Part V, Chapter 25 Summary and Analysis
All of Chapter 25 focuses on the attempt to save a young Haitian named Paul. Paul's mother brought Paul to the clinic in Cange with swellings in his neck. A surgeon was hired to come from Mirebalais to biopsy them. John was diagnosed with nasopharyngeal carcinoma, a rare form of cancer, but one that had a good survival rate if diagnosed and treated early. Farmer and Serena Koenig, a Brigham doctor serving in Haiti, were going to try chemotherapy in Haiti, but were convinced it would kill him. They decided to bring him to the United States. This meant creating a birth certificate for John and then getting a passport. They hired a battered truck to haul John and his doctors along crumbling, flooded roads, then, eventually, decided on hiring a medevac flight to carry John from Port-au-Prince to Boston. Once there, John received first-rate treatment in Massachusetts General Hospital, but it was too late. John died.
Chapter 25 is as focused as Chapter 24 had been scrambled and confused. Kidder artfully recounts this humanitarian mission until it is as tense and emotionally charged as the best suspense thriller. Rather than fighting spies or evil geniuses, however, Zanmi Lasante, Serena, and Farmer are fighting economic conditions, treacherous roads, and subtle forms of politics. Here again one can see how his extended mission has changed Farmer. His instinct is to heal the sick, regardless of cost or implication...but he now worries that buying one medevac flight for a sick patient will set a precedent and others will expect similar treatment. In his early days, Farmer was the man on the spot, fighting illness alone. Now he has to settle for being the voice on the phone, the distant advisor, somewhat like the figure of Q in a James Bond film (and somewhat like a guardian angel).
Without Kidder saying so in so many words, efforts like this one, in which people fight to save one sick boy, are clearly what makes all of Farmer's struggles worthwhile. This is the child about whom the voice of Haiti whispered at the end of Chapter 24. And this is what happens if Farmer and PIH do not act—and sometimes, even if they do.
Running in harmony to the mission and the tension is a continual tone of condemnation. John died because he was Haitian (not American). John died because of the bureaucratic delays in his treatment. John died for a host of reasons when he did not have to.