Everything is Tuberculosis - The History and Persistence of our Deadliest Infection by John Green is an in depth examination of tuberculosis (TB), it's causes, history, treatments and cures and why it is that so many people continue to die of the disease each and every year.
TB is an infection caused by bacteria and it's airborne, meaning anyone can catch it. According to the author, between 1/4 and 1/3 of all living humans have been infected with it but only a small percentage of those (up to 10%) will end up becoming sick with active TB. Malnutrition and a weakened immune system can trigger a dormant case of TB to become active, making it largely a disease of poverty.
The author of The Fault in Our Stars began to take a serious interest in the topic when he met a young boy with TB in Sierra Leone. Referring to Henry's case throughout the book enables him to put a face on the disease and Green sets the scene early on when he informs the reader just how many people have died from TB in the last 200 years.
"Just in the last two centuries, tuberculosis caused over a billion human deaths. One estimate, from Frank Ryan's Tuberculosis the Greatest Story Never Told, maintains that TB has killed around 1 in 7 people who've ever lived." IntroductionI remember learning this fact at some point in the last few years and it's precisely the reason I decided to read this book. Also known as consumption, and sometimes referred to as the white plague, tuberculosis is the oldest contagious disease and I wanted to know more about it.
The audiobook is narrated by the author himself and I was most interested in the history of TB and in particular the romanticisation of consumption in the late 18th and early 19th centuries. At that time, it was believed TB was only acquired by people with great sensitivity and intelligence. If that wasn't bad enough, women with consumption were thought to become more beautiful, ethereal and wondrously pure. Ugh!
TB is a wasting disease and death was commonly a long and drawn out process during which sufferers became weakened and bed-bound. It's hard to believe now - until you recall the popularity of waif models and the heroin chic style from the 1990s - but this began to affect beauty standards of the time. Patients with active TB became thin and pale with wide sunken eyes and a rosy tint on their cheeks from fever and this beauty ideal became desirable and highly valued. (You can see this reflected in the art and literature of the time).
Green moves on to the science of TB and describes the various breakthroughs in medicine that led to TB eventually becoming treatable and then curable. In 2023, a million people died of TB and while Green acknowledges we can't eliminate TB completely, we can make sure nobody dies from it. So why haven't we?
The author explains that the drugs to treat TB aren't being produced and made available in the countries that need them most. Essentially, the drugs are where the disease is not and the disease is where the drugs are not.
A whole host of factors, including big pharma companies keep drug prices high; only a finite amount of aid sent to foreign countries is allocated to medicine and lack of access to basic medical facilities in poorer countries means that TB goes on to kill a million people unnecessarily each year. Learning TB is basically an expression of injustice and inequity was grim and depressing.
At the end of all this, there was no call to action, no website to donate to or petition to sign which was a lost opportunity in my opinion. Green is clearly calling for global healthcare reform, but provides little for the average reader to do with their frustration at the current situation.
For novels with consumptive characters, I can recommend:
- The Haunting of Mr and Mrs Stevenson by Belinda Lyons-Lee ⭐️⭐️⭐️⭐️
- Bone China by Laura Purcell ⭐️⭐️⭐️⭐️⭐️
- Laetitia Rodd and the Case of the Wandering Scholar by Kate Saunders ⭐️⭐️⭐️
