On Gumption — Mountains Beyond Mountains

I’ve been diligently chipping away at Mountains Beyond Mountains, but in the interim I’ve also been reading Zen and the Art of Motorcycle Maintenance, a gem by Robert Persig.

Persig discusses the idea of “gumption” in the latter half of his book. In summary, gumption is motivation, diligence, and persistence all bundled into one word. It’s the driving force behind our focus when times get rough. When we suddenly encounter a bug we can’t fix, or an argument we can’t seem to win, strong gumption will win us that extra 1%. Weak gumption, on the other hand, leads to frustration, burnout, and boredom.

I can’t help but wonder how Pel Farmer keeps a steady supply of gumption… He stares tuberculosis in the eyes in areas where people are much too poor to help themselves. The world’s leading political health specialists have turned against Farmer, pronouncing resources are wasted on MDR-TB patients (multi-drug resistent TB patients). Even worse, the then-current standards in place to combat TB only stymie the treatment of MDR-TB. Standard treatment for TB called for a second round of two first-line drugs — drugs designed to treat two common types of TB-bacilli. But repeated treatment with identical drugs encourages the evolution of other drug-resistant bacteria. Even the dominant political stakeholders refuse to amend their treatment procedures to reflect the evolution of the illnesses they are trying to address.

Farmer and his PIH project are the only salmon swimming against the currents of medical professionals, government institutions, and billions of bacteria. But in the face of all of this, Farmer still dedicates himself to his cause, dumping hundreds of thousands of dollars into a program he helped create. He flies to and from Boston, where he is still doing his clinical rounds as a resident, starts a family, and battles Hepatitis A. Farmer never wavers, and never burns out.

His job is harder than most, but he sticks with it. It’s a cliche, but that’s something everyone can admire and learn from.