Another important element is irony - when something happens, or is seen, or is heard that we may know, but the characters do not, or that appears opposite of what is expected. Some examples of irony include:

1. Farmer argues with the American sergeant that it makes no sense to apply principles of constitutional law to a country that has no functioning legal system. So they come to a stalemate - one is a redneck arguing for due process while the other is a champion of human rights arguing for preventative detention.

2. Farmer explains that he had come to Captain Carroll to warn him. The Haitians in the area were upset with Carroll's decision about Nerva Juste and had challenged the doctor to stop and talk to the soldier. Ironically, as they were passing the army compound, the got a flat tire and Farmer had commented that you have to listen to messages from angels.

3. His Haitian colleagues had told Farmer that the patients must pay user fees of about eighty cents a day. However, Farmer has his own rule: every patient must pay the eighty cents, except for women, children, the destitute, and anyone who us seriously ill. So everyone has to pay except for almost everyone!. And no one is allowed to be turned away.

4. Farmer and his entourage pass smiling children, carrying water in buckets that had once held paint, oil, and antifreeze.

5. Farmer's comment on his childhood was, The way I tell myself the story is a little too neat. I'd like to be able to say that when I was young I lived in a trailer park, picked fruit with Haitians, got interested in migrant farm workers, and went to Latin America. All true, but not the truth. We're asked to have tidy biographies that are coherent. Everyone does that. But the fact is, a perfectly discrepant version has the same ending.

6. Kidder finds the sights of Cuba lovely after the deep and destitute vision of Haiti while Farmer can finally sleep, because everyone here has a doctor.

7. There is a Haitian phrase, looking for life, destroying life. Farmer explained it as an expression they used if a poor woman selling mangoes falls off a truck and dies. In other words, trying to keep her family alive, she sells mangoes, only to die when she falls off the mango truck.

8. When Farmer and Goldfarb held a press conference to announce their findings about TB in Russia, it was the same day that the Special Prosecutor released his report on the Monica Lewinsky scandal, so few reporters showed up.

9. When they sit down to eat in Russia, Farmer tells an interesting story: he had been named the TB commissioner for the state of Massachusetts, and so every time he needed lab resources, he went back there, because Massachusetts has a lot of TB labs, lots of TB doctors, lots of TB nurses, lots of TB lab specialists. What Massachusetts doesn't have is TB. That's the irony for Russia.

10. Kidder sees a sign taped to the wall in Bostoon which reads, If Paul is the model, we're golden. Upon looking closer at it, he sees the word golden is on another piece of paper taped over another word which now reads, If Paul is the model, we're f*****. It's not meant to sound as harsh as it does, but merely to emphasize the irony to all staffers that no one can be Paul Farmer, and if the poor have to wait for a lot of people like Paul to come along before they receive good health care, they are totally f*****.

11. Ironically, at the opening banquet of the meetings with the Russian generals who run the prisons, it is karaoke that makes everyone friends.

12. Serena calls Kidder and says that a formidable group of physicians have examined John and discovered that he has one solid tumor growing back into his spinal column and the roof of his mouth. Ironically, they worked like fools and spent a lot of money to get him to Boston and now he's going to die.

 

MOTIFS

Another important element is a motif which is a recurring element used to develop a literary work. There is one major motif in this book:

1. Farmer is portrayed as a kind of priest of a belief system he calls liberation theology. That is, he believes that he is there to bring a better life to as many people as he can and he is the minister who serves them. Like a priest who is married to the church, Farmer is married to Haiti.