Our Common Opportunity


A favorite question my son likes to ask after we watch a movie is, “which character did you most identify with?” My response is usually based on similarities in age, role, and intent. As I have gotten older, I find myself relating much more to the character serving as a mentor than the younger protagonist making life altering decisions. Being able to see ourselves in the story greatly adds to the enjoyment and engagement of the experience. The inability to relate to the main character can also be a challenge in reading the biography of a historic figure or one who has been recognized for their superlative achievements.


The biography of Paul Farmer, Mountains Beyond Mountains, by Tracy Kidder creates that kind of a challenge. Farmer has been a leader in tackling some of the biggest global health challenges over the last 40 years. From the very beginning, the reader finds it difficult to find much overlap with Farmer’s experiences. A good part of his childhood is spent living in a bus in campgrounds reflecting an unorthodox approach to life by his parents. While in college he becomes aware of the plight of Haitians and decides to spend a year in Haiti before attending Harvard Medical School. During medical school he splits his time between classes in Boston and working in a clinic in Haiti. He also earns a doctorate in Medical Anthropology from Harvard along the way. After medical school he spends most of his time in Haiti expanding his clinic and community development work, starts a not-for-profit health organization, and serves as an attending physician at a leading hospital in Boston. Over the years, his organization expands globally, he writes books, travels extensively, and serves in various leadership positions at Harvard as well as Brigham and Women’s Hospital. He does all this while devoting most of his energy to alleviating suffering by living in the highlands of Haiti. Farmer’s story can leave the reader asking, “what did I do with my life?” or “would I have even wanted to have lived my life that way?”


Farmer is clearly incredibly intelligent, driven, and quirky with his share of flaws. He comes across as the kind of inspiring person that you are grateful is part of your cause but also thankful you don’t have to work with every day. While we may struggle to keep pace with the Paul Farmers of the world, we certainly see some applicable lessons even if we are unlikely to receive numerous awards for our work in anthropology, medicine, and service to humanity. Farmer’s most obvious key to success is his passion for his cause and his role in it.


Perhaps the most obvious lesson is that purpose matters. Early in his adult life, he identified with the suffering of the poor and found a specific place to make a difference, Haiti. That purpose informed every other decision and determined what he studied (both medicine and anthropology), how he invested his time and resources, and how he evaluated his success. His level of commitment and sacrifice reflected he was driven by a singular purpose. His abandonment to the cause demonstrated the depth of his love for his calling.


He also maintained a core set of values that guided his decision making. Because he saw value in each person, he extended the highest level of care possible with his limited resources. He also went beyond treating the immediate medical need to provide education, housing, and justice for his patients. At points in his career Farmer has been criticized or at least misunderstood for his willingness to spend his valuable time caring for the needs of an individual patient. Kidder tells the story of accompanying Farmer on a seven hour hike to visit two patients. There was nothing particularly special about these patients in terms of their medical conditions or standing in the community. They were simply Farmer’s patients who needed someone to follow up and see how they were doing. Farmer defends his approach this way, “if you are saying seven hours is too long to walk for these two families of patients, you’re saying the lives of these two families are less important than others’, and the idea that some lives matter less is the root of all that is wrong with the world.”



He also understood the context of his battle and the need for perseverance. He described working with the poor as the “long defeat.” He said, “I am not going to stop because we keep losing. Now I actually think sometimes we may win…. We want to be on the winning team, but at the risk of turning our backs on the losers, no, it’s not worth it.” The title of Kidder’s book, “mountains beyond mountains,” captures the needed attitude when taking on big challenges. The title comes from a Haitian expression meaning that as you solve one problem another presents itself. While there will be successes, there will not be that moment you can declare victory and enjoy a comfortable life.



Farmer also realizes he feels most alive when he is simply being a doctor to the poor. He travels in two very different worlds between acclaimed global health expert and Harvard professor and a doctor kneeling beside a suffering child in a mud hut. While Kidder’s biography of Farmer is quite flattering, he does capture the complexities and paradoxes of a man who frequently experiences both great joy and frustration. Farmer’s self-awareness of what keeps him engaged in the battle is critical to maintaining the needed passion. That passion for the work and the patient has also helped Farmer identify the practical steps needed to address health needs in the most difficult environments.


After finishing the biography, there were a number of reasons I couldn’t completely identify with Farmer. Earning two doctorate degrees from Harvard provided significant separation as did his personality and some of his life choices. I didn’t find myself saying, “that could have been me” or “that sounds like me.” And yet, I recognized in Farmer’s life what often makes us feel most alive: waking up in the morning and believing that what I do today will make a difference in someone’s life. For some that may mean making a difference in the lives of thousands and that difference may mean the difference between life and death. But for most of us, it is simply helping make someone close to us more of who they were created to be; to give them hope and a better chance to experience a fuller life. Farmer provides an example of an individual who found joy and purpose whether the task at hand might impact thousands or simply one.


I also recognized the power of faith when we find ourselves locked into a battle that can be described as the “long defeat.” We long for comfort and success and often organize our lives to pursue it, but we are most alive and engaged when the outcome is far from certain and we feel like we can make a difference. We are willing to sacrifice our comfort because we feel compelled by purpose. Farmer doesn’t play it safe and at times pays a price for it. That rare quality of being abandoned to a cause is so seldom experienced, we forget the joy of putting everything aside and racing single-mindedly towards the finish line.


There will always be the next mountain to climb or problem to solve but there is also always the next opportunity to make a difference. The story of Paul Farmer is not just about the enormous talents he applied to solving big problems but his willingness to use whatever resources he had to help the next person on his path. Albert Schweitzer, another well known medical humanitarian who won a Nobel Peace Prize in 1952, captured it this way, “I don’t know what your destiny will be, but one thing I know: the ones among you who will be really happy are those who have sought and found how to serve.” 


About a week after I wrote this article, Paul Farmer died unexpectedly from a cardiac event at a university in Rwanda he helped established. He was only 62. Just a few weeks earlier I had never heard of Paul Farmer and yet his death created a surprisingly strong emotional reaction. Perhaps it was because of the similarity of our ages or the loss of such an important advocate for the poor. I also felt an appreciation for a life well lived and a reminder that today is always the best time to serve those around us.