Monday, August 07, 2006

Mountains Beyond Mountains

A footnote to yesterday's homily: Planes can, obviously, be very very good things, tools for ending isolation instead of promoting it. (Duh. Thank you, Dr. Obvious. For this I need a PhD? Okay, I haven't had much coffee yet, so let me cut myself a break!) Several days ago, I read this very moving news story about Dr. David Nichols, who for twenty-seven years has been flying to Tangier Island in Virginia to provide medical care to the people who live there.

And that reminded me of Mountains Beyond Mountains, Tracy Kidder's stirring account of the work of Dr. Paul Farmer, an infectious-disease specialist who's done simply amazing things eliminating TB and treating AIDS in impoverished Haiti (and in many other areas of the world). The title of the book comes from a Haitian proverb, "Beyond mountains there are mountains," meaning that when you've solved one problem, you need to solve the next. Farmer has flown, literally, millions of miles. Working with very little money and seemingly scant resources, he's achieved results many people would consider impossible. He's living proof that one individual really can make a huge difference in people's lives. He's also a very colorful character. It's a great book; go read it.

And while I'm on the subject, let me recommend a few other works of medical nonfiction written for general audiences:

Perri Klass' A Not Entirely Benign Procedure: Four Years as a Medical Student, about her experience at Harvard Medical School.

Abraham Verghese's My Own Country: A Doctor's Story, about his experience treating AIDS in Tennessee while adjusting to America (he was born in India).

Anne Fadiman's The Spirit Catches You and You Fall Down, a fascinating and heartbreaking story about a Hmong girl with epilepsy, whose medical treatment in the United States was complicated and undercut by cultural miscommunication.

I've taught the Klass and Verghese books; I read the Fadiman this past summer, at the urging of my friend Wendy.

Anyway, back to Farmer. Among his favorite authors is J.R.R. Tolkien, and Tolkien loved mountains (and also drew and painted them; the picture at the beginning of this post is his). One of my favorite passages in The Lord of the Rings -- you surely don't need a hypertext link for that, do you? -- is the moment at the beginning of "The Muster of Rohan" where Merry grasps the difference between hearing stories about a landscape and actually traveling through it:

Merry looked out in wonder upon this strange country, of which he had heard many tales upon their long road. It was a skyless world, in which his eye, through dim gulfs of shadowy air, saw only ever-mounting slopes, great walls of stone behind great walls, and frowning precipices wreathed with mist. He sat for a moment half-dreaming, listening to the noise of water, the whisper of dark trees, the crack of stone, and the vast waiting silence that brooded behind all sound. He loved mountains, or he had loved the thought of them marching on the edge of stories brought from far away; but now he was borne down by the insupportable weight of Middle-earth. He longed to shut out the immensity in a quiet room by a fire.

I always find that passage especially moving in counterpoint to the moment in "Leaf by Niggle" (which you'll find in The Tolkien Reader) when Niggle sets off into the landscape that lies beyond death:

He was going to learn about sheep, and the high pasturages, and look at a wider sky, and walk ever further and further towards the Mountains, always uphill. Beyond that I cannot guess what became of him. Even little Niggle in his old home could glimpse the Mountains far away, and they got into the borders of his picture; but what they are really like, and what lies beyond them, only those can say who have climbed them.

When I lived back East, mountains didn't mean much to me. Then I moved to Nevada, the most mountainous state in the country. After living in the foothills of the Sierra Nevada, with other mountains in almost every direction, I'm not sure I could live in a flat place again. There are places in Nevada -- especially if you're driving across Highway 50 -- that look quite a bit like Tolkien's picture. The geography of my home is a concrete reminder that beyond mountains, there are mountains, but that we can journey into and through them if we set out with the supplies, companions, and hope we need.

I have no intention of learning to pilot a plane, though. Learning to drive at the age of 36 was scary enough.


  1. Susan,

    The Spirit Catches You and You Fall Down is one of the all-time favorites of my book group. I also recommend Anne Fadiman's Ex Libris: Confessions of a Common Reader, which consists of short essays such as "Marrying Libraries" and "Insert a Caret," about how the Fadimans are compulsive proofreaders.

    Getting back to medicine, I further recommend Who Goes First?: The Story of Self-Experimentation in Medicine by Lawrence K. Altman (of the N.Y. Times), which was first published during my days at Random House.


  2. Hi, Ruth! Thanks for stopping in! And thanks for the book recommendations.

    If your book group loved the Fadiman book, they'd probably love the Kidder, too.

  3. Mountains Beyond Mountains is a fantastic book, and one which I was just remembering yesterday for some unexplained coincidental reason.


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