More than once in Mountains Beyond Mountains, people refer to Paul Farmer as a “saint.” Although Farmer always denies such a label, saying that he’d have to work much harder to become one, Tracy Kidder makes it clear that Farmer works harder (and comes closer to embodying sainthood) than anyone Kidder has ever met. Farmer barely sleeps, travels constantly to attend to his patients in Haiti, Russia, and Peru, gives hours of his time to advising other doctors on the best treatments, and, in spite of his immense prestige and lucrative fellowships, lives in a tiny apartment. Whether or not Farmer qualifies as a saint, his selflessness and generosity are worth considering more closely. Where did these qualities come from, and what does Farmer’s example—an example that’s almost impossible to follow—tell us about ourselves?
Whether Farmer intends it or not, his selfless devotion to other people often makes his friends and colleagues guiltily question their own lives and choices. This is especially clear when Kidder meets Farmer: Kidder is amazed by Farmer’s hard work and love for medicine, but he’s equally upset by his own inaction, which, relative to Farmer, looks like pure laziness. This sense of guilt is even more apparent in Ophelia Dahl, Farmer’s long-time friend and former lover. After many years of loving Farmer, Ophelia decided that she couldn’t live up to his lofty standards of right and wrong: she couldn’t entirely sacrifice her own happiness and wellbeing for others’ sake. Ophelia became so exasperated with Farmer’s saintliness that she’d secretly cheer whenever Farmer showed any negative affect or emotion, such as anger, fear, or frustration. Ultimately, Farmer’s life is something of a paradox. Although his good deeds have inspired thousands of doctors to follow his example and devote themselves to charity and nonprofit work, the handful of people who know him very well—Ophelia and, arguably, Kidder—find his example maddening as well as inspiring. As Ophelia admits, Farmer’s saintliness reminds her of her own selfishness and close-mindedness—in other words, he’s a deterrent to good deeds, as well as an inspiration for them.
Mountains Beyond Mountains also shows the limitations of a life spent traveling from country to country, curing disease. Farmer can be angry or stubborn at times, and more importantly, he neglects his wife, Didi, and his child, Catherine. As he willingly admits, he values the lives of his patients, most of whom are extremely poor, much more highly than those of his loved ones, whose cares and problems simply aren’t as important. Kidder suggests that Farmer’s unorthodox behavior may be the result of his own experiences as a child: Farmer’s father refused to show any love for him for fear that Farmer would become arrogant. Farmer is afraid of playing favorites with his own loved ones, just as his father was. As a result, he overcompensates by almost never seeing his own family. In this way, Farmer’s saintly life comes at a high cost. He embodies a form of love and compassion that few human beings could hope to imitate—and yet he’s uncomfortable with the one form of love and compassion that most humans do exemplify: love for one’s family.
Ultimately, Kidder doesn’t doubt that Farmer is a very, very good person, but Kidder never gives in to the temptation to canonize Farmer. Instead, he grapples with the definition of saintliness, and challenges Farmer’s neglect for his family even as he praises his life-saving work around the globe. The goal isn’t merely to lionize Farmer, but rather to show him in his subtle weaknesses as well as his enormous strengths. In this way, readers can decide for themselves which aspects of Farmer’s life to imitate and which to avoid.
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Saintliness Quotes in Mountains Beyond Mountains
The world is full of miserable places. One way of living comfortably is not to think about them or, when you do, to send money.
As Farmer was leaving the shelter, he heard Joe say to another resident, just loudly enough to make Farmer wonder if Joe meant for him to overhear, “That guy’s a fuckin’ saint.”
He made about $125,000 a year from Harvard and the Brigham, but he never saw his paychecks or the honoraria or royalties, both fairly small sums, that he received for his lectures and writings. The bookkeeper at PIH headquarters cashed the checks, paid his bills—and his mother’s mortgage—and put whatever was left in the treasury. One day in 1999, Farmer tried to use his credit card and was told he’d reached his limit.
By then Farmer had quit his fraternity. He wrote them that he couldn’t belong to an all-white organization. (“I received quite a frosty reply,” he would say, in a tone of voice that implied this still surprised him.) He’d come to admire his father’s distaste for putting on airs.
For a long time I thought I could live and work in Haiti, carving out a life with you, but now I understand that I can’t. And that’s simply not compatible with your life—the life you once told me you would like to lead even ten years ago.
He was already attracted to liberation theology. “A powerful rebuke to the hiding away of poverty,” he called it. “A rebuke that transcends scholarly analysis.” In Haiti, the essence of the doctrine came alive for him. Almost all the peasants he was meeting shared a belief that seemed like a distillation of liberation theology: “Everybody else hates us,” they’d tell him, “but God loves the poor more. And our cause is just.”
On the way back they laughed about the incident, and yet of all the times she’d eaten things that she could hardly bear to look at, this one occasion when she failed the test stood out for her.
One time when they were together in Boston, White said, “You know, Paul, sometimes I’d like to chuck it all and work as a missionary with you in Haiti.” Farmer thought for a while, then said, “In your particular case, that would be a sin.”
The motion of his mind toward root causes had always excited him. He loved the challenge of diagnosis and all its accoutrements—the stains on the microscopic slides, the beautiful morphologies of the creatures under the lens. But what he called “the eureka moment” had a bad aftertaste this time. Later he would tell me, “God, I’d hate to ever feel triumphant about something so rotten.”
Farmer and Kim began collecting a number of official WHO statements. Some put the case more plainly: “In developing countries, people with multidrug-resistant tuberculosis usually die, because effective treatment is often impossible in poor countries.” For Farmer […] there was a larger principle involved. A TB epidemic, laced with MDR, had visited New York City in the late 1980s; it had been centered in prisons, homeless shelters, and public hospitals. When all the costs were totaled, various American agencies had spent about a billion dollars stanching the outbreak. Meanwhile, here in Peru, where the government made debt payments of more than a billion dollars every year to American banks and international lending institutions, experts in international TB control had deemed MDR too expensive to treat.
He distrusted all ideologies, including his own, at least a little. “It’s an ology, after all,” he had written to me about liberation theology. “And all ologies fail us at some point. At a point, I suspect, not very far from where the Haitian poor live out their dangerous lives.” Where might it fail? He told me, “If one pushes this ology to its logical conclusion, then God is to be found in the struggle against injustice.
It still seemed to me that he took a stance all too conveniently impregnable. He embodied a preferential option for the poor. Therefore, any criticism of him amounted to an assault on the already downtrodden people he served. But I knew by now he wasn’t simply posing. I felt something about him that I’d later frame to myself this way: He said patients came first, prisoners second, and students third, but this didn’t leave out much of humanity. Every sick person seemed to be a potential patient of Farmer’s and every healthy person a potential student. In his mind, he was fighting all poverty all the time, an endeavor full of difficulties and inevitable failures.
“Well, this boy is a challenge. But I’ve cured sicker kids.” Serena laughed nervously. She said, “Well, now he’s in Man’s Greatest Hospital.” That was what Mass General people called the place, playing on its initials, MGH. Dr. Ezekowitz chuckled. “As soon as we start to believe that, we won’t be.” He turned to the young intern. “Isn’t that right? We can always do better, can’t we.”
