Mountains Beyond Mountains

Rating:
Summary: It will break your heart and give perspective along the way.
Review: "Beyond mountains there are mountains" is apparently a Haitian proverb. Tracy Kidder's book covers his travels observing Doctor Paul Farmer, who grew up poor on a boat and bus, only to attend Harvard and also develop a public health clinic in Haiti. Farmer's career becomes a lens for Kidder to view the world's medical crises among the poor with a major emphasis on TB. Tracy Kidder brings the magnitude of the crises among the worlds poor into brilliant focus by highlighting Farmers life and dedication and, or obsession to cure the world's poor. Farmer works by treating patient by patient and yet his methods and expertise come to impact programs in Peru, the Siberian prisons of modern Russia, Cuba and his beloved Haiti. The book is able to give an excellent medical and political overview of the gap between the health and wealth of elite and the barren poor. Because Farmer is so intense with each individual patient it allows Kidder to illustrate the crises and the world's reaction dramatically, through many individual patient's. In reading I found I was amazed, angry, hopeful and depressed. It all reminded me of the ant pushing the large pebble up hill only to have it roll back down and over him. At the end of the book Farmer seems to sum up this overwhelming challenge by saying his is life spent in service to the "long defeat". Yet, along the way there are many small victories and some amazing people who join in the effort. People such as Tom White who owns a heavy construction firm in Boston who has given almost his whole fortune away to support Farmer's work. This book is mandatory reading for anyone in politics, public service, or feels they are entitled to have one more tax cut.

Rating:
Summary: Mountains Beyond Mountains: Inadvertently Serves a Certain A
Review: "Mountains Beyond Mountains" is absorbing and Paul Farmer to be truly amazing. However, there is something quite troubling about this book. I hate to get racial about things (especially since Caucasians tend to tune out nowadays, when ever an African American does so, refusing to even listen to what's being said, as will be demonstrated, I predict, by the many who will push "No" at the bottom of this review to indicate that it wasn't helpful). But I think that, as a so-called race, Caucasians can read this book and pat themselves on the back for producing a Paul Farmer. Here's why I say this. Clearly, the book portrays Haiti as an extremely poor and oppressed place, where too many of those in power are extremely uncaring about the poor. So bad are conditions there, and so amazing is Paul Farmer that Caucasians can pat themselves on the back for producing someone like him, and, simultaneously let themselves off the hook for maintaining the type of society we have here in the U.S. because, at least in the U.S. the poor aren't faring nearly as badly as they are in Haiti. And look at who is making the biggest difference of all down there: not another Haitian; not another "black person" period, but "one of their own." The other thing that struck me about this book. Kidder is much older than Paul Farmer. Yet throughout the book, he displays an awe of Farmer. Here's why this interests me. I cannot imagine this same writer displaying a similar awe for an African American physician, no matter how talented that physician was. I may be wrong. But in my experience with the vast majority of Caucasians, rare is the African American they don't condescend to. Rare is the African American of any background, whom they don't expect to prove that he or she deserves even the basics of their respect, no matter what the African American's vocation (unless that vocation has something to do with athletics or entertainment). Yet at the same time, rare is the African American who, like Farmer, would be willing to turn conventional wisdom in a scientific field on its head, rather than conform to accepted notions in her or his field in order to prove that he or she deserves the respect of peers. This is why I have such mixed feelings about this book. I admire Farmer and am convinced of his sincerity of mission. But I am conflicted about how he is being used by a publishing and media environment eager to prove that the world would be lost without Caucasians of intelligence and good will.

Rating:
Summary: A Contrast Between What Should Be and What Is
Review: "Mountains Beyond Mountains" is no exception to Tracy Kidder's excellent body of work. I have been a fan since he wrote "Soul of a New Machine." Kidder impressed me then, as he does now, with his upfront investment of time before putting pen to paper. Fortunately for us, his hard work translates to first class storytelling.

The title "Mountains Beyond Mountains" is a metaphor for life - once you have scaled one mountain (challenge), there are more to come. This is especially true for Paul Farmer, MD, who has devoted his life to what most people call "the impossible." He has faced mountain after mountain in his quest to help mankind.

Farmer starts out devoting his life to providing the most rudimentary medical care to impoverished Haitians (the shafted of the shafted). By age 27, he had treated more illnesses than most doctors would see in a lifetime. With time, he finds himself on the world stage trying to find a cure for drug resistant tuberculosis, undertaking the difficult role of a global fundraiser, and fighting big pharma for lower drug prices. He is a modern day medical hero.

For me, Farmer serves as a startling contrast to Robert K. Maloney, MD, the well known Los Angeles ophthalmologist who has been featured on TV's "Extreme Make-over." Maloney, who was profiled October 26, 2004 in the Wall Street Journal, said that after he completed his medical training, he came to a disquieting conclusion: "I really didn't like sick people." Maloney has since specialized in LASIK refractive surgery (considered cosmetic surgery) and pampers his patients with 25 person staff, and a suit-and-tie concierge who serves pastries and coffee in the waiting room. He then follows up after his patients return home with a gift box of gourmet chocolate chip cookies and a mug bearing the invitation, "Wake up and smell the coffee." He says he now earns more than the $1.2 million in salary and bonuses he made during his last year at UCLA (several years ago), but he won't say how much.

Farmer serves as reminder of what medicine aspired to be - the buck as only a means to an end....ending poverty, ending tuberculosis, ending the plight of many humans who cannot receive treatment from a qualified and trained doctor. Dr. Maloney serves as a reminder of what medicine has become - the buck and celebrity as ends. We should all get one of Maloney's mugs so we, too, can "Wake up and smell the coffee" ...before it is too late.

Read "Mountains Beyond Mountains," if only to regain hope of what medicine can be.



Rating:
Summary: A relentless man of action
Review: "People call me a saint and I think, I have to work harder. Because a saint would be a great thing to be." This quote recurred in my mind often while reading Pulitzer winner ("The Soul of a New Machine") Kidder's profile of Dr. Paul Farmer, an amazing man "who would cure the world."

Now in paperback, this is a harrowing, heart-wrenching, heroic story of Haiti as well as the man who knew at age 23, before entering Harvard Medical School, that he had found his life's work there. The portrayal of Haiti's poverty is staggering. It's so all encompassing and deeply rooted that many idealists return home defeated and burned out.

Farmer, however, rejects the existing inadequate, bureaucracy-ridden clinics, and establishes his own public health system/clinic/hospital in a remote, mountainous area. Poverty there has been intensified by US aid, in the form of a dam, which deprived subsistence farmers of their land to benefit US-owned agribusiness downstream.

The product of an unconventional childhood, spent in a camper bus and a houseboat, Farmer is brilliant and tireless. He passed his medical school years mostly in Haiti and still graduated near the top of his class. During home intervals he was, and is, relentless about raising money. He shows little patience for "WLs," white liberals, who shy from personal sacrifice. He doesn't hesitate to impose his views. Wealth amid so much world poverty is absolute anathema to him. He inspires and intimidates. Close friends often feel inadequate, sometimes resentful and guilty. He's also sunny-natured, highly emotional and charismatic. The combination often seems to overwhelm people, including Kidder.

Kidder chronicles the building of Haiti's Zanmi Lasante (Partners in Health) from its inception to its position as Farmer's home base, the place where he still practices hands-on medicine between worldwide jaunts promoting TB and AIDs policies and raising money. Kidder travels with him, to Cuba, Russia, Venezuela, and the reader can only marvel at the man's capacity for work and personal engagement and be glad there are such people in the world.

Rating:
Summary: 3 stars
Review: As a public health professional who has followed the work of Partners In Health and read much of Paul Farmer's work, I assumed that Mountains Beyond Mountains would be an interesting read, offering new insight about Farmer himself. While the book did offer a new look at Dr. Farmer, I was dissapointed with the character depicted. While I do not know if Kidder's characterization of Farmer is accurate, it is a depiction that left a poor taste in my mouth about a man that I previously admired. In Mountains Beyond Mountains, Farmer comes across as arrogant, self interested, and suffering from a God complex. The book reads like another tribute to an ego that already suffers from too much stroking.
Farmer's work does not lose its importance nor does his public health approach become less credible if this portrayal is accurate. However, it does lessen my interest and admiration in the man behind Partners In Health.
Substantively, the book covers much of what those who have read Pathologies in Power, The Uses of Haiti and any of Farmer's academic pieces has already learned so much of the book is redundant. 3 stars.

Rating:
Summary: A Brilliant Book
Review: As a sociologist, this book has impacted me very deeply. It contains none of the romance that many books about "saving the world" contain. Paul Farmer has taken a compassionate, yet realistic approach to the problems of the poor. His unflappable nature is inspiring and his work has yielded actual results which will hopefully serve as a model for what can be done. Kidder successfully captured the reality in helping the poor.

Rating:
Summary: Great read but lags outside of Boston-Haiti axis
Review: As usual, Tracy Kidder has done a marvelous job capturing the spirit and complexity of a superhuman effort. Think of Tom West - Kidder's protagonist in the groundbreaking 'Soul of a New Machine - times about 20 & spread out over a lifetime, and you start to get a feel for Dr. Paul Farmer, 'the man who would heal the world.' Kidder crosses paths with Farmer and is drawn into the world of the doctor's Haitian/Bostonian organization 'Partners in Health,' a.k.a. 'Zanmi Lasante' in Creole.

Kidder has done Farmer justice by painting a warts-and-all portrait. He's not presented here as a saint, but instead as a complex being, not always easy to like, trying to all that come into contact with him (especially those that try to organize his personal life - travel, finances, etc.), but - in the end - a good soul who is a force (almost superhuman) for good in the world.

Kidder's work is strong when it focues on Farmer and his cohorts and their efforts along the "Boston - Haiti axis." Indeed, the contrast between the two environments makes for one of the most compelling aspects of the book. I feel a little sheepish giving such a great work by Kidder anything less than 5 stars, but I really feel like the book loses focus and steam when it ventures outside of those two main locales. [Kidder also travels with Farmer and/or fellow 'PIH-ers' to Paris, Russia (separate trips to Moscow and Siberia), and Peru.]

Above all, though, 'Mountains' is an important and forceful book about just how possible it is for one person to make a difference in the world.

Rating:
Summary: Beyond Proselytizing
Review: Countless historians, theologians, English professors, and critics over the years have agreed that in any form of story - be it fiction or non-fiction - there are certain recognizable moments that make the best of them similar. The hero, for example; all stories have a hero. And some sort of villain: often more difficult to pin-point, the villain can be an opponent, an organization, or an idea... anything really. Most good stories set up this hero/villain opposition in a dramatic way that increase the tension over time, and maximize the payoff of victory (or failure) by the end. In fiction, this is easier to do, as the story itself is within the author's control. In non-fiction, one must remain true to the source material. If the story is long and drawn out in reality, it will be difficult to make it seem not long and drawn out in a book. This appears to be the case with Mountains Beyond Mountains, though matters aren't helped by Tracy Kidder's flat boring prose or his apparent inability to focus on those things that are interesting to readers for the sake of those things that are a part of his and subject Paul Farmer's overwhelmingly biased agenda.

The hero: Paul Farmer, the villain: TB, the setting: Haiti and other, the message: if you haven't given all your money away, you're bad. Paul Farmer doctor extraordinaire is the subject of what can't truly be called a biography, as he is never truly revealed to the reader. The facts include his education at Harvard and his work in Haiti, Russia, Cuba (and other) to combat TB. Parts of this story are fascinating. The economic climate of Haiti is stunning to anyone who may not previously know how dire its situation is and has been. The struggles people have gone through to contain something like TB (which most think is pretty 'tame' here in the states) are monumental. Tame in the U.S. isn't necessarily tame in a country with 70 percent unemployment and zero medical care. The development and discovery of MDR TB (Multi-Drug-Resistant TB) and its following treatment is of global interest and importance, but here its just another subplot. Farmer is never human, the author's voice is to over-bearing, the story never fixed upon. A potentially interesting narrative packed with not enough good hard facts sinks in the telling. When compared with other works of non-fiction, the information isn't revelatory enough and the story isn't engaging enough for it to be recommended.

Rating:
Summary: Is that all there is?
Review: Dr. Farmer grew up to be just like his father--he needs to be wanted, needs to dominate, and needs to be on the edge. He is the type of character who will win all kinds of humanitarian awards, but you wouldn't want to be his son. Of the 3 Kidder books I have read, this is my least favorite and a let down.
Farmer is the type of person who gives fish to the poor so he can be appreciated and they will become dependent on him vs. teaching them how to fish so they can improve their lot in life. Of course there is a conspiracy behind everything to keep certain people poor. For example, a hydroelectric dam was built in Haiti to take away farmland from the poor rather than to provide clean, cheap electricity. He despises corporate types,but in the end reminds me of a workaholic corporate excecutive who is shallow and one-dimentional. He sees his wife and daughter for one night as he stops off on a flight from Haiti to Russia. I vision him in the end in a hotel room somewhere with a bullet through his head. The suicide note will
read--"Is that all there is?".

Rating:
Summary: A Dare for You
Review: First I want to thank all the reviewers ahead of me, who got it right and made me want to buy it and read it.

Then I want to challenge you. I dare you to read this book. If it doesn't make you weep and curse, then you aren't much good.

I take issue, though, with the reviewers who criticized religion as part of the solution to the horror of it all. Two thousand years ago, people still believed in magic. There were no hospitals. Slavery abounded and was taken for granted. Women had no rights. Children were merely possessions and illness was considered punishment or the work of demons.

Dr. Paul Farmer, M.D., and others like him who are changing this world view are the heirs of belief in God, a God who prefers the poor and with good reason, as this book will show you.

Go ahead and read it. I dare you.