It has been well understood for some time now that COVID-19 and its ensuing global pandemic are unprecedented events in our contemporary world. Not since the Influenza Pandemic of 1918 has global life been so drastically altered so quickly due to a viral outbreak.

In the century since 1918, countless individuals, organizations, and nations have striven to eradicate the unnumbered diseases, parasites, and structural barriers that cause unnecessary death, needless suffering, and the squandering of human potential.

Paul Farmer is one of those individuals. Chair of the Department of Global Health and Social Medicine at Harvard Medical School, Farmer is co-founder of Partners in Health, serves as a Special Advisor to the United Nations, and has authored several books on the topics of global health, human rights, and international cooperation.

Given our aforementioned collective moment in history, UC Press would like to bring renewed attention to these topics and Farmer’s role as a leading public figure.

The following is an excerpt from To Repair the World, part 1, “Reimagining Equality,” delivered as the commencement speech for Boston College class of 2005.

Ladies, gentlemen, fathers, sisters, parents, families, graduates: surely you don’t blame me for being nervous. It’s been a while since I sat in that seat, and I don’t want you all to find this boring or irrelevant. A week ago, a friend emailed me an article from the Boston Globe about how commencement speakers are chosen. It sent a chill right through me: “The graduates almost always prefer well-known figures, particularly from the entertainment world, in hopes of a speech that will provide a lighthearted finale to their college years, college administrators say.” The article, which mentioned Boston College and yours truly, noted that students preferred— and vocally so—speakers like Ali G and Jon Stewart. As my mother would say: “oh, boy.”

So, terminally unhip, I’m going to stick with what I know best: Haiti and Rwanda, health and human rights. For all of you who take pride in BC’s cosmopolitan culture and secular success, I warn you further that I’m going to frame my remarks today around a couple of concepts I learned growing up Catholic: epiphany, metanoia, and praxis. But don’t worry— I won’t talk about theology and still less about philosophy or any particular faith tradition. I’ll confess right here that for years I thought “epiphany” was either a hot young starlet or a Latin American vacation day; I was pretty sure that “metanoia” was a heavy metal band whose members trashed hotel rooms and ended up in rehab; and, for the longest time, I thought a “praxis” was a disease-transmitting insect indigenous to the part of Amazonia shared by Brazil, Peru, and Venezuela.

Epiphany, metanoia, praxis— these were, the priests assured us dazed kids, very important concepts. But you’d all be disgruntled if I wasted this important day by asking you to remember three arcane Greek words. After all, you quite reasonably want your commencement speaker to say something like, “Go forth and conquer! The world is your oyster! Give ’em hell!”

Now, granted, “give ’em hell” is not a common way to kick off a speech at a Jesuit institution, but I’ve cleared this with Father Leahy, who pointed out, quite gravely, that the term “hell” is perfectly acceptable in theological discourse. He was less pleased, however, with the vulgar contraction “’em.”

Hell. What on earth is “hell”? Today’s question, more properly posed, is “What is hell on earth?”

That’s what you guys need to figure out because you are setting forth, at the height of your powers, into a world in which some have so much and others have next to nothing. I’ve met several members of the Class of 2005 and know just how talented and committed you all are. You will— you must— find out about the world’s wounds. My own guess is that poverty and powerlessness and untreated disease are hell on earth and that there’s nothing God given about such conditions. They are man given. And if hell can be created by others, rather than by some inescapable force of God or nature, we humans might just have a salvific role to play.

My own authority, such as it is, draws on the fact that I’m a doctor to people who are living in the worst sort of destitution, people who would say in a flash that they are living in hell. In fact, they say this all the time. I’m talking mostly about Haiti, of course. And the man-made hell to which I refer is slavery and its after-effects. Haiti, for over a century a lucrative slave colony, became the first nation to outlaw “the peculiar institution.” Born of a violent slave revolt, Haiti is our oldest neighbor. We owe Haiti a lot, and we haven’t always been very neighborly. More on that later.

First allow me to natter on a bit about epiphany, metanoia, and praxis. By giving a few examples, I hope to suggest how important, how life changing, these three lousy Greek words can be.

I. Epiphany

The term “epiphany,” less obscure than the other two, has entered the popular vocabulary. I’m sure it’s used in several Britney Spears ballads, and it’s rumored to be the title of a forthcoming album by Fifty Cent.

To have an epiphany is to suddenly understand something that had previously escaped you. A eureka moment, like when Archimedes found that lost bar of soap in the tub, or shampoo-and-conditioner- in-one, or whatever it was he’d dropped. We’ve all had epiphanies— and if you’re lucky you’ve had quite of few of them here at BC. Given the tuition, your parents have every right to be disgruntled if you’ve had no epiphanies at all. In such case, my advice is to fake at least one, which adds up, counting tuition and expenses, to close to a quarter million dollars per eureka.

The epiphany to which I refer concerns slavery. Not the sudden discovery by an isolated slave that slavery was evil—the slaves knew that from the get-go—but rather that of a person like you or me. Much more like you than me, though, since he was 25 years old and had just finished his schooling. This was in late eighteenth-century England at the height of the slave trade.

Like many of you, Thomas Clarkson was ambitious, bright, and ready to set out to do something good in the world. He looked forward to a career as an Anglican minister. We know a lot about Clarkson. “Over six feet tall,” we read in Adam Hochschild’s wonderful new book, Bury the Chains, “Clarkson had thick red hair and large, intense blue eyes that looked whomever he spoke to directly in the face.”

Like some of you here today, Clarkson submitted, prior to graduating, an original piece of scholarship, an essay about slavery (an enterprise in which England was deeply invested). “His essay,” recounts Hochschild, “won first prize. Clarkson read it aloud in Latin to an audience in the university’s majestic Senate House, where such ceremonies are still held today. His studies finished, already a deacon in the Church of England, he mounted the horse he owned to head for London and for what seemed a promising career.”

All this was prior to proper roads, and it was prior to road rage, too. But Clarkson had, en route to London, a severe attack of road angst:

Riding to the capital in the black garb of the clergyman-to-be, he found himself, to his surprise, thinking neither of his prospect in the church nor of the pleasure of winning the prize. It was slavery itself that “wholly engrossed my thoughts. I became at times very seriously affected while upon the road. I stopped my horse occasionally, and dismounted and walked. I frequently tried to persuade myself in these intervals that the contents of my Essay [on slavery] could not be true. The more however I reflected upon them, or rather upon the authorities on which they were founded, the more I gave them credit.” These feelings grew more intense at the midpoint of his journey, as he was riding down a long hill. . . . “Coming in sight of the Wades Mill in Hertfordshire, I sat down disconsolate on the turf by the roadside and held my horse. Here a thought came into my mind, that if the contents of the Essay were true, it was time some person should see these calamities to their end.”

Some person should see these calamities to their end. If there were a single moment at which the English antislavery movement became inevitable, it was that day in June 1785 when Thomas Clarkson sat down by the side of the road at Wades Mill. That moment would reverberate throughout the remaining sixty-one years of his life and beyond. For us today, it is a landmark on the long, torturous path to the modern conception of human rights.

Let’s stop a minute, recap the road-angst part. Picture this scene: young dude, tall and ambitious, graduates and wins prize. Wears hip black threads. Only 25 years old. Has a cool ride (though there’s nothing to suggest the horse was pimped out). Good in Latin, stumbles across topic, pulls all-nighter, gets the declensions right, and blows old school away with his oratory. Tools back to London to party. Finds self dazed, “disconsolate,” sitting in front of some bloody mill, wondering why in God’s name self is obsessed by essay topic. Just a damn essay! An exercise! Clarkson curses self: why not an essay on Etruscan pottery, a sonnet, even Beowulf? Why on earth did he have to choose slavery, about which he knew nothing? Meanwhile, horse is munching roadside greenery, staring at crazy white guy, grazing, waiting, staring, grazing. Said white guy, still disconsolate, goes wandering into woods. Horse concludes he’s gone mad. Horse keeps grazing.

But something far better than madness was enveloping Thomas Clarkson. A light was dawning. A bell went off. A deep chord was struck. This, you see, was an epiphany.

And the best was yet to come, although you’ve already guessed it or read the book. Hochschild continues:

Long months of doubt followed [Clarkson’s] roadside moment of revelation. Could a lone, inexperienced young man have that “solid judgment . . . to undertake a task of such magnitude and importance—and with whom was I to unite?” But each time he doubted, the result was the same: “I walked frequently into the woods, that I might think on the subject in solitude, and find relief to my mind there. But there the question recurred, ‘Are these things true?’—Still the answer followed as instantaneously ‘They are.’— Still the result accompanied it, ‘Then surely some person should interfere.’” Only gradually, it seems, did it dawn on him that he was that person.

To summarize, dear graduates, Clarkson asked the simplest question: “Are these things true?” And he came up with the simplest answer. Yes. Surely someone should interfere with this man-made abomination, slavery?

And interfere he did. Clarkson and his friends and consociates, some of them former slaves, spent decades building up a movement, performing the hard chores of what we now call community organizing. From it we learn not that one person—Clarkson, say—can have great force in the world. That may be true, but the lesson to be gathered from abolitionists is that broad social movements can have great force in the world. Because Clarkson and a dozen or so others, many of them Quakers and a couple of them influential, began a vast campaign. They went from town to town, traveling tens of thousands of miles on horseback, collecting signatures for petitions, calling town meetings, researching the slave trade, gathering expert witnesses, compiling testimony.

Sound modern? It was. And imagine what these people were up against. They lived in a monarchy; almost no British subjects could vote. The United Kingdom derived huge profits from the slave trade; this was in part why it ruled the high seas. Sugar, rum, tobacco, and other tropical produce had become everyday staples in Europe and the emerging “new world” in which we live today— and most of these products were drenched in the blood, sweat, and tears of people kidnapped in Africa and sold as things.

I can’t resist going back to Jesuit teachings for a second. Pedro Arrupe, in laying out the principles guiding the Society, reminded us of the primary importance of “a basic attitude of respect for all people which forbids us ever to use them as instruments for our own profit.”17 The millions of people who finally brought a halt to the slave trade went back to this first principle again and again. It was step one in building a modern social movement.

II. Metanoia

Step two, for Clarkson, was metanoia. Metanoia, a change of heart, can of course come in many circumstances. Symptoms, as Clarkson’s horse could tell you, include obsessive ideation, shortness of breath, facial redness, sleep loss, and the desperate urge to change something. Tom Clarkson’s epiphany on the way from Cambridge to London led to metanoia and then on to informed action, which some term “praxis.”

Haiti was my own Wades Mill. Haiti taught me how to better understand places like Rwanda and—more to the point—how to understand my own country and its history. I first went to Haiti right after I tossed my mortarboard in the air: I was 22 years old and graduated from college with a vague plan to go to Haiti.

Turns out that a brief “visit” to Haiti was pretty hard to pull off. Haiti stayed with me. Trying to shake Haiti, I could identify with Tom Clarkson’s road angst. I found myself asking the same simple question: yes or no—are these things true?

This metanoia was hard for me. The brutal sledgehammer of poverty and disease was striking the people we sought to serve; it was hard, even, to watch. But Haiti taught me a great lesson, the very lesson underpinning the revolution that brought down slavery there in 1804: human life and human values cannot have price tags attached to them.

I think it’s safe to say that General Roméo Dallaire, who is receiving a much-deserved honorary degree here today, had this same epiphany and experience of metanoia when he found himself in charge of a too-small United Nations peacekeeping force in Rwanda in 1993. Dallaire watched as Rwanda went up in flames and hundreds of thousands of people were murdered at close range with machetes and other crude tools. Talk about hell on earth. But the general couldn’t get the troops he needed to intervene. One story from his memoir is worth recounting:

As to the value of the 800,000 lives in the balance books of Washington, during those last weeks we received a shocking call from an American staffer, whose name I have long forgotten. He was engaged in some sort of planning exercise and wanted to know how many Rwandans had died, how many were refugees, and how many were internally displaced. He told me that his estimates indicated that it would take the deaths of 85,000 Rwandans to justify the risking of the life of one American soldier. It was macabre, to say the least.

A cost-effectiveness analysis, a price tag, applied to a peacekeeping effort in Africa. Macabre indeed. And how terrible it often feels, we have learned, to survive when so many others died.

III. Praxis

Dallaire has often said that what happened in Rwanda was made possible by the world’s racism. The world’s indifference to the fate of a large subset of humanity continues to haunt him. He wasn’t able to stop the genocide, nor could he walk away from it. He wanted to make sure the lesson would not be forgotten. This put him on a path of incessant nagging about Rwanda and justice for those who’d died. That’s what praxis means. This accounts for the honor you confer on him today.

But General Dallaire was not always honored. In fact, he was given a stern dressing-down by his superiors in the Canadian armed forces. He was to give up the “Rwanda business” or he’d be forced to leave the military. Dallaire, like Clarkson some 200 years before him, stuck to his principles, and so was given a “medical discharge” from the armed services. As a civilian he has only escalated his campaign for justice. It hasn’t been easy. “My soul is in Rwanda,” he once said. “It has never come back, and I’m not sure it ever will.”

I promised I would not try to be an amateur theologian, but what could be more soulful than allowing yourself to be open to epiphany and metanoia and so to know the suffering of others? To have your road angst followed by action? To admit failure and to soldier on?

Still, I know what the general means about being haunted by experiences of hell on earth, which is to say, experiences in impoverished and war-torn regions of the world we share. It’s easy to look at the world as it is and to lose hope. Can we live—move forward—without hope?

Whoa! As some of you might say, “Dude! I can’t believe I just said that!” But even though the Boston Globe warns us that you want, in your speaker, “a lighthearted finale to your college years,” I’m going to close by asking you for something.

Whatever it is you do, and you will do great things, try to turn your road angst into hope and action. Do it for us, do it for each other, and do it for the millions you’ll never meet but who may well be affected by your action and inaction.

You don’t have to be an archbishop, or the head of a peacekeeping force, or even a doctor laboring in some isolated backwater. You can transform road angst into hope and action as a teacher or an artist or a banker or as CEO of a company. Indeed, the world is counting on the next generation of Americans to think more like Thomas Clarkson and Roméo Dallaire. I make this claim because I know, from working in Haiti, that we have great power on the global stage. The world is your oyster.

See? I promised I’d get that in somehow. But while we’re at it, I’d like to know who coined the oyster declaration because I’ve never been sure what it means. Perhaps it’s just that oysters are delicious to many and repugnant to others; perhaps it’s that oysters can give you hepatitis or a pearl or a nasty cut. Perhaps the world is more like an oyster than I thought.

Whatever it means, the world is in fact counting on you, perhaps more than ever before. Many of you feel its ever-increasing interconnectedness. Technological advances will continue to make ours a smaller planet (my second safe prophecy today). I’ve recently been in Haiti and am soon off to Rwanda— but not in one of the awful ships that inspired Thomas Clarkson’s indignation.

As someone who is on the road a great deal, I feel a deep admiration for his epiphany, metanoia, and praxis. Back then there were no frequent-rider miles or upgrades to a better saddle or a faster horse. What he and others did was hard work.

Above all, Clarkson and General Dallaire both learned the lesson that to do nothing is also to act. So act affirmatively—by making things happen, not just letting them happen. Aristotle said it best: “Action is the perfection of potential.” We’re counting on you to go forth now with all the potential you have stored up in you and act. Not “acting” in the sense of Ali G acting, but acting on your convictions.

You’re going to have some road angst along the way. Let it invade you, change you, drive you to act. Whether you become doctors or lawyers or bankers or teachers or even theologians, make room for a movement to make this world—a world you’ll shape decisively—a better place.