The first time I read
Mountains, I was so overwhelmed by Paul Farmer's biography that I just couldn't imagine any other way to work for the global poor other than being a jet-setting, Ivy-League-trained doctor-anthropologist. My mind was thrilled at the idea of a person operating at maximum efficiency, getting, as it were, as many lives-saved-per-minute as his machine could possibly handle. When I evaluated my own my life in those terms, it felt pretty suboptimal. But upon rereading the book, I see that not everyone agreed with my overawed assessment of Farmer's time management. One of his academic overseer thought Paul Farmer was wasting time by treating individual patients instead of focusing systemic problems:
Farmer, [Harvard Professor Howard] Hiatt seemed to say, should be solely engaged in the battle against those scourges, and at a level commensurate with their size. 'The six months a year that Paul's looking after patients one-on-one in Haiti, if that time were converted to a major program for treating prisoners with TB in Russia and other easter European countries or malaria around the world, or AIDS in southern Africa—it doesn't matter where or what because you know he'll do important things. Because look at what he's done with only part of his time on MDR. Look what he's done with his skills and political acumen!' (181)
But what Professor Hiatt saw as a tragic inefficiency ("if that time
time were
converted," as if our lives were simple arithmetic), Farmer regards as the lynchpin of his work (see his list of priorities in the second paragraph of p. 182). Had I been in Hiatt's position, I would have made the same criticism.
Had I been in Judas' position, I also would have demanded to know why Mary had wasted such a fortune in an ostentatious emotional display. And had I been at that meeting of top TB policy makers, I would have probably nodded my headed and smirked smugly when a Russian TB director insisted, "I only have six million dollars" to implement this program (p. 161). One of the most astonishing takeaways from
Mountains for me, then, is to see the way that a certain compassion for the people and situation immediately before you yields long-term results. This kind of compassion is repeated not just by Paul Farmer but throughout PIH (in Jim Kim's refusal to give up on MDR-TB patients, and the astonishing story of John, the Haitian boy nasopharyngal carcinoma, and Serena, in Chapter 25). I have often questioned the church's seemingly imprudent affection for "small" problems that I felt promoted more egoism than compassion. But here are a group of people admire, at a "secular" organization, doing exactly as Jesus did, for the reason he did it, in the way he did it: addressing people's immediate needs, in a rash of compassion, inadvisedly. It echoes Mother Teresa's maxim about "small acts of great love," an impulse I've always struggled to effect.