books · MS-2

A preferential option?

I just finished reading Tracy Kidder’s Mountains Beyond Mountains, our assigned summer reading.  Even though I admire what Farmer and his organization Partners in Health have done for the poor, I felt more irritated reading this than probably any other book I’ve read.

I think what annoyed me most about Mountains Beyond Mountains was the blinders that you’d have to wear to enjoy it. At one point, Kidder describes the expansion of Partners In Health from a one-room club of three to a large administrative organization employing people from all strata of Boston society.  Farmer rails against the fact that some of his new workers want overtime; as he says, there’s no overtime when you’re dealing with poverty.  Fair enough. But the head administrator ends up paying overtime to the lowest-salaried employees, only because that is a condition of PIH’s Harvard affiliation.  No mention of the fact that the “lowest-salaried employees” (janitors and the like) are probably quite poor themselves. Evidently they are not Haitian, though, and so they get no sympathy from the Great White Father.

There was a similar situation where Farmer has a huge fight with one of his closest allies, because the other physician is planning to speak at an international conference on Lake Como rather than walk around Siberian prisons on Farmer’s behalf.  It’s a legitimate criticism, but it would carry a lot more weight if it hadn’t been followed by a very dramatic story–probably the best in the book–about one of Farmer’s dying pediatric patients in Haiti, who is airlifted to Boston for treatment, arranged by two young physicians involved in PIH.  Their plan is almost foiled numerous times.  Where is Farmer during the crises? In a German castle, for a scientific meeting he “felt he couldn’t refuse.” No one questions his travel decisions the way he questions his colleagues’.

In short, Mountains Beyond Mountains takes on the distinct tang of Farmer-flavored propaganda.  And my natural instinct, upon encountering propaganda, is to resist it, even if I actually agree with its underlying message.  This is how I felt when reading The Jungle for a class in undergrad: the constant emphasis on Crappy Immigrant Life made me want Jurgis and his entire family to fall in the meat processing vat, just so Upton Sinclair would shut up.

Perhaps I am being too literalist here.  Perhaps I am missing an ironic subtext in which Tracy Kidder points out all these flaws in the Farmer personality cult. Perhaps the moon is made of sawdust and glue.

There is nothing wrong with Farmer’s ideology, if it’s truly meant.  As a matter of fact, I think a “preferential option for the poor” makes perfect sense.  But all I really got out of Mountains Beyond Mountains was an appreciation of the bureaucracy of international health (inevitably mired in politics, especially the Cuban sections) and an idea of Paul Farmer’s evidently enormous ego.

That’s a pity.


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