We often compartmentalize knowledge so rigidly that we overlook how deeply interconnected human life, health, and society truly are. In Everything Is Tuberculosis, John Green reminds us of these intersections, exploring the tangled complexities of medical and social issues through the lens of history. He urges us to look back, to understand, and to ensure we don’t keep repeating our past mistakes.

It’s an odd truth that humans historically haven’t given enough attention to disease, despite its profound impact on our lives. Green highlights tuberculosis (TB), a prime example of an illness we could control, yet tragically choose to neglect. As he points out, it’s as though we know exactly how to live in a world without TB but consciously decide not to. The cure and the disease always seem frustratingly separate, knowing what’s necessary, yet somehow unable to implement it.

Green begins this book by recounting a personal encounter that occurred during a past visit to Lakka, a facility supported by a global health nonprofit. There, he met Henry, whom he initially mistook for a young child due to his frail appearance. In reality, Henry was a severely malnourished 17-year-old battling tuberculosis. Henry’s story served as the emotional foundation of Green’s passionate investigation.

Throughout the book, Green navigates multiple layers of tuberculosis’ history: from its romanticized portrayal in the past to its harsh realities of racialization and marginalization. He shows how stigmas and ethical narratives around illness shape our responses and often blind us to the broader picture. Remarkably, even after tuberculosis became largely curable in the mid-20th century, treatments frequently failed to reach those most in need due to systemic racism and colonial attitudes.

Green highlights the irony and tragedy here: despite the existence of effective treatments, society’s systemic failures, often misinterpreted as individual moral shortcomings, continue to fuel the disease. The devastating rise of antibiotic-resistant TB, exacerbated by a 46-year gap (1966 to 2012) in developing new treatments, further highlights these glaring economic and social inequities.

Ultimately, Green started writing this book out of curiosity about how one disease quietly yet powerfully shaped human history. But more crucially, he explores how human culture has shaped tuberculosis itself. TB has consistently thrived by exploiting biases, prejudices, and unjust social systems, flourishing precisely where society chooses to overlook human lives.

Everything Is Tuberculosis is a historical reflection and a reminder. We need to confront uncomfortable truths about ourselves and urges us toward a more compassionate, interconnected approach to global health.

Summary

Tuberculosis, More Than Just a Disease

Tuberculosis (TB) is a medical issue and a lens through which we can view the patterns of injustice, resilience, cruelty, and compassion that define human society. For centuries, it has quietly shaped the world around us, influencing how we live, how we die, and how we see each other.

A Disease That Defied Logic

Long before we understood its microbial cause, TB was known as “consumption,” a name that captured how it seemed to waste away the human body. It didn’t behave like other diseases. It struck both the rich and the poor, the educated and the illiterate, entire families or random individuals. Its symptoms, such as night sweats, weight loss, coughing blood, were once so common that healthcare workers worldwide recognized them instantly.

But TB isn’t confined to the lungs. It can appear in the pancreas, the spine, the brain, mimicking other illnesses and confusing doctors for centuries. It was seen not as one disease, but many.

The Bacteria That Waits

Mycobacterium tuberculosis, the bacteria behind TB, is a master of slow motion. It grows at an extraordinarily slow pace, building a thick, fatty cell wall that’s difficult for immune cells to break through. In most people, the body manages to trap the bacteria in tiny hardened lumps called tubercles, preventing it from spreading. This is called latent TB, and most people with it never get sick.

But in about 5 to 10 percent of cases, the immune system can’t keep up. The bacteria break free, multiply, and overwhelm the body, causing full-blown disease, and often, death.

TB and the Vicious Cycle of Inequality

TB is a disease that both causes and worsens inequality. It thrives in poverty and deepens it, damages already weak healthcare systems, preys on malnutrition and exacerbates it. And it compounds the effects of illnesses like HIV and diabetes.

Worse still, TB is wrapped in stigma. It isolates people, causes shame, and fuels social exclusion. That stigma makes it even harder to treat, and more likely to spread. The fight against TB can’t be won by medicine alone. It demands structural change. Food security, access to care, and human dignity are just as essential as vaccines.

How We Imagine Disease Shapes How We Treat It

Humans respond to illness biologically and interpret it culturally. In places where the healthcare system fails, people may turn to trusted alternatives like churches or faith healers. And historically, we’ve often ignored disease in our historical narratives, possibly because pain leaves no visible trace unless someone records it.

We’d rather see history as the story of human decisions. But diseases like TB remind us that much of human history was also shaped by forces beyond our control.

The Romanticization of TB

Strangely, TB was once romanticized, especially in 18th and 19th century. Because it often killed young adults in the prime of life, it was seen as tragic, beautiful, even noble. Artists and poets with TB were idealized. Pale skin and thinness became beauty standards inspired by the disease’s physical effects.

But this idealization, like stigma, turned TB patients into “others,” either elevated or excluded. Both reactions fail to recognize people with TB as fully human, deserving of care without judgment or fantasy.

Colonialism and the Racialization of TB

TB’s history is entangled with colonialism and racism. European doctors once claimed that TB was a disease of sensitive, intelligent white people—completely ignoring its presence in colonized regions. Some even argued that enslaved or colonized people couldn’t get TB, despite overwhelming evidence to the contrary.

After the bacteria was discovered in 1882, the narrative flipped. Suddenly, TB became associated with poverty and “uncleanliness,” and people of color were seen as more susceptible. It is not due to biology, but because of systemic racism: overcrowded housing, poor nutrition, limited healthcare, and chronic stress.

TB didn’t discriminate. Society did.

Systemic Failures, Not Patient Failures

When patients don’t finish TB treatment, we often blame them for being “noncompliant.” But is it fair to expect people to follow medical plans when they’re starving, depressed, or living in unstable conditions? As historian Christian McMillen argues, the failure often lies with the system, not the patient.

We must stop framing treatment abandonment as a moral failing and start addressing the structural issues that make staying on treatment so difficult.

The Price of Profit: Why TB Treatments Stalled

Between 1966 and 2012, no new TB drugs were developed. Why? Because treating TB wasn’t profitable. While companies funneled resources into cosmetic products, TB research was neglected. This lack of innovation helped antibiotic-resistant TB to spread.

It’s not that TB evolved too quickly, it’s that we stopped fighting it. When the healthcare system values market return over global need, deadly diseases slip through the cracks.

We Are the Cause—and the Cure

TB flows through the same channels as injustice. It survives and spreads in a world built on inequality. But the inverse is also true: if we build a world rooted in fairness, equity, and shared responsibility, TB has nowhere left to go.

We can’t cure TB with medicine alone. We must also cure the world that allows it to thrive.

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Author: John Green

Publication date: 18 March 2025

Number of pages: 208 pages

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