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Literature & Medicine: Must Reads
by Elayne Clift :::
bio
This edition’s book review is by Elayne Clift, a Literature & Medicine facilitator for the Vermont Humanities Council.
An exploration of contemporary morality: Tracy Kidder’s Mountains Beyond Mountains
I don’t know Paul Farmer, but I’ll bet his favorite mantra
is: “Just Say No To Authority!” Farmer is the physician activist
who’s the subject of this book, subtitled: The Quest of Dr. Paul
Farmer, A Man Who Would Cure the World.
Farmer would certainly cure the world if he could, and he’s made
an impressive start. He and his colleagues at Partners in Health, an organization
he started in 1987, have established exemplary primary health care programs
in Haiti, Peru, Mexico, Boston, Siberia, and Guatemala. But in the process
of curing the world, Farmer wouldn’t stop at improving patient care
and health promotion; he would reform anyone who is selfish, unenlightened,
overindulged, lazy, fatalistic, and rigidly bureaucratic.
So who is this savior? Paul Farmer is a doctor, a Harvard professor, a
world-renowned infectious disease specialist, a medical anthropologist,
a prolific writer, a husband and father, an iconoclast, a polemicist with
a sense of humor, and an all-out good guy with an ego that some describe
as oversized. Like most leaders of movements, he is charismatic, needs
little sleep, and he sees his way as the high way.
Recipient of a MacArthur “genius” grant among other awards, Farmer
became involved in the health care crisis in Haiti as a medical student.
While working there he met his main benefactor, Tom White, a Boston construction
magnate who gave him $1 million to start Partners in Health, and who has
been supporting his work ever since. That work soon extended beyond Canges
in Haiti to prisons in the Russian gulag, to villages in Chiapas, Mexico,
to the Peruvian Andes, and to the ghetto of Roxbury, Massachusetts.
Farmer’s mission, beyond bringing health care and dignity to the
poorest people in the world, is to foster a moral understanding of public
health among donors, practitioners, politicians, and ordinary people.
His mentor was a German named Rudolf Virchow, who believed that epidemics
were “indicative of mass disturbances of mass life,” and that “it
is the curse of humanity that it learns to tolerate even the most horrible
situations by habituation.” He saw physicians as “the natural attorneys
of the poor,” and often prescribed “full and unlimited democracy”
as the way to cure endemic disease. Paul Farmer embraced this philosophy
and political perspective, combined it with his own brand of liberation
theology and sense of the ironic, and set out to change the way international
health is practiced. One measurable result, despite doubt and opposition
on the part of the “experts,” was the protocol he and his team developed,
and proved effective, for treating drug-resistant tuberculosis, and for
treating people with both HIV/AIDS and TB.
Farmer is an extraordinary character, and Pulitzer-Prize winning author
Tracy Kidder captures his personality well. He is fair and balanced in
his portrayal of a man who is at once arrogant and humble, likeable and
irritating, self-deprecating and overly assured. Kidder, who spent many
months traveling with Farmer, emerges as something of a heroic figure
himself. Our Literature & Medicine discussion group found his even-handed
treatment of Farmer enlightening. As Kidder grappled with his own feelings
toward the hero of Haiti, we too struggled to come to grips with our ambivalent
feelings about a man who has contributed so much to medicine, but who
demands so much.
Kidder’s book is a biography, an economy-class travelogue, a lesson
in international public health, and perhaps most of all, an exploration
of contemporary morality as it plays out in the peaks and valleys of health
care delivery. It is into the territory of Farmer vs. own ethics and morality
that discussion groups may find themselves venturing. Our group spent
a good deal of time exploring such issues as corruption for a greater
cause (was it okay to “borrow” drugs from a Boston hospital so those
drugs could be used for the poorest of the poor?), charisma vs. cultism
(suppose Farmer’s charm had been put to less lofty use?), and ego
over extraction (does Farmer ask too much of, and give too little to,
his colleagues?).
A Creole bus sign Kidder saw once said, “Lord, a word on all this.”
Paul Farmer has a lot more than a word to say about the world’s
inequities. Tracy Kidder has done a compelling job of inviting us into
the conversation.
Mountains
Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the
World by Tracy
Kidder, Random House Trade Paperbacks (August 31, 2004)
ISBN: 0812973011
Click here
for more information on Paul Farmer.
Must Reads is an opportunity for Literature & Medicine facilitators to review good texts for Literature & Medicine seminars. A fixture of every Synapse issue, Must Reads will have a rotating authorship. We invite any Literature & Medicine facilitator to submit a review of a reading that may have gone unnoticed by other groups.
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Literature & Medicine has received major support from the National Endowment for the Humanities.