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Mountains Beyond Mountains: Discussion Questions

There are many ways to read Mountains Beyond Mountains. First of all, you can read it as the deeply moving story of Paul Farmer, a doctor in Haiti as well as an expert consultant in Peru, Cuba and Russia. But, it's more than a good story written by a master storyteller. It's also author Tracy Kidder's effort to explain what made it possible, even necessary, for Farmer to take his life in the direction that he did. Have no doubt about it, Farmer had a vocation, a calling even, that he discovered as a young man.

As a reader, you can trace the experiences that shaped Farmer. But you can also see the influence that the country and people of Haiti had on his mission as well as the impact of Farmer's religious and intellectual mentors and supporters. One of the themes of the book is that "Lives of service depend on lives of support" (page 108). You can read the book to learn about the politics, policies and problems of poverty and health not only in Haiti, but also in the U.S. and the world. In addition, you can read the book as a how-to manual about the quest for meaning in life.

Here are some questions to help you understand the "story," and others to get you thinking about what shapes us, who influences us and how we become the people we become. These questions should get you looking for the answers in the book, thinking about the implications of what happens to Farmer and exploring the larger issues the book raises. Also, these questions will get you asking other questions which will lead to discussions with your teachers and your fellow students. Read critically with a pencil in hand. A second reading always helps you answer the deeper questions.

The Land and Its People

  1. What do you know about Haiti? What questions do you have about Haiti? Many people go to the Caribbean for cruises or vacations. Is Haiti one of the typical destinations? Why?

  2. What would you guess the title means? What have been your experiences with mountains? Do they have a spiritual dimension for you? (Note that the title comes from a proverb.)

  3. What percentage of Haitians die before they are 40? What percentage of Americans die before they are 40? What makes the difference?

  4. What impact did the eradication of the Creole pig and the building of the Peligre dam have on Haiti?

  5. Kidder uses the term "narrating Haiti." What do you think he means?

The Author and his Subject

  1. Farmer tells Kidder that he will be his Virgil. Who was Virgil? What do you make of this comment?

  2. Which of Farmer's qualities attract Kidder? What annoys Kidder about Farmer?

  3. As you read, note the way Kidder uses direct quotes to reveal Farmer's character and his own. What kind of relationship developed between the author and his subject?

  4. Kidder frequently notes shorthand expressions used by Farmer and his colleagues. What are WL's? Kennedys? Look for other terms like these throughout the book.

  5. What is Kidder's purpose in writing this book? Does he present an argument? If so, what is? Are there other arguments?

What Shaped Farmer's Values and World View?

  1. How do you think Farmer's childhood affected his personality, behaviors, and attitudes? Pay particular attention to his relationship with his father. What impact do fathers have on children?

  2. Why does Farmer insist on seeing patients even in places that are hard to get to and which take him away from his clinic for long periods of time? Do most doctors make house calls today? Why does Farmer? What's the connection between his work with individuals and his mission to the poor? Note that he often develops a personal relationship with his patients. His behavior is not cost-effective. How does he respond to these criticisms?

  3. Is Farmer a religious man? Explain your response. What impact does liberation theology have on him? Explain the importance of Matthew 25 to Farmer’s mission (221).

  4. Respond to Verchow's quote: "Medical education does not exist to provide students with a way of making a living, but to insure the health of the community." Farmer believes this. Do you? Do most doctors?

  5. Farmer calls liberation theology a "powerful rebuke to the hiding away of poverty" (78). Discuss what he means.

Those Who Support Farmer

  1. Why was Tom White so willing to help Farmer? What was White's goal in life?

  2. Describe the relationship between Farmer and Jim Kim, Farmer and Pere Lafontant, Farmer and Father Jack, Farmer and Goldfarb. What does love have to do with it?

  3. Ophelia loves and admires Farmer as well as working with Partners in Health. Why did she decide not to marry him?

  4. Do you think Farmer neglects his wife Didi and his child? In what sense is their marriage a modern marriage? Would you feel differently if Farmer were a woman?

  5. Do you agree with Margaret Mead's point made on p.164? Why or why not?

  6. Respond to the following: "Lives of service depend on lives of support." Who supports Farmer? Who supports you? Whom do you support?

The Struggle of Rich and Poor, Good and Evil

  1. How is Haiti "covered with the fingerprints…of France and the United States?" (73) In what ways are wealthy countries responsible for the poverty of other countries?

  2. Farmer believes we should give more of the world's wealth to the poor: the O for the P (the central imperative of liberation theology). Do you agree with the idea that we should have a preferential option for the poor? Why? Why not?

  3. Kidder often describes the patients that Farmer treats. He spends a great deal of time on the story of John near the end of the book. How do this and other stories illustrate the complexities of poverty? How do this and other stories relate to the title of the book?

  4. What's the relationship between poverty, women and AIDS? Find out about Kathleen Harrison and Project Harambee.

  5. How does MDR-TB threaten the health of the world? What role does Farmer take in trying to make countries more involved with the treatment of patients, prisoners and poor people?

  6. Look up the website for Partners in Health (PIH). What gets your attention? Would you consider making a donation?

  7. No doubt Farmer has made personal sacrifices to accomplish what he accomplishes in Haiti and elsewhere. Most people probably admire his accomplishments. Do we hesitate to make such sacrifices ourselves? Why?


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