Everything is Tuberculosis

Everything is Tuberculosis, John Green. Crash Course Books (ISBN: 9780525556572) 2025.

Summary: A scientific and social history of this deadly disease seen up close in the struggle of one young man to live.

One of John Green’s passion is global health and particularly access to treatment for those with the least resources around the world. This took him to Sierra Leone and the Lakka Government Hospital where he met Henry Reider. He thought Henry was a young boy who volunteered by encouraging the patients. Then he learned that Henry was one of the patients. Also, he discovered that Henry was seventeen and that he had been ill with tuberculosis from childhood.

Through telling Henry’s story, Green helps us understand why tuberculosis, presently a curable disease, results in the death of over a million people a year. We learn of the delayed diagnosis, allowing the infection to be more deeply established in Henry’s lungs. Henry’s course of treatment was interrupted by a father who wanted to try religious healing practices. By then Henry’s infection was more drug resistant. And it was hard to get the second- and third-line drugs.

The infection stunted his growth by taking away his appetite. When patients respond to treatment, they get hungry. And in the poverty conditions Henry lived in, food was scarce. Nevertheless, Henry was ambitious to get an education, and go to college. But would he live when friends at the hospital were dying and his own conditioning worsening? John follows that story and the efforts of his doctor to get the drugs that would offer hope of a cure. Would he succeed and would it be in time?

For John Green, the story of one boy is illustrative of millions. While part of the book traces the history of the disease and attempts to treat it, the most significant message is the injustice evident in the lack of equitable access to the best treatments in an early manner: X-rays rather than sputum tests, access to and full compliance with treatment, prophylactic treatment of those with close exposures, and reduced costs for the newer drugs to treat drug resistant strains.

Behind all of this is the truth that of the million who will die of the disease this year, none need to. The problem isn’t the bacteria, it is the inequitable systems of health care delivery as well as poverty and crowding that increase exposures and undermine immunity.

But we don’t see so much of that in the West. Yet even in the U.S., 10,000 will die this year. And if we perpetuate the conditions to allow drug-resistant strains to develop further, we run the risk of an untreatable super-tuberculosis. But it is not just the possible consequences down the road. Rather, it is all the promising youth like Henry. Throughout history, tuberculosis has cut short promising lives in their prime.

John Green humanizes tuberculosis. We meet a young man not unlike our own children. And Green helps us understand that if we remain indifferent, it could be our child, our grand-child. And it doesn’t need to be…