Cutting for Stone

After two days, Genet leaves without warning. Every night when he comes home, Marion hopes she will be there. His neighbor tells him to hire a private detective to find her and get closure. Marion finally agrees when he points out that Genet might be trying to reach him and is unable to. The investigator finds out that she did not return home or work and hasn’t been in contact with her probation officer. He also finds out that she has tuberculosis.

Marion gets a phone call in the middle of the night but cannot understand it. He is in bed for several days before he wakes to Deepak examining him. Marion tells him everything, and Deepak takes him to the hospital by ambulance. Marion is very ill, and one day, he realizes that Thomas Stone is at his bedside, looking concerned. Thomas contacts Hema, and she and Shiva immediately travel to New York. Three days later, they arrive at Marion’s bedside. Thomas tells them that Marion has hepatitis.

Shiva climbs into bed with Marion and touches his head to his. Deepak believes that Marion, upon finding out Genet had tuberculosis, started treating himself, which contributed to his liver damage. The biggest danger is the hepatitis, and they are not sure he will survive.

The next day, Hema returns to Marion’s bedside, where Thomas is still waiting. They both blame themselves for Marion’s condition. Shiva returns and tells them that Genet was at Marion's house and then disappeared. He found out from Tsige and Marion’s neighbor, both of whom are in the waiting room. They discover that Genet has hepatitis, which Marion was exposed to when she bled during intercourse.

Shiva calls a meeting with Hema, Thomas, and Deepak to discuss a liver transplant. Deepak says they considered it, but the transplant process and anti-rejection medication would only make the hepatitis stronger. Shiva argues that if the liver were a perfect match, Marion would not need anti-rejection medication, and he volunteers part of his liver. He references the paper that Deepak and Thomas published together to convince them.

Hema tells Thomas he cannot walk away again; he is the only one who can do the surgery. She asks him what he would do for a patient who was not his son. Shiva says he is acting as Marion would and would not be able to live with himself if he didn’t try to save his brother. Finally, Thomas commits to the plan, and they decide that they will do it at Our Lady.

The hospital and staff prepare for the transplant, bringing other experts and equipment from Boston. Thomas Stone vomits before the operation, which the doctors from Boston say is a good sign. News of the surgery has gotten out to the media, and there are television crews outside the hospital. After several hours, Shiva is already in recovery, and they are working on Marion’s transplant. The surgery is successful, although there was a dangerous moment where they nearly lost Marion. Hema prayed to Sister during the surgery and believes she interceded at that moment. Marion is recovering but is in critical condition because his kidneys are not working.

Usually, a liver transplant comes from patients with brain death, so the operation with a living donor becomes global news. Marion wakes after four days, and Hema tells him about the transplant. Thomas brings Shiva to Marion’s bedside. Even though Marion is on a ventilator and cannot speak, they are still able to communicate. Marion is in intensive care when Thomas visits again. The hospital has been quiet all day, and Marion is taken for an X-ray of his brain, which seems odd to him. He finds out that Shiva experienced a brain bleed and is now on a ventilator. Later, Thomas tells Marion that the brain bleed resulted in brain death, and they visit Shiva.

When Hema takes Marion back to his room, she apologizes for believing that he was responsible for what happened to Genet. The next day, Marion argues for surgery to relieve the pressure in Shiva’s brain, but when Thomas shows him the CAT scan, he realizes there is no hope for Shiva’s recovery. Marion lies in the bed with Shiva after they turn off the ventilator, feeling like he wants to die, too. He realizes that they are still one, despite distance and history, and that they are together inside Marion now. This allows him to say goodbye and finally leave Shiva’s body behind. Afterward, Marion thanks the surgical teams and hospital staff and hugs Thomas. He tells Hema they can go home now, and she understands that Shiva and Marion are now both inside one person.

Three weeks after Shiva dies, Marion and Hema return to Ethiopia. It is 1986, and Marion has been in America for seven years. Before they leave, Marion finds out that Genet died in prison after going to Texas to search for her child. Thomas takes them to the airport and asks Marion if he will return. Marion has not thought beyond burying Shiva in Missing, but he still has a home and a job in New York and says he will be back. Thomas feels guilty about Shiva, and Hema admonishes him, then forgives him.

Instead of returning directly home, Marion and Hema decide to stay in Rome for a few days. They see Bernini’s Ecstasy of St. Teresa, which is so familiar from Sister’s print. Marion and Hema kneel and pray, and Marion feels at peace.

When Marion and Hema return to Missing, Marion gets out of the taxi early and visits Shiva’s workshop. Three days after he returns, Marion performs surgery and reflects on Thomas, Ghosh, and Shiva, and how he is now taking his place in Missing. Time passes, and Marion stays. His liver works perfectly, and his hepatitis is subdued, so he is no longer a carrier.

Five years later, the government is overthrown, and President Mengistu flees. Every night, Marion visits Matron, who is now elderly, and a few months after Mengistu’s fall, she dies in her sleep. Almaz and Gebrew are retired, and the hospital continues to grow, especially the fistula surgery center, where the probationer has become a skilled fistula surgeon. Marion discovers one day that Thomas had been funding Shiva’s work all along. In 2004, Marion finds Sister’s letter to Thomas behind the St. Teresa picture that Ghosh had framed for him.

In the letter, Sister tells Thomas that she is pregnant and feels she must leave Missing because of the shame. She wants him to come with her but will love him regardless. Marion realizes that she loved Thomas and had sought him out after they met on the ship. After Thomas disappeared and Ghosh found the book, he could not send the letter as he did not know where Thomas was. Putting it in the picture frame was typical of Ghosh, leaving it to fate and trusting Marion to do the right thing.

Marion calls Thomas, who is over 80 now and no longer practicing. When Thomas answers the phone, Marion hears in his voice the surgeon who devoted his life to his practice and training countless others. His voice sounds so close despite the international connection that he seems to be with Marion. The novel ends before their conversation begins.