Everything Is Tuberculosis

Technically, this was an audiobook narrated by John Green himself. But hey, who says you can't count an audiobook as a book read? Maybe you can't on technicality. But in my opinion, this counts.

Tuberculosis and I have a complicated history. My first encounter was a health scare during my internship stint in China. A doctor noticed my persistent cough and the blood I was coughing up, and suggested I might have TB. She had me scrambling through my memory for any record of a vaccine jab. Spoiler alert: I had no vaccine, and no tuberculosis. I was diagnosed with a new form of pneumonia instead, and weeks later, news broke about a new coronavirus. The rest is history.

My second encounter came through Arthur Morgan in Red Dead Redemption 2, slowly beaten by consumption after a vagrant coughs on him early in the game. "Consumption" is another term I learnt from John Green and this book: a disease that doesn't just infect you, but inevitably consumes you. Watching Arthur deteriorate hit differently once I understood what that word actually meant. Side note: RDR2 was one of the last few games I genuinely enjoyed. Can't remember another title like it.

Green makes this all extremely accessible and easy to follow. Navigating the world of Henry Reider, a patient ridden with tuberculosis, he shows that the whole recovery and cure process requires more than just medication. It's a concert of every single component in the system working in harmony. For the medication to even be effective, patients require access to more food: both as a side effect of the drug, which induces severe hunger, and as a basic demand of the disease itself, which burns through whatever nourishment the body has left.

And in a world where food is scarce or unaffordable, the cure becomes exponentially harder to reach. Then there's the matter of completing the full course of medication, until the strain is killed before weaning off. In Henry's story, financial strain pushed his father to take him off medication and turn instead to church, to the gods they believed in. This, in turn, allowed a stronger strain to evolve, making recovery far harder. That he survived at all feels like the right word is miracle. (Spoiler alert: he's alive today.)

My one take: pull out any single thread and the whole thing unravels.

To quote John Green:

"And so we must remember that illness is not only a biomedical phenomenon, but also a constructed one, and how we imagine leprosy or OCD or tuberculosis matters. In a place where the formal healthcare system is not particularly effective at treating an illness, it is easy to imagine how more trusted spaces and people — like churches and faith healers — can be a better bet than doctors and hospitals."

Accessible, personal, quietly devastating. Green makes you care about a disease most people assume was solved a century ago, because it wasn't, and in much of the world, it still isn't.

And I keep coming back to Dr. Mugyenyi's words, which Green holds up near the beginning:

"Where are the drugs? The drugs are where the disease is not. And where is the disease? The disease is where the drugs are not."