A book about healthcare that IS worth reading

I recently had the pleasure of reading Mountains beyond Mountains by Tracy Kidder, (also a Harvard alum!), and highly recommend it to anyone interested in health care.

It is almost a narrative of Kidder's relationship with Dr. Paul Farmer, founder of Partners in Health which is based in Boston with a mission to provide community based healthcare in the developing world. Kidder takes a dramatic journey through Dr. Farmer's life, (personal and professional), and the journey gives an insight into how to make things happen. Not all of it is complimentary to Dr. Farmer, and a friend who had also read the book did not like him as a result. She felt that he had dumped his co-founder, (and close friend), Ophelia Dahl, but the evidence does not support that, so I disagreed. (It is co-incidental that Ophelia Dahl had a baby last week, so congratulations to her and her family.) Whatever you think about this book, you will almost certainly have an opinion on the participants in it.

Don't expect this book to be an, "easy," read, because it is not, although it only took me two days to read it all because I could not leave it down. That is a testament to Tracy Kidder's writing style, as much as to the story, but the point is that the reader with a conscience should not expect to leave this book untouched. The disparity in treatment is incredible, and the various contributing factors are equally important highlights.

It is also interesting in that it discusses the politics of the WHO attitude to TB treatment, and the value of taking a sceptical view on, "gold standard," treatments, which were shown to have contributed to people's ill-health, not to their health. This is particularly timely given the case of the now CDC imprisoned irresponsible U.S. patient who has XDR TB and took a flight from Europe to Canada, (don't they worry about security screening for people who are on the no-fly list or is that just an American constraint?) because he did not want to spend time in an Italian hospital. The fact that he risked infecting others with not alone TB, but the XDR version, whilst on board, makes him one of the worst public enemies around.

Having recently condemned a book about how doctors think as a waste of time, and as strongly as I reviewed that book negatively, this one is equally positive because Tracy Kidder talks about real medical decisions with an honesty and detail sadly lacking in Dr. Groopman's book. Whilst Kidder obviously had a politico/medical agenda influenced by Dr. Farmer, what a wonderful agenda he laid out. The challenge is for those of us interested in patient care to pay attention and take action.

Thanks for the refreshing blast of reality Tracy.

Stay healthy, and ask your physician to tell you what is really wrong with you.