From a 2020 global health class and in honor of Paul Farmer, who fought the good fight.
Whose Justice? Which Calculations?[1]
“When life itself seems lunatic, who knows where madness lies? Perhaps to be too practical is madness. To surrender dreams – this may be madness. Too much sanity may be madness – and maddest of all: to see life as it is, and not as it should be!”
~Miguel de Cervantes, Don Quixote
Tracy Kidder’s Mountains Beyond Mountains is in many ways a book after my own heart. It’s certainly not that my life could compare to Paul Farmer’s, or even that my writing could compare to Tracy Kidder’s. As a Christian, a surgical tech, and a worker in the medical mission field, I have a serious interest in global health, which makes Paul Farmer’s life as attractive and inviting as it is inspiring. And yet, the book would probably not stand out much at all in my own mind if it did not stand so far apart from one of the first assignments in this class, the TED Talk from the famous statistician Hans Rosling.
I have often wondered what exactly Albert Einstein meant when he said that the certainty of mathematics depends on a kind of distance from reality.[2] Of course, he wasn’t saying that mathematics has no relation to reality, but surely it’s true that, since life always retains some degree of mystery and ambiguity (as well as disorder and value), using mathematics requires a certain separation from what we normally experience. I still can’t say that I completely grasp what he meant, but I think that if I were going to apply Einstein’s meaning to the work of any one person in the world, it would be Hans Rosling. In the assigned talk, posted under the title “Reducing Child Mortality—A Moral and Environmental Imperative,”[3] Rosling laments what he claims is the false belief that places like Africa are not doing well or that the data in Africa is nonexistent or unreliable. “I’ll prove them wrong on both points!” he says. What follows this claim is a series of charts and graphs that supposedly prove something. What it is they prove I haven’t figured out, much less how they amount to any sort of “moral imperative.” Maybe it’s best to admit that I’ve never liked talking about people and numbers in the same sentence, so when Rosling says, with no small amount of excitement, that he’s got numbers to prove how wrong we are about the world, that everything is much better than we imagine and experience it to be, I can only feel a certain resistance to his enthusiasm. And it didn’t help that I had already started reading about Paul Farmer.
Putting aside the question of whether the story that Rosling tells—and it is a story—is even factual or narratively correct,[4] it stands in remarkable distinction to the life, and the approach, we are confronted with in Mountains Beyond Mountains. In some ways, the distinction is written in plain language, as when Farmer is asked by Ophelia to define anthropology: “He told her, in effect…that anthropology concerned itself less with measurement than with meaning” (72). In fact, it would seem that in many ways measurement is antithetical to such meaning. The sort of meaning that Farmer has in mind is not the sort that can be gathered and collected to form some point or line on a chart. Continuing to summarize Farmer’s answer about anthropology, Kidder says, “As in mastering a language, one had to learn not just the literal meanings of words but also their connotations, and to grasp those one had to know the politics and economic systems and histories of a place. Only then could you really understand an event like the mango lady’s death” (72).
The mango lady is a woman who, because of inexcusably terrible roads, fell off a truck and died on her way to a market in Haiti. For Farmer (and for Ophelia), she is an unforgettable representation of the myriad needless deaths that take place every day. And for me, she represents at least two clear points of departure from Rosling. First is simply that it was unnecessary—and it matters that it was unnecessary. As Thomas Pogge has pointed out, the problem with data sets, like those Rosling champions, is that they do not tell a moral story at all. “The morally relevant comparison of existing poverty… is not with historical benchmarks but with present possibilities: How much of this poverty is really unavoidable today? By this standard, our generation is doing worse than any in human history.”[5] Like Pogge, Farmer is not ultimately concerned with historical benchmarks but with present ones; he simply thinks we should be doing more, much more, to help the poor. Rather than seeing how historically low the numbers might be, he sees how unnecessarily high they certainly are.
Second—although, in a sense, preceding the first—her death cannot be understood from far away. Farmer’s approach, both through his use of anthropology and through the entire life Kidder portrays, is necessarily a present and personal one. In a word, it is incarnational—only once you’ve embedded yourself into a place like Haiti could you possibly understand what even one death means, much less place some sort of value on it. William James once remarked, in an essay otherworldly to Rosling, that a man “would needs be a presumptuous calculator who should with confidence say that the total sum of significances is positively and absolutely greater at any one epoch than at any other of the world.”[6] Ask a Syrian refugee on the southern border of Turkey, or a Yazidi woman in Iraq, or a Rohingya father in Bangladesh, or a starving child in Yemen—ask them if the world is a much better place than ever before. Whose world? According to whom?[7]
I could not pretend to speak for Rosling, or Farmer, or Kidder, but the experience of reading about Paul Farmer and the experience of listening to Hans Rosling are, it seems to me, as night is to day. On one level, both men believe something very similar: both believe that most of us in the west have a certain view of the world, particularly of poorer countries, and they want to correct that view and promote a corresponding reaction. On a deeper level, the views we are asked to adopt could not be further apart, both in what they view and from where they view it. One invites us to soar above the mountains and see how nice things have become; the other stands where there are mountains beyond mountains and invites us to see the world and history “as if written in collaboration with a Haitian peasant” (116). One rises above the world and organizes numbers to make things look a certain way;[8] the other gets down on his hands and knees to listen to the world and to see what and who we are overlooking. One requires that you be wealthy and well-off and detached enough to do the math; the other requires that you be low and humble and involved enough to hear the poor.
Peppered throughout Kidder’s book, and Farmer’s life, is a quality not only of depth and perspective but also of inspiration. In a world where we are more capable than ever of helping the poor, how do you inspire people to a life of care, service, and sacrifice? This is not only a question repeatedly asked by Farmer, but a question that a view of his life provides the answer to: it’s the life that inspires belief and belief that inspires action. A biography of someone like Paul Farmer’s is not neutral nor does it sit as a collection of data waiting for some application. “Not as a figure to watch from a distance, thinking, Oh, look, there is good in the world. Not as a comforting example, but the opposite” (102). The reason for that discomfort was mentioned earlier in the book: “because it implied such an extreme definition of a term like ‘doing one’s best’” (8).
That challenge is as present today as at any time in any past.[9] And in that sense, Farmer’s life can intimidate as well as inspire. But here again Farmer stands out as an example. He did not begin by trying to change the world, but by applying himself to something relatively small.[10] Whether in Haiti or in downtown Augusta, each of us can be inspired to do the same. Rather than trying to quantify suffering, or progress, or our own moment of greatness, maybe we should listen again to William James, in a quote that Dorothy Day often handed out on little cards:
“I am done with great things and big plans, great institutions and big success. And I am for those tiny, invisible, loving, human forces that work from individual to individual, creeping through the crannies of the world like so many rootlets, or like the capillary oozing of water, yet which, if given time, will rend the hardest monuments of human pride.”[11]
Farmer seems to me to be an invitation to that sort of life, and also proof that that sort of life does not mean a life will have only a minimal impact. In the real world there are not always neat figures and progressing lines; instead there are mountain beyond mountains, and we only remain undefeated because we have gone on trying,[12] listening to and caring for those in need, even in some small but genuine way.
[1] The title is a reference to Alasdair MacIntyre’s Whose Justice? Which Rationality?
[2] “As far as the laws of mathematics refer to reality, they are not certain; and as far as they are certain, they do not refer to reality.” Taken from a speech titled “Geometry and Experience,” given at the Prussian Academy of Sciences in Berlin, January 27th, 1921. A transcript can be found here: http://mathshistory.st-andrews.ac.uk/Extras/Einstein_geometry.html
[3] https://www.gapminder.org/videos/reducing-child-mortality-a-moral-and-environmental-imperative/
[4] https://quillette.com/2018/11/16/the-one-sided-worldview-of-hans-rosling/
[5] http://www.themarknews.com/2016/02/07/the-end-of-poverty/
[6] William James, “What Makes Life Significant.” Essay published in 1900. Rosling is, I think, exactly the presumptuous calculator James had in mind.
[7] The UNHCR is apparently not required to share Rosling’s optimism: https://www.unhcr.org/en-us/figures-at-a-glance.html
[8] Jerry Fodor: “It belongs to the millennial moment to want to sum things up and see where were have gotten and point in the direction that further progress lies.”
[9] Charles Taylor, A Secular Age: “Our age makes higher demands of solidarity and benevolence on people today than ever before. Never before have so many people been asked to stretch out so far, and so consistently, so systematically, so as a matter of course, to the stranger outside the gates.” Pg. 695.
[10] Kidder discusses this in the afterword in Mountains Beyond Mountains.
[11] This quote is taken from a fantastic little lecture given in 2016 by the American Catholic theologian William T. Cavanaugh at Biola University Center for Christian Thought: https://www.youtube.com/watch?v=J0qti9EyZzw
[12] T.S. Eliot, from the epigraph to Kidder’s book.