Grab the Lapels

Everything is Tuberculosis by John Green

I know John Green is a wildly popular young adult author, but before Everything is Tuberculosis, I hadn’t read his work. His first novel was published in 2005, and by then I was a college student, not a teen. My new book club, called Rotating Reads, picked Everything is Tuberculosis, so I read it. Running in the background is Green’s mental health challenges, including anxiety and OCD, both of which led him to hyperfixating on Tuberculosis for a reason I forget. He’s not a doctor or someone who has had TB. However, Green defers to and quotes doctors in the countries he studies and visits (India, Ethiopia, Sierra Leone), medical professionals who study and advocate for TB patient care, and patients themselves — some of whom do not survive.

During our book club meeting, folks argued whether John Green is the right person for a book on TB that largely affects places struggling with poverty, malnutrition, and sanitation. Some of us felt we place too much faith in wealthy white saviors; others said any help is help, and don’t worry if Green lets us down in the future because he’s doing something now. I pointed out that efforts to donate money to poverty-stricken areas largely fail because that money is temporary. To support a community, they need schools, hospitals, work that is sustainable in that specific location, clean water, etc. I felt like the other people in the book club weren’t having it. Oh, well.

Everything is Tuberculosis has two main moving parts: the story of Henry, a teen in Sierra Leone who has TB and lives in a hospital, and facts about TB throughout history. Green introduces readers to Henry first, but it’s unclear if the boy will be alive by the last page. Then, Green pivots to the ubiquitous nature of TB; when you see a character in a movie cough into a hankey only to find blood spots, we all know that person’s days are numbered, even if we don’t know why. He also discusses TB’s public relations — when white people were wasting away from the disease, they were seen as artist-types, frail geniuses. Black people couldn’t get TB. Later, the PR shifted, taking on a negative reputation of TB only affects those who are poor and dirty.

Instead, Green notes that TB cures are where TB is not, and TB is where the cure is not. Johnson and Johnson had the medications necessary to cure patients, but the price was astronomical for poor people. In the U.S., public tax dollars fun medical research. Green writes, “But I would challenge them to look into [Henry’s mother’s] eyes and tell her [Johnson and Johnson’s] price gouging has nothing to do with a medicine funded primarily by the public being unavailable to the most vulnerable members of that public.” One member of the book club said her instant reaction was to boycott J&J, but nearly everything medical/hygiene in the U.S. is made by J&J. What can we do?

While our shared humanity doesn’t appeal to everyone, saving money typically does. Green points out, “A 2024 study commission by the WHO found that every dollar spent on tuberculosis care generates around thirty-nine dollars in benefit by reducing the number (and expense) of future TB cases, and through more people being able to work rather than being chronically ill or caring for their chronically ill loved ones.” It’s easy for us in developed countries to forget TB still exists, even though it’s there. In fact, Green notes that if we continue to let TB spread because we don’t want to share medicines with poor countries, the bacteria could mutate and no longer respond to the medications we have. Once TB harms those in power, they will seek remedies again.

Everything is Tuberculosis is an easy-to-understand book for people who want to be introduced to TB history and current treatment and information on spread.

27 comments

  2. I’ll admit to TB not being on my radar either, and I also think this seems like an odd digression for an author like him, but the author’s heart want the author’s heart wants. I think TB sort of struck me as one of those diseases that had largely died off due to medicine and vaccinations, but of course, I also thought Polio was like that, and it still remains in poor countries as well.

    I understand the criticism that white saviours aren’t much help, but in this case, there’s so much clouding people’s attention on what impoverished countries are struggling with, that I’d like to hope books like these will spur action for a few people. I also feel the same way about charitable funds going towards these issues. Of course it’s better if the money is directed in an organized way, and many charities like the Red Cross are doing good work, but if people are told their money isn’t going to the right places, I think people are just more apt to stop donating entirely, which feels like more of a danger. I think it’s already happened in some cases with news stories of charities using money unethically, but the truth is that the majority of NPOs and charities are doing their best, and a few bad apples give our whole industry a bad reputation.

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    • I know there are websites that will advise you on which charities have passed an accreditation check of sorts. I’m not sure which ones are doing bad work except for people who set up things like a GoFundMe account that is fraudulent, or the issue that they’re trying to raise money for is fake. I’m all for going in and doing Hands-On things with that community, like building a well or a school, something like that. Basically like a habitat for humanity. Kind of thing, but in other countries. Basically, I’m not against charity, but I know that giving money alone can support a person for a while, but not just staying their economy or improve the area. I think the most recent thing that I donated to was an organization called minorities and shark science, which I learned about after reading the book. Sharks don’t sink. I did review that one here. Much like you, I keep thinking that certain diseases were eradicated, but that just shows how focused I am on my own country, or perhaps how much we don’t focus on other countries in general. I can’t know what isn’t publicized.

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  4. I think you are oversimplifying Green’s work. From what I’ve seen it isn’t primarily fundraising but putting pressure on companies such as J&J to make the treatments available where they are needed. I think putting pressure on American companies to do the right thing is a great thing for American celebrities to do. Getting the companies to release key patents is a lasting good. While the main work on that has been done by other organizations over a long time period his large social media reach ensures that J&J knows that choosing the evil path will lead to bad press also in the US. I’m not sure what an author with a youtube channel can do that would be more useful.

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  5. I’ve read almost everything John Green has ever written; he went to Kenyon! My kids loved his YA novels because they were the right age for them as they came out.

    So we read this one. I found it…thin. There’s nothing wrong with it, but it seemed a fairly brief treatment of the topic, as if he’d read Tracy Kidder’s Mountains Beyond Mountains and set out to make his own updated version.

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    • Yeah, I think this book is aimed at the novice with a big heart. While I appreciate that he spoke to medical folks who worked in the countries that still have rampant TB in their communities, it’s not in-depth research.

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  6. I’m not really following Green’s career any more, but his work in this area definitely isn’t just fundraising – he’s been working with the same healthcare charity for a long time on specific long-term infrastructure and training projects, along with encouraging Americans to pressure American drug companies to release patents, so that generic forms of drugs can become available worldwide. The latter in particular strikes me as honestly one of the most useful (and enduring!) forms of advocacy that someone who isn’t a healthcare professional or researcher *can* do. I think this is more like Jimmy Carter’s foundation working solely on the eradication of Guinea worm – which has done a huge amount of good – than it is like a one-off charity drive.

    That said, I haven’t read this because it was increasingly clear in his videos that Green’s intended audience is not healthcare professionals – his analysis tends to be a bit superficial, and while he’s read very broadly he hasn’t gone deep in the way that a healthcare scientist and/or historian hopefully would if they were writing about the subject. (This is part of why I stopped watching his stuff). So I’m glad this book exists – it’s just not for me!

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    • I’m so glad you replied, Lou, as you’ve cleared up a lot for me! I definitely thing this book is aimed at the novice in global healthcare, but one who has a big heart and wants to make a difference. In that sense, it can work. He doesn’t write about his long-term healthcare work, so I’m really pleased to read that. It’s exactly what I meant when I said setting up a fundraiser isn’t helpful to the longevity of the recipient, but what you mention — infrastructure and training, pressuring drug companies, etc. — is absolutely effective according to the research. While I was reading Green’s book, I was thinking about the book The Plague & I by Betty MacDonald that I reviewed. You commented on how the treatment she received (no moving, no reading, no talking, deflating her lungs, etc.) was the best treatment at the time. That comment has stuck with me.

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  7. It’s just wrong that TB is still a thing when vaccination has been available since I was in primary school (the 1950s). I can remember my whole class lining up for their shot and for the big lump on my arm which indicated the antibodies were working.

    My father was paranoid about TB and the few times we were in city streets (we lived in the country) he would be vigilant about us picking up anything off the ground. His pet hate was that we couldn’t eat the last part of an ice cream cone in case our fingers were dirty (my fingers were always dirty).

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    • I don’t remember ever getting a TB vaccine, and I Googled it in case my memory is off. Google says people don’t commonly get that vaccine in the U.S. I pulled up my vaccine records and don’t see it there. However, this reminds me of the time I was at Notre Dame, and an Irish grad student was insistent that I had been given de-wormer medicine my whole childhood. “The pink stuff!” I was adamant that I had not, and after confirming with Biscuit, I had never been given regular de-worming medication. It’s interesting to think how healthcare varies across the Western world, because my simple mind assumed it was all the same. Then again, given our age difference, I’m assuming your dad knew people who had suffered with and died from TB before the vaccine and didn’t want you to get sick like that. The detail about him telling you to throw away the bottom part of your ice cream cone is an interesting, powerful comment.

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  8. I admit to being one of the novices about TB that you referenced earlier. I didn’t even know it was still a thing, which is shameful and goes to show how isolated the US media is on issues like this. Anyway, I enjoyed this book (weird to say “enjoy” about a disease like this!) It is definitely an overview. I applaud his efforts and his use of his platform to do something positive – sort of like how Bono advocated for HIV medication for decades. I think I saw a video of Green going around to congress people talking about TB funding. I hope he moves the needle just a little bit – but given this administration, probably not much. Anyway, I read a couple of his YA books as an adult some years back and thought they were well written.

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    • See, Lou mentioned something similar in her comment about the great work Green is doing, and none of it he mentions in his book! Maybe it felt too braggadocios to write about his efforts? I think had he written what he’s doing, he could have modeled to people what they can do, too. I mean, I’ve written to politicians many times, like how public schools across Indiana got a 2% budget increase, but the Deaf school, which is also a public school, had 5% take away from their budget.

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  9. I’ve been wondering if the John Green who wrote this is the John Green YA author and decided it wasn’t since it seemed like an odd thing for him to write, but now all is clear! As for TB, people in the US still get it too, not like in poor countries, but it is not eradicated here. My mom worked for an elementary school district for 25 years and I remember before she started she had to have a TB test but she couldn’t do the skin scratch because it would come back positive because she was exposed to TB (but never sick) as a kid, so had to have an x-ray to “prove” she didn’t have TB before she could work for the school district. With the way health care is going in the US these days, I won’t be surprised if more people start getting it.

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    • Wow, I’ve never heard of the X-ray test. I mentioned the blood test in my post, and I thought that was extreme. I know it’s here in the US because it struck me that the medical staff that did a TB test said they’re exposed to it all the time. However, we expect to recuperate. I don’t know if you read the other comments in other people’s posts (I often skim but didn’t read), but Bill noted that they all got a vaccine when he was a kid in the 50’s, and that surprised me.

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      • I did skim the other comments and saw Bill say he got a vaccine which I too was surprised about as I have never heard of such a thing. Yeah, when I was a kid I was always worried my mom would get TB and that I would then get it from her. It was years before I understood how it all worked and stopped worrying about it :p We do expect to recuperate here in the US but I wonder with antibiotic resistance and the US dismantling USAID how much longer that will actually be the case.

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  10. I’ve read some of Green’s novels and enjoyed them. I know he has a strong online presence where he tackles a variety of subjects and so I could see a book like this being a good starting point for someone who might not know much about the topic and wouldn’t pick up a science-y book but will read a John Green book.

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      • I did a project on TB in high school so I feel like I know a decent amount about it. Peter has been tested for it twice – once because he was exposed in a university class and the second time because he was travelling to Ghana. If he had started to show symptoms after going there it is apparently helpful to know if he picked it up there or in Canada.

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        • Perhaps it’s helpful to know in case there is an outbreak or they want to prevent an outbreak through contact tracing.

          Isn’t it wild that a high school project can stick with you like that? I wonder what’s changed in the 20-ish years since your project. Have things improved or gotten worse?

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          • I know they do a lot of contact tracing here if someone is diagnosed with TB so I imagine that’s a big part of it.

            I believe TB is on the rise in recent years. I don’t know if it’s because of increasing anti-vax ideas, like measles, or something else. It’s not a routine vaccination anymore, at least in Canada, so that could be part of it too.

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