Mountains beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World

#27
Title: Mountains beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World
Author: Tracy Kidder
Publisher: Random House
Year: 2003
Genre: Biography/Medical Anthropology
317 pages+ Satisfying tone and pace, an uplifting and far-flung narrative- Nothing substantive to critique
Highly readable and very satisfying, this is, to the best of my knowledge, the first of Kidder's books in which he appears other than as a distanced narrator. While House and The Soul of a New Machine were certainly very enjoyable, Mountains beyond Mountains is simply engrossing. This is due not only to its subject, the eccentric, opinionated, and deeply generous Dr. Paul Farmer, but also to Kidder's participation as an active player. Given the subject (poverty, disease, and class bias), Kidder's vulnerability, sometimes-irritation with Farmer, and willingness to slog over Haitian mountains hour after hour to visit patients with him lend the narrative a personal immediacy that is both consonant with those foci and serves as an enactment of the effects of Farmer's works: The event may be a world AIDS conference with global implications, and Kidder reports both the unfolding medical policy decisions and his concern about having offended Farmer with an offhand remark.

Farmer is a character, and Kidder gives the reader ample opportunity to see his many facets: Brillian intellectual, maddening boss, odd duck, lovable eccentric, annoying narcissist, and others. Farmer is a man with a vision, one with an admirable talent for sitting down and whipping out such seminal works as Infections and Inequalities and Pathologies of Power: Health, Human Rights, and the New War on the Poor in record time. Clearly deeply committed to his work and to humanity, Farmer seems like a hard person to live with, and I admire both his deeds and the people committed to supporting him in them.

Central to Farmer's work, and hence to Kidder's narrative, is the question of triage: How are resources allocated? Who is first in line? To what extent should affluent nations provide external (non-sustainable) resources for poor nations? Less well-treated, but amply alluded to, is the question of the balance between indigenous and Western allopathic medical practices. In this regard, The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures is an excellent companion piece. I will be re-reading and reviewing it shortly.

Kidder's voice, self-reflection, and observations here were sufficient to make me buy his next book, My Detachment: A Memoir, which treats Kidder's Vietnam service.