Mountains Beyond Mountains by Tracy Kidder
Published by Random House, 2003
In the first third of Mountains Beyond Mountains, the two sections that stay in my mind are first the time when Tracy Kidder asks Paul Farmer what he gets out of sacrificing so much of his life for a job with so many hardships and second when they both witness the mango truck overturned and the dead “mango lady” lying on a bed of fallen mangos next to it. In the first passage Farmer talks about feeling “ambivalent” about “selling my services in a world where some can’t buy them.” For desperately poor people who are sick and dying he thinks he should feel ambivalent about making his living out of their dying. In fact we know that he thinks all doctors should feel this way and everyone who isn’t upset about the unfair distribution of money for medicine in this world. We know this because he uses his special word, “comma” after these opinions, which Tracy Kidder
says comes before the unsaid word, “asshole,” meaning what all of us are who are comfortable with the world as it is and its great injustice. In the passage about the tipped over mango truck, Farmer is silent for a long time after seeing the dead body of the “mango lady.” We know from the opinions he’s expressed earlier that his is thinking about all that is wrong with the world that would have made that “accident” happen including the terrible dirt roads that are just tracks with huge bumps, the wreck of a truck that is completely unsafe to drive, the deforestation that makes the heat burn much more, and the fact that the poor woman had to go so far to sell her mangos to help her hungry family. There are many more reasons why the poor “mango lady” died than just having been hit by a turned over truck, and they should not have been allowed to happen. After reading these sections in just the first third of the book, I think the loud message is that we all have responsibility for the poorest people of the world and that not thinking about the fact that most are sick and dying or what we can do about it is not acceptable.
Quotes
Page 25
A sixteen-year-old boy too weak to walk, who weighs only sixty pounds. Farmer diagnoses an ulcer. “His body’s gotten used to starvation. We’re gonna buff him up.” Farmer hefts a can of the dietary supplement Ensure. “This is good stuff. WE’ll give him three cans a day. So we’ll give him a couple hundred dollars of Ensure, and I’ll take great pleasure in violating the principle of cost-efficacy.”
Farmer shows here that he will do whatever he can to save this boy. If that means giving him enough Ensure to get his weight back up, he will do it no matter whether someone far away in the international health community thinks that spending that much to save one person is cost-effective. If you can save a life, do it. What would be the point in half-saving people, meaning not giving the amount they need to survive just to save money.
Page 31
Then he (Farmer) walks back up the hill, to the TB hospital…Most of the patients have gathered in one room and are sitting on the beds watching a soccer game on a wavy, snowy TV screen. “Look at you bourgeois people watching TV!” Farmer says.
The patients laugh. One of the young men looks up at him. “No, Dokte Paul, not bourgeois. If we were bourgeois, we would have an antenna.”
.This is a great paragraph because it shows how close Farmer is to his TB patients that he can joke around with them and they with him.. It also shows how much understanding Hatians have of their place in the economic hierarchy.
Page 32
In a bed by the door of the hospital lies a moaning thirteen-year-old girl, just arrived y donkey ambulance… “I’m very good at spinal taps”…The veins stand out on Farmer’s thin neck as he eases the needle in. Wild cries erupt from the child: “Li fe-m mal, mwen grangou!’ Farmer looks up, and for a moment he’s narrating Haiti again. “She’s crying, “It hurts, I’m hungry.” Can you believe it? Only in Haiti would a child cry out that she’s hungry during a spinal tap.”
Farmer shows his incredible sympathy for the girl and also the fact that he can still be surprised by the pain of hunger being so extreme that it can even overpower the pain of a
spinal tap. He is also probably making it clear to Tracy Kidder who is there to write about him about the crime of hunger in the sense that it should not be allowed for anyone to be that hungry.
Page 36
Just recently, a TB patient from a village called Morne Michel hadn’t shown up for his monthly doctor’s appointment. So – this was one of the rules – someone had to go and find him. The annals of international health contain many stories of adequately financed projects that failed because “non-compliant” patients didn’t take all their medicines. Farmer said, “The only noncompliant people are physicians. If the patient doesn’t get better, it’s your own fault. Fix it.”
Farmer shows how he understands the reasons behind the reasons. When poor Haitians don’t take all their medicine, it is the fault of non-compliant physicans who aren’t taking the responsibility they have to heal their patients. Farmer knows that there can be many reasons why desperately poor and starving people might not be taking all their medicine.
He conducted a test and found that when patients were given a little cash for food, transportation and child care they did get and take their medicine.
Page 42
“And if it takes five-hour treks or giving patients milk or nail clippers or raisins, radios, watches, then do it. We can spend sixty-eight thousand dollars per TB patient in New York City, but if you start giving watches or radios to patients her, suddenly the international health community jumps on you for creating nonsustainable projects. If a patient says, I really need a Bible or nail clippers, well, for God;s sake!”
Farmer shows what a maverick he is. He is not going to stick to economic rules made by people in the international health community thousands of miles away that come down hard on small items needed by impoverished TB patients in Haiti when thousands of dollars can be spent on TB patients in wealthy areas.
After reading these sections in just the first third of the book, I think the loud message is that we all have responsibility for the poorest people of the world and that not thinking about the fact that most are sick and dying and what we can do about it is not acceptable.
Reading this book is what made my brother decide to major in public health at Tufts University. It inspired him to apply for a fellowship to work for a summer with the street children of Nairobi. I remember his saying that the poorest children receive a tiny amount of milk in a paper bag that has not been refrigerated in the morning and can’t get any more that day. They all look ill and hunt for food on the garbage heaps. I have seen how Paul Farmer could inspire someone (my brother)to take action to prevent the dying of the world’s poorest people, and maybe this book will influence what I decide to do in college too.
No comments:
Post a Comment