Farmer’s faith
Dr. Paul Farmer is rightly hailed as a great physician, medical anthropologist and humanitarian. And he has a very pragmatic message for us in the age of COVID-19 and near political despair, perhaps near political nihilism: Concentration — of public attention, will, resources, and devoted, educated and continually refined expertise – will make things better.
The problem, be it Parkinson’s, lead poisoning and asthma in poor kids, or bigotry in a thousand forms, will not vanish with such focus. And it will not get better overnight. But it will get better.
And, as Barack Obama liked to remind people, “better is still better.”
Dr. Farmer is the co-founder of Partners in Health, which seeks to bring clinical care to the poorest of the poor around the world. It is perhaps the most-focused and efficient private charity of its kind in existence. PIH is particularly noted for its work in Haiti and West Africa.
He is also a polymath — a medical professor at Harvard, a medical missionary constantly traveling the world and doing hands-on work with the sick and the destitute, a celebrity evangelist for better public and preventive health systems, everywhere, including in the United States, and an author.
He has just published a book titled “Fevers, Feuds and Diamonds: Ebola and the Ravages of History,” which is one part reportage, one part scientific paper, and one part meditation on the passions of his own life and work.
Dr. Farmer, too, uses the term nihilism, but in the classical sense of all meaning and purpose lost, or rejected.
He says that in the case of fighting Ebola, the culprit was “clinical nihilism”: We cannot treat all the people with the disease, so we will instead try to contain it. Consequently, thousands died who could have been saved with simple and inexpensive medical care. Thousands more avoided a medical system they reasonably distrusted.
In the case of fighting COVID-19, Dr. Farmer says the great error was “containment nihilism”: We will never be able to stop the spread of the disease because we don’t know how to do contact tracing well and people will not wear masks.
Both errors, of course, derive from
a lack of investment in public health.
But they also evolve from something even more fundamental: Lack of faith in human ingenuity, action and reason, which is to say, lack of faith in ourselves.
This is the root of true pessimism (a word that might make more sense for most Americans) or true nihilism in the way Dr. Farmer means it: We can never progress. We never really make things better.
But, in fact, we can, and have. And this is what science is really all about and what the American dream is all about.
We have, at last, made progress on the coronavirus — tremendous progress in the last 10 weeks to three months, especially. People are wearing masks and it is helping. We have three vaccines, and we are getting them out to people. We are not, and were never, helpless — as a people, economy or government. We are beginning to defeat the disease.
We have also, historically, made progress on polio, TB and cancer, and on race, poverty (especially for the elderly) and child labor.
We can make progress on free but respectful speech and social decency, too — if we put enough American will and thought into both.
Dr. Farmer is often accused of being “pathologically optimistic,” an odd trait in one who spends so much time with the hurting and the dispossessed.
But he says he is no such thing. He says he is, on the contrary, realistic and empirical. For he says he knows of no instance in which a person has applied himself, or a community has applied itself, in which there was not at least a partial positive result.
He adds: “If you irrigate a medical desert [with ‘staff, stuff, space and systems’] it always blooms.”