Sunday, July 13, 2008


Tracy Kidder and Paul Farmer
For the past month, driving on the road and in town, I've been listening to the CD version of Tracy Kidder's Mountains Beyond Mountains. It's an extended profile of the incredible Paul Farmer, a Harvard M.D. who specializes in infectious diseases and has made a career out of combatting MDR (Multiple-Drug Resistant) TB and AIDS, problems that often co-exist, especially in the developing world. He spends much of his time at a clinic he founded on Haiti's central plateau, but Partners in Health (PIH), the organization he helped start up, has outposts in Peru, Siberia, Rwanda and other locations. Farmer's background in anthropology (an undergrad degree from Duke) and his abiding interest in the cultural roots of medical issues gives him a unique perspective on some of the world's most intractable health problems. It helps too that he has seemingly unlimited energy and a mind like a steel trap. It's hard to overstate the impact his ideas and practices have had on the world health scene. For the book, Kidder follows his usual modus operandi, shadowing his subject and engaging in what is often called "immersion research." This includes flying all over the world with Farmer, observing him in action in almost every conceivable venue, which takes in a lot; Farmer is in great demand as a consultant and speaker.
I've read every book Kidder has written since his Pulitzer Prize-winning Soul of a New Machine (1981), a fascinating account of the seemingly boring process of building a new computer. My favorite is House (1985), a detailed account of the contruction of a house in Massachusetts, with an emphasis on the builders, the owners, and the architect. Kidder's work, like that of John McPhee, suggests that nearly anything can be made interesting when it's given painstaking and creative attention. In the case of Mountains Beyond Mountains he was dealing with an inherently interesting subject, the amazing Paul Farmer, as well as others in his circle like Ophelia Dahl and Jim Yong Kim.
One difference between this and Kidder's previous journalsm is the author's stance. Kidder makes himself a character, something he avoided in previous books, so that we are aware of his struggle to keep up with the tireless Farmer as he treks up a mountain to visit a patient. Kidder followed this 2003 book with a memoir, My Detachment, an account of his service in Vietnam--and there too he obviously revealed much of himself. According to this recent interview, Kidder is still in touch with Farmer and is pleased that his book has played a role in publicizing the doctor's work.

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