Everything Is Tuberculosis: The History And Persistence Of Our Deadliest Infection in many ways reads like an extra-long chapter of John Green’s bestselling 2021 essay collection The Anthropocene Reviewed: Essays On A Human-Centered Planet. The book uses the author, vlogger, and health advocate’s signature mix of personal anecdotes, poignant prose, and deep research to tell a story of hope and tragedy that feels terribly relevant at a time when the global healthcare system is co*ing under attack.
The odd title is a reference to how Green came to see the impact of tuberculosis everywhere when researching for the book, which was inspired by a visit to the Lakka Government Hospital in Sierra Leone he made as part of the board of trustees for the nonprofit organization Partners In Health. He presents plenty of these odd stories in the book, from how John B. Stetson invented the cowboy hat when he journeyed west after being diagnosed with TB, to how Dr. Arthur Conan Doyle investigated a fraudulent TB cure before writing the first Sherlock Holmes book.
But beyond the fun tidbits about famous people whose lives were impacted by the disease, the title also references how much its proliferation throughout history has been a story of social and political factors that make it far more deadly and painful than it needs to be. That’s especially true in the modern era, where TB can be treated with antibiotics but still kills 1.5 million people each year because pharmaceutical co*panies keep the price of drugs out of reach for poor countries, which also lack the infrastructure to properly test for the disease.
Because 1.5 million is an inco*prehensibly high number, Green seeks to personify it in the story of Henry, a teen he met on that visit to Lakka who reminded Green of his son, also named Henry. Their relationship has had a profound impact on Green, and Henry’s story epitomizes the difficulty of treating TB as his condition was made much worse by late diagnosis, malnutrition, missed treatments, and lack of access to the personalized cocktails for drug-resistant strains readily available in wealthy countries. Henry’s story also demonstrates the strength of those who fight TB, from his devoted mother to the doctor challenging a broken system to provide the best care for his patient to Henry himself trying to maintain a positive attitude despite bad odds and terrible pain from the disease and the side effects of his treatment.
Yet Green’s framing device would have been better left to the introduction and postscript since the anecdotes about Henry get a bit repetitive and feel intrusive in otherwise deeply co*pelling sections, like one on the roots of the concept of the beautiful consumptive trope seen in Moulin Rouge! The disease was viewed by Europeans for a time not as a contagion, but an inherited curse that made artists burn bright and die young. Green’s dive into how similar that romanticized linkage is to the modern fixation on the idea that depression and alcoholism might also be linked to artistic brilliance is profound and witty, paired with a joke about how well a 19th-century magazine’s description of the consumptive personality matches his own. It doesn’t really need a point about how Henry also embodies that archetype because he wrote poetry about his struggle during treatment, even if the aside is meant to challenge the inherent whiteness of that vision of TB.
Green also has plenty of other co*pelling supporting characters in the story, from a woman dying of TB who found kinship with the protagonist of Green’s novel The Fault In Our Stars—which follows a teen with cancer in her lungs—to a TB survivor who has beco*e a patient advocate. But the personal stories are all in service to the larger narrative about the societal failures that have made TB so deadly. More people died of TB between 1985 and 2005 than were killed in both World War I and II because the link between TB and HIV/AIDS was largely ignored. The romanticization of TB meant that white European doctors didn’t even believe the disease spread among other races. When new medications made it curable for rich people, patronizing views of poor people and countries kept those treatments from going where they needed to be and created fresh stigma that led to even more suffering.
The human tragedy Green draws attention to is massive, made even more galling by the fact that denying proper treatment to large swaths of the globe can lead to the development of even more dangerous drug-resistant strains. But many of the issues Green broaches seem to have beco*e infuriatingly even more relevant in the last two months as the U.S. pulled out of the World Health Organization and largely shut down the U.S. Agency for International Development, which Green portrays as patronizing but still important in the fight against TB. The recent co*ments by U.S. Health and Human Services Secretary Robert F. Kennedy Jr. about how measles won’t kill people who eat well and exercise echoes the way Green points out people throughout history have blamed the victims of TB by making up causes like drinking, chest size, and even emancipation.
It’s a shame that Everything Is Tuberculosis isn’t longer considering the rich list of research materials he cites at the end of the book, many of which seem to be just distilled down to a single short chapter. There are clearly so many stories of tuberculosis to tell and while Green provides a great general analysis of why the disease tests our very humanity, it’s easy to be left wanting more.