Medicine is a very important recurring idea in the novel overall for many reasons. On the surface, medicine is important because most of the main characters in the novel are doctors, and the protagonists grow up in a hospital. Medicine also provides a second level of competition and jealousy in the relationship between Marion and Shiva. When Shiva begins to earn accolades for his work in fistula research, Marion is envious and angry with Shiva for invading American newspapers. Medicine is also an integral element in the reunification of the Stone family: without Thomas Stone's groundbreaking work with liver transplants, Marion would have died from hepatitis and would not have been given a chance to repair his fractured relationship with Shiva.