On the last day of a 2019 trip to Sierra Leone, Green was taken to Lakka Government Hospital without any particular expectation. A patient named Henry, who shared a name with Green’s nine-year-old son and who appeared to be about the same age, walked him through the wards. Only when the doctors sent Henry away did Green learn the truth: Henry was 17. Drug-resistant TB and malnutrition had reduced his body to the size of a small child. That single fact dissolved whatever distance Green had kept from the disease.

John Green

I think I care about it because I care about Henry. All the data in the world and all the statistics in the world matter. You know, it matters that this is the world’s deadliest infectious disease. It matters that it’s been curable since the 1950s and since it’s been curable, we’ve allowed 150 million people to die of it. But what really matters is caring about individuals and the human-to-human work that we do as humans. And so, if it weren’t for Henry, I don’t think I could have written this book. I’m very grateful to him for making it possible.

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onehealthtrust.org, “From Young Adult Romance to the World’s Deadliest Infectious Disease – Writer John Green takes on TB”

What made the encounter at Lakka so disorienting was not only Henry’s condition but Green’s own ignorance going in. He had considered himself reasonably engaged with global health issues. TB had simply never registered on his radar, a gap that the book would come to treat as a symptom of something larger than personal inattention.

John Green

I really wanted to write this book because it felt urgent to me... it was very difficult for me to work on a novel when I was thinking about this book, because this book just felt so much more urgent and necessary to me. It was the one that I had to write, and the one that you have to write is the one you have to write. [paraphrased from audio]

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SciFri, “EVERYTHING IS TUBERCULOSIS: Author Livestream and Q&A with John Green - #SciFriBookClub”

For several years after Sierra Leone, Green stalled on fiction. The novels he attempted during that period kept losing to the pull of this subject.

Green lives with OCD, with contamination fears that have shaped both his daily life and his earlier fiction. When Kirkus asked about the connection between that history and a book about the world’s deadliest bacterial infection, he did not deflect.

John Green

I don’t think it’s a coincidence that so much of my life and my writing have been oriented around my long-standing fears around contamination and infectious disease.

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kirkusreviews.com, “John Green Writes a Tuberculosis Tell-All”

Green does not describe his preparation as research in any disciplined sense. For roughly four years, TB was simply what he read. His wife has said that estimate is conservative. The reading was not organized around chapters or an outline; it was organized around obsession.

John Green

I started out writing to try to understand, because writing is my way of thinking, and then slowly over years I realized that I might be actually writing a book. [paraphrased from audio]

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WFYI, “John Green on his new book, public media, and his Indianapolis roots | Cultural Manifesto”

The title the book eventually carries came from a mistake. Green had submitted the manuscript under a longer name that captured what his wife had observed for years: that every conversation in their house eventually arrived at TB. His editor’s misreading turned out to be the sharper version.

John Green

My wife Sarah has been joking for years that, in my mind, everything is about tuberculosis and tuberculosis is about everything, so I called the book Everything Is About Tuberculosis. Then my longtime editor misread the title, writing me to say, ‘I really enjoyed Everything Is Tuberculosis.’ That was much better.

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kirkusreviews.com, “John Green Writes a Tuberculosis Tell-All”

The shorter title does something the longer one does not: it refuses to place TB at a comfortable remove. The disease is not something that other things are merely about. It is the thing itself, everywhere.

Switching from YA fiction to a nonfiction book about infectious disease was not an obvious move for an author whose audience had built around novels like ‘The Fault in Our Stars.’ Green was aware he was asking readers to follow him somewhere unfamiliar, and he expected some of them not to.

John Green

I think I’m trying to strip away some of the ways we’ve imagined TB and argue that we might imagine it a different way. We might imagine it as a disease that is optional for us, a disease that we’re choosing to live with and that we could make a different choice.

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sciencefriday.com, “The Many, Many Ways Tuberculosis Shaped Human Life”

The book’s central claim is not a medical one. Green locates the cause of TB deaths in the 21st century not in bacterial biology but in the architecture of human decisions, spending priorities, and political will. The bacterium that causes TB, Mycobacterium tuberculosis, has been killable since the mid-1950s. What has not been defeated is the indifference that decides who gets the drugs.

John Green

Death from TB is not caused by bacteria anymore; it’s caused by human choice. It’s caused by human-built structures and systems.

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atmos.earth, “For John Green, Tuberculosis Is Everywhere—Even in Climate Change”

The scale of what that indifference has cost is the moral weight the book asks readers to carry. Green returns to the arithmetic of it more than once, because the number is large enough that it needs repetition to land.

John Green

It’s hard to even get your head around the extent of the inequity. But since tuberculosis became curable in the mid-1950s, we have allowed over 150 million people to die of the disease. It’s one of the great marks of shame in human history, I think.

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wbur.org, “Author John Green argues the global community could choose to live in a world without tuberculosis | Here & Now”

Green is deliberate about not leaving readers in despair. The book closes with evidence that pressure works: the price of a critical TB drug dropped after sustained advocacy, and Henry Reider, the teenage patient who started all of this, is now a university student. The hope Green offers is tethered to specifics rather than sentiment, and it is offered in the same breath as his frustration.

John Green

We know how to live in a world without climate change, and we know how to live in a world without tuberculosis. That we haven’t yet chosen to live in those worlds is a great disappointment to me—but science remains a source of hope.

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atmos.earth, “For John Green, Tuberculosis Is Everywhere—Even in Climate Change”