abraham verghese cutting for stone review

Through his characters, Verghese goes on to describe the malar flush of mitral stenosis, the slow pulse of the Typhoid state, the sweet odour of ketosis, the embossed skull of the infant with rickets, the sabre-shaped legs of the child with syphilis and the stomping sensory gait of the adult with tabes dorsalis. He teaches his (adopted) son to differentiate relapsing fever from other forms by pressing the thigh muscles and eliciting a myalgic wince, and excitedly points out a patient with Corrigan’s sign (visible filling and emptying of the carotid artery). He assesses, he opines, he advocates, but he does not spend an equal amount of time on documentation. In Cutting For Stone, the medical paragon Ghosh (a physician who becomes a surgeon) barely writes in the notes, let alone codifies his interventions. Sabre tibia, seen in advanced syphilis infection Craniosynostosis seen in infantile rickets, from Wang et al, Radiology Case Reports 2(3), 2007. The EMR’s association with burnout is also well described ( see this post). He worries that this slavish relationship threatens to warp our attention away from the person sitting or lying before us. In his role as a Professor for the Theory and Practice of Medicine, Verghese speaks about our disconnection with patients, in particular the duty to feed the monster that is the electronic medical record. It is easy to become disenchanted with medicine in this modern age. Then I asked myself – where is the art in what I do now? Reading Cutting For Stone (which is also an emotionally involving story with marvellously wrought symmetries of fate), I compared what I do now with the image of the complete physician I constructed during my training.

To the young person wondering whether to become a doctor, the art of medicine is centred on the mysteries of physical diagnosis. Interpretation of clinical signs is key, and deep knowledge of their variety is required to understand what is truly happening beneath the skin. In both, doctors strive to make correct diagnoses in a pre-technological setting, and innovate with limited resources. The scenes set in Ethiopia rekindled the same emotions of excitement and wonder I experienced reading Jurgen Thorwald’s Century of The Surgeon years before I entered medical school. Abraham Verghese’s Cutting For Stone reminded me why I became a doctor.

Abraham verghese cutting for stone review