San Francisco

Yesterday was a whirlwind, as we searched for the Great Spirit in and around San Francisco.

My day started early, before sunrise, with a 4 mile run/walk along the Pacific Ocean in Carmel. What impressed me the most, along with the natural beauty of the coastline, was the crashing of the waves. On the Monterey Peninsula, next to Big Sur, the Pacific Ocean is loud.

The roar reminded me of my childhood in Pittsburgh in the 1980s. Sometimes I would have trouble falling asleep, and my mom would put on a wave cassette tape. I haven’t listened to a wave tape in years, but sometimes I dream of sleeping near the ocean so I could hear the real thing.

As I jogged in the dark, the ground lit by the moon and my iPhone’s LED, I spotted the shadow of a strange animal on the beach. It was a bit like seeing the Loch Ness monster, and I thought of a deer, a coyote, or perhaps a mountain lion? I fled, picking up a small chunk of asphalt, just in case.

When I looked over my shoulder, it was gone. The Great Spirit, embodied in an animal? Or a demon? It was hard to say.

After a big breakfast of eggs, hash browns, and fruits (thanks again, Ja-Yun), we took off for Portola Redwoods State Park. Our group was comprised of a bunch of parents and seven rambunctious kids.

Two hours later we found ourselves standing by an enormous, 1200-year-old redwood tree. As the kids sprinted around and climbed the hills joyfully, I played a fiddle tune, Angeline the Baker, and my friend Susannah Graves sang along. Later, we saw a seed shower, a magical moment with flurries in the forest, a few seconds of calm, forest bathing.

Then we parted ways with our friends, and Kristen, Joe, and I headed for San Francisco. After a bunch of windy curves, I got cell phone service again and saw a flurry of text messages from friends saying that Dr. Paul Farmer had died in Rwanda. Wow.

What can I say about Dr. Farmer? I first heard of him in 2001 when I read AIDS and Accusation during my medical anthropology class with Prof Daniel Jordan Smith at Brown University. Later I read Infections and Inequalities, and Dr. Farmer kindly autographed my copy, writing “with best wishes for a career in medicine.” In 2002 I went to the rural Mississippi Delta to learn about HIV and health disparities with Murtuza Gunja and Heather Clark (and later, Gabe Popkin). Murtuza, Heather, and I met inspirational leaders like Dr. Hamza Brimah, and I used Dr. Farmer’s advice.

His council went somewhat like this — “take your time, and listen carefully for discrepant messages from the people you speak with. Then return to Brown University and figure out a way to make things happen, to address the health (in)equity issues.” It was a lesson in accompaniment and pragmatic solidarity, “a preferential option for the poor,” as he often said. He was a powerful advocate for the right to health.

I spent the next two decades trying to “be” Dr. Farmer (and Dr. Brimah) in different ways, traveling to various countries, working on HIV and tuberculosis with the CDC. Along the way I studied TB transmission control in the Brigham and Women’s Division of Global Health Equity, which Paul had led. Working there, I made two of my closest friends in the professional arena, Duncan Maru and Ruvandhi Nathavitharana.

I recall a 30 minute chat I had with Dr. Farmer in 2017 in the lobby of Boston’s Fairmont Copley Plaza Hotel after one of his lectures. I was heading to Peru on a tuberculosis study and he reiterated his most important advice, which was very anthropological – to listen to people.

This was blog post was not intended to be a hagiography to Paul. There is a danger to hero-worship, particularly when that hero was a white male doctor from Harvard. Dr. Farmer was a complicated person, just like each of us. All I’m going to say is his work in Haiti, Peru, and elsewhere had a profound impact on my life. Thanks Paul.

Driving in a bit of a daze, I pulled up to the San Francisco Giants Oracle Park for one of our last stops of the day. In Greek history, an oracle is “a priest or priestess acting as a medium through whom advice or prophecy was sought from the gods, in classical antiquity.”

We walked around the ballpark with our friend Ben Sigelman, looking at the statues of the Giant superstars like Willie Mays. Where was the oracle we desperately needed?

Could Willie Mays help us find the Great Spirit, if we hadn’t found him or her among the Redwoods? Was Dr. Hamza Brimah or Dr. Paul Farmer the oracle we desperately needed? What about Mays himself, possibly the greatest baseball player of all time, with his 660 home runs? (The slugger had a different approach than Jackie Robinson or Hank Aaron on racial justice issues, mostly staying silent, focusing on the ballgame. Maybe silence was what I needed).

Mays was a giant. I knew that, but I couldn’t tell if he was the Great Spirit.

In the end, we left Oracle Park, drove to Oakland past RingCentral Colosseum, where the Oakland Athletics play, and returned to Carmel for the night.

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