by Abraham Verghese
Vintage Books, 2010, 543 pp., £7.99
ISBN 9780099443636

 
This is a book of memories that lingers on long after it is read. Right from the start, in a short, engaging prologue, Abraham Verghese takes us with him in the retelling of a touching portrait of an Indian family that made Ethiopia its home and the lives and tortured relationships of two identical twins born of an Indian nun and a British surgeon, who runs away in shame and disgrace for having fathered by a nun sworn to a life of poverty, celibacy and obedience. This is a book that deals with big themes: forbidden love; sex; faith, guilt and shame; the purpose-driven life; and devotion to one’s country of birth. It is, above all, about betrayal and redemption, and love that transcends geography, ethnicity and blood lines.

The great writers usually engage the reader right from the start with powerful introductory lines or paragraphs. Tolstoy is perhaps the best example as can be seen from his well-known, stunning one-sentence opening paragraph and the immediately following paragraph in Anna Karenina. He eschewed static introductions and colourful background paintings and plunged the reader directly into the middle of an action among persons unfamiliar to him ‘so that the reader would be drawn into their situation like a participant, and not remain aloof like a mere observer.’1 Verghese, too, throws us directly into the middle of the action in the first few sentences and evocative prologue by telling us the shock, disbelief and commotion at Missing Hospital, Addis Ababa, caused by the fact that Sister Mary Joseph Praise, a much loved nurse and a nun sworn to a life of celibacy, had been, unknown to all those closest to her, pregnant and was now in the throes of cataclysmic labour which was endangering both her life and her unborn twin babies.
 
The story is narrated by one of the twins, Marion Stone, now 50 and a respected surgeon, to render some order to the events of his life and the mysteries that surrounded his birth, and to express his gratitude to his estranged twin brother Shiva for ‘the gift of yet another sunrise’. It is above all an effort to exorcise old ghosts and heal old wounds. ‘Only the telling can heal the rift that separates my brother and me. Yes, I have an infinite faith in the craft of surgery, but no surgeon can heal the kind of wound that divides two bothers. Where silk and steel fail, story must succeed.’
 
The twin brothers were born at Missing Hospital, Addis Ababa, in the very room where their mother, Sister Mary Joseph Praise, ‘spent most of her working hours, and in which she had been most fulfilled’. In a beautiful paragraph that is likely to be amusing and familiar to the Ethiopian ear and a damning but correct commentary on our cavalier attitude towards precision and attention to details, Marion tells us that ‘Missing was really Mission Hospital, a word that on the Ethiopian tongue came out with a hiss so it sounded like “Missing”’. A clerk in the Ministry of Health who was a fresh high-school graduate had typed out THE MISSING HOSPITAL on the license, a phonetically correct spelling as far as he was concerned. A reporter for the Ethiopian Herald perpetuated the misspelling. When Matron Hirst had approached the clerk in the ministry to correct this, he pulled out his original typescript. ‘See for yourself, madam. Quod erat demonstrandum it is Missing’, he said, ‘as if he’d proved Pythagoras’s Theorem, the sun’s central position in the solar system, the roundness of the earth, and Missing’s precise location at its imagined corner. And so Missing it was.’
 
Sister Mary Joseph Praise stayed and worked at Missing hospital in the presence of Thomas Stone, a respected British surgeon. The two were close and worked together in perfect harmony; they were ‘pure ballet’, ‘a heavenly pair’. But when his assistant of seven years, a nun of the Diocesan Carmelite Order of Madras, unexpectedly went into labour, Thomas Stone, the man who everyone believed to be the father, didn’t know or suspect she was pregnant! But there she was, bleeding profusely and dying of child birth. When he therefore saw her
lustreless eyes, her lips turned blue, in agony and quickly fading away, he was overwhelmed with fear of losing the woman he secretly loved. He ‘could do nothing but call and repeat her name. From his lips, Sister Mary Joseph Praise’s name sounded like an interrogation, then an endearment, then a confession of love spun out of one word. Mary? Mary, Mary!’
 
In spite of all their efforts, all the three physicians who lived and worked together at Missing Hospital – Stone, Dr Kalpana Hemlatha (Hema), and Dr Ghosh –were unable to save her. Stone was totally devastated. And, he who had been asking for a miracle to save her was not moved by the sight of the twins. In fact, he detested them and wouldn’t look at them. He left the room, run away, no one knew where, and was never heard from.
 
For Dr Kalpana Hemlatha, or, Hema as she was known, the death of Sister Mary Joseph Praise while giving life to these two infants was worse than tragic. It was madness, and the ‘only sensible response to the madness of life …was to cultivate a kind of madness within’ and, in a scene reminiscent of Zorba the Greek, she started dancing and dancing and dancing ‘to the music in her mind’. But she finally saw the beauty of having these two infants and said to herself that she had won ‘the lottery without buying a ticket’ and that ‘these two babies had plugged a hole in her heart’ that she didn’t know she had. She became their mother. She named them Marion and Shiva, and ‘finally, reluctantly, almost as an afterthought, but because you cannot escape your destiny, and so that he wouldn’t walk away scot-free, she added our surname, the name of the man who had left the room: Stone.’
 
Marion tells us of a warm and loving family and a happy childhood – he and Shiva falling asleep, ‘arms around each other, breathing on each other’s face, heads touching’; growing up with and like other Ethiopian and neighbourhood kids; enjoying the free and inclusive Ethiopian-Western social life; and exposed to culture and good education. Above all they grew up very much loved and dotted by their cultured and cosmopolitan adoptive parents, Hema and Gosh. It was apparently an ideal, boisterous and colourful family.
 
The twins were extremely close; they were one. ‘All one of us had to do was think of an action and the odds were the other would rise to carry it out’. But they were also different. Marion was the more thoughtful, obviously emotional, and inhibited especially about sex. Shiva, on the other hand, was the more detached, rational, practical and worldly. Although still in his teens, he had more experience with sex and no qualms about sleeping with women, any woman.
 
Marion describes Shiva as a genius, impatient with school, someone who did not subscribe to convention but knew more medicine, certainly more gynecology, than many a trained physician and was formed into a brilliant surgeon, thanks to his non-formal training and apprenticeship under Hema’s supervision. Shiva had an exceptional eidetic gift while Shiva lived in the now, without bothering about the consequences of his action. As close as he was to his brother and as harmless and totally decent as he was, he did eventually commit an act of betrayal which left a deep wound and rift that separated the two brothers. It was while this wound and estrangement between the brothers was still raw that Marion was wrongly suspected of being an accomplice or a member of a radical student group that hijacked an Ethiopian Air Lines plane and therefore had to leave his country of birth for the United States.
 
Life in the US involved hard work and rigorous training to be a doctor. Emotionally, his life was barren, empty and bitter. He was bitter that he left his beloved country because of the infantile act and behaviour of a woman he loved but who along with his twin brother caused him the deepest sorrow and disappointment. He missed terribly his family and his Ethyo-pya, as he would call his country. But it was also a life of surprises where he experienced, even if for a few fleeting days, the taste and ecstasy of rekindled love and the joys of a dream fulfilled but one which turned into a nightmare. He would have died were it not for love that was pure and selfless. In a strange twist of fate that evokes the birth of two twins from the womb of a dying woman, we bear witness, towards the end of the book, to a life born out of the death of another and a resurrection which unlike that associated with divine act was inspired by the love and sacrifice of a very human, life-loving brother who didn’t care a damn about the life beyond but lived in the now and present.

The principal characters in this book are mostly a good and saintly group. These are people who are inspired by the most sacred of motives and aspirations, perhaps best encapsulated in the ‘’Bunyan’s Hymn’ which, we are told, Matron must have sung a thousand times to a dying friend and would-have-been-lover and husband:
 
He who would valiant be ‘Gainst all disaster Let him in constancy Follow the Master. There’s no discouragement Shall make him once relent His first avowed intent To be a Pilgrim.
 
They are also an ambitious lot. There is Matron, an enduring inspiration and the one who advised Marion to go for the hardest thing he could possibly do, to make his life ‘something beautiful for God’ and not to settle for ‘Three blind Mice’ when he can play Bach’s ‘Gloria’. There is also Hema, the woman he calls his mother, who decided early on in her life ‘to avoid the sheep life at all costs’.
 
The same commitment to a higher goal is reflected in Shiva. Otherwise unconventional in his attitudes and actions, Shiva devoted his life to serving the least wanted and most marginalised, instead of pursuing formal education in medicine like his brother. He was the embodiment of the secular saint. These kinds of inspired and saintly figures give the novel its unique moral compass.

Faith is a highly personal matter and must be respected. Yet, one cannot help but wonder about the wisdom of aspects of it, for example celibacy which has led to many scandals that have befallen the high priests and citadels of morality and caused damage to the lives of many, many young girls and boys around the world. ‘Birth and Copulation and Death’ are common denominators. Nothing is more natural, and anything that ascribes sin to Sex is all too often a challenge to our being that almost inevitably leads to dissonant behaviour in our lives, as is told in this novel. Sister Mary Joseph Praise received her nursing pin and took the final vow of celibacy when she was only nineteen. Though undertaken at a young age, she had to live with the consequences of the vow, both in the respect and breach of it.
 
It was impossible for all involved that the everyday miracle of conception had taken place in the one place it should not have – the womb of a devout and much loved nun, one of their own, a bride of Christ! Even for the good and expansive Matron, who herself had her share of loss and missed fortunes to love and be loved, it was unthinkable that this pregnancy, ‘a mortal sin’, could take place.
 
It was the taking of the vow and the expected or assumed adherence to it which compromised their expectation and ability to see what was happening in front of their eyes. Even the secular Hema, an accomplished gynaecologist, was blinded to the obvious signs she would otherwise have detected. The celibate and virgin nun was above suspicion – she couldn’t possibly be in love with Thomas Stone, let alone be impregnated by him. But Hema could not help also reflecting on her blindness and blaming herself for it. It should have been clear to her that Stone and the young nun

were a perfect match; maybe if we’d encouraged them it could have been something more. How often did I see Sister assisting him in surgery, working on his manuscripts, taking notes for him in his outpatient department? Why did I assume that was all there was to it? I should have reached over and smacked him at my dinner table. I should have shouted at him, Don’t be blind. See what you have in this woman! See how she loves you. Propose to her! Marry her. Get her to discard her habit, renege her vows. It is clear her first vow is to you. But no, Thomas, I didn’t do it because we all assumed that you were incapable of anything more. Who knew that this much feeling was hidden in your heart? I see it now. Yes, now we have these two [the twins] as proof of what was in your hearts.’

 
It was proof of the tragic consequences of archaic moral standards and the denial of one’s sexuality. Sister Mary Joseph Praise’s death could have been avoided. As Hema says to Thomas Stone, while trying desperately to save her, ‘One prenatal visit? Could you have let me see her for at least one prenatal visit? … Look at the soup we are in! …Completely avoidable…completely avoidable’.

Of all the characters in this book none is as honest, as committed to the fate and wellbeing of the twins and as blunt with the truth and Thomas Stone as Hema, the adoptive mother of the twins. And none is as intriguing and conflicted as Stone. When Hema confronted him, as we saw above, with the possibility that a prenatal visit could have prevented the tragedy and that he should have alerted her, he stammered that he didn’t know she was pregnant! Hema couldn’t believe her ears. ‘You are thinking virgin birth, Dr Stone. Immaculate conception?’ She goes on to tout him: ‘In that case, guess what? This is better than the manger in Bethlehem. This virgin is having twins!’
 
We come back to this same point on two other occasions where Stone says that, though the pregnancy was somehow his doing, he had no recollection how or where or when it happened. This is one of those mysteries left unexplained in the book although we can guess from a short reference to Stone’s sometimes bizarre behavior how or when it might have happened. The persistent Hema tries to force the issue of his fatherhood believing that Stone, having foolishly ‘lost the one woman in the world who fated for him’, would now rejoice for having gained two sons. She asks him ‘What shall we name these babies?’ To which he hurtfully and cruelly replied, ‘Please get them out of my sight’. And when Hema asks him to think about it again and not to turn his back on his children, he says simply and once again cruelly, ‘Hema, I don’t want to set eyes on them, ever’.
 
There are attempts by Hema, and Ghosh, her husband, and even by the embittered son, Marion, to explain and excuse Stone’s behaviour. For Ghosh, Thomas Stone was a good surgeon who ‘had no understanding of life’; he had lost his parents when he was a child and was terrified that if he got too close to anyone they would hurt him or he would hurt them.
 
Whatever the explanation, the fact that Stone did not try to contact Hema and Ghosh and find out about the fate of his sons even after having established himself as a leading and highly respected surgeon and long after the twins were born is an inexcusable act of omission. Even Ghosh, who was the most sympathetic and understanding of the three, says that he had after all expected Stone to contact him and was disappointed that he did not do so. Though this is not the place for a discussion of gender differences in parenthood, one cannot help but wonder as to how the mother, Sister Mary Joseph Praise, might have responded had she been faced with a somewhat similar situation or opportunity. Would she have abandoned her twin sons? Would she have been totally indifferent to their situation were she have to have the same set of opportunities and the same level of success that Dr Stone had in later years? We would never know, of course, but we can guess what the answer might be.

One of the striking features of  erghese’s engaging book is how likeable and manifestly decent his characters are, something which normally wouldn’t be a good recipe for tension and momentum in a novel. They are also supremely wise – unpretentious, down-to- earth and appreciative of the simple life. They have none of the existential doubts that afflict many of us or the insatiable needs that make our affluent lives so unnecessarily miserable. Take, for instance, Hema, the twins’ adoptive mother, devoted wife and saviour of many lives.

She’d been kept busy from her first day. If the truth be known, she secretly relished the emergencies, the situations where her heart was in her mouth, where the seconds ticked off, where a mother’s life hung in the balance, or a baby in the womb, deprived of oxygen, needed a heroic rescue. In those moments she did not have existential doubts. Life became sharply focused, meaningful just when she wasn’t thinking of meaning. A mother, a wife, a daughter, was suddenly none of these things, boiled to a human being in great danger…

 
These were committed humanists who saw meaning in service. Or take Dr Ghosh, Hema’s husband and the twins’ adoptive father. Ghosh, a lecher who loved his drinks and women and yet turned into a dotting husband and devoted father, was immensely appreciative of each day. ‘Another day in paradise’, was his frequent pronouncement when he settled his head on his pillow. Like Maurice in Tuesday’s with Morrie, he says ‘the uneventful day was a precious gift’. ‘The key to happiness,’ Ghosh tells us, ‘is to own your slippers, own who you are, own how you look, own your family, own the talents you have, and own the ones you don’t. If you keep saying the slippers aren’t yours, then you will die searching, you will die bitter, always feeling you were promised more’. This indeed happened to Genet, Marion’s great love and his source of misery and unhappiness; she ‘died chasing greatness and never saw it each time it was in her hand, so she kept seeking it elsewhere, but never understood the work required to get it or keep it.’

A common narrative in our modern age is the tension between work and life or work and the family. This is a real challenge in daily life that is directly addressed in this novel. Matron, as we saw earlier, challenges and advises the young Marion to play his Gloria and to go to the height of his possibilities. He found his purpose in life by being a physician. Similarly, Hema, his mother, was of the same caste of mind; her ambition was ‘to avoid the sheep life at all costs.’ At all costs?
 
Ross, who, as we learn later in the book, was the young Thomas Stone’s guardian, was very much impressed by the young man’s academic and professional achievement. After all, Stone had successfully ‘skipped a real childhood and gone directly to doctorhood’, and Ross tells him, ‘You are my consolation for never having married. That wasn’t by choice, by the way – not being married. “Perfection of the life or of the work” – I could only do the one. I hope you don’t make that mistake.’
 
But Thomas Stone did not agree. He was convinced that ‘he had found the cure and he’d found it himself. Ross had it wrong, or so Thomas thought; perfection of the life came from perfection of the work.’ Work was all that mattered; it ‘was his meat, his drink, his wife, his child, his politics, his religion.…until the day he found himself seated …in the room of a child he had abandoned; only then did he admit to his son how completely work had failed.’
 
And so, what or which is the right path? It is obviously not one or the other. Nor is the path linear – from the
perfection of the work to the perfection of the life or vice versa. It is a meeting of both. In this story, the best example
of the fusion of the perfection of life and of work are Ghosh and Hema, both successful in their profession, very much endearing to each other, and successful parents. Unfortunately, that path and destiny is only for the few; the vastmajority can only envy them; and those who achieve it can only be grateful for their good luck and good fortune.

On a personal level, the story resonates with Ethiopians of my generation for several reasons. There are, of course, the familiar events that form the backdrop to the story - the Haile Selassie period which in hindsight was arguably amongst the most glorious in Ethiopian history; the attempted coup d’état against him which saw the beginning of the end; the long, bloody fratricidal war between Ethiopia and Eritrea, ultimately resulting in the amputation of our country, and so on. But there are two other aspects to this book that make it endearing for Ethiopians, other than the moving story and the way it is narrated.
 
The first is the Indian connection. Many of us of the Haile Selassie generation were products of Indian ‘teacher-hood’. In those days, most of the few free-government elementary and secondary schools were run or staffed by Indian teachers from the Christian Indian state of Kerala.

Ask an Ethiopian abroad if perchance they learned mathematics or physics from a teacher named Kurien, Koshy, Thomas, George…, and the odds are their eyes will light up. These teachers were brought up in the Orthodox ritual which St Thomas carried in south India. But in their professional roles, the only ritual they cared about was engraving the multiplication and periodic tables as well as Newton’s laws into the brains of their Ethiopian pupils, who were uniformly smart and who had a good aptitude for arithmetic.

 
So the Ethiopian affection for India is both apparent and incontestable. Similarly, the love Marion feels for his birth country is palpable and moving. No ferenji2 novelist has arguably written about Ethiopia with as much love, delicacy, and passion as Abraham Verghese does through his Marion, the narrator. Geography brought him there but he embraced his destiny in a manner that converted fate into a meaningful life of giving. His descriptions of the beautiful landscape, the Ethiopians’ propensity for both kindness and violence, the arbitrariness of justice and of power that has been the hallmark of our history to this day and the heart wrenching pain of exile are unsurpassed literary works.
 
Varghese’s feelings are echoed through many of his characters. Marion, the narrator, smells Ethiopia wherever he goes – ‘the faint scent of charcoal and the frankincense that permeates [every Ethiopian woman’s] clothes.’ Ghosh, perhaps the most colourful character, also described as dooriye or lecherous, is struck by the natural beauty of the land, now seriously threatened and undermined by its inhabitants’ callous and indifferent abuse of their habitat, and the conflicted Ethiopian psyche. ‘My greatest consolation,’ Ghosh thought, for only the hundredth time since his arrival in Ethiopia, ‘has been the women of this land’. This country had completely surprised him. Despite pictures he had seen in National Geographic, he had been unprepared for this mountain empire shrouded in mist. The cold, the altitude, the wild roses, the towering trees, reminded him of Coonoor, a hill station in India he had visited as a boy…

Their [Ethiopians’] sharp, sculptednoses and soulful eyes set them between Persians and Africans, with the kinky hair of the latter, and the lighter skin of the former. Reserved, excessively formal, and often morose, they were quick to anger, quick to imagine insults to their pride. As for theories of conspiracy and the most terrible pessimism, surely they’d cornered the world market on those. But get past all those superficial attributes, and you found people who were supremely intelligent, loving, hospitable, and generous.

 
The observant Ghosh in a sharp dig at Ethiopians, further tells us of a people interested in ‘getting their shoes shined more often than they bathe’.
 
And there is the ever present shadow of fear, injustice and abuse of power that is at the heart of Ethiopia’s social, economic and political fabric. We see this in a brief but illuminating incident involving Gosh, who was arrested and taken to Alem Bekagne (Kerchele) – then, and for long after the central prison in the country – apparently because of his association with a general who had tried to topple Emperor Haile Selassie. His wife, Hema, and adoptive son, Marion, didn’t know where he was arrested and naturally went there to look for him. In one of the most beautifully constructed passages evocative of the theatre of the absurd, the sentry at the prison says without looking up, ‘I don’t know if he or she is here, I don’t know when I will know if he or she is here or not here, if you leave food or blankets or whatever, if he or she is here, they might get it, if not somebody else gets it. Write his name on a paper with whatever you are dropping off, and I will not answer’.
 
Marion recalls a conversation with a university lecturer he met at the same prison and whose father had been in this same jail many years before. ‘As a boy,’ the lecturer tells him, ‘I would run the three miles from my house, once a day, to bring food. He was so thin, but each time he would feed me first and make me take back more than half the food. He knew that for him to eat, we had to starve. One day, when my older brother and mother came with food, they heard the dreaded words, “No need to bring food anymore”. That’s how we knew my father was dead. And you know why they arrested my brother today? For no reason. He is a hardworking businessman. But he is a child of one of their old enemies. We are the first suspects. The old enemies and the children of enemies ....” I have quoted so extensively because such stories, especially those of fear of retribution, remain to this day an unfortunate facet of our lives and political fabric.
 
Even so, Marion’s love and loyalty never waivered. Soon after Ghosh was released, he once overheard him and his wife contemplating taking the family somewhere else (Persia or Zambia), before another attempted coup. Marion was not amused: ‘Were they joking? This was my country they were talking about, the land of my birth. True, its potential for violence and mayhem had been proven. But it was still home. How much worse would it be to be tortured in a land that wasn’t your own?’ He continues:

Call me unwanted, call my birth a disaster, call me a bastard child of a disgraced nun and a disappeared father, … but the loamy soil that nurtured Matron’s roses was my flesh. I said Ethyo-pya, like a native. Let those born in other lands speak of Eee-theee-op-eee-ya, as if it were a compound name like Sharm el Sheikh, or Dar es Salaam or Rio de Janeiro. The Entoto mountains disappearing in darkness framed my horizon; if I left, those mountains would sink back to the ground, descend into nothingness; the mountains needed me to gaze at their tree-filled slopes, just as I needed them to be certain I was alive. The canopy of stars at night; that, too, was my birthright. A celestial gardener sowed meskel seeds so that when the rainy season ended, the daisies bloomed in welcome. Even the Drowning Soil, the foul-smelling quick sand behind Missing, which had swallowed a horse, a dog, a man, and God knows what else – I claimed that as well…All possibilities resided within me, and they required me to be here. If I left, what would be left of me?

 
 
But, sadly, he had to. He went on exile because of a suspicion that he was part of a conspiracy in a political/criminal act committed by Genet, the girl he always loved. Those years of exile were years of painful memories, playing and singing in his mind the ever-enchanting, melancholic and haunting Ethiopian song, Tizita.

Tizita is almost certainly the most beloved of Ethiopian songs. There is no English equivalent that captures the meaning of Tizita. Abraham Verghese translates it to mean ‘memory tinged with regret’, which is almost correct. But it is more than that. In its simplest form it means memory, or memory of one’s love, or, of a turbulent love affair, a longing for one’s lover, even for his/ her anger and irritating behaviour. You sing it when you are happy and when you are sad, or, when you are in love and out of love. You listen to it in the comfort of your sofa, but you are also as likely to waltz on the floor with the one you love. You sing it in the familiar surroundings of your native land, but especially when and if you are banished to exile. It is mostly melancholic but it can sometimes be fast. It is a very unusual song which speaks to the Ethiopian psyche and soul. It is in the end about remembrance of things past in all their manifestations.

It grows with and on you and stays with you forever. And so it does with Marion, the Ethiopian/Indian. ‘After lunch, Shiva and I fall asleep, arms around each other, breath on each other’s face, heads touching. In that fugue state between wakefulness and dreaming, the song I hear is ... Tizita’, he says. It is the song he hears through all his years in Ethiopia, the one he carries with him whenever and wherever he goes, and the one he hears during his years of exile in America.

 
There are various versions of Tizita – for example, those of Bezawork Asfaw, Rahel Yohannes, Getachew Kassa, and Mahmoud Ahmed. As Verghese says, ‘every Ethiopian artist records a Tizita . They record it in Addis Ababa, but also in exile in Khartoum… and of course in Rome, Washington, D.C., Atlanta, Dallas, Boston, and New York. “Tizita” is the heart’s anthem, the lament of the diaspora…’ It is therefore not surprising that that the first thing Marion carried in his bag upon leaving suddenly his house is the bag which had the slow and fast Tizita, and it was Tizita cassettes that were among his precious possessions and a connection to his land of birth. Tizita is the symphony that plays throughout the story, and Verghese, in an appropriate tribute, devotes a whole chapter to it.

In a replay and yet another confirmation of the American dream, Marion’s stay in America was successful and satisfying professionally. He was also able, during this stay, to reconnect and exorcise the potentially destructive spell of his beloved, who nearly caused his death were it not for the miraculous intervention of Shiva. The end was both tragic and uplifting, resulting in feelings of longing and gratitude. ‘Twin brothers, we slept in the same bed till our teens, our heads touching, our legs and torsos angled away. We outgrew that intimacy and proximity, but I still long for it, for the proximity of his skull. When I wake to the gift of yet another sunrise, my first thought is to rouse him and say, I owe you the sight of morning.’
 
Marion returns to his Ethiopia to work alongside Hema, his devoted mother, at Missing Hospital. ‘Born in Africa, living in exile in America, then returning at last to Africa, I am proof that geography is destiny. Destiny has brought me back to the precise coordinates of my birth, to the very same operating theatre where I was born.’

This is a sensitive, often elegiac book with a well-constructed and engaging plot and full of vivid characters. The title is taken from the Hippocratic Oath but remains a poor and unconvincing choice that fails to do justice to the underlying themes and to the story beautifully told in this book. Although he sometimes tells us about things he couldn’t possibly remember or know, Marion the narrator does a good job of describing the events and the personalities that shaped his life, and does so with respect and balance, without making them persons ‘neither of superlative goodness nor repellent wickedness’.

This is a novel which should reach a much wider audience than would otherwise be through an American or UK edition. It is of manifest interest to an audience in Ethiopia, where much of the action takes place. But it would be of equal appeal to the wider African audience or to minority communities within and outside Africa. It serves as a counterpoint to the conventional narrative on the relationship between minority groups and indigenous majorities, and speaks of the rich and interwoven relationships between them. More importantly, it is a moving eulogy and testament that love of country and love of a woman can transcend ethnicity and cultural barriers. It is an alternative and uplifting antidote to the real or imagined grievances about the parochialism of Asians in Eastern Africa and the racist policies that it ostensibly triggered or justified in Amin’s Uganda.

Early on in the book, Marion shares with us in a deeply moving and philosophical way his reflections on the flow and flood of life, more precisely his life, the piercing losses that shaped the very beginnings and last phase of his life, and the nostalgia, sentimentalism and wisdom that elusive memory bestows on the past. We live and act in the present, without the benefit of hindsight to judge whether our actions and decisions are right or wrong, he concludes. Says Marion: ‘You live forward, but understand it backward. It is only when you stop and look to the rear that you see the corpse caught under your wheel.’ But, having returned to his country of birth, he also sees ‘in the African night’ the many ordinary miracles of life, grateful for the privilege of yet another sunrise and the life of service to the people he loved and that needed him most.
 
Abraham Verghese is a manifestly passionate observer and lover of Ethiopia, warts and all. This book is a moving and memorable evocation and confession of love to his Ethiopia. We are however told in the inside cover this writer of obviously great moral values now lives and teaches in the United States. This last piece of information is a minor detail, but it raises a big ethical question.
 
Clearly, the aim of good literature is not to pontificate on religious, social or political dogma. It is to reflect life in its varied facets, to make people happy or sad and experience and even dream life in its infinite ways. So, the author should not be constrained by a social or political agenda or expectation. Yet, the reader cannot help being unsettled by the dissonance between, on the one hand, the book’s moving conclusion where the narrator and principal character, Marion, resists the temptation to stay in America and returns to serve in a somewhat primitive hospital in his Ethiopia and, on the other hand, the knowledge that the author of this inspiring book is not where one would expect him to be but has a post as professor of medicine at the highly respected Stanford University, California. Is it too much to ask, Abraham, why only Marion? And what in the world are you doing there?

1 From, “Introduction and notes,” by E.B. Greenwood, in Leo Tolstoy, Anna Karenina, Wordsworth Classics, Chatham, 1999, p. xi.
2 Amharic for ‘foreigner’.