To Repair the World: Paul Farmer Speaks to the NextGeneration

The first time I heard about Dr. Paul Farmer was when he was asked to give the commencement speech at Boston College in 2005. As a newcomer to Boston that year, I was not yet familiar with Dr. Farmer’s educational history in the city (earning a Ph.D. and M.D. at nearby Harvard University) or with his endeavors creating Partners in Health (PIH) many years before. A friend was kind enough to give me her copy of Mountains Beyond Mountains by Tracy Kidder, which had been published only 1 year prior to Dr. Farmer’s Boston College commencement speech. This book detailed Dr. Farmer’s work around the world, but specifically in Haiti, where he was attempting to bring secure health care to one of the world’s poorest countries. I was immediately entranced by Dr. Farmer’s efforts, and I have continued to be amazed at his accomplishments. Dr. Farmer would have inspired me if my knowledge of him stopped at the reading of this book, but hearing his commencement speech that year increased my admiration for the immense amount of work that he has put into PIH worldwide. To Repair the World is a book that consists primarily of commencement and awards speeches that Dr. Farmer has made in the past 12 years. I was excited to see that the Boston College commencement speech is included, along with speeches given at Harvard Medical School, Oxford University, Tulane School of Medicine, and Johns Hopkins Bloomberg School of Public Health, to name a few. Each one of Dr. Farmer’s speeches has a unique angle and message to its audience. Although most of his speeches draw from similar stories or sentiments, Dr. Farmer was able to confidently tailor each discourse to the student body to whom he was speaking. He makes jokes about his “Hogwarts attire” and living up to Stephen Colbert (the 2011 speaker at Northwestern University). He is not afraid to use pop culture references, although some of his jokes reminded me of puns that my dad uses when he wants to appear younger than he is. Jokes aside, the quality of Paul Farmer’s speeches lies in the heart of his subject matter, which should not be taken lightly. The book is divided into four sections: “Reimagining Equity,” “The Future of Medicine and the Big Picture,” “Health, Human Rights and Unnatural Disasters,” and “Service, Solidarity, and Social Justice.” Each section groups speeches that have a common message. The first section was one of the most poignant to read. In these talks, Dr. Farmer relates several stories of his time in Haiti among the poor, driving home his point that those who are currently excluded from effective disease intervention (those living in poverty) are those who would benefit most from efforts to eradicate infectious disease. The addresses that comprise section two are similar to those of the first group, but more directed toward medical students. These are the speeches in which Dr. Farmer’s passion for changing the way doctors currently pursue medicine really comes through to the reader (or listener). He points out that medical doctors today sometimes forget to see the “Big Picture” of medicine — the social and economic forces that are often the grounds that bring patients to clinics and hospitals — focusing instead on administering to patients from the point of view of their specialty. These talks emphasize PIH’s goal of “accompaniment” to its patients as a means to ensure that medicine is taken and hardships are eased for those in need. The third section focuses on unnatural disasters, such as Hurricane Katrina and the earthquake that struck Haiti in 2010. More somber in tone, these speeches quickly got to Dr. Farmer’s point that we, as doctors, scientists, and policymakers, should be making “weapons of mass salvation” instead of weapons of mass destruction. Finally, Dr. Farmer’s book closes with a few short discourses concentrating on “Service, Solidarity, and Social Justice.” These speeches, which could be considered the weakest in the book, are still encouraging. Perhaps their “weakness” is only because Dr. Farmer attempts to broach very complicated and difficult topics not usually addressed in medicine in only a few pages. The publication of this book is timely. It would make a perfect gift for a medical or biology graduate, but it would be inspiring to anyone who reads it. His speeches make one feel empowered ― to make a difference, to contribute to health policy, to accompany another who is struggling. In the speeches collected in To Repair the World, Dr. Farmer teaches us crucial lessons that we must all learn from, as scientists, as doctors, and as human beings. The only thing that would make Dr. Farmer’s message more inspiring would be to hear him speak in person, instead of simply reading his words.