Mountains beyond mountains

In Mountains Beyond Mountains (<a href="http://www.tracykidder.com/books/mountains/">http://www.tracykidder.com/books/mountains/</a><a href="http://www.tracykidder.com/books/mountains/">), </a>Tracy Kidder chronicles the journey of Dr. Paul Farmer, a man who “would cure the world.” Farmer's quest to change lives for the better, through the implementation of medicine in impoverished places, is mirrored by Kidder's own quest to understand the enigma that is Farmer. With a multidimensional character, Farmer eludes and captivates in his own humble way, and Kidder captures that in an epic profile of a man intent on serving justice to the world.

Kidder met Farmer by accident, at a beheading in Haiti in 1994. Kidder was there to report on American soldiers and their political endeavors in the country, and witnessed an exchange between Farmer and an American captain – one that left him viewing Farmer as a cocky self-assumed champion of human rights. Five years later, in Boston, they met again – at Kidder's request – and soon Kidder was jetting off to Haiti to witness the life and journey of Dr. Paul Farmer.

As Kidder follows Farmer around the globe, from Haiti – Farmer's beloved hub – to Cuba to Peru to Russia, he learns bit by bit what makes Farmer tick. Intelligent and skilled enough to make a wealthy living as a doctor in a renowned hospital, young Farmer instead chose to reside in the underbelly of poverty, curing the homely and sick. This is curious enough to peak the interest of both Kidder and the reader: and while Kidder embarked on a long journey to finally understand why, he reports back with a full account for the reader.

The primary theme in this novel is injustice. As a moral crusader against any injustice, Farmer utilizes his Harvard medical degree to materialize his idea of how the world should turn. He is stubborn, brash, and tireless, a constantly-moving powerhouse who sweeps in, drops rays of hope into dark and dismal hearts, and moves on again.

Though passionate about his vision to bring much-needed medical aid to places such as Haiti, Farmer is no stranger to the bureacracy of the global healthcare economics. He tirelessly campaigns against the hypocrisy of the World Health Organization (<a href="http://www.who.int/en/">http://www.who.int/en/</a> ), is consistently annoyed by the bloated disparities in healthcare fund allocations, and never takes a back seat where he can stand up front: a realistic idealist.

In all his accounts of personal encounters, lengthy dialogues, and Farmer's commentary to him on his own doings, Kidder slowly paints a picture of Farmer that materializes increasingly with each chapter. While he understands Farmer's passion for helping, he doesn't understand the various contradictions Farmer exhibits about himself: he purposely makes his life's direction to help others, but seems to believe that his life is not his own. He sees himself as merely a tool – moving not unwillingly, but perhaps involuntarily, as a beacon of medical assistance, comfort, and hope in the impoverished nations of the world, maintaining that he essentially has no choice; rather, it is his duty.

“If you do the right thing well, you avoid futility,” he says. (p. 295)

With his go-getter, do-good mantra, one could easily argue that Farmer is a modern, rough-around-the-edges Jesus Christ.

“I'm not truly humble. I'm trying to be humble.” (p. 288)

And yet he is not Jesus. He is not perfect, not sinless, and certainly not without his faults. In his quest to change the world, he neglects his own wife and child...and even himself. The key is that he understands that himself: “All the great religious traditions of the world say, love thy neighbor as thyself. My answer is, I'm sorry, I can't, but I'm going to keep on trying...” (p. 213)

Embedded in his idea of charity is the value of the individual – another underlying theme that permeates the novel. Farmer often travels long distances simply to see a single patient, embodying his idea that it is not enough to help the masses – one must start with the individual first. One saved soul is worth thousands in hindsight, a perspective reflected in Christian roots – and yet completely ignored in cost-benefits analysis (<a href="http://www.significancemagazine.org/details/webexclusive/1100611/Healthcare-research-the-end-of-cost-benefit-analysis.html">http://www.significancemagazine.org/details/webexclusive/1100611/Healthcare-research-the-end-of-cost-benefit-analysis.html</a> ), on which the major healthcare conglomerates all operate.

This is perhaps Farmer's biggest crusade: with a help-every-man attitude, he resents the politics of cost-benefits analysis. Large companies see impoverished countries and high rates of disease, infections, and inflictions. They see numbers, and pit them against the cost of curing each number...which often add up to an outrageous and unprofitable sum. Farmer, on the other hand, scowls at their logic, insisting that there is no other way to alleviate the suffering without taking a blow to the resources we do have. Illness and disease will not disappear, and it will take setbacks – often in funds – to cure them at first, but in the long run it will balance out.

“If you're making sacrifices...you're trying to lessen some psychic discomfort,” he says. (pg. 24)

And Farmer runs with that notion. In addition to his own towering mountain of undertakings, he supplements them with educational crusades, informing people and organizations everywhere he goes of the conditions in Haiti. Education is power, and power is fuel to “walk the walk.”

Such is the basis of Farmer's Partners In Health, (<a href="http://www.pih.org/">http://www.pih.org/</a> ), an organization he founded with his friend Ophelia Dahl, which campaigns on behalf of the ill and utilizes all available resources to provide healthcare for them as passionately as if the individual were one's own sibling.

This is but one of the complex dyads Kidder brings to light about Farmer: he talks the talk and walks the walk. And so deep is Farmer's character, that Kidder takes up to the last page to comprehend it fully. While he accompanies Farmer on his medical missions, converses with his girlfriend, partner, wife, mother, and those whom he aids, they are all just as flummoxed by his personality as Kidder is – at first. Farmer is not someone who is definable in one word, one sentence, or even by spending one day with him. He is a mystery, a deeply intriguing spirit that breaks the mold of normality so fiercely, even an observant and intuitive journalist must dig to get to his core.

Yet, this is what Kidder does purposely. As with any journalist, he selects the passages to tell. He had the freedom to portray Farmer as a saint, as Jesus. He had the freedom to portray him as a crazy, unstable man with an unrealistic goal. Yet he writes both sides, the truth, the reality, and the events, so the reader can observe and mold the two halves together to create one hybrid.

Perhaps this is reflected in the title of the book, which itself is the main underlying theme, the crux of all Farmer tries to do and how he does it. Though an old Haitian saying, which could suggest a practical use of theology since Farmer works extensively in Haiti, “mountains beyond mountains” embodies various viewpoints: obstacles lie beyond obstacles, or opportunity lies beyond more opportunity, and massive understanding at once is followed by a valley of confusion, followed by another bout of understanding. Kidder says himself on his Web site (<a href="http://www.tracykidder.com/books/mountains/behind.php">http://www.tracykidder.com/books/mountains/behind.php</a> ), “Those two meanings aren't inconsistent, and I meant to imply both in the title.” The title leaves much to the imagination, another clever integration of Kidder's profile.

Having spent months on end with Farmer, Kidder journeyed through the path of discovery blindly, not knowing what he would learn next, where he would fly next, or what would come out of Farmer's mouth next. His experience was much like reading a book – and thus, he recreated that in his book so the reader would journey the same way.

Writing in first person, Kidder provides an “everyman” perspective to a deeply complex character, allowing the reader a crutch on which to establish footing and understanding. He reflects the reader's curiosity, confusion, and even times of overwhelmed emotion, while still serving as a springboard for further insight. In writing his novel, Kidder undoubtedly rediscovered some functions of Farmer's character, and it is quite possible he even discovered new dynamics he never witnessed or understood before – a phenomenon reflected in the reader's experience.

Kidder writes on his Web site that he learned “two things above all” in his time with Farmer. One can see the world through new eyes, perhaps magnifying the injustice and cruelty usually hidden in the shadows, when looking at medicine and healthcare. And then when a “small group of determined people” storms in and addresses those concerns, we can see an ever-changing landscape of injustice turned to help, and despair turned to optimism. Farmer resembles that notion, spearheading a movement to transform a black-inked canvas to a vividly watercolored landscape.

We don't understand Farmer at all in the first chapters: we merely see a man who loves to help, wants to transform the world, and who goes to extraordinary lengths to do so. He is a fascinating curiosity, a confusing and perplexing contradiction of himself, and a sometimes frustrating enigma. But by and large, with exposure to his various adventures in various countries; his encounters with health “experts” and organizations; his own words revealing his thoughts about healthcare, the politics surrounding it, and the human spirit itself; and the reflections of his loved ones, Kidder presents a finished portrait of a man who, in the end, stands humbly in front of the reader. It's up to the reader to open his or her eyes to see it.

For a compelling journey through the underbelly of poverty, the war on health, and an extraordinary man's dynamic approach to both, pick up a copy of Tracy Kidder's Mountains Beyond Mountains.