Verghese's work speaks to the idea that the immigrant experience is one in which there is not a real or full separation from the elements of one's home. There is a form of a "divided consciousness" in the heart of one who is exiled or one who is an immigrant. Little, if anything, is "clean." One sees this in Stone, himself. At one point, he flees from his world, from his sons, thinking that he can rid himself of the pain of the past. In the end, his sons end up finding him and he must overcome his own pain and fear to perform surgery to save their lives. Marion is in a similar predicament. His exile to New York could be seen as a chance to escape Ethiopia. Yet, embers of his past help to dominate his life in the new world. He ends up bringing memory and remembrance to a place that lacks it. Verghese might be suggesting that consciousness is a complex entity. When a person goes to another land, through emigration or through exile, they are not necessarily able to fully rid themselves of their past. The immigrant experience is one in which individuals live a "double life" both in the new world and internally, in the world of old.