Dr. Stone, and Hema hopes the loss of blood is from a vessel rather than something more substantial. She begins speaking aloud all the potential problems that could occur once these babies are removed from their uterine home. This is a strategy she often uses to organize her own thoughts and prepare her assistants for all possible contingencies. It has a secondary advantage of allowing other people to help her find any flaws in her thinking or reasoning. Her commentary is met with silence, and she prays both babies will live as she cuts the tube that connects them.
(The entire section is 554 words.)
Chapter 10 Summary
The legend of these two unnamed babies, still not breathing, is a simple one: identical twins born to a nun who died in childbirth, father unknown, “possibly but inconceivably” the sons of Dr. Thomas Stone. It is a legend that has grown and changed over time, with new details occasionally coming to light. Now, fifty years later, Marion is still unsure about some of the particulars. He recalls—is sure he remembers—rescuing his brother from some kind of a spear and being wrenched from the womb and even lying in a copper basin, not breathing, but what he remembers most is being separated from his brother, Shiva.
The nurse probationer takes both of the tiny babies in the copper basin used for placentas to the window and makes a notation on the delivery chart: “Japanese twins connected by the head but now disconnected.” (The word Siamese eludes her at the time of her writing.) In her eagerness to be useful, she has forgotten her ABCs: airway, breathing, and circulation. She does remember reading about jaundice in her textbook, which is why she brings the boys to the window; however, she realizes the sun can only work if the babies are alive, and these two are not. She leaves them there, unattended except for the sun’s rays, which are glowing red in the copper basin and shining directly on the stillborn babies, infusing their deathly pallor with light.
Dr. Hemlatha, meanwhile, is fighting to save the woman she thinks of as her sister. They were two Indian women in a foreign land, sharing the same memories and experiences of a homeland far away, and they had been family to one another. After removing the uterus, Hema does what she can to save Sister Mary Joseph Praise, but it is too late. Matron is lost in her grief at one end of the table, and it is a long time before Dr. Hemlatha makes the pronouncement of death. It is in that in-between time, in the silence of mourning, that the firstborn child makes his presence known. There is a small rapping against the side of the basin; he is telling the world to come take care of his brother.
Hema rushes to the sound, the name of the Hindu god Shiva on her lips. He is seen by most as a god who seeks to destroy, but to her he is the god who transforms something terrible into something good. Later Hema will say that she assumed others, including Matron, had been attending to the tiny babies, though she remembers seeing Matron sitting with Sister Mary...
(The entire section is 1546 words.)
Chapter 11 Summary
On the morning Sister Mary Joseph Praise dies, Dr. Abhi Ghosh wakes to the sound of pigeons cooing on the windowsill. Mornings are the times he misses Hema the most when she is gone from Missing, and this morning her bungalow next door to his is silent in her absence. Every time she leaves he is terrified she will return married, and he is tormented by such thoughts until she returns.
They play a game: he pretends to woo her and she pretends to chase him away. But Ghosh is not pretending, and when she left for this visit to India he wanted to ask her to marry him. He knew she would laugh— a sound he loved unless she was laughing at his expense—so he did not. Instead, he mailed off applications for an internship in America. Even at thirty-two, he is not too old to start again, and it makes him feel as if he has control of his destiny. However, when the letter and ticket voucher arrive from Cook County Hospital in Chicago, his anxiety about Hema does not diminish.
In the kitchen, Almaz is clanging things and grumbling about heating the stove so he can have a bath and a cup of instant coffee. Almaz arrived at Missing Hospital when she was twenty-six, apparently pregnant and ready to deliver. She had been so sure she would deliver this child after losing several others, but it was a false pregnancy. Eventually her uterus and a giant fibroid cyst had to be removed, and Almaz stayed because she could not bear to go back home without a baby. She is now part of Missing Hospital and, despite her grumbling and disrespectful tone, she and Ghosh live in harmony.
Ghosh experiences some pain when he urinates, and he understands he may have some kind of disease, probably transmitted sexually the only time he did not use a condom, which has yet to be cured. The hours he has spent studying his own condition have made him the de facto expert on sexually transmitted disease in the country. After his bath, the doctor drives the two hundred yards to the outpatient building. If he had known then about Sister Mary Joseph Praise’s condition, he would have acted and might have saved her. He stays busy seeing patients and drives out of Missing just a few moments before Thomas Stone carries the Sister to Operating Theater 3.
Ghosh drives to an exclusive barbershop near the railroad station. The barber, Ferraro, always treats Ghosh well. Ghosh is tempted to confide in the impeccable Ferraro, to share his broken heart and...
(The entire section is 835 words.)
Chapter 12 Summary
No one finds Dr. Stone that night. In the morning Matron asks Adam, compound maker for the hospital, to send their waiting patients to the Russian hospital. When the phone rings, Matron eagerly answers it, hoping for some news about the missing doctor. It is the Minister of the Pen, offering the Emperor’s condolences for Missing Hospital’s loss. Matron wonders how the Emperor learned about their loss so quickly, but he keeps his power by knowing such things. Before hanging up, the Minister tells Matron that the Emperor will appreciate hearing about any member of the Imperial Bodyguard who shows up at Missing for surgery. Matron tells him they have closed the surgery because their surgeon is “indisposed,” struck with grief at the death of his assistant. After the call, Matron thinks about the loss of their surgeon. With him, Mission Hospital is elevated above other medical facilities in the city; without him, everything has changed.
The phone rings again, and this time it is Eli Harris of the Baptist congregation in Houston that has supported the hospital. Matron tells him they have lost a staff member and it will be a few days before she can talk—then she hangs up on him. Matron has received support from such places by sending them a copy of Thomas Stone’s textbook, which contains illustrations done by Sister Mary Joseph Praise. Ghosh arrives soon after, and Matron takes him with her to make funeral arrangements. As they leave the compound, they see a white man coming up the hill in a taxi. Matron suggests it is probably Eli Harris, come to check on the citywide campaign against gonorrhea and syphilis that his church believes it funded—a program Missing Hospital never had.
The cemetery in Gulele is the final home to all kinds of people, including soldiers and babies. As Matron and Ghosh walk through it, Matron is reminded of a young man she once loved. She was a young nun volunteering at what is now Missing Hospital. John Melly died trying to save her from the rioters and looters rampaging through the city in 1935. He was shot trying to help a wounded person on the street, and she nursed him for ten days until he died. Ghosh is stunned at the news and realizes how little he really knows about the people with whom he works every day. Matron is overcome by the memory and weeps quietly for the passing of years and the losses it has brought. After she composes herself, Matron decides this is not the place for...
(The entire section is 619 words.)
Chapter 13 Summary
As native workers dig a grave outside, Matron summons Dr. Ghosh to Casualty. The pale White man is there with her, but Ghosh’s back is to him and he is able to walk past without having to talk to him. Behind the curtain, some men are praying around a man lying on the table. The man is obviously in pain; he is also vaguely familiar to Ghosh. It takes very little time for the doctor to diagnose the problem called volvulus—a twisted colon that is obstructing the bowels. It is a common problem among Ethiopians, and it can only be corrected with surgery. Many die without access to surgery. Ghosh explains that their surgeon is gone, which the patient has already heard. Suddenly the doctor remembers where he has seen the man before: he and Hema had been unable to drive home due to a crude, impromptu hanging of three men from the back of a truck. The reluctant executioner was Colonel Mebratu—this man. He is here, even knowing their surgeon is gone, because another doctor was prepared to betray him by turning him in to the Emperor. He and his men came to town to meet other insurgents but their plan was compromised; then his pain began. This is the man about whom Matron was asked in the phone call that morning. She tells Ghosh she will not turn the man away because he has nowhere else to go. The Colonel and his men are thankful.
Ghosh calls Hema at her bungalow in the hopes that she will assist him with the surgery. Ghosh explains who the man is and that he needs her help, but he is stunned by her response. She is busy with the twins and is not in the least sympathetic to his plight. She appears not to care if Ghosh gets shot or if the patient dies. When he reminds her of their Hippocratic Oath to save lives, Hema snorts in derision and says that oath is for civilized places and does not apply here in the jungle. Her parting words are clear: the twins are her first responsibility, and the Colonel is lucky to have Ghosh as his doctor because he is better than nothing.
Dr. Ghosh is an internist and quite adept at diagnosing common surgical conditions; however, he is not trained to do the surgeries himself. He would occasionally assist Thomas Stone and even more rarely Dr. Hemlatha. But now he is alone. The surgery is successful, and as Ghosh is finishing he catches a glimpse of Hema’s face in the window. He runs to catch her, thrilled that she would have helped him if he had needed it. He notices she has gained a...
(The entire section is 732 words.)
Chapter 14 Summary
Dr. Ghosh rises early the day after the funeral. He checks to see if Thomas Stone has returned; he has not. Ghosh hopes all is well with his postoperative patient, and he is gratified to see Colonel Mebratu up and feeling relatively well. The Colonel is getting dressed to leave and apologizes that he has to go now in order to save his own and others’ lives; he does, however, promise to obey whatever guidelines the doctor sets for him. The Colonel’s brother is an educated man, and he has taken over a medical clinic in his former province. It has been difficult to get legal funding and donations, but he has a missionary doctor who visits the clinic once a week, a retired army nurse to help dress wounds, and a midwife who was willing to move there. The Colonel’s illness has been a life-changing experience. He realizes that he was very fortunate to have been treated and sees it as a message from God. Now he knows that most Ethiopians who suffer from volvulus will die painful, awful deaths because they do not have access to adequate—or even minimal—medical care. He intends to help his brother treat the peasants; he understands that the way a country treats its lowest citizen is how it will be judged.
Matron is finally able to meet with Mr. Elihu Harris and expects him to be angry that he has been put off for the past two days. Eli is grateful for the opportunity to meet with Matron. She apologizes for the delayed meeting and explains that Sister Mary Joseph Praise has just died and was buried yesterday. Harris knows who the Sister is and is sympathetic. Matron also explains that Dr. Stone is gone. She senses that this is a man with a tender heart and tells him the entire story in a “rush of simple sentences.” She explains that without Thomas Stone, Missing may be forced to close, for it is only because the skilled surgeon operated on the royal family that they have been allowed to stay open. The government charges hospitals and clinics for the opportunity to serve the country, she tells him, which is a ludicrous concept that keeps them virtually penniless.
When she is finished speaking, Harris sits silently for several moments. Matron is worried that he will ask for a reckoning of the money his church has sent, and she knows she will not be able to give it to him. What Eli Harris eventually says is a surprise. He admits that another medical mission his church has been funding has been occupied by the police and the...
(The entire section is 978 words.)
Chapter 15 Summary
The twins are baffling to Ghosh; he resents the attention they are getting from all the women of Missing Hospital. No one notices when he leaves and drives to town to make some enquiries regarding Thomas Stone. There has been no word, so Ghosh stops for a beer and solidifies his plans to leave. He has a ticket to Chicago via Rome; he will leave in four weeks, though he has not yet worked up the nerve to tell Almaz, Matron, or Hema. He returns home after dark. Almaz is waiting for him again, huddled in the driveway as she was the night Sister Mary Joseph Praise died. He assumes she has news of Dr. Stone, but he is wrong. Almaz tells him one of the babies stopped breathing, and they go immediately to Hema’s bungalow.
When Ghosh walks into the room, Hema immediately flies into his arms and begins to cry. After she calms down a bit, she tells him how Shiva quit breathing as she watched; finally she could wait no longer and touched him, and he breathed once again. It happened again about thirty minutes later. Dr. Ghosh explains that he thinks the cause is something called apnea of the premature, a condition common to premature babies whose respiratory systems are not yet fully developed. These babies simply forget to breathe sometimes. Hema, the new mother, needs reassurance and wondering what can be done. Ghosh is unwilling to tell her that there is little that can be done aside from connecting the baby to a breathing machine, which is unlikely in most civilized places and impossible here. He sends Hema for some items to make a plan that may or may not work, and she is uncharacteristically willing to act without questioning him.
Ghosh places Hema’s jingling anklet around Shiva’s leg, then he ties a string to it; the other end of the string is wrapped around his finger. If the baby ever stops breathing, the anklet is quiet and a gentle tug on the string will rouse him and remind him to breathe. They will take turns keeping watch. Ghosh gets a book from the shelf to help him stay awake as Hema sleeps nearby; at 4:00 a.m. Ghosh wakes Hema up so she can do her shift. He had to tug on the anklet twice during his shift. Hema is thankful to have seen the first episode so they can ensure the boy will keep breathing. She reads the same book Ghosh (who is snoring as he sleeps) had started, Middlemarch, and night becomes day.
Dr. Ghosh wonders if the Colonel made it back safely to his garrison. He knows there...
(The entire section is 1038 words.)
Chapter 16 Summary
Hema has fresh cow’s milk delivered to her house every morning; however, Ghosh will not let her give cow’s milk to the newborns, insisting they must stay on formula. Although Hema had felt certain Ghosh would leave Missing—and her—he has stayed and is as reliable and steady as he ever was. He carefully charts and graphs the “waning and disappearance” of the apnea incidents. Without him and his surprisingly meticulous record keeping, Hema would not have been courageous enough to eventually discontinue their nightly vigils. They have decided to keep the bracelet on Shiva’s ankle because it has come to represent his voice. Now, though, Hema realizes she will miss Ghosh’s constant presence in her home. She still argues with him occasionally, but now she sees it as a sign of affection. Hema does not want Ghosh to leave.
Hema has never been a mother, but she has often felt, just as she was falling asleep, as if someone were calling her name. Now she knows it was the twins—her boys. The everyday sights and sounds of motherhood create an aura of contentment around her. One day a Maharashtrian astrologer comes to her house and, despite Ghosh’s objections, Hema pays him to read the children’s fortunes. He obtains the exact time of the twins’ births then asks for the birth dates of their parents. Hema gives her birth date and Ghosh’s, shooting her colleague a warning look as she does so. The astrologer is troubled as he makes copious notes and calculations, and he finally pronounces it “impossible.” He looks nervously at Hema but avoids Ghosh’s eyes altogether as he immediately walks out of the cottage. His final words are that whatever the boys’ destiny may be, it is most assuredly linked to their father. Ghosh follows the man to the gate and offers to pay him; however, the traveling seer declines the offer and mournfully announces that Ghosh cannot be the boys’ father. The doctor pretends to be troubled by this revelation, but when he tells Hema she is not amused. Now she is fearful that somehow Thomas Stone will be returning for her sons. The next day Ghosh finds that Hema has created and hung shrines and amulets throughout the house to ward off evil spirits, but he does not comment on them.
Unexpectedly, Dr. Ghosh has become Missing’s surgeon. He has performed several emergency surgeries, each of them with some trepidation but also with success. Operating Theater 3 is still a rather unfamiliar...
(The entire section is 1653 words.)
Chapter 17 Summary
Marion remembers dancing around the kitchen in Ghosh’s arms; for the longest time, the boy thought dancing was the doctor’s job. Almaz and Rosina arrive, bundled up from the cold. The first time Rosina touched her icy fingers to Marion’s warm cheek, he made the mistake of laughing rather than crying. Now it has become a morning ritual he both anticipates and dreads. Soon Hema and Ghosh kiss the boys good-bye; despite the clinging and tears and despair, they leave for the hospital. Rosina puts them in the double stroller and Shiva is content as long as no one tries to remove his anklet. Marion, however, demands a higher, more adult view, and he finally gets what he wants. Rosina talks nonstop, but the twins are silent and speechless; they are busy taking it all in. Almaz is now the cook for Hema’s and Ghosh’s household and rarely shows her teeth. Rosina’s teeth “shine like headlights.”
In midmorning, when Rosina brings the boys home, the kitchen is alive with Almaz’s lively cooking. Rosina abruptly hands the twins off to Almaz and hurries out the back door. The boys do not know it yet, but Rosina is pregnant with a girl who will be known as Genet, “the seed of revolution.” The three of them are together from the beginning, two outside the womb and one inside it. Again Shiva is content to sit in his seat; Marion whimpers as Almaz holds him near the simmering cauldrons. Almaz shifts Marion to her hip, reaches into her blouse, and hands her breast to the child. The cook resumes her duties, humming as she stirs. It is a gift, the first one Marion remembers receiving, and he is fascinated by it. Shiva, too, is compelled by the novelty, sharing his brother’s fascination from his seat in the stroller. Years later, when he first kisses a woman’s breast, Marion becomes ravenous, as it is something forever associated with Almaz and this spicy, steaming kitchen. Rosina returns, the breast disappears as mysteriously as it appeared, and Marion is back in Rosina’s arms. After lunch, the twins fall asleep with their arms around each other, breath on each other’s face, foreheads touching. As Marion dreams, he hears the song Almaz had been singing in the kitchen, “Tizita.”
Marion will hear this song through all his years in Ethiopia. When he leaves Addis Ababa as a young man, he will have it on a cassette tape he takes with him. During his years of exile, his cassette will wear out. He will meet fellow...
(The entire section is 524 words.)
Chapter 18 Summary
Six years have passed, and the household is a noisy one. In order to be heard, one must “dive into the din” and make his way to the front. Ghosh’s voice is a foghorn that usually tails off into laughter. Hema, the songbird, can become a sharp blade when provoked. The cook, Almaz, is silent on the outside but her mouth is in constant motion; no one knows if she is praying or singing. Rosina is never silent; she speaks even when no one is around. Rosina’s daughter, Genet appears to be taking after her mother and recites stories about herself in a singsong voice. Shiva and Marion could not have been delivered in the usual way because of their connected heads, but if they had been, Shiva would have been the oldest. Instead, the natural birth order was reversed, and Marion was the first to breathe by mere seconds. He has become the oldest, and he has become the “spokesperson” for the entity known as ShivaMarion.
In the shopping markets of Addis Ababa, Ghosh and Hema are never allowed to browse and shop as most people do. Instead, they are treated as royalty and the boys are measured as people gathered around them to gawk. Each purchase they make is double: two shirts, two bicycles, two fountain pens. Marion wonders if the people who think he and Shiva are so adorable really believe they choose their own outfits. The one time he did dress differently than Shiva, he felt uneasy and somehow exposed.
The twins are not only known for dressing alike, but they do nearly everything as if they were a four-legged creature. They run as if they were in a three-legged race, they sit together in one chair, and they even use the toilet together—double streams of urine jetting into the bowl. Marion and Shiva must take some responsibility for the fact that others treat them as a “collective.” People address them as “the twins,” “boys,” and “ShivaMarion.” “You” never means just one of them, and when one of the boys replies, it is assumed he speaks for both of them. Given all of that, people assume Shiva is either parsimonious with his words (though the rattling of his anklet made him a constant chatterer) or Marion will not give his brother much of a chance to speak (which is true). It is a noisy, happy house filled with music, dance, and laughter; however, two years pass before any of the adults in his life realize Shiva has stopped speaking.
Shiva started as the more fragile brother, partly because...
(The entire section is 1523 words.)
Chapter 19 Summary
A week before Shiva will give up his anklet, the family is driving into town. They are forced to the side of the road to allow His Imperial Majesty, Haile Selassie, and his motorcade to pass. They are near the Emperor’s Palace, which is lit for the Christmas season. It is 1963, the year in which America’s President Kennedy has been assassinated. Everything—pedestrians, cars, and horse-drawn carts—has come to a stop. A Land Rover, part of the Imperial Bodyguard, drives by; sitting on the tailgate are uniformed men with machine guns across their laps. After the Land Rover are eight roaring motorcycles followed by the royal Rolls Royce, green and polished. His Majesty sits inside to see and be seen as he drives past his people with his Chihuahua Lulu on his lap.
Under his breath, Ghosh mutters that the money spent on this royal display could feed every child in the country for a month. Next to Ghosh, an old man on his knees kisses the ground after the Rolls drives by him. The Emperor looks directly at Hema and puts the palms of his hands together, a gesture of admiration and respect. Ghosh teases her, but Hema says that he was simply admiring her sari and that she likes the old man. The front of the procession arrives at the gate and the guards dismount to present arms.
A single policeman is responsible for holding back the crowd, and suddenly an old lady begins waving a paper. The sight captures the Emperor’s eye and the Rolls stops. As the woman approaches and thrusts her paper at the window, Lulu begins barking at her. The woman appears to be speaking, and the Emperor appears to be listening. She is gesticulating as the Rolls begins to move; she tries to keep up with it, hollering “Thief! Thief!” She does not get any response and throws her shoe at the trunk of the Emperor’s car. The policeman, like the rest of the crowd, is stunned but finally acts. He clubs the old woman to the ground. Several of the motorcycle soldiers also start clubbing members of the crowd near the gate. Those near Ghosh and Hema’s family cannot believe anyone would treat an old woman in such a way, but no one acts.
As Marion’s family drives away, Marion turns around and sees the motorcycle riders turn their attack on the policeman. His mistake was not clubbing the woman down earlier, before she had a chance to embarrass the Emperor. Many years later Marion will still think of the policeman beating the old woman. Such...
(The entire section is 1237 words.)
Chapter 20 Summary
July and August are the rainy months in Ethiopia, and the headmaster of Loomis Town & Country School makes sure those are vacation months for students. While the students are stuck in soggy Addis Ababa, he is no doubt vacationing somewhere hot and sunny. It rains incessantly in these months the natives refer to as winter, and the eleven-year-old twins react differently to the weather. Shiva is content to spend his time writing and drawing, but Marion gets morose and somewhat depressed. Hema takes the boys regularly to the library and the cinema. They can read whatever they want as long as they keep a journal of new vocabulary words and write down any interesting ideas to be shared at the dinner table.
One soggy afternoon Genet suggests they play a game of blind man’s buff. Though she is only ten, she is much more mature in many ways than the twins are. The rules have to be modified for indoors (here there will be no “buffing” of whoever is “it”), so they compete to see which of them can find the other two the quickest. Marion has never much liked the game, but it is a diversion from the pounding rain, so they play. While Marion is generally willing to trust and assumes adults know what they are doing, Genet (now aged ten) is naturally distrustful and is always ready for an argument. When she is blindfolded, however, she seems vulnerable, as if all her heat and fire are concentrated in her eyes. While Genet looks for them, Marion and Shiva remain silent, which Marion does not mind. It reminds him of the superhero Invisible Man. It takes Genet fifteen minutes to find Shiva and twenty-five to find Marion, though she is within inches of him several times.
Both Marion and Shiva are able to find each other and Genet in just minutes, and Marion knows it is because of smell. Genet accuses the twins of cheating, but they are playing by the rules. When Ghosh comes home and they tell him of this phenomenon, Genet insists he monitor the boys for cheating. Ghosh sees that they are, indeed, able to find Genet and each other much more quickly than she is able to find them. Ghosh tries the experiment and is as slow as Genet at finding the children. In everything else, Genet is nearly equal to the boys; in this, they have found a difference.
That evening, as Hema is reading to the boys (a ritual begun to prod Shiva out of silence), Hema is called to the hospital to help deliver the Princess’s baby. Ghosh goes...
(The entire section is 1368 words.)
Chapter 21 Summary
After the incident in the kitchen, Rosina takes care to place herself between Marion and her daughter. Something happened in the pantry that night, and Marion wants to be around Genet more than he ever had—and Rosina knows it. They all become cunning and keep their thoughts to themselves. For the remainder of their holiday, Genet gravitates more to Shiva. They practice their dancing often, but Marion is not jealous. Shiva is his proxy, and having Genet be with his twin is the next best thing. They never play blind man’s buff again, and Marion avoids Zemui when he comes to pick up or drop off his motorcycle. When the two of them finally do come into contact, Marion wants to feel angry with the older man but cannot. Zemui pulls out a new letter from Darwin and is eager to have Marion help him translate. Marion is tempted to ask him to have his daughter help him, but then he realizes that Genet is intent on making things more difficult for her father and that he has Marion read and write these letters because his daughter has refused.
A group, including Colonel Mebratu, gathers to play bridge in Ghosh’s former quarters. The Colonel brings them gifts from his recent visit to London. In the course of the evening, he announces that he has been promoted to Brigadier General, and they spend the evening celebrating.
Ghosh seems to be aware of and understand Marion’s struggles after the incident with Genet in the pantry. He seems to see that Marion has been “quarantined” from the girl but that Shiva is still in her good graces. Ghosh is a steady presence in the boy’s fluctuating and changing life; he never pries but bides his time. Marion is sure Ghosh would keep a secret from Hema if it would not hurt her to do so. One wet afternoon when Shiva and Genet are practicing their dance, Ghosh calls Marion to Casualty to observe something unusual. Although Gosh has become a surgeon, he is still drawn to the unusual and puzzling cases that need the specialized knowledge of an internist.
A young man named Demisse is sitting on a stool. Marion is embarrassed and hopes the twenty-year-old patient will not be offended at the presence of a young boy during this examination. He does not understand that his presence makes the young man feel privileged; his condition got him in to see not only the doctor but also this boy. Ghosh has Marion feel the man’s racing and irregular pulse and shows him the significant difference...
(The entire section is 730 words.)
Chapter 22 Summary
One day on the way home from school, Marion, Shiva, and Genet are walking to the gate of the Missing compound when they see a couple racing up the hill, a child’s body dangling in the father’s arms. It is clear the couple is winded and beginning to falter, but they are both desperate to reach help. As long as they keep moving, somehow their child is alive to them and there is hope. As one entity, as ShivaMarion, the twins run to the couple and relieve them of their burden. Marion grabs the boy and runs, Shiva’s hand on the small of his back, propelling him on and prepared to take over if Marion cannot make it. They hand the child over to the doctors, but it is too late. The sounds of mourning are all too familiar to the boys.
Another sound the twins have come to dread is the sound of Gebrew dragging open the Missing gate, for it always indicates a dire emergency. A childhood spent in the shadow of Missing Hospital has helped the children learn the lessons of fragility of life, the fine line between living and dying. One thing Ghosh does not have to teach Marion is that white is the color of suffering. White-robed supplicants make their way to Missing, a white-robed mass moving up the hill for healing.
Marion sees many things, many forms of illness and suffering. He draws what he sees, and even though his sketches are not as precise as Shiva’s drawings are, they are enough to help him remember what he saw. He sees children whose faces have been deformed by illness or infection who are operated on by Dr. Ghosh. Marion is awe when the same doctor who is able to rotate flaps of skin in ways that will rebuild a nose and cheeks sits down across from him at dinner. Ghosh tells him not to be too impressed, for he is an accidental surgeon; his father, Thomas Stone, is a real surgeon. When Marion asks what makes a real surgeon, Ghosh replies without hesitation: passion and skill, a dexterity and a sureness that he does not have. He can do basic surgery, but he does not have the finesse or passion Thomas Stone had. Ghosh is competent, but he is “scared to death half the time.” Ghosh is being modest, but he is right that his passion is not surgery. Instead, he loves listening to patients, observing what might have been done already by some village witchdoctor, and pursuing the clues to help him heal.
One other thing Marion sees at Missing during this time explains how Shiva discovered his “life course” and...
(The entire section is 771 words.)
Chapter 23 Summary
The rains have ended and school is back in session for several weeks when Hema wakes the boys up with the news that they will not be going to school that day. Marion stops listening after that, though Hema explains there is “trouble in the city.” It is a perfect day to be at home, but the household is eerily silent. Ghosh is fully dressed for work but has a strained expression on his face. Hema is huddled next to him in her dressing gown, nervously twirling her hair. Genet is there and seems surprised to see Marion his own home; Rosina is nowhere to be seen. Almaz is nearly frozen at the stove and moves only at the smell of burning eggs. Marion asks Almaz what has happened. She tells him the Emperor Haile Selassie, God’s chosen, has been overthrown and the city taken over by a group of Imperial Bodyguards—led by Brigadier General Mebratu, who is accompanied by Zemui.
Genet walks by and Marion asks if she is okay; she looks frightened and fingers a gold chain with a strange cross that is around her neck. She nods and goes out the back door. Ghosh explains that the evening before, Mebratu told the Crown Prince that there was a plot against his father and asked him to summon the ministers for a meeting; when the loyal men arrived, the General had them all arrested. Ghosh knows this much because one of the old, frail ministers suffered an asthma attack and the General sent for Ghosh. Mebratu does not want there to be any deaths; he wants this to be a bloodless coup. Ghosh does not think the General wants to be a usurper; he wants to take money and land from the rich so the poor can have food and their own land.
Shiva does not like ambiguity and likes to know exactly how things stand, so he asks whether this coup is a good thing or a bad thing. Ghosh winces at the piercing question. This is not his country, so Ghosh is loath to judge; however, he is convinced Mebratu did not have to do this. While he is doing this for the people, Mebratu had also been under some suspicion again and felt he might be arrested soon. As Ghosh left the palace, Zemui gave him a gold necklace and pendant that Darwin had given him. He asked Ghosh to give it to Genet and express his love for both Genet and Rosina.
The two doctors leave for the hospital but warn the boys to stay home and not leave the Missing compound for anything. Marion disobediently walks out of the gate and into the tiny Arab souk (store) between cinder-block...
(The entire section is 1729 words.)
Chapter 24 Summary
Ethiopia is a land of beautiful skies. Marion is outside on the front lawn when three jets streak through the sky; a loud explosion follows, and smoke rises in the distance. Hundreds of birds fly screeching into the sky as every dog in the city begins barking. He wants to believe this is all part of a plan, that the jets and the explosion were planned, that Ghosh and Hema can fix things. When Ghosh comes running from the house in fear to bring Marion back into the house, his illusions are shattered. The adults in his life are not in charge, and he feels he should have known this. Even when they could not stop the beating of the old woman at the palace gate, he thought his parents “still controlled the universe.” But this is beyond their ability to fix.
They move mattresses into the hallway. It is the safest place in the house as the bullets whir overhead and artillery sounds in the distance. Later they find a pane of broken glass in the kitchen. It is clear that the army decided not to join the coup. Genet is clearly distraught because Rosina has been gone for twenty-four hours, and she grasps Marion’s hand for comfort. The fighting intensifies by dusk, but the fearless Matron insists on making trips back and forth to the hospital. Gebrew has locked and chained the main gate to the hospital complex, and the entire nursing staff, the nursing students, and the rest of the staff are bedded down in the nurses’ dining room.
At midnight there is a knock at the back door—it is Rosina. Genet is happy to see her mother but screams at her for frightening her. Matron is standing behind Rosina and beaming; she and Gebrew found her huddled outside the gate when they went to check it one last time for the night. Rosina tells them things are as bad as they appear: the army, air force, and police are all attacking the Imperial Bodyguard and have honed in on General Mebratu’s position. She spent the day taking cover and trying to get back home. Rosina goes to her home to change clothes and comes back with her mattress; Genet has not forgiven her mother but clings to her nevertheless. As Matron lies down, she pulls a revolver from under her robes. Hema is appalled, but Matron insists she did not spend any Baptist money on it. She wants to protect them from looters. Two men in the hospital also have guns, Matron tells them. Almaz brings them food and they eat in silence.
Marion is too tense to do anything but lie...
(The entire section is 785 words.)
Chapter 25 Summary
It is all over by the next evening; the coup has failed. In three days, hundreds of Imperial Bodyguard soldiers have been killed and many others have surrendered. As the military closed in on the palace, General Mebratu and a small contingent of men fled through a back entrance and headed north under cover of darkness. The next morning, Emperor Hailie Salassie the First (Conquering Lion of Judah, King of Kings, Descendant of Solomon) returns by plane to Addis Ababa. Crowds take to the streets, wildly cheering and dancing as the Emperor’s motorcade passes through the streets of the city. Almaz is one of the cheering crowd, and she tells them their leader’s face was full of love for his people and their loyalty; she swears there were even tears in his eyes. No one has seen the throngs of university students who were protesting in the streets just days before.
The mood is celebratory on the streets but somber in Ghosh’s and Hema’s home. Marion is unsure of who the actual heroes are, but he knows he wants his friend the General to be successful at what he started. Rosina and Genet are beyond impatient as they wait for news of Zemui. Marion realizes the exchange of letters to translate and write will be no more, and the lively parties are almost certainly going to be less fun without the General’s presence. The Emperor offers a gigantic sum as a reward for the capture of General Mebratu and his brother.
Marion wakes the next morning to loud wailing emanating from Rosina’s quarters. Two soldiers stand outside the door, and the reason for their presence could not have been clearer. As the story unfolds, they discover that the General and his small band of followers made their way to safety but were eventually betrayed by some local peasants. When the police surrounded them, the General’s brother shot him in the face before putting the gun in his own mouth. Whether it was a suicide pact or a decision made by one brother, no one will ever know. Genet’s father, Zemui, refused both to surrender and to take his own life. As he charged the forces surrounding him, Zemui was gunned down without compunction.
The four people in the bungalow try to block out the wailing next door. Hema has gone to see them, but Marion has not found the strength to do so. Shiva keeps his hands over his ears and has tears in his eyes. Mr. Loomis calls to tell them school is open; despite their reluctance to go, Ghosh convinces them...
(The entire section is 877 words.)
Chapter 26 Summary
Gebrew meets the boys at the gate and tells them Ghosh has been taken—and Marion’s childhood has also been taken. At twelve, Marion knows he is too old to cry, but for the second time that day he cries because he does not know what else to do. Shiva is silent but his eyes reflect his brother’s pain. As one, they race up the hill toward home. When they get there, Hema is on the couch, pale and sweaty. Almaz is hovering over her and holding a bucket. Their cook tells them Hema drank the water—which they should not do—and Hema insists she is all right. Marion knows it is not all right, that nothing is right now that Ghosh is gone and Hema is so ill. It is his worst nightmare.
As Marion weeps into Hema’s sari, Matron and another doctor burst into the bungalow and announce that the poisoning rumor is not true. Shiva looks at Marion with a glimmer of hope in his eyes. People all over the city are responding the same way Hema did, for the power of suggestion is strong. Now they think only of Ghosh, and Almaz tells them they must gather food, blankets, soap, and clothes before they go to Kerchele prison.
The drive through the city is uncomfortable. Marion, who once thought Addis Ababa was a beautiful city, now sees the destruction left by the coup and recognizes treachery in the streets. He can smell it. “Perhaps it had always been there.” When they arrive at Kerchele, they join hundreds of citizens who ware anxiously waiting to see their relatives as well. The sentry at the office does not even look up as begins a monotonous and obviously well-rehearsed speech that tells Matron nothing: whatever relative she wants to see may or may not be there; he does not know when he will know if that relative is here; she is welcome to leave blankets and other items and if the relative is here he or she may get them; if not, someone else will get them; write the relative’s name on a piece of paper; he will not be answering any questions.
Almaz picks a spot where she can see everyone coming and going and stays there. The others join the crowd and wait. An hour passes. They are the only foreigners in the group and the crowd is sympathetic, telling stories of those who had been in prison before. Dr. Bachelli is the only Missing doctor left while Ghosh is in prison and Hema is outside waiting. He stops at the Italian consulate to see if he can get any help, but then he has to return to the hospital. The others spend...
(The entire section is 1894 words.)
Chapter 27 Summary
Anyone who had been close to General Mebratu is being hanged. Dr. Ghosh seems to be alive only because of the prayers of his family and legions of friends and because he is an Indian citizen. In his despair, Marion thinks about Thomas Stone. Before the coup, Marion would go for months without thinking of him, for he had never seen the man and did not know he wrote a famous textbook. (Hema had removed all copies of the book from Missing when he left). He finds it hard to believe his father was as white-skinned as Matron is; an Indian mother is not as difficult to imagine. Now, in his greatest need, Marion wonders why his father is not here to love and support him—especially when he needs to free the only father he has ever known from prison.
For two weeks the pattern is the same: back and forth from the jail to the embassies to Missing. Marion is convinced this could have been avoided if he had been a better son to Ghosh and vows to change. He waits for a sign to tell him how he should change. It comes one blustery morning when a man is brought to Casualty by his friends. A sweet, citrusy scent emanates from the man. Marion has smelled this before but cannot quite identify it. He searches Ghosh’s medical books and pieces together that the man is in a diabetic coma. Later Dr. Bachelli confirms that was the man’s condition. Just a few days later, Marion encounters a woman lying on a bench with the same scent emanating as she breathes. Marion pronounces “diabetic acidosis,” and later blood and urine tests confirm his casual diagnosis.
Patients keep coming to Missing Hospital but all surgical patients must be turned away. Marion haunts the hospital and spends time in the bungalow browsing Ghosh’s textbooks. Time does not pass more quickly, but Marion has found a passion (like Shiva’s dancing and drawing) that keeps his most disturbing thoughts at bay. In those days his olfactory brain, his “feral intelligence,” is awakened. He has always recognized odors; now he begins putting names on them, and his list of recognizable odors is huge.
One evening Marion is sitting in Ghosh’s armchair looking at textbooks; Marion thinks Hema understands that he is preserving Ghosh’s place. The boy happens to be looking at a picture in one of Hema’s gynecology textbooks when Hema walks by and notices. She stops and appears to want to say something but sighs and thinks better of it, as if to say she understands...
(The entire section is 773 words.)
Chapter 28 Summary
One morning Marion wakes before dawn and runs as fast as he can to the autoclave room, wondering if Sister Mary Joseph Praise could intercede on their behalf. Since his “father” is not going to come and help them, perhaps his birth mother can but is just waiting to be asked. He sits in her small office in silence, looking at the print of The Ecstasy of St. Teresa and feeling as if he is in a confessional but with no desire to confess. After about ten minutes of silence, he begins to talk; he does not want to rush into his primary request. He explains that for a long time he thought all babies came in pairs. While they are identical, he and Shiva are not the same; Shiva is actually his mirror image. Marion is right-handed while Shiva is left-handed. Marion’s swirl on the back of his head is on his left while Shiva’s is on the right. Shiva is intimately tuned to the distress of animals and pregnant women, but Marion is “blissfully unaware” of others’ pain. The topography of Shiva’s head is much different than Marion’s. When asked, Ghosh explained it may have been because of the trauma to Shiva’s head at birth or perhaps it was because they had been conjoined. Marion had to look up that word, conjoined. He found a textbook that had pictures of several sets of conjoined twins, including one set that was touring the world as a circus act. Marion was mesmerized by everything he saw and read about twins of all kinds, and especially conjoined twins.
As he talks to Sister Mary Joseph, he hopes she understands he is not trying to be disrespectful, talking about their birth when it was also the event of her death. He finally asks if she can help get Ghosh out of jail. He immediately feels guilty, for he knows he has committed sins. He also knows he withheld something from her, something he understood only after seeing the pictures of the other twins. While the connection between Shiva and him was severed, it is not gone. Marion feels as if pieces of him are still connected to his brother. For better or worse, he and Shiva are still connected. He abruptly leaves the autoclave room, knowing he cannot expect Sister to help him when he is withholding so much from her. He does not deserve her intercession, but an hour later it comes.
Someone passes Gebrew a note scribbled on a hospital prescription pad. On one side a doctor has scribbled that Ghosh is fine and in no danger. On the back, Ghosh has written that...
(The entire section is 1356 words.)
Chapter 29 Summary
Two days after the General’s execution, the hospital staff holds a celebration. During the preparations, an army jeep arrives and a uniformed officer enters the family’s bungalow. With trepidation, the twins slowly make their way to the house; just as they arrive, Hema and Ghosh step out onto the porch with the officer. Marion is relieved that Ghosh is still here but feels panicked when Ghosh asks them about the man who came for the motorcycle. They had told Hema a story on the day it happened: they said a soldier with a key came and got the motorcycle but they exchanged no words with him. Marion is about to speak when he looks at the officer and sees that it is the same man who came for the motorcycle.
It is the same face, but his body is not as “lean and gangly.” This man is dressed as a professional soldier, which the other man had not been. Marion feels his face turning colors. Rosina and Genet have joined the crowd that has gathered. Shiva makes the simple statement that the soldier came with a key and drove the motorcycle away, and the officer asks for more details. Before Shiva has a chance to answer, Ghosh asks Rosina to tell the man what happened. Again Rosina assumes the position of a supplicant, and Marion hopes she will not provoke an argument this time.
Rosina stammers a bit, obviously shocked to recognize his likeness to the dead soldier. She tells him that the man who came looked like him but was not as polite or well dressed as he is. The officer smiles wryly and says they have the same mother; then he asks what the man was wearing. When she tells him the details, some of which the brother offers, Rosina varies a bit from the script they had rehearsed. It seems to be working. Suddenly Shiva asks, with a deadpan expression, why the officer wants to know and what happened to the motorcycle. Marion is stunned at his brother’s nerve. The officer says he does not know, that the military would not have let the man keep the bike, and explains he had been out of town and is only now able to ask about his brother’s whereabouts. Then he asks to take a quick look around.
Ghosh graciously allows the man to look, and Marion is again filled with the fear of losing Ghosh just as they got him back. “After an eternity,” the officer and his driver return, having found nothing. He explains that he fears the worst, for his brother had been part of a group who stole a lot of money. Perhaps, he says,...
(The entire section is 1793 words.)
Chapter 30 Summary
It has been sixty days since Zemui’s death. Genet is still confined to the house; Rosita, with her missing tooth, is still prickly and easily antagonized. Gebrew finally tells her it is time to stop mourning—even Zemui’s legal wife has finished mourning. When he says that, Rosina explodes with angry passion and calls that woman a harlot. The next day she boils everything she owns that is not already black and many of Genet’s school clothes in a vat of black dye. When Hema asks about sending Genet back to school, Rosina curtly replies that the girl is still in mourning.
Two days later, on a Saturday, Marion hears a shout of celebration from Rosina’s quarters and knocks on her door. Rosina opens the door just a crack, enough for Marion to see a blade in her hand and Genet with a towel pressed to her face and bloody rags on the floor. Rosina says everything is fine and quickly shuts the door. Marion feels compelled to tell Hema what he saw, and Hema immediately knocks on the door. Rosina is surly but tells her she can come in if she wants, since they are all finished.
The room smells of cloistered women and fresh blood. Marion finds it difficult to breathe. Rosina snaps at him to close the door, but Hema countermands the order, telling him to leave the door open and turn on the light. Genet is sitting demurely with a rag in each hand covering her temples. Hema gently pulls back the rags and finds two cuts, like the number eleven, on each side of Genet’s face, just outside her eyebrows. Hema demands to know who did this, and Rosina smirks quietly from across the room but says nothing. Genet says this is the tribal mark of her father’s Eritrean people and that he would be proud of her for carrying the mark. Hema softens a bit and tells Genet her father is dead but she is alive, then she asks the girl to come with her to have her wounds tended to. Marion kneels beside the stubborn girl and asks her to come with them; in response, Genet hisses that he is making it worse for her, that she wanted the marks as much as her mother did.
When he hears of the incident, Ghosh advises they practice patience and reminds Hema that Genet is not their daughter. Hema disagrees and says they cannot abdicate their responsibility to this girl who has been their daughter just when things get difficult. Marion is stunned at the thought of Genet as his sister; the concept certainly complicates his feelings about her. A week...
(The entire section is 1491 words.)
Chapter 31 Summary
It is 1968; the rains are torrential and cause flooding. Rosina and Genet have been gone for three weeks and there has been no word from either of them, though Genet promised to call or write. Marion and Shiva are about to turn fourteen, and Marion keeps expecting something to be different. He tries to stay busy but ends up wondering what Genet is doing. He hopes she is as miserable as he is; without her as a witness, nothing he does is meaningful.
Late one Tuesday evening, Marion watches Ghosh remove a gall bladder and then goes with him to visit a diplomat from the Ivory Coast. Dr. Ghosh discovered a rectal cancer during a bowel obstruction operation and had to create a colostomy from Etien’s abdomen. When they visit him, Etien is depressed and worried about who will ever marry him. Ghosh tells him the right woman will marry him for who he is, not for where his waste is eliminated. Ghosh has one other patient to see and sends Marion home so he will not be late for dinner.
It is raining hard, so Marion winds his way through the wards to the other side of the hospital. As he passes the nurses’ ward, he hears music coming from the corner room that had once been his mother’s. The music is driving and rhythmic, compelling Marion to explore further. He opens the door and sees a barefoot woman wearing a slip that covers her to her knees but leaves her shoulders exposed. She is swaying sensually to the music, one hand on her abdomen and the other in the air to keep the melody. She turns; Marion sees her closed eyes and recognizes her rather pockmarked face. She was a nurse probationer at Missing for years until Matron took pity on her and gave her the title of Staff Probationer. She is masterful at teaching new students how to memorize facts from a textbook.
Marion has always thought of the Staff Probationer as plain, but it is clear she has been hiding her many curves behind her starched and stiff uniform. Marion is about to leave when she steps forward and pulls him into the dance, kicking the door shut. Without speaking, she begins to teach him to dance, and he is an apt pupil, following her lead at every turn. Their bodies are close and both are content. Then the music from the radio ends. They are still pressed together, and she holds his eyes with her gaze. Marion blurts that she is “so beautiful,” surprising both of them. She gasps, and a joy seems to ripple through her. She kisses him slowly; Marion...
(The entire section is 945 words.)
Chapter 32 Summary
Genet and Rosina arrive home two days before school begins, and everyone celebrates their arrival. Rosina has a gold tooth that shows because she is grinning; Genet is radiant and transformed. She is wearing native dress and leaps first into Hema’s arms and then makes the rounds until she is back to hug Hema. Rosina’s hug for Marion is warm and affectionate, but he is envious of the long, loving embrace she gives Shiva. Now Marion sees that Rosina has always favored Shiva. Genet is happy, but she has changed. Her hair is shorter, her palms are orange with henna, she has pierced her ears, and she has grown more womanly. Rosina says, in a semiscolding tone, that the boys all want to be with her daughter and Genet does not discourage them; she seems oddly pleased by this fact.
As their new furniture—gifts from their family—is being unloaded into Rosina’s quarters, Marion talks with Genet. He is shy talking to this woman in front of him, but she is not reserved at all. She asks him what he has been doing while she was gone. Marion had saved up all kinds of things to tell her, but none of them seem important in the face of Genet’s transformation. He finds himself telling her about the incident with the Nurse Probationer, though he begins by making it sound innocent with his indifference. Soon he has told her everything, and she wants to know if he “did it” with her. When he tells her no, she is aghast and asks why not. Marion does not want to answer but she pushes him to it; he tells her he wants his first time to be with her. Genet’s reaction is not what he expected. She explodes with laughter and even kneels in her hysteria.
The family shares dinner with the returning travelers. After dinner Marion tunes the radio to the same station the Nurse Probationer played in her room. Tonight is the first night he hears the same song that had been playing then, and he tells Genet this is the song from that night. Marion uncharacteristically leads the group, and soon all of them are dancing. At the end of the night, Genet goes to her own quarters, now that she has her own bed.
On the evening before school starts, Hema and Ghosh take the boys to the Greek club to celebrate the end of “winter.” The crowd is made up primarily of expatriates; the band plays and everyone dances. Soon Shiva is dancing with anyone who looks as if they would like to dance, but Marion is no longer interested. As he walks up the...
(The entire section is 616 words.)
Chapter 33 Summary
A taxi drops sixteen-year-olds Shiva and Marion off at the gate in front of the Missing grounds, across from the cinderblock buildings doing business, one evening after cricket practice. A striking woman approaches them, and Marion recognizes her as Tsige, the woman he comforted after she lost her son. She was a plain woman and had dressed in black for a year of mourning; now she is dressed and made up and is beautiful. Shiva is not shy around women and asks her if she works here. Tisige tells them she now owns the building and invites them in, but Marion tells her their mother is waiting. Shiva says she is not waiting, but the boys still do not move. Tsige holds Marion’s hands and thanks him for comforting her; she has wanted to thank him before but did not want to embarrass him. She explains that she could have saved her son if she had not listened to the advice of the rustics around her and hopes God will forgive her and give her another chance. When she asks if he is going to be a doctor, both Shiva and Marion answer yes. It is one of the only things they can agree on, and it is becoming the only thing they seem to have in common.
On their way home, Shiva asks why they did not go to Tsige’s house, for she would have let Marion have sex with her. Marion is appalled at the thought and tells his brother he has had opportunities and tells him about the Nurse Probationer. Shiva is matter-of-fact about such things and says today is as good a day as any for them to have sex with women. Marion grabs Shiva’s shirt and tells him they are not to do anything to embarrass Hema and Ghosh. Shiva says he is sure Hema and Ghosh have sex, and—Marion stops him there.
The month the twins turn sixteen, Marion’s voice begins to crack, his skin begins to break out, hair appears in unusual places, and his clothes become all too tight or too short. It is hard for him to concentrate because he is continuously thinking about Genet. There is no solace for him in knowing Shiva’s body is also changing. Ethiopian students his age have all had a sexual initiation with a bar girl or a housemaid, so they are spared the confusion of imagining the unimaginable.
A few weeks after Marion and Shiva met with Tsige outside her bar, the Staff Probationer is walking toward Missing’s gate with a group of probationers. Usually she ignores Marion, but today she seeks him out and thanks him for last night, hoping the blood did not scare...
(The entire section is 1094 words.)
Chapter 34 Summary
The incident with Genet at her house is a distraction. Marion is determined to do well enough on his finals to be admitted into the grand, new teaching hospital five times larger than Missing. As Rosina continues scolding her daughter next door, Marion spreads his books out on the table and prepares to study. He has a plan and must stick with it if he wants to play on the cricket team, sleep, and get into medical school, so he eats while he studies so as to not waste time. Genet arrives an hour later to study with him, and soon Shiva joins them. Although Genet says she is as interested in medicine as Marion is, she does not show it in her study habits.
Shiva is not at all interested in school and is trying to avoid finishing so he can work as Hema’s assistant. She is blunt with her son, though, and tells him if he wants to be her assistant he must finish school, even if he does not take his final exams. Shiva continues studying Hema’s books, and Marion overhears Hema tell Ghosh that Shiva knows as much about gynecology and obstetrics as most final year medical students do. The tool shed is Shiva’s domain, and Marion was surprised about a month ago to see that the motorcycle was nowhere in sight. Shiva has taken it apart, and pieces of it are tucked in odd places all over the space, including in boxes on metal shelves Shiva has welded together.
After studying (or hiding behind her book) for only ten minutes, Genet asks Shiva what it was like to have sex. In a very matter-of-fact way, Shiva answers every question they ask in clinical fashion and without embarrassment. Genet is getting aroused by the conversation, and Marion has to leave the room because he, too, is aroused. The scent emanating from Genet is overpowering—a shimmering cloud of pink in the air around her. He shoves his notes in his pocket and leaves. As he passes by the kitchen, he sees Rosina hovering at the door and is concerned. He likes Rosina’s protectiveness of Genet, but he is disturbed by her hovering. Rosina is his ally, but she makes him nervous.
Marion goes to the souk and buys a Coke he does not drink. When he finally trudges up the hill, he hears music in the tool shed. Marion passes the shed and is almost to his house when Rosina comes out of the dark, yelling at him and hitting him. He is too shocked to understand what she is screaming at him. She tells him he was so clever, pretending to go to the souk while Genet left for...
(The entire section is 1720 words.)
Chapter 35 Summary
When they took down her mother’s body from the rafter and buried her in Gulele Cemetery, Genet’s vivacious and lively self died and was buried with her. She now attends Empress Menen School and wears the same uniform as every other girl in attendance; her only adornment is a St. Bridget’s cross around her neck. Genet wants to blend in with the crowd.
On Saturday evenings, Marion’s new ritual is to visit Genet at school, just up the hill from the palace where General Mebratu and Zemui had taken hostages and accomplished their bloodless coup. She could have come home on weekends, but now Missing evokes bad memories for her, and she insists she is happy at Empress Menen. The strict Indian teachers are very good, and Genet works very hard now that she is away from other distractions.
Marion and Genet enter university together for their premedical coursework, and they enter medical school together the next year. Although Genet is out of her uniform, her demeanor is still “reserved and subdued.” Each time Marion visits her at the hostel where she lives, he prays this will be the day Genet will open the “locked door of her heart” and traces of the old Genet will appear. She always appreciates the food Hema and Almaz send, but the barrier remains. Marion still loves her but wishes he did not.
In 1974, Genet and Marion enter the Haile Selassie the First School of Medicine as part of the third class to be admitted. They are paired as dissection partners on a cadaver, which is a blessing for Genet. Any other partner would have been angry about her frequent absences and not doing her share of the work. Marion knows Genet is not being lazy and believes there is something else happening, though for once he has no idea what it is.
The teachers at the school are good; they come from many countries and have had extensive training. Only one of them is Indian: Dr. Ghosh. His official title is Professor of Medicine and Adjunct Professor of Surgery. Over the past twenty-eight years in Ethiopia, Ghosh has become a medical scholar, which none of the family had realized. Ghosh has published forty-one papers and written a textbook chapter. His initial work was done in sexually transmitted diseases, but he has become the world’s leading expert on relapsing fever because the louse-born variety of this disease is endemic to Ethiopia and no one has observed it as closely as he has.
(The entire section is 657 words.)
Chapter 36 Summary
Ghosh calls it heuristics, solving problems for which no formula exists. Life is full of signs; the key is learning how to read them. Marion’s heuristics are a mix of “reason, intuition, facial appearance, and scent”—and none of them are found in a book. But he does not trust his nose when he scents something different about Ghosh, the man who excelled at the “Three L’s: Loving, Learning, and Legacy.” Marion attributes Ghosh’s even more jovial self to his new position.
On the morning of Hema and Ghosh’s anniversary, Marion awakens at 4:00 a.m. to study. At six o’clock he leaves Ghosh’s old bungalow and goes to his boyhood home, where Shiva still lives. The door to the bathroom hallway is open and steam is coming from the room. Ghosh is wearing a towel around his waist and leaning heavily on the sink. It is early for him to be up, but Marion assumes Ghosh is using this bathroom so he will not wake Hema. Marion can hear the man’s labored breathing before he sees him; obviously the simple effort of bathing had winded him. In this unguarded moment, Marion sees the real Ghosh: a terribly fatigued man who is full of sadness and apprehension. Then Ghosh sees Marion, and by the time he turns around he has assumed his jovial persona.
Marion smells the familiar scent of death and asks what is wrong. Ghosh dismisses the question by saying how wonderful his life is and recounting his plans to go dancing with Hema that night and asking her to extend their marriage contract for another year. Hema appears and Ghosh dances her around the room while whistling, but his whistling is staccato because he does not have enough wind to do both activities.
Marion attends his early morning class but then follows his intuition—his nose—to find Ghosh in Casualty, where he sees Matron waiting for Ghosh. Adam enters with a bottle of blood and exits without it a moment later. Adam is startled at Marion’s presence and tries to close the door, but Marion has his foot firmly in the way. He walks in to see Ghosh lying in a lounge chair and Matron preparing to give him a blood transfusion. They are both stunned to see Marion. When the son tells the father not to bother to lie to him, Ghosh realizes the moment to tell him has arrived. Always the teacher, Ghosh is also now the patient, and he tells Marion to make a diagnosis.
Marion uses his own heuristics and realizes he had noticed Ghosh’s...
(The entire section is 1959 words.)
Chapter 37 Summary
Marion leaves Ethiopia on Wednesday, January 10, 1979. It is two years after Ghosh died, though Marion’s leaving the country has nothing to do with Thomas Stone or with the fact that the Emperor has been deposed and the new regime is ruled by a dictator (Mengitsu) who will rival Stalin in his cruelty and destruction. He left because on that day four Eritrean guerrillas posing as passengers commandeered an Ethiopian Airlines plane and forced it to land in Khartoum, Sudan. He left because one of those rebels was Genet, who had been a medical student that morning but is now a liberation fighter.
Finally Marion is a doctor, an intern finishing his final rotation. Word is out about the hijacking, and when Hema calls Marion he tells her there is nothing to be done for Genet. Hema tells him her old friend Adid just called, and the police are looking for a co-conspirator named Marion Praise Stone.
Genet’s tiny little roommate, who no doubt had no knowledge of the hijacking scheme, blurted Marion’s name within an hour of the incident. Immediately Marion’s thoughts go to Ghosh in prison; he knows Kerchele is worse by a hundredfold than when Ghosh was there. Marion parks his car and takes a taxi home, thinking about the many previous unsuccessful attempts at hijacking the national airline. This time someone in security may have turned traitor, since the incident occurred quickly and without violence. A woman with the distinctive cornrows of the Eritreans stops the taxi, but the driver tells her to take a plane instead. As the taxi arrives at Missing’s gate, Marion sees Tsige getting out of her expensive car. The woman has been amazingly successful, and she never fails to encourage Marion in his studies and prays for him faithfully. He is tempted to stop and tell her good-bye but cannot. He hopes she will never have to flee her land, as he will have to do.
Hema has packed all of Marion’s important documents as well as bread, cheese, water, money, and a few items of clothing into an Air India shoulder bag. Marion layers his clothes against the cold and adds a cassette containing “Tizita” to his bag, though he leaves the player behind. He would like to take several of his beloved textbooks, but they are too heavy. They leave on foot, and Marion insists on walking past the gravesites of Ghosh and Sister Mary Joseph Praise. Shiva escorts Matron as Hema walks with Marion. Almaz and Gebrew have gone ahead....
(The entire section is 1874 words.)
Chapter 38 Summary
Marion flies from Nairobi to Rome to London to New York. The immigration process when he arrives is so minimal he is afraid he missed it. There are no dogs, no soldiers, no long lines, no body searches. No one is rifling through suitcases or cutting the linings to make sure nothing gets missed. Before he is ready, Marion is outside the Customs area and in the middle of a crowd. Instead of the sea of White faces he had expected to see, Marion sees every color and type among the crowd, and their scents are overwhelming to him. He sees a rather swarthy and scruffy man holding a sign that might have said “Marvin” or “Marmen” or ”Martin,” followed by “Stone.” When Marion introduces himself, the man insists Marion is a girl’s name. When Marion tells him about the famous gynecologist he was named for, that there is a statue in his honor in Central Park, that Marion Sims opened the hospital now known as Sloan-Kettering, the man insists gynecologists should be women.
Nevertheless, the man leads Marion to his yellow taxi and soon they are driving out of Kennedy Airport and into the Bronx. Marion is struck by the silence, for in Africa drivers drive with their horns. The cityscape is familiar to him from movies, and he is embarrassed to think of how proud he was that he knew so much about America. Now he understands the hubris is America’s, an arrogance of scale. Everything here is done on a grand scale, including the speedometer in the taxi, which registers seventy miles per hour—a speed unthinkable in the family Volkswagen even if they could find a road on which to try. His life in Africa seems small, as if it did not count, “a gesture in slow motion.” Everything he once considered to be precious is plentiful and cheap here, and what he once saw as “rapid progress” turned out to be “glacially slow.” Marion wants to remember what he is feeling and tries to imprint it on his memory.
At first Marion is hurt by the taxi driver Hamid’s discourtesy. He would have liked to ask him about what he was seeing along the way in an effort to assuage his fear, especially because Hamid also once immigrated to this country. Then he chooses to see Hamid’s silence as instruction, a silent message that he must gather his nerve and find his backbone “or be swallowed whole.” It is an exhilarating insight, and he speaks Ghosh’s constant admonition out loud to himself: “Screw your courage to the sticking...
(The entire section is 986 words.)
Chapter 39 Summary
The patient is under and ready for surgery. Marion is to perform the operation and Deepak is to supervise, with Sister Ruth as the scrub nurse. Sister Ruth announces a change in plans: Popsy (Dr. Abramovitz) wants to operate and is on his way. Everyone in the room groans good-naturedly and tells Marion it is his job to contaminate Popsy as soon as he picks up a scalpel in whatever creative way he can find. No matter what, he must contaminate Popsy. Marion turns to Sister Ruth, hoping for some help. She tells him to pray for the intercession of Our Lady...and contaminate Popsy.
This is the twelfth week of Marion’s surgery internship at Our Lady of Perpetual Succour, and all he has seen of America during that time is what he glimpsed from the window of his taxi. At times he feels as if he has left America and entered a different country. Here in the Bronx, most of his patients speak Spanish, and the English he hears is not as refined and proper as he expected. The hospital is severely shorthanded compared with other American hospitals, but Marion is not aware of the norm. Our Lady has three times as many surgeons as Missing’s entire staff, and they see many more patients. The entire experience is worlds apart from Marion’s experience at Missing, and he learns that those sleek American cars, those “floating living rooms on wheels,” can create monstrous injuries when they crash. The doctors at Our Lady are able to save people who would never be seen at Missing because no one would bring them to the hospital. It never crosses the minds of rescue workers or doctors that a patient cannot be saved.
Marion has no time to be homesick because he and the other interns are on call every other night. The schedule is “brutal, dehumanizing, exhausting”—but he loves it. Sometimes Marion can see traces of the former glory of Our Lady of Perpetual Succour; however, like most things in the community, it has become poor in taking care of the poor. The hospital is subsidized through Medicare and Medicaid, and the helicopter and helipad are paid for by the rich hospitals that cater to the rich and are connected to universities to underwrite their costs. It is in their interest to support hospitals like Our Lady that have an abundance of “spare parts” due to the anger and frustration of the people who live in such neighborhoods. People get angry or jealous and kill one another, and the result is dead bodies, from which all...
(The entire section is 1368 words.)
Chapter 40 Summary
After leaving Mr. Walters’ room, Marion sits on a park bench and thinks how unfair it is that the kind man had to receive his darkest news on such a glorious day. The colors of fall are new to Marion; this never happened in Africa. Nearby, laughter and squeals come from the dormitory; sometimes Marion feels as if he is living in Sodom. When it gets chilly, Marion goes inside, where he smells spices and tobacco and marijuana smoke. (Nestor has a garden in the back that grows tomatoes, sage, and cannabis.) Behind Our Lady is a fence topped with razor wire that separates the medical complex from a housing project named Friendship, though everyone now calls it Battleship. The sounds of handguns can be heard emanating from the neighborhood at night.
On Mondays the nurses generally invite the interns to their quarters for a communal dinner; tonight it is the nurses’ turn to visit the interns. Marion and a few other interns, plus Deepak, engage in a discussion about the ironies of clean living versus living as a hedonist who abuses his body. The theory is that the “four dirtballer” (the man who beats his wife, abuses alcohol, falls off buildings, has heart attacks, gets stabbed, suffers strokes) will always live through a major operation because he has already demonstrated his capacity to survive. The “zero-to-one dirtballer,” on the other hand, does not fare as well because he has lived a good, clean life (stays married to the same woman, goes to church regularly, monitors his blood pressure, does not eat ice cream, raises his kids). In short, they conclude that Mr. Walters, as a zero dirtballer, is fortunate to have survived his surgery.
They pass a joint, but it does nothing for Marion’s deep fatigue. The noises around him continue, and Marion expresses something about which he has thought much: it is strange that foreign doctors are taking care of American patients. Nestor is more blunt and asks if he wonders where the White doctors and White patients are. Marion asks if all hospitals are like theirs, and Nestor bursts out laughing at Marion’s naiveté. Marion’s colleagues try to explain the way things work.
The pepper shaker, they say, is their kind of hospital; this hospital can always be found in poor neighborhoods and is not connected to a university or medical school. The salt shaker is the other kind of hospital and is almost always connected to a major university or medical school. Every...
(The entire section is 596 words.)
Chapter 41 Summary
Nine months after he arrived at Our Lady of Perpetual Succour, Marion is walking to the operating room with Chief Resident Deepak Jesudass when a bailiff serves Deepak papers. The Chief Resident takes them without comment and the two of them continue their work. Long after midnight, they are in the locker room smoking. Deepak says anyone else would have asked about the papers, but Marion says Deepak will tell him if it concerns him.
Deepak is in his late thirties and does not look like a leader. Later, when he looks back at his surgical training, Marion knows he is indebted to Deepak for his surgical skills. In the operating room, Deepak is “patient, forceful, brilliant, creative, painstaking, and decisive.” He is a true artisan, and he teaches Marion not to waste motion and to pay more attention to where he has been than where he is going when suturing. Marion reties more knots than he ties when they work together.
That night Deepak tells Marion what he has probably told no one else at Our Lady. Deepak is from Mysore, India. When he graduated from medical school, his parents hastily arranged a marriage for him with a girl in Birmingham. She was not a willing bride but her parents were concerned about the friends she was choosing. She and her parents flew down a few days before the wedding, and she left the day after to attend college. It took Deepak six months to get his visa and join her at her parents’ home. His bride was embarrassed of him and did not want him near her in public or in private. After a few weeks he left and found an internship in Scotland. He passed the difficult exams and became a Fellow of the Royal College of Surgeons, a prestigious honor.
He could have gone back to Mysore, but he could not bear to face all those who had attended his wedding. The next level of work for him in England would have been as a surgical consultant, but those positions were limited and only became available when someone died. So he came to America. He had to start from the beginning because America does not recognize postgraduate training from any other country, and Deepak was not sure if he could do it. Here, after working as an intern for one year and four years as a resident and moving to the position of Chief Resident, a surgeon can take the exam to become a board-certified surgeon—America’s version of a consultant.
He did his internship at a prestigious school in Philadelphia, and he...
(The entire section is 805 words.)
Chapter 42 Summary
Prayer does not help. With two months left in Marion’s year of internship, Our Lady’s residency program is put on probation. There will be a final appeal, so until they are shut down the staff can only keep working.
One Friday night an ambulance drives up and the crew rushes in with a rolling stretcher. Marion hears the story as he walks with them. This young Black boy, about twenty, ran a red light because he was in a gang-related gunfight. Someone got shot in the head and is on his way here as well. This boy on the stretcher is the shooter. He was broadsided by a van, flew out of his vehicle (he was not wearing a seat belt), and got hit again by his own car as it spun around in the crash.
Although he is unconscious, the boy’s skull is intact. His pulse is thready and racing under Marion’s fingers. His blood pressure is dropping and his belly is swelling. Marion takes him immediately to the operating room and the surgical team prepares for an effulgence of blood once the incision is made. Even knowing what is coming, they are unprepared for the amount of blood that escapes the cut and pours over everything. Deepak enters the room and Marion steps aside, but the Chief Resident tells him to stay where he is.
As they work, Marion senses the source of the bleeding is somewhere behind the liver, and he is correct. However, the boy has lost too much blood, what blood he does have is no longer clotting, and his temperature is dropping. They do what they can to close the boy up and send him to the Intensive Care Unit in the hopes that he will be more stable in a few hours so they can finish the surgery. In the meantime, transplant teams are on their way to harvest organs and body parts from the man he shot.
His name is Shane Johnson, Jr., and his family is gathered in the waiting room. In the Intensive Care Unit two hours after they began surgery, Shane is alive—barely. In surgery, Marion and Deepak determine the boy’s vena cava is torn, and the placement of the liver makes it impossible for them to repair it. After several moments of silence, Deepak cuts open the boy’s chest with an electric saw. Marion does not ask what his superior is doing, and Deepak does not explain. In the larger operating room next door, a crowd of White faces is gathered around the operating table.
Deepak modifies a chest tube to use as a stent that will also serve as a “crude bypass” so blood can...
(The entire section is 1069 words.)
Chapter 43 Summary
Marion believes in a world in which past and future can “smack together” and in which a father who ran away to put a continent between him and his sons will find himself in the same room as one of them.
Marion spent years longing for Thomas Stone to come walking through the gates of Missing; the disappointment helped shape and harden him and reminded him that he must be ready for a lifetime of difficult moments. The life lesson of Missing and Thomas Stone is that “the world does not owe you and neither does your father.”
There has not been time for Marion to do what he promised Ghosh he would do, so Marion does not feel guilty about not following through. He has developed a respect for Thomas Stone through reading his textbook; he had obviously accumulated years of observations in a world of disease and poverty. Now the man of the textbook has become flesh, and Marion should have been able to feel a kinship with his voice and his scent. The way the man observed Deepak’s surgery, leaning in but remaining small so he would not interfere with the operating field, were “echoes” of his own manner. When his father was in the operating room, he should have felt an aura or a tingling; instead all he felt was pride in his colleague’s work. Now, though, for the first time since he was a boy, Marion wants to know more about the man he encountered in the operating room, the real man who stood next to him.
Marion spends his free time studying the life and career of Thomas Stone. He searches out scholarly work his father did after leaving Addis Ababa. In a notebook, Marion plots out the scientific career of Thomas Stone. In America he was interested in liver surgery and was part of the fabric of early liver transplantation. Thomas Starzl was the first doctor to attempt a liver transplant, but Thomas Stone was the first surgeon to perform a liver transplant in which the patient survived. While others in the field are now focusing on antirejection medicines such as cyclosporine, he seems to have concentrated his efforts on something most other liver surgeons see as a dead end: removing only part of the liver so that both donor and sick patient can live. Great work is being done in this field, and it is being done by Thomas Stone. Marion is excited as he reads about the history of transplants. He thinks it is one of the most “compelling stories in American medicine.”
After forty-three days, Shane...
(The entire section is 1834 words.)
Chapter 44 Summary
Two weeks later, as Marion is resting in his room after a cricket match, there is a knock on his door. From his bed he invites his visitor to enter. The room is dark and it takes Thomas Stone a few minutes to adjust. By the time he sees his son, Marion is sitting up in bed; the sight startles him. Thomas Stone shuts the door behind him as he walks into his past.
Marion did not invite him here, and they both wait in silence. Marion gives him credit for figuring it out and for tracking him down. He thinks about how strange it must have been to see a son he never thought of while conducting a morbidity and mortality conference. Finally Marion tells him he might as well sit but does not offer to turn on the light. Thomas Stone walks quickly to the chair across the room and sits down hard. Marion studies his father’s face while his father studies the room. Marion has more possessions—with the exception of books—than Stone has, and he sees his father’s eye light with recognition on the framed picture of St. Teresa from his mother’s office. When he sees the glass jar with a finger, he must know he is in the right room.
It is ten o’clock at night, and they continue sitting in silence. Finally Stone asks to smoke. Marion knows the man does not smoke or he would have smelled it in his apartment. Despite that, they both take a cigarette, and his father gets up from his seat and flicks his lighter just as Marion swings his feet over the side of the bed. The father shields the flame for his son. This cigarette and the smoke make Marion think of home. Stone says he does not expect Marion to understand; Marion says they should not talk about it, then. More silence. This time his father cracks first. He asks how Marion likes surgery.
Marion makes him wait. Surgery is a complex topic of discussion because it connects him in too many ways to his father. Ghosh became a surgeon because Thomas Stone left Missing, but he had no one to teach him; Marion became a surgeon because of Ghosh. Deepak has taught him the basic good habits of surgery, something his father also admires. He does not want to seem as if he is seeking his father’s approval, for he is not. Finally he says he is lucky to have Deepak.
Thomas Stone begins talking about the man who trained him, a man like Deepak, though he still finds it difficult to—and then he stops. Marion gives him plenty of time then prompts him to speak. Stone says he...
(The entire section is 1025 words.)
Chapter 45 Summary
As a child, Thomas Stone asks the gardener where little boys come from. The dissolute gardener tells the boy he found him washed up on the shore, cut off his fins, washed him up, and brought him to his mother. Thomas does not believe him and walks away. The gardener can make things grow from the earth, but if Hilda Stone had heard the exchange she would have fired him for telling lies to her only son.
Thomas lives just outside the rock walls of Fort St. George in Madras, India. St. George is the first home of the East India Company, and the first Anglican church in India was built here in 1680. Here a tutor and governess, Hilda Masters Fife, married Justifus Stone, a British civil servant twenty years her senior. Thomas thinks everyone’s childhood is like his. His father is gone often for his work, and when he is home he is noisy as he crashes into furniture and makes “alarming sounds all night.” Thomas knows instinctively, though he may not have been able to express it, that even when his father is home he is not really there. He understands his father is selfish and neglectful of his wife, which is probably why she turns to the church for solace. She asks God to help her with a husband who loves gin and native women. Her blessing comes with the arrival of her blue-eyed, towheaded son.
She spoils him in every possible way, carrying him on her back during play and fanning him at night when it is too humid to fall asleep. He has an ayah (nanny), Sebestie, but she has little to do because his mother meets all his needs and more. Thomas does not sleep well when his father is home. He keeps a vigil outside his parents’ bedroom door until all the noise finally stops, then he returns to his own bed. Thomas lives to please his mother as much as she lives to please him. They could not know their time together would be short.
Hilda can no longer sing in the choir when he is eight, for she has developed a cough. The doctor tells her she can no longer sleep in her son’s bed for the child’s sake. The coughing gets worse, and the doctor pronounces consumption, the gentler word for tuberculosis. He speaks to Thomas in precise medical terms and says all she needs are rest and hydrotherapy but adds that it is not up to them, anyway. When Thomas asks who it is up to, the doctor raises his eyes to the ceiling. For the longest time, Thomas thinks the doctor meant Justifus, not God.
One morning Thomas wakes...
(The entire section is 2152 words.)
Chapter 46 Summary
Thomas Stone has stopped talking, and Marion thinks he is debating what to tell him next. He thinks perhaps his father will skip his years at Missing and is about to interrupt the silence with a rude comment, but he is glad he did not do so because now he will hear about his mother.
Thomas continues talking. Outside the windows of his room, Thomas sees the glorious colors of fall; in him, there is an awful sickness. His nerves are oversensitive and he has vomited until there is nothing left in his stomach, but the impulse to run is no longer present. Several oceans now divide him and the place from which he fled. Eli Harris and another man, maybe a doctor, leave him a “tincture of paregoric” in a small bottle by his bed. Once he sees it, Thomas drinks it as if it is the only thing that can save him. He tells himself it is the small bit of opium that brings him relief, not the alcohol. “He is done with alcohol.”
The only two women he has ever loved are now dead. Although their deaths occurred years apart, this has caused him to lose his mind. That is why he ran, not knowing where he was going or even from what he was escaping. He has no memory of how he arrived in New Jersey from Kenya, but he knows it is far enough and he has a benefactor named Eli Harris. It takes two weeks for him to detoxify his system—two weeks of cold sweats and night terrors. He sees bread and cheese and a newspaper by his bed, but there is no longer a small bottle. Thomas is finally able to sit in a chair and make sense of what he sees and to see things for what they are. One morning he is steady enough to go downstairs. From the porch, he sees a cat is preparing to pounce on a sparrow, and he wonders if he is still hallucinating. When the kitten finally pounces and the sparrow flies easily to safety, Thomas is released from his torpor.
Thomas knows the ceiling of his bedroom better than he knows his own body. Clumsy work was done when the room was subdivided, but the marks of a craftsman remain in the carved details of the woodwork. When he looks at the ceiling, it is if his life plays, reel after reel, on a screen above him. At first he thinks it is another side effect of the paregoric, but the films continue after the bottle is gone. He cannot control which reel plays but he can view his life dispassionately, separate emotions and events, and judge the actor who plays in all of the films. An early winter storm strikes the...
(The entire section is 1085 words.)
Chapter 47 Summary
Thomas Stone remains in his son’s room until after midnight. Marion has forgotten he is even there, as he finds himself transported by the sound of his father’s voice to a past that happened before his birth. He believes his father could have a vision of his mother, just as he has seen and felt her in the office behind the autoclave room. Only when the voice stops is Marion conscious of Thomas Stone’s presence. “The silence afterward was terrible.”
Thomas Stone saves the surgery program at Our Lady of Perpetual Succour by making it an affiliate of his hospital in Boston. A signature on paper makes it so, but each month Stone sends residents and medical students there to do a rotation. Our Lady residents have the same opportunities to work in Boston on rotations. Marion is in his second year of residency, and Deepak is finally a board-certified surgeon. He could go anywhere and set up practice; instead he becomes Director of Surgical Training at Our Lady and is appointed Clinical Assistant Professor at the Boston Hospital. True to his word, Thomas Stone helps Deepak publish his paper on the vena cava, and the work is now cited by everyone when discussing liver injuries. The influx of doctors and students on rotation allows Deepak more sleep and more time to pursue other experiments on animal livers in the unused basement space of the staff quarters, where he still lives despite his increase in salary. Popsy’s condition is no longer a secret to be kept. He is often seen harmlessly wandering the halls in his scrubs, though he is not allowed anywhere near the operating room.
A few months after Thomas Stone’s first visit to Marion’s room, on a Friday night, the doctor returns. He is tentative and unsure of his reception. Marion had once found it easy to be angry with him; however, that night changed things for him. Now Stone’s presence feels awkward, and Marion does not invite him into his room. The doctor stammers out an invitation to eat at an Ethiopian restaurant in Manhattan with him on Saturday. He hands his son the address and suggests seven o’clock. Marion is surprised by the offer and would have turned his father down if it had been any other restaurant. He does not particularly want to be around Thomas Stone, but Marion says they have unfinished business and agrees to meet him.
Thomas Stone looks out of place as he stands in front of the restaurant, but he looks relieved when he sees...
(The entire section is 1666 words.)
Chapter 48 Summary
On the first Sunday of every month, just after midnight, Marion calls Hema. It can be an expensive call because Almaz, Gebrew, and sometimes Matron want to talk first. They are no longer afraid their phone is being bugged—not since Hema delivered Comrade Mengistu’s child. Life in Marxist Ethiopia is difficult for most, but those who do favors for its leader—and particularly for his wife—are not forgotten. Missing faithfully receives its medicines and supplies without having to spend its precious money on bribes. As he dials, Marion thinks about his extended family, watching the clock and waiting for a call from a continent none of them have ever seen.
Almaz and Gebrew tell him they are praying for him. Matron is chatty and talks as if they were in the hospital hallway at Missing. When he talks to Hema, Marion is open about his time with Thomas Stone because he believes she can no longer feel threatened by him. When he tells her about the bookmark and what he did to the man’s apartment, Hema is silent. Marion can tell she knew nothing about Shiva’s having a copy of Stone’s textbook. Later, Matron will confirm that it was Hema who wanted every copy of the book removed or destroyed because she did not want the twins to see his work or even his picture.
When Marion tells Hema about his dinner with Thomas Stone and the message he delivered from Ghosh, her silence again says she did not know about Ghosh’s dying wish. When he tells her what Ghosh wanted Thomas to know, she cries; the message speaks more about Ghosh’s goodness than anything about Thomas Stone. He asks if she knew anything about the bookmark or a letter. She did not, and as Marion waits to talk to Shiva, he hears Matron answering no as well.
The telephone is not a comfortable instrument for Shiva, who says he knows nothing about a letter. As they talk, Marion learns the story of the textbook. Shiva got the book from Ghosh before he died; Ghosh took it from Thomas Stone’s quarters on the day the twins were born. Shiva had never seen a picture of their father before then, and Ghosh did not mention anything about a letter from their mother. Ghosh did not say why he wanted Shiva to have the book. When Shiva saw the reference to a letter on the bookmark, he did not go back and ask Ghosh anything about it because he thought that Ghosh would have given Shiva a letter if he had wanted to. Shiva gave Marion the book because he wanted him to...
(The entire section is 1295 words.)
Chapter 49 Summary
The yellow house is not impressive, but four yellow taxis are parked in front of it. Marion and Mesfin, his taxi driver, are escorted downstairs, where the sights and smells are exactly what might have been found in a home or restaurant in Addis. They are served quickly and the food is delicious. Later, Marion sees a white Corvette purr up to the house. First he sees a shapely leg, and then he sees the rest of her. She has skin the color of café au lait, and she is dressed in a maroon pin-striped blazer over a white blouse and skirt. This lovely Ethiopian lady is wearing heels and red nail polish, and her hair is cut in a “perky, asymmetrical style.” There is no doubt she is the Queen, and she makes her way to her office next to the kitchen. When she sees Marion she immediately stops and stares as if she has seen a vision. Marion is wearing a suit with his tie loosened and feels as if he is perfectly presentable, so he wonders why she is staring. The woman begins to praise God and Jesus, and Marion looks around to see who else she might be talking to.
Speaking Amharic, she asks if he recognizes her, says she prays for him every day, and wonders if she has changed so much. Now he knows it is Tsige and finds himself tongue-tied. When they first met, she was a mother and he was a boy. She hugs him and kisses his cheeks, and for the first time in the six years he has been in America, Marion feels at ease. He feels his guard come down and the muscles in his neck and belly relax. Marion has always liked Tsige and felt a connection to her, so he kisses her cheeks just as vigorously, knowing he will not be the first to stop the ritual. He tells her he is now a surgeon but had no idea she was here.
Everyone in the room is a displaced person, and all of them understand these kinds of reunions. Tsige proudly takes his hand and tells everyone that this is the one who took her to the right clinic, who got his father to treat her baby, who stayed with her as her baby fought for life, who held her hand as her baby died. She is overcome with emotion, and the joyous crowd has grown somber. After she collects herself, she tells them she has never forgotten his kindness and has prayed for him every day since then as she watched him grow to be a man and a surgeon. He is proof, she says as she lifts her hands to the ceiling, that there is a God. Today is a celebration, and Tsige says no one will pay for their meal this day. Marion spends...
(The entire section is 1531 words.)
Chapter 50 Summary
Now that he is an attending surgeon and can afford it, Marion purchases a duplex in Queens. He maintains a garden, repairs shingles on his roof, paints walls, and installs bookshelves. He is creating a home in the country he calls his home. It has been six years, and he has still not made time to go back to Ethiopia. Everywhere around him he sees beautiful women, many of whom make subtle advances toward him, but he is still alone.
He could have gone anywhere in the country to practice surgery, but Our Lady of Perpetual Succour has become a “war zone,” a place where prominent medical schools send their residents to perfect their skills. Marion is Head of Trauma. There are more resources and personnel at Our Lady than ever before, but tonight he is restless and knows he must take some action, do something new. That weekend, he examines the Times to find something interesting to do, and he forces himself to go out and do things.
The next Friday, shortly after he arrives home from the hospital, Marion hears a knock on the door and panics. He looks through the peephole and sees part of the face he knows better than any other. She begins to walk away and he knows he could let her. He opens the door. Genet freezes when she hears him, then she turns around to make sure it is him. She drops her eyes and will not meet his gaze. Her hair is lank and straight but her face is as stunning as always. Genet is not well. She is thin—too thin—and she is wearing a long, wool coat even though it is summer. Like a trapped animal, Genet stands motionless.
Marion comes down the steps and reaches for her face. Her skin is cold to his touch. He sees the vertical scars just outside her eyebrows and remembers when they were raw and bloody. He jerks her chin farther up, but she still will not meet his eyes. He wants her to see his own scars—the hurt and the pain she caused him first by her betrayal with Shiva and then with her liberation activities that forced him to leave his home and country. He wants her to see his rage through his calm, to sense his fingers twitching near her windpipe and ready to squeeze. It is good that she does not look, for he would have “consumed her.” Instead he takes her by the elbow and leads her inside; she walks with him like a woman heading for the gallows. After he shuts and bolts the door, he takes her to his library and places her on the ottoman, where she perches on the edge. They...
(The entire section is 1402 words.)
Chapter 51 Summary
For two days Marion and Genet are “like children playing house.” Marion discovers that Genet is capable of selfless love—just not with him. Despite that, he experiences a momentary equilibrium—“or the illusion of it.” And then she is gone. She places her father’s St. Bridget’s medallion on the dining table, then she leaves. Looking back, Marion knows his illness began on the Sunday morning he woke up to a silent house and knew she was gone. Forty-three days later the nausea arrived, and by the forty-ninth day he had lost unconsciousness.
Every night after work, Marion rushes home to see if she has returned; by Friday he realizes he is a “fool” to think she is coming back to him. He is not angry with Genet, for she is consistent; he is angry with himself because he still loves her or at least his dream of their being together. His feelings are not reasonable or rational but he cannot change them. He settles in with a bottle of alcohol, bought nearly a year ago, and spends four hours remembering their last conversation. She told him his house seems similar to his description of his father’s apartment; he told her he made his own bookshelves and surgery was not his life. The specter of her husband was between them, and he went to bed. She said she would be right up; he did not believe her. Soon, though, she joined him under the covers and they made love sweetly. In that moment, Marion thought she would stay. It was actually her good-bye.
Two weeks later Marion is discontented with everything in his house; he finds it oppressive and stifling. His neighbor, seventy-year-old Sonny Holmes, is a curious man for whom Marion is thankful. He is aware of the major happenings of Marion’s previous weekend, and now he suggests Marion hire a private detective. Even though Marion does not want to see Genet again, knowing where she is and what she is doing will assure him that she is alive and safe, and it might bring him closure. Marion latches on to this noble motive and hires East Coast Investigations of Flushing—a serious, blond young man named Appleby who is a relative of Sonny’s. Appleby quickly establishes that Genet has not returned to her halfway house, has not been to the restaurant where she works, has not checked in with her probation officer, and has not contacted Tsige.
He also discovers Genet was diagnosed with tuberculosis while in prison. She began taking medication but did not follow...
(The entire section is 2970 words.)
Chapter 52 Summary
Sometime during the night, a helicopter from Boston General arrives at Our Lady of Perpetual Succour carrying special instruments and key personnel from Boston’s specialized liver-transplant team. The normally rather desolate hallway outside the operating rooms of Our Lady are turned into the headquarters of a military-like campaign. Each patient has a team of surgeons; Deepak will lead the donor (Shiva’s) team, and Thomas Stone will lead the recipient (Marion’s) team. Each team has a blackboard listing everything that must be done and wears a different color of scrubs. The only two people who are allowed to be in both rooms are the team leaders, Deepak Jesudass and Thomas Stone.
A dry run at midnight disclosed several problem areas, but they have been addressed, and by 4:00 a.m. it is time for “the real thing.” Thomas Stone vomits in the surgeon’s dressing room, which is a common occurrence for him though he does not usually look quite so pale and weak. All the activity at the hospital would have been hard to hide; television crews and journalists are hovering outside the hospital preparing to pass judgment on both the science and the ethics of this operation. Neither surgeon has any thoughts about making history or keeping the surgery a secret as they prepare to operate. At 4:22, the donor operation begins. The surgeons expect it to take four to six hours.
Deepak makes the incision and starts by removing the gall bladder so he can have better access to the liver. He has to take extra steps so he does not compromise the function of the lobe they are removing, and he is worried that Thomas Stone’s mind seems to be wandering. Deepak has no idea his senior partner is struggling not to think about his “futile efforts” to save Sister Mary Joseph Praise and his “dangerous attempts at crushing a baby’s skull.” Despite that, Shiva’s operation goes perfectly; and at 9:00 Marion is taken to his operating room and the Boston General team begins working on him.
Both surgeons change scrubs and gloves before they join the recipient team and complete the removal of Marion’s liver. At 1:00, the liver is gone and an “unnatural void” remains. Connecting Shiva’s right lobe is a tedious process, and the bleeding must be “meticulously controlled.” In the meantime, Shiva is taken to the recovery room. The donor team is now unexpectedly somber because they know the outcome is out of their hands,...
(The entire section is 2596 words.)
Chapter 53 Summary
Three weeks after Shiva’s “transference,” Hema and Marion leave Our Lady of Perpetual Succour. Thomas Stone insists on escorting them. The air is crisp and the hospital and its grounds look better than they ever have. The recent publicity led to an influx of funds for the hospital, and it is almost unrecognizable to Marion.
As the cab takes them to the airport, Marion reflects. The year 1986 was a “disaster” for their family. Hema believes it has something to do with the numbers, for 1 is the number of birth and 8 is the number for destiny. The Challenger exploded on January 28 (first month, eighth day), and the Chernobyl accident followed eighty-eight days later. Shiva died on the eighteenth. He recently learned through Appleby that Genet died in prison eight days after that. Her son had been adopted by a family in Texas, which is where she went after leaving Marion. The official cause of her death was kidney failure due to tuberculosis, but Marion knows better. Genet died “chasing greatness.” She was never able to see it when she held it in her hand, so she kept seeking it elsewhere. She never understood the work required to get it or to keep it. Marion is ashamed that he feels relief at the news, but now they will not spend the rest of their lives tearing each other apart.
At the airport, Thomas Stone asks Marion if he will return. All Marion knows is that he wants to be there when Hema buries Shiva’s ashes between Ghosh and Sister Mary Joseph Praise, and he wants to spend some time with Almaz, Matron, and Gebrew. His presence will give them some consolation. After that, his plans are unclear. He tells his father he will be back, of course, because he has a house and a car and a job. Thomas Stone tells him to be careful what he eats and drinks—a reminder to protect his work. Other transplant patients have to take drugs to fight their bodies’ rejection of a new organ, but Marion takes nothing. The only pain he feels is an occasional twinge as Shiva’s liver grows to fill the space it has been given.
Marion jokingly asks his father if he will have a job waiting for him in Boston, for he has been away every since Marion became ill. Thomas Stone just smiles. He is now a sad man who takes Shiva’s death personally; he feels as if fate has never forgotten that he once attempted to destroy Shiva. The two men part with a nod. Hema, though, takes his hand in both of hers and scolds him...
(The entire section is 772 words.)
Chapter 54 Summary
Hema and Marion land in Addis Ababa at dusk. Marion has been gone seven years, and when he returns to Missing he can see how worn down the buildings look. He asks the taxi to stop and gets out at Shiva’s tool shed; he tells Hema he will walk the rest of the way. He passes the spot where a motorcycle felled its rider, but he feels no dread. As he walks up the hill, Marion is flooded with memories of his childhood with Shiva and Genet. Near their cottage, he sees a group gathered around Hema; when they see him, Almaz, Gebrew, and Matron turn to him and wait.
Three days after his return, Matron asks Marion to Casualty. A young girl has been gored in the abdomen by a bull and is bleeding out as they watch. She will not make it to another hospital, so Marion takes her to Operating Theater 3 and locates the bleeder. The rest of the surgery is routine, but Marion feels as if he is on “consecrated soil”: Thomas Stone, Ghosh, and Shiva have all stood here. As he turns to leave, Marion looks up and sees Shiva in the glass that now separates Operating Theater 3 from the new Operating Theater 4. He remembers Shiva asking their parents, when Koochooloo’s puppies were killed, if they would forget if someone killed either of them. Marion tells his brother he will never forget, and as he says it his future is decided.
Marion finds an odd key among Shiva’s belongings, and he knows it once belonged to Zemui’s motorcycle. In the tool shed, Marion finds a strange-looking motorcycle. Hema tells Marion that Shiva bought it secondhand several years ago and kept tinkering with it, but too many of the parts look familiar. When he starts it and hears the roar of the engine, Marion knows this is Zemui’s motorcycle.
Marion operates three days a week, and when his return ticket to New York is about to expire he takes no action. Shiva’s liver functions as if it were his own, year after year. Marion takes Hepatitis B immunoglobulin shots, and eventually blood tests show he is not a carrier of Hepatitis B and cannot infect anyone. Matron insists it is a miracle, and Marion agrees. Five years after his return, in 1991, Marion stands at the gates of Missing as he had when he was a child and watches the Tigre People’s Liberation Front and other freedom fighters move into the city. There is no looting and no mayhem; the only looting is done by Mengistu, who empties the Treasury and flies to Zimbabwe.
(The entire section is 893 words.)
Chapter 55 Summary
The letter is dated September 19 and is addressed, “Dear Thomas.” Sister Mary Joseph Praise confesses that she came to Missing under false pretences, which she has never confessed to anyone, including God. Years before, when she was in Aden, she was harmed by a man in a way that no woman should ever be hurt. Because she felt God had forsaken her, she turned from Him. She could not forgive the man, and she could not forgive God. “Death would have been better than what she endured,” but she came to Missing in the guise of a nun in an attempt to hide her bitterness and shame from the world.
She came to Ethiopia in deceit but her work there changed her, and she would have been his assistant forever. But things have changed since he came to her “like a man possessed” a few months ago and she tried to comfort him. Now she is pregnant but does not want him to feel any blame. She tells him it has been difficult for her to hide her condition, and many times she wanted to tell him but never knew how. Now she is frightened, for her time is short and the child is strong and active. She knows she must leave so she will not bring shame and disgrace on Missing, but she wants Thomas to know. She does not want to leave him, hiding and in deceit. If he comes to her after receiving this letter, she will know he wants to be with her. Whether he comes or not, her love “will always be the same.” The letter is simply signed “Mary.”
Marion has trouble concentrating in the operating room that day. He finally walks to his quarters with the letter in his hand and takes time to think. His mother loved Thomas Stone. She loved him so much she ran from Aden and made her way to the doctor she met on the ship from India. Years later, after working closely with him, she loved him so much she was ready to leave him. At the last moment she decided to write and tell him. Then she waited, not knowing if he would come.
Thomas Stone did come. As she lay on her bed nearly unconscious, she must have known it was he who picked her up and carried her, running, to the operating theater. She must have felt his tears fall onto her face and she must have seen them as affirmations of his love. He did not come because of the letter; he never received it. He came because some part of him must have known what he had done and felt responsible.
Now Marion thinks about Ghosh and how he must have found the textbook and the letter in...
(The entire section is 941 words.)