Paul Farmer Interview (page: 9 / 9) Founder, Partners in Health	Print Interview

Do you think you were always destined to be an achiever? Do you feel you were any different than other kids?

Paul Farmer: No. I had a lot of opportunities, to go away to have a great education. But no. Working in the different countries over the last 25 years, I'm not so struck by difference. I'm more struck by similarity. This is a cliché, but people tend to be similar, in my experience. They have aspirations similar to our aspirations. So I'm more struck by similarity than by difference.

What advice or encouragement would you give to your grandchildren? What would you want to leave behind as your verbal footprint?

Get the Flash Player to see this video. Paul Farmer: The most satisfying things that I've done -- I'd like to use first person plural -- that we've done, have been in service of other people. It shouldn't be a secret. A lot of people say things like that. You can do all kinds of different things. Think of other people you've interviewed, or will be interviewing. Clearly, their areas of achievement are from all over the map. But whether you're involved in basic science, or public health, or justice, it's really, focusing on other people is a very satisfying thing to do. I mean that's something that I would encourage anybody's children or grandchildren is, get involved in work that is of utility to other people. And it doesn't have to be your whole life, know what I mean? Say for example, you're running a successful business somewhere. I'm not saying, give up your successful business and go be a social worker in -- name the -- you know, Los Angeles or Lisutu or whatever. What I'm saying is, some part of everybody's life ought to be focused on this kind of work, 'cause it's satisfying. That's just, I think, good advice.

[ Key to Success ] Passion

How do you define being an American?

Get the Flash Player to see this video. Paul Farmer: I'm an American by birth, so I had all the birthrights of an American. Ability to speak my mind, ability to write and say what I wanted, the ability to go -- I never worried about would I be able to go to high school. It never even occurred to me. That was just because I was born in the United States. It was only much later, when I went to other places and said, "Wow, they don't even get to go to school." Now that's an embarrassing thing to confess. I should have been able to understand that, sitting right in my high school in Florida. But I didn't. You just don't know, and so the obvious definitions, those are definitions around the privilege of being born there. But you know, I would just say the ability to have those basic needs met, to be able to go to school all the way through -- in my case, grad school and medical -- but just to go through high school and know that you're going to have something to eat at school. Or you're going to be able to get your books.

Other people don't really enjoy those freedoms. I would go ahead and call them "freedoms."

Get the Flash Player to see this video. FDR called it "freedom from want," as the fourth freedom, is freedom from want. I do believe, even someone of modest origins like me, still had freedom from want. I never experienced want. You asked me earlier about my childhood, living in a bus. But that's not the same thing as living in a bus and having to run from violence, or not having enough to eat. It's a very different kind of thing. So those are my sort of twin definitions of being an American, is a certain amount of protection from vulnerability around want. And then the civil and political liberties that we have. It's terrific to be able to write what you want, and say you want and, and I've done that my whole life.

[ Key to Success ] The American Dream

There's a phrase you've used in the past, and we'd like to ask what it means to you. "If it's in front of you, it has a reality."

Paul Farmer: Did I say that? It's true. I'm getting philosophical here.

Get the Flash Player to see this video. Humans, we have limitations, and we have limitations in terms of empathy and sympathy. And even the most gifted empaths in the world, it's hard to imagine other people suffering. And so when it's right there in front of you, it's the most real thing in the world. I have a friend who says, "If you try to take a lollipop from a two-year-old, that lollipop's the most important thing in the world to that two-year-old." Well, I think you can be 50, and it's still the same challenge. For example, isn't it a failure of imagination that we can't figure out what it's like to be a woman who has no job, has a bunch of kids, doesn't have safe housing? Shouldn't we be able to figure that out? We should. But it's not that easy to do.

The late Susan Sontag wrote a great essay about this. "Regarding the Pain of Others," I think is the name of the essay. It's a little book. She just lays it out there, very honestly. Some emotions she calls fragile and evanescent, like pity and compassion. Others less so, like solidarity.

Get the Flash Player to see this video. We could take these failures of imagination, address them by trying to say, "Okay, this person isn't in front of me, but that doesn't make their suffering any less real. How can we try to attenuate suffering, regardless of where we are or how close we are to it?" I'll give you an example that again is optimistic. I read somewhere that 45 percent of American households responded to the Asian tsunami. They have never been to Sri Lanka probably, right? That, to me, shows that if we cannot tap into that empathy and potential for solidarity, someone like me, then we've failed, because we have been right up against that suffering. We should be sharing that. We should find ways to make that real and vivid to everyone.

What is the effectiveness of having a government position versus working in the private sector?

Paul Farmer: I think what can be said about that is the same thing I've been talking about for years.

Get the Flash Player to see this video. Unless we can build public-private partnerships that support public health and public education, we're going to get a lot of energy going into NGOs, but not really being able to be sustainable over time. And you know, again, back to growing up in the United States. It's not like my parents built the school we went to as an NGO. We went to a public school. And there's public water systems and public roads and public communications. Those are really important, and they're no less important in Rwanda than they are in Florida. So finding a way to -- regardless of whether you're a university, whether the university's an NGO, or Partners in Health is an NGO, and I can go down the long list of NGOs -- we need to find a way to support public health and public education. And there are lots of other public goods that we could talk about. Those are the ones I know most about. And you know, I would put water in there. Do we really want to only be able to drink water out of a bottle, or do we want a public water system where you don't get sick when you drink the water? And I would say, we need a public. We need public goods.

As a last question, what does the American Dream mean to you?

Paul Farmer: If you look back to the Depression of the 1930s...

Get the Flash Player to see this video. I would say that it's hard to have an American Dream if you can't get an education and you can't feed your family. Again, I learned this as an adult, not as a child, because I was shielded from those problems as a child. I didn't know that across the world, hundreds of millions of people would never enjoy education or basic health services. I didn't know that. A big part of the American Dream for me is, again, yes, the ability to speak one's mind, and the civil and political liberties that we enjoy there. But also, making sure that there's some sort of safety net, so that people just don't hit the ground and end up in the ground. That's a big part of the American Dream in my view, is not having to worry if you're going to not have another meal to eat, or not worrying that if you lose your job, then your whole family, you know, collapses into the poor house.

[ Key to Success ] The American Dream

That's something that's worth fighting for.

Get the Flash Player to see this video. I think that's what's going on in the United States now, is people are saying, "Well, if unemployment hits ten percent, what do we do?" Well, in the Depression it was 25 percent, maybe more. And a lot of effort had to go into addressing the needs of the most vulnerable Americans then. That's a big part of the American Dream. I think it's worth restoring, and sort of rehabilitating, and talking more about that, about what was done after the Depression, during the Depression. What was done to say, "Hey people need not to be ill-clad, ill-housed and ill-fed." The Second Bill of Rights, Roosevelt's last inaugural -- if I'm not mistaken, in 1944 -- and he laid this all out very clearly. What did that mean, "freedom from want?" And he talked about, people ought to be able to get good jobs and good education and be safe, and I think that is a huge part of the American Dream. And people sometimes forget, we all forget. I get vivid reminders, because I go to places where there is danger and a great deal of want, and no sound safety net. So I get these reminders of what privilege we have. That's really something that's worth hanging onto.

[ Key to Success ] The American Dream

Thank you, Dr. Farmer.

Paul Farmer: Thank you. Thank you very much.

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