The Subject Breaks the Mold

Physician/anthropologist Dr. Paul Farmer was remarkably committed to the idea of a preferential option for the poor. While his rock-solid conviction may be easy to summarize, its application is anything but. The context–the culture of those impacted–is historically obscure. The work is logistically ominous and tragically political. And the personal ramifications are a strange mix of awkward, disappointing, and inspiring. In Mountains Beyond Mountains, author Tracy Kidder adapts some conventions of the biography in an attempt to fit it all in.

Kidder’s explanations of the patients’ societies is frankly a bit weak. He includes some insight about Voodoo in Haiti, but really only to the extent that’s necessary to contextualize Farmer’s comments on the topic. One-dimensional as that may be, there’s even less background on life in Peru, Mexico, and Russia. This might be in deference to Farmer, a prolific anthropologist who had published plenty on these topics. Kidder explicitly endorses Farmer’s The Uses of Haiti, for instance. Whatever the reason, the omission makes the book feel a little abstract at times.

Although Farmer’s convictions never wavered, they led him on a dizzying path across continents. From TB clinics in Peru to symposiums in Chicago to hospital tours in Cuba to prison visits in Russia and even medical rounds in Boston, I often felt a little lost in the weeds. Even at the book’s conclusion, it’s difficult to see a coherent strategy behind it all. I wouldn’t fault the biographer for failure to construct a narrative, though; Farmer’s efforts matched the frenzy of his passion. He was really doing as much as he could, wherever he could. Kidder even notes at one point how Partners in Health (Farmer’s non-profit organization) was in some ways averse to accruing funding. On reflection, it’s really only fitting that the book doesn’t present a pat strategy.

Mountains Beyond Mountains has a sub-title: “The Quest of Dr. Paul Farmer, a Man Who Would Cure the World.” Such a grandiose description is sure to raise any reader’s guard about bias. I was scrutinizing Kidder’s reporting when he surprised me by acknowledging his struggle with objectivity:

In any case, [Farmer] seemed to think I knew exactly what he meant, and I realized, with some irritation, that I didn’t dare say anything just then, for fear of disappointing him.

Kidder’s relationship with Farmer makes for an unexpected but important theme. The book only mentions a handful of questionable actions by Farmer, but Kidder never criticizes. Any doubt he has in the doctor is usually followed by reflection on the particulars of their relationship. This transparency wins him credibility that would be hard to achieve through mere adoration. It’s thoughtful and relatable wisdom that meets even the high bar set by Farmer. Kidder never truly commits to being a subject, though–we learn almost nothing about his background. Unfortunately, that limits his exploration of the balance Farmer tries to find between his cause and his family.

By all accounts, Dr. Paul Farmer was an extraordinary person. It seems to me that any reasonably complete list of his achievements would prove why this is true. Mountains Beyond Mountains offers one explanation of how. Chronicling a heroic figure is in some ways an impossible task, as the subject resists circumscription. I think Kidder has done as good a job as any one person could do, and I welcome additional perspectives on the topic. Although Farmer passed away this week, I’m sure I’ll be finding new inspiration from his example for years to come.