HW 24 - Illness & Dying Book, Part 3

Tracy Kidder, Mountains Beyond Mountains, Random House, 2003

Precis: Paul Farmer met Father Jack when he was in Harvard Medical School. He used to board in his parish. Father Jack was a character, he would play little games on Paul and Ophelia when they would stay there. In the early 1990's Father Jack left his Parish to move to a slum on the outskirts of Lima, Peru. So when he told Farmer he should open a TB clinic, Jim Kim, Paul's right hand man was ready for the task. There was heavy political unrest in Peru between the Government and the Guerrillas. The Guerrillas used the TB clinic as as bedroom, and even blew up the pharmacy that Partners In Health had built for the community. It wasn't long after that, that Father Jack got sick with Tuberculosis and was flown back to Boston for treatment. He died a month after starting therapy, when they tested his disease for drug susceptibility, they found out that his disease was immune to all four of the drugs he was on as well as one other that he wasn't on. The next thing that Farmer investigated was how many people really did have drug resistant TB.

Quotes:

1. "Pel, you wouldn't believe what Father Jack just did. He's hiring all these people because he feels sorry for them, and they can't do the work." (p.131)
2. "Eventually he TB had been cultured and found to be resistant to the four first line drugs. She'd been re-treated again--with those very same drugs, strangely enough--and now she was sick again and coughing up blood. Along the way her doctors had accused her of non-compliance." (p.133)
3. "The air carried a strengthening smell of urine. There were no sewers up there, only bathrooms secluded places among the boulders above the last dwellings. I looked to the north. In the distance i could see a river, a line of green, but all around and high above, only dirt and rocks." (p.136)

This was more then a matter of a friend dying for Paul Farmer, it was that this whole new aspect of a disease had been overlooked because for a global organization to try to come up with personalized instructions for everyone who came up with a disease like TB or AIDS would be out of control. The simple problem here is that similar, if not more intensive care was put forward for Father Jack, but he died because he was immune to the drugs he was given. In a country where we value our health enough to have to pay an outrageous amount every month just in case we get sick and we wont be able to actually pay the hospital. These are people who can't do that, so they take whatever treatment they can get, but these treatments aren't helping because sometimes the system can fail for people because the safety net can never be big enough for us all. The thing is that for most of us, that will never be a problem because we probably wont ever get E Coli or TB, because there are measures put in place to try to prevent that. We read stories about people who that happens to, but its never us. When it is though we always want to implement a serious change so that it will never happen to us or anyone else, because it was a stupid mistake that shouldn't have actually affected anyone, but it did. That is the saddest thing is that it always takes something more serious for us to learn, then if we had just listened in the first place. I am no exception, and since it hasn't happened to me yet i don't know what i can do to change it. Is there really such a thing as looking at the world through too many lenses?