Cutting for Stone Summary

Summary

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 children, Hema decides to raise the babies. She names one boy Marion, after a well-respected women’s surgeon, and the other Shiva, after an Indian god. She gives them the name Praise in honor of their mother and—thinking that one can never escape his identity—the surname Stone.

The next day, Dr. Ahbi Ghosh, the third staff doctor, and Matron Hirst resume duties in the clinic, but they send any patients needing surgery to the military clinic. Soon they discuss funeral arrangements for Sister Mary, and they leave Missing Hospital to go to Gulele Cemetery. On the way out, Matron Hirst avoids Mr. Elihu Harris, a representative of the Baptist congregation in Texas that largely funds the hospital because she has been dishonest about where the donations have gone. Matron Hirst chooses to deal with Harris later and focuses her attention on choosing a plot at Gulele but decides that the cemetery is not suitable for Sister Mary. Instead, she and Ghosh choose a plot in the fields behind Missing Hospital, and they bury Sister Mary in the fields she loved.

Before Sister Mary’s funeral, Matron Hirst receives a phone call from a government minister on behalf of Emperor Haile Selassie, requesting that a particular soldier be turned over to the government if he should seek services at the hospital. But the matron advises the doctors to treat this man in honor of their oath to care for the sick, and when Colonel Mebratu arrives a few days later suffering from a twisted bowel, Ghosh does his best to treat him anyway. Ghosh recognizes this man as one who performed an execution of civilians on the roadside several years before. Mebratu admits to being forced by the government to perform the execution and says that the victims were his friends. He also tells Ghosh that his brother had been the operator of a health clinic that was closed by the government for lack of funding. He is angry that the government stands by while his countrymen suffer, and he admits to being part of plans to create an uprising.

Later, Mr. Elihu Harris finds his way to Missing and greets Matron Hirst. Rather than turn him away, she decides to show him the harsh reality faced by the...

(The entire section is 1880 words.)

Cutting for Stone Chapter Summaries

Prologue and Chapter 1 Summary

Prologue

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 successful operation is the one that never happens; his father reminds him of the Eleventh Commandment: “Thou shall not operate on the day of a patient’s death.”

Even now, when Marion faces a chest laid open, he is ashamed at the human capacity “to hurt and maim one another, to desecrate the body.” He is also moved by the harmony and ordinary miracles of the created, complex, and compact body. Each time he has such thoughts he thanks another surgeon, his twin brother, Dr. Shiva Praise Stone, for allowing him to be a surgeon. Shiva believes life is about fixing holes, and that is exactly what he does. But some holes cannot be mended—wounds that divide families—and it is the task of a lifetime to fix what is broken. The next generation will have to continue the work.

Marion was born in Africa, lived in exile in America, and is now back at the hospital and in the small operating theater in which he was born—the same place his mother and father both worked. Geography, he believes, is proof of destiny, and this is what has brought him back here. The sights and sounds are familiar and make him nostalgic for Shiva. The two of them slept in the same bed into their teens, and now every morning Marion wakes to the gift of a new day and wants to tell Shiva he owes this blessing to him. What Marion owes Shiva most, though, is to tell this story. It is a story Sister Mary Joseph Praise, their mother, did not tell. It is a story their “fearless father,” Thomas Stone, ran away from. Marion has had to piece the story together, and only its telling can heal the rift that separates him from his beloved twin brother. This is the kind of a wound not even a skilled surgeon can heal.

Chapter 1

On the same day, Sister Mary Joseph Praise and Sister Anjali receive their nursing pins and take their final vows of celibacy, poverty, and obedience. Now they can be called “sister” both in the hospital and the convent. Almost immediately, these nineteen-year-old girls are sent as missionaries from India to Africa as the first members of the Madras Discalced Carmelite Mission to Africa. It is 1947, seven years before the twins are born.

Sister Mary Joseph Praise was raised on a chain of beautiful islands founded by Christians, but in high school she was moved by the passion of a “charismatic Carmelite nun” and abandoned that religious family tradition. Her parents were disappointed but would have been even more so if they had known she also became a nurse. On board the ship, she and Sister Anjali sequester themselves in their cabin and do their best to maintain the rites and rituals of the convent. On the sixth night, a portion of the deck splinters and buckles. On the ninth, night four passengers contract a fever—including Sister Anjali and one crew member. Sister Anjali is soon “raging in feverish delirium,” so Sister Mary Joseph Praise seeks out a young surgeon she met earlier. When she had stumbled on the wet metal stairs, he had grabbed her and easily righted her, though both were flustered by the unexpected intimacy. She had been struck then by his strength, but as she enters his cabin she discovers the young doctor is horribly sick.

She does not have much medical knowledge, but...

(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...

(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...

(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...

(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...

(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...

(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...

(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...

(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...

(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...

(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...

(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...

(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...

(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...

(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.

...

(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...

(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...

(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...

(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...

(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...

(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...

(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...

(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...

(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...

(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...

(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,...

(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...

(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...

(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...

(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...

(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...

(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...

(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...

(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...

(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,...

(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...

(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...

(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...

(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...

(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...

(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...

(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...

(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...

(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...

(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...

(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...

(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 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...

(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...

(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...

(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...

(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...

(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...

(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...

(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...

(The entire section is 941 words.)