Cutting for Stone

by Abraham Verghese

  Thank you, Father.

  I sat back on the bed. He found an old Styrofoam cup in arm's reach. I took a thoughtful draw, passing judgment on his cigarette. It was a Rothmans, a throwback to his Ethiopia days, or, lest I forget, his British days. Rothmans was also what we puffed at Our Lady, courtesy of B. C. Gandhi, who got cartons at deep discount from Canal Street.

  The smoke made sinuous shapes in the shaft of light leaking past the bathroom door. I remembered our kitchen at Missing and how the dust motes dancing in the morning rays formed their own galaxy. When I was a child, that sight had hinted at the wonderful and frightening complexity of the universe, of how the closer one looked the more one saw revealed, and one's imagination was the only limit.

  “I don't expect you to understand,” he said, and for a moment I thought he was talking about the dust motes. The sound of his voice irritated me. Who gave him permission to speak? In my room?

  “Then let's not talk about it.”

  More silence.

  He cracked first. “How do you like surgery?”

  Did I really want to answer him? By answering, was I conceding something? I had to think about this for a few minutes. Let him sweat.

  “How do I like surgery? Hmmm … I am lucky to have Deepak. He takes great pains with me. The basics, good habits. I think it is so important …” I clammed up then. I felt I had said too much. I detected in my tone a need for his approval, his affirmation—that was the last thing I wanted. I thought of Ghosh who became an accidental surgeon because of Stone's departure. He had no one to teach him. Ah, Ghosh! Ghosh's dying wish was that—

  “I know some of the people Deepak trained with,” Stone said, interrupting my train of thought. Ghosh's message to him could wait. This wasn't the time. I wasn't in the mood.

  “Oh, really?”

  “I made inquiries about him. You are lucky.”

  “But Deepak isn't lucky. He is going to get screwed all over again. In fact, we all are.”

  “Maybe not,” he said.

  I didn't pursue this. No favors, please. I wanted nothing from him. He squirmed in his chair, but not from discomfort. It was what he was holding back, waiting for me to ask. I would not give him the pleasure.

  “I had a Deepak in my life,” he said. “All it takes is one. Mine was a Dr. Braithwaite. A stickler for the right way. I appreciate him more now than I did then. Despite him, after all these years, I find it extraordinarily difficult to …”

  The words had dried up on his tongue. This was such an effort, a physical trial for him to converse. He wasn't a man who ever spoke like this, I didn't think. Sharing his inner thoughts wasn't something he had practiced. Not even with himself. I gave him lots of time.

  “What? You find it extraordinarily difficult to … what?”

  I should have just told him to leave. Here I was conversing, helping him along.

  “I find it difficult to operate. Particularly elective surgery. I have anxieties.” He spoke slowly, drawing out his words. “No one knows. Even if I'm doing a hernia or a hydrocele … in fact the simpler the operation, the more likely this is to happen … I have to look up the surgical anatomy, go over all the steps in an operative book, even though after all these years I don't need to. I'm terrified I will forget. Or that my mind will go blank … Sometimes I throw up in the lounge. I feel sick, dizzy. It has never stopped. It made me consider giving up surgery. It's worse if it's someone I know, a hospital employee brings his mother …”

  I thought of the surgical anatomy atlas I had seen in his condominium, a big folio book, and next to it an operative anatomy atlas, both open on his desk as if they were the last things he looked at before he left his apartment.

  “What about the day I … the day of your morbidity and mortality conference?”

  “Exactly. Early that morning I had to do a simple breast lump excision, and if the biopsy was positive, then a mastectomy and auxiliary node dissection. I've done hundreds of them. Maybe more. But this was one of our nurses. Someone putting faith in me.”

  “So what happened?”

  “I walked into the theater, feeling as if I were about to faint. No one knows, of course. The mask helps. But as soon as I make the incision, it all vanishes. Then it feels silly to have been so anxious. Ridiculous. It'll never happen again, I tell myself. But it does.”

  “Did it ever happen in Ethiopia?”

  He shook his head. “I think it was because I knew I was the only choice the patient had. There were no other options. Two other surgeons in the whole city. Here there are so many surgeons.”

  “Or maybe those lives weren't as valuable. Natives, right? Who cares? The alternative was death anyway, so why worry? Just like you come and take organs from our patients at Our Lady.”

  He flinched. I sensed that no one ever talked to him in this manner. We hadn't agreed to any rules. If he didn't like it, he could just leave. He had come to Our Lady. This wasn't Mecca.

  He clamped his lips together. “I don't expect you to understand,” he said.

  I knew he wasn't talking about his surgical anxieties.

  He patted his pockets. He didn't find what he was looking for. So he just sat there and blinked, waiting for more punishment.

  He slumped down in the chair. He had crossed his legs, and hooked his free foot under the calf of the other, like a twisted vine. “You see … Mar-ion—” He wasn't used to saying my name. “I … It is not as if everything can be explained by logic.”

  Now he uncrossed his legs and leaned forward. “I can't give you a neat explanation about why … I did what I did, because I don't understand it myself. Even after all these years …”

  Which “it” was he talking about? I had my daggers lined up, and my lances and mace ready just behind them. I thought of all kinds of clever things to say: Save your breath. Or, I understand all'right. You took the path less traveled. You bailed out. What else is there to understand? But perhaps he meant the “it” of impregnating my mother.

  “Ghosh said you didn't know how it happened. That it was a mystery to you.”

  “Yes!” he said, relieved, but then I sensed he was blushing. “He said that? Yes, it was.”

  “Like Joseph? Clueless about Mary and the baby? Babies, in your case.”

  “… Yes.” He crossed his legs.

  “Maybe you don't think you are my father.”

  “No, it's not that. I am your father. I—”

  “No, you're not! Ghosh was my father. He raised me. He taught me everything from riding a bike to hitting a square drive off the back foot. He gave me my love for medicine. He raised me and Shiva. I am here because of Ghosh. A greater man never lived.”

  I had baited the trap, lured him in. But I was the one who snapped.

  “ ‘Lived’ … ?” he said, leaning forward, the foot no longer wagging.

  “Ghosh is dead.”

  His features turned leaden, then pale.

  I let him ruminate on that. I'm sure he wanted to know how, why, but he couldn't ask. The news had stopped him cold, saddened him, I could see. Good. I was touched. But I wasn't done kicking him. I was impressed that he took it, waited for more.

  “So you are off the hook,” I said. “I had a father.”

  He sighed. “I don't expect you to understand,” he said again.

  “Tell me anyway.”

  “Where shall I start?”

  “ ‘Begin at the beginning and go on until you come to the end,’ the King said, very gravely, ‘then stop.’ Do you know who said that?”

  I was enjoying myself. The famous Thomas Stone being grilled, getting screwed, getting a dose of his own medicine. Sure, he could rattle off the branches of the external carotid artery, or the boundaries of the foramen of Winslow, but did he know his Lewis Carroll? Did he know his Alice in Wonderland?

  He surprised me with his answer. It was wrong but it was right.

  “Ghosh,” he said, and the air went out of his lungs.

  CHAPTER 45

 
; A Matter of Time

  WHEN THOMAS STONE WAS A CHILD, he asked the—the gardener—where little boys came from. The ma-alt, a dark man with muddy eyes and acid breath from the previous night's arrack, said, “You came with the evening tide, of course! I found you. You were succulent and pink with one long fin and no scales. Such fish they say only exist in Ceylon, but there you were. I almost ate you, but I wasn't hungry. I cut off the fin with this very sickle and brought you to your mother.”

  “I don't believe you. My mother and I must have washed in from the sea together. We were one large fish. I was in her belly and came out,” the little boy said, walking away. The maali could coax roses out of the earth where their neighbors failed. But Hilda Stone would have fired him for telling such tales to her only child.

  The little boy's home was just outside the rock walls of Fort St. George in Madras, India. The spire of St. Mary's poked up from behind the incomplete battlements. Its quaint, well-tended cemetery was his playground, a place where more than five generations of English men, women, and babies were buried, taken by typhoid, malaria, kala azar, and rarely old age.

  Fort St. George was the first home of the East India Company. St. Mary's, built in 1680, was the first Anglican church in India (but by no means the first church, that being the one built in A.D. 54 by St. Thomas the Apostle, who landed on the Kerala coast). A plaque inside St. Mary's commemorated the marriage of Lord Clive, and another that of Governor Elihu Yale, who later founded a university in America. But the little boy saw no plaque to commemorate the marriage of Hilda Masters of Fife, tutor and governess, to Justifus Stone, civil servant in the British Raj and almost two decades her senior.

  Thomas thought every child grew up as he did—in sight of the Indian Ocean, hearing the fearsome-sounding waves crashing around Fort St. George. And he assumed that all fathers were like his, crashing into furniture and making alarming sounds at night.

  Justifus Kaye Stone's voice rumbled down from a height, and his bottle-brush mustache kept little boys at bay. District collectors in the Indian Civil Service were demigods, with secretaries and peons hovering around them like flies around overripe mangoes. Collectors went on tours for weeks at a time, holding court in each city. When Justifus Stone was home, despite his noisy presence, he was somehow not there. Thomas understood (in that way that children do, even though they lack words to express themselves) that Justifus was a self-centered man and neglectful of his wife. Perhaps this was why Hilda turned to religion. To imagine Christ's suffering allowed her to live with hers.

  Blessed are the meek.

  Blessed are the peacemakers.

  Blessed the young governess who marries a DC hoping to clear his yellow-tinged skin of quinine and cure his taste for gin and native women, for hers is the kingdom of heaven.

  Hilda's blessing came in the form of her blue-eyed, towheaded boy whose feet she hardly let touch the ground, even when he was old enough to walk.

  The little boy's ayah, Sebestie, had nothing to do other than join in the play since it was Hilda who let him ride on her back pretending he was Jim Corbett, the big-game hunter, and she the elephant carrying him to the tiger blind. Hilda drew red-chalk wickets on the whitewashed walls and bowled to him with a tennis ball. She sang hymns to him, and fanned him when it was too humid to fall asleep. The bell-like clarity of her voice caused somnolent lizards on the wall to snap to attention. Her brown hair, parted in the center, fell from a steepled head. Regardless of how she restrained it, a frizzy halo framed her face.

  In the middle of the night he reached for her and she was there. But on the nights Justifus Stone was home, the little boy slept poorly, fearful for his mother because those were the only times she left his bed. He kept vigil with his cricket bat outside the closed bedroom door, prepared to break in if the noises did not subside. They always did and only then would he retreat to his room. In the morning, when he opened his eyes, she would be back in his bed, awake and peering out through her fringe of hair.

  Every child should have a mother of such even temperament, her rare displeasure evidenced so gently that the effect was lasting. Thomas lived to please his mother and he was earnest in his pleasing. It was as if they both knew, though they could not have known, that life was short, the moment fleeting.

  HE WAS EIGHT when Hilda had to excuse herself from the St. Mary's choir. A cough that at first was like distant artillery soon sounded like nails rattling in a paper bag. Dr. Winthrop, an overdressed man who did not converse as much as make pronouncements, said mother and son were to sleep apart, “for the child's betterment.”

  The little boy heard her nightly paroxysms from the other room and covered his ears with the pillows. “Undoubtedly consumption,” Dr. Winthrop said to Thomas one day, using a delicate word for tuberculosis as he put away his stethoscope and thermometer. “It has turned dry. The sicca form of phthisis, you know.” He talked to the little boy as if to a colleague and shook his hand with gravity. When would she get better? “Rest and diet and hydrotherapy,” said the doctor. “Some of the time— let's say, much of the time—it becomes quiescent. After all, it's not up to us, is it, Master Stone?” When Thomas asked, Please, sir, whom might it be up to, Winthrop raised his eyes to the ceiling. It was only later that the little boy understood the doctor did not mean Justifus, whose heavy tread shook the chandelier. He meant God.

  One morning Thomas awoke dreaming of horse-drawn carriages, and with the thunder of hooves echoing in his ears. He discovered that in the night his mother had coughed up blood, lots of it, and Winthrop had been summoned. They bundled her off, not letting her kiss her son's brow. She traveled to Coimbatore, and from there the narrow-gauge toy train took her up the mountain to a hill station sitting just below Ooty. Dr. Ross had built a sanatorium in the Nilgiri Hills fashioned after Trudeau's famed Saranac Lake in New York. The white cottages around the hospital were replicas of those at Saranac, with the same airy porches and trundle beds.

  Thomas wept himself to sleep on Sebestie's bony chest. He was angry with Hilda for getting sick, for having fostered such a closeness with him so as to make this separation unbearable. He was not like his schoolmates who loved their ayahs more than their parents and cared nothing about long separations. Overnight, Sebestie blossomed into a surrogate mother, but Thomas was wary of giving her his love. For then she, too, might disappear.

  Before school Thomas visited St. Mary's and recited fifty Our-Father-Hail-Marys and did the same on his way back. He was on his knees so often that boggy sacs formed under his kneecaps. Around his neck he fastened with twine the heavy crucifix that had been on her wall, hiding it under his school uniform, where it gouged the skin over his breastbone and the twine cut into his neck. Not having a firstborn or a ram or ewe, he sacrificed his Don Bradman signature cricket bat, smashed it on the washing stone. He fasted till he was dizzy. He cut his forearm with a razor, spilling blood onto the shrine for the Virgin Mary that he built in his room. Sebestie took him to the Mambalam Temple and even to the tiny pavement temple behind their house. If it was up to God, He did not seem to listen.

  Meanwhile his father never missed a stop on his circuit: Vellore, Madurai, Tuticorin, and parts in between. When Justifus Stone was home, he barely had time to remove his pith helmet or unpack his bags before he was off again. Justifus called his son the Archbishop of Canterbury, and if these were words of reassurance, they did nothing for Thomas. He spoke to his son as if he were addressing multitudes. At night Thomas could hear his uneven footsteps like those of a giant in a bedroom of Lilliputian dimensions who could not help knocking over furniture. It was a relief when Justifus went out on tour again.

  A YEAR PASSED with Thomas living all but parentless in the big house, along with Sebestie, Durai (the cook), the maali, Sethuma (who washed clothes and swabbed the tile floors), and an untouchable who came once a week to clean the toilets—that was his family.

  On Christmas Day, son and backslapping father came together for dinner; his father's clerk, Andrew F
othergill, was their sole guest. “Well, what a feast! Good to have you all. Fine repast, just fine. Eat, do eat”—this when it was just the three of them at the table, with Durai waiting behind the kitchen door. “We can't let them get away with it all. There is money to be made in coir. Rope, you know, or matting. We deserve, we earned it, I'll say, and by golly we are going to have it,” and on he went, barely stopping to swallow, the crumbs spraying from his lips. Fothergill tried valiantly to connect Justifus's thoughts, to give his superior's scattered remarks a spine, a thread of meaning. Justifus began to rub one thigh, then the other, fidgeting, glancing down with irritation as if the dog were underfoot, but of course she never came into the house when Justifus was around. By the time pudding was served the leg rubbing was so furious that Thomas had to ask, Please, sir, what is wrong.

  “I have fur on me legs, son. Keeps me from feeling, it does. Ruddy nuisance.” His father struggled to rise, almost upsetting the table in the process. He stumbled out, grabbing sideboard and wall, his feet sticking like magnets to the floor. Thomas remembered Fothergill's look of consolation as the boy saw the guest to the door.

  Jan. 20,

  My darling son,

  My temperatures were 36.7, 37.2. 37. 8, 37.3. I threw out the 38.6 because I didn't believe it. They roll our beds out to the porch, and back in at night. In and out. I'm not even allowed to go the lavatory. TOTAL BED REST, though the huge effort this requires seems to be against the idea of rest. I find it difficult to believe that on this porch, with the mist outside and the air so cold, that a body can generate a temperature over 36 degrees. No wonder we are called warm-blooded animals.

  She had circled a splotch on the page and captioned it with “My tears, as I cry for you, my darling boy.” In each letter Hilda told him that he must be brave, and be patient.

  TIME FOR THOMAS was no longer divided by days and nights or seasons. Time was a seamless yearning for his mother.

  They say I have not made any great improvement but that I should be glad I am no worse …