WEBVTT - Special Episode: John Green & Everything Is Tuberculosis 0:00:44.280 --> 0:00:47.760 Hi, I'm Aaron Welsh and this is this Podcast Will 0:00:47.800 --> 0:00:52.320 Kill You. Welcome to our very first tp w k 0:00:52.640 --> 0:00:56.720 Y book Club episode of the season. In these episodes, 0:00:56.800 --> 0:00:59.520 I get to chat with authors of popular science and 0:00:59.600 --> 0:01:03.200 medicine books about their latest work, and I get it 0:01:03.280 --> 0:01:06.200 behind the scenes look at what goes into putting these 0:01:06.200 --> 0:01:09.880 books together. I am so excited to be bringing you 0:01:10.000 --> 0:01:13.039 more of these episodes over this next year, and we 0:01:13.200 --> 0:01:16.840 have got such an incredible lineup so far. For a 0:01:16.920 --> 0:01:18.920 sneak peek of some of the books that will be 0:01:19.000 --> 0:01:22.240 featured on upcoming episodes, or to check out the ones 0:01:22.280 --> 0:01:25.160 that we've covered in past seasons, head on over to 0:01:25.240 --> 0:01:28.440 our website This Podcast will Kill You dot com, where 0:01:28.480 --> 0:01:30.600 you can find a link to our bookshop dot org 0:01:30.640 --> 0:01:35.640 affiliate account, which has all sorts of TPWKY related lists, 0:01:36.040 --> 0:01:39.160 including a book club list. I'll be updating that list 0:01:39.240 --> 0:01:41.600 throughout this season as I add more books to the 0:01:41.640 --> 0:01:46.200 episode lineup, and so check in regularly. As always, we 0:01:46.560 --> 0:01:48.920 love getting your feedback on the work that we do, 0:01:49.240 --> 0:01:52.040 so please reach out via the contact us form on 0:01:52.080 --> 0:01:56.040 our website to share your thoughts. I especially appreciate each 0:01:56.120 --> 0:01:58.680 and every one of you who has written in about 0:01:58.720 --> 0:02:02.960 these episodes or suggested books to cover. I've definitely followed 0:02:03.000 --> 0:02:05.880 up on a few of these recommendations, so stay tuned. 0:02:06.560 --> 0:02:09.200 Two final things to mention before moving on to the 0:02:09.200 --> 0:02:13.320 book of the week. Number one, please rate, review and 0:02:13.440 --> 0:02:17.280 subscribe really does help us out. And number two, we're 0:02:17.400 --> 0:02:21.240 now on YouTube. You can find full video versions of 0:02:21.280 --> 0:02:24.079 most of our newest episodes by going to the Exactly 0:02:24.160 --> 0:02:27.880 Right Media YouTube channel. Make sure you subscribes you never 0:02:27.919 --> 0:02:30.600 miss an episode. All right, let's get to the real 0:02:30.680 --> 0:02:35.520 reason we're here. John Green's Everything Is Tuberculosis. I know 0:02:35.600 --> 0:02:38.040 that many of you out there, like me, have been 0:02:38.280 --> 0:02:42.320 eagerly awaiting this book's publication, and let me tell you 0:02:42.520 --> 0:02:46.200 that it is well worth the wait, and its arrival 0:02:46.280 --> 0:02:49.600 could not have come at a better time, as tuberculosis 0:02:49.680 --> 0:02:53.920 cases surge across the globe amidst massive funding cuts to 0:02:53.960 --> 0:02:59.840 global health programs such as USAID. In Everything Is Tuberculosis, Green, 0:03:00.200 --> 0:03:05.560 award winning, internationally best selling author, famous YouTuber, and excellent 0:03:05.639 --> 0:03:10.200 science communicator, takes a panoramic view of this fascinating and 0:03:10.320 --> 0:03:14.760 deadly disease, linking its biology and history with the perception 0:03:14.919 --> 0:03:19.920 and prevalence of tuberculosis today. For many of US, tuberculosis 0:03:19.960 --> 0:03:24.840 may conjure up Charles Dickens or long abandoned sanatoriums in 0:03:24.960 --> 0:03:30.240 Upstate New York. But as Green describes, tuberculosis is far 0:03:30.400 --> 0:03:34.040 from a disease relegated to the past. Despite the fact 0:03:34.080 --> 0:03:38.000 that curative treatments for this disease have existed for decades, 0:03:38.400 --> 0:03:44.440 hence those sanatoriums being abandoned, tuberculosis remains a significant contributor 0:03:44.520 --> 0:03:48.920 to morbidity and mortality around the world. This is a 0:03:48.960 --> 0:03:54.760 disease caused by a microorganism, Mycobacterium tuberculosis, but it's also 0:03:55.200 --> 0:03:58.440 so much more than that. Over the centuries, people have 0:03:58.520 --> 0:04:03.160 ascribed various meanings to tuberculosis, each of which carries the 0:04:03.240 --> 0:04:08.200 significant burden of othering. It has been used to romanticize 0:04:08.200 --> 0:04:11.680 and stigmatize. It has changed the course of history in 0:04:11.920 --> 0:04:16.320 untold ways, and it stands today as a deadly consequence 0:04:16.800 --> 0:04:19.640 of how the global health care decisions that are driven 0:04:19.680 --> 0:04:24.640 by profit lead to unnecessary death and suffering for millions 0:04:24.680 --> 0:04:29.039 of people around the world. Through his heartfelt and incisive writing, 0:04:29.279 --> 0:04:34.000 Green demonstrates the human cost of tuberculosis and how intervention 0:04:34.400 --> 0:04:39.599 is not only possible but necessary. It was an absolutely 0:04:39.680 --> 0:04:42.680 surreal delight to get to chat with John, and I 0:04:42.720 --> 0:04:46.080 am very excited to share our conversation with you all, 0:04:46.240 --> 0:05:13.960 So let's get right to it after this short break. John, 0:05:14.080 --> 0:05:16.279 thank you so much for joining me today. I really 0:05:16.360 --> 0:05:18.320 can't tell you what a thrill it is to get 0:05:18.360 --> 0:05:19.040 to chat with you. 0:05:19.320 --> 0:05:21.000 Oh well, thank you, Erin. It's great to be here. 0:05:21.040 --> 0:05:22.000 I'm a fan of the pod. 0:05:22.440 --> 0:05:26.920 That is so thrilling. That absolutely made my day. So 0:05:27.279 --> 0:05:30.440 usually I start off these book club episodes by asking 0:05:30.480 --> 0:05:33.159 someone how did you get the idea for this book 0:05:33.320 --> 0:05:36.120 or how did this book come to be? But today, 0:05:36.160 --> 0:05:39.600 with you, I'd love to begin by asking about Henry. 0:05:40.080 --> 0:05:42.960 Can you tell me how meeting Henry started you on 0:05:43.040 --> 0:05:44.760 this journey that led to this book. 0:05:45.320 --> 0:05:49.120 Sure, in twenty nineteen, I had no idea that tuberculosis 0:05:49.200 --> 0:05:51.960 is the world's deadliest infectious disease. I would have been 0:05:52.000 --> 0:05:55.159 stunned to hear that. I was visiting Sierra Leone with 0:05:55.200 --> 0:05:58.280 my wife, where we work with Partners in health on 0:05:58.320 --> 0:06:04.080 maternal mortality infant mortality in the Cono region, and on 0:06:04.120 --> 0:06:06.520 the last day of the trip, some of the doctors 0:06:06.560 --> 0:06:08.400 we were traveling with asked if we could go to 0:06:08.440 --> 0:06:13.240 a tuberculosis hospital, and I was like, tuberculosis hospital, that's 0:06:13.279 --> 0:06:15.520 still a thing, right. I hadn't listened to enough of 0:06:15.560 --> 0:06:18.760 the pod, so when we got to the hospital, I 0:06:18.839 --> 0:06:22.080 was immediately grabbed, like physically grabbed by the shirt by 0:06:22.279 --> 0:06:24.760 a boy whose name was Henry, which is also my 0:06:24.839 --> 0:06:26.920 son's name. And this boy appeared to be about the 0:06:26.960 --> 0:06:29.119 same age as my son, who was nine at the time, 0:06:30.000 --> 0:06:33.520 and this boy started walking me around the hospital. Most 0:06:33.520 --> 0:06:37.440 sier Leonians are multi lingual, but Henry spoke particularly good 0:06:37.480 --> 0:06:40.839 English for a young child, and so I was able 0:06:40.880 --> 0:06:43.920 to kind of talk with him and enjoy the conversation 0:06:44.000 --> 0:06:45.720 with him. And he took me to the lab where 0:06:46.080 --> 0:06:48.159 he showed me a microscope and told me to look 0:06:48.200 --> 0:06:52.560 for TB bacteria in the microscope. He took me around 0:06:52.600 --> 0:06:55.080 the wards, he took me to the kitchen where the 0:06:55.080 --> 0:06:57.000 food was being made, and then eventually we made our 0:06:57.040 --> 0:06:59.840 way back to the entrance of the hospital where the 0:07:00.000 --> 0:07:02.200 doctors were meeting, and one of the nurses sort of 0:07:02.240 --> 0:07:05.960 lovingly showed him away, and I was like, whose kid 0:07:06.000 --> 0:07:08.120 is that? Is that like a doctor's kid, and they 0:07:08.160 --> 0:07:10.000 were like, no, that's one of the patients we're really 0:07:10.000 --> 0:07:12.760 worried about. And it turned out he wasn't nine years old, 0:07:12.840 --> 0:07:17.880 he was seventeen. He'd just been so emaciated, stunted by 0:07:18.200 --> 0:07:23.960 mountnourishment and then emaciated, further emaciated by tuberculosis. And it 0:07:24.040 --> 0:07:27.800 was really through meeting Henry and knowing Henry that I 0:07:27.840 --> 0:07:30.760 came to be interested in tuberculosis. I came home after 0:07:30.800 --> 0:07:34.600 that trip and just started reading voraciously about the disease, 0:07:34.640 --> 0:07:37.480 trying to understand how there'd been this massive hole in 0:07:37.520 --> 0:07:39.240 my understanding of the world around me. 0:07:39.960 --> 0:07:44.240 Yeah, it is. You know, there's this statistic that you 0:07:44.320 --> 0:07:46.280 say early on in your book about one hundred and 0:07:46.360 --> 0:07:49.800 fifty million people having died since we've had a cure 0:07:49.840 --> 0:07:53.320 for tuberculosis, and that's just been like circulating and echoing 0:07:53.360 --> 0:07:55.120 in my head over and over again, and I pull 0:07:55.200 --> 0:07:58.040 people aside and I'm like, did you know this? And 0:07:58.120 --> 0:08:00.280 I feel like it is so it's such a stark 0:08:00.320 --> 0:08:02.960 statistic because it really cuts to this core question of 0:08:03.040 --> 0:08:07.320 like how did we allow this to happen? And later 0:08:07.360 --> 0:08:09.200 in our conversation, I do want to touch on more 0:08:09.200 --> 0:08:12.560 of like the details of that, but like, broadly speaking, 0:08:12.640 --> 0:08:15.080 can you kind of take me through what are some 0:08:15.160 --> 0:08:17.840 of the major drivers in allowing that number to grow 0:08:17.960 --> 0:08:18.960 every single year? 0:08:19.920 --> 0:08:24.800 Yeah, I think the biggest driver is choice, human choice. 0:08:24.960 --> 0:08:28.440 We have chosen to live in a world with tuberculosis. 0:08:28.440 --> 0:08:30.480 We've chosen to live in a world where in countries 0:08:30.520 --> 0:08:33.680 like Germany or the US or Australia, TB is very rare, 0:08:33.720 --> 0:08:36.920 and in countries like sier Leone or even middle income 0:08:36.960 --> 0:08:39.920 countries like India and the Philippines, TV is very common. 0:08:41.120 --> 0:08:44.760 And some of that is because TV is difficult to cure. 0:08:45.040 --> 0:08:47.280 You know, it takes four to six months of daily 0:08:47.320 --> 0:08:50.680 antibiotics with the newest regimens it used to take even longer, 0:08:51.520 --> 0:08:53.960 and so it's it's a hard disease to cure. But 0:08:54.120 --> 0:08:57.080 my brother had Hodgkin lymphoma a couple of years ago, 0:08:57.360 --> 0:08:59.640 which is also a hard disease to cure, but curable, 0:09:00.280 --> 0:09:02.079 and there was no question as to whether or not 0:09:02.160 --> 0:09:04.440 he would receive treatment, or whether or not we would 0:09:04.480 --> 0:09:08.240 do a good job of getting him treatment. Doctor Peter Mugeny, 0:09:08.320 --> 0:09:12.559 this great Ugandan physician, said in two thousand of HIV drugs, 0:09:12.800 --> 0:09:15.560 which were still not getting to where they were most 0:09:15.600 --> 0:09:18.280 needed at the time, he said, where the drugs, the 0:09:18.360 --> 0:09:20.640 drugs are where the disease is not, and where is 0:09:20.640 --> 0:09:22.800 the disease the disease is where the drugs are not. 0:09:23.520 --> 0:09:26.000 And that's very much still the case with tuberculosis. 0:09:26.400 --> 0:09:30.560 Yeah, absolutely, And you know, I want to kind of 0:09:30.559 --> 0:09:34.160 circle back to the current present and then the potential 0:09:34.200 --> 0:09:37.240 future in a bit, but let's take a step back 0:09:37.280 --> 0:09:39.800 and look at the deep history of tuberculosis. I mean, 0:09:39.840 --> 0:09:43.239 this is a disease that has been with humans for millennia, 0:09:43.920 --> 0:09:47.840 and yet, as with many other infectious diseases, it is 0:09:47.960 --> 0:09:52.040 rarely acknowledged outside of you know, specific disease history books, 0:09:52.080 --> 0:09:55.760 you know on influenza or on cholera, as like this 0:09:55.920 --> 0:09:59.920 major force that is shaping historical events. I've wondered this 0:10:00.120 --> 0:10:02.320 so much, like why is that? Why do we not 0:10:02.559 --> 0:10:06.319 consider the role of an infectious disease in shaping history? 0:10:07.080 --> 0:10:09.400 Well, I think it's a great mystery. But in the book, 0:10:09.440 --> 0:10:11.240 I argue that one of the reasons we do is 0:10:11.280 --> 0:10:14.400 that we're so biased toward human agency. We love a 0:10:14.440 --> 0:10:17.360 story where humans are in control, and we love a 0:10:17.360 --> 0:10:21.080 story where humans make choices rather than have those choices 0:10:21.120 --> 0:10:25.120 made for them by micro organisms or viruses. Like that's 0:10:25.120 --> 0:10:28.559 an uncomfortable thing to live with. So I speculate in 0:10:28.600 --> 0:10:31.560 the book that maybe the reason we continue to spread 0:10:31.600 --> 0:10:34.040 the rumor that Alexander the Great died by poisoning when 0:10:34.040 --> 0:10:36.880 he almost certainly died of malaria or typhoid, is that 0:10:36.920 --> 0:10:39.000 we just don't want to reckon with a world where 0:10:39.360 --> 0:10:42.360 where the most powerful person on earth can be killed 0:10:42.400 --> 0:10:45.520 by a tiny bacteria or virus. 0:10:45.960 --> 0:10:48.040 Let's take a quick break, and when we get back, 0:10:48.120 --> 0:11:08.960 there's still so much to discuss. Welcome back everyone. I've 0:11:08.960 --> 0:11:12.080 been chatting with John Green about his latest book, Everything 0:11:12.200 --> 0:11:16.200 Is Tuberculosis. Let's get back into things. I mean, especially 0:11:16.240 --> 0:11:19.680 when you're when examining wars and the history of wars, 0:11:19.760 --> 0:11:23.320 like generals aren't acting in isolation, and neither are the 0:11:23.360 --> 0:11:27.320 diseases that are spreading throughout the entire military or through 0:11:27.400 --> 0:11:31.160 war torn regions. You can't look at these diseases or 0:11:31.200 --> 0:11:34.760 these factors leading to disease individually, which is a point 0:11:34.800 --> 0:11:36.760 that you bring up in your book, that we can't 0:11:36.800 --> 0:11:41.400 look even at tuberculosis through these narrow lenses. That being said, 0:11:42.040 --> 0:11:45.520 I'd love to ask you about a few specific influences 0:11:45.559 --> 0:11:49.559 that tuberculosis has had throughout history, especially on the granting 0:11:49.600 --> 0:11:53.080 of statehood and early twentieth century global politics. 0:11:53.760 --> 0:11:56.840 Sure, I mean it's very unlikely New Mexico would have 0:11:56.840 --> 0:11:58.719 become a state, or at least become a state when 0:11:58.760 --> 0:12:02.600 it did, without tuberculos, because New Mexico had all the 0:12:02.600 --> 0:12:06.880 institutions needed for statehood, and it wanted statehood, but Congress 0:12:06.920 --> 0:12:10.160 repeatedly rejected it because it had such a large Spanish 0:12:10.200 --> 0:12:17.520 speaking population, for just reasons of outright racism, and also 0:12:17.559 --> 0:12:21.520 because it had a large population of indigenous people. And 0:12:21.600 --> 0:12:24.200 so New Mexico realized that in order to become a state, 0:12:24.200 --> 0:12:27.040 it needed to attract more white residents. And the way 0:12:27.080 --> 0:12:30.000 that it did that was making itself sort of a 0:12:30.000 --> 0:12:33.680 advertising itself as a great place for people with consumption 0:12:33.880 --> 0:12:37.040 to come and recover. Had the dry air, it had 0:12:37.040 --> 0:12:40.400 the sunshine, and at the time we believed that sunshine 0:12:40.720 --> 0:12:43.880 and dry air would sort of heal the wet lungs 0:12:43.960 --> 0:12:48.040 of consumption. And so by I think by nineteen hundred, 0:12:48.160 --> 0:12:51.400 about ten percent of all people living in New Mexico 0:12:51.520 --> 0:12:56.760 were tuberculosis patients, and there were enough of them that 0:12:56.920 --> 0:13:01.400 Congress eventually acknowledged that New Mexico should become a state 0:13:01.400 --> 0:13:04.240 in accordance with its desires, and that's how, or one 0:13:04.280 --> 0:13:06.120 of the reasons why New Mexico became a state in 0:13:06.120 --> 0:13:09.040 the first place. Then you have something like World War One. 0:13:10.240 --> 0:13:13.720 You know, I think you're so right that every war 0:13:13.800 --> 0:13:16.600 is shaped by disease. The Franco Prussian War was shaped 0:13:16.640 --> 0:13:18.880 in part by the fact that one side had access 0:13:18.920 --> 0:13:21.840 to antiseptics and the other side didn't, and so, you know, 0:13:22.160 --> 0:13:27.480 injuries that were utterly unsurvivable five years earlier were suddenly survivable. 0:13:28.800 --> 0:13:32.240 But with TB in particular, I'm fascinated by the role 0:13:32.280 --> 0:13:36.280 that TV played in World War One because all three 0:13:36.320 --> 0:13:41.000 of the assassins who sort of semi succeeded in killing 0:13:41.000 --> 0:13:44.320 the Archduke Frans Ferdinand, knew that they were dying of consumption. 0:13:44.520 --> 0:13:46.839 They were all quite sick, and they knew that they 0:13:46.840 --> 0:13:49.199 were dying, and they wanted to die for a great cause, 0:13:49.240 --> 0:13:52.760 as young people often do. And they thought this great 0:13:52.800 --> 0:13:56.719 cause was the nationalism of their community being able to 0:13:56.760 --> 0:14:00.080 be a nation independent of the Austro Hungarian Empire. And 0:14:00.080 --> 0:14:03.000 that's why they assassinated the Archduke Franz Ferdinand. All three 0:14:03.040 --> 0:14:06.640 of those boys, they were nineteen, and I think all 0:14:06.640 --> 0:14:09.079 three of them were nineteen died within a couple of 0:14:09.160 --> 0:14:12.880 years of tuberculosis after assassinating the Archduke. 0:14:13.800 --> 0:14:16.360 That is wild to think about that this disease could 0:14:16.400 --> 0:14:20.880 have such far reaching consequences, and I'd love to hear 0:14:21.000 --> 0:14:24.760 more about one of these consequences slightly less extreme than 0:14:24.800 --> 0:14:28.280 a World war maybe, And that is why we may 0:14:28.360 --> 0:14:31.920 have tuberculosis to think or blame, depending on who you 0:14:31.960 --> 0:14:33.680 ask for the cowboy hat. 0:14:34.000 --> 0:14:36.920 Oh yeah, no, that's an interesting one. So this young 0:14:37.000 --> 0:14:39.760 hat maker was living in New Jersey, his name was John, 0:14:40.560 --> 0:14:44.560 and he got TB and was told that his only 0:14:44.640 --> 0:14:47.840 chance of survival was to head west, which young people 0:14:47.880 --> 0:14:51.480 were often told, especially young men who got consumption, and 0:14:51.560 --> 0:14:54.240 so he headed west. He only made it as far 0:14:54.240 --> 0:14:57.160 as Saint Joseph's, Missouri, which might be the most humid, 0:14:57.520 --> 0:15:02.520 least dry airplace I've ever been and personally, but nonetheless 0:15:02.600 --> 0:15:05.520 that's where he ended up. And while he was there 0:15:05.320 --> 0:15:08.000 he recovered. So about twenty five percent of people, for 0:15:08.080 --> 0:15:12.760 reasons we still don't really understand, recover spontaneously from tuberculosis. 0:15:13.800 --> 0:15:15.840 One of the things that made it such a difficult 0:15:15.880 --> 0:15:20.760 disease to deal with societally was its unpredictable and is 0:15:20.880 --> 0:15:25.400 its unpredictable course? And so John recovered and as he 0:15:25.480 --> 0:15:28.000 recovered this hat, this young hat maker noticed that the 0:15:28.040 --> 0:15:30.000 hats in the West weren't very good. There were the 0:15:30.080 --> 0:15:34.480 kind of coonskin caps that were bug infested and gross, 0:15:34.520 --> 0:15:38.120 and then there were straw hats that folk from Mexico 0:15:38.160 --> 0:15:41.720 and Texas had brought up to Missouri, but those didn't 0:15:41.720 --> 0:15:45.120 hold up particularly well in the rain. And so eventually 0:15:45.240 --> 0:15:48.320 John B. Stetson invented what we now know is the 0:15:48.320 --> 0:15:49.760 stetson or the cowboy hat. 0:15:50.320 --> 0:15:53.240 It's amazing that that final reveal of like and then 0:15:53.400 --> 0:15:56.560 Stetson was his last name. Yeah, it's really good. Also, 0:15:56.600 --> 0:15:59.640 it's just it's so funny that like, it was just 0:15:59.720 --> 0:16:02.160 all of these different factors combining. I mean, it's what 0:16:02.200 --> 0:16:04.480 I love about history and how we can make these 0:16:04.520 --> 0:16:09.840 different connections. But yeah, so humans have long given different 0:16:09.960 --> 0:16:12.640 meanings to disease in part to you know, make sense 0:16:12.680 --> 0:16:15.280 of the world, to answer why me or why them? 0:16:15.560 --> 0:16:18.600 And that meaning seems like it varies a lot depending 0:16:18.600 --> 0:16:21.920 on how the disease is transmitted, who's affected, or what 0:16:21.960 --> 0:16:25.360 the disease looks like like on the outside, something like 0:16:25.520 --> 0:16:29.480 plague compared to tuberculosis, for instance, And for a long 0:16:29.480 --> 0:16:34.280 period of time, tuberculosis, as you discussed, was romanticized. Why 0:16:34.440 --> 0:16:36.920 was such a devastating disease seen this way? 0:16:37.600 --> 0:16:39.440 Well, I think you make a really good point that 0:16:39.520 --> 0:16:41.920 part of it is the outward appearance of the disease, 0:16:42.000 --> 0:16:46.000 right like Mycobacterium, tuberculosis is very closely related to the 0:16:46.040 --> 0:16:49.760 bacteria that causes leprosy, and leprosy, of course, is perceived 0:16:49.880 --> 0:16:53.000 very differently because it's seen as a disfiguring disease rather 0:16:53.080 --> 0:16:56.640 than as an ennobling one, although at times leprosy has 0:16:56.640 --> 0:16:59.560 also been seen as ennobling because of its connection to Jesus, 0:16:59.600 --> 0:17:06.040 at least in the Christian world. But with TV, everybody 0:17:06.600 --> 0:17:12.360 started to get it. In the late eighteenth century in England, 0:17:13.119 --> 0:17:16.960 about a third of all people who died died of tuberculosis. 0:17:17.480 --> 0:17:19.520 About a third of all death was caused by TV. 0:17:19.720 --> 0:17:21.200 It's a staggering statistic. 0:17:21.400 --> 0:17:25.080 Staggering, I mean, it was completely overwhelming. One writer referred 0:17:25.080 --> 0:17:28.399 to it as the frightful tuberculization of humanity and it 0:17:28.480 --> 0:17:32.000 was terrifying. Yeah, And so how do you make sense 0:17:32.040 --> 0:17:35.080 of a disease that, as Charles Dickens put it, wealth 0:17:35.160 --> 0:17:38.360 never warded off. A disease that you can't easily stigmatize, 0:17:38.400 --> 0:17:42.200 a disease that doesn't just affect poor people or marginalized people. 0:17:42.240 --> 0:17:44.240 I mean, the richest guy of the nineteenth century died 0:17:44.240 --> 0:17:47.000 of tuberculosis. How do you make sense of that disease? 0:17:47.040 --> 0:17:48.680 And I think one of the ways we made sense 0:17:48.720 --> 0:17:51.280 of it was through stigma, and another way we made 0:17:51.320 --> 0:17:53.639 sense of it was through romanticization. And it's easy to 0:17:53.680 --> 0:17:58.280 think of those things as opposites. One dehumanizes someone, one 0:17:58.480 --> 0:18:00.639 argues that someone is sort of like more more than human, 0:18:00.760 --> 0:18:03.280 more beautiful than is possible if you're a regular human. 0:18:03.680 --> 0:18:07.240 But they're really alternate ways of othering the sick, you know, 0:18:07.480 --> 0:18:10.760 just kind of creating a world where the sick exists 0:18:10.800 --> 0:18:13.840 that isn't the so called normal world or the healthy 0:18:13.880 --> 0:18:18.159 world or whatever. And the romanticization of tuberculosis was so 0:18:18.359 --> 0:18:21.320 intense in Northern Europe and the United States that it's 0:18:21.359 --> 0:18:25.040 really hard to overstate. It was really really weird. Looking 0:18:25.080 --> 0:18:28.880 back on it, it feels weird to us. Men were said 0:18:28.920 --> 0:18:33.399 to become geniuses because they had tuberculosis. I think I 0:18:33.440 --> 0:18:36.399 write in the book about when Shelley found out that 0:18:36.480 --> 0:18:39.000 Keats had tuberculosis. He was like, well, you know, this 0:18:39.200 --> 0:18:41.560 is a disease that affects people who write good verses 0:18:41.560 --> 0:18:44.400 as you have done, which I think is especially funny 0:18:44.640 --> 0:18:48.560 or sad or whatever it is, because Shelley also had tuberculosis, 0:18:48.960 --> 0:18:51.040 and so he was kind of like patting himself on 0:18:51.080 --> 0:18:55.040 the back, even if he was complimenting Shohn Keiths. But 0:18:55.119 --> 0:18:57.280 also like for women, it was seen as this disease 0:18:57.320 --> 0:18:59.359 that made you really beautiful, you know, it made you 0:18:59.480 --> 0:19:02.560 very pale, and whiteness of the skin was really kind 0:19:02.560 --> 0:19:05.080 of worshiped at the time. It gave you rosy cheeks, 0:19:05.119 --> 0:19:08.160 and so people would use rouge to try to affect 0:19:08.200 --> 0:19:14.240 the same outcome as tuberculosis. It gave you big sunken eyes, 0:19:14.960 --> 0:19:17.480 and so people would apply belladonna to their eyelids to 0:19:17.520 --> 0:19:23.840 make their pupils look appropriately tubercular. And I think all 0:19:23.920 --> 0:19:27.679 of this was an attempt to make sense of the crisis, 0:19:28.160 --> 0:19:31.359 an attempt to just deal in some way with the 0:19:31.400 --> 0:19:35.280 fact that an overwhelming number of people were dying young. 0:19:36.000 --> 0:19:40.520 The words like tubercular and tuberculized, tubercular, what is it tuberculization. 0:19:41.800 --> 0:19:47.360 It's what other infectious diseases have so many derivative words 0:19:47.840 --> 0:19:51.280 developed from them. It's remarkable. And you know, I think 0:19:51.640 --> 0:19:54.920 this again, these statistics that you bring up one third 0:19:55.520 --> 0:19:58.240 of everyone you know dying of tuberculos or who died 0:19:58.280 --> 0:20:02.480 died of tuberculosis. This is so it's so fascinating because 0:20:02.920 --> 0:20:07.040 in contrast with other infectious diseases during that time, you know, 0:20:07.240 --> 0:20:11.160 in the pre antibiotic, pre an acceptive, pre vaccine era, 0:20:11.920 --> 0:20:15.000 they the spread was so different too, you know, plague 0:20:15.119 --> 0:20:17.960 tour through a community caller, a tour through a community, typhus, 0:20:18.000 --> 0:20:20.920 all these things, and to some degree or another, maybe 0:20:20.960 --> 0:20:23.919 they weren't quite as what does Dick and say, they 0:20:23.920 --> 0:20:27.560 weren't quite as wealth never warded off. But at the 0:20:27.600 --> 0:20:30.200 same time, like, how do you think that that played 0:20:30.200 --> 0:20:34.439 a role the way that tuberculosis spread so insidiously in 0:20:34.480 --> 0:20:34.840 a way. 0:20:35.440 --> 0:20:37.119 Yeah, and this is a really I think that's a 0:20:37.200 --> 0:20:41.560 really important point. Tuberculosis was almost universally in Northern Europe 0:20:41.560 --> 0:20:44.600 believed to be inherited, and so it was seen as 0:20:44.600 --> 0:20:48.120 a hereditary disease that ran in families, and that as 0:20:48.160 --> 0:20:51.720 such also came with certain other personality traits the way 0:20:51.800 --> 0:20:54.119 that those are also passed down in families, and one 0:20:54.160 --> 0:20:58.119 of those personality traits, this was called spez tysika, I 0:20:58.119 --> 0:21:03.879 think the burular spirit. And one of these personality traits 0:21:03.880 --> 0:21:06.199 was that you were very sensitive, if you're a very 0:21:06.280 --> 0:21:09.320 deep thinker, you were attuned to the suffering in the world, 0:21:10.119 --> 0:21:12.919 and you were also quite quite beautiful and wispy. This 0:21:13.000 --> 0:21:17.480 idea that as the body shrank, the spirit grew was 0:21:17.600 --> 0:21:20.520 very powerful at the time. But because it was seen 0:21:20.560 --> 0:21:23.480 as hereditary, as opposed to a disease like cholera or 0:21:23.520 --> 0:21:26.399 typhus or plague that would just tear through a community, 0:21:26.760 --> 0:21:29.240 and even if it wasn't quite understood to be infectious, 0:21:29.240 --> 0:21:33.800 it was certainly understood to be something weird and not inherited. 0:21:34.400 --> 0:21:37.760 That changed the way that consumption was imagined in the 0:21:37.800 --> 0:21:40.240 eighteenth and nineteenth centuries, which is why it was such 0:21:40.240 --> 0:21:43.600 a big deal when Robert Coch discovered that tuberculosis was 0:21:43.640 --> 0:21:47.600 in fact caused by a bacteria like cholera, like anthrax, 0:21:47.760 --> 0:21:50.480 like the other diseases that were coming to be understood 0:21:50.480 --> 0:21:51.240 as infectious. 0:21:51.560 --> 0:21:53.639 I want to kind of get into that switch of 0:21:54.080 --> 0:21:57.640 what that medicalization of tuberculosis meant. But before I want 0:21:57.680 --> 0:22:01.480 to ask how we can see the effects of tuberculosis 0:22:01.520 --> 0:22:03.840 in the art and literature of the day. I know 0:22:03.880 --> 0:22:06.560 we've mentioned Dickens a couple of times, but it's everywhere 0:22:06.600 --> 0:22:08.840 else and Shelley and yeah. 0:22:08.359 --> 0:22:11.800 It's everywherewhere. It's everywhere, and not just in Western art. 0:22:11.800 --> 0:22:14.840 It's also I write a lot about the Japanese and 0:22:14.880 --> 0:22:18.359 Indian artists and poets who lived with tuberculosis. But in 0:22:18.640 --> 0:22:22.360 Northern Europe in the nineteenth century, because there was this 0:22:22.680 --> 0:22:28.640 romanticization of tuberculosis, there was also a romanticization that affected 0:22:28.760 --> 0:22:33.640 art and poetry. You see paintings by Toulouse Latrek, for instance, 0:22:34.400 --> 0:22:37.400 of a woman applying rice powder to her face and 0:22:37.440 --> 0:22:41.280 she's very pale. The great actor Eliza Poe, who was 0:22:41.400 --> 0:22:45.640 Edgar Allan Poe's mother, looked stereotypically tubercular and was sort 0:22:45.640 --> 0:22:49.439 of worshiped for her beauty. And you see it a 0:22:49.440 --> 0:22:53.000 lot in poetry. I mean, Keats writes about youth growing specter, 0:22:53.119 --> 0:22:56.560 thin and dying, which is of course precisely what happened 0:22:56.560 --> 0:22:58.760 to him when he was just twenty five years old. 0:22:59.000 --> 0:23:02.720 And so I think from poetry to visual art to theater. 0:23:03.480 --> 0:23:08.239 Tuberculosis played a huge role in shaping the both what 0:23:08.280 --> 0:23:13.120 we sort of thought of as beautiful but also what 0:23:13.160 --> 0:23:16.560 we thought of as very fragile. You know, at the time, 0:23:16.800 --> 0:23:21.440 we really associated beauty with a kind of fragility, of fleetingness, 0:23:21.480 --> 0:23:23.679 you know, that the idea that maybe you won't be 0:23:23.760 --> 0:23:25.720 in the world for very long, but you'll be very 0:23:25.760 --> 0:23:30.879 beautiful while you're here. Victor Hugo, I remember his friends 0:23:30.880 --> 0:23:32.760 would joke with him that he would become a great 0:23:32.800 --> 0:23:36.760 novelist if only he got tuberculosis. That's how much it 0:23:36.880 --> 0:23:39.840 was believed that this disease made you a great artist. 0:23:40.320 --> 0:23:43.240 The name consumption comes from the fact that, like it 0:23:43.800 --> 0:23:47.280 is a consuming disease, so how it's just it's fascinating 0:23:47.320 --> 0:23:49.320 to think about how that connection was made. How can 0:23:49.359 --> 0:23:53.920 you produce novels or plays or pieces of art while 0:23:53.960 --> 0:23:55.840 you are being consumed from the inside. 0:23:56.080 --> 0:23:59.280 I think that's exactly right. I mean, look, this romanticization 0:23:59.320 --> 0:24:02.240 of consumption, like the romanticization of mental illness today, or 0:24:02.240 --> 0:24:06.199 the romanticization of whatever diseases we romanticize or stigmatize, like 0:24:06.560 --> 0:24:09.520 it's all hooey. That's really important to note that, like 0:24:10.000 --> 0:24:16.840 dying of tuberculosis is horrible and really painful, and it's 0:24:16.880 --> 0:24:19.679 not nearly as romantic as it was made out to be. 0:24:19.960 --> 0:24:25.119 Yeah, this ever present threat of death from tuberculosis and 0:24:25.480 --> 0:24:28.520 everything else that was happening during in many industrialized regions 0:24:28.560 --> 0:24:32.600 of the world during the seventeen hundreds eighteen hundreds. I 0:24:32.680 --> 0:24:34.600 was thinking about this in the context of how people 0:24:34.680 --> 0:24:38.119