by Tracy Kidder
On a fair number of the trees that remained in those hills, and also on rocks, I saw political graffiti, usually scrawled in red paint: “Titid” and the number “2001.” These were, respectively, the nickname of former President Aristide and the year in which, judging from all the posters and graffiti I had seen around Cange, he would be reelected. Politics, I supposed, was one means by which Haitian peasants avoided hopelessness. Many aid experts from prosperous places gladly expressed hopelessness on the Haitians’ behalf, Farmer would say. By this point on our hike, I too was guilty. The houses we passed in the mountains were much worse than most of the ones around Cange. They had dirt floors and roofs made of banana fronds, which, Farmer pointed out, leaked during the rainy season, turning the floors to mud. We passed a group of women who were washing clothes in the rivulet of a gully. “It’s Saturday,” said Farmer. “Washing day. I guess the Maytag repairman didn’t come.” Haitians, he said, are a fastidious people. “I know. I’ve been in all their nooks and crannies. But they blow their noses into dresses because they don’t have tissues, wipe their asses with leaves, and have to apologize to their children for not having enough to eat.”
“Misery,” I said. But this would not suffice. He was on a roll.
“And don’t think they don’t know it,” he said. “There’s a WL line—the ‘They’re poor but they’re happy’ line. They do have nice smiles and good senses of humor, but that’s entirely different.”
Like many of his remarks, this one gave me pause.
Just when you thought you had the hang of his worldview, he’d surprise you. He had problems with groups that on the surface would have seemed like allies, that often were allies in fact, with for example what he called “WL’s”—white liberals, some of whose most influential spokespeople were black and prosperous. “I love WL’s, love ’em to death. They’re on our side,” he had told me some days ago, defining the term. “But WL’s think all the world’s problems can be fixed without any cost to themselves. We don’t believe that. There’s a lot to be said for sacrifice, remorse, even pity. It’s what separates us from roaches.”
We walked on. I noticed, as I had around Cange, that many people we passed wore clothes from America, brand-name running shoes that had seen much better days and baseball caps and T-shirts bearing the logos of professional sports teams and country clubs. “Kennedys” was the generic name for stuff like that. Back in the 1960s, Farmer had explained, President Kennedy sponsored a program that sent machine oil, among other things, to Haiti. The Haitians tried to use the oil for other purposes, such as cooking, and concluded that the gift was of inferior quality. Ever since, the president’s name had been synonymous here with secondhand and shoddy goods. Now and then one saw another kind of import, meant strictly for adornment. There was a young worker at Zanmi Lasante who wore a new-looking, Haitian-style straw hat on which he or his wife had sewn a homemade piece of cloth that read NIKE.
We went on, deeper and deeper into the mountains, Farmer leading the way. We chatted front to back. I was drenched in sweat. I couldn’t see even signs of perspiration on his neck—his pencil neck as friends of his called it. Many people waved to him—the lifted hand motionless, the fingers fluctuant, like the legs of insects on their backs. “Do you see how Haitians wave? Don’t you love it? You dig?” he said to me, waving back with his fingers. The trail wound across barren, steeply folded mountainsides. I had thought that I was fairly fit, but at the top of every hill, Farmer would be waiting for me, smiling and making excuses for me when I apologized—I was fourteen years older; I wasn’t used to the climate.
The one-way trip to Morne Michel usually took him two hours. About three hours after we’d set out, we arrived at the hut of the noncompliant patient, another shack made of rough-sawn palm wood with a roof of banana fronds and a cooking fire of the kind Haitians call “three rocks.”
Farmer asked the patient, a young man, if he disliked his TB medicines.
“Are you kidding?” he replied. “I wouldn’t be here without them.”
It turned out that he’d been given confusing instructions the last time he was in Cange, and he hadn’t received the standard cash stipend. He hadn’t missed any doses of his TB drugs, however. Good news for Farmer. Mission accomplished. He’d made sure that the patient’s cure wasn’t being interrupted.
We started back. I slipped and slid down the paths behind Farmer. “Some people would argue this wasn’t worth a five-hour walk,” he said over his shoulder. “But you can never invest too much in making sure this stuff works.”
“Sure,” I said. “But some people would ask, ‘How can you expect others to replicate what you’re doing here?’ What would be your answer to that?”
He turned back and, smiling sweetly, said, “Fuck you.”
Then, in a stentorian voice, he corrected himself: “No. I would say, ‘The objective is to inculcate in the doctors and nurses the spirit to dedicate themselves to the patients, and especially to having an outcome-oriented view of TB.’ ” He was grinning, his face alight. He looked very young just then. “In other words, ‘Fuck you.’ ”
We started on again, Farmer saying over his shoulder, “And if it takes five-hour treks or giving patients milk or nail clippers or raisins, radios, watches, then do it. We can spend sixty-eight thousand dollars per TB patient in New York City, but if you start giving watches or radios to patients here, suddenly the international health community jumps on you for creating nonsustainable projects. If a patient says, I really need a Bible or nail clippers, well, for God’s sake!”
I was scrambling down yet another steep incline when from a copse below I heard a commotion—yelling, then a little lull, then yells again. In a few minutes a cockfighting pit came into view, a corral entirely surrounded, several people deep, by men in straw hats and ragged pants and shirts, shod in torn sneakers, flip-flops, old brown dress shoes without laces. On the periphery, there were a pair of competing food sellers and a couple of men who had set up games of Zo—it involved a board and a thing that looked like a Victorian teapot, for shaking dice. There were also women at the edges of the crowd. A place was made for Farmer at the railing. He watched for a moment. The cocks were circling each other. Then one made a charge, wings flapping, and Farmer turned away.
He moved to the edge of the trees, where suddenly a couple of chairs materialized, metal chairs with torn Naugahyde seats, one red, one blue. This always happened in the countryside when I was with Farmer, the appearance of chairs, one for Doktè Paul, one for his blan. We sat. In a moment, we were surrounded. By women, a dozen or more—elderly-looking women, lovely young women in sundresses with one torn shoulder strap. A middle-aged woman, with a beautiful face but several front teeth missing, leaned against a tree and spoke softly to Farmer. The others stood by other trees or sat in the dirt close by, some speaking to him, too, from time to time. One woman was telling him that they needed an additional community health worker up here, but mostly they were just passing the time. Is there a more widespread notion than the one that rural people are laconic, and is there a rural place anywhere in the world whose people really are?
I was worn out, my clothes completely drenched. My thoughts were wandering. I thought of the chairs we sat on—discarded, I imagined, during the refurbishing of an office in Minneapolis or Miami—and about their long journey here. I imagined I knew why the women were doing this, ignoring the national sport on a Saturday to gather around Farmer and chat with such mild desultoriness, voices low and musical and unhurried. Some years ago he had added to his growing medical program a health project just for women and, lacking a gynecologist on the staff, had made his own quick study of the specialty and for a time practiced it here. He’d probably given a number of these women the first pelvic exams they’d ever received, and had talked to them about birth control, offering it if they wanted. The shouts and cries from the cockpit seemed to be reaching a crescendo, but they sounded far away. I felt as if I could fall asleep, and as if I already had
, enfolded in femininity.
The rest of the way back was mostly a descent, but there were still some slopes to climb. I straggled up out of another ravine and as usual found Farmer waiting for me. He stood at the edge of a cliff, gazing out. I walked over to him. The view from where he stood was immense. Scrims of rain and clouds and swaths of sunlight swept across the yellow mountains in front of us and the yellow mountains beyond those mountains and over the Lac de Péligre. The scene, I realized, would have looked picturesque to me before today. So maybe I’d learned something. Not enough to suit Farmer, I suspected. Education wasn’t what he wanted to perform on the world, me included. He was after transformation.
I offered him a slightly moist candy, a Life Saver from my pocket. He took it, said, “Pineapple! Which, as you know, is my favorite,” and then went back to gazing.
He was staring out at the impounded waters of the Artibonite. They stretched off to the east and west and out of sight among the mountains. From here the amount of land the dam had drowned seemed vast. Still gazing, Farmer said, “To understand Russia, to understand Cuba, the Dominican Republic, Boston, identity politics, Sri Lanka, and Life Savers, you have to be on top of this hill.”
The list was clearly jocular. So was his tone of voice. But I had the feeling he had said something important. I thought I got it, generally. This view of drowned farmland, the result of a dam that had made his patients some of the poorest of the poor, was a lens on the world. His lens. Look through it and you’d begin to see all the world’s impoverished in their billions and the many linked causes of their misery. In any case, he seemed to think I knew exactly what he meant, and I realized, with some irritation, that I didn’t dare say anything just then, for fear of disappointing him.
CHAPTER 5
It was impossible to spend any time with Farmer and not wonder how he happened to choose this life. I did some looking in the usual place.
His parents came from western Massachusetts. He was born in the aging mill town of North Adams in 1959, the second of six children, three boys, three girls. His mother, Ginny, was a farmer’s daughter. She quit college early to marry. You could see her in him quite clearly. She was fairly tall, and slender. Her nose was his exactly, and her tendency to blush.
Farmer’s father—Paul, Sr.—was a big man, about six two, weighing in at between 230 and 250 pounds. He was a fine and ferociously competitive athlete, known as Elbows to people who played basketball with him. In later years his younger daughters would rechristen him the Warden, on account of his strictness—no makeup, no boyfriends, no staying out late. He was a restless sort of man. He had a steady job as a salesman in Massachusetts, but then a friend of his told him there was real money to be made in sales down south in Alabama: “Alabama is a sleeping giant.” In 1966 the Warden moved his growing family south to Birmingham.
In retrospect, the years in Alabama were happy ones for Ginny. They were a little short on furniture but lived in a real house, and they bought an automatic washing machine, the first one she’d ever had. The Warden also arranged for economical family vacations by buying, at public auction, a large bus. The bus, oddly enough, had once been used as a mobile TB clinic, and to accommodate an X-ray machine, a turretlike extrusion had been added to its roof. The bus’s brand name was Blue Bird. The Blue Bird Inn, the Farmers called it. Meanwhile, Paul, Jr.—P.J. or Pel to his family—was flourishing. His sisters remember him as a scrawny boy, intense in anger and affection. “And,” they’d say, “he had this huge brain.” The elementary school authorities placed him in a gifted and talented class. In fourth grade he started a herpetology club. He invited all his classmates to the house for the first meeting, and asked Ginny to make Rice Krispies Treats. None of his classmates came, and he was very quiet for a time, a sure sign to his older sister that he was upset. But the family, in effect, became the club, attendance required by the Warden’s decree. They’d meet in the living room. P.J. would dress up in a bathrobe and point with a stick at charcoal drawings he’d made of reptiles and amphibians—even his siblings had to admit the pictures were beautiful. He’d discourse on the animals’ diets, reproduction, life spans, their interesting and unusual characteristics. He’d always announce each species by its Latin name. A sister remembered thinking, “We should just beat him up and go back out and play.” But after a while she and the others would get interested and start asking questions.
Both his grandmothers were devout Roman Catholics, and his family went to church and he went through the rites of first communion and confirmation, even serving as an altar boy for a time, but he didn’t feel engaged. “It was perfunctory,” he’d remember, “although I liked the Mass itself and still do. But it was nowhere near as exciting as the stuff I was reading.” The parents of some fellow students in the gifted and talented class owned a bookstore, and when he was about eleven they gave him a copy of J.R.R. Tolkien’s trilogy, The Lord of the Rings. He read it all in the space of a couple of days, and immediately read it again. Then he brought the book to the public library and told the woman at the desk, “I want other books like this.” She gave him a handful of fantasy novels. He brought them back. “No, this isn’t it.” That went on for a time, until finally one day the librarian—no doubt with some misgivings; the boy was only eleven years old—handed him a copy of War and Peace. “This is it!” he told the librarian about a week later. “This is just like Lord of the Rings!” Years afterward he’d say, “I mean, what could be more religious than Lord of the Rings or War and Peace?”
Sales work in Alabama disappointed the Warden. He turned to teaching. But the atmosphere in Birmingham in the latter 1960s made him and Ginny worry for their children’s safety. The Warden found a job in a public school in Florida, and so one day in 1971 the family stowed their belongings inside the Blue Bird Inn, all that it would hold. The Warden and Ginny and the children wrestled the washing machine out to the bus, but it wouldn’t fit through the side doors. One of Farmer’s most vivid memories was of the moment when they pulled away from their rented house in Birmingham. He watched his pretty young mother gaze sadly out the back windows of their bus at the washing machine, white among the bits of coal that littered the backyard. It would be her last washing machine for many years. They headed for Brooksville, a small town north of Tampa near the Gulf Coast.
Farmer’s older sister remembered riding in the Blue Bird Inn down the town’s fancy street, all overhung with Spanish moss and flanked by houses with antebellum-looking porticoes, and the Warden at the bus’s wheel saying, “We’ll get a house like one of these.” For the time being, though, they drove out to the Brentwood Lake Campground, a trailer park beside a piney woods. The Warden must have been preoccupied. He drove toward the campground office and either forgot about the turret on the roof or didn’t see the power wires overhead. In any case, the turret snagged the wires and tore them down.
After the mess was sorted out, the Warden found a concrete block for a front step, and they settled in. Ginny took a cashier’s job at a Winn-Dixie supermarket and learned to work the register while smiling at customers and stomping on the pedal that moved the conveyor belt. She was a Winn-Dixie cashier who read Cry, the Beloved Country to her children at night and, years later, went to Smith College and got her bachelor’s degree. What none of the family remembered from those days in Florida was hearing her complain. “My mother is like the Virgin Mary without the virgin part,” one of Farmer’s sisters would say. “Loving, kind, nonjudgmental. She was the calm one always.” Ginny would remark years later that she wished she had stood up to her husband and defied him more often, but this was the era of the dutiful wife, and besides, she said, “You didn’t argue with Paul Farmer, you just didn’t.” She also said, “We knew that he loved us.”
In the turret, the Warden had constructed a tier of three bunks for the boys. P.J.’s was on top. He’d lie on it and read and do his homework while down below his brother Jeff practiced playing the drums, now and then declaring, “And this is the Krup
a beat.” P.J. excelled in school, regardless. He had some advantages, he’d say. The kind of father who thought it reasonable to house his family in a bus was also the kind who saw no reason P.J. shouldn’t keep a large aquarium inside. Farmer insisted that he never really felt deprived throughout his childhood, though he did allow, “It was pretty strange.” He remembered coming back to the campground on a school bus once and an African American classmate saying to him, “Is this where you stay at?” They remained at the campground for five years, and took trips away in the bus.
The Warden hadn’t fully figured out the vehicle’s wiring—he never did—and every time they pulled into a campground and plugged into a power outlet, there was a fifty-fifty chance that whoever did the plugging in would insert the plug wrong, reversing the polarity, and get a nasty shock. The boys would argue: “I did it last time!” The Warden seems not to have thought about labeling the plug, maybe because he didn’t take a turn at inserting it himself. He was too busy at other tasks, Ginny would tell me with a smile. One time, returning from a trip to Massachusetts, his jury-rigged device for towing a car behind the bus malfunctioned, in a rainstorm on an interstate. The Blue Bird Inn slithered off the highway, then plunged down a steep embankment, then flipped onto its roof. The turret kept the bus from rolling. Miraculously, no one got seriously injured. But it took the Warden some months to repair, more or less, their living quarters.