Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World

Tracy Kidder is a winner of the Pulitzer Prize and the author of the bestsellers The Soul of a New Machine, House, Among Schoolchildren, and Home Town. He has been described by the Baltimore Sun as the “master of the non-fiction narrative.” This powerful and inspiring new book shows how one person can make a difference, as Kidder tells the true story of a gifted man who is in love with the world and has set out to do all he can to cure it.

At the center of Mountains Beyond Mountains stands Paul Farmer. Doctor, Harvard professor, renowned infectious-disease specialist, anthropologist, the recipient of a MacArthur “genius” grant, world-class Robin Hood, Farmer was brought up in a bus and on a boat, and in medical school found his life’s calling: to diagnose and cure infectious diseases and to bring the lifesaving tools of modern medicine to those who need them most. This magnificent book shows how radical change can be fostered in situations that seem insurmountable, and it also shows how a meaningful life can be created, as Farmer—brilliant, charismatic, charming, both a leader in international health and a doctor who finds time to make house calls in Boston and the mountains of Haiti—blasts through convention to get results.

Mountains Beyond Mountains takes us from Harvard to Haiti, Peru, Cuba, and Russia as Farmer changes minds and practices through his dedication to the philosophy that "the only real nation is humanity" - a philosophy that is embodied in the small public charity he founded, Partners In Health. He enlists the help of the Gates Foundation, George Soros, the U.N.’s World Health Organization, and others in his quest to cure the world. At the heart of this book is the example of a life based on hope, and on an understanding of the truth of the Haitian proverb “Beyond mountains there are mountains”: as you solve one problem, another problem presents itself, and so you go on and try to solve that one too.

“Mountains Beyond Mountains unfolds with the force of a gathering revelation,” says Annie Dillard, and Jonathan Harr says, “[Farmer] wants to change the world. Certainly this luminous and powerful book will change the way you see it.”

From the Hardcover edition.

Customer Reviews:

The story of a modern American medical hero
This is an inspiring book about a true hero of humanity , Dr. Paul Farmer. The journalist Tracy Kidder tells the story of Farmer's work in treating the poor people of Haiti, and in trying to provide for them a system of decent medical care. Just an account of one day of Farmer's treatment of so many different kinds of illness indicates the degree of his dedication, medical skill and above all humanity. Farmer cares to help the suffering. He puts his life and fortune on the line dedicates his MacArthur Prize money, gives all his time to caring for the sick. He opposes the medical and aid establishments in what he regards as their mistaken approaches to proper care.
Kidder shows Farmer in action. Not simply is he an incredible doctor and humanitarian he is one person who may truly make a difference for a vast group of people in the world.
--2006-12-17

An unreasonable man who has changed the world
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.

--2006-12-16

A five star book about a ten star man
"Margaret Mead once said, Never underestimate the ability of a small group of committed individuals to change the world," states Jim Kim during a speech in Tracy Kidder's Pulitzer-Prize winning book, Mountains Beyond Mountains. The subject of the book, Doctor Paul Farmer, is one of those individuals, as is Kim. Not only is Farmer a selfless, determined, persistent, smart, multilingual, and skilled doctor-anthropologist, he, along with others of similar character and skill, is determined to reduce the incidence of, improve the success of treatment of, and/or cure diseases like tuberculosis and AIDS, which disproportionately affect the poorest of the poor. Besides treating patients in a clinic in Cange, Haiti, he raises funds and sets treatment policy for his cause, notably helping fellow Partners in Health colleague Jim Kim create and implement an extremely successful treatment regime for victims of multi-drug resistant tuberculosis in Peru. Similarly, he helped acquire additional funding to treat prisoners in Russia, whose incidence of tuberculosis is "forty to fifty times higher" than in the civilian population. Farmer is a self-professed "action kind of guy" who says he has "faith" [in the standard sense of the word] as well as "faith in penicillin...clinical trials, scientific progress, that HIV is the cause of every case of AIDS, that the rich oppress the poor, that wealth is flowing in the wrong direction, that this will cause more epidemics and kill millions." This story of his disease busting crusade is a lesson to us all that "changing the world" is possible and provides examples of folks who do so every day.

--2006-12-11

A must-read for ANYONE struggling to figure out how they can help make a change in the world
I've read several of the most recent reader reviews and thought I'd add my perspective. This book was introduced to me by my wife who works for the University of Washington and was part of the "Common Book" program for incoming freshmen this acedemic year. As a result I had the opportunity to see "DPF" (meaning, "Doctor Paul Farmer", as was shouted as his designated moniker with on of the FIGs or Freshmen Intersest Group [I believe] at the engagement) speak to the incoming freshmen at U of W a few weeks ago. It was truly a privilege. What was most striking about his presentation was not just his incredible accomplishments and sense of what it takes to help the needy, but the electric energy in the air as a result of his mere presence! The rooms were filled with excited and engaged people of all ages, inside and outside the University system. His message was not solely of that of the destitute in third-world countries, but also in our own communities where there is still great inequity and a very real need. This book hightlights his accomplishments and devotion, evoking the spirit of the Margaret Mead quote, "Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has." Farmer is proof of this. This man is truly inspiring, and in times like these, a tremendous leader in a world in desperate need of them.
--2006-12-05

What on Earth are YOU here for?
What an amazing, remarkable book! This is more than simply the story of one intelligent doctor who has made huge strides in the treatment and prevention of infectious disease throughout the Third World. It's actually the story of Paul Farmer, a remarkable individual who was fortunate enough to identify and pursue his life's work from a very young age. Yes, he's a bit singleminded and even zealous, perhaps, in his pursuit of what he sees as the human rights of every individual -- clean water, sanitation and health. Yes, he's quick to condemn those who don't agree with him or who might somehow slow him down in his pursuit of what he clearly views as a moral quest.

But throughout the book, I found that what I felt overall was --- jealousy. I envied Paul Farmer his vision and his confidence and his maturity -- and the fact that he KNEW (as Rick Warren would say) "what he was put on this earth to do." That's what was so remarkable to me -- that as an undergraduate at Duke University (where according to Tom Wolfe's novels, most undergrads are busy with booze and broads, for the most part) he had already identifed a problem, a field of study, and a dream and a goal. When we hear about most American students in their twenties today, we picture them engaged in a period of extended adolescence, busily text messaging, updating their Ipods and paying too much attention to reality TV. In contrast, here was a guy in his early twenties who had already figured out how to bend the rules at Harvard Med School so that he could work on an M.D., a Ph.D. in anthropology while actually spending most of his time building a hospital in Haiti!

Personally, I"m hoping to assign this book to my son's church youth group at some point -- because Paul Farmer provides such an awesome example of how God uses people, how it's possible to have a "life's work" and how one's age or circumstances seem to matter little when you have a goal and a passion that size. But, as I said, I'm still jealous that I don't have one.
--2006-11-27

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