Everything Is Tuberculosis: The History and Persistence of Our Deadliest Infection

In Chapter 6, romanticization is presented as a complementary strategy to stigmatization, even though it exaggerates idealized qualities in contrast to stigmatization. When one romanticizes illness, they imagine sick people in a category of otherness that reduces their suffering. This wrongly suggests that suffering is worthwhile in order to make a sick person appear more pleasing, beautiful, or creative. This mindset gave rise to beauty trends such as “consumptive chic.”

The sanatorium was a facility that served as the predominant form of treatment for TB prior to the invention of its cure. With the assumption that TB was caused by air tainted with bacteria, Western society sought to create facilities that removed patients from urban spaces and allowed them to seek respiratory therapy via clean air. These spaces were prone to control-based treatments, however, which put the burden of recovery on patients. If patients did not respond to treatment, they were summarily blamed and disciplined, which exacerbated their emotional health.

The social determinants of health are factors that signal the quality of life in a given social setting. Green identifies some of these determinants in Chapter 23: “food insecurity, systemic marginalization based on race or other identities, unequal access to education, inadequate supplies of clean water” (180). He argues that these factors necessarily have a direct relation to healthcare because these factors enable effective treatment across a community.

Stigmatization is the process of excluding a person or community from society because of a perceived undesirable quality. In the context of Green’s book, many people with TB are stigmatized by their family and friends. This comes from a lack of awareness around the disease and a misconception that association puts one at the risk of instant infection. Instead, this response has the effect of making the patient feel that they are “less than” people who don’t have TB.

The superbug is defined in Chapter 18 as a strain of illness that evolves to resist all available forms of treatment. This leaves all of humanity vulnerable to infection, especially since the superbug is likely to be more aggressive than its earlier iterations. Green proposes that while the superbug is an alarmist scenario, it is also helpful in spurring rich communities to pursue social solutions that prevent the evolution of new illness strains.

Tuberculosis is the subject of Green’s book. It is an illness caused by the microorganism Mycobacterium tuberculosis and is characterized by a slow development process. This means that it could take several decades for the bacteria to grow from latent TB into active TB, which starts to manifest harmful symptoms within a patient. Though TB is most commonly associated with the lungs, the bacteria can attach itself to any organ. This made TB hard to detect at first before modern diagnosis methods were developed. Since the 1950s, TB has been a curable disease, though access to effective cure regimens is restricted by choices that disadvantage low- and middle-income countries. TB has sub-strains categorized according to levels of resistance, including drug-resistant TB, multidrug-resistant TB, and extensively drug-resistant TB.

A vicious cycle is a series of choices that exacerbate an issue to the point of injustice. Vicious cycles gave rise to the global TB crisis as control-based treatments restricted access to the cures and vaccines that would have eliminated TB by the 21st century. Instead, humanity faces the threat of the superbug as TB grows more resilient to the available cures that exist for the disease.