Opening
A death, a disappearance, and two frail newborns rewire the entire world of Missing Hospital. Over five chapters, everyday routines collide with emergency surgeries, political tremors, raw grief, and the unexpected making of a family. By the end, the center holds—but only because new people step forward to become it.
What Happens
Chapter 11: Bedside Language and Bedroom Language
The morning the twins are born, Dr. Abhi Ghosh moves through his day unaware of catastrophe. He frets over the absence of Dr. Kalpana Hemlatha (Hema), away in India, and fears she will return married. That fear pushes him toward escape: he has secretly applied for an American internship. At home, his housekeeper Almaz scolds him about drink yet fusses over him like family. Her origin at Missing comes to light—she once arrived with a phantom pregnancy that proved to be a massive fibroid; after Hema’s hysterectomy saved her, she never left.
At the hospital, Ghosh tends to patients while battling a chronic urinary pain that has ironically made him the resident expert on venereal disease. He heads into Addis Ababa for the calming ritual of a shave and haircut, musing on the city’s Italian past, then drifts to a bar and spends the night with a young prostitute. He thinks through his theory that the language of intimacy and the language of medicine are one and the same, foreshadowing the larger theme of Medicine as a Calling and a Metaphor.
Night falls, and dramatic irony breaks. Ghosh returns to Missing to find Almaz distraught: Sister Mary Joseph Praise has died in childbirth, the twins live, and their father, Thomas Stone, has vanished. The ordinary day is over.
Chapter 12: Land’s End
Morning brings command and containment. Matron Hirst closes Missing to new patients and fields two critical calls. From the Emperor’s Minister of the Pen come condolences and a request to notify him if high-ranking officers need care—an oblique signal of political unrest. From Eli Harris, a major American donor, comes concern; Matron, numbed by grief, brusquely dismisses him. She and Ghosh scour Addis for Stone and find nothing.
The search turns to burial. Ghosh and Matron visit the bleak Gulele cemetery, which Matron rejects as unfit for Sister. The desolation stirs her past: she shares the memory of John Melly, a man she loved who died during the Italian invasion—a confession that presses on the theme of The Weight of the Past and Secrets. Matron refuses to leave Sister there and instead claims a sunlit promontory on the Missing grounds that Sister loved. Choosing this beautiful spot folds Sister back into the hospital family and affirms The Intertwined Nature of Life and Death—loss and care rooted in the same soil.
Chapter 13: Praise in the Arms of Jesus
As laborers begin to dig Sister’s grave, Ghosh is summoned to the emergency room. Colonel Mebratu, a feared officer Ghosh once saw preside over an execution, arrives with a strangled bowel (volvulus). He whispers that he is part of a failed coup and cannot risk the military hospital. With Stone gone, the knife falls to an internist who has never operated. Ghosh calls Hema; she refuses to scrub in, pleading that she is “postpartum,” immersed in the twins’ care, and will not risk stepping away.
Cornered by duty, Ghosh opens a rhyming surgical handbook, drafts a probationer to assist, and performs the operation. He saves Mebratu. Only then does he spot Hema in the doorway—she has watched quietly, ready to intervene if he faltered. The crisis forges intimacy; she invites him home to eat.
Sister’s funeral follows. Gebrew chants a Geez prayer; nurses sing. Hema and Almaz attend with the swaddled infants, Marion Praise Stone and Shiva Praise Stone. The narrator, Marion, recalls this as the moment he and his brother “open our eyes to contemplate a world in which so much is already amiss.”
Chapter 14: Knowledge of the Redeemer
The next day, Colonel Mebratu insists on leaving against medical advice. His brush with mortality sharpens his political purpose: he vows to fight for ordinary Ethiopians, his twisted gut a metaphor for the nation’s pain.
Matron properly receives Eli Harris, who arrives in a pith helmet and good intentions. He learns of Sister’s death and other failed missions he supported. Matron counters his dream of bringing “knowledge of the Redeemer” to a country with ancient Christianity by showing him what Missing truly needs. She walks him past raw suffering, opens the doors to “Operating Theaters 1 and 2”—closets overflowing with useless donated Bibles—and lays bare her prayers: not for abstract salvation but for funds to ease suffering. Harris leaves chastened, his outlook transformed.
Chapter 15: Crookedness of the Serpent
Five days after the funeral, crisis strikes Hema’s bungalow. Shiva stops breathing. Hema collapses into Ghosh’s arms; he diagnoses apnea of prematurity—the infant’s brain forgets to breathe. Improvising, he ties a string with bells to Shiva’s ankle, the other end held by whoever keeps vigil; a tug cues the baby back to life.
The emergency seals a partnership. For two weeks, Ghosh and Hema trade shifts, read Middlemarch aloud to stay awake, and knit themselves to the twins through exhaustion and care. Ghosh cancels his American plans. A new family constellation takes shape, fulfilling the arc of Family, Identity, and Belonging.
Six weeks after Sister’s death, word arrives: Stone lives in Kenya. Hema is relieved he has left the babies yet spits the epithet “serpent.” Ghosh answers, “He is my friend.” The loyalty surprises her and reframes their bond, touching the fault line of Brotherhood and Rivalry.
Character Development
Crises pull hidden selves to the surface. Roles at Missing reorganize around competence, courage, and care rather than titles or tradition.
- Dr. Abhi Ghosh: From anxious romantic and would-be emigrant to the de facto surgeon who saves a life under fire. The apnea vigil cements his devotion to Hema and the twins, and his defense of Stone reveals fidelity and moral nuance.
- Dr. Kalpana Hema: Bristling independence softens into vulnerable motherhood. She refuses the operating room to protect the newborns, then builds a round-the-clock pact with Ghosh, allowing mutual reliance to replace guarded solitude.
- Matron Hirst: Unflappable administrator and keeper of graves and secrets. Her memory of John Melly humanizes her authority, while her unvarnished tour for Harris shows faith as logistics, budgets, and relentless love.
- Thomas Stone: Absent but defining. His disappearance reads as abandonment born of shame and shock, casting a long shadow over the twins and everyone who must fill the space he leaves.
Themes & Symbols
Loss births responsibility, and responsibility births belonging. The hospital’s routines become rites of passage as characters answer calls they did not choose. The chapters braid Medicine as a Calling and a Metaphor through every scene: a shave that becomes reflection, a surgery that becomes moral courage, a bell on a string that becomes a tether of love. At the same time, The Weight of the Past and Secrets shapes choices—Matron’s buried grief, Stone’s flight, the city’s colonial residues—so that every present act converses with remembered pain.
Life and death coexist in the same courtyard, literalized by Sister’s grave at Missing and the twins mewling at its edge—embodying The Intertwined Nature of Life and Death. Family is made, not merely inherited: the apnea vigil stitches a household into being under the banner of Family, Identity, and Belonging. Even allegiance is complicated—Ghosh’s quiet “He is my friend” refracts Brotherhood and Rivalry into adult loyalty that defies simple judgment.
Symbols concentrate these ideas:
- The burial site: A hill of beauty beside the wards, refusing to exile the dead, turning grief into daily remembrance.
- The Bibles-stuffed “operating theaters”: A portrait of misaligned charity and the gulf between doctrine and deed.
- The string and bells: Innovation born of scarcity; medicine and devotion braided into a lifeline.
Key Quotes
“I can’t imagine leaving our cherished daughter in this place.”
Matron rejects the Gulele cemetery. The sentence reclaims Sister as family and asserts a theology of presence: love insists on proximity, not propriety.
“Postpartum.”
Hema’s one-word refusal to scrub in is a boundary and a creed. She prioritizes the twins’ survival over heroics, defining care as triage of attention.
“He is my friend.”
Ghosh’s defense of Stone complicates the easy story of betrayal. Loyalty here is mature, acknowledging failure without abandoning relationship.
“Knowledge of the Redeemer.”
Harris’s missionary phrase exposes the gap between spiritual abstractions and Missing’s material needs. Matron’s rebuttal grounds faith in sutures, salaries, and soap.
“We opened our eyes to contemplate a world in which so much was already amiss.”
Marion marks the funeral as his origin point. Consciousness itself is born in mourning, fusing identity to loss and responsibility.
Why This Matters and Section Significance
These chapters deliver the novel’s hinge. The tragedy foreshadowed in the Prologue becomes the engine that reorganizes Missing Hospital and launches the twins’ story. With Sister gone and Stone fled, power and care redistribute: Ghosh steps into surgery and family, Hema into shared leadership, Matron into guardian of the living and the dead. Political rumblings, donor illusions, and bedside improvisations weave into one claim: the work of love is practical, constant, and shared.
This turn sets the long arc ahead. The twins’ upbringing now rests on a chosen family; secrets harden into fault lines; loyalties tested today will echo into adulthood. The hospital becomes both sanctuary and crucible, where healing binds people to one another as surely as blood.