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I believe Haiti was a French colony, not British.
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Dr. Paul Farmer and Mountains Beyond Mountains
Started by Drogba
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of course you will read right past what i wrote and go into a sarcastic tirade. i understand that promoting a good cause and going public can bring in money and awareness. but you are missing my point, i was talking about altruism. although farmer is doing an honorable even great thing by going to the third world and saving countless lives he cannot be considered an altruist and therefore not a true hero in my opinion. this is why: he may be doing all this work out of the goodness of his heart but because his work is so widely recognized and praised, he has already received his reward for all his labor. sure he may not be looking for this sort of reward at all, but nonetheless he received it. an altruist is someone who does charitable work or any sort of kind act, but in such a way that he/she is not acknowledged so as not receive any sort of reward or recognition even if it's not sought. it doesnt even have to be a great act, it could just be returning a lost wallet anonymously or dropping off gifts at a night drop during the holiday season. public acts of goodwill and charity like farmer's are very helpful to suffering people and can have a massive impact on the world, but you just cant argue that they are acts of altruism.
Oh, sorry. I didn't know we were making up new definitions for words.
But wait, by your definition, wouldn't anybody you consider to be altruistic automatically disqualify, since they are receiving recognition and praise from you for their actions? Likewise, Ghandi, Jesus and Buddha must not be altrustic because there are countless people that recognize their efforts, correct.
This is foolish, right? Right. Thats because anonymity is not a condition that must be met in order for an action or a person to be altruistic. Instead, something is altruistic based on the motives of the individual.
You really need to stick to the widely accepted definitions of english words. Otherwise intelligent discourse is pretty much impossible. Or would you like to continue arguing that the person who returns your wallet is only altruistic if you happen not to get the chance to thank them?
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first of all there is no widely accepted definition of altruism, people disagree on what it is all the time. second even if the defintion of altruism you describe is the one held by the majority i dont agree with it.
and when was it ever a general consensus that people like ghandi, Jesus, and Buddha were altruists? just because someone leads a noble cause and has a peaceful philosophy, it doesnt make them altruists. i think youre the one with the mixed up definitions.
and i think you understand my point very well but just dont accept it. in fact the people i consider altruistic i dont know personally, but only know of their existence. and yes to your question with the wallet example. your motive criterion sounds right but it breaks down. even if someone has genuine motives and does not seek recognition, they still receive it regardless, thus making their service paid in full. the definition of altruism i hold on to, is that one does not receive any reward for their good deed, but that is not saying that it spoils the deed by any means, just that the deed is no longer altruistic.
So basically what you're saying is that altruism is a negative quality? (not negative as in bad, but negative in that it implies an absence of something) I'm curious, can you give some examples of people you consider altruistic? It makes little sense to me to ascribe to a definition of altruism that implies that an individual can be altruistic their whole lives, then if anyone stumbles upon the story and makes it public, even against their will, suddenly it isn't altruistic anymore. I mean, under that definition, altruism is nothing but a hypothetical construct, as you cannot use it to describe anyone without paradoxically removing that quality from them at the same time. I think it would be worth reevaluating the validity of your logic there.
I prefer heinlein's description of altruism 🙂
"Being generous is inborn; being altruistic is a learned perversity. No resemblance--"
So please, do tell, what is your acid test for heroism?
I stated it in one of my previous posts: putting yourself at great immediate risk in the course of service to their fellow man. Martin Luther King, Jr was a hero; those serving in our armed services in combat roles are heros; my brother firefighters are heros, etc. Simple altruism does not make someone a hero.
hmmm.. how about voluntarily working in a hostile environment in which uprising is the norm and people of your nationality are actively mistrusted and threatened by elements in the government? How about risking being jailed for these things?
how about immersing yourself in an environment of widespread infectious disease, taking on the risk of being infected yourself?
how about personally standing down an armed soldier who is attempting to enter your clinic and haul away a critically ill patient, at risk of being shot?
A few of many things described by Kidder in MbM. Seems like a significant risk to me. To use your example of MLK Jr. as a comparison, Dr. King acted the way he did knowing full well he could easily be jailed. He acted the way he did knowing full well he could be injured or killed for it. I agree that Dr. King was a hero. However, the above circumstances are shared by Dr. Farmer as stated above. The difference, that I can see, is that Dr. King WAS jailed, and he WAS shot. To me, the fact of actually suffering the risked consequence is not the defining factor. I'm sure you wouldn't claim that the only soldiers that are heros are the ones who were wounded or killed, or that the only firefighters who are heroes are the ones who had a house collapse on them, that would be absurd as I'm sure you agree. Dr. King was a hero and a martyr... given the chance, I'm sure he'd have preferred to not take on the latter role. That doesn't diminish the former.
I do agree, however, that altruism does not equate with heroism. And for the record, I'm not a Paul Farmer fluffer. I agree in fact with those who have stated that his efforts alone will never solve the problems he is trying to solve. Rule of rescue is great for those rescued, but PIH is not going to bring Haiti out of poverty, or end the spread of TB and HIV. He is, however, demonstrating the good things that can be done if the effort is made, and that is a worthy goal in my opinion. Just because the guy isn't going to save the world doesn't mean he isn't saving a small portion of it, and that's plenty worthy to me.
Again, by your own definition, doesn't this recognition you award immediately disqualify those individuals from the status of an altruist? After all, they are being acknowledged by you for their efforts. Or is there some certain threshold of recognition you have to meet before your altruistic actions just become plain old 'good' or 'admirable'?
Okay, seriously? You can't really believe this. So say I push an old gradma out of the way of a speeding car and get hit myself, rendering me paralyzed from my neck down and unable to ever walk or have sex or pursue a career in medicine. You are saying it was only an altruistic action until the evening news does a 2 minute story about it, then I am paid in full? Or if the life work of Paul Farmer ultimately saves thousands of humans from a slow and painful death, he still does not qualify as an altruist because someone wrote a book about him?
You either a) have not actually taken the time to think through the implications of your reasoning, or b) know that your argument is rediculous and merely refuse to admit you are wrong.
I don't disagree that social change is difficult to bring about, requiring decades or centuries and many dedicated people. That social change is possible is evident, however.
I agree with the gist of this, insofar as grandiose idealism is impoverished. Yet, to forego any discussion of change is irresponsible and reprehensible, unless you believe change itself to be undesirable.
Social inequality is NOT a natural state, simply A state, the result of historical and structural elements in a society. It just so happens to be ubiquitous, yet if experience tells us anything, variable depending upon the society. Since the latter is the case, you cannot dismiss someone or a set of ideas that value the decrease of inequality, since the very state of the world reflects the fruits of this struggle, to different degrees in different places...unless of course you don't value equality in the first place, but that is altogether a different debate.
Okay.
Believe it or not I didn't think this thread would be so contentious when I opened it!
Nope. That's not real danger.
So working in a nursing home makes one a hero then..
....hmmm, when will they start handing out Silver Stars for C. diff bedpan detail I wonder.I have a hard time actually believing that Farmer would do such as thing, as he seems to have a hard time making eye contact when one confronts him academically, let alone if someone were packing an AK. I watched him stare at his feet as a nationally known ethics prof took him to task over some assinine point regarding his work- I was too busy trying not to laugh at this mousy guy trying to exit the conversation quickly because he was losing to pay attention to the actual argument. That would not be the type of person (especially since he doesn't seem to also be totally nuts) to stand up to someone pointing a gun at him.
He is no doubt a humanitarian, no doubt a brilliant man, but from what I've seen the spine in his family went to his brother. Perhaps what Kidder related is akin to a fisherman's tale....by the time the story is retold and polished, the bass is not 12" and 14 oz, but 3 feet long, 25 lbs and packing an Uzi and a bad attitude. I've seen people play up "armed gunmen" as though they were going to shoot everyone execution style before when all the guy did was have a pistol stuffed in this waistband. I am not completely denying the possibility, but it seems unlikely in my book.
This we agree on. My problem is with the near idolization by premeds, as though he is the ninth incarnation of the Buddha, simply because he has a good PR department. The effort is worth making- otherwise I would not be active in international health operations myself- but my issue comes with the fact that people on SDN seem to ignore, not recognize or at least underestimate the problems with grandiose plans to save the world.
No, I don't claim any of those. However, just because you're in an area that is openly hostile does not mean you are a hero. Otherwise a bunch of the chicken****s from my Air Force unit who were in Afghanistan with me could be classified as heros. They also did not enlist out of selflessness, they did it because they had no other decent options and they conducted themselves in an entirely self-serving manner.
Yes, but it is normally possible only if it starts internally, within the people. It being externally motivated generally works in the short term, but not the long term. France is a good example....after a couple of go-arounds of German occupation, they still have not learned a decent work ethic.
No, no...change needs to occur, but it must occur as more a cautious steering of a people in the correct direction towards an endpoint carefully chosen based on the local issues. You are not going to end rape by soldiers in Africa, the spread of AIDS (until a vaccine is developed), or instill economic self-reliance simply because there is nothing there to rely upon. The joke from the Onion about the 'stick market' comes to mind in regards to the latter.
The problem is that complete equality is counterproductive in an economic sense. There needs to be a basic, although not be any means ideal, level- of nutrition, housing, healthcare and education- below which no person is allowed to fall, but beyond that there should completely be a class system based upon how much you contribute to society. If everyone is to be treated entirely the same- with equal access to the very best of everything- you leave people no reason to work to advance themselves.
Ah, that reveals you have not spent much time here young Jedi.
We can make a discussion of the sky being blue contentious.Dienekes,
Sometimes exposing yourself to danger for the sake of being in a dangerous situation is not heroic but reckless. PIH is having a much greater impact on public health then an army medic regardless of the level of danger involved. If you measure heroism in self sacrifice then I think Farmer measures up quite well, and I think when you mention danger as a requisite for heroism the integral part is the self sacrifice and not danger itself, though maybe I'm misunderstanding. Frankly though I'm not interested in arguing Farmer's hero status. I believe his work is founded on great principles and has shown great promise so he deserves as much exposure as possible. Thank god the man knows how to navigate the politics of international health to some degree (the good PR dept you mention).
The spread of AIDs in Africa might be ended by a vaccine, but that vaccine won't cure the structural issues that encourage the spread of infections in a general sense. Curing a disease is great, but only partly valuable if we are just waiting for another infection to come around and take its place. A treatment for TB has been available for well over 50 years and yet it is one of the top infectious killers. You know, the whole philosophy of treating the etiology vs the symptomotology.
As far as equality is concerned, have you read any of Amartya Sen's work? I think you would find Inequality Reeaxmined especially interesting. The goal is not to guarantee equal outcomes (an impossible task), but equal opportunity to pursue wellbeing (capability). So we should try to eliminate the structural hindrances that restrict peoples capabilities not attempt to force equal outcomes. One aspect of this is guaranteeing access to standard of practice health care.
Indeed I have not spent much time on SDN, and it seems many people here look intently for excuses to launch tirades, which is unfortunate. Must be a coping mechanism.
Sometimes exposing yourself to danger for the sake of being in a dangerous situation is not heroic but reckless. PIH is having a much greater impact on public health then an army medic regardless of the level of danger involved. If you measure heroism in self sacrifice then I think Farmer measures up quite well, and I think when you mention danger as a requisite for heroism the integral part is the self sacrifice and not danger itself, though maybe I'm misunderstanding. Frankly though I'm not interested in arguing Farmer's hero status. I believe his work is founded on great principles and has shown great promise so he deserves as much exposure as possible. Thank god the man knows how to navigate the politics of international health to some degree (the good PR dept you mention).
The spread of AIDs in Africa might be ended by a vaccine, but that vaccine won't cure the structural issues that encourage the spread of infections in a general sense. Curing a disease is great, but only partly valuable if we are just waiting for another infection to come around and take its place. A treatment for TB has been available for well over 50 years and yet it is one of the top infectious killers. You know, the whole philosophy of treating the etiology vs the symptomotology.
As far as equality is concerned, have you read any of Amartya Sen's work? I think you would find Inequality Reeaxmined especially interesting. The goal is not to guarantee equal outcomes (an impossible task), but equal opportunity to pursue wellbeing (capability). So we should try to eliminate the structural hindrances that restrict peoples capabilities not attempt to force equal outcomes. One aspect of this is guaranteeing access to standard of practice health care.
Indeed I have not spent much time on SDN, and it seems many people here look intently for excuses to launch tirades, which is unfortunate. Must be a coping mechanism.
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Rule #1 of EMS: Your ass before anyone elses.
Can't say that I recall doing so, but I will definitely will try to find that book.
The vaccine is not a treatment, but a preventative measure, so it would be of no benefit to those who already have it. If you can prevent the spread of the infectious agent via immunologic methods, then you reduce (but not eliminate) the need to attack the disease from other angles. Better hygeine, safer sexual practices, and control of vectors would all need to still be encouraged, but the consequences for failure would not be nearly so dire with the possible exception of the emergence of a "super-strain" of malaria in Sub-Saharan Africa or the Caribbean.
Or boredom.
There is already a superstrain of TB. The things you mentioned (better hygeine, safer sexual practices, and control of vectors) are not simply choices, there are structural reasons that make each of these less likely. Also, AIDs prevalence is one result of structural violence to borrow a term Farmer is fond of, but it is not the only one. War, crime etc won't be rectified by immunologic methods, though no one will complain if we find an aids vaccine. The problem isnt even that we don't have adequate treatment for AIDs, its a question of access, again a structural problem, much like with TB.
Definitely check out Amartya Sen, he is a nobel prize winner in economics. You will probably gain a lot more than I did seeing as you have a background in the subject, though its not very technical.
This I know..... 😉 I'll PM you and explain something about my background.
I was stating that beyond these things (HIV and TB) the next most disastrous thing we could potentially see is a superstrain of malaria develop. Even the WHO points this out...hence the funding for malaria vaccine research.
negative, right, in the way that it is imbalanced, unpaid for, what ive been explaining the whole time. i gave examples in an earlier post. and yes it is the unfortunate truth that if someone somehow accidentally stumbles upon your altruistic behavior and makes it public it is like robbing you of the great act, corrupting it's sanctity, so better try hard to not make it known, it must be only for your personal satisfaction. you are explaining my point very well, youre are absolutely right in that you cannot describe any altruistic person specifically because by doing so you are giving them the recognition that they absolutely deny. instead again like i said earlier we can only acknowledge that they exist in a general sense, that they are out there. by simply understanding that they exist, we are not making them public figures.
you are either a) a brick who cannot think creatively or b) extremely stubborn
ha i should have expected this, well done, coming up with the most extremely example such as bodily sacrifice. okay, youre right i didnt cover all my bases, but ill make an addition to it now. what i was refering to previously did not entail permanent damage to one's body or mind, but i guess i have to address it now. damage to one's body or mind for another may still be considered altruistic even if it is recognized because you cannot be repaid fully for permenant damage to body or mind, once it's lost its lost. other acts of goodwill, when just the plain act is concerned, can indeed be paid for in full simply by recognition.
and yes how many times do i have to say it, i dont consider paul farmer an altruist even though he's a great humanitarian because he has already been duly recognized for his charity, sacrifice, and hard work.
What about a firefighter who hates his job but does it for 40 years because he believes it is his duty to help others? Sacrificing four decades is paid in full once he gets a plaque commemorating his service upon retirement? If you are weighing the payment someone receives from recognition against their sacrifice, why limit it to bodily or mental damage? Why not include time, money spent, relationship problems incurred, etc?
Your first definition left it up to luck - awarding the status of altruism only if one was clever or lucky (or unlucky) enough to avoid getting recognized for their actions. Now it seems that you are trying to implement some convoluted formula to determine if the individual in question has been adequately repayed for their efforts. If this is the case then you should be consistent with this reasoning and weigh each potentially altruistic action against the benefit the individual received from being recognized.
Any impartial application of this formula would surely find that having a biography written about you is not adequate reimbursement for a lifetime of dedication to saving lives. Just as you pointed out that recognition is not sufficient payment for bodily damage incurred from an altruistic act.
This has been a fairly simple exercise in detecting and critiquing erroneous reasoning, but if you still insist on sticking to your guns then there is no point in continuing. In a formal debate we would be at what is called a Judge's Halt, where the reasoning provided in your argument has been identified as logically inconsistent and demonstrated to lead to unacceptable consequences and therefore the original premises and conclusion of your position must be modified in order to continue.
Leave the assistant chief of the volunteer fire department I used to run with out of this.
(No, I'm not kidding...that seriously reminded me of someone I used to work with)
Side note: did you work as a EMT/first responder or as a firefighter? Either way that is pretty sweet - I am going to try to hang with some firefighters as an EMT this summer.
bwahahahahahaha or if they don't have reference to that book they have reference to similar thoughts about saving the world after their one or two 2-6 week trips abroad thinking they know everything about saving the world.
I suppose its been the center of Panda Bear's dead african babies joke from his fake personal statement that he wrote on here.
That said, I've never read the book but I have seen Dr. Paul Farmer in person at USF last year and he's an amazing speaker. Very witty and very funny and definitely someone to admire. BTW don't take me the wrong way for what I wrote above this paragraph. I do see international health as an important initiative just as I see getting people who lack proper healthcare here being an important issue. What I don't get however is the number of premeds who say that they see it as being important but by the time they are done with med school will never really show proof of intention to help poorer people which is why I'm cynical towards people who claim they are going to go out and save the world after med school. Numbers speak louder then words and the number of people who keep to those initiatives is very minimal compared to the number who start out saying they'll work towards those initiatives.
Yeah he spoke at USF last March at the end of the month and then again a couple days later at a conference in downtown tampa. I didn't meet him downtown but I saw him at USF and the part i most admired about him wasn't that he was from HMS, or that he went overseas and had an MD but the fact that he remained so very humble and humorous rather then one of those way too serious for their own good kind of doctors I've met where I grew up.
Have you ever met Paul farmer? I think someone who is doing something only for pure fame and fortune would be truly arrogant and Paul farmer in person was not an arrogant ass at all. In fact, he was one of the most humble people I've met among physicians. Also, I don't know how he'd be considered selfish considering he'd be making wayyyyyyyyyyyyy more money in the US. I highly doubt avoiding on call hours is an issue considering that when you work in academic medicine you don't have as bad on call hours as someone working in the same field in a private practice since you also have other projects to worry about like research and teaching students.
Last but not least, why the hell would Paul farmer stay in the states when his field of medicine is infectious diseases and the worst and most challenging cases of infectious diseases occur in the developing nations? Have you ever taken any infectious diseases, or medical microbiology or epidemiology courses? if you have you'd know that the most prevalent cases of infectious diseases occur in Latin America and carribean islands, Africa, Middleast, and Asia where there are more underdeveloped conditions; where the water is less sanitary, where the conditions are more tropical and hence humid nature allows a lot of parasitic infections, and viral infections to spread. The worst cases of AIDS, multiresistant TB, malaria, etc. are not in our own nation so what would be the sense of becoming and infectious disease specialist and not doing any overseas work???
It is the same reason that one of the more famed doctors in Moffitt Cancer center at Tampa go overseas. There's a lot more work in those fields abroad then there is here.
Why and how did this turn into a whole argument about the idea of altruism? I didn't read the whole thread. I agree about the part about considering Paul farmer as a great humanitarian and that's all I think he's ever considered himself to be and tried to promote others to be. I don't think he's trying to label himself as above others as an altruist.
There is a reason they call it ID now and not tropical medicine. Suggesting that countries in the tropics are inherently susceptible to infectious diseases is a way to obscure the real causes. Russia has one of the largest problems with TB and AIDs, can't get much colder than that. Britain was full of TB not too long ago, much like the rest of industrialized temperate Europe. The black death, the most infamous of infectious diseases, killed people all the way across Asia into the furthest northern regions of Europe. None of the big killers have anything to do with climate, except malaria. Even malaria however can exist naturally in most of southern Europe and the southern US, but it doesn't and that has nothing to do with climate. The idea of tropical medicine is an outdated colonial construct that suggested these areas of the world were inherently sick thereby obscuring what the real differences were between the "tropics" and temperate Europe.
This post is not meant to minimize the rest of your comments. I agree largely with everything you said, but assigning cause to a "tropical" environment is a mistake that has roots in colonial medicine.
I have done both, for over a decade now. It is very unusual to see non-combination departments (EMS/Fire) where I grew up, so you had to do both. I also did HAZMAT and swiftwater/ice/dive rescue. I also previously taught EMS courses from first responder through to the complete EMT-Intermediate level and parts (airway/respiratory, cardiac, trauma) of the paramedic curriculum.
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I wish I had the money to take an EMS course ;[. Want to train me for free?
If you have any questions, feel free to ask. 😉 You might talk to some of your local volunteer departments...many times, if you are willing to volunteer enough they will pay for your course. The other option is they may be sponsoring the course themselves.
I started reading the thread, but it seems to have gone off topic. I just wanted to thank you for sharing this book. I'd never heard of it before. As a Caribbean person, I plan to work in the Caribbean and Latin America, at least part time. Since Haiti and Guyana are on the top of places for me to work so I look forward to reading this book
Lys
I tried to read mountain beyond mountains this past Christmas and I eventually stopped half way. I really respect his work and dedication but something about him was a bit too perfect for me in a way I could not relate to or even see myself ever becoming.
If I remember correctly, as at the time the book was written, he was seeing his family very few times a year and spending most of his time in the hospital in haiti...etc. It made it look like one required super human qualities to get to the level he was at. I am more inspired actually by Dr.Ben Carson because he just seems like a more realistic role model for me...
If I remember correctly, as at the time the book was written, he was seeing his family very few times a year and spending most of his time in the hospital in haiti...etc. It made it look like one required super human qualities to get to the level he was at. I am more inspired actually by Dr.Ben Carson because he just seems like a more realistic role model for me...
Just because you are inspired by him doesn't mean you have to become him (or do exactly what he does). That fact is addressed several times in the book. People find inspiration in many individuals that have sacrificed much more than they are willing to sacrifice. Many people are working with Partners in Health, Boston Health Care for the Homeless, MSF and myriad other clinical settings who still have a relatively balanced life.
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Although, I haven't read the book yet, I saw him speak...phenomenal!
