April 22, 2005

Paul Farmer

For this entry I would like to include a review by a medical doctor about a book which I really enjoyed reading: Mountains Beyond Mountains by Tracy Kidder. Thank you Martina.
Dear Colleagues,
I recommend to you this book, by Tracy Kidder, about the work of our collegaue Paul Farm, MD. In a time when it is easy to become jaded and cynical, to lose the optimism and fortitude of youth, this book about an extraordinary person and physician gives me a feeling of reinforcement. It is fascinating to me that Dokte Paul loves the Lord of the Rings, because he looks to me like the moment when the dawn breaks, and Gandalf appears on the white horse on the ridge above Helm's Deep, and plunges into the fray, cutting off the enemy and starting the rout which looked absolutely impossible.
I was in the Peace Corps in South America in my 20's. It is easy, as Dr. Paul found, to see what needs to be done when the systems are simpler, and the needs are starker, and the inequities more pronounced, as they are in Haiti. But just as wonderful is the work of his partner Jim Kim, who pushed to get the 2nd line pharmaceuticals costs down, making it possible to treat the multi-drug resistant Tuberculosis in Peru and in Siberia. The moment in the book when Jim Kim uses the karaoke player to get the Siberian generals of the gulags-- whom he calls the "gulag-meisters" to sing, and thus to open their hearts to the "beyond cynical" vision of treating the MDR TB in Siberian prisons, is enough to make me cry. Dr. Paul makes me feel like I have been lazy and standing still all my life.
That he loves his garden, and his goldfish, and his wife and daughter are some comfort in the ego-busting clarity of his love for patients, prisoners and students. But there are wonderful reflective moments when he discusses the issues of the "preferential option for the poor", and the assumptions in medical triage, and the need to meet the needs of real, unique and beloved patients in whatever way we can do so. It is because he is such a great physician that he can muster the help and support and loyalty of others in his work. To call this book inspirational is almost too low a praise. It is like an infusion of gamma globulins and maybe even 2 units of PRBCs to an anemic self. One could say he is a type 1 in the Enneagram, and that he uses righteous anger to fuel his hypomanic energy to do what he sees needs to be done. But that leaves out the friendship, fierce loaylty and love, and the joy people can see in him when the small victories come, in "the long defeat". It is a great book.
Sincerely,
martina