I just finished Tracy Kidder's Mountains Beyond Mountains, an acclaimed biographical account of Paul Farmer. If you don't know about Paul Farmer, he is essentially the greatest doctor/humanitarian/anthropologist/practitioner-of-social-medicine of our generation. He started administering treatment to the poor in Haiti as a young Harvard Med student, and never looked back. He has spent over 20 years traveling the globe constantly, tirelessly implementing new epidemiological programs, from Russia to Peru, dealing with the "big three pandemics" (tuberculosis, AIDS, and malaria) and more, while also teaching classes in Boston, being a father and husband, and continuing to return almost weekly to his original clinic in Haiti's central plateau (Zanmi Lasante). Along with his philanthropy, Partner's in Health, which he started with a few trusted and talented colleagues, Farmer has helped to re-structure the way huge social medicine groups (like the World Health Organization) approach the Big 3. Essentially, in a world where those in power said that there aren't enough resources to cure the poor, Farmer said, "Yes, there are." His life itself appears to be a monument to humanity's potential.
The "problem" with Paul Farmer that Kidder addresses well, though, is whether or not his legendary capacity for work, combined with his creative intelligence, his ceaseless drive, and his seemingly endless love for patients, can ever be replicated and/or sustained. He has done such an extraordinary thing that it's feared his projects will fall apart once he's gone. His response to this sort of inquiry is simply to say, "I'm a doctor, and I treat poor, sick people," like some sort of Zen master. I didn't take this as a false humility as much as I took it as Farmer's one-day-at-a-time philosophy - just like the Buddha pointing at the Earth.
I have struggled with this issue before while studying the fiction of David Foster Wallace. Unlike Paul Farmer's genius, which is predicated upon his almost inhuman ability to tirelessly practice and improve real-world medical strategies, Wallace's genius was staunchly intellectual, existing on paper rather than in daily clinical visits. That isn't to say that their minds weren't similarly effervescent; they are both, after all, winners of the MacArthur Foundation's so-called "Genius Grant". Reading DFW made me understand the literary phrase "tour de force." One can't help but be impressed by the sheer volume of his lexical knowledge, his ability to change and manipulate voices, all means to a carefully orchestrated, concrete end - a true master of motifs. And, as an English Major, I suppose I studied great authors in some sense so that I could learn to write well, or at least think well. But that's the problem: to understand why David Foster Wallace is a genius is to recognize simultaneously that you can never be on his level, you can never think as well as he did. The fact that I am even writing this blog post is evidence of the effect his creative shadow has cast on me.
So what? Well, the precedents and examples set by people like Paul Farmer are relevant to aspiring humanitarians everywhere - especially in an age when human creativity and resourcefulness will be tested to their limits. But no one can really be Paul Farmer; to aspire to his success is at once to miss the mark. The comparison invites defeatism; if we can't begin to unite the Globe in some field, as he has done, then why try? But then I remember the Farmer response to such inquiries, the Zen approach: there is only today, do what you can. Ironically, perhaps achieving a global cooperation on important issues is rooted in local, personal connections. You keep your head down, do what you can with good will at any given moment, take your opportunities as they pop up, and forget about all the speculation. Sort of.
Kidder mentioned towards the end of Mountains that Farmer seemed to depend on his interaction with patients (which is the reason he would make 11 hour hikes to visit them), that no matter how famous he became, these relationships were his real fuel. This analogy can probably be expanded to any field.
I write all of this to say, simply, that I am leery of what Farmer calls "personal efficacy," though apparently it is a trait we all seek.