Indian Journal of Medical Ethics

OBITUARY


Remembering Paul

Vikram Patel

Published online first on February 24, 2022. DOI:10.20529/IJME.2022.016

Paul Farmer and Vikram Patel

Much has been written, and much will be written, about Paul Farmer whose sudden passing on February 21, at the age of 62 has left legions of people bereft. This is my personal eulogy to a man I knew for about a decade, most closely since I joined the Department he chaired at Harvard Medical School in April 2017. This is how I remember him; this is the man I will miss for the rest of my life.

Paul, it might come across as a trite thing to say that you were no ordinary person. But it must be said that this description, which has become stale with overuse in our times, was intended only to describe that rarest of persons who, with a profound dedication to the service of others, not only transforms the world through their ideas, but through the sheer example of their life’s work. There are many scholars of global health or social justice who may have spent a few months, a few years even, with the less privileged in less resourced environments. But there are very few who have spent most of their lives in those environments, not only conducting research but serving as a doctor, an educator and a builder of institutions whose legacies will outlive us all. There are many inspirational activists and practitioners who have spent their lives dedicated to serving the poor and challenging structural violence, but few have simultaneously written luminous books which have transformed these actions into ideas and concepts which can nourish and inspire generations of scholars. Scholar, writer, activist, doctor, friend and above all, a humanist. You wore all these cloaks beautifully.

I was privileged to witness you at close quarters in the past few years. The very earliest of these memories were your persistent appeals to me to leave my comfortable position in the London School of Hygiene & Tropical Medicine to join your Department in Harvard Medical School. That the Department was the historic birthing place of my field was already a huge draw. But I had a job at an institution I loved, and, what was more valuable to me, I was able to live in India building Sangath, the NGO I had co-founded and which was the institution closest to my heart. It turned out that you recognised in me a kindred spirit, for you had also pursued a similar path, co-founding Partners In Health in the US, which served communities in a number of less resourced countries while holding a full-time academic position in Harvard. You will remember how resistant I was to the notion of abandoning my work in India to join Harvard. I will never forget that moment of frustration when, one day in a cab in Boston which was taking us to dinner after an oration you had engineered for me to deliver, you exclaimed that I could live as long as I wanted in India and then, with a flourish, showed me your passport to demonstrate that you, Paul Farmer, one of the handful to have been anointed with a University Professorship from Harvard, did not even have a Boston address. I was amazed that you did not have a home in the city where you were employed because your ‘home’ was far away. That was when I made up my mind. And I have never regretted it for a moment.

Paul, you know that I have never been happier in my professional life than since I joined your Department, and it did not take me long to figure out why. As you would have guessed, it was not the hype that the Harvard title carried with it! It was watching and learning, how you had transformed global health from a highly academic subject, typically taught in wealthy countries about the less fortunate peoples of the world, by scholars whose lives are disconnected from those peoples, into a subject suffused with rights, equity, dignity, inclusion, compassion, and most of all, outrage at the structural forces which had created and perpetuated poverty, violence and injustice, where entirely preventable suffering continued to prevail even as a handful of countries and peoples with historic power and gunpowder created a world polluted by their greed, which in turn now threatened the very existence of our civilisation. These high ideals permeated every pore in the department, for example, when you spoke with such passion on behalf of those who had displayed courage and fortitude in navigating the disadvantages of gender, race and social class, to have arrived at the world’s leading medical school. I remember being moved by the way you described community health workers, that precious human resource who we both believed were the key to transforming healthcare everywhere, as an accompagnateur, the French word for “a person who accompanies”. I remember vividly your words from a speech you gave where you said, “To accompany someone is to go somewhere with him or her, to break bread together, to be present on a journey with a beginning and an end…accompaniment is much more often about sticking with a task until it’s deemed completed by the person being accompanied, rather than by the accompagnateur.” How we dreamed that all health workers might see this as their duty one day.

Paul, I watched with awe as you conducted meetings with ambitious agendas with such tenderness, that glint of mischief in your eye, always finding time to express greetings to each of your faculty colleagues. I know (not least because others have observed the change in me) that I am a better man now for that. While I rue the missed opportunities to experience more of your heartfelt hugs, I am so fortunate I could count you as a friend and mentor. I know I am just one amongst the multitude who feel the same way. That is who you were, a man whom so many felt belonged to them, because you were an authentic person to each of us.

All lives must come to an end, but one has to be truly blessed for that end to come in the midst of one’s sleep, spirited to another world peacefully and painlessly, after a day devoted to work that one loves. Such was your final journey, and, even for those of us who do not believe in such things, it is hard not to imagine that you sleep forever with the angels.