i heart paul farmer

I'm currently reading Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World. Paul Farmer is one of the most famous people in the public health world, the Bruce Springsteen of health service delivery for the poor. I'm a fan.

"The central imperative of liberation theology--to provide a preferential option for the poor--seemed like a worthy life's goal to him. Of course, one could pursue it almost anywhere, but clearly the doctrine implied making choices among degrees of poverty. It would make sense to provide medicine in the places that needed it most, and there was no place needier than Haiti, at least in the Western Hemisphere, and he hadn't seen any place in Haiti needier than Cange. He didn't stick around in Leogane to see the blood bank get installed [for which he had raised funds]. He'd found out that the hospital would charge patients for its use. He told me he had these thoughts, as he headed back toward the central plateau: 'I'm going to build my own fucking hospital. And there'll be none of that there, thank you.'"

"Farmer entered Harvard Medical School in the fall of 1984. He was only twenty-four... At the medical school, the first two years of the curriculum consisted mainly of large lecture courses. Often, Farmer would show up in Cambridge just in time for lab practicums or exams. Then he'd go back to Haiti. It wasn't as though no one noticed. By the second year, his classmates had nicknamed him Paul Foreigner. But while this kind of commuting by a student was almost certainly unprecedented, it would have been hard for any professor to disapprove. The young man was trying to bring medicine to people without doctors. Besides, his grades were excellent, some of the best in his class."

"One day the president of the Brigham [& Women's Hospital, in Boston] stopped [Howard] Hiatt in a corridor. 'Your friends Farmer and [Jim] Kim are in trouble with me. They owe this hospital ninety-two thousand dollars.' Hiatt looked into the matter. 'Sure enough. Paul and Jim would stop at the Brigham pharmacy before they left for Peru and fill their briefcases with [tuberculosis treatment] drugs. They had sweet-talked various people into letting them walk away with the drugs.' He was amused, all in all. 'That was their Robin Hood attitude.'"

"Little sleep, no investment portfolio, no family around, no hot water. On an evening a few days after arriving in Cange, I wondered aloud what compensation he got for these various hardships. He told me, 'If you're making sacrifices, unless you're automatically following some rule, it stands to reason that you're trying to lessen some psychic discomfort. So, for example, if I took steps to be a doctor for those who don't have medical care, it could be regarded as a sacrifice, but it could also be regarded as a way to deal with ambivalence. I feel ambivalent about selling my services in a world where some can't buy them. You can feel ambivalent about that, because you should feel ambivalent. Comma.' This was for me one of the first of many encounters with Farmer's use of the word comma, placed at the end of a sentence. It stood for the word that woudl follow the comma, which was asshole. I understood he wasn't calling me one--he would never do that; he was almost invariably courteous. Comma was always directed at third parties, at those who felt comfortable with the current distribution of money and medicine in the world. And the implication, of course, was that you weren't one of those. Were you?"

"I remarked on his sleepless nights, his hundred-hour weeks, his incessant travel, as he hobbled along. He said, 'The problem is, if I don't work this hard, someone will die who doesn't have to. That sounds megalomaniacal. I wouldn't have said that to you before I'd taken you to Haiti and you had seen that it was manifestly true.'"