Good Morning, Hank, it’s Tuesday.

I’m not sure if I’ve previously mentioned this, but I’ve been reading a lot about Tuberculosis lately. Like I’ve read many journal articles and over twenty books and today I want to highlight for you, my favorite tuberculosis reads this far.

So when I talk about TB people get most excited about the historical stuff. Like, the fact that TB gave us the cowboy hat and the stethoscope and Pasadena, California and I do get why that stuff is fascinating, but I want to begin with a contemporary first-person account of tuberculosis published by a small press in 2020 because it reminds us that TB is not exclusively or even primarily historical. Stigmatized by Handa Enkh-Amgalan is a wonderful memoir about a young woman, growing up in an impoverished community in Mongolia.

Sorry I have to keep moving because the light is moving. So eventually Handa is diagnosed with tuberculosis which begins a completely different life from the one she thought she was going to have. A life of dehumanization and stigmatization.

It’s just a beautiful book and it’s not a spoiler to say that eventually the author gets a masters degree from New York University. The whole story is just astonishing. I loved it.

Secondly, I learned so much amazing history. Like, how Arthur Conan Doyle participated in TB research and how TB effected our ideas of vampires and so much more. From Phantom Plague by Vidya Krishnan.

It’s probably my favorite overall history of TB because it’s approachable and readable, but at the same time very rigorously researched. And then in the final section of Phantom Plague, Krishnan tells the story of Shreya Tripathi a teenager who was diagnosed with multi-drug resistant tuberculosis and had to sue her government in order to access treatment. She eventually won the lawsuit but it took so long to wind its way through the courts that the treatment arrived too late for her and she died of tuberculosis at the age of 19.

I recently learned that Shreya was actually a big fan of my book The Fault in Our Stars and reread it toward the end of her life and I just so wish I could have met her because she’s become one of my heroes and I’m really grateful to Phantom Plague for telling her story. Ok, the last TB writing I want to recommend is a paper written by another one of my heroes Dr. Paul Farmer called Social scientists and the new tuberculosis.

In this article he argues that we really can’t separate tuberculosis from the social conditions like poverty, and malnutrition and overcrowded housing that lead to tuberculosis. I mean, he tells the story of a Haitian teenager named Robert David who was diagnosed with tuberculosis and had to take a daily walk to be able to access his medications. But they didn’t have all of the right medications at that clinic so he eventually developed drug resistance and over the course of the next nine-years, continued to seek treatment.

Every way he could. But the system just couldn’t support him. And so, like Shreya, he died of tuberculosis.

But did he really die of tuberculosis? Or did he die from poverty and systems that simply do not act as if all human lives are equally valuable. It’s a brilliant paper and I highly recommend you read it but I can’t tell you exactly how to read it because the world of academic publishing is so fully labyrinthine that I couldn’t figure out a way to access this paper without paying 42 dollars which is a little absurd, so maybe somebody in comments will be able to help.

So, just to state the obvious Hank, we tend to solve the problems that we devote resources to. Like, between 1950 and 1961, many drugs were synthesized that could effectively treat tuberculosis. And then between 1961, which is around the time that TB stopped being a problem in rich countries, and 2012, no drugs were developed that can treat tuberculosis.

And so my last recommendation is to vote with global health in mind, to work to increase awareness of this profound injustice, and to donate if you can to Partners in Health or other organizations that are working to make TB what it should be, history. Hank, I’ll see you on Friday.