Paul Farmer on the Power of Community

Paul Farmer delivering the commencement address at the College of the Holy Cross.
(Photo credit: Dan Vaillancourt, College of the Holy Cross)

At the commencement ceremony at the College of the Holy Cross in Worcester, Massachusetts this past May, Paul Farmer recalled a poignant memory, and the lessons learned.

The story began with an inhaler, carried in a young doctor’s pocket on a long walk through rural Haiti.

Farmer had just graduated from Harvard Medical School a year earlier, and had recently returned to work in a small medical clinic in Haiti’s Central Plateau. That day, he left his medical supplies at home, and took a walk to a village about eight miles away to speak at a town hall meeting.

Anxious to beat the rain and rest his recently injured leg, Farmer intended to head home after the meeting. He hadn’t gone far when a community health worker stopped him and began leading him towards the home of a sick young man. He initially refused, explaining that he had no medical supplies—not even a stethoscope—with him. The community worker insisted, and Farmer relented.

A man’s life was saved because he did.

He entered a small hut and found a man weakened by a severe asthma attack, lying close to death. Farmer realized he did have the one tool that could save the man’s life—an albuterol inhaler, a device used to treat his own asthma. He slowly administered dosages into the man’s lungs. His gasping slowed, and he began breathing normally.

Dr. Farmer used the story, whose full text is available here, to illustrate the significance of both circumstance and solidarity.

He explained that without the nudging of the village’s community health workers, he might not have taken the time to travel up the hill and save a man from an easily preventable death.

The story of the inhaler, Farmer said to the class of 2012, could serve as a reminder of the power of social networks—a term not meant to refer to today’s online communities, rather the interpersonal support systems that surround and encourage each one of us.

These human social networks, he offered, allow us to see with greater clarity the inequalities that persist and grow today despite modern technological advances. “What does it mean to die unattended of a severe asthma attack in the age of Facebook or LinkedIn?” Farmer asked. “If we're really linked-in, what does that mean for the good stuff, such as albuterol?”

Farmer touched on the same theme of social networks while delivering the commencement speech at Dartmouth College’s Geisel School of Medicine on Saturday, June 9. There, he reminded graduates to acknowledge the privilege of teamwork that goes into a successful and meaningful medical career. He urged them, as they began their residencies, to “be open to the irruptive force of new ideas, new experiences, [and] unpredicted events,” and to ally with fellow nurses, doctors, patients, and families towards a unified desire for better health care.

To end his address to the young doctors, Farmer quoted the school’s namesake, children’s author Theodor Seuss Geisel. He said, “Dr. Seuss could have been referring to medicine when he wrote: ‘It's not about what it is, it's about what it can become.’”