Making a Difference

Title: Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World
Author: Tracy Kidder
Publisher: Random House
Publication Year: 2003
Rating: A

You could imagine after seeing this blog that the most popular presents I received this holiday season were books. Mountains Beyond Mountains was special because my gentleman friend’s grandmother gave it to me as a gift. When I opened it she informed me that her other grandson – my gentleman friend’s cousin – had known Dr. Paul Farmer, the person the book was about, from Harvard Medical School. She’s so proud of her grandsons -- and they are all brilliant -- so I was excited to read the book.

What I found is the story of one man truly trying to heal the world. Fans of the amazing guitarist Warren Haynes know that he is referred to as the “hardest working man in rock ‘n’ roll.” Well, Paul Farmer has to be the hardest working man in medical anthropology. And even that title does him no justice.

Tracy Kidder depicts Farmer’s works through about a fifteen-year span, from when a young Farmer was finishing his medical degree to developing into a global force on behalf of the world’s poor. Along the way, Kidder describes the patients, doctors and adversaries that Farmer touched and was touched by along the way.

What sets Farmer apart from many other doctors is his belief that socioeconomic situations have a direct link to illness and health matters. Farmer was one of the first people to work based on the theory that just treating illness is not enough. Certain circumstances breed illnesses (i.e. TB, malaria, AIDS) more than others. Just treating the symptoms does nothing to curb these epidemics. There is a reason why TB is rarely seen these days in the United States. But it is the number two killer among infectious diseases in the world after HIV/AIDS, according to Mountains Beyond Mountains.

Farmer began his work in Haiti, where he set up a model that was eventually transplanted to other regions of the world. This model was based on raising the standards of living – as much as was possible – in impoverished areas to help treat the people of those regions. It was not enough to give them the drugs they needed if they had no potable water to drink. It meant nothing to stitch wounds if there was no food. As common sense as this may sound, this was a new way of thinking in global medicine. “The physicians are the natural attorneys of the poor, and the social problems should largely be solved by them” was one of Farmer’s favorite aphorisms, Kidder writes.

Breaking ground became Farmer’s forte, but the connection between poverty and illness may have been his greatest. At one of his many lectures on AIDS, Farmer describes a study he did in Haiti regarding women and AIDS. His findings showed that most of the women affected by AIDS did not have multiple sexual partners, but surprisingly, they did many times cohabitate with men from two specific groups: truck drivers and soldiers. What Farmer pointed out to the audience was that it was the men with jobs that the women of Cange had sexual relations with. And these jobs often required men to travel to many places, thus “a woman in every port” comes to mind. Kidder reports that Farmer concluded his speech by quoting a woman in the Cange who said, “You want to stop HIV in women? Give them jobs.” Kidder displays many similar connections of Farmer’s throughout the book.

One of the most fascinating segments of the book occurs when Kidder accompanies Farmer to Cuba. Farmer believes Cuba has one of the best public health programs in the world. Kidder has a hard time digesting this and writes:

I just wondered what price in political freedom its people paid for that achievement (first-rate public health). But I understood that Farmer would frame the question differently, and ask what price most people would be willing to pay for freedom from illness and premature death.

This glimpse provides insight into how dedicated to medicine Paul Farmer truly is. I can do no justice writing here how many directions this man has been pulled (and probably still is). But what stays true throughout this book is his absolute dedication to the poor and the ill – no matter the sacrifice.

In the end, though, Kidder’s ultimate success in this worthy portrait is not only the idea that there are people out there that can change the world. It is also that this is a story about a human being. Paul Farmer is as human as any of the patients he’s treated. That is the key to his success.

At one point in Mountains Beyond Mountains, Farmer describes his struggle with not being able to love all children like he loves his own. When a woman’s child died at birth, he pictured his own daughter and it made him break down. He had always viewed himself as being “the king of empathy.” He said, “It was a failure of empathy, the inability to love other children as much as yours.” Kidder questions why Farmer thinks he could be capable of doing this when no one is. Farmer replied: “All the great religious traditions of the world say, Love thy neighbor as thyself. My answer is, I’m sorry, I can’t, but I’m gonna keep on trying, comma.”

One Man Gathers What another Man Spills

Title: Heaven Lake
Author: John Dalton
Publisher: Scribner
Publication Year: 2004
Rating: A

John Dalton’s first novel places the reader with a young missionary in modern day Taiwan. Vincent traveled halfway around the world from the Midwest to Taiwan to teach English and spread the word of God. But his goal is harshly detoured when he indulges in a sexual affair with one of his teenage students. The affair forces him to take an offer from a wealthy businessman to go to Mainland China to retrieve the man’s future wife. What unfolds is a travel adventure into the depths of a curious country and an even deeper adventure into Vincent’s own relationship (or lack thereof) with his faith.

Heaven Lake causes the reader to constantly feel sorry for poor Vincent because of the predicaments he finds himself in. But this pity gives way to relief and pride in the young man because of his eventual shedding of guilt and acceptance of life without strict Christian guidelines. And the realism of the character – his ability to make mistakes (constantly) in love and in cultural misconceptions – is easy to relate to. His growth is apparent by the end of the novel.

At one of Vincent’s most enlightened moments, while he’s visiting Heaven Lake after his long and tumultuous journey through China, he contemplates a “lifetime of partial answers and shady intuitions,” a life without believing in Jesus. He came to the realization that “you could navigate your life without knowing” all of life’s answers. He concludes, “You could sometimes love the mystery as devoutly as the believers loved their gods.” This is a breakthrough for Vincent, who essentially viewed everything in life through the context of Christianity. Instead of focusing on what would happen in the afterlife, he learned to live his life.

Bird Flu, Schmurd Flu

Title: The Stand
Author: Stephen King
Publisher: Signet
Publication Year: 1990
Rating: A+

At 1,141 pages, The Stand is a force to be reckoned with. It’s epic in nature, and horrifying in its details. Not only will this story scare the bejeezus out of its reader, it will also force them to ask what they would do in a similar situation.

The Stand is an old tale, one that has been told in many forms for centuries. It is the story of good versus evil, light versus darkness, God versus the devil. It is the story of an apocalypse of sorts.

The government has created a flu virus, one that has leaked and wiped out most of mankind. Only the immune have survived, but they have lived to watch all the people they loved die a gruesome death. Not only are the details of the flu’s symptoms horrifying, the psychological trauma of watching the world crumble for these characters sets the tone for the entire novel. King is brilliant at telling the survivors’ stories from beginning to end. He hits home the fact that their slates have been essentially wiped clean. They are no longer the people they were before. Circumstances have changed them.

Two characters in particular exemplify this. Stu Redman, a worker at a calculator factory in a small town in Texas, never finished school. He was always considered the quiet one, more of a follower than a leader. He had struggled in his life, as many did. But he kept much of that to himself. It wasn’t until he was forced into a leadership role after the flu had erased society as they knew it that he really shined. He became strong, forthcoming and proved to be a man of strong moral standing and common sense.

In another instance of metamorphosis, Lloyd Henreid was a criminal before the flu. He had robbed and murdered, was in jail when the epidemic quickly ate away at the human population. He was saved from a death of starvation by the evil Randall Flagg, and eventually became his right-hand man. In the community they set up in the West, Lloyd became a leader much like Stu Redman did. He had always been a follower before, was uneducated and weak of mind. But in this new community, its members sought guidance from Lloyd. He suddenly had answers to their questions, which ranged from infrastructure to their own moral dilemmas.

King’s development of all of his characters contributed to the epic nature of this story. His signature gore and shock was also incorporated, but this is much more than a horror story. This is a book about faith and strength of will. It makes you consider, Would I have the strength to go on in similar circumstances? And it is about the continuation of good and evil through eternity.

Third Time Not Such a Charm

Title: South of the Border, West of the Sun
Author: Haruki Murakami
Publisher: Vintage International
Publication Year: 1998
Rating: B

This is the third novel I’ve read and reviewed by Haruki Murakami, and unfortunately, it is my least favorite. Although it is classic Murakami, mysterious and passionate, it didn’t hold the magic so inherent in his other works.

I went into the reading of South of the Border, West of the Sun expecting that it would have the same fantastic surrealism apparent in both Kafka on the Shore and Wind-Up Bird Chronicle. But it was simple in its plot, exploring the connections of people over time and the obsession that can so easily take over a person’s mind.

The characters were smart and beautiful, the dialogue reflecting this throughout. And the unsettling nature of the main character, Hajime, is realistic in its confusion. The story follows the frustrations of Hajime as he tries to find his place in a life that seems to have gone on without him. He is married and has two daughters. His father-in-law gave him the opportunity to open several successful bars. But he still finds something lacking in his life. The novel doesn’t quite end in resolution, but it is implied that Hajime, instead of looking outward for something to fill the hole in his life, will look around him, towards the people that love him.