Love is a complicated realm for the characters in Cutting for Stone, and unfortunately, the characters’ inability to deal with their feelings leads to betrayal. The ultimate betrayal in the novel is perhaps that of Thomas Stone abandoning his sons to Missing Hospital after the death of Sister Mary Joseph Praise. The forbidden love between the nun and her mentor is never realized until Thomas has a lapse of judgment during one of his drinking binges, but afterward the two continue to pretend that their affection for each other is strictly professional. It is almost as if this secret leads to the fateful death of Sister Mary as she attempts to birth the offspring of their union. Unable to cope with the death of his beloved, Thomas Stone turns his back on Missing Hospital and his sons. Their father’s betrayal haunts Shiva and Marion until they are adults. Even though Stone has attempted to keep the boys in his heart (later it is revealed that Stone was the financial donor for Shiva’s clinic and research on fistula surgery), he does not manage to fully make amends for having abandoned the boys as infants.

Shiva and Marion are born conjoined by an artery in their heads, and their lives will be forever linked. By the time the boys go to school, they are known as "ShivaMarion." They are given identical clothing, they share their room, and they play the same games. But as the boys grow older, they begin to forge individual identities that challenge the sense of unity they had as younger boys. When Hema gives the boys and Genet dancing lessons, Shiva excels while Marion is clumsy. Marion pulls away from the lessons, and thus begins the twins’ separation. Even though Shiva and Marion become individuals and suffer a major rift caused by Shiva’s betrayal, the twins never lose their sense of connection.

Shiva’s sacrifice of his liver (and ultimately his life) at the end of the novel may be his way of making amends with his brother, Marion, for having slept with Genet, Marion’s long-time love. The betrayal pulls the two brothers apart, but Shiva never appears troubled by the growing distance between him and his brother. Like his father, who cannot deal appropriately with the heartache he has caused others, Shiva harbors his feelings from those around him. Shiva does not hesitate in his decision to take the risk in donating part of his liver to his brother and even feels that it is his duty to help save Marion’s life.

Throughout the novel, life and death knock on the same door. When Sister Mary Joseph Praise loses her life, her twins Shiva and Marion struggle to hang on to theirs. This sets the tone for the future of Missing Hospital. In the operating theatres, Hema and Ghosh handle complicated surgeries to keep death at bay, but for as many babies are born healthy, there are others who simply cannot be saved. When Shiva dies after having donated part of his liver to Marion, the death of one twin leads to the life of the other. In this manner, the cycle of life and rebirth is represented in the novel.

Addis Ababa, home to native Ethiopians, is also home to “others.” On the heels of Dr. Thomas Stone, Sister Mary Joseph Praise makes the dangerous trek to Ethiopia to escape her suffering in Yemen. Once she gets there, Ethiopia opens its arms to the young nun, and she finds a home, a purpose, and a sense of belonging. Similarly, both Ghosh...