HW 23- Illness and Dying Book Part 2

Tracy Kidder, Mountains Beyond Mountains

Random House, 2004

Precis on chapters 12-14:

As Paul continued to make his trips between Boston and Cange, military rule was growing rapidly and Paul's girlfriend Ophelia became worried. Paul had become somewhat reckless, being rude to soldiers and smuggling thousands of dollars towards pacifist movements. It took the circumstance of gunpoint for Farmer to finally give in to the immense sacrifice (according to him of course) of saying "long live the Haitian army." After receiving a MacArthur grant in 1993, Paul retreated to Quebec to write his to-be successful and controversial book, "The Uses of Haiti" where he questioned the credibility of 'heroes' such as Woodrow Wilson and Mother Teresa. Finally, Farmer was formally banished from returning to Haiti (even bribery could not undo this) until October of 1994 when Aristide was reinstated. Paul returned to a different Haiti this time however, one that had been ravaged and virtually broken to shambles after the rule of the junta. Partners in Health had done quite the opposite, and only strengthened during this time. After obtaining a permanent HQ in Cambridge, it was now time for Paul to stretch his revolutionary arm to a new location.

Paul takes this new time to reflect on perhaps his biggest opponent: MDR, Multi-Drug Resistant TB. TB was one of the most common diseases Paul treated in Haiti, but MDR did not appear on the radar until the rule of the junta. Paul comes to realize that poverty is diseases' greatest boon, but super diseases such as MDR do not often appear in universally poor populations like in Haiti. This poverty creates a lack of basic human necessities: food, water, shelter that all help prevent deadly diseases. When a friend of Paul's falls victim to the frightening MDR in Peru, he takes this a sign as to where his efforts are needed most.

While still attending medical school, Paul had lived in the infamous Roxbury neighborhood of Boston. However, he was living in the hands of Father Jack, a priest who allowed Paul to stay at St. Mary of the Angels for the better part of his education. Long since after, Father Jack moved to the quaint slum of Carabayllo in Peru. Upon one of his visits back to Boston, Father Jack tells Paul that Carabayllo could use his help. Jim Kim, Paul's right hand man makes it clear that he wants to take charge of the Peru project and not long after helps to build a pharmacy next to Jack's church. Jim and Jack survey the medical scene in Carabayllo, and all seems fine until Father Jack becomes suddenly ill. He is diagnosed with TB, flown to Boston to be treated by Dokte Paul himself and treated with 4 of the 5 main TB drugs. Much to Paul's dread and dismay, Father Jack is of no saving and dies a month later. It turns out his friend had MDR, but not just any MDR, but a species impervious to all 5 TB drugs. Paul is broken.

BEST LINE (would post multiple gems but I found this particularly striking):

"Perhaps it is a universal tendency to view the deaths of strangers philosophically."- I found this quote to be very deep because in a sense I think we all disconnect ourselves from those who have died in order to view it in a strictly objective way. All the time we see people die on the news, and although these are strangers, we often take advantage of the news to widen our views on illness and dying. When a close family member becomes ill or dies, it becomes personal, not just to the sick or dead person, but it seems like the devil is out to screw you personally. We can't exactly take a step back to think about our loved ones' death in a philosophical way, whether it be because of pain or lack of memory (trauma often ends up as a blur in our memories).

Thoughts and Questions:

Up until now Paul seemed to me like a superhero. Maybe I was mislead but I felt like at the beginning of the book, if I was ever in danger, this guy was a definite trip to safety. Finally seeing one of his best friends die from a disease he could do nothing about was heartbreaking. Throughout these chapters one word has been ringing through my mind: bravery. The bravery Paul had to be so smug and disrespectful toward the junta, the bravery of Jim to lead PIH in Peru, the bravery of Father Jack to survey the sick people in his community. From the outcome of these events and my own personal experiences I know that bravery alone cannot save you, and in some cases, it's all about luck. Who's to say one day Paul wouldn't have run into a particularly pissed off soldier to find a cap in his head? What were the odds of neither Jim or Father Jack being in the pharmacy when it blew up? These are just thoughts that make me admire Paul and co. a lot more than I already did (which is pretty damn impressive!).