EverythingIsTuberculosis

I recently read Everything is Tuberculosis: The History and Persistence of Our Deadliest Infection by John Green (2025).

 JG is most well-known as a writer of fiction. He undertook this work as a departure from his usual foci, as much as anything out of curiosity as to why tuberculosis, with a known cure, seems so recalcitrant.

My top takeaways:

Ø  Roughly 30% of all humans have been infected with TB.

Ø  90 percent of people infected with TB will never become sick.

Ø  Inexplicably, 20-25% of people recover from active TB without treatment.

Ø  It is foolish to think that history belongs to the past.

Ø  Since TB thrives in crowded living and working conditions, it is often seen as a disease of poverty.

Ø  “Courage” and “Encourage” are powerfully related words in that they tend to call forth our best selves.

Ø  The colonial British Empire was excellent at building systems, with the intent of resource-extraction.

Ø  “Poor” is almost always multidimensional in nature.

Ø  In places where formal healthcare systems are not particularly effective more trusted spaces and people—like churches and faith healers—are often viewed in higher regard than doctors and hospitals.

Ø  Tuberculosis is listed in Guinness World Records as the oldest contagious disease.

Ø  “Inspire” = breathe in; “Expire” = breathe out, all the way out.

Ø  Many diseases exist where the cure does not; and the cure is where the disease is not.

Ø  Disease, and its treatment, are not only issues of biology; they also have nutritional, educational, economic, social, and political dimensions.

Ø  There are vicious cycles, and there are also virtuous cycles. The differentiators are CARING and LOVE.

Ø  What constitutes a good time and manner of death is purely subjective.

Ø  To effectively fight pernicious disease we need an entire set of robust systems that work perfectly in concert with each other.

Ø  We lose 1,250,000 people each year to tuberculosis. A curable illness.

 

My favorite quotes:

“Looking at history through any single lens creates distortions, because history is too complex for any one way of looking to suffice.” (p. 19)

“Once, when Isatu talked to me about her childhood, the interpreter used the word “woven.” ‘Myself and my friends were woven.’” (p. 27)

“History is often imagined as a series of events, unfolding one after the other like a sequence of falling dominoes. But most human experiences are processes, not events.” (p. 77)

“Before the germ theory of disease, we did not know that around half the cells in my body do not, in fact, belong to my body—they are bacteria and other microscopic organisms colonizing me. And to one degree or another, these microorganisms can also control the body—shaping the body’s contours by making it gain or lose weight, sickening the body, killing the body. There’s even emerging evidence that one’s microbiome may have a relationship with thought itself through the gut-brain information axis, meaning that at least some of my thoughts may belong not to me, but to the microorganisms in my digestive tract. Research indicates that certain gut microbiomes are associated with major depression and anxiety disorders; in fact, it’s possible that my particular microbiome is at least partly responsible for my OCD, meaning that the microbes are the reason I’m so deeply afraid of microbes.[*]” (p. 94)

“And this is why I would submit that TB in the twenty-first century is not really caused by a bacteria that we know how to kill. TB in the twenty-first century is really caused by those social determinants of health, which at their core are about human-built systems for extracting and allocating resources. The real cause of contemporary tuberculosis is, for lack of a better term, us.” (p. 182)

“In a world where everyone can eat, and access healthcare, and be treated humanely, tuberculosis has no chance. Ultimately, we are the cause. We must also be the cure.” (p. 184)

“This is the gut-wrenching, heartrending injustice of living with tuberculosis in the twenty-first century: You live if you’re rich. And if you’re not, then you hope to get lucky.” (p. 187)

Glad my lovely bride recommended that I put my nose in this one. Enlightening.