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An unreasonable man who has changed the world
on 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.