Everything Is Tuberculosis: The History and Persistence of Our Deadliest Infection

by John Green

We are powerful enough to light the world at night, to artificially refrigerate food, to leave Earth’s atmosphere and orbit it from outer space. But we cannot save those we love from suffering. This is the story of human history as I understand it—the story of an organism that can do so much, but cannot do what it most wants.

We know how to live in a world without tuberculosis. But we choose not to live in that world.

“Where are the drugs? The drugs are where the disease is not,” Dr. Mugyenyi said. “And where is the disease? The disease is where the drugs are not.”

tuberculosis has come to be seen as a disease of poverty, an illness that walks the trails of injustice and inequity that we blazed for it.

The world we share is a product of all the worlds we used to share. For me at least, the history and present of tuberculosis reveal the folly and brilliance and cruelty and compassion of humans.

But as a friend once told me, “Nothing is so privileged as thinking history belongs to the past.”

Looking at history through any single lens creates distortions, because history is too complex for any one way of looking to suffice.

In general, colonial infrastructure was not built to strengthen communities; it was built to deplete them.

But history, alas, is not merely a record of what we do, but also a record of what is done to us.

Let’s turn back now to 1804, the year that James Watt’s son Gregory died of tuberculosis. In May of that year, Napoleon Bonaparte was named Emperor of France; in July, Aaron Burr shot Alexander Hamilton. I understand if this all feels like ancient history, but it’s really not. As of 2025, around 117 billion modern humans have lived. Over 100 billion were born before 1804. Almost everything that ever happened to us, and almost everyone who ever happened, happened before 1804.

“We cannot be created for this sort of suffering.” He would wish for death, but then wish for life, because “death would destroy even those pains which are better than nothing.”

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. Divorce may be an event, but it almost always results from a lengthy process—and the same could be said for birth, or battle, or infection. Similarly, much of what some imagine as dichotomous turns out to be spectral, from neurodivergence to sexuality, and much of what appears to be the work of individuals turns out to be the work of broad collaborations.

We love a narrative of the great individual whose life is shot through with major events and who turns out to be either a villain or a hero, but the world is inherently more complex than the narratives we impose upon it, just as the reality of experience is inherently more complex than the language we use to describe that reality.

Framing illness as even involving morality seems to me a mistake, because of course cancer does not give a shit whether you are a good person. Biology has no moral compass. It does not punish the evil and reward the good. It doesn’t even know about evil and good.

Stigma is a way of saying, “You deserved to have this happen,” but implied within the stigma is also, “And I don’t deserve it, so I don’t need to worry about it happening to me.” This can become a kind of double burden for the sick: In addition to living with the physical and psychological challenges of illness, there is the additional challenge of having one’s humanity discounted.

Why must we treat what are obviously systemic problems as failures of individual morality?

But survival is not primarily an act of individual will, of course. It’s an act of collective will.

the reason you’re miserable is because misery is the correct response to the world as we find it, and so on. I am prone to despair, and so I know its powerful voice; it just doesn’t happen to be true.