Mountains beyond mountains

by Tracy Kidder

Paper Book, 2009

Status

Available

Publication

New York : Random House Trade Paperbacks, 2009.

Description

"[A] masterpiece . . . an astonishing book that will leave you questioning your own life and political views . . . Kidder opens a window into Farmer's soul, letting the reader peek in and see what truly makes the good doctor tick."--Nicholas Thomas, USA Today In medical school, Paul Farmer found his life's calling: to cure infectious diseases and to bring the lifesaving tools of modern medicine to those who need them most. Tracy Kidder's magnificent account shows how one person can make a difference in solving global health problems through a clear-eyed understanding of the interaction of politics, wealth, social systems, and disease. Profound and powerful, Mountains Beyond Mountains takes us from Harvard to Haiti, Peru, Cuba, and Russia as Farmer changes people's minds through his dedication to the philosophy that "the only real nation is humanity." Praise for Mountains Beyond Mountains "A true-to-life fairy tale, one that inspires you to believe in happy endings . . . Its stark sense of reality comes as much from the grit between the pages as from the pure gold those pages spin."--Laura Claridge, Boston Sunday Globe "Stunning . . . Mountains Beyond Mountains will move you, restore your faith in the ability of one person to make a difference in these increasingly maddening, dispiriting times."--John Wilkens, The San Diego Union-Tribune "Easily the most fascinating, most entertaining and, yes, most inspiring work of nonfiction I've read this year."--Charles Matthews, San Jose Mercury News "It'll fill you equally with wonder and hope."--Cathy Burke, People "In this excellent work, Pulitzer Prize-winner Kidder immerses himself in and beautifully explores the rich drama that exists in the life of Dr. Paul Farmer. . . . Throughout, Kidder captures the almost saintly effect Farmer has on those whom he treats."--Publisher's Weekly (starred review) "[A] skilled and graceful exploration of the soul of an astonishing human being."--Kirkus Reviews (starred review)… (more)

Media reviews

''Mountains Beyond Mountains'' is inspiring, disturbing, daring and completely absorbing. It will rattle our complacency; it will prick our conscience.

User reviews

LibraryThing member The_Hibernator
In this moving biography of Paul Farmer, Tracy Kidder takes us on a world tour of medical missionary work. Farmer started his mission to save the world from tuberculosis one patient at a time in the slums of Haiti. Practically from scratch, he developed a clinic that would treat the poor. But
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Farmer not only treated his patients, he listened to them, he cared about each one with individual interest, and he provided food and supplies so that his patients wouldn't be saved from tuberculosis only to die of starvation.

As his mission in Haiti gained more and more momentum, Farmer's expertise on tuberculosis (especially antibiotic-resistant strains) became world-renowned. He was asked to help set up clinics in Peru. He worked with the health systems of prisons in Russia, where antibiotic-resistant tuberculosis was rampant. And he loved each and every patient, regardless of who they were.

While describing the incredible non-stop work of Farmer, Kidder managed to make the doctor more human. I could imagine Farmer, cheerful despite sleep-deprivation shadows under his eyes, flying from one country to another in a worn-down suit that he would never have time to replace. From the book, it seemed that Farmer might pause for hours to have a heart-felt conversation with a patient, even while a room-full of self-important Harvard doctors awaited his arrival. I could empathize with Olivia, Farmer's old flame, who once felt a twinge of satisfaction to realize that Farmer was only human - she could annoy him. Being around someone like that must be exhausting. Kidder painted a brilliant man with limitless energy, unimpeachable morals, and the charisma to make his dreams a reality. I felt overwhelmed just listening to the book. I can't imagine what it must be like to work for him (or date/marry him). And yet, it's impossible for me to not admire him.

I found this book fascinating not only because it was a description of an amazing man with a daring love for humanity, but also because I enjoyed learning more about the social/economic conditions of Haiti. The narrative flowed smoothly between Kidder's personal impressions of Farmer and Haiti to well-researched narratives of Farmer's life outside his work.

I enjoyed Paul Micheal's narration of the book - though I have little to comment on his style of reading. It was one of those audiobooks that I was so absorbed in the story that I forget to be distracted by the narrator - which means Micheal must have done a good job.
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LibraryThing member msf59
“Beyond mountains there are mountains.
--Haitian proverb

This epigraph is a metaphor for life but it also perfectly describes the awe-inspiring life of Dr. Paul Farmer. A Harvard trained MD, who has dedicated his life, to helping the poor, no matter how difficult the path is or how high these
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treacherous peaks can be.
He spends his early career in Haiti, one of the poorest countries on the planet, riddled with corruption and deep poverty. Through hard work and complete dedication he builds clinics, contains epidemics and tends to the down-trodden, giving them the attention, medical and moral, that they have always been denied.
The author spent several years, off and on with Farmer and witnessed first-hand, how this incredible man, creates a safety net for the under-privileged, not only in Haiti, but also in Peru, Cuba, Russia and other locations.
This is riveting narrative non-fiction and it will inform, inspire and prove that these devastating issues can be dealt with in an effective and humane way. Highly recommended.
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LibraryThing member TadAD
If you haven't already read a dozen reviews, this is Tracy Kidder's look at the life work of Paul Farmer, a doctor who has dedicated every aspect of his life to bringing sound medical treatment to the poorest areas of the world, leading a fight against the tuberculosis pandemic, and trying to
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change the ways the "haves" of the medical world interact with the "have nots".

I find my reaction to the book is one of ambivalence or, more accurately, I find that I enjoyed the book unquestionably but my reaction to the contents is ambivalent.

Looking at this story simply from a perspective of "Is this worth reading?" my answer is a definite "Yes!" Kidder's writing flows along smoothly, never getting bogged down in medical details, bringing a very clear picture of this man and his work. The first-person perspective he uses draws you right into the story, giving it immediacy and intimacy. I'm sure that there are accusations that Kidder seems to have fallen under the spell of Dr. Farmer and doesn't provide a balanced picture. However, I don't think that's fair. There is no intent to deceive or slant and Kidder does raise the counter-arguments; the reader who is not, himself, under Farmer's spell will see them and can follow them as he chooses.

Looking at this story from the perspective of the word I've heard applied most often..."inspirational"...I find that I'm less in accordance. As someone else implied, Dr. Farmer is so extreme that I almost have to read this book as a type of fiction, populated with a superhero whose exploits I admire but have no thoughts of attempting myself. The sign in his facility seems to show that even his own staff has that reaction: "If Paul is the model, we're f*****."

I cannot help but compare this to another book I read this year, Greg Mortenson's Three Cups of Tea. While Mountains Beyond Mountains is unquestionably better written, easier to read and more entertaining, the other retained a sense of human proportion that inspired me to think about what I, personally, might do. Mountains Beyond Mountains, lacking that scale, did not personally inspire, rather it moved me to compassion and awareness.

Part of the Olympian remoteness I feel about Dr. Farmer is that he inhabits a land of moral absolutes, whereas I cannot so easily walk away from the real world. To take a stance that the rich of the world have an absolute moral obligation to do whatever they can to help the poor is a moral high ground...and to do everything you can to bring that about is admirable and wonderful. However, to conduct your actions as if you have already succeeded lets you occupy that moral high ground at a cost to those you want to help. We can thrill to the heroics that spent more resources than the organization had to rush a boy from Haiti to Boston for an operation that might cure his advanced cancer. However, we can also acknowledge that the child's chances were not good and that the $20,000 spent to save, ultimately, zero lives would have bought 16 or so others from the same plateau the drugs needed to save them from dying of multi-drug-resistant tuberculosis. We can all think on Shaw's dictum about unreasonable men and progress, but we cannot forget that progress is not always benign to those caught up in it.

This is a book I think everyone should read—well-written, entertaining and thought-provoking. If it inspires you to a similar life, even in part, then it's wonderful. If it only moves you to compassion and helping out, then perhaps Farmer would say, "Well, I'll take that."
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LibraryThing member goorhuis123
Fascinating look at Haiti and all it's problems. Interesting politics, social justice/gospel, etc.
Horrible maternal/child health, admirable the way he fights it. Read soon after the horrible earthquake of 2010.
LibraryThing member rgruberexcel
RGG: Both a memoir about Paul Farmer, a courageous ally, and an expose about the state of medical aid for the world's poor.
LibraryThing member wealhtheowwylfing
I've been saving this until I really needed a book this good. I'm glad I did. Kidder's take on Farmer's work and philosophy is energizing, enraging, and engaging. I wish I could have kept reading it forever.
LibraryThing member CarolynSchroeder
This is an astounding book about a modern-day hero, few or none, of us know anything about ~ the kind of person that just seems not to exist anymore. But as we traverse the globe with infectious disease physician, Paul Farmer (who also has a PhD in anthropology), I felt myself being inspired by
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what one person can truly accomplish if he sets his mind to it. I will say, I've never met anyone with Farmer's pure and myopic drive towards helping first, his patients (and that means any patient, poor, destitute, wealthy or moderate), but secondly, the effort to bring medicine and aid to the people of the world who need it the most. It's wild, I had the racing feeling that one lifetime just wasn't enough for someone trying to accomplish so much. Farmer takes on the international bureaucratic nightmare that is global health care (which of course, weaves in political unrest in many areas as well as the greed of pharmaceutical companies) and amazingly, comes out on top most of the time. I think he just never imagines NOT succeeding. But also, the guy got results ~ he cured patients, saved lives, hundreds of them. He improved areas deemed inhabitable and made a difference in so many people's lives.

But behind Farmer is a very small army of dedicated people, from gracious donors like Tom White, to his core team, Ophelia and Dr. Jim Kim. They are also fascinating to read about.

Kidder is a wonderful journalistic author who brings the seemingly insurmountable data together and he does so beautifully. At times, the medicine gets slightly dry (I think a reader has to have some seed of interest in the topic), but I learned more about MDR TB (multi drug resistent tuberculosis) than I ever thought I could/would. Also, the AIDS epidemic, and how TB and HIV are inter-linked. Of course, explosion of either of those two diseases occurs in areas of severe poverty ... and Kidder takes us to many of those areas (mostly Haiti, but also Peru, Mexico and Russia), which are hard to read about, but I think, necessary, to understand the gravity of the problem.

I highly recommend this book to anyone who cares about social change and helping this fractured world.
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LibraryThing member strandbooks
My brother has been trying to get me to read this for a year, and after the Haiti earthquake I finally checked it out. He was right that it is a page turner. It is a biography of Paul Farmer, a genius who has created an oasis in a poverty stricken area of Haiti to treat patients as well as gone on
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to fight TB around the world by challenging the accepted ways of dealing with disease and poverty. I struggled with the book. Even Farmer admits in the beginning that what he is doing is pallative. Treating one patient at a time of diseases that mainly afflict people in poverty. Yet he does create communities and schools in the hopes that it will give them more opportunity than sex trade, but in a place like Haiti the goal for most is to find a way out if educated. It feels dismal and I realized when I got to one of the final chapter where he explains that his fight is is a fight of defeat. He will not succeed in treating every patient, but will fight to do it and if that includes a lot of money to change people's circumstances so there is less chance for infectious diseases then he will do it.
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LibraryThing member myfanwy
Paul Farmer is a rather unique man. He started a hospital in Haiti where they have one of the lowest life expectancies in the Western Hemisphere (~50 years). He teaches at Brigham and Women's in Boston for a small fraction of the year, then donates the rest of his time to Haiti, walking for hours
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to visit patients and funneling charitable funding towards buying AIDS and TB medications for the people there. He now teaches in Boston, practices in Boston, Haiti, Peru, and Siberia, and works on health policy to change the bureaucratic obstacles to improving health for the poor. He is utterly tireless, doesn't sleep, doesn't hardly see his family, and doesn't seem to mind. He writes his full paycheck over to his organization every year. The patient is paramount. It is a martyr's job, but effective. Here's one example:

In Peru they started a program to treat multi-drug resistant tuberculosis (MDR-TB). At one point they couldn't get funding because the WHO kept saying "hey, it's too expensive!" while the pharmaceutical companies kept saying, "well, there's no market!" No market for expensive drugs whose patents had already expired because the thousands of people with MDR-TB did't have enough money to buy them. Solution? They went to the pharmaceutical companies and said "Hey, we'll buy your drugs if we can negotiate a lower price!" Result? 97% decrease in cost. Basically, instead of leaving the last 10% to die in ignominy they found a way to save every one, or at least every one that could be saved with the best medicines in the world (not just the best medicines in Haiti/Peru/Siberia). And now *voila* treating MDR is no longer beyond WHO's funding. How easy was that?!

In some ways Farmer's story is inspiring. Here he is giving every waking hour to his work. If you say you can't ask that of everyone, he'll just say "Why not?" While there is an inequity in the world he figures everyone should spend every moment working to change that. It's a hard business model to sell but obviously has the moral high ground. He feels that you have to try to save every patient, even if that means spending $25,000 on drugs, even if that means medevacing a kid to Boston MGH to have open heart surgery. And then you start to think, well, that's morally pure, but I'm not entirely sure that works. He is anti-utilitarian. There's no such thing as the greater good. Everyone's good is just as great. In his mind, you can't say "don't spend this money on this child because you could be providing pre-natal care to 150 women." And I wonder at that. I'm sorry, but I'm a statistician, not a clinician, and I wonder. I cannot deny that his pressure on drug companies for TB medications has been a win-win situation. Will that same tactic bring down the cost of medical procedures, too? By providing all possible medical technology to everyone in his care, does that mean that eventually all medical care can be supplied to everyone. Is that even possible? (You can see I'd make a terrible saint. I ask the question "Is that possible?")

His work obviously makes me question myself and how much I would give. I couldn't work the way he works. I am willing to spend years of my life abroad, but not the majority of my years. I am willing to take less pay in order to do greater good, but not no pay. I am willing to work overtime, but I still want to be able to see my family from time to time. That's just my choice. Clearly, he has made the right choice for him. He has a calling, as few people have. I can only hope that I find something that suits me and to which I am suited even half as well as he is suited to be a jet-setting innovative rural doctor. And I cannot deny that there is a lot of work to be done. There is poverty and there is abject misery throughout this world. Now I just have to figure out how I, not being Paul Farmer, can help.
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LibraryThing member janey47
The biography of Paul Farmer. Farmer is a doctor (specialist in infectious diseases) and anthropologist who has undertaken the treatment of AIDS in Haiti and multi-drug resistant tuberculosis in Russia (and elsewhere), and who looks at disease as social/cultural ill and poverty as the single most
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significant factor in healthcare issues. He makes a powerful case in his own writings for a radically new picture of the politics of health and the allocation of resources, and this book is a great introduction to him and his writings, because he tends to disappear in his own books. His own story is very much worth reading. He scoffs at the idea of "sustainable" programs (i.e., AIDS prevention to the detriment of AIDS treatment) and just tackles what is in front of him with all his force and determination. In the offices of his non-profit org, one of his co-workers has a little sign posted that says "If Paul is the model, we're fucked." And that's a good reminder. I mean, this book could totally inspire you or it could make you throw your hands in the air and think that if you can't give everything, the way the Farmer does, there's no point in trying. But Farmer, via Kidder, would say with Gandhi that everything you do will be insignificant, but it is very important that you do it.
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LibraryThing member mimosapudica
This book is truly an inspiration. Dr Farmer is a man who is a true healer. This book also makes you realize the consequences of corrupt government on the people of such countries
LibraryThing member MargMcM
No other book read by my book club engaged people as this book did.
LibraryThing member Don1
This is the true story of Doctor Paul Farmer who set up a clinic in Haiti to treat really poor people for all kinds of horrible but preventable diseases (like malaria) except for their horrible living conditions. Dr. Farmer simply wants to make the world a better place, and I developed a really
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strong admiration for him and his work. He is not above laying guilt trips on rich people to donate to his causes. I liked this book so much that I sent a check to his organization. A truly uplifting book that gives you some hope for the future of humanity. I believe Dr. Farmer was the subject of a story on 60 Minutes a few years ago.
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LibraryThing member wordygirl39
I loved this book. I usually like Kidder's social explorations, but I thought this book was necessary and important.
LibraryThing member rmwilliamsjr
This book was a loan. It is a worthwhile and absorbing read, mostly because of Kidder's writing ability. The book exists on three distinct levels: the first is as a biography of an interesting man-Paul Farmer, the second is a story about Haiti, the abuse of both it's people and it's land over time
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and how that creates the modern morass, and lastly is the story of how Kidder became a Farmer fan or how i came to write this book. The book is tying these three levels, these distinct threads into an engrossing and fascinating story so that by the end you too are a Farmer fan.

Why do some, a pityfully few people, seem to do something with their lives, seem to matter in the long run, seem to get useful work out of their time here that others just seem to waster and squander? Is it technique, is it passion, is it ability and in their genes, is it just restless energy? The book offers a few insights into this complex and important topic. But mostly it is a straightforward biography of Paul Farmer, from an unusual childhood to travelling often from Haiti to Boston, from the bottom to the top of the social and material world, about a dichotomy expressed in the life of one man: love of these poor people and love of modern medicine and what it can do for patients as real people.

I appreciated the book, i can hope to read more like this, i can never hope to be like him and will remain a spectator of such people, who seem to exist on a plane of their own. I am glad they live among us and i would believe that their presence blesses the rest of us. But i will remain in the bleachers cheering them onward, perhaps i can write a few small checks to their works but i will always see them from afar. Kidder does all us avid readers a great service by writing down what he saw and heard, thanks.
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LibraryThing member whjensen
Challenging book. Hardly a likable protagonist in Paul Farmer, but challenges you with the overabundant wealth that surrounds us.
LibraryThing member Niecierpek
A biography of Dr Paul Farmer, the man who has devoted his life to bringing high standard health care to the poor and underprivileged in Haiti, Peru, Siberia and wherever needed.
I really enjoyed it- found Kidder’s account both well written and informative and Farmer inspiring. Farmer may appear
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almost manic in his resolve, but he proves that one man- sufficiently selfless, insistent and resolved- can actually make a difference. Highly recommended.
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LibraryThing member irishwasherwoman
Bless Dr. Paul Farmer. His dedication, energy, and vision have all served to make a difference in his adopted home of Haiti and the world when it comes to treating infectious diseases and caring for the poor. The story as told by Tracy Kidder is a compelling one. The writing is somewhat uneven
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(using indigenous terms without explaining them and adding inconsistent dialect, for example) and definitely detracts from the story. What Kidder did do write was ask the right questions both of Farmer and of himself.
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LibraryThing member Pferdina
I was prepared not to like this book. I expected it to be either preachy or depressing (maybe both) and it was neither. In short, it describes the simply amazing work of Dr. Paul Farmer in Haiti, in Peru, in Russia, and elsewhere, treating poor people and extending care especially for tuberculosis
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and AIDS. Of course there are many other people involved whose contributions should not be minimized, but Farmer is the charismatic leader who holds everything together. The book is a relatively easy read and never detours too deeply into esoterica. I would not say it is "inspirational" exactly, because few people are willing to follow Farmer, but at least the book brings up many important questions about poverty, disease, and how the developed nations of the world deal with them.
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LibraryThing member co_coyote
Tracy Kidder always seems to enter into the heart of his subject, and this book is no different. Here he expounds on the life and work of Paul Farmer, a Harvard Medical School doctor who spends most of his time striving to improve the lives of his Haitian patients. Inspirational and eloquent.
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Highly recommended.
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LibraryThing member Lilac_Lily01
This is an excellent example of what medicine should be. Dr. Paul Farmer is a brilliant physician who has dedicated his life to helping the poor. Instead of taking his high salary and living the good life he chose to life a very modest life. Most of the money that he makes is used to help people
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that are less fortunate. As a matter of fact, his staff thinks that he is one of the hardest working poor people out there. Just reading about his frequent travels from Haiti to Boston, to Peru, to Russia and back makes you wonder where he gets his energy from. It seems as long as he knows that there is somebody that needs help he will do whatever it takes. To me that is true commitment and Dr. Farmer is a very rare breed of human being. If we could all take a few lessons from him, the world would be a better place.
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LibraryThing member subbobmail
Mountains Beyond Mountains is a portrait of Paul Farmer, an American doctor who has been fighting infectious diseases on a global scale (but particularly in Haiti) for a couple of decades. Farmer specializes in the diseases of the poor, refusing to accept that a man of his talents would be wiser to
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use them by sitting in a Boston office and raising funds. No, he'd rather raise funds AND run a clinic in Haiti AND establish a new global protocol for fighting tuberculosis AND make semi-regular seven-hour hikes through the Haitian countryside to call on patients who can't travel. The man hardly sleeps because when he stops moving, he thinks of the patients out there he might be saving instead.
No one would believe this character if he didn't actually exist. Author Tracy Kidder gets to know him well over the course of the book (and a few Haitian treks) and still finds him hard to believe. Despite setting the kind of moral example that makes people feel uncomfortable by comparison (i.e. "What am I doing with MY life?"), Farmer is cheerful and puts people at ease. He fights "the long defeat" against poverty and disease and corruption because it's the only way to attain eventual victories. He's downright inspiring.
My local library has about eight copies of this book, and I'm glad. Farmer is an inspiring figure, and the highly accomplished Kidder is just the man to write his portrait. Read this.
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LibraryThing member SmokeJumper
good book. I think I remember there being a few slow parts, but overall good book. It was a very inspirational book. Paul Farmer is an excellent role model for anybody.
LibraryThing member WintersRose
This is a life-changing book. After reading Tracy Kidder's account of Dr. Famer going hut to shack to cure the poor in Haiti, I skimmed through the Gospels and realized this was exactly what Jesus did, the "unglamorous scut work" [294], as Famer calls it. Kidder, whom I heard speak at the
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University of Illinois, Urbana-Champaign, (this was an all-campus read), explained the writing strategies he used to portray Dr. Farmer as a real human being, something that's difficult to accomplish when writing about someone who is good.
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LibraryThing member ckoller
Paul Farmer is amazing, simply amazing. This book makes me want to go help people all over the world. It highlights a rare breed of human.

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