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

by John Green

My great-uncle was twenty-nine years old. I often wonder what it must have been like for my great-grandfather, having trained as a doctor, to be unable to save his own son from disease. 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.

What’s different now from 1804 or 1904 is that tuberculosis is curable, and has been since the mid-1950s. We know how to live in a world without tuberculosis. But we choose not to live in that world.

As Conan Doyle would later write of M. tuberculosis, “What an infernal microbe it is!…How absurd that we who can kill the tiger should be defied by this venomous little atom.”

Conan Doyle went home to England and within a decade published his first Sherlock Holmes story, all about a detective who uses reasoning and evidence to reach rigorous conclusions about causes of death, meaning that Holmes’s work was not so distant from that of his author.

But the obsession with cost-effectiveness often ends at, “Can we get this disease diagnosed more cheaply?” rather than a broader consideration of the human costs.

And so we have entered a strange era of human history: A preventable, curable infectious disease remains our deadliest. That’s the world we are currently choosing. But we can choose a different world. In fact, we will choose a different world. The world will be different a generation from now. The question is whether we will look back in gratitude at the virtuous cycles, or in horror at the vicious ones.

We must also address the root cause of tuberculosis, which is injustice. 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.