I finished Tracy Kidder’s Mountains Beyond Mountains over the weekend, his biography of Dr. Paul Farmer, and it’s working its way in like a splinter. A lot of the inspiration that sticks these days is from writing that is about medicine, or business– anything but teaching. Maybe subconsciously I don’t trust teachers who have time to write. (Yeah, yeah, I know. Shut up.)

Paul Farmer keeps his head organized in an undeniably low-tech fashion:

On the wall beside his desk, Farmer has taped up three sheets of yellow legal lined paper, on every line a task to be completed, and beside each of these a hand-drawn box, in Creole a bwat. [...] The list on the wall contains about sixty imperatives– to assemble the slides for upcoming speeches, to get Lazarus a Bible and nail clippers, to give another patient the wristwatch he bought for him in the Miami airport, to obtain sputum samples from some of the patients with drug-resistant TB and take them to Boston for testing.

I love the word “bwat,” by the way: it has that mudball-splat, no-way-to-get-wussy-about-it sound that should accompany crossing items off a list. How much of genius, I wonder, is just having the tenacity to slug through your checklist, longer and harder than other people?

It appears Farmer works on completing these lists as methodically as he makes them:

We got to the airport early for once, and went to a cafe for breakfast. “Okay,” Farmer said, when we found a table, “time to get to work.” He pulled out his most recent bwat list. Only about two-thirds of the little boxes had been checked. “This is shameful.” He stared at the sheets of paper. “All these bwats were supposed to be done before we left Cuba.”

…which, I think, suggests something important. Farmer insists on a worldview where the universal right to health makes such terms as “cost-effectiveness,” “appropriate technology,” and “triage” absurd. It is a world where decisions about what is accomplished are only defined more or less by what fate happens to put in front of you, as Farmer comments in the case of spending $20,000 to medivac a Haitian patient to Boston.

“The bottom line is, why do we intervene as aggressively as we can with that kid and not with another? Because his mother brought him to us and that’s where he was, at our clinic.”

I don’t pretend to have anywhere near the life-and-death impact of Dr. Farmer in my own line of work. But I would not be a public school teacher if I did not believe in another, similarly universal right of human beings.

I also have a checklist. I triage it daily.

What if I didn’t?