Cutting for Stone

by Abraham Verghese

  When I emerged from the elevators I was met by five men and one woman of my age, all dressed in dark suits, chests labeled with visitor tags exactly like mine. “We're supposed to wait here,” the woman said to me, helpfully.

  Just then a young man, a white coat covering his blue scrubs, approached. “Sorry I'm late,” he said, not sounding sorry at all. “Welcome to the Department of Surgery. My name's Matthew.” He grinned at us. “God, a year ago I was in your shoes, interviewing for my internship. Time flies! Love the suits! Okay, we have about twenty minutes before morbidity and mortality conference. I'll give you a quick tour of the Department of Surgery. After M&M you'll have lunch with the house staff, then your individual interviews begin, and then the grand tour of the hospital. When I get you to the conference room, I'll break off. One of my patients is being presented at M&M. I have to go strap on the body armor.”

  In the year I'd been at Our Lady of Perpetual Succour, I had yet to take any potential intern recruits around. Indeed, I'd never seen anyone come to be interviewed. At Mecca this was a weekly event. I tagged along.

  The individual on-call rooms had a television on the wall, a fridge, a nice desk, and an attached bathroom; it was a far cry from Our Lady's solitary on-call room crammed with bunk beds, with just one phone and interns from all the specialties expected to bed there; I never used it. Next, Matthew showed us the “small” conference room where the Mecca surgical team held their morning report. It looked like a corporate boardroom with high-backed leather chairs around a long table. Oil portraits of the past chairmen of surgery stared down from the walls, a who's who of surgery.

  “Check this out,” Matthew said, pushing a button. Screens came down behind the curtains to black out the room, and a projector rose out of what I took to be a coffee table. Constance, the woman in our group, rolled her eyes as if she thought this was so gauche.

  When we arrived at the auditorium where morbidity and mortality conference was to be held, Matthew excused himself. “I have to change out of scrubs. Dr. Stone is a stickler for that. He doesn't even like scrubs on rounds.”

  The auditorium was a small version of the Cinema Adowa in Addis, only with better seats, upholstered in a nubby beige fabric that felt smooth to the touch. A steep incline made the view from the back excellent, and this is where we prospective interns sat. A bank of motorized X-ray viewing panels was built into one side of the wall behind the podium. A resident stood loading films, stepping on a pedal to advance panels.

  Constance sat next to me. A gaggle of medical students in short white coats filed in and joined us in the back. I'd forgotten about the existence of medical students. How nice it would be at Our Lady of Perpetual Succour to have someone below me on the food chain. The residents wore longer coats, and their expressions were not as carefree as the students’. The attending physicians wore the longest coats and were the last to come in. We interviewees in our dark suits stood out like penguins at a polar bear convention. In all my time at Our Lady, we never had this kind of an assembly. Deepak got us together regularly for coaching sessions, but one sensed a tradition in this room, a way of doing things that had not changed for decades.

  “So what school are you from?” Constance asked. Id overheard her say she trained in Boston, but it wasn't at this institution.

  “I went to school in Ethiopia,” I said. If she could have moved one seat over, she probably would have.

  Thomas Stone didn't look at the crowd when he walked in; he assumed their presence. He was taller than I'd realized from seeing him in the theater, almost as tall as Shiva or me. The room turned quiet. His hands were in the pockets of his white coat. The way he slid into his seat, the ease and fluidity of that motion, reminded me of Shiva. He was alone in the front row. I was well behind him but off to one side, so I could see his profile. This was my first good look at my father. I felt my body grow warm; it wasn't possible to study him dispassionately, clinically. My mind was racing, my heart pounding—I worried that I was giving away my presence. I looked away to try and calm down. When I looked back, Stone was studying a paper in his hand—it was hard to tell he was missing a finger. His hair was quite gray at the temples, but still dark brown on top. His masseter muscles stood out, outlining his jaw, as if he habitually clenched his teeth. The one eye socket that I could see was a recessed dark hollow on his face. I noticed that he kept his head exceptionally still.

  I CAN'T TELL YOU MUCH about the case being discussed or exactly what transpired. While I looked at Thomas Stone and sat next to the supercilious Constance, a slow fuse burned inside me and it was about to ignite. I was ready to hurl furniture, activate the ceiling sprinklers, scream obscenities, and disrupt this orderly meeting. I felt an impending loss of control. At one point I had to grab the arms of my chair as my rage peaked, and then gradually subsided.

  “It was my fault,” Thomas Stone said, turning to face me. For a moment, I thought he was clairvoyant. He had heard me. Earlier, Matthew, our escort and the presenter of the case, came under harsh criticism from different quarters of the room. Matthew was only the messenger, but since his attending physician and the Chief Resident didn't come to his defense, he took the brunt of the attack. The snapping jaws were silenced when Thomas Stone stood up.

  “Yes, it was my fault. Without a doubt we can do better surgically. I am installing a video camera in the two trauma bays. I want us to review the video after every major trauma that comes in. Were we standing in the right place? Did we take three steps to reach for an endotracheal tube when it should have been at hand? Did someone have to ask for something that should have been there? Did we distract each other with what we said? Who didn't need to be there? Is there a better way? That is always the challenge.” He pulled out a piece of paper from his pocket and unfolded it.

  “I take responsibility also for something addressed in this letter.” His accent was faintly British, the years in America having softened it, but without accruing any jarring American inflections. The day he spoke to Deepak over my shoulder in the operating room at Our Lady, I hadn't registered a particular accent. “This letter came to me from the deceased patient's mother. I want to make sure that this does not happen again. Here is what she says: ‘Dr. Stone— My son's terrible death is not something I will ever get over, but perhaps in time it will be less painful. But I cannot get over one image, a last image that could have been different. Before I was asked to leave the room in a very rough manner, I must tell you that I saw my son was terrified and there was no one who addressed his fear. The only person who tried was a nurse. She held my son's hand and said, “Don't worry, it will be all right.” Everyone else ignored him. Sure, the doctors were busy with his body. It would have been merciful if he had been unconscious. They had important things to do. They cared only about his chest and belly. Not about the little boy who was in fear. Yes, he was a man, but at such a vulnerable moment, he was reduced to a little boy. I saw no sign of the slightest bit of human kindness. My son and I were irritants. Your team would have preferred for me to be gone and for him to be quiet. Eventually they got their wish. Dr. Stone, as head of surgery, perhaps as a parent yourself, do you not feel some obligation to have your staff comfort the patient? Would the patient not be better off with less anxiety less fright? My son's last conscious memory will be of people ignoring him. My last memory of him will be of my little boy, watching in terror as his mother is escorted out of the room. It is the graven image I will carry to my own deathbed. The fact that people were attentive to his body does not compensate for their ignoring his being.’ “

  Thomas Stone folded the letter and put it away in his breast pocket. There was a rustle in the auditorium, a murmur, an uncomfortable shifting of body weight. I sensed a willingness in the room to shrug off the letter, to scoff at what it said, but Stone's demeanor made it necessary to conceal that urge. Stone stood there, silent, looking out, as if considering the letter's context himself, unaware of his audience. No one spoke. As the moment stretched on, even the
smallest noises were stilled until there was only the hum of the air-conditioning. Thomas Stone's expression was reflective, certainly not angry. Now, as if waking up, he searched the room for a reaction, seeing if the writer struck a chord. The scoffers had reconsidered their position.

  When Stone finally spoke, it was in a quiet voice that was firm and commanded attention. He asked a question.

  I knew the answer because it was in his book, a book I'd read carefully and more than once in my voyage out of Ethiopia and during my stay in Kenya.

  “What treatment in an emergency is administered by ear?”

  Surely with about two hundred people in the room, at least fifty would know the answer.

  No one spoke.

  He waited. The discomfort grew even more acute. I could sense Constance stiffening next to me.

  Thomas Stone spread his feet and put his hands behind his back. He appeared willing to stand there all day. He raised his eyebrows. Waiting. The students sitting to my left were too scared to blink.

  Stone looked over to me, surprised to see a response from the row of dark suits. I felt his eyes bore into mine. It was only the second time he registered my being in this world; the first was when I was born. This time, I only had to raise my hand.

  “Yes?” he said. “Tell us, please, what treatment in an emergency is administered by ear?”

  All eyes were on me. I was in no hurry. None at all.

  Then my sight turned misty as I thought of Ghosh and the sacrifice he'd made for us. Though he died of leukemia, it now felt to me as if he'd given up his life from the time we were infants so that Shiva and I should have ours. When he died, it was as if a second umbilical cord had been severed. I thought of Hema, widowed, now laboring alone with Shiva at Missing, writing to me to say that her heart was breaking not to have me there, and would I forgive her for not giving me the attention and love I deserved? And all through those years, Thomas Stone probably never missed an M&M conference, never had a day of discomfort over Shiva, or over me. I thought of Matron, holding Missing together, an active and loving godmother to two boys, an anchor in our lives, and I thought of Gebrew, Almaz, and Rosina, who had stepped in to fill the void of this man's absence.

  How unjust it was that Thomas Stone's reward for his failings, for his selfishness, should be to preside in that chair and command the respect, the awe, and the admiration of the likes of Constance and others in this room. Surely you couldn't be a good doctor and a terrible human being— surely the laws of man, if not of God, didn't allow it.

  I met his gaze and I did not blink. “Words of comfort,” I said to my father.

  The intervening years lay compressed between us as if by bookends. The others in the room looked from my face to his, distressed, uncertain if mine was the right answer. But no one else existed for me or for him.

  “Thank you,” he said, his voice altered. “Words of comfort.”

  He left the room, but looked back at me once when he reached the door.

  I FOUND WHERE HE LIVED by accident. An elegant condominium complex across the river would have been my guess. But at the base of Tower A, I saw a glass door leading to the outside. Across the street was the lobby to another building. I saw Thomas Stone enter and a doorman greet him. I waited. A few minutes later he emerged, without his white coat and with a yellow-and-black box in his hand—a slide carousel. He was on his way to the transplant conference. I gave him half an hour, and then I went up to the doorman. I flashed my badge. “I'm Marion Stone. Dr. Stone forgot some slides he needed for a talk he is giving. He sent me to pick them up.”

  He was about to quiz me, deny me, but then he cocked his head. “You a relative?”

  “I'm his son.”

  “By God you are!” he said, coming closer to look into my eyes, as if that was where the similarity resided. He beamed as if the news vindicated him. As if it gave Thomas Stone a human dimension, a redeeming quality.

  “By God you are!” He slapped his thigh in delight. “And not a word to us all this time.”

  “He never knew till this year,” I said, winking.

  “Joseph and Mary! Get out of here!”

  I smiled and looked at my watch.

  “You know where it is?” he said.

  “Fourth floor?”

  “Four-oh-nine.”

  I ENTERED HIS HOUSE using my penknife and the sort of ancillary surgical skills only a B. C. Gandhi can teach you.

  It was a one-bedroom apartment.

  The living-dining room had nothing to justify that label. A large worktable like a draftsman's desk occupied most of that area, with two side tables at its ends to form a U. There were papers in neat stacks on the side tables. Sectional bookcases covered three walls and were full of books and papers. They weren't arranged for display but for access.

  The coffeepot in the kitchen was collecting dust. The stove appeared never to have been used. A toaster on the counter had a trace of crumbs on the top. The refrigerator held only a carton of orange juice, a stick of butter, and a half loaf of bread.

  His bedroom was dark, the curtains drawn. There were no books or papers here. Only an army cot, a blanket folded neatly at its foot, as if he were camping for one night.

  A single framed snapshot sat on the mantelpiece above the electric fireplace. The airbrush technique of the 1920S gave mother and son alabaster skin. They were posed like Madonna and Child. The boy was perhaps three, ensconced in the lap of the woman who must have been my grandmother—a presence in the world I realized I'd never once thought about.

  Next to the picture was a glass cylinder, filled with murky fluid. Closer inspection revealed a human finger floating in the liquid.

  I had come there wanting to … to do damage.

  That picture made me change my mind.

  Instead, I opened all the kitchen cabinets and left the doors ajar. I pulled down the oven door. I opened both sides of the fridge. I took the top off the juice container. I opened the bathroom cabinets. I unscrewed toothpaste, shampoo, and conditioner, setting the tops carefully alongside the bottles. I opened anything that had a lid or a cover. I left open wardrobe, chest of drawers, filing cabinet, ink bottle, medicine bottles. I opened the windows.

  In the center of his desk I placed the bookmark with Sister Mary Joseph Praise's writing on it.

  I felt certain he had the letter my mother referred to. Now, in his home, I asked myself again: Where was it … and what did it say? I was tempted to ransack the place to find it but that would have spoiled what I had created.

  I twisted open the formalin bottle, fished out his finger, shook it free of fluid, and put it next to the bookmark. I studied what Id done. I changed my mind about the finger. I put it back in the formalin bottle, capped it, and took it with me. It was only fair. After all, Id left him something of mine.

  I propped the door open on my way out.

  CHAPTER 44

  Begin at the

  Beginning

  IT WAS TWO WEEKS LATER on a Sunday that I heard the knock on my door. We had beaten our archrivals from Coney Island at a limited overs match on their turf, coming away with the interhospi-tal cricket trophy Nestor had taken six wickets for twenty-five runs in a torrid spell of pace bowling, and four of those were by catches I took standing well behind the wicket. I had slipped away from the festivities in B. C. Gandhi's room, my fingers sore despite the keeper's gloves and my knees aching. I planned an early night.

  “Come in,” I said.

  He scanned the dark room, getting his bearings. If he saw the shadow of my bed, he didn't see me because he looked away, to the light leaking from under the bathroom door. Then to the curtained window. When he looked back I was sitting up. It gave him a start.

  He shut the door and stood there, a man who had walked into his past.

  I waited. I hadn't invited him here. The seconds ticked away and he showed no inclination to speak. I had to give him this: he tracked me down, he figured it out. Perhaps he did register my presence in the ope
ra ting room the day he peeked over my shoulder. Perhaps in the auditorium when I answered his question he saw in my face features of my mother or of himself. How strange to spot a son you've never seen or thought of till the day he appears at morbidity and mortality conference and gives new meaning to that activity.

  “You might as well sit,” I said. I didn't offer to turn on the light.

  There was a chair beyond my bed. He walked forward quickly like a blind man who'd risk bumping into something rather than seem hesitant or ask for help. He sat down hard.

  I didn't think he could see my face. I studied his. As his eyes adjusted, he looked at my possessions. I had more things than he did. If you didn't count books. I saw him linger on the framed print of the Ecstasy of St. Teresa—he must have recognized at once where that came from. Oh yes, and the finger in the jar. He knew he was in the right room.

  The minutes passed. It was ten at night.

  “Mind if I smoke?” he said at last.

  “You don't smoke.” I hadn't picked up the smell of cigarettes in his condo. Just his scent, which my nostrils registered again.

  “I do now … When did you start?”

  His nose was pretty good. I took my time answering.

  “Since coming here. It's a prerequisite for surgical training. Go ahead.”

  He fumbled in his shirt pocket and brought out two cigarettes. I thought of Ali and his little souk, the only place I knew where you could buy loose smokes. In America you bought them in cartons or by the truckload.

  He held a cigarette out to me. I stared at it. He was about to withdraw his hand when I took it. He flicked his lighter and stood to meet me as I swung my feet over the side of the bed.

  His fingers shielded the fire, a nine-fingered sepulchre. I bowed to the flame and drew till my tip glowed.