Law in Contemporary Society
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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 was 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 my professional dance and college career in D.C., my friend succumbed to AIDS. A few months after his funeral, my closest friend revealed that he had contracted HIV. Around this very same time, the CDC disclosed a study that found that if current HIV diagnoses rates persist, about 1 in 2 black men who have sex with men (MSM) in the United States will be diagnosed with HIV. While recovering from my friend's death and burdened by the thought of losing another, I felt 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 – an even larger 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 into 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 was a way to add to a narrative around HIV/AIDS that drew attention from insufficient proximal explanations for higher HIV/AIDS risks among Black people and 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. These oral histories allowed for a reflexivity that other methodological approaches did not. They gave 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 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. Such biosocial analyses, Paul Farmer, suggested, must draw freely on clinical medicine and social theory; they 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 in my life. The populations vulnerable to HIV transmissions are those captured within forms of social exclusion, abandonment, and violence.

Talking to the “Idol”

I emailed Farmer several times throughout 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 were 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 despite 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 others’ 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 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.

Marvin, I was really moved while reading this. It was powerful, vulnerable, and honest. I think it shows how lived experiences, however personal they may be, inform you and make you a better lawyer than even some of the professors we’re learning from. Your piece reminds me of our conversation about the way HIV was discussed in our criminal law course, and it is clear to me now how much you withheld during that class, where students’ comments are just tallied up for participation points despite lack of depth and insight. But beyond the law school classroom, I hope that your career allows you to continue taking up the charge to flourish however you choose.

- Rubí


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