Study Guide

Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World

by Tracy Kidder

Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World Summary

Introduction

The title Mountains Beyond Mountains comes from a Haitian proverb and is a metaphor for life’s challenges. Once you have scaled one mountain, you reach a place where you can see that there are always more mountains farther away: you will never stop climbing, never be finished. In the case of Paul Farmer, whose visionary spirit is the subject of this book, his mountain is the struggle to provide medical help to all desperately poor people. In fact, the man Tracy Kidder writes about in this nonfiction account is something of a secular saint, for Paul Farmer really only comes alive when he is tending to the illnesses of people the rest of the world has forgotten.

During the years chronicled in the book, Farmer crosses the globe many times, from his origins in the American South to his medical training at Harvard University, but he focuses his attention on some of the world’s most struggling people: the prison population in Russia, the slum dwellers of Lima, Peru, and, most especially, the rural poor of Haiti, who have a particularly intense grasp on his heart.

Mountains Beyond Mountains tells Farmer’s story but less for its own sake than as a way to understand what led this man to dedicate his entire life to solving health crises that everyone else seems willing to let stand. The book is informative, but Kidder also writes it as a kind of challenge, a challenge that can be summed up in three lines: Helping the suffering poor is possible. Paul Farmer is doing it. Why aren’t you?

As readers follow Farmer’s treatment of developing ideas and practices of public health, his gentle interactions with rural Haitians, his development of a private charity, and his attempts to change international medical policies, that challenge will always be echoing through their minds.

Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World Summary

Part I: Dokte Paul

Part I: Dokte Paul
This section introduces Paul Farmer and explains how Tracy Kidder came to write his story. It opens with a dramatic line: “We met because of a beheading, of all things.” Kidder then dramatically recounts a clash between Farmer and Jon Carroll, a captain in the American Special Forces. Both men were in Haiti to save the country, but each in different ways. Carroll was one of 20,000 American soldiers who had come to Haiti to oversee the reinstitution of democracy (Kidder was there to report on this mission). Farmer was in Haiti to implement an ambitious public health program. The two men argued over how to pursue the beheading of a local assistant mayor. Everyone knew who had killed the...

(The entire section is 592 words.)

Part II: The Tin Roofs of Cange

Part II: The Tin Roofs of Cange
Kidder begins the next section with another revealing sentence: “It was impossible to spend any time with Farmer and not wonder how he happened to choose this life.” He follows this claim with an extended review of Farmer’s life. His father, Paul Sr., was an athletic and strong-minded but idiosyncratic man who led his family on a life of self-chosen adventure. Paul Sr. left a good job in Massachusetts to move his family to Alabama. Once there, he bought a bus and the family lived on it, moving from campground to campground without running water. Later, they lived for a time on a boat. Farmer’s parents encouraged them all to pursue their own interests, but Paul Sr. was...

(The entire section is 1018 words.)

Part III: Medicos Aventureros

Part III: Medicos Aventureros
While in medical school, Farmer had lived at St. Mary of the Angels. The priest there, Father Jack Roussin, had left Boston in the early 1990s to go work in Lima, Peru. He urged Farmer to establish a branch of Partners in Health there, which they did. However, while the pharmacy they built was helping the poor, Father Jack died of multidrug resistant (MDR) TB. In the industrialized world, TB was relatively easy to treat for a serious disease, but if treatment was interrupted, there was a strong chance that the surviving TB bacillus would become resistant to the drugs first used to treat them. This made the disease harder and more expensive to cure and more likely to kill the...

(The entire section is 448 words.)

Part IV: A Light Month for Travel

Part IV: A Light Month for Travel
The next section of the book uses descriptions of Paul Farmer in the act of travel and on site as a way to show how his work was developing, how the developments were putting Farmer under ever-greater tensions, and how his actions showcase the complex ideological context in which medicine occurs. Chapter 20 focuses on Farmer’s travels between the United States and Haiti, describing how he takes responsibility for all Haitian challenges (including, for example, flying or using an escalator for the first time), adapts his personal dress to Haitian demands (somewhat), and maintains an almost continuous stream of email correspondence with friends and colleagues around the...

(The entire section is 296 words.)

Part V: O for the P

Part V: O for the P
The fifth section of Mountains Beyond Mountains brings the narrative up to the present. It shows what happens when Farmer and Partners in Health move from being struggling rebels to becoming models for others’ actions; it also shows how much has changed since Farmer began his quest—and how much has not. Chapter 24 begins with a measure of Partners in Health’s success: the Gates Foundation donated $45 million to eradicate MDR TB in Peru. It is an enormous project, with plans to last five years and treat thousands of patients, and it would be a tremendous victory, fundamentally changing conditions for the poor there, perhaps for decades. This very success, however, pushed...

(The entire section is 683 words.)