Digame, Mi Amor

“Speak to me, my love” is what a waitress in Cuba says to Dr. Paul Farmer after he calls her over to make his order. This story is from the nonfiction book Mountains Beyond Mountains. Farmer’s primary battle against infectious disease is in Haiti, but he visits Cuba and describes the state of the health care system there. However, what caught my eye was the “Digame, mi amor” or “Speak to me, my love” that a woman says to him so naturally in passing at a restaurant. He laughs and tells Tracy Kidder (the author of the book), “You have to love a country where people do that”.

It reminded me of the people I knew when I was growing up in Russia, and the people I met in Italy and Scotland, and the many “foreigners” I met in my university studies. The cultures are different, that’s obvious, but what’s also different is the view on what matters in life and more broadly what life is. That sounds a bit too philosophical / romanticized, and I have trouble explaining exactly what I mean, what makes a poor person from Russia or Israel or South Africa somehow more appreciative of life in an existential sense (in my limited but real experience). The people I met seem to have more suffering (or maybe peaceful melancholy) in their eyes. Perhaps struggle breeds introspection. They tend to have a view of life that to me has always seemed more honest that the one I encounter for many red-blooded Americans. In U.S., materialism has taken over our psyche to the point that would disappoint the vision of Nietzsche, Camus, and even Kerouac for a good society.

I’m sorry if it sounds like I’m criticizing my fellow countrymen. I only mean constructive criticism, and mostly of myself.

Closing with a letter to Jack Kerouac from Neal Cassady seems appropriate.

The Great Epidemiological Divide

The “Great Epi Divide” is a term coined by doctor Paul Farmer (who is the subject of the book Mountains Beyond Mountains) to describe two groups of people in the world based on what makes them sick and what kills them. The first group are the people that tend to die in their seventies from illnesses that are loosely-speaking “inevitable accompaniments to the aging of bodies”. The second group of people dies 10 to 40 years earlier than that from violence, hunger, infectious diseases that medical science knows how to prevent and to treat (if not cure).

The second group is defined by absolute poverty, lacking nearly every necessity: clean water, shoes, medicine, food.

What Mountains Beyond Mountains reveals (as many other sources do) that the people in the first group have very little real awareness of the conditions of life in the second group. More importantly, we can’t handle thinking of them as fellow human beings. The problem is overwhelming. Early on in the book, Farmer describes other doctors working in Haiti that couldn’t wait to get back to America. They thought of themselves as “American first”, and human second, longing for the comfort of their life in the States over the brutal reality of their moral calling in Haiti.