Really enjoyed this story of twins who are raised by surrogate parents who are chosen by default. Shiva is a genius who is oblivious - or maybe uncaring - to the effect his actions have on others - particularly his twin. Hema and Ghosh - their adoptive parents are honest, loving humans who teach all of us about life and how to live it. Matron - what a great non-profit administrator who loves her hospital and her work. Rosina, Almaz, Gebrew, Tsinge - all help shape the lives of the twins. 
When their childhood friend - and the love of Marion's life - becomes involved in the Eritrean rebellion and Marion has to flee the country - I believed the story line. When Marion is working in the hospital in New York City and a surgeon from Boston arrives to harvest organs for transplant who just happens to be his father - I believed it. With most other authors - these plot lines would have annoyed me - but Verghese tells the story well - and I loved it.