Summary
Chapter 1 introduces Paul Farmer and describes author Tracy Kidder's first encounter with Farmer. Kidder had come to Haiti as a reporter to cover the actions of American soldiers there. It was just before Christmas in 1994 when Kidder observed Farmer arguing with Captain Carroll, one of the American soldiers. The assistant mayor of the Haitian town of Mirebalais had been killed—beheaded, in fact—and Carroll had taken the main suspect (Nerva Juste, a sheriff) into custody. They had not been able to find proof or testimony that Juste had done the killing, so they released him.

Dr. Farmer and Captain Carroll argue over the best way to seek justice in the situation, with the soldier arguing for due process and the doctor for preventive custody. Despite their disagreement, they part in a friendly fashion.

Kidder then encounters Farmer again by chance: they share a flight back to Miami. Although Farmer is flying first class and Kidder is not, Kidder is allowed to join Farmer for a while. They talk about Haiti, and Farmer shares some of his background.

Analysis
The entire first section is dedicated to painting a multifaceted portrait of Paul Farmer in his various contexts. Chapter 1 introduces both Farmer and Kidder, and emphasizes the situation and position of both men. Kidder finds it ironic and meaningful that Captain Carroll, who calls himself a "redneck," argues for the side of due process, while Farmer, who is more aligned with the liberals, argues that the mechanisms of justice must be adapted to the specific circumstances of Haiti. This first chapter also begins two processes. It begins the process of showing just how desperate the situation in Haiti is (and how overtaxed Western attempts to help are). By closing with Kidder's account of how he had given a small donation to help, and then forgotten about it, Chapter 1 also begins the process of showing how Paul Farmer creates change in the world.