On Losing Paul Farmer

-- By MarvinBell - 26 Apr 2022

The Start

To say that HIV has always played a role in my life would be a gross understatement. When I five or six years old and living in Jamaica, I watched a close family friend of mine, whom I affectionately referred to as “cuz” succumb to an illness that my community refused to name. It was not until I came of age, moved to America, and had long since forgotten what “cuz” looked like that I learned that she had died from AIDS. Two years into both my professional dance and college career in D.C. a friend of mine succumbed to AIDS. A few months after he was buried, my closest friend revealed that he had contracted HIV. Around this very same time, the CDC disclosed a study which found that, should current trends continue, one in every two Black man who has sex with other men (MSM) would contract HIV in their lifetime. While I was still recovering from the passing or my friend and burdened by the thought of losing another, I felt deeply mobilized to conceptualize what was happening around me. A part of me knew that my friend and cuz’s death and my other friend’s diagnosis were not by chance – a bigger part of me knew that there was a way to understand what was happening. In the depths of my confusion and sadness, I found Paul Farmer.

What Farmer Meant to Me

For physician and anthropologist Paul Farmer, every ill person seemed to be a potential patient and every healthy person a potential pupil. “Medical education does not exist to provide students with a way of making a living, but to ensure the health of the community.” The duty of physicians – “the attorneys of the poor” – is therefore to solve the “social problems experienced by the poor.” Despite not being called to practice medicine, I desperately wanted to rise to the challenge Farmer issued “healthy person[s].” There was a way, I thought, that some of us outside of the medical field could work to ensure the “health of the community.” Reading Farmer’s words at that point in my life turned my apathy to passion. And while there was very little that I could do to change the realities of those in my life who either contracted HIV or succumbed to AIDS, I knew that there as a way to contribute to a narrative around HIV/AIDS that drew attention from the proximal “reasons” for higher HIV/AIDS risks among Black people to the larger structural forces that conferred heightened vulnerability.

To Jackson

Between May 2018 and September 2018, I collected the oral histories of some of the queer men of Jackson, Mississippi who were either living with HIV or AIDS or “at high risk” of contracting the virus. Through these oral histories allowed for a certain reflexivity that other methodological approaches did not. They allowed the men I spoke with access to an avenue to verbalize those often unspoken and unspeakable elements of their social worlds that impacted them. I then situated these men’s experiences in a biosocial context, attune to the fact nothing short of a biosocial contextualization would be insufficient to capture the multiplicity of factors that conferred onto them heightened vulnerability. This biosocial analysis, Paul Farmer, suggested, must draw freely on clinical medicine and social theory; it must link epidemiology to history, ethnography, and political economy. The inequalities of outcome that Farmer describes are, more than anything else, biological reflections of social fault lines. His conceptualization of structural violence deepened my understanding of what was unfolding in Jackson and what was occurring within my own life. The populations produced a vulnerable to HIV transmissions are those captured within forms of social exclusion, abandonment and violence.

Words from the “Idol”

Despite my thesis advisor’s disapproval, I emailed Farmer several times throughout the course of my time in Jackson – each email providing an update of where I was in the process, what specific portions of “Infections and Inequalities” meant to me, and agitatedly asking him for advice. On September 18th, 2018, I received an email from paul_farmer@hms.harvard.edu. “Dear Marvin - It brings me great pleasure to know what my work has meant to you,” it started. In the four-paragraph email, he answered every question I had asked him over the months. His parting words was that I should not let my lack of medical training “disincentive me from “examining and amplifying what is happening in Jackson.” “Anthropologists like you,” he ended, “can see things in ways others cannot. Please let me know if I can be of any further assistance.” I regret not following up, if only to let him know what his words meant to me.

February 21, 2022 & Beyond

Paul Farmer’s death on February 21, 2022 in Butaro, Rwanda shocked me, but not in the way that losing one’s parent, sibling or close friend often renders one hopeless and apathetic. Losing Paul Farmer is like being so close to your destination and losing your map; it is like being forced to learn to walk in the dark with only your hands as a guide. “It is the curse of humanity that it learns to tolerate even the most horrible situations by habituations.” Indeed, the world is full of miserable things, people and places, and one way to live in spite of them is to not think about them or, even better, to send money when they do cross our minds. And while I remain largely cynical about other’s capacity to both recognize and mobilize against the ails of others, I have learned to accept Farmer’s words, that “cynicism is a dead end.” While the sadness of losing friends and family to HIV/AIDS is still largely paralyzing, I take solace in Farmer’s imprecise recitation of a Haitian proverb: “God gives us humans everything we need to flourish, but he’s not the one who’s supposed to divvy up the loot. That charge was laid upon us.” The charge is very much on us.

You are entitled to restrict access to your paper if you want to. But we all derive immense benefit from reading one another's work, and I hope you won't feel the need unless the subject matter is personal and its disclosure would be harmful or undesirable. To restrict access to your paper simply delete the "#" character on the next two lines:

• #Set ALLOWTOPICVIEW = TWikiAdminGroup, MarvinBell
• #Set DENYTOPICVIEW = TWikiGuest

Note: TWiki has strict formatting rules for preference declarations. Make sure you preserve the three spaces, asterisk, and extra space at the beginning of these lines. If you wish to give access to any other users simply add them to the comma separated ALLOWTOPICVIEW list.