story of struggle with multi-drug resistant tuberculosis, inadequate resources and stigmatization. Henry personifies, for Mr. Green and the reader, the burden of disease and the restricted availability of treatment so pervasive in developing world countries. Henry’ s chronicle, shared in excerpts throughout the book, serves as a foundation upon which the rest of the book is built.
While Henry’ s persona, as a recurrent inpatient in multiple tuberculosis hospitals, is clear, his unmasked character is left somewhat to the imagination. There is, curiously, limited intimate character development in Everything is Tuberculosis for the book’ s central character. Empathic as any reader may be to Henry’ s story, Mr. Green does fall short of endearing readers to Henry, the person. For an author who nurtured his career in young adult fiction novels, this feels like an oversight. However, Mr. Green readily admits his preternatural obsession, and his own OCD diagnosis, with the decidedly non-fiction topic of tuberculosis. As such, Henry’ s story, presented as an embodiment of the scourge of the perennially deadliest infection in the world, suggests character development was never the intention.
Citing one estimate that TB has killed one in seven humans who have ever lived, Mr. Green subsequently develops a rather concise review of the historical gravity of tuberculosis. He grabs readers’ attention with both the famous names that have perished with tuberculosis, and the inevitable cultural phenomena humans have developed to deal with the overwhelming burden of tuberculosis. The most depth is found in the book’ s exploration of the Victorian-era concept of consumption, likely the most relatable to the modern reader, and the purported euphoric and hypercreative state of spes phthisica, or“ consumptive hope,” observed in those with terminal cases.
Former Washington Post theater critic, Naveen Kumar, makes the point of consumption’ s cultural ubiquity in a recent editorial on Timothée Chalamet, the modern-day movie star, and his recent public verbal blunders opining on the relevance of ballet and opera. Writing about his recent transition to a more brash,“ alpha male smarm”, she described his early career appearance on the Hollywood scene as“ waifish and pale, with a fine, wavy mop, he looked like a consumptive Victorian garret-dwelling artist.” Regardless of one’ s expertise in the historical aspect of tuberculosis, very likely it is this image that’ s conjured in one’ s mind, from pervasive cultural references to tuberculosis, when reading Ms. Kumar’ s words, even if the origins of this mental image are not immediately apparent.
Mr. Green, for his part, in a moment of brevity on the role of the dreaded symptom of consumptive hemoptysis in tragic literary and stage plot twists, supports his own historical supposition on consumption. Recounting his favorite contemporary comedy routine, reflective of the current state of affairs, the punchline lands with,“ if America was a character in a movie … this would be the part where America coughs into a rag and then pulls away and sees blood.” He suggests the ominous nature of the reference lands for the average comedy consumers, even if, again, they are not immediately aware of the exact origin.
With rapid-fire succession, Mr. Green lays out the various theories of the origin of tuberculosis infection over centuries, including a fascinating Persian scholar’ s assertion of a nascent germ theory written over a thousand years ago. Subsequently, he breezes through a brief discourse on the varied treatments prescribed over the centuries. Depending on the reader, one may find his historical discourse fascinating, layering historical fact upon brief anecdotes of history or simply frustrating in its relative paucity of detail and depth.
Indeed, the sheer ubiquity of tuberculosis is hard to overstate and Mr. Green provides adequate proof. His attempt, however, to demonstrate the something-is-everything concept calls to mind another published author of the same genre who was more successful at the attempt, Mark Kurlansky. His early aughts volumes Salt: A World History and The Big Oyster: History on the Half Shell, were remarkably convincing that the world could not exist as we know it without the epic quests to procure sodium chloride, nor could New York possibly exist if not for the once abundant bivalves found in its harbor.
Mr. Green purports that“ everything is tuberculosis” but he does not succeed entirely in proving his assertion. He is more convincing, in proving his assertion at least beyond a supposition, that tuberculosis is somehow found in nearly everything by the sheer fact of prevalence. In laying bare the prevalence of tuberculosis, he does demonstrate the inevitable adjacent position, if not by ubiquity of infection, then culturally, to many human lives of antiquity, continuing to the present. Nevertheless, despite the succinct explorations of tuberculosis, Mr. Green does write with cohesiveness. The attuned reader will notice his juxtaposition, over many pages, of the infamous physical deformity of Pott’ s Disease, exemplified in the Hunchback of Notre Dame, with the deformities inflicted by tuberculosis upon families, societies and public health infrastructures.
As many in medicine would likely conclude about disease in general,“ The history and the present of tuberculosis reveal the folly and brilliance and cruelty and compassion of humans.” On this point, Everything is Tuberculosis, and Mr. Green, are convincing to the reader. Yet, on many points in the book, Mr. Green rests his case too early, presumably as either a concession to editing for larger audience palatability or as a surrender to the reality that a plethora of volumes could be written on the subject he chose to tackle.
Ultimately, though, what Mr. Green best asserts in Everything is Tuberculosis, as would nearly any practicing physician about so many infectious diseases, is that“ TB is both a form and expression of injustice.” On this point, as a nod to the title, everything is, indeed, tuberculosis.
Dr. Kolter is an internist with Baptist Health.
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