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191 of 194 people found the following review helpful:
4.0 out of 5 stars
An unreasonable man who has changed the world, December 15, 2006
Trace Kidder has written an excellent book about an extraordinary man. My one critique would be that Kidder has immersed himself so thoroughly in Farmer's life that I think he is at times incapable of believing that Farmer can make a mistake. The section with Farmer describing the virtues of the Cuban system of health care was accepted too uncritically for my taste. By the end, Farmer was even acting as a de facto cardiology consultant for Kidder during strenuous climbs in the Haitian mountains. Farmer must have an incredible personality, and I think it would be natural for this to happen to anyone who spent as much time with him. Still, it strikes an occasionally awkward tone. Please don't construe this to mean that the book is not enjoyable and worthwhile. It really is both.
As a physician myself, I probably read this book with less objectivity than most readers. On a certain level, a doctor like Paul Farmer is an indictment of the way most physicians in this country practice. Paul Farmer could, if he chose, be one of the highest paid consultant in the country. He has demonstrated the intellect and the force of will to succeed at any branch of medicine. And yet, he chose infectious disease and epidemiology as his twin callings, two of the lower-paying specialties within the field. Furthermore, he chose not just to dedicate superhuman effort to this profession, but to practice in one of the poorest of poor regions of the world, Haiti, where every newcomer is "blan" (white), even African Americans from the US. It's hard to read about such a man an not feel at times inadequate. After all, what have I done with my education that comes anywhere near what Farmer has accomplished?
I think even non-physicians might have this initial reaction. I think a common defense mechanism might also be one that occurred to me, to pathologize Farmer, to think of his drive to help others as a need to satisfy some kind of internal conflict. After all, if Farmer does what he does to "quite the voices", then the rest of us are off the hook.
In the end, I came to realize that this was grossly unfair. A reader does not know and never can know what drives a man like Farmer, we can only judge him by his works. And those works are amazing. Time and again in his career, Farmer chose to push for the absolute best care for the absolute poorest of his patients. He refused to accept that the best HIV and tuberculosis drugs were "inappropriate technology" for Haiti. Instead, by tirelessly fighting for his patients, he redefined how tuberculosis and other horrible diseases are treated. I would encourage a reader to look closest at this aspect of Farmer, as it can be applied to all of our lives.
To close, I am reminded of the old saying:
The reasonable man adapts himself to the world;
the unreasonable man persists in trying to adapt the world to himself.
Therefore all progress depends on the unreasonable man.
--George Bernard Shaw
Dr. Paul Farmer is an unreasonable man who has changed the world.
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199 of 215 people found the following review helpful:
5.0 out of 5 stars
A Contrast of What Should Be with What Is, November 29, 2004
"Mountains Beyond Mountains" is no exception to Tracy Kidder's excellent body of work. I have been a fan since he wrote "Soul of a New Machine." Kidder impressed me then, as he does now, with his upfront investment of time before putting pen to paper. Fortunately for us, his hard work translates to first class storytelling.
The title "Mountains Beyond Mountains" is a metaphor for life - once you have scaled one mountain (challenge), there are more to come. This is especially true for Paul Farmer, MD, who has devoted his life to what most people call "the impossible." He has faced mountain after mountain in his quest to help mankind.
Farmer starts out devoting his life to providing the most rudimentary medical care to impoverished Haitians (the shafted of the shafted). By age 27, he had treated more illnesses than most doctors would see in a lifetime. With time, he finds himself on the world stage trying to find a cure for drug resistant tuberculosis, undertaking the difficult role of a global fundraiser, and fighting big pharma for lower drug prices. He is a modern day medical hero.
For me, Farmer serves as a startling contrast to Robert K. Maloney, MD, the well known Los Angeles ophthalmologist who has been featured on TV's "Extreme Make-over." Maloney, who was profiled October 26, 2004 in the Wall Street Journal, said that after he completed his medical training, he came to a disquieting conclusion: "I really didn't like sick people." Maloney has since specialized in LASIK refractive surgery (considered cosmetic surgery) and pampers his patients with 25 person staff, and a suit-and-tie concierge who serves pastries and coffee in the waiting room. He then follows up after his patients return home with a gift box of gourmet chocolate chip cookies and a mug bearing the invitation, "Wake up and smell the coffee." He says he now earns more than the $1.2 million in salary and bonuses he made during his last year at UCLA (several years ago), but he won't say how much.
Farmer serves as reminder of what medicine aspired to be - the buck as only a means to an end....ending poverty, ending tuberculosis, ending the plight of many humans who cannot receive treatment from a qualified and trained doctor. Dr. Maloney serves as a reminder of what medicine has become - the buck and celebrity as ends. We should all get one of Maloney's mugs so we, too, can "Wake up and smell the coffee" ...before it is too late.
Read "Mountains Beyond Mountains," if only to regain hope of what medicine can be.
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58 of 59 people found the following review helpful:
5.0 out of 5 stars
Mountains Beyond Mountains, September 10, 2003
In a world where it is easy to feel as though we are helpless in the face of everyday violence, war, greed, and inhumanity, the story of Dr. Paul Farmer and his colleagues is an important reminder of the power within all of us to contribute to a better, more just world. I suspect many people who read this book begin it with little or no knowledge of Haiti's history nor of its desperate situation today (not something we see in school curriculums!) and so the book also serves as a great "primer" for readers on Haiti and the impact of US policy there. Tracy Kidder does an excellent job of allowing us to "shadow" the steps of Paul Farmer as he moves in Haiti and around the world. I think Kidder's detailing of his own evolving relationship with Paul Farmer is particularly well done. He does an excellent job of chronicling the details of personalities, individuals, and events without ever letting the reader lose sight of the larger global context in which they are situated.
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