HW # 24 - Illness & Dying Book, Part 3

Mountains Beyond Mountains, by Tracy Kidder
Random House, New York, 2003

Mountains Beyond Mountains is the story of Dr. Paul Farmer, a famous infectious disease specialist and an even more famous defender of the poor. While he is still in medical school, he builds up a medical clinic in Cange, a treeless and godforsaken part of central Haiti and raises money so that patients with drug-resistant TB can have the expensive drug treatment that can cure them. He also becomes involved with curing poor TB patients in Peru and with TB sufferers in jail in Russia. Later he focuses on fighting HIV and AIDS.He is a workaholic doctor and fund raiser who hates being away from his patients and thinks it is a privilege to take care of them. He does not think it is a privilege to be a hotshot doctor who speaks at the U.N. the World Health Organization conferences, and with wealthy donors like Bill Gates. Doing these things and using his charm helps him get the money and the policies to make life a little fairer for poor people.

Paul Farmer hates the idea that resources are scarce but only when it comes to the poor. The idea that the rich deserve great medical care and living conditions and the poor don’t because they are responsible for their bad luck makes him fume especially because it is the exploitation of their land and resources by the rich and powerful that has made the poor people poor.

Quotes

The problem is, if I don't work this hard, someone will die who doesn't have to. That sounds megalomaniacal. I wouldn't have said that to you before I'd taken you to Haiti and you had seen that it was manifestly true (191).

Farmer is explaining to Tracy Kidder, who has to try to keep up with him, why he gets hardly any sleep, works an insane amount of hours (100 hours a week, and will work in Cuba and go back to Haiti the same day with no rest. He does spend his time saving lives in places where there aren’t a lot of other doctors or sometimes any doctors. For him losing patients is so painful that he would do anything to save them.


It’s a parallel universe. There really is no relation between the massive accumulation of wealth in one part of the world and abject misery in another (218).

Farmer is talking about how so many wealthy people, corporations, and governments take no responsibility for the poverty of other people.


My suspicion is that [bankers] are not getting a lot of sex, because they spend a lot of time screwing the poor (253).

Farmer is angry at a banker who thinks that if Haitians could control “their sexual appetites,” AIDS would not be a problem. He hates the ignorance of wealthy people who convince themselves that it is their own fault that poor people are poor and don’t admit that it is bad governments and greedy rich people who have taken the resources where the poor people live so that there are no jobs.


I think, sometimes, that I'm going nuts, and that perhaps there is something good about blocking clean water for those who have none, making sure that illiterate children remain so, and preventing the resuscitation of the public health sector in the country most in need of it. Lunacy is what it is (258).

Farmer is talking about what happened in Haiti when the U.S. stopped giving funding to Haiti because it did not want to support President Aristide, probably because he was not a dictator it felt it could control. Farmer cannot see how punishing poor people for being poor is a sane thing to do. It is definitely an inhumane thing to do.


That's when I feel most alive, when I'm helping people (295).

This quote gives another idea about why Farmer works so incredibly hard. He almost says that he is selfishly helping poor people. Since Farmer lives for his mission of having a democratic world in the sense that everyone would be treated equally, he is most alive when he is looking after someone who needs his help.

In the last part of Mountains Beyond Mountains, when Farmer is trying to control the spread of AIDS, he had to fight people who thought that in poor parts of the world it was only possible to try to prevent AIDS not to treat it. Using antiretroviral drugs would be too complicated and expensive. Just as was the case with drug-resistant TB, Farmer had to argue that sick and dying people have a right to whatever the new technology was producing whether they are rich or poor. Wealthy people act as though dying is just something that poor people do because they can’t afford treatment and even if they get it for a while because someone is generous, they won’t be able to “sustain it,” meaning keep paying for it. Farmer greatly admires Cuba for using its poor resources well enough to have excellent health care and fight the spread of AIDS. There is success at the end of the book when the Gates Foundation gives Farmer’s organization $45 million to wipe out drug-resistant TB in Peru, and Farmer helps George Soros with his $13 million grant to fight TB in Russian prisons after the fall of the Soviet Union. The original plan was just to give the prisoners the first-line drugs, and if the drugs did not help the prisoners could go to a hospice to die. Farmer is inspiring because he acts on what he believes, which is that dying people are all part of humanity and they are even more helpless if they are poor. He takes responsibility to try to save them and he thinks they are all of our responsibility (commas).