Good book: Mountains beyond Mountains.

July 6th, 2006

I held off on reading Tracy Kidder’s Mountains beyond Mountains longer than I care to admit. Partly this came from my general habit–a poisonous one shared by most people I know–of putting off some things I know to be needful or important. Partly this came from my knowledge about the book’s subject, Dr. Paul Farmer. I first learned of Farmer in an article that Kidder published several years ago in The New Yorker. Farmer is the sort of person, a genius possessed by a higher vision of human capabilities, who puts the rest of us to shame, not by trying to show anyone up, but merely by being who he is.

Kidder does a fine job of humanizing Farmer, especially by using first-person accounting of his own interactions with and reactions to the doctor. Still, the simple facts of Farmer’s resume are daunting: He is the eldest son of a poor, eccentric family; he was a scholarship student at Duke, then a brilliant medical student at Harvard who earned his M.D. while (a) spending most of his time working in rural health clinics in the poorest parts of Haiti and (b) earning a Ph.D. in anthropology. Farmer is now the guiding force behind Partners in Health, as well as the primary physician of the Zanmi Lasante clinic in Cange in Haiti, as well as an attending physician in infectious disease at the Brigham and Women’s Hospital in Boston, as well as a professor of medicine and anthropology at Harvard, as well as a prolific author of books and articles and a highly sought speaker and consultant on infectious disease and the medical plight of the poor worldwide. As Kidder makes clear, Farmer also gives lots of his time as a mentor to other physicians. He is a friend to the poor and sick everywhere, and, as icing on the cake, he has a wicked sense of humor. Although Kidder never makes this comparison, it is hard not to compare Farmer to Albert Schweitzer, and indeed I wonder whether Schweitzer doesn’t come off the worse for the comparison.

The book is lovely to read because of Kidder’s great smoothness and punch as a writer. The book is inspiring as it shows the impact that one person–albeit a gifted and driven one–can have in the face of entrenched problems. Farmer treats the patients at his clinic without regard to their ability to pay. Haiti is one of the world’s poorest places, a “fourth world” country as some have called it, and it deserves all the Farmers it can get. The book is sobering, though, inasmuch as it leads me to compare my own efforts to change the world with the good intentions I have long held.

For as long as I can remember, I have been fascinated by the lives of writer-polymaths–those who led big lives while writing lots of books. But the achievements of Richard Burton or Teddy Roosevelt or Winston Churchill or Bill Buckley are mixed. You can always find something to disagree with, whether in their politics or in their actions. Farmer, although he has a well-articulated political outlook and has imperfections of his own, lives a life of such service that it is hard to find fault with him. (One of the few areas to question–which Kidder does not flinch from discussing–is the small amount of time that Farmer’s overburdened schedule allows him to spend with his wife and daughter in Paris.) No doubt there are epidemiologists who disagree with Farmer’s take on certain issues of patient treatment or health policy, but the outcome of all his work is to help sick people–especially the poorest sick people–to get well. Who can question the merits of that?

Reading Mountains beyond Mountains opened my eyes, not for the first time but with renewed force, to the inequalities embedded in our systems of medical care. In the days after I finished the book, I noticed articles in Foreign Policy and The New York Times on the effects of treatable invectious disease upon the poor. Because I had read Kidder’s book, I took the time to read these articles. Now I find myself pondering how to work the themes of Kidder’s book, and Farmer’s life, into my own scholarship on U.S. foreign policy: treatment of the poor, promotion of quality medical care for all, and especially the systematic–the systemic–mistreatment of Haiti.

This is an important, compelling book. I urge you to read it.

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More on Tracy Kidder and Paul Farmer:

2 Responses to “Good book: Mountains beyond Mountains.”

  1. Common Sense » Blog Archive » Not Later. Says:

    […] Paul Farmer started giving medical care to sick Haitians six years before he finished his medical degree. He did not pretend to be a doctor, but he did use the abilities he had to deliver skilled care to sick people. Mozart didn’t wait to graduate from a conservatory before he started composing music, and neither did Quincy Jones. A whole slew of modern entrepreneurs — Bill Gates, Steve Jobs, Larry Ellison, Richard Branson — launched into business without finishing college. They had the ability and the passion to move ahead with their dreams, and they weren’t going to wait until after . . . anything. […]

  2. Common Sense » Blog Archive » Interesting reading. Says:

    […] If poverty in Haiti concerns you, lay hands on Mountains beyond Mountains posthaste. […]

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