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3 April 2012

Paul Farmer’s executive priviledge & the peculiar nature of “a calling”

Awhile back I read Tracy Kidder’s excellent Mountains Beyond Mountains, an inspiring portrait of physician Paul Farmer’s work in the area of public health, specifically the pioneering work he’s done in Haiti. FYI, I was not inspired to read it by the Arcade Fire‘s charitable giving to the cause, though it’s easy to see, in this book, why they, in turn, were inspired to give so generously of their time, resources and fan attention.

This particularly beautiful passage gives an account of what it’s like to have what they call “a calling” to be driven by that peculiarly human kind of passion, in all of its illogic. When one has “a calling” how it is is, often, just how it has to be. And don’t let my use of the word “beautiful” give you the wrong ideas. The passage is actually rather dry, delivered in the matter-of-fact manner in which, I imagine, Dr. Farmer works & thinks. The beauty is in a person hovering above the mundane efficiencies of 20th century management thinking, who knows that the way to get things done is, sometimes, to just move inexorably toward a goal with a force & intensity that others are simply incapable of maintaining.

    [The former dean of the Harvard School of Public Health, Howard] Hiatt seemed to say, [Paul Farmer] should be solely engaged in the battle against those scourges, and at a level commensurate with their size. “The six months a year that Paul’s looking after patients one-on-one in Haiti, if that time were converted to a major program for treating prisoners with TB in Russia and other eastern European countries, or malaria around the world, or AIDS in southern Africa–it doesn’t matter where or what because you know he’ll do important things. Because look at what he’s done with only part of his time on MDR. Look what he’s done with his skills and his political acumen! I have been urging him to take the role of consultant in Haiti and spend most of his time on worldwide projects.”

    Farmer was forty now, and he had the credentials to operate in the way Hiatt envisioned, on a purely executive level. In academic circles his reputation had grown. He was about to become a tenured Harvard professor. He was near the head of the line for the big prizes in medical anthropology; some of his peers were now saying that he’d “redefined” the field. As for his standing in clinical medicine, he’d become one of the doctors whom medical schools, in Europe as well as in the United States, invite to their campuses to deliver the lectures known as grand rounds. At the Brigham the surgeons had recently asked that he lecture to them, a signal honor not often granted to a mere medical doctor. He also sat on a number of councils in international health, and he’d made his views heard. But he didn’t seem disposed to abandon any side of his work, including seeing patients one-on-one in Haiti.

    It wasn’t as though Farmer didn’t want to do all he could to cure the world of poverty and disease. He just had his own ideas on how to go about it. Actually, he seemed to be the only person who understood the plan fully. A young assistant of his once said to him, in exasperation, that he had no priorities. That wasn’t true, he replied. Patients came first, prisoners second, and students third. But you could see how the assistant might have felt lost in the details.

…and, for once, that’s all I have to say about that.

Posted by Alec Hanley Bemis  

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