A Great Book

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Rud42

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Has anyone else read "Mountains Beyond Mountains" by Tracy Kidder?

If not, do immediately. It is a great book about Dr. Paul Farmer, and a few of his colleagues, that do work in medically underdeveloped countries, esp. Haiti.

I recommend this book to everyone.
 
one of my favorite books... I just bought every book Dr. Farmer wrote and am about to start working through the pile.
 
Who is Paul Farmer?

No, wait. Let me rephrase. I just wikied him. Why do we care about Paul Farmer?

Honestly, he's come up before and I want to know why people think he's the cat's meow.
 
I don't think he's the best or anything, but the book is a great story of his influence over medicine in a few countries that desprately need it.
 
Who is Paul Farmer?

No, wait. Let me rephrase. I just wikied him. Why do we care about Paul Farmer?

Honestly, he's come up before and I want to know why people think he's the cat's meow.

He is crazy smart and dedicated. I think the biggest thing is that he's been able to disprove a lot of theories about providing healthcare in resource-poor areas. Lots of people assumed that expensive, long-term treatment regimens for diseases like HIV/AIDS and TB were unsustainable in third-world countries, but he's had some considerable success.
 
You should really read the book. It's not boring at all, an enjoyable read in my opinion.
 
Who is Paul Farmer?

No, wait. Let me rephrase. I just wikied him. Why do we care about Paul Farmer?

Honestly, he's come up before and I want to know why people think he's the cat's meow.
.
 
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Who is Paul Farmer?

A self-righteous douchebag who probably was a hippie in his younger days judging by his views and his actions.

No, wait. Let me rephrase. I just wikied him. Why do we care about Paul Farmer?

Honestly, he's come up before and I want to know why people think he's the cat's meow.
Because he basically has the sugarcoated view that we can fix insurmountable problems that most premeds like to believe they are the one who will solve them. Personally that book is my second least favorite (don't get me started) that gets trumpeted to premeds as a great read. Given my choice, I wouldn't rip pages out of it to wipe my ass, even if the only other option was to use a pinecone dipped in Tabasco sauce.
 
He is crazy smart and dedicated. I think the biggest thing is that he's been able to disprove a lot of theories about providing healthcare in resource-poor areas. Lots of people assumed that expensive, long-term treatment regimens for diseases like HIV/AIDS and TB were unsustainable in third-world countries, but he's had some considerable success.
Just because he is "crazy smart" and "dedicated" doesn't mean he's not wasting his time. We have more important issues to fix than worrying about Africans and Haitians with AIDS and TB. Isolate them, let the disease run its course, and save a whole bunch of money in the process. No, instead he goes out and makes a massive ego-stroking name for himself by "helping" these people. I question his allegedly altruistic motives. Personally I think it's all ego, otherwise he wouldn't have written a "pile of books"; which are all repetitive and boring by the way....I should know we had to read some of them for a class I took. Paul Farmer can s.....well never mind.
 
Just because he is "crazy smart" and "dedicated" doesn't mean he's not wasting his time. We have more important issues to fix than worrying about Africans and Haitians with AIDS and TB. Isolate them, let the disease run its course, and save a whole bunch of money in the process. No, instead he goes out and makes a massive ego-stroking name for himself by "helping" these people. I question his allegedly altruistic motives. Personally I think it's all ego, otherwise he wouldn't have written a "pile of books"; which are all repetitive and boring by the way....I should know we had to read some of them for a class I took. Paul Farmer can s.....well never mind.

Wait, I thought we invented medicine so we could have an alternative to this "strategy". Everybody has their priorities, i doubt what he does is egotripping. he started this way before he made a name for himself. And honestly, if this is how he wants to ego trip, by all means do it. Sure beats some plastic surgeon making millions/yr doing tit jobs and stroking his ego by appearing on Dr. 90210
 
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Wait, I thought we invented medicine so we could have an alternative to this "strategy".

It works fine in an educated, (relatively) easily controllable society. It doesn't work so well in a tribal and uneducated region with no grasp on anything but immediate gratification, brutality and a few other rudimentary tasks. You're talking about groups of people too stupid to stop breeding in the middle of famines. We have people here we could be treating with these medications or spending the money we waste trying to manage an epidemic in Zaire (picked for the sake of argument) that can be better spent finding better treatments for asthma, cardiac disease, etc. If we spent the money we blow every year on these stupid natives and their problems, we might not have to be staring down the barrel of a health care crisis in this country.

Everybody has their priorities, i doubt what he does is egotripping. he started this way before he made a name for himself.
So? Everyone starts doing what feeds their ego even before they start getting massive external recognition for it.

And honestly, if this is how he wants to ego trip, by all means do it.
Yeah, I don't mind him doing it. I just have a problem with him tooting his own damn horn about it because he chooses to waste his time in this fashion. It doesn't make him special in any real sense other than he's wasting his talents.

Sure beats some plastic surgeon making millions/yr doing tit jobs and stroking his ego by appearing on Dr. 90210
Not really....they're both misguided and self-absorbed....just different ends of the spectrum. I would imagine Dr. Farmer lives pretty high on the hog courtesy of his "altruism". In fact, I'd bet money he makes more than most plastic surgeons between his salary (at Harvard I believe), his books, and his speaking engagements.
 
It works fine in an educated, (relatively) easily controllable society. It doesn't work so well in a tribal and uneducated region with no grasp on anything but immediate gratification, brutality and a few other rudimentary tasks. You're talking about groups of people too stupid to stop breeding in the middle of famines. We have people here we could be treating with these medications or spending the money we waste trying to manage an epidemic in Zaire (picked for the sake of argument) that can be better spent finding better treatments for asthma, cardiac disease, etc. If we spent the money we blow every year on these stupid natives and their problems, we might not have to be staring down the barrel of a health care crisis in this country.


So? Everyone starts doing what feeds their ego even before they start getting massive external recognition for it.


Yeah, I don't mind him doing it. I just have a problem with him tooting his own damn horn about it because he chooses to waste his time in this fashion. It doesn't make him special in any real sense other than he's wasting his talents.


Not really....they're both worthless misguided sacks of crap....just different ends of the spectrum. I would imagine Dr. Farmer lives pretty high on the hog courtesy of his "altruism". In fact, I'd bet money he makes more than most plastic surgeons between his salary (at Harvard I believe), his books, and his speaking engagements.
but you can treat people a lot cheaper in africa than you could in america. If his goal was treating underserved patients, then it seems like Haiti and Africa are pretty good places to do it. Plus a lot of his work involves setting up good clean facilities and educating people about how to take care of themselves. Paul Farmer isn't the US government, he doesn't have to treat only Americans. A lot of his work in Haiti was done through private donatins, not the US government. Seems like your complaint lies in how the US distrubes its money, not in Paul Farmer doing his job.

Not to mention asthma and cardiac research are getting plenty of funding as it is, i doubt what money paul farmer raises up isn't going to signficantly quicken the pace.

And as far as his speaking engagement and publications, does this mean anyone who publishes or speaks has to be doing it for egostroking reasons? They coudln't possibly want to rally people to his/her cause? By your definition Ghandi was an egostrking d-bag
 
I dunno, i doubt the patients he's treated see his actions as a waste of time.

I know oncologists who treat patients with 99.99% mortality who still see trying as a worthwhile endeavour. Your point?

Most of Farmer's work in Haiti was done through private donations, not the US government.
I didn't mention government funding. If people donated to fund healthcare here rather than feeling guilty for a bunch of dying people elsewhere, we might be able to improve things for ourselves.

And if you did something in your job that other people wanted to emulate, would you refuse to go on these speaking engagements or refuse to write hte books simply because you dont want recognition?
Well, if I wasn't serving as a bad example, no. That is what Farmer is. He's a shining example to a bunch of wide-eyed premeds that reality be damned, you too can shuffle off your mortal coil helping people who would likely cut your throat just to say they did (or for your wallet, either way).
 
I know oncologists who treat patients with 99.99% mortality who still see trying as a worthwhile endeavour. Your point?


I didn't mention government funding. If people donated to fund healthcare here rather than feeling guilty for a bunch of dying people elsewhere, we might be able to improve things for ourselves.


Well, if I wasn't serving as a bad example, no. That is what Farmer is. He's a shining example to a bunch of wide-eyed premeds that reality be damned, you too can shuffle off your mortal coil helping people who would likely cut your throat just to say they did (or for your wallet, either way).
Some people feel more responsibility to people in general rather than a nationality. And isn't Farmer alive? Seems like he's manage to dodge all the throatcutting patients that are at every turn.

So essentially, you're mad at Paul Farmer for helping nonAmericans. Yes?
 
Wow we derailed this thread. Anyway, Murphy, I love the asystole shirt on your site. I seriously laughed aloud when I read it.
 
but you can treat people a lot cheaper in africa than you could in america. If his goal was treating underserved patients, then it seems like Haiti and Africa are pretty good places to do it.

Yes, but what good does it do to treat them? They barely manage to support themselves. Instead of a (relatively) quick death from AIDS, they slowly starve or die in a civil war when they realize the guys in the next tribe down the road have bigger penises than they do. Besides, treating an AIDS patient in a setting like Africa only leaves them alive to spread it further.

Plus a lot of his work involves setting up good clean facilities and educating people about how to take care of themselves
Yeah, and we see how well that works on a large scale. How long have the Christian charities been trying to fix Africa? Since the late 1800s? As soon as the Westerners leave, the natives tear the **** up, have a war, burn their neighbors' crops and we're back where we started.

Paul Farmer isn't the US government, he doesn't have to treat only Americans.

No, but it seems pointless to go to a country with NO tangible infrastructure at all and try to fix problems when someone who is knowledge and driven could make a difference here.

Seems like your complaint lies in how the US distrubes its money, not in Paul Farmer doing his job.

Actually both. I have no problem with him sitting over in some sweltering, festering ****hole of a nation tending to the sick if that's how he gets his jollies. What I want is him (and all the goodie two shoes premeds on this forum) to shut the hell up about it. "Yes, that's nice Paul. You dealt with DABs? That's nice. Shut up already."

I see the funding sources now as a waste of money. There are other countries (Peru, India, Nepal, the Kurdish state in northern Iraq, etc) that would benefit far more than the squallid tenements of Africa or the Caribbean from an influx of cash, equipment, supplies and persons willing to teach. It's not a matter of doing something for the most people, it's a matter of the doing the greatest good for the most people. Seems like some people forget that.

Not to mention asthma and cardiac research are getting plenty of funding as it is, i doubt what money paul farmer raises up isn't going to signficantly quicken the pace.
I used those as examples, but there are plenty of conditions where if half the money we waste on hopeless cases in foreign countries were to be put towards research the lives of contributing members of society would be vastly extended and improved. Hell, I'd rather see the money put towards palliative care research here, in Europe, and in Asia than towards extending the lives of HIV+ tribesmen and civil warriors so they can spread the disease further whilst slaughtering innocent civilians.
 
Some people feel more responsibility to people in general rather than a nationality. And isn't Farmer alive? Seems like he's manage to dodge all the throatcutting patients that are at every turn.
I believe he is. I'm thankful for that.....I don't think the mourning period for him here on SDN will be much fun. 🙄

So essentially, you're mad at Paul Farmer for helping nonAmericans. Yes?

Two things: One: I'm not mad in the slightest. I'm not a fan of his in the slightest.

Two: I have no problem with helping people from other countries. Hell, I'm learning Spanish and going to Peru to teach in January so that should give some indication of the fact that it's not a just a "He's not helping Americans!" issue. It's the fact he's frittering away money on things where the benefit is less than what we could be getting if we used it for something else. As I said, there are a lot better places- geographically speaking- we could be spending the money.
 
I believe he is. I'm thankful for that.....I don't think the mourning period for him here on SDN will be much fun. 🙄



Two things: One: I'm not mad in the slightest. I'm not a fan of his in the slightest.

Two: I have no problem with helping people from other countries. Hell, I'm learning Spanish and going to Peru to teach in January so that should give some indication of the fact that it's not a just a "He's not helping Americans!" issue. It's the fact he's frittering away money on things where the benefit is less than what we could be getting if we used it for something else. As I said, there are a lot better places- geographically speaking- we could be spending the money.
Didn't he do work in Peru as well?
 
Wow we derailed this thread. Anyway, Murphy, I love the asystole shirt on your site. I seriously laughed aloud when I read it.
Glad you like it.....I unintentionally wore that to an informal meeting (I was pulled along to the lunch time meeting at the last minute) once with a doc who is on the ACLS committee for AHA. He laughed pretty hard. My personal favorite is the "ACLS donkey punch" one though. :laugh:
 
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Yeah, partners in health has a pretty sizable presence in peru. Also in Russia, Boston, Haiti, and Rwanda. Let me repeat... BOSTON. So stfu already. He went to Haiti as an anthropologist, fell in love with the destitute of the countryside, who are in that situation through no fault of their own (hell he married a Haitian), and decided to try to help. In the process, he started a foundation that works on public health worldwide. They've developed new and improved methods of treating and managing xdr-tb, and has shown that aids can be managed if there's a will to do it. You mention oncologists who work with patients with a '99.9% mortality rate'. Do you spew venom at those individuals as well? Aren't they wasting their time? Or maybe they just feel that HUMAN BEINGS deserve to be helped, if there's ability to help them. Quite frankly, I don't give a **** about spending a few billion dollars to make some American dude who was gonna have a heart attack at 65 have it at 68 instead. If that same money can stop a few million 30 year olds from dying, and give them till 60, I say that's the way to go. And this is coming from someone with family Hx of heart disease, so I have a reason to want that **** taken care of. The fact is, there's more than one way to skin the utilitarian cat. And utilitarianism isn't always the answer anyway. I'm not becoming a physician to 'provide some care to the most people', I'm becoming a physician to provide the BEST care to whoever the hell is my patient. If this dude chooses to have Haitians, Rwandans, Peruvians, Russians as his patients, more power to him. If you don't like the guy, stay out of the ****ing thread and let other people talk about it. You've made your point, nobody gives a ****, so move along.

BTW, it's rather interesting that you're perfectly happy to learn spanish and go treat people in peru, or treat people here in the states. Nice caucasian/hispanic populations. But when it comes to the blacks in Haiti and "Africa", your response is 'Let those ignorant sub-humans die, let the diseases run their course and depopulate them all, we don't need them'. Yeah, I went there. Yeah, you'll deny it. But it's about the most racist ****ing thing I've heard on here in a while, and I'm calling you out on it. Who the hell made you the God who gets to decide who's worthy of life and who deserves to die?

For all you premeds who want to maintain a little of that love of humanity that you hopefully harbor, don't let dicks like this dissuade you. Go out and love people, care for them, do the best you can, and don't let a damn soul make you feel bad for it.

Dropkick, you want to throw around utilitarian arguments like their gospel, maybe you should go do a little reading in ethics instead of grabbing the first 'enlightened and pragmatic' viewpoint you saw. I suggest reading 'A Theory of Justice' by Rawls. It's a little bit different from what you may have seen but personally I think his ideas are enlightening, especially for someone who may claim to want to do the best work to help the world. It's one of my favorites, but certainly isn't the only point of view out there that disagrees with the philosophy of 'to hell with them, they're far and different from me'
 
http://www.pih.org. Farmer's org supports clinics in south Boston, Peru, Russia, Rwanda, Malawi, Lesotho, Guatemala and Mexico. And Haiti.

If teenagers read Mtns Bynd Mtns and get all excited about global medicine and think they can be the next Farmer, that's one thing. That's pretty much fluffy headed optimism and sparkly eyed dreams about changing the world, which will die in residency.

OK, but if a software engineer quits her 15 year career to go into medicine because that damned book sufficiently quashed her cynicism about how nothing's really worth doing because people f&ck everything up and nobody's worth saving and everybody's full of **** and stockholder value runs the world, maybe that's something else. Maybe that's a midlife crisis (thus the name). Or maybe it's what happens when there's a little bit of hope that doesn't come wrapped in Jesus or a self-help movement or botox. I'm taking a very expensive risk that I'll keep a bit of this hope through ten wicked years of training.

That damned book turned my sorry-ass life around. I don't want to be Farmer. I'll be happy to be 15% as effective.
 
Let me repeat... BOSTON.
It's based out of there. That's where their offices are.

Do you spew venom at those individuals as well? Aren't they wasting their time? Or maybe they just feel that HUMAN BEINGS deserve to be helped, if there's ability to help them.

Nope, because chances are good that the patients they are treating have contributed something meaningful to society.

They've developed new and improved methods of treating and managing xdr-tb, and has shown that aids can be managed if there's a will to do it.
The MDR-TB thing, yes that worked and needed to be done. Why waste more money on treating these AIDS patients when it would be simpler and more cost effective just to round them up and quarantine them? That would bring the problem to a far more rapid resolution than trying to educate a mass of insipid people who lack even common sense.

BTW, it's rather interesting that you're perfectly happy to learn spanish and go treat people in peru, or treat people here in the states. Nice caucasian/hispanic populations. But when it comes to the blacks in Haiti and "Africa", your response is 'Let those ignorant sub-humans die, let the diseases run their course and depopulate them all, we don't need them'. Yeah, I went there. Yeah, you'll deny it. But it's about the most racist ****ing thing I've heard on here in a while, and I'm calling you out on it

I was waiting for someone to not be able to take me on point and play the race card. I guess the time I spend working with people of basically every ethnic group you can name (short of Hmong, I've yet to see one of them here) at a clinic here in town is just for show. 🙄 I don't care about their race. I care about the color of their skin. If these problems were infesting a group of stupid white liberals, I'd have no problem quarantining their butts either.

Go out and love people, care for them, do the best you can, and don't let a damn soul make you feel bad for it.

I'm not telling them not to. I'm just demanding that they be realistic in how they expend relatively limited resources. Focus on those things you can address successfully, and those people who will benefit the most and, in turn, benefit others.

If this dude chooses to have Haitians, Rwandans, Peruvians, Russians as his patients, more power to him. If you don't like the guy, stay out of the ****ing thread and let other people talk about it.

Yeah, more power to him too.....he just should not expect to get his ass kissed for it. I've met the man at one of his speaking engagements (forced to attend by my then girlfriend). He's a self-righteous piece of work.

You've made your point, nobody gives a ****, so move along.

No, you don't give a ****. Slight difference there. If it weren't for the rule against re-posting PMs, I could show you the seven or eight PMs I've gotten since I chimed in on here. Only one of them sided with you. Most of them are to the effect of "Thank you for having the balls to say it."

Dropkick, you want to throw around utilitarian arguments like their gospel, maybe you should go do a little reading in ethics instead of grabbing the first 'enlightened and pragmatic' viewpoint you saw.

Sorry, I'm probably better read in ethics than you are. Just because I disagree and reject your view as idealistic nonsense does not imply I'm ignorant of the stances you take and how you feebly attempt to back them up.

I suggest reading 'A Theory of Justice' by Rawls. It's a little bit different from what you may have seen
Actually I read it while you were probably still in elementary school.....didn't really think it was anything special. It was better than most books out there, but then again it wasn't anything I had to change my shorts after reading either.

I think his ideas are enlightening, especially for someone who may claim to want to do the best work to help the world
Then maybe Dr. Farmer needs to read it, not me. I've never claimed that.

It's one of my favorites, but certainly isn't the only point of view out there that disagrees with the philosophy of 'to hell with them, they're far and different from me'
Once again with the racism retort.....nice......apparently you should find some good books on how to formulate a proper argument. I can recommend a few to you if you like. It has nothing to do with them being far away (I would lock up my roommate if he posed a threat to society), it has nothing to do with them being different (I would do the same to my own family) and I would expect the same to be done to me if I were suddenly struck down and found myself stupid and infected with something contagious. It's only a biased opinion if you don't apply it to everyone regardless of factors beyond their control (race, sex, ethnicity, height, eye color, country of origin). Please get off your pedestal and get down here with the rest of the guilty self-absorbed white (I'm guessing you're white based on your location and the limp wristed nature of your racism argument; if I'm wrong, I apologize) liberals before develop HACE.
 
http://www.pih.org. Farmer's org supports clinics in south Boston, Peru, Russia, Rwanda, Malawi, Lesotho, Guatemala and Mexico. And Haiti.

If teenagers read Mtns Bynd Mtns and get all excited about global medicine and think they can be the next Farmer, that's one thing. That's pretty much fluffy headed optimism and sparkly eyed dreams about changing the world, which will die in residency.

OK, but if a software engineer quits her 15 year career to go into medicine because that damned book sufficiently quashed her cynicism about how nothing's really worth doing because people f&ck everything up and nobody's worth saving and everybody's full of **** and stockholder value runs the world, maybe that's something else. Maybe that's a midlife crisis (thus the name). Or maybe it's what happens when there's a little bit of hope that doesn't come wrapped in Jesus or a self-help movement or botox. I'm taking a very expensive risk that I'll keep a bit of this hope through ten wicked years of training.

That damned book turned my sorry-ass life around. I don't want to be Farmer. I'll be happy to be 15% as effective.
Good luck. I think you'll make a kickass doc. At least something positive came out of what was otherwise a waste of a few trees.
 
OK, but if a software engineer quits her 15 year career to go into medicine because that damned book sufficiently quashed her cynicism about how nothing's really worth doing because people f&ck everything up and nobody's worth saving and everybody's full of **** and stockholder value runs the world, maybe that's something else. Maybe that's a midlife crisis (thus the name). Or maybe it's what happens when there's a little bit of hope that doesn't come wrapped in Jesus or a self-help movement or botox. I'm taking a very expensive risk that I'll keep a bit of this hope through ten wicked years of training.

Nope, sorry, the hope gets stomped out three weeks into first year. The world really IS that f'd up after all.



Just yanking your chain. It's actually kind of bizarre, I'm came into medicine this incredible cynic and it's slowly starting to reverse. I think a combination of my previous experiences in health care, those of my family, and also a healthy dose of medical theme programming (both fiction and non) made me all pessimistic about patients and the role of the doctor and all that jazz.

Now, I'm not Mr. Sunshine yet. Patients still are the own worst enemy, smoking and eating and sitting themselves to death. Drunks and druggies are still simultaneous hilarious and annoying. The end of life decisions made by family members still perplex me. But I'm actually starting to feel like I'm *gasp* helping people. And that's a good feeling.

Best of luck to you. I hope (and believe) that you've made the right decision.
 
Not really....they're both worthless misguided sacks of crap....just different ends of the spectrum. I would imagine Dr. Farmer lives pretty high on the hog courtesy of his "altruism". In fact, I'd bet money he makes more than most plastic surgeons between his salary (at Harvard I believe), his books, and his speaking engagements.

His books and speaking engagements probably don't really make all that much...honestly, who's ever heard of AIDS and Accusation? It's a modified version of his doctoral thesis, and probably no one outside the field of medical anthropology is all that interested. Same w/ his other books.

And even with a physician's salary, it'd be pretty hard to "live high" in Haiti, where he spends a good deal of his time...
 
Nope, sorry, the hope gets stomped out three weeks into first year. The world really IS that f'd up after all.
:laugh: :laugh:

Drunks and druggies are still simultaneous hilarious and annoying.

Drunks are some of my favorite patients.....especially the ones who retain a sense of humor.

But I'm actually starting to feel like I'm *gasp* helping people. And that's a good feeling.

Believe it or not, so do I. *waits patiently for collective gasp from the crowd and the accusation that I am lying from MattD*

And even with a physician's salary, it'd be pretty hard to "live high" in Haiti, where he spends a good deal of his time...

Maybe, but I heard the same thing about Afghanistan, and you'd be amazed what you can get in war-torn third world nations if you have money.
 
Now PeepShow actually raises an interesting point. Even Western patients are killing themselves off with relatively little interest in changing their habits. No patients on Earth think as similarly to American doctors as do American patients and yet doctors can hardly convince them of anything.

Can you imagine the difficulty in trying to convince Africans who are in desperate need of clean water and food that they should spend their time eradicating AIDs from their own population? These guys don't need our guidance. They have their own priorities and they themselves are not interested in what Western medicine has to offer. How are we to convince them otherwise when we can't even convince our own people to change less deeply ingrained habits?

For all you people who think this is a race issue, even if Hawaii (or even better--a fictional all-white island state of the U.S.) was suddenly stricken by AIDs and the people there could not be convinced to use condoms or to take their medicine or to change their habits, do you think the rest of the world would keep trying? Do you think that they would keep pumping in money and drugs if the people didn't even want the help? If instead of drugs, they wanted food? I doubt it.

Now add in the political situation. The people don't share your urgency. The government is corrupt and untrustworthy. Who are you going to give the medicine to? What use is your millions of dollars when they meet skeptical villagers and corrupt officials? I think you'd stop trying.
 
a fictional all-white island state of the U.S.
:laugh: A perfect example- in non-island form- of this that DOES exist is Harlan County, Kentucky. I worked there for a while and it is as white as driven snow, the people are uneducated (although some of them are the nicest people you could ever ask to meet) and don't have the common sense to take their hand off a hot skillet. All they care about (even at the expense of feeding and clothing their children) is access to booze, cigarettes and gas for their ATVs.
 
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This thread is really getting interesting. And its almost obvious that giving medicine and trying to cure a underdeveloped area like Africa is going to be hard, especially when people there are more concerned about living today, than what will happen five, six, maybe seven years from now. In a way this is a good example of Maslow's hierarchy of needs.

And 👍 to Dropkick for acually saying what I was going to say.
 
:laugh: A perfect example- in non-island form- of this that DOES exist is Harlan County, Kentucky. I worked there for a while and it is as white as driven snow, the people are uneducated (although some of them are the nicest people you could ever ask to meet) and don't have the common sense to take their hand off a hot skillet. All they care about (even at the expense of feeding and clothing their children) is access to booze, cigarettes and gas for their ATVs.
Same with most of the hobos Ive encountered at the local homeless shelter.
 
This thread is really getting interesting. And its almost obvious that giving medicine and trying to cure a underdeveloped area like Africa is going to be hard, especially when people there are more concerned about living today, than what will happen five, six, mabye seven years from now. In a way this is a goood example of Manslow's ierachy of needs.

And 👍 to Dropkick for acually saying what I was going to say.
OMG Manslow. I just got a flashback of general psych from 7 years ago.
 
OMG Manslow. I just got a flashback of general psych from 7 years ago.

Ironic how the classes that you think are the most useless in college turn up to be the most useful in life, no?
 
Ironic how the classes that you think are the most useless in college turn up to be the most useful in life, no?
I wouldn't say useful haha
 
I wouldn't say useful haha
I find psychology extremely useful. It comes in handy all the time. Such as during discussions in class I try to figure out on which axis my classmates' more overt psychopathology happens to belong. :laugh: Ah, boredom..... :laugh:
 
I sent the memo to my advisees, so I might as well suggest this book to you all too. It just came out in June.

Treatment Kind and Fair by Perry Klaus (who wrote Not an Entirely Benign Procedure in the 90's?). Anyone who has ever considered going to med school (or have friends or family who want to) should really read this book. Anyone who will be applying or interviewing should at least go through the first chapter.
 
Sorry my topic got such heated debate from both sides (although the debate was interesting to read, and both sides, in my opinion, had very valid points.).

Yes, the man is over-idealistic in many of his dreams on helping, but he seems totally intent on helping some of those that cannot help themselves (and I agree with DKM that the TB mission was much more valid than the one on AIDS).

Back to the topic. I think this book should show that people still do strive for the greater good, and they spend their time and money to try and help others. That is what I got from the "Mountains Beyond Mountains" book, not the specific details.
 
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Had to read this book for Freshman year.

Got through about half of it (CLEP tests anyone?) and didn't find it memorable. I bet if I read it now I'd like it more.
 
Just because he is "crazy smart" and "dedicated" doesn't mean he's not wasting his time. We have more important issues to fix than worrying about Africans and Haitians with AIDS and TB. Isolate them, let the disease run its course, and save a whole bunch of money in the process. No, instead he goes out and makes a massive ego-stroking name for himself by "helping" these people. I question his allegedly altruistic motives. Personally I think it's all ego, otherwise he wouldn't have written a "pile of books"; which are all repetitive and boring by the way....I should know we had to read some of them for a class I took. Paul Farmer can s.....well never mind.

I'd like to hear your plan for isolating AIDS and TB patients and letting the disease "run its course." Forgive me if I don't think rounding 30% of a country up and quarantining them doesn't sound like an appealing solution. Or perhaps there isn't a solution, or the solution is inaction?

Your posts seem to center on the fact that using resources for socially and economically unstable countries is wasteful, and could be used much more efficiently in other geographical locales. You acknowledge that the MDRTB campaign is effective, had to be done, and helpful, but you scathe the guy for his ego and his AIDS program. So how much of this exactly is "waste." And I don't really care about someone's ego if what they're doing is effective in any way. So how significant do you really think Paul Farmer's expenses are.

http://charitynavigator.org/index.cfm/bay/search.summary/orgid/4884.htm

How much of that ~20 million dollars a year in expenses do you think is wasteful, and is this whole argument really just about AIDS. All I know is that Farmer has done a lot, and I'm having a hard time buying that what he has done to help people worldwide is harmful or "wasteful." Just because funds could be used for something else doesn't mean they would be. It's not as if some force could reroute all the revenue from donations / charity / whatever from PIH into programs that you'd deem beneficial and effective. Paul Farmer worked to receive funds for his programs, what's to say by doing so he's taking AWAY from other highly-effective health programs. The money is there. Just because people donate to his program does not mean that they would've donated to others with their money.
 
Some of the people here don't seem to understand the basic hypothesis underlying Farmer's works.

First, he has an understanding of intricate connected in modern societies, that when people start becoming afflicted with X-MDR TB in ghettos of urban Peru, it's not just a ghetto problem, or a Peru problem, but a global problem that in a few years is going to bite everyone in the ass. When people continue becoming infected with HIV by the millions in Eastern Africa, the opportunity for infections like TB and a host of other infections to turn into more deadly strains multiplies, and that is going to come back and bite your comfortable ass here in America.

Second, the people who suffer the most from the aforementioned diseases and infections are not a geographical class of people, but a socioeconomical class of people, the poor all over the world. They are the ones who have limited access to medicines and to health care workers and treatment, they are the ones who when coughing up blood are worrying about how to pay for their next meal, they're the ones who see their children die lose their body parts and die over something as easily preventable as arsenic contaminated water. A quote that I can't find the location of in Farmer's Infections and Inequalities particularly comes to mind-- about how it's painful to have HIV, but to be infected with HIV and be in poverty is suffering. The poor are the ones who have no voice, and Dr. Farmer happens to subscribe to Virchow's view that doctors are the natural attorneys of the poor.

Third, the approaches that public health organizations have taken in the past few decades--- including a purely preventive measure is not effective, and then blaming the victims when things go wrong is not effective. What is effective is when you start attacking problems from all sides. When you start recognizing the fundamental underlying inequality and destitute conditions that people are living in is just as much responsible for their diseases as are the viral/bacterial hosts that infect them.

With their philosophy, PIH and their partners have has been responsible for driving down the costs of some of the most expensive second-line medicines.

On a personal note, certain individuals above should get off their high horse and take a good look at themselves, because people like Paul Farmer (the "self-righteous douchebag who probably was a hippie") accomplish more in a day to alleviate and find solutions global suffering, to help us all, than you will in a lifetime.

👍
 
With respect to quarantining infected populations, with the intent of protecting the rest of the population, I know of one case that worked and one that didn't.

Around 1984, when HIV had been "out" for maybe a year, Cuba did HIV tests on its entire population, and quarantined everyone who was HIV-positive. The "civilized" world went nuts over this - it was obviously fascism. Oh yeah? These folks were held voluntarily at an unlocked compound and were free to visit family etc. As treatments became available, this population was uniformly treated, and after a few years, the quarantine ended. Because of the way Cuba runs health care at a community level, the early quarantine was extremely effective, based on the current HIV infection rate in Cuba compared with other Caribbean nations (it's close to zero).

The other case is Drew Speaker, who we now know doesn't have XDRTB, just MDRTB. Getting him into isolation took a SWAT team. This is a guy who had the means to avoid a quarantine, for a while, and with all his education and wherewithal didn't consider himself a vector. Out of 300 million Americans, I bet there are at least a quarter million who would do the same out of entitlement. OK, now who did Speaker catch MDRTB from? Why was the source not in isolated treatment, given that the CDC requires it? As far as I can tell, not one party involved in MDRTB-on-a-plane is currently in isolation, and the source hasn't been found.

I'm making a very loose point here, but if you can't test the whole population, and if the population has personal rights, you can't do an effective quarantine. If we have nothing else in the US, we have contempt of government and basic financial means, even in our ATVs-Camels-&-Schlitz populations, and you simply can't screen or isolate on any large scale here. You pretty much have to have a small repressed island nation.
 
I'd like to hear your plan for isolating AIDS and TB patients and letting the disease "run its course." Forgive me if I don't think rounding 30% of a country up and quarantining them doesn't sound like an appealing solution. Or perhaps there isn't a solution, or the solution is inaction?

Your posts seem to center on the fact that using resources for socially and economically unstable countries is wasteful, and could be used much more efficiently in other geographical locales. You acknowledge that the MDRTB campaign is effective, had to be done, and helpful, but you scathe the guy for his ego and his AIDS program. So how much of this exactly is "waste." And I don't really care about someone's ego if what they're doing is effective in any way. So how significant do you really think Paul Farmer's expenses are.
the thing is until there is a definate way to get rid of AIDS for good, we are actually making things worse for them. You are just allowing them to spread it even more. Here in America, one of the most educated nations around, we cant even get a good majority to use condoms, or other sorts of things to prevent AIDS like abstinence. With that in mind what makes you think that one will be successful in teaching people how the disease works and how people should be going about it there, when they are more concerned about finding resources to make it throughout the day?
 
I'd like to hear your plan for isolating AIDS and TB patients and letting the disease "run its course." Forgive me if I don't think rounding 30% of a country up and quarantining them doesn't sound like an appealing solution. Or perhaps there isn't a solution, or the solution is inaction?

It's not inaction. It would actually be cheaper and would improve the quality of life for many of these people who currently live in squallor. I guess it depends on whether you're more concerned with one person's wellbeing than a society full of people. I value people's right to have self-determination, but there are limits. When you can't trust some brain dead tool from Biafra not to rape every female he comes across and visit every ***** in town despite knowing he has HIV, then someone needs to step in and stop him (even if it takes locking him up). If I really didn't care about these people in the slightest, I would not be advocating quarantine but rather simply euthanasia. That however is not a viable option in anyone reasonable person's book, not even mine.
 
It's one of the books on my summer beach reading list, I'll get to it soon enough.
 
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