In “Everything Is Tuberculosis,” John Green—best known for young adult novels like “The Fault in Our Stars” and “Looking for Alaska”—ventures deeper into non-fiction territory following his essay collection “The Anthropocene Reviewed.” This time, he tackles tuberculosis, a disease that kills 1.25 million people annually despite being both preventable and curable. Green’s journey begins with a chance meeting with a Sierra Leonean teenager named Henry at Lakka Government Hospital, evolving into a passionate exploration of how TB has shaped human history and continues to reveal the profound inequities in our global healthcare systems.
Green has a remarkable ability to make complex subjects accessible without sacrificing nuance. In this book, he seamlessly weaves personal narratives, historical accounts, scientific explanations, and critical examination of global health policies into a compelling tapestry that transforms our understanding of a disease many in wealthy nations consider a relic of the past.
Narrative Approach: Henry’s Story as the Beating Heart
At its core, “Everything Is Tuberculosis” is a tale of friendship and advocacy. Green chronicles his relationship with Henry Reider, whose story serves as both the book’s emotional anchor and a powerful case study in healthcare inequity. The brilliance of Green’s approach lies in how he uses Henry’s journey—from diagnosis through failed treatments to eventual recovery—as a thread connecting broader discussions about global health systems, historical contexts, and colonial legacies.
The book gains tremendous power from this narrative choice. We’re not just reading about tuberculosis statistics; we’re following Henry through his harrowing ordeal:
“Henry would be the first Sierra Leonean to receive this kind of highly personalized, tailored cocktail, and Dr. Girum knew how much that meant—not only to Henry but to the country as a whole. If Henry survived, he would be living evidence that even complex drug-resistant TB can be cured in Sierra Leone.”
This human-centered approach creates an intimacy that pulls readers through complex discussions of drug patents, bacterial resistance mechanisms, and historical stigmatization that might otherwise feel distant or academic.
Historical Perspective: Tuberculosis Through Time
Green excels at demonstrating how tuberculosis has threaded itself through human history, evolving from “consumption”—a romanticized disease believed to enhance creativity and beauty in 19th-century Europe—to a modern “disease of poverty.” His exploration of TB’s cultural impact is fascinating:
“To try to understand the state of medicine in this era, I sometimes think of the eighteenth-century physician Johann Storch, whose patient histories were the subject of Barbara Duden’s brilliant book The Woman Beneath the Skin. In one passage, Dr. Storch tries to imagine what might’ve happened to a pin that had been swallowed by a tailor’s assistant. ‘It could exit from nearly anywhere: from a lump next to the navel, through the urine, with the excrement, through the vulva, at the inside of the calf through an abscess, or after eighteen years through the leg.’ All of which is to say that three human lifetimes ago, a trained physician in Germany had no idea that the human body contained a digestive tract.”
Green’s analysis of how societal beliefs shaped responses to tuberculosis is particularly compelling, from how it was romantically linked to creative genius in poets like John Keats to how beliefs about race influenced who received treatment. These historical sections provide crucial context for understanding contemporary attitudes and policies.
Scientific Clarity: Making Microbiology Accessible
One of the book’s greatest strengths is Green’s ability to explain complex scientific concepts with remarkable clarity. His descriptions of how Mycobacterium tuberculosis operates within the body, how drug resistance develops, and how diagnostic technologies work are accessible without being oversimplified.
Green skillfully explains:
- The unique characteristics of M. tuberculosis, including its slow growth rate and waxy cell wall
- The mechanisms by which TB bacteria develop drug resistance
- The different diagnostic methods from smear microscopy to GeneXpert molecular testing
- How treatment regimens evolved from sanatorium “rest cures” to modern antibiotic protocols
Green’s talent for analogies and clear explanations comes into play here, making medical and scientific concepts digestible for lay readers without losing accuracy.
Global Health Politics: An Unflinching Examination
Where “Everything Is Tuberculosis” truly shines is in its unflinching examination of how global health politics, pharmaceutical patents, and cost-effectiveness analyses directly contribute to preventable deaths. Green doesn’t shy away from naming the economic and political forces that keep life-saving drugs from those who need them most.
He effectively punctures the myth that treating TB in poor countries is “too expensive” or “too complex”:
“I find it interesting that even here, in the supposedly pure world of science, we feel the weight of historical forces pressing in upon discovery. Our desire to create outsiders, the competition for resources among communities that would be better off cooperating, and our long history of warfare all come together in this moment of discovery.”
Green’s analysis of how pharmaceutical companies like Johnson & Johnson used secondary patents to maintain monopolies on life-saving drugs like bedaquiline is both damning and nuanced. His explanation of how “cost-effectiveness” becomes a moving target—serving as justification for inaction until pressure forces prices to drop—is particularly illuminating.
Stylistic Elements: Balancing Outrage with Hope
Throughout the book, Green maintains a delicate balance between righteous anger at preventable suffering and genuine hope for change. His prose retains the conversational, occasionally self-deprecating style readers will recognize from his novels and “The Anthropocene Reviewed,” but with added gravitas appropriate to the subject matter.
Green’s signature ability to find meaning in connections shines through, particularly when he explores how tuberculosis intersects with seemingly unrelated historical events:
- How tuberculosis shaped the American West and the cowboy hat
- The connection between TB and the assassination that sparked World War I
- How TB influenced fashion trends, from beard styles to hemlines
These connections never feel forced; rather, they illustrate Green’s central thesis that tuberculosis has shaped human history in countless overlooked ways—that, in a sense, everything really is tuberculosis.
Criticisms: Areas That Could Be Strengthened
Despite its many strengths, “Everything Is Tuberculosis” has a few shortcomings worth noting:
- Limited Global Perspective: While Sierra Leone and Peru receive significant attention, the book might have benefited from more extensive exploration of TB experiences in other high-burden countries, particularly India and China, which account for a large percentage of global cases.
- Technical Terminology: Though Green works hard to explain medical terminology, occasional sections dense with acronyms (RIPE, DOTS, MDR-TB, etc.) might overwhelm readers unfamiliar with medical literature.
- Policy Solutions: While Green effectively diagnoses problems in global TB control, his discussion of specific policy reforms could be more detailed. The STP (Search, Treat, Prevent) initiative is mentioned toward the end but might have warranted more thorough analysis.
- Pacing: The book occasionally feels uneven, with some chapters deeply immersed in Henry’s story and others pivoting to broad historical surveys, creating slight narrative whiplash.
These criticisms, however, are minor compared to the book’s substantial achievements in making tuberculosis accessible, engaging, and urgent for general readers.
Comparison to Similar Works
“Everything Is Tuberculosis” stands alongside important works like Siddhartha Mukherjee’s “The Emperor of All Maladies” and Paul Farmer’s “Infections and Inequalities” in its ability to humanize disease while maintaining scientific rigor. While not as comprehensively historical as René and Jean Dubos’s classic “The White Plague,” Green’s book benefits from contemporary relevance and personal investment.
The book most closely resembles Tracy Kidder’s “Mountains Beyond Mountains,” which chronicled Paul Farmer’s work fighting TB in Haiti. Green acknowledges this influence, writing that “Mountains Beyond Mountains” was “one of the most important and deeply moving books I’ve ever read.” However, Green’s approach is more wide-ranging, connecting historical, scientific, and personal narratives across centuries and continents.
Conclusion: A Call to Action Disguised as a Book
“Everything Is Tuberculosis” ultimately reveals itself as a powerful call to action disguised as a book. Green concludes:
“We cannot address TB only with vaccines and medications. We cannot address it only with comprehensive STP programs. 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.”
This book succeeds brilliantly on multiple levels—as a history of an ancient disease, as an examination of global health inequity, as a tribute to caregivers and survivors, and as a deeply human story of friendship and advocacy. Through Henry’s journey, Green makes distant statistics devastatingly personal, challenging readers to see tuberculosis not as a problem of the past or of distant countries, but as a moral test for our shared humanity.
For readers familiar with Green’s fiction or essays, “Everything Is Tuberculosis” represents a natural evolution of his interests in human connection, meaning-making, and the complexity of suffering. For those interested in global health, the book offers an accessible entry point to understanding one of our world’s most pressing yet overlooked health crises. And for everyone, it provides a powerful reminder that diseases are never just biological phenomena—they are always expressions of how we choose to organize our societies and distribute our resources.
In making tuberculosis visible, Green has created something rare: a book about disease that leaves readers feeling not helpless, but empowered to demand and create change.