John Green

The History and Persistence of Our Deadliest Infection

Everything Is Tuberculosis

Emiley Jones

It reminded me, that when we know about suffering, when we are proximal to it, we are capable of extraordinary generosity. We can do and be so much for each other. But only when we see one another in our full humanity. Not as statistics or problems, but as people who deserve to be alive in the world.

Bethany Jenkins

Parmin

But then as now, tuberculosis does not travel primarily through paths forged by race, except insofar as human power structures force it to.

But in residential schools, the rate was 8,000 per 100,000--meaning that 8 percent of all kids confined in these schools died of tuberculosis each year. And these inequities persist—today, Inuit people are over 400 times more likely to contract tuberculosis than white Canadians. 

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." 

Green argues that this captures our obsession with learning why bad things happen and our inclination towards giving meaning to disease (“not just a strategy for conceptualizing the pain of others, but also a way of reassuring ourselves that 

Man got to sit and wonder, “Why, why, why?" 

In the U.S., we still often use the phrase TB control" in public health departments, whereas for illnesses like cancer we're more likely to use the phrase "cancer care." This "control over care" dynamic, as the physician and an- thropologist Paul Farmer termed it, is seen with many infectious diseases.

Why must we treat what are obviously systemic problems as failures of individual morality? Many patients have described the experience of receiving their drugs as humiliating they may be handed their medicine while being told that this only happened be- cause they were unclean or poor or otherwise lesser.23 This is often not an environment patients are excited to return to—and yet somehow we always seem to blame the patient for noncompliance, rather than blaming the structures of the social order that make compliance more difficult.

Tuberculosis is so often, and in so many ways, a disease of vicious cycles: It's an illness of poverty that worsens poverty. It's an illness that worsens other illnesses—from HIV to diabetes. It's an illness of weak healthcare systems that weakens healthcare systems. It's an illness of malnutrition that worsens malnutrition. And it's an illness of the stigmatized that worsens stigmatization. In the face of all this, it's easy to despair. TB doesn't just flow through the meandering river of injustice; TB broadens and deepens that river.

Sadie Hoffman

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.

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.

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