The book does offer us insight into the life of Ethiopians under Emperor Haile Selassie (Verghese lived in Ethiopia for a time), a perspective we don't often hear about. A fellow book club member raised an interesting issue during our meeting: is all fiction written by a "colonial", per force, about colonization? In this case the perspective is further muddied by the fact that the South Asians, depicted here, serving as surgeons and doctors, are in positions of power over the Africans they treat. The traditional colonial dynamic where Indian peoples are subjugated is reversed.
Marion, as he is the narrator and main character, is fully fleshed out, introspective and sensitive, but his twin Shiva is an enigma, a blank for the reader. The female characters suffer similar fates: Sister Mary Joseph Praise is presented as saintly and sweet but utterly hollow. We learn only of her devotion to God and then Stone – but what motivated this young girl to give up her celibacy to Stone? One reader suggested that we never learn if their union was consensual, an interesting conundrum that I had not considered. Hema, the boys' foster mother who is also a physician surgeon and saves the boys from death, suffers a similarly saintly representation.
It is inexplicable that a trained doctor like Marion would have unprotected sex with Gennette who has lead a dangerous and unsavory life. The only reason, in terms of the mechanics of this novel, is to create the crisis that serves as a denouement: the hero becomes dangerously ill with hepatitis; his brother Shiva offers a portion of his liver to save him; the father, Thomas Stone, who abandoned them performs the operation. One twin is saved, the other perishes.
You may read the first chapter here.