Little sleep, no investment portfolio, no family around, no hot water. On an evening a few days after arriving in Cange, I wondered aloud what compensation [Dr. Paul Farmer] got for these various hardships. He told me, "If you're making sacrifices, unless you're automatically following some rule, it stands to reason that you're trying to lessen some psychic discomfort. So, for example, if I took steps to be a doctor for those who don't have medical care, it could be regarded as a sacrifice, but it could also be regarded as a way to deal with ambivalence." He went on, and his voice changed a little. He didn't bristle, but his tone had an edge: "I feel ambivalent about selling my services in a world where some can't buy them. You can feel ambivalent about this because you should feel ambivalent. Comma."

This was for me one of the first of many encounters with Farmer's use of the word comma, placed at the end of a sentence. It stood for the word that would follow the comma, which was asshole. I understood he wasn't calling me one – he would never do that; he was almost invariably courteous. Comma was always directed at third parties, at those who felt comfortable with the current distribution of money and medicine in the world. And the implication, of course, was that you weren't one of those. Were you?

            - Tracy Kidder, Mountains Beyond Mountains

Beyond mountains there are mountains... are you willing to climb them?