Everything Is Tuberculosis: The History and Persistence of Our Deadliest Infection by John Green is the book that finally explains why, even in 2023, about 1.25 million people still died of a curable disease and why we keep looking away.
Everything Is Tuberculosis argues that tuberculosis is no longer mainly about Mycobacterium tuberculosis but about the human decision to let some lives matter less than others.
Green braids together his own family history of TB, the story of Sierra Leonean survivor Henry Reider, and two centuries of medical and social history to show that “the cure is where the disease is not, and the disease is where the cure is not.”
By the time he calmly notes that TB has killed roughly a billion people in the last two hundred years and may have killed “around one in seven people who’ve ever lived,” I felt the ground of “background illness” give way under me.
Green’s case rests on both narrative and data: WHO’s Global Tuberculosis Reports now estimate roughly 1.25 million TB deaths and about 8.2 million newly diagnosed cases in 2023, making it again the world’s leading infectious killer after a brief period when COVID-19 took that grim title.
Inside Everything Is Tuberculosis, he anchors those numbers in places like Lakka Government Hospital in Sierra Leone, where a nurse tells him, “We feed everyone three times a day… but it is not enough,” because food isn’t even funded as part of TB treatment.
Everything Is Tuberculosis is best for readers who can handle visceral hospital corridors, structural injustice, and moral argument braided with memoir, and not for anyone looking for a breezy John Green YA novel, a tidy inspirational illness story, or a purely technical epidemiology textbook.
Table of Contents
1. Introduction
Reading Everything Is Tuberculosis, I kept thinking of it less as “a disease book” and more as a biography of an idea: that some lives are quietly treated as expendable.
The full title, Everything Is Tuberculosis: The History and Persistence of Our Deadliest Infection, tells you almost everything you need to know about its scope: this is a 2025 nonfiction work by John Green, published by Crash Course Books, an imprint of Penguin Random House, and running just over 200 pages in its U.S. hardback edition.
Formally it sits at the intersection of narrative history, science writing, and moral essay, closer in feel to Rebecca Skloot or Atul Gawande than to Green’s own YA novels like The Fault in Our Stars, though that earlier novel about cancer and unfairness haunts this book in the background.
Green writes not as a detached historian but as a novelist-turned-YouTuber-turned-health-advocate whose life has been reorganized by tuberculosis; at one point he bluntly admits that TB has “become the organizing principle of my professional life over the last five years.”
From the first pages, his purpose is explicit: to understand why a curable infection still kills more than a million people each year and to argue that TB is “both a form and expression of injustice,” sustained by policy choices rather than biological inevitability.
Green grounds that big claim in two family stories: the death of James Watt’s son Gregory from “phthisis” in 1804 and the death of his own great-uncle Stokes Goodrich from tuberculosis in 1930, even though Stokes’ father was a doctor.
Those narratives show how TB has shadowed the rise of modern industrial society, riding the same trains, ships, and respiratory droplets that moved coal and cotton.
They also allow Green to establish a tone that is both intimate and unsparing, as he writes, “We are powerful enough to light the world at night… But we cannot save those we love from suffering.”
That tension between technological power and moral failure is the thread he keeps tugging for the next two hundred pages.
2. Background
In global health terms, tuberculosis is an ancient, airborne infection that spreads through tiny droplets when someone with active TB coughs, sneezes, or even talks, and between a quarter and a third of the world’s population is estimated to carry latent TB bacteria.
Most infected people never fall ill, but up to 10% will develop active disease—especially if they are malnourished, living with HIV, or facing other immune-weakening conditions—which is why TB mortality maps so brutally onto maps of poverty and marginalisation.
According to the World Health Organization, TB once again became the leading killer among infectious diseases in 2023, with an estimated 1.25 million deaths and about 8.2 million people newly diagnosed—numbers that have only barely begun to fall again in 2024.
WHO also estimates that global deaths have dropped only about 23% since 2015, far short of the End TB Strategy’s target of a 75% reduction by 2025, a shortfall that Green explicitly cites as evidence that “we choose not to live in [a world without tuberculosis].”
Public-facing pieces by Green in outlets like Vox reinforce this point, stressing that more than 1.2 million people dying every year of a disease with a decades-old cure is not a scientific failure but a political one.
When I cross-checked his numbers and his framing against current WHO fact sheets and Lancet editorials, I kept finding the same blunt message: TB remains the leading killer from a single infectious agent, and we are, globally, off-track to end it by 2030.
Green’s personal background matters for how this story is told.
Best known to general readers for fiction like The Fault in Our Stars and for co-creating the Crash Course educational channel, he has spent the last decade increasingly involved in global health advocacy, especially around TB and HIV, building relationships with researchers at places like Harvard and with clinicians in Sierra Leone and Lesotho.
Everything Is Tuberculosis is the product of that network: the acknowledgments list reads like a mini-directory of the contemporary TB movement, from Dr Carole Mitnick and Dr Jen Furin to survivors such as Phumeza Tisile and Handaa Enkh-Amgalan.
Ultimately, Green frames tuberculosis not just as a pathogen but as a mirror held up to the systems we’ve built.
3. Everything Is Tuberculosis Summary
Themes and Lessons Highlights
Key people and personal stories
- James Watt’s family (1790s–1804): Everything Is Tuberculosis opens with the inventor James Watt, whose daughter Jessy dies of phthisis (tuberculosis) in 1794, followed by his son Gregory, who dies at 27 in 1804, despite Watt’s desperate attempt to engineer a nitrous-oxide–based cure.
- Stokes Goodrich (1900–1930): Green’s great-uncle Stokes, born in 1900, is diagnosed with miliary TB and dies in a sanatorium in Asheville, North Carolina, on May 18, 1930, even though his father is a doctor and he receives “the best of care.”
- Henry Reider (2010s onward): In Sierra Leone, at Lakka Government Hospital, Green meets Henry, a small, undernourished teenager with a huge smile, who has survived TB since early childhood, endured brutal injectable treatments that damage his hearing, and is still not cured. Henry becomes the emotional center of the book—calling Green “Dad,” going to college, winning a TikTok award, and living with the long-term consequences of both the disease and its treatment.
- Shreya Tripathi and Dr. Girum: Green also weaves in the late Indian TB activist Shreya Tripathi and Ethiopian TB doctor Dr. Girum, who embody resistance and care in countries where drug-resistant TB and drug access battles are everyday realities.
Key dates and scientific milestones
- 1882: German doctor Robert Koch identifies the TB bacillus (Mycobacterium tuberculosis), shifting TB from a romantic, vaguely “hereditary” condition to a clearly infectious disease.
- 1921: The BCG vaccine (Bacillus Calmette–Guérin) is first used, based on attenuated bovine TB bacteria grown in a potato–beef bile medium.
- Late 1940s: The first effective TB drug, streptomycin, is used; patients like “Gale” move from childhood sanatoria into adulthood, though stigma lingers.
- Mid–late 20th century: Multi-drug regimens (later including isoniazid and rifampin) make TB curable, leading wealthy countries to treat TB as “solved” while poorer nations remain heavily burdened.
- 2010s–2020s: Newer drugs such as bedaquiline, linezolid, and pretomanid and regimens like BPaL/BPaLM emerge, offering shorter cures for drug-resistant TB—but access is limited by patents, pricing, and donor fatigue.
Main arguments
- TB is curable, but people still die because of injustice, not science. Green repeatedly stresses that over 1.25 million people died of TB in 2023 even though we have effective drugs, and that these deaths are rooted in poverty, underfunded health systems, corporate decisions, and political neglect rather than biological inevitability.
- The real “cause” of TB today is human choice. The bacteria matter, but Green argues the true engine of the epidemic is where we choose to locate clinics, send money, sell drugs, and pay attention.
- Stories shape who lives and who dies. For centuries, TB has been romanticized (the “flattering malady” of pale poets), moralized (a disease of weakness, sin, or “bad character”), or rendered invisible (treated as a Victorian disease that no longer exists), and those stories still influence funding, stigma, and patient treatment.
- TB is a disease of systems, not just individuals. Green shows how colonialism, capitalism, racism, and patriarchy have carved the global map of TB risk: mines, prisons, slums, and migrant camps become the places where TB flourishes.
- There are vicious and virtuous cycles. Underinvestment, stigma, and drug resistance reinforce one another (“vicious cycles”), while good policy, affordable diagnostics, and community-based care can flip into “virtuous cycles” that reduce transmission and build trust.
Core themes and lessons
- Injustice as pathology: TB is framed as a “disease of injustice” and a mirror of whose lives we value.
- Bias as an illness of the spirit: The way we imagine TB patients—lazy, “noncompliant,” contagious—often says more about our prejudices than about their actual behavior. (Teachers Pay Teachers)
- The limits of romantic suffering: Past eras glorified TB as making people sensitive and artistic, which obscured the brutal reality of coughing up blood, starving lungs, and social exclusion.
- The power and danger of technology: From Watt’s nitrous-oxide contraption to GeneXpert machines priced beyond many health budgets, technology can save lives or deepen inequality depending on who has access.
- Hope as obligation, not mood: Even as Green details death, drug resistance, and aid cuts, he insists that despair is a luxury—especially for those in low-burden countries whose votes, donations, and attention can change outcomes.
4. Everything Is Tuberculosis Extended Summary
1. Introduction – Gregory, Jessy, and Stokes: Tuberculosis as a Family Story
Everything Is Tuberculosis opens not in a modern hospital, but in the late 18th and early 19th centuries with James Watt, the engineer whose steam engines helped fuel the Industrial Revolution. Watt’s daughter Jessy dies of phthisis (one of TB’s older names) at fifteen in 1794. His son Gregory develops the same illness—persistent cough, night sweats, fever, wasting—and Watt, desperate, concocts a device to deliver nitrous oxide to the lungs, hoping that adjusting oxygen intake will help.
The attempt fails: Gregory dies in 1804 at twenty-seven after years of suffering.
Green uses these scenes to highlight a recurring pattern: great scientific and industrial achievements coexisting with an utter inability to protect those most loved. We can change the atmosphere, he suggests, but not guarantee the survival of our children.
He then jumps a century to his own family. His great-uncle Stokes Goodrich, born in 1900 in rural Tennessee, grows up the son of Dr. Charles Goodrich, a country doctor. When Stokes is diagnosed with miliary TB, an X-ray technician tells Charles that he’s never seen such a case live more than two months. Stokes is sent to a sanatorium in Asheville, North Carolina, one of a network of American TB colonies. Despite “the best of care,” Stokes dies on May 18, 1930, aged twenty-nine.
Green reflects on how strange it is that his great-grandfather could ride horseback to deliver babies and treat others yet not save his own son. He sets up his central tension: human power has exploded, but our capacity to prevent individual suffering is uneven, fragile, and biased. TB, he says, has killed over a billion people in the last two centuries and may have killed about one in seven humans who have ever lived, yet we treat it as background noise. (Wikipedia)
The introduction closes with a blunt framing: today, we have a proven cure for TB, but over a million people still die every year, overwhelmingly because they lack money, access, or political representation. TB, in Green’s words, has become both “a form and an expression of injustice.”
2. Meeting Henry at Lakka: The Present-Tense Face of TB
The narrative then swivels to Sierra Leone, a West African country where Green and his wife Sarah travel to learn about maternal and neonatal health. Sierra Leone’s maternal mortality rate is among the worst in the world—about 1 in 17 women die in pregnancy or childbirth—and the trip is supposed to focus on that crisis, not TB.
On their last day, a doctor from Partners In Health (PIH) asks them to visit Lakka Government Hospital, a TB and MDR-TB facility “on the way to the airport.” Green is tired, sick, and, by his own admission, somewhat fragile. He barely knows anything about TB; to him it’s a disease of “depressive nineteenth-century poets,” the stuff of classic novels and coughing heroines, not a present-tense emergency.
When they arrive, a boy introduces himself as Henry. Green notes that this is also his young son’s name. Henry is small, with spindly legs and a big endearing smile, wearing an oversized rugby shirt.
He speaks remarkably good English and loves using the word “encouraged”: “I am encouraged, sir.” Henry takes Green by the T-shirt and leads him through Lakka, acting as an eager host.
Inside the wards, Green sees thin mattresses, barred windows, no toilets, no electricity, inconsistent running water. The hospital feels both like a refuge and a prison. In the lab, a technician shows them sputum samples that remain TB-positive after months of treatment, hinting at drug-resistant TB.
What Green slowly realizes—painfully—is that Henry is not a visiting staff child but a patient with drug-resistant TB who has been hospitalized for months, repeatedly treated, and repeatedly failed by standard regimens.
Henry’s body is fragile; his life, precarious. That misreading—seeing him as a cheerful guide rather than a gravely ill patient—becomes emblematic of how people from high-income countries mis-see TB in poor ones: we fail to recognize who is at risk, who is already harmed, and how long the suffering has been going on.
From this point on, Henry’s story is woven through the book. Green meets Henry’s mother Isatu, who has held her son through years of coughing, hospitalization, and stigma. He hears about patients leaving Lakka early because the hunger from TB treatment, unaccompanied by adequate food, is unbearable. Lakka provides three meals a day, but those meals are small and underfunded; food is not officially part of TB “treatment packages.”
Henry comes to symbolise both TB’s cruelty and TB patients’ resilience, and his relationship with Green evolves from chance meeting to deep friendship; he later calls Green “Dad,” texts him constantly, and shares the small triumphs of his life.
3. How We’ve Imagined TB: Cowboys, Poets, and “The Flattering Malady”
After rooting us in Henry’s present, Green broadens the focus to TB’s historical “image.” He spends several chapters showing that how we imagine TB has always shaped who lives, who dies, and who gets blamed.
He revisits 19th-century Europe and America, where TB—then most commonly called “consumption”—kills one in seven people in some cities. Yet it is often romanticized as “the flattering malady”: a disease of pale, thin, soulful artists and delicate women. Pale skin and thinness become beauty ideals, and the wasting illness is cast as a sign of sensitivity, heightened passion, even spiritual refinement.
Green talks about writers and artists who die of TB, and how culture, from poetry to opera, turns their suffering into a sort of tragic glamour. At the same time, medical opinion flip-flops between explanations:
- Inherited weakness,
- Moral failing or “excesses,”
- Bad climate, lack of sunlight, and “depressing emotions,”
- Or even demonic possession or divine judgment.
In this era, treatment often revolves around “cure-by-climate” sanatoria—mountain retreats in places like Switzerland or Colorado where patients rest, breathe fresh air, and are fed nourshing food. People with money can go to such facilities; people without it die at home or in cramped tenements. The idea that TB is airborne and infectious is slowly emerging, but it competes with older, more moralizing stories.
Green shows how these narratives serve the interests of the privileged: if TB is a disease of weak wills or “certain temperaments,” then society does not need to invest in housing, nutrition, or labor protections. If it is a romantic affliction of artists, then its victims can be admired in death while being neglected in life.
4. The Bacillus and the Betrayal: Koch, Tuberculin, and the Limits of Genius
The next arc centers on Robert Koch, the German doctor who, in 1882, announces that TB is caused by a specific organism—Mycobacterium tuberculosis—and that this organism can be stained, cultured, and seen under a microscope. This transforms TB from a vague “wasting disease” into an infectious disease with a specific pathogen.
Green quotes and paraphrases Koch’s own writing, in which Koch feels the need to justify why TB is worth attention, as if the world’s leading cause of death needs a PR pitch. The discovery leads gradually to better public-health measures: improved ventilation, sputum control, and eventually pasteurization of milk and testing of cow herds to prevent bovine TB transmission.
However, Koch’s reputation is dented when he announces tuberculin, a supposed cure derived from bacterial cultures.
The substance is heralded, clinics fill with hopeful patients, and the wealthy flock to be treated. But tuberculin turns out not to be a cure; in some cases, it seems to worsen illness.
Koch’s premature claims and the rush to profit from them show how charisma, fame, and desperation can distort science, a pattern that echoes into the COVID era and modern TB drug rollouts.
Green uses this episode to underline a key point: scientific breakthroughs alone do not save lives. They must be embedded in ethical practice, careful trials, transparency, and equitable access—and those conditions are often missing for TB patients.
5. Sanatoria, Stigma, and the Slow Arrival of Real Cures
Green then walks through the late 19th and early 20th centuries in more detail, showing how sanatoria become semi-segregated worlds where TB patients spend months or years isolated from their communities.
He tells the story of Gale, a child who grows up essentially in a sanatorium, separated from family and normal life, internalising the message that she—and others with TB—are dangerous and shameful.
Even after she receives streptomycin in the late 1940s, one of the first effective antibiotics against TB, the stigma lingers.
Many former patients are told to lie about their diagnoses and say they had polio instead, because polio—though also infectious—is deemed less morally tainted than TB.
We see how TB becomes associated with poverty, dirt, and “irresponsibility” in the public mind. Green notes that public-health language often speaks of “TB control” rather than “TB care,” contrasting it with how we talk about cancer.
This reflects the “control over care” dynamic described by the late Dr. Paul Farmer: infectious diseases of the poor are managed, policed, surveilled; illnesses of the wealthy are treated, empathized with, and funded.
Prevention, meanwhile, begins to improve. The BCG vaccine, first used in 1921, arises from French scientists’ experiment with attenuated bovine TB grown in a potato–beef bile medium; it offers partial protection, particularly in children, and is widely used in many countries, though not universally.
Pasteurization and testing of cattle reduce bovine TB transmission. But despite these advances, TB keeps killing millions—especially in colonized and industrializing regions—because structural conditions and overcrowding remain unchanged.
6. The Antibiotic Century: Cure Arrives, But Never Everywhere
Mid-century brings a revolution: streptomycin, followed by other drugs such as isoniazid, eventually combined into multi-drug regimens that, taken properly for months, can cure TB.
Green describes how this feels like a miracle compared to the era of sanatoria and collapse therapy. Hospitals empty, death rates fall dramatically in wealthy countries, and TB is declared, prematurely, a solved problem.
But this “victory story” is sharp-edged. Green illustrates that the new cure does not arrive everywhere at the same time. In many poor or colonized regions, TB remains rampant, and drug supplies are irregular, interrupted, or substandard.
Patients often receive incomplete courses of antibiotics because health systems are weak and global attention is already drifting elsewhere.
This uneven rollout sets the stage for drug-resistant TB. When patients are under-dosed, or their therapy is interrupted, the bacteria that survive are often the ones that can withstand standard drugs. Over time, this produces multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB, which are harder, longer, and more expensive to cure.
Green shows how this is not an accident of biology but a predictable outcome of underfunded, unequal health systems: “We created the conditions for superbugs, then blamed patients for not complying perfectly with impossible treatment regimens.”
7. Where the Cure Is Not: DOTS, GeneXpert, and the Geography of Neglect
In chapters around “The Cure,” “Where the Cure Is Not,” and “Marco. Polo.”, Green zooms out to global health policy—especially the DOTS strategy (Directly Observed Therapy, Short-course) and later technological advances like GeneXpert diagnostic machines.
He explains that DOTS, developed in the 1970s and promoted in the 1990s, standardizes TB treatment: patients, often in poor communities, must show up regularly to swallow pills under observation.
While DOTS improves cure rates in some settings, it is also criticized for being paternalistic and failing to address structural barriers like hunger, transport costs, and lost wages.
Then there’s GeneXpert, a machine that can, in just a couple of hours, detect TB DNA and identify rifampin resistance. This should be a game-changer. But cartridges for each test are expensive—around $10–15 per test—which Green notes can be more than half of Sierra Leone’s annual per-capita public health spending.
Drug company executives from Cepheid and its parent conglomerate Danaher brag about a “razor-blade business model,” where machines are relatively affordable but consumables (the cartridges) are priced high.
In practice, this means GeneXpert machines often sit underused in countries that need them most. Clinics run out of cartridges; tests are rationed. Diagnostics, like drugs, are distributed along fault lines of wealth and geopolitical importance. Green uses these examples to reinforce his thesis: TB persists not because solutions don’t exist, but because they are not placed where the disease actually is.
8. Dr. Girum, Shreya, and the Moral Landscape of Drug Access
In “Dr. Girum” and related chapters, Green introduces Dr. Girum, an Ethiopian TB physician working with people suffering from drug-resistant TB. Through Girum’s clinic, we see patients who have already swallowed months of toxic drugs, lost hearing, lost weight, and lost hope. They’re often young, parents, or breadwinners whose illness will impoverish entire families.
Green also tells the story of Shreya Tripathi, a young woman in India with drug-resistant TB whose case became emblematic of battles over access to lifesaving drugs like bedaquiline.
Activists, including Shreya herself, fight to pressure pharmaceutical companies (notably Johnson & Johnson, in real life) and governments to allow generic production and compassionate-use access, arguing that proprietary pricing and secondary patents are literally costing lives.
These stories illustrate how global intellectual-property rules, corporate strategy, and national politics determine who gets “miracle drugs” and who remains on older, more toxic regimens.
Green is careful not to reduce these individuals to symbols; he shares details of their personalities, families, and small preferences. But he also insists that their experiences are not isolated tragedies. They are the predictable, repeated outcomes of a system that treats life-saving TB drugs as scarce luxury goods in precisely the countries where TB is most common.
9. Henry’s Treatment: Injectables, Hearing Loss, and New Regimens
Returning to Henry, Green details the specific regimens that nearly destroy Henry’s body while not fully curing his disease. Henry is given a cocktail that includes kanamycin, an injectable TB drug that is ototoxic—meaning it causes permanent hearing loss in a sizable fraction of patients—and nephrotoxic, risking kidney failure.
Henry should never have been put on kanamycin, Green notes, because newer oral drugs like bedaquiline had been approved in rich countries since 2013, with far better safety profiles.
Yet, due to pricing, regulatory lag, and global neglect, patients like Henry in Sierra Leone are still being given the older, more harmful drugs well into the late 2010s. Henry starts losing his hearing.
He is a teenager who loves music, conversation, video, and the sound of his own life, and now the treatment that may or may not cure him is robbing him of that.
Over time, with advocacy and support from organizations like PIH and TB activists, Henry gains access to newer regimens, including combinations involving bedaquiline, linezolid, and pretomanid, sometimes referred to as BPaL and its variant BPaLM (adding moxifloxacin). These regimens are shorter, more effective, and far less brutal than the old 18–24-month injectable courses.
Green is clear: Henry is not “lucky” to finally get these drugs; he is belatedly receiving what should have been standard care years earlier. The delay is a symptom of global injustice.
By the time Green is writing, Henry is studying at college, still susceptible to severe illness when he gets infections like malaria because his lungs are damaged.
He lives with his mother in a small home; he is proud of it but dreams of buying art for the walls. He texts Green one word at a time—“Dad.” “Hello.” “How is my namesake?”—and is thrilled to have been named “best TikToker” at his college, wearing a suit to the ceremony and bringing his mother as his guest.
Henry also experiences hearing loss and other long-term side effects, which Green treats not as footnotes but as central elements of TB’s legacy: even when curable, TB leaves scars on bodies, families, and futures.
10. Superbugs, Vicious Cycles, and “Diseases of Injustice”
In “Superbug,” “Vicious Cycles,” and “Hail Mary,” Green lays out the global picture of drug-resistant TB and how it intersects with politics. He incorporates current data: TB caused about 1.25 million deaths in 2023 and an estimated 10.8 million new cases, with 400,000 or so involving multidrug- or rifampin-resistant TB.
He explains vicious feedback loops:
- Underfunded TB programs →
- Poor diagnostics and incomplete treatment →
- Drug-resistant strains →
- Higher costs and more complex regimens →
- Donor fatigue and political abandonment →
- Even worse underfunding.
These cycles are worsened by conflict, displacement, climate change, and HIV, all of which increase vulnerability to TB and undermine health systems.
Green references his own advocacy work around the End TB Now Act in the US Congress and the fights to convince companies like Danaher to lower GeneXpert cartridge prices, showing how even partial wins can ripple outward but are constantly at risk of being undone by aid cuts and shifting political winds.
In “Vicious Cycles” and “Virtuous Cycles,” he flips the metaphor: just as bad policy breeds more TB, good policy can breed less.
When patients receive timely diagnosis, proper nutrition, humane support, and modern oral regimens, their cure allows them to work, care for families, and advocate for others, fueling trust and community resilience.
These virtuous cycles, he suggests, are already visible in places where TB programs embrace patient-centered, rights-based care rather than mere “control.”
11. Like Magic and The Cause and the Cure: What Ending TB Would Actually Mean
In the near-final chapters—“Like Magic,” “Virtuous Cycles,” and “The Cause and the Cure”—Green turns explicitly to hope and responsibility.
He recounts new regimens that cure drug-resistant TB in six months or less, replacing the absurdly long, toxic courses of the past. For patients who have only known injections, deafness, vomiting, and years of isolation, these regimens feel “like magic.”
But Green insists they are not magic at all; they are the fruits of research, funding, and patient activism. If made widely available and affordable, they could fundamentally change the trajectory of TB worldwide.
He distills his thesis:
- We know how to live in a world without tuberculosis.
- We have chosen not to live in that world—so far.
TB, Green argues, is one of several “diseases of injustice”—illnesses that persist primarily because we accept a world where some people’s lives are worth less. If those underlying injustices were addressed—through stronger health systems, fair drug pricing, better housing and nutrition, and a genuine commitment to global solidarity—TB could be pushed to the margins of history.
Everything Is Tuberculosis closes with Henry very much alive, texting, studying, getting malaria and recovering, dreaming about the future.
Green admits that he cannot truly comprehend what 1,250,000 deaths in a year means; he can, just barely, comprehend Henry. That gap between abstraction and person, he suggests, is precisely where TB continues to thrive: in the distance between our moral imagination and our actual policies.
His final lesson is not that everyone must become a TB expert, but that we must stop treating distant suffering as inevitable. TB is a test—not of bacteria, but of our willingness to see every person, including a teenage boy in Sierra Leone, in their full humanity, and to act accordingly.
5. Everything Is Tuberculosis Analysis
For me, the heart of Everything Is Tuberculosis is not its timeline of discoveries—Koch’s bacillus, streptomycin, GeneXpert—but its insistence that stories and metaphors determine who gets diagnosed, who gets treated, and who is left to cough and die offstage.
Green repeatedly shows how earlier eras mis-imagined TB: as a disease of sensitive artistic types, of inherited weakness, of “poisoned air,” of demon possession, or, in his great-grandfather’s case, of childhood sweets and coffee, and he traces how each story justified some people’s suffering as deserved or inevitable.
He then juxtaposes those older misconceptions with the contemporary myth that TB is “over” in rich countries, an almost Victorian affliction confined to literature, even as WHO reports quietly count more than ten million new cases a year, many in migrants, prisoners, miners, and people living with HIV.
That framing is, in my view, the book’s most powerful intellectual contribution: it shows that TB is not just biologically airborne but socially constructed through policies, funding flows, and prejudice.
Everything Is Tuberculosis absolutely does support its arguments with concrete evidence, even though it favors narrative over dense tables.
Green leans on historians of medicine like Frank Ryan, whose estimate that TB has caused about a billion deaths and “the greatest infectious killer in history” he weaves into his own claim that TB may have killed around one in seven humans ever born.
He brings in epidemiological studies about preventive therapy in high-burden settings like Bethel, Alaska, where a comprehensive TB program in the 1950s cut incidence by roughly 69% in a single year, then compares that success to the chronic underfunding that leaves places like Lakka without enough food for patients or GeneXpert cartridges for rapid diagnosis.
His account of diagnostic technology is especially strong: he explains how tools like GeneXpert can, in a few hours, detect not only TB but resistance patterns, then contrasts that promise with the reality that cartridge costs of roughly $10–15—more than half of Sierra Leone’s annual per-capita health spending—have slowed rollout, in part because of Danaher’s “razor-blade” business model.
Alongside these structural analyses, he never lets us forget individuals: young Marie at Lakka, dreaming of eating mud soup because the hunger after TB treatment is so extreme, or Henry plotting YouTube videos while trying not to cough up blood, giving the statistics a face and a voice.
As a reader, I felt that the book absolutely fulfills its stated purpose: it both makes TB’s history visible and argues, convincingly, that TB today is a disease of injustice, where survival depends grotesquely on the passport and pharmacy near your lungs.
Green’s style is very much “John Green but for global health,” which worked for me but may not be for everyone.
He writes in clean, essayistic chapters with recurring motifs—steam engines, cowboy hats, spit, and saints—and regularly pauses his narrative to confess his own blind spots, like the fact that he didn’t know TB was “still a thing” when a young Indian woman named Shreya Tripathi first wrote to him years ago.
Those meta-moments put his own complicity on the table and mirror the way many of us in low-burden countries have learned to ignore TB, which makes his later moral arguments feel earned rather than scolding.
At the same time, his Crash Course instincts mean he is constantly summarising, refocusing, and signposting, which makes the book unusually accessible given the complexity of the science and policy.
I never felt lost in the history, even when he dove into tuberculin fiascos, sanatorium movements, or the evolution of drug-resistant strains; instead, I felt like I was being guided through a narrative syllabus by a teacher who cares as much about feelings as about facts.
If you’re used to dry policy reports and academic articles on TB, this mix of intimacy and explanation feels almost shockingly generous.
6. Reception, Criticism, and Influence
When I looked up early coverage, I found that Everything Is Tuberculosis almost immediately debuted as a #1 New York Times, Washington Post, and Indie bestseller, an unusual achievement for a book whose main character is a bacterium and whose plot involves sputum microscopy.
Reviewers in mainstream outlets tended to praise exactly what struck me: the book’s ability to make complex history “unputdownable,” its humane portrait of Henry and other survivors, and its argument that infectious-disease stories don’t have to be narratives of inevitable tragedy but can be narratives of choices.
At the same time, some critics—including public-health professionals writing in specialist forums—have gently worried that centering a celebrity author risks overshadowing decades of work by less visible TB activists and that some of the policy discussions (say, around migrant detention and TB) are necessarily simplified for a general audience.
In terms of influence, Everything Is Tuberculosis seems already to be doing some of what it set out to do.
It has pushed TB into general-interest conversations—on podcasts, in book clubs, in YouTube comments—in a way I haven’t seen since the early HIV memoirs, and Green’s presence in Vox, AP interviews, and advocacy campaigns has helped keep TB in headlines that might otherwise be dominated by flashier crises.
Advocacy groups like the Stop TB Partnership and Doctors Without Borders have been quick to use the book’s publication as a hook for renewed calls around drug pricing, diagnostic access, and funding gaps, especially as USAID cuts and other donor retrenchments threaten to erode progress.
From a purely literary perspective, it’s also expanding what we expect “John Green” to mean: not just sad teens and existential questions but adults trying to rewire donor priorities and rethink who gets to be at the center of health narratives.
7. Comparison with Similar Works
Everything Is Tuberculosis sits in a lineage of big, humane disease histories, and it’s interesting to see where it converges and where it diverges.
If you’ve read Frank Ryan’s Tuberculosis: The Greatest Story Never Told, you’ll recognise much of the scientific arc—sanatoriums, streptomycin, multi-drug therapy—but Green pushes harder on contemporary policy failures and on the ongoing “new global threat” of drug resistance, whereas Ryan’s book, originally published in the 1990s, reads more like a heroic saga of discovery.
Compared with books like Siddhartha Mukherjee’s The Emperor of All Maladies or Laurie Garrett’s The Coming Plague, Green’s focus is narrower but more personal, anchored in a single disease and in a handful of relationships rather than in a synoptic sweep across pathogens.
What distinguishes Green’s book, though, is its insistence on action: there is a persistent sense that this is not just a story to admire or be moved by but a dossier to act on, a briefing disguised as a memoir-history hybrid.
As a reader, I came away feeling that if Mukherjee gives us the emotional and scientific history of cancer, Green is trying to do the same for TB—but with a sharper edge toward global justice and philanthro-politics.
8. Conclusion and Recommendation
In the end, Everything Is Tuberculosis left me with that rare combination of sadness, clarity, and a slightly uncomfortable sense of responsibility.
Green closes by reminding us that “we know how to live in a world without tuberculosis… but we choose not to live in that world,” and by arguing that we must work together to end TB and “all other diseases of injustice,” a phrase that has lodged in my mind like a quiet indictment.
Based on both the book and the data, I would recommend Everything Is Tuberculosis wholeheartedly to general readers who enjoy serious nonfiction, to students in public health or medical humanities, to policy-makers who have somehow managed to overlook TB in their “global threats” briefings, and to book-club readers willing to trade plot twists for ethical ones.
It is probably less useful as a technical manual for clinicians or epidemiologists, and readers looking only for classic John Green romance will be startled by how little this book cares about their expectations, but as an accessible, emotionally intelligent, and rigorously sourced account of our deadliest infection, it is hard to beat.
If you finish Everything Is Tuberculosis and still think of tuberculosis as a nineteenth-century footnote instead of a twenty-first-century emergency, I suspect you weren’t really reading it.
