The book is written from the point of view of author Tracy Kidder. It is set mainly in Haiti and Boston, Massachusetts. Kidder first met his subject, Dr. Paul Farmer, in Haiti in 1994. At the time, Kidder was researching a story about American soldiers sent to reinstate Haiti's democratically elected government led by president Jean-Bertrand Aristide. Kidder met Farmer again on his flight back to Miami, Florida from Haiti and began to learn about his life.
Farmer was born in Massachusetts and grew up as one of six children in a poor household in Florida. He studied at Duke and Harvard, where he earned his M.D and Ph.D. The rest of the book details Farmer's life and accomplishments, including his work with the health and social justice organization Partners in Health, especially in Haiti, Peru, and Russia.
Kidder describes Paul Farmer as follows:
- "And I was drawn to the man himself. He worked extraordinary hours. In fact, I don’t think he sleeps more than an hour or two most nights. Here was a person who seemed to be practicing more than he preached, who seemed to be living, as nearly as any human being can, without hypocrisy. A challenging person, the kind of person whose example can irritate you by making you feel you’ve never done anything as important, and yet, in his presence, those kinds of feelings tended to vanish. In the past, when I’d imagined a person with credentials like his, I’d imagined someone dour and self-righteous, but he was very friendly and irreverent, and quite funny. He seemed like someone I’d like to know, and I thought that if I did my job well, a reader would feel that way, too."
The book is primarily a biographical work broken into five parts.
PART I: Doktè Paul
Introduces Farmer's work at the Brigham in Boston, Massachusetts and at PIH founded by Zanmi Lasante in Cange, Haiti.
PART II: The Tin Roofs of Cange
Describes Farmer's family background and gives accounts of Farmer from sources close to him. Farmer's dedication to PIH led to the breaking off of his engagement to Ophelia Dahl, the daughter of noted author Roald Dahl and actress Patricia Neal. The two have remained close confidantes, and Dahl has continued to work for the PIH organization.
PART III: Médicos Aventureros
1995 MDR-TB claimed the life of a close friend known as Father Jack, in Lima, Peru. PIH co-founder, Dr. Jim Kim convinces Farmer to extend PIH into Peru, where they fight against the rigid orders of the DOTS program. This was regulated by the World Health Organization, and largely supported financially by an American benefactor, Tom White.
PART IV: A Light Month for Travel
Follows Farmer from Haiti to Cuba, Paris, Russia, and other locations in his quest to treat infectious disease.
PART V: O for the P In 2000, PIH learns it has been awarded a $45 million grant to combat MDR-TB in Lima, Peru, along with other organizations. "O for the P" refers to an expression within PIH that is a shortened form of saying “a preferential option for the poor”.