Study Guide Mountains Beyond Mountains by Tracy Kidder

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Ophelia came back to Haiti every summer from 1985 through 1989. They were months of nearly constant work. From time-to-time, she longed to get away from the desolate region where they worked and convinced Paul to take a trip into Port-au-Prince on the pretext that they needed medical supplies. She’d take along a pile of his flashcards in case they’d end up broken down, as was often the case. However, it wasn’t enough to satisfy Paul who wanted to get back to Cange. Once, she wanted to stop along the way at a supermarket, which was used only by the elite, for a case of Diet Coke. Paul refused, saying they didn’t have time to do it. It would mean only a twenty minute delay, but it would also mean walking by the beggars at the market. She knew he was right, that she could get along without the Coke, but she lashed out at him, calling him self-righteous. He became so angry that he slammed on the brakes and ordered her out of the car, calling her a foul name at the same time. She refused to get out, feeling offended, but she also smiled inwardly and exalted that she had finally found a human flaw in him.

On another trip to Port-au-Prince, they arrived after Baby Doc had left Haiti, and the peasantry was rebelling, because the military was acting like it was life as usual, just a different dictatorship. The smell of burning tires filled the air, and at one point, their car was trapped when some kids stole the car keys. Then, a military truck came screaming down the street after a huge crowd of protestors, firing indiscriminately into the crowd. Paul got her to the house where they were staying, but he went back into the crowd again and again, helping the wounded and viewing the action. Once they returned to Cange, they saw changes there as well. They people were now openly talking about politics and how the government could be blamed for dirty water and the resulting illnesses and death. These events and the smell of burning tires would be an abiding part of Ophelia and Paul’s lives for years to come.

In 1988, Ophelia came to Boston to live with Paul, who had now entered the phase of medical school called clinical rotations. Paul rarely missed a day of these clinical labs, but Haiti was never far from his thoughts. He asked Ophelia to help him bring resources to the country, and he also turned to Tom White again. Together, the three of them, plus another friend named Todd McCormack, created an organization called Partners In Health (Zanmi Lasante). This organization would solicit contributions, make them tax-free and funnel them to Haiti. White himself put up one million dollars as “seed money.” This became Paul’s Catholic Church. He expanded the group a few months later with a fellow Harvard anthropology and medical student, a Korean-American named Jim Yong Kim. They would spend many hours together, even into the wee hours of the morning, discussing such ideas as political correctness, the significance of cultural barriers, appearance, and medicine addressing the symptoms of poverty. They believed anything was possible. Among other things, PIH decided to build a school in Cange called Kay Epin (House of Pines). Because there wasn’t much in the way of trees, Ophelia’s father gave a large sum of money to plant some.

On one evening in 1988, Farmer was rushing around with last-minute errands in Cambridge, before leaving the next morning for Haiti, when he stepped off a curb into the path of a car. His knee was shattered, and so instead of going to Haiti, he went to Mass General for surgery. He spent three weeks in the hospital and then was discharged to the apartment he shared with Ophelia. Setting up housekeeping with Paul was a difficulty that Ophelia hadn’t anticipated. She knew he loved her, but for her, relations were strained: “the strain of living with a fellow who was in love with something else, something that I could never compete with, even if I wanted to.” Even before the accident, it was difficult when he left for Haiti, but afterwards, when he couldn’t go, he became very restive, and they argued frequently over his recovery. Finally, he said, “I’m going to Haiti. They don’t mind looking after me there.” That was December 10, 1988, and Ophelia knew something had irrevocably changed. A couple of years later, he proposed to her, but she found it hard to say no and impossible to say yes. He was hurt and angry and said, “If I can’t be your husband, I can’t be your friend. It would be too painful.”

For a time after that, Ophelia received word about Paul only through Jim Kim. However, she hated being separated from him. More than ever, he seemed like a person to believe in. he was proof that it was possible to put up a fight. Because she knew he had a weakness for forgiving people, she decided to remain a part of PIH and his life. She gradually filtered back in, taking on the organization’s finances. As for her relationship with Paul, within a few years, they seemed perfect to her: no one could make him laugh like her and he could tell her anything. So she said to herself, “Being his wife would have been no bargain. But to be his friend is simply wonderful.”



This chapter reinforces how the relationship between Ophelia and Farmer gradually evolved from one of a couple on the verge of marrying to a deep and abiding friendship. Ophelia knew he was really in love with Haiti and helping the poor and so has to find a way to be with him that doesn’t mean a marriage. This also reinforces the motif of Farmer as a kind of priest to what he so firmly believes and that he is married to Haiti.


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