Our take on John Green's hit book "Everything is Tuberculosis". Is it just another white saviour story?
Book report! What Daniella & MJ liked and didn't like about John Green's newest book, "Everything is Tuberculosis".
Written in the age of COVID, does he address the thing TB is known for: airborne disease transmission? Can he separate himself from tired old tropes of white saviourism in Africa? Do we think the book does enough to challenge the systems producing inequity in the first place?
Hit play and our opinions will be revealed!
Another crossover episode edited by MJ of Everything is Public Health.
RESOURCES
(Note/Correction: Daniella quotes a sentence from the book that says "Inuit people" but this is redundant as Inuit means "the people" in Inuktitut therefore should have only said "Inuit".)
MJ: Welcome back to Public Health Media Club. I'm MJ.
Daniella: I'm Daniella.
MJ: We picked a book this time we're trying to mix it up. You know, every episode is a different media. We're trying to mix it up. We picked a book this time, and I wanna know how you came across this book, because I know exactly when I heard of this book.
Hmm.
Daniella: Because
MJ: I'm a big fan of the author.
Daniella: Oh, okay.
MJ: How did you come across this book?
Daniella: I live in… maybe like three years behind pop culture. So I don't know who this person is, and I just saw the book when I was in my local bookstore. Shout out to Iron Dog books. It's an Indigenous-owned bookstore in my neighborhood.
MJ: Shout out.
Daniella: I was in there looking for a different book. And then I saw everything is tuberculosis and I was like, “interesting”. Relevant to my interests. Yes. So I picked it up and it was actually a signed copy and I was like, who is this person? Okay, I'll give it a shot. And then after I bought it, I couldn't escape it.
Like I saw it all over the internet, people are talking about it, how great it was. And so I was like, good thing I picked that up. I'll give it a read.
MJ: So you did buy it?
Daniella: I did. Yeah,
MJ: that's, I mean, maybe we shouldn't talk about like bookstore behavior because my behavior at a bookstore is like totally opposite,
Daniella: Really?
MJ: If I come across a book that I like, I will take a picture and I'll go home, do a bunch of research about the book, and then if I like it, then I'll go back to buy it. Almost never pick up a book on a whim.
Daniella: Oh, wow. Well, bookstores are dangerous for me because I'm like, Ooh, I want this and this and this. And then it's like, where did my paycheck go?
MJ: Are you the type where you go into a bookstore looking for one book and you leave with five?
Daniella: Yeah. Yeah.
MJ: I know exactly
Daniella: Look behind me (laughing)
MJ: (laughing) uh, listeners. Uh, she's sitting in front of a stacked bookshelf. Anyway,
Daniella: How did you come across the book?
MJ: I'm a fan of John Green. How much do you know?
Daniella: Uh, well, pretty much nothing.
MJ: So John and Hank Green. Are a pair of brothers and they are YouTube elders, YouTube royalty. They are on YouTube in the early days and they have done genuinely, in my opinion, a lot of good stuff on the internet and for the community. They are like the good people of the internet. There's a lot of problematic people on the internet.
They are the few people that are generally trying to do good. And Hank Green is very famous for starting scishow, which is like an online free online educational YouTube channel that was very popular when I was in school. And John Green is an author. John Green is the author of Most Famously, the Fault in Our Stars, which did get turned into a movie as well as a bunch of other things: Paper Town. Turtles all the way down. A few others, but pretty established author.
Daniella: I've definitely heard of these things.
MJ: And he and his brother generally are good people. They are online personalities. Hank Green is a vertical video sensation. He does a lot of TikTok. He's very big on TikTok. I have a positive image of them going into this.
And then John Green, I want to say six months before he said he was gonna publish this book, started talking about tuberculosis exclusively on his socials. Mm-hmm. And. I have a feeling that it's probably coordinated, probably, right? I don't know about these things, so it's probably coordinated, like he probably had an idea for this book.
And then he's also probably just genuinely learning a bunch about tuberculosis at that moment. So. For a period of a few months, his entire socials was talking about tuberculosis, and then after that he announced that he was writing this book and then he was gonna publish it. And that's how I came across it.
Like he was promoting it on his platform amply before the book was even out. And he led a big initiative trying to get Johnson and Johnson to lower the price of Rifampin or one of the TB drugs that is very important to curing TB. But Johnson & Johnson being Johnson & Johnson said, actually, we're gonna keep the cost as high as we can because big pharma, et cetera, et cetera.
Daniella: That's what pharmaceutical companies do. Yes.
MJ: Correct. So I have a pretty positive image going into this. Like, I like John Green. I was part of his campaign against Johnson and Johnson as it was happening.
Daniella: Oh, what did you… how were you involved?
MJ: Oh, no, I just knew about it, like I followed it live.
Is what I meant.
Daniella: Oh, I see. Okay.
MJ: And they got Johnson and Johnson to back down, like Johnson Johnson agreed to reduce price and generics and allowing generics to compete in certain markets, not all markets. Uh, it was a partial concession because again, it's Johnson and Johnson, one of the biggest pharmaceutical companies.
So that's how I came across it. So when it came out. I was like, oh, I should probably should read it. I should probably buy it. And I also can relate, after it was published, you could not escape it. The positive reviews were everywhere.
Daniella: Mm-hmm.
MJ: Online and stuff. So that's how I came across it.
Daniella: So I guess the next question is, what did you, or what do you expect when you read it?
MJ: Here's the prediction section of this show. I expect him to probably talk about the history of TB, probably talk about the current state of tb. And because I followed his TB, social media, I don't know, campaign, he's probably gonna talk about the stuff that he mentioned on social media already about how it's like a disease of inequity, which is true.
He's probably gonna go into that. I do think there might be a potential problem with the optics, because, how do I put this? Um, there is a history of. White people, particularly white men, who tries to save Africans.
Daniella: Oh, as an African, I'm very well aware.
MJ: Yeah. And I'm hoping it doesn't happen.
Daniella: Well, yes, that is exactly what I anticipate from this actually.
Like after picking it up and not having yet read it. I did see like a lot of conversation and so I did kind of look up who this person was generally
MJ: and what did you learn
Daniella: My immediate thought was, oh no, here goes another white guy off to save Africa.
MJ: Yeah,
Daniella: As I flipped through. Yeah. I was like, oh, this is giving Me to We. Do you know what that is?
MJ: No. What is that?
Daniella: Oh, okay. Canada lore! So Me to We, is this…I believe it has folded… It was this extremely successful gathering of young people through high schools to come together and support, I don't know, other children in other parts of the world. So the person who started it, his name is Craig Kielburger, and he was like a 12-year-old, you know, prodigy,
MJ: 12-year-old! Oh, okay. Interesting.
Daniella: Yeah, like many, many years ago. And was this… everybody was bending over backwards to be in awe of this child who was trying to help other children around the world.
MJ: That's not good for a child to get that level of attention, but continue.
Daniella: And then he grew up and he and his brother started this Me to We sort of social… What’d they call it? “Social enterprise”, I guess.
MJ: Movement.
Daniella: Yeah. And it was huge. They would fill stadiums of high school students
MJ: Dang, that's a red flag
Daniella: coming in. And it was very culty.
MJ: Yeah, sure.
Daniella: Actually, CANADALAND, before that fell off into its own spiral of chaos
MJ: Sure.
Daniella: But CANADALAND had an excellent series called The White Saviors I think. I think you'd actually really like it.
MJ: Oh, okay. I'm definitely gonna listen.
Daniella: It's the whole story of the Kielburgers’ fall from grace and, yeah. Fascinating. Anyway, this book is giving “Me to We, I go to Kenya, build a school come back and think that I have saved the world.”
MJ: I see.
Daniella: It made me think a lot about that and I was like, Ooh, interesting. I wonder how this is gonna play out.
MJ: Okay. I love how we both have our respective blind spots because John Green is very big in my immediate circle and also big in America. But you didn't know. And I have no idea about this. Me to We stuff. This is deep Canada lore that I really should be aware of.
Daniella: I think you're gonna enjoy hearing about how messed up that got. Yeah. I remember writing a paper about it actually when I was in, I think my first year of university being like all of this volunteerism is awful. I'm a hater. Been a hater my whole life.
MJ: And you wrote it before their downfall?
Daniella: Yes. I continue to be a hater.
MJ: Prophet. You're a prophet. Yeah. When you were describing it, there was a few red flags already, just from your very short description. If you're filling stadiums with high school students. Something's just not right. 'cause high school students are not supposed to be that cohesive. You know what I mean?
Daniella: Yeah. Like I said: cult.
MJ: Yeah, A little bit culty. Okay. So it seems like both of us have similar concerns about this book. I'm really hoping that it doesn't go that route like this will be an interesting one because we're going into this piece of media from a different perspective. This will be the first time that we might fight on the show, it'll be fun to listen to, but I am going in optimistically because I have a positive impression of John Green. And you're going in…
Daniella: As a hater?
MJ: Yeah, as a hater. So it'll be an interesting conversation. But you're right. We've seen this many times.
We've seen this with malaria.
Daniella: Mm-hmm.
MJ: People building schools in Africa. Right. It's a thing.
Daniella: It's a trope. Yeah.
MJ: It's a trope
Daniella: And it's tired and ignores a lot of the systemic issues. And often there will be a disease that becomes some celebrity’s pet disease.
MJ: Yes. I hope it doesn't go down that route. I think John Green is like genuinely like a good person in theory.
Daniella: Okay. I say “a hater”. I just mean that I feel like we could do so much better in so many ways when it comes to public health, and that's why I am hypercritical. Sure. Understanding how that system works and then seeing all of these, like white kids decide that they're gonna go and fix Africa is really interesting.
MJ: Yeah. That's a perennial problem.
Daniella: Mm-hmm.
MJ: Well, I truly don't know. We're about to find out.
Daniella: Yeah, let's go.
MJ: Let's see whose prediction is right for listeners. It'll be a few seconds, but for us it will be a few weeks and we will see you in a bit
Daniella: on the flip side,
MJ: And we're back. How are we feeling?
Daniella: Good. I think despite the state of the world.
MJ: Oh, I wasn't talking about the world. Oh, come on. Like we are acutely aware of how terrible the state of the world is. I was specifically referring to the book.
Daniella: Oh, the book. You know. Alright.
MJ: That's my impression as well. It's alright.
Daniella: Yeah.
MJ: I am kind of torn. I like some parts of the book. And I think it does a few things pretty well. John Green, I mean, you didn't know him ahead of time, but I did. And he's a very popular author in America. Like he knows how to write. He is a writer, and that does come through in the book. There is of course, an elephant in the room that we have to address, which we won't get to in a bit.
But I think overall, if this book is about the history of TB and bring awareness to the issue, I think it did that. What do you think
Daniella: Overall? Yeah, you're right. He is a good writer. Like it was easy to read. It was interesting. There were all these fascinating little vignettes. About things that I didn't know, like the cowboy hat and how TB was involved in that.
Yeah. Overall it was Okay. I feel like one of the things that really stuck out to me was just how recently he said he learned about TB five years before he was writing this. Pretty much. Yeah. Which was also like, okay. Yeah. Many people have been doing this for a very long time.
MJ: Decades upon decades.
Daniella: Like, welcome.
MJ: Yeah. I know how you feel about that, and we have to save it for later. Let's talk about the things that we like about the book. First, let's get the pleasantries out of the way, and then we can really hit hard at the elephant in the room, of which there are multiple, but there's one big one and two small ones.
What I like about the book. I think in terms of going over the general history of tb, also a little bit of the scientific history behind TB and the cultural impact of TB. I think the book did a pretty good job with that. True to its title, everything is tuberculosis. It really did show how this disease had a significant cultural impact about how people behave, like parts of history, like why?
Certain things are a certain way, like the long dresses, dresses used to go to the floor, but then people were afraid of TB. So dresses were made shorter so that it doesn't go to the floor anymore amongst a bunch of other things. So I think that aspect of the book, I thought it was pretty good.
Daniella: Yeah, I agree. I really liked all of the different angles he took on TB. Like I think it could very easily have been kind of a boring science book that wasn't that appealing to people. But I think bringing in the cultural elements and things that I hadn't really thought of too much, like even the, um, the way that TB was romanticized and seemed to only affect poets of a certain intelligence and sensitive disposition.
MJ: Disposition.
Daniella: Exactly. And how yeah, that just has influenced so much culture, even like body image, beauty standards, especially in the West. All of them sort of wasting away that being seen as desirable, like things that I hadn't really thought about too much. So yeah, that was interesting.
MJ: Generally my favorite part of the book, and this theme was present throughout, I think the first two thirds of the book. My favorite part of the book was his discussion of how humans have this tendency to give meaning to things that really don't deserve any meaning. And so one of the quotes that I found that I thought was really resonated with me was the following quote, I forgot what page is on quote “Framing illness as even involving morality seems to me a mistake because of course, cancer does not give a shit about whether you are a good person. Biology has no moral compass. It does not punish the evil and reward the good. It doesn't even know about evil and good” end quote. He brought this back up multiple times throughout the discussion, throughout the history.
They were trying so hard to give in, meaning that they even affected beauty standards like tuberculosis chic was a thing.
Daniella: Mm-hmm.
MJ: Women are supposed to be skinny and frail and white. They were trying everything they could to justify it because otherwise. Kind of scary. Diseases are scary. I like that part. I think that part of the book, that message I really resonated with, and I can't help but to connect this with COVID.
Daniella: Oh, you said it before me! You said it before me!
MJ: (laughs) Well, I didn't realize we were taking the over and under about this, but. It's hard not to because this book was published during COVID.
Essentially this happened with COVID too. Like so many people try to give COVID meaning, and that was a huge mistake. COVID should not have, meaning COVID is an infectious disease, and public health should be, should be just a scientific thing about here's an infectious disease that's spreading. Here are the things that we need to do to contain this infectious disease.
MJ: There shouldn't be any meaning above. This is a rapidly spreading infectious disease. However, that wasn't the case. People try to give COVID meaning, and I'm sure you have a lot to say about this too.
Daniella: Yeah. I think as a book published in the age of COVID, the ongoing age of COVID, did that come up even once in the book?
MJ: I don't think so. Okay. We have to talk about what we like first. We gotta save this for the second half. We'll come back to this, I promise.
Daniella: Um, then I have nothing to say. Okay.
MJ: It is curious that a book published in the age of COVID doesn't really mention COVID. I think. Maybe once if that, but I have no recollection of him talking about COVID at all.
I think the COVID parallels are very evident, right? During COVID, people are like, why are you forcing us to wear masks? It's an infringement on our freedom, right? They try to give COVID meaning,
Daniella: What do you mean? During COVID?
MJ: I guess now too. But yeah, I thought that was a very good point that the book made humans continuously try to give disease meaning always to disastrous results.
Uh, as the case with. TB as the case with Ebola, as the case with AIDS, as the case with COVID.
Daniella: Yeah. But I definitely say that there are parallels there and the ways that COVID came to mean things to people or trying to prevent COVID or not prevent COVID also came to mean things and just became almost like a political shorthand
MJ: to the detriment of millions of people.
Daniella: Exactly. Yeah. One thing I wrote down that I liked was how he connected it to his family first and placed TB and the history of TB so firmly in the United States as well, instead of the thing that often happens, which again will be a lot of our conversation about things we didn't like. But the thing that often happens that diseases are like that are things that happen over there to those people that, and it doesn't affect me.
So I liked that in the beginning he did place it in his own family and talk about how that has rippled outwards for him. So yeah, one thing I liked.
MJ: That's definitely a good point. He also was very conscious about highlighting the global inequity issue with this disease, right? He's like this disease ravaged America and Europe for like centuries upon centuries, upon centuries, but because that's where all the money is.
When treatments start to came about, obviously America and Europe got treated and then this sort of fade into the background and he was very conscious of like highlighting this inequity, which I also think was a positive. This is a massive global health inequity issue that a lot of people in the west don't talk about because this is not a disease that, or I guess I don't know, with the current landscape, with the CDC, maybe TB will be back again.
In North America, who knows? Mm-hmm. And measles is back.
Daniella: Measles is back. TB is on the rise as well. There was a salon article that my podcast was, we got to add a little bit to just about how it is rising. Mm-hmm. And in the book, he specifically makes the. Clear connection that we've known for decades about the interplay and comorbidity of HIV and TB and how damage to the immune system because most people have been exposed to tb.
MJ: It's that prevalent. Yeah. Yeah.
Daniella: It's dormant for most people until something like HIV shows up and like damages the immune system for HIV that can obviously be very serious if it's untreated. And so TB has a chance basically to like show up and like cause these horrific deaths. Yeah. I just really wonder, again, writing something like this in the age of COVID where we know that COVID also causes immune dysregulation and that it's basically been left to run rampant.
I really do wonder whether this rise in TB is connected to that, at least partially, and also just the ridiculous cost of living people being forced into situations of poverty, which we know is where TB thrives.
MJ: Yeah, I do think the rise in TB probably has more to do with just the breakdown of public health in general than the actual COVID infection.
But you're right, like public health sort of let COVID run rampant. We're seeing the long-term effects of that, which is higher levels of infractions of other disease because of what COVID does to the body. Who knew? It turns out a lot of people knew, but didn't matter
Daniella: who wanted to know, maybe, is a better question.
MJ: We're laughing, but we're also crying.
Daniella: Yeah.
MJ: Anyway, last quote that I'll bring up, this is, I think towards the end of the book when he was sort of doing his call to action parts, he said, quote. But of course people are not just economic productivity, we do not exist primarily to be plugged into cost benefit analysis, end quote.
And I thought that was a good line. I thought that message was very clear towards the end of the book, and I do think that's a good message. I think unfortunately, during the current administration of public health, hence your show, public health is dead. There's so much. Way too much like economist brain thinking than like public health thinking of like, it's okay.
It's just the old and immunocompromised. They're just a fraction of the population, which is a horrible way to think. But if you study economics long enough, am I going too hard on economists?
Daniella: I don't think so. I mean. People's lives get ascribed a value in this system, and that's really sad.
MJ: Yeah.Economists, sorry, not sorry. Now I do think cost effectiveness is an important concept, but it needs to be long term. Mm. So not immediate, like what is the cost effectiveness of this in two months? In the scope of public health, when you think about cost effectiveness, it needs to be on the scale of like decades.
Daniella: Absolutely. And we're not doing that.
MJ: Yeah. For example, you could think of what's the cost effectiveness of letting TB be a continuing issue in this country. If you extend the scale to decades, then let's talk about cost effectiveness, because in my opinion, and I'm sure if you run the calculation that it was supported, the cost of letting a disease like TB or COVID or any sort of disease continue to exist.
It's probably really bad. It's probably way more productive for your country as a whole. If you eradicate measles. If you eradicate COVID, or if you eradicate TB instead of just like next year, how much of the economy will tank because we implement a few public health policies like mandatory vaccination, hence why public health is dead.
Any other thoughts about positives about this book?
Daniella: There was another quote that I pulled out that maybe will lead us into the next section.
MJ: Oh, go for it
Daniella: This was from when he was talking to a pastor who was helping, I think he was doing like a traineeship as a chaplain in a hospital. But anyway, the quote that he shares from the pastor is that “death is natural. Children dying is natural. None of us actually wants to live in a natural world.”
Daniella: I think that was so key, and I really also appreciated how much emphasis he put on vaccinations and childhood vaccinations as such a key part of public health.
MJ: Absolutely.
Daniella: And all of this sort of idea that natural is better and like drink raw milk and unpasteurized this and that.There's this idea that that's better somehow or natural is better but
MJ: It’s not
Daniella: But that's also so incredibly dangerous that people just because they don't know, quote unquote, what's in vaccines, then that means they're dangerous. Well, no, your child being exposed to all of these pathogens before the age of five is what's dangerous.
They'll probably die. That's what happened throughout most of human history. Yeah, so I appreciated that point. He actually drove home a few times in the book.
MJ: Yes. The pro-vaccine message was very loud and clear. And I also love that quote, humans spent thousands of years trying to escape the natural world for a very obvious reason. That is the natural world is very dangerous to be in, and we're seeing a complete regression on that, which is awful. And the book does have this point, which I think is very lovely for this book to have, which is good. Yeah. Okay.
So. It's not a bad book. It's certainly better than the things that we did the first two episodes of Public Health Media Club on.
Daniella: I think so, yeah.
MJ: But let's talk about what we don't like about it.
Do you want to start? Okay. She's about to go off guys.
Daniella: Not entirely. Well, related to. To the COVID thing. He does say “airborne” on like page five of the book. Yeah.
MJ: Three times I think. Yeah.
Daniella: Just like a few times throughout the book he sprinkles, sprinkles it through and mentions masks once I think on page 10 and then never again.
I think what is so interesting, again, this book being written at the time it was
Speaker 3: Age of COVID
Daniella:. Yeah. Just so little discussion about airborne transmission and what that means and especially like when it comes to TB. TB is like the most–besides measles, the most well known airborne disease, and there's been a lot of study into that and a lot of like conversations about it. Some which have misinformed public health for a while.
MJ: Yeah. Unfortunately the record is not the greatest on that.
Daniella: Yeah. Just thinking that one of our episodes, something's in the air is kind of all about that mix up of the size of TB particles.
MJ: Go check it out. Great episode.
Daniella: That misunderstanding, I think has influenced a lot of our ongoing misunderstanding and reluctance to act on airborne transmission. So that was one thing I didn't like. I think he could have really contextualized it in the COVID era and didn't, and I think that's a missed opportunity for making these connections that he could have and made the case for public health even stronger in his book.
MJ: I have three main critiques about this book. Three elephants, if you will.
Daniella: Mm-hmm.
MJ: That was one of the elephants. The weird lack of mention about the infectious mechanism of TB. He talks a lot about like what happens after you get TB, which is important to talk about for sure. But yeah, a surprising lack of mention about the spread of TB, the mechanism, and also a surprising lack of mention about how to prevent TB.
There's a lot of talk about treatments. Yeah, a lot of talk about drugs. A lot of talk about the current drug dosing regime, the debate with that. In the nineties, not a lot of talk about prevention, which I thought was curious. One of the weaknesses he could have contextualized this because we live, unfortunately in the COVID era, he could have spent, I wanna say maybe 25 to 40 pages talking about here are all the ways that we could prevent TB from spreading. And sort of provide some, maybe some cultural context or historical context, like do some storytelling, which he's very good at doing. But yeah, it almost seems like for him, the story of TB starts when someone gets TB
Daniella: Yeah.
MJ: I thought that was a flaw.
Daniella: Yeah. And I wonder. I wonder if he did. I know there are lots of different powerful players in publishing world. Like I wonder whether there were conversations about that
MJ: If it was cut?
Daniella: Yeah, I don't know.
MJ: Could be.
Daniella: But yeah, I would love to know more about that process because it does seem like quite a glaring thing to leave out.And I wonder if maybe we were not living in the COVID era. There may have been more focus on it because it does have implications about, well, if we can recognize that with TB, why can we not recognize this with the other thing that's flying around our faces, you know?
MJ: Yeah. The only possible explanation that I have for the lack of mention about TB prevention and TB transmission is TB is unique.
In that it's a very slow infection. It's not like, uh, for example, COVID, where you get it, trajectory of the disease will start very quickly. TB is sometimes dormant, sometimes people get it and they don't realize they have it. Some people are completely asymptomatic throughout their entire life.
Daniella: Yeah,
MJ: it doesn't have that neat classic epidemiological disease progression curve. But I don't know. I feel like you could still talk about it, like how does the slow nature of TB affect prevention measures?
Daniella: Exactly.
MJ: I don't know. I thought it was a big missed opportunity to not talk about this, and maybe, who knows, maybe it was cut from the book.
Daniella: Maybe!
MJ: The next critique that I have is the other elephant in the room, if you will.
There is a weird lack of discussion about. Systematic and structural issues, like you talked about it a little bit, but there's this quote that I really love from a book that I forgot the name and title of, so, excuse me, but it's Africa is not underdeveloped, it's over-exploited.
Daniella: Mm-hmm.
MJ: Perfect quote to encapsulate the effects of colonialization.Why are poor countries poor? Because they're over exploited. They're not underdeveloped. And I would've loved it if he spent a few pages addressing that large scale systematic problem, because with issues like TB or HIV or any sort of these like global health inequity issues, if we just keep drip feeding resources like, oh, here's a little bit of drugs for you.
Oh, here's a little bit of money to help you do x. It's not gonna get anywhere. And I would've loved it if he just like straight up said, yeah, like the entire thing needs to be overhauled, because that's just the effects of colonialization. And then all of the richer, wealthier nations have a moral duty to essentially do reparations.
But at a nation scale, here's all the investment that you would have gotten had we not taken this away from you over the last century. But also I'm like, it's a big topic. And I could see how in a book about the history of TB, you probably don't want to dedicate like 50 page about the effects of neoliberalism.
So I could see why he didn't put it in there. Yeah. But it was a suspicious lack of just fundamental structural issues with, again, over exploited countries in Africa.
Daniella: Yeah. You're making me think of, uh, Walter Rodney's book, How Europe Underdeveloped Africa, and yeah, you're right. I also feel like that's been my frustration with public health as a field and studying it in the sort of academic sense for so long has been: it stops. The ceiling is at social determinants of health, and we can only talk about things like poverty, housing, food security. But when you start talking about how capitalism and the system that we operate in, no one wants to talk about things. Then that's too much.
That's, no, we can't talk about that. And I think that's been my ongoing frustration with public health as a field is, for many people who just like work institutionally and work within systems that already exist, I think it's so hard to do what the field purports that it will do without addressing the neoliberal….
MJ: You kind of can't. You have to address them.
Daniella: And I think maybe that's by design. If we're gonna build up a field of people working within this system and so like connected to government, that does not work for a lot of people for public health to be talking about that. So that's why I've always sort of felt on the outside of public health and really appreciate epidemiologists who are in the more critical stream, critiquing the way that public health is framed, how we do research, how we talk about race in public health.
MJ:Mm.
Daniella: And so many other researchers and black like critical public health scholars also talk about these things. And yeah, I've been like, yes, they exist! But for most of my education. Everything is sort of just stopped at social determinants of health. That's the end. We can't talk about anything else.
MJ: Yeah. I also have that feeling as well. They get so close, they're like, oh yeah, poverty is a huge determinant of why someone is sick and we should address poverty and we should like do things to alleviate poverty or fix poverty.And they never asked the next question of like Why does poverty exist in the first place?
Daniella: (laughs) You can't go that far upstream,
MJ: And that was also the issue with this book, but I understand that a 50 page digression on neoliberalism just wouldn't fit in this book, so I get it. Okay. What's something else that you didn't like about the book?
Daniella: Let me flip through my pages. One of the things that I appreciated was how he consistently tried to avoid doing the thing that so many people do, where they. Go to some country in Africa and have these sad World Vision-esque stories about crying African children and the plight they face and then, you know, go home and it's over. Boohoo, I cried. He did try to sort of foreground the histories of colonization.
MJ: Mm-hmm.
Daniella: And how that has influenced disease transmission and harmed communities for a long time. He did seem to have built a relationship with Henry who's the kid sort of central to the story and seems that that's an ongoing relationship.So that I found was kind of different from the typical sort of helicopter fly in, fly out, white savior story.
Speaker 3: Yes.
Daniella: However, in trying so hard –not because of trying so hard, he tried to avoid it, but I think you cannot avoid the fact that you are a white man going to Sierra Leone learning about this disease a few years ago and then deciding you're the person to write this book about everything is tuberculosis, and that definitely, I don't know, tracks with white people kind of discovering, quote unquote, something that people have been fighting for a long time.
MJ: Mm-hmm.
Daniella: Dealing with for a long time. And it seems like he is relatively self-aware, but also positioning yourself as an expert in some way on this, to me, felt interesting. Even if he was kind of reversing some of the tropes a bit, they were still there. You still went to Africa, found a little black kid and like made a bunch of money on a book. You know, even if you did it differently, that still happened.
MJ: Yeah, that was one of my critiques about this book as well. You can tell that he tried.
Daniella: Mm-hmm.
MJ: You can tell that he really tried to not do that. To be fair, if I was in his position, I don't know if I would've done a better job not falling into that. I wouldn't know what to do. And to his credit, he recognized that he was in that position and he tried to do something about it. I don't think he was super successful. He got like halfway there maybe. Would you say that's about…
Daniella: Maybe I just, I don't think you can extract yourself from that historical narrative though. Yeah. As a white man going into Africa, I don't think you can, like you can do everything, but that is still your position in a colonial world.
MJ: I'm trying to come up with a better phrase of saying this, but like I am glad that he tried.
Daniella: Yeah. It was refreshing. To have an expectation that this was going to be another one of these…
MJ: classic white man go to Africa book. Right? Yeah.
Daniella: And then it was like still kind of that, but still different. And I did appreciate that he also, instead of like using Henry entirely as a prop, highlighted him as a three dimensional person and shared his writing, like Henry has a memoir. I would love to read that memoir. I don't know if I like needed to read this book, but that would be a book that I would really love to read.
MJ: After I read this book, I had a long and hard internal reflection about what is the difference between helping and saving.
Daniella: Mm-hmm.
MJ: The white savior trope is alive and well still to this day, and. I think the best analogy that I could come up with, how do you help someone without falling into that trope of like white savior? I think the difference between helping and saving is whether you recognize the person's agency and whether you respect them.
Daniella: Mm-hmm.
MJ: For example, I don't know if this is a good analogy. If someone falls in front of you, do you reach out? Your hand to help them up. Here's my hand. Take my hand, I'll pull you up. Or do you scoop them up? Princess style, then twirl you around
Daniella: while someone's taking a video for Instagram.
MJ: And I don't know whether John Green was able to navigate that line. What do you think?
Daniella: I think you're right that there's definitely an element of agency and like ensuring that the people that you are quote unquote, helping actually. Want to be quote unquote helped or just need, I don't know, some money that's been pillaged outta Africa to like do it themselves, you know?
Speaker 3: Yeah.
Daniella: So I think agency is key, right? It's hard. I don't know. I think… thinking about what could have been different, I don't know. I think he was trying to use his position. I didn't know who he was, but you do, and a lot of other people do to bring attention to an issue and maybe if that was what he intended to do, this was.
A way to do it. I don't know. I'm just thinking of options. Like maybe Henry's memoir could have been published with a foreword by this guy, or you know. And then Henry got a bunch of money to like share his story about tuberculosis and maybe that would be a way to use your platform. But as a writer, I guess maybe if your plan is to write about this, maybe that's not an option for you. I don't know.
MJ: Yeah. I don't have the answer to this situation. I think he tried, and I'm glad he tried, but I don't think he got there. Nor do I know how he could have gotten there, to be perfectly honest. But I pulled out a quote.
That did make me cringe a little bit, quote, “and here in Shia saying Polo to me from across the great divide. But she is also saying Marco, she is also telling me to hear her voice and answer her call. People often ask me why I'm obsessed with tuberculosis. I'm a novelist, not a historian of medicine.TB is rare where I live. It doesn't affect me, and that is all true. But I hear Shia and I hear Henry and so many others calling to me, Marco. Marco, Marco.”
And I'm like, Hmm. Did that quote stand out to you when you read it?
Daniella: I cannot remember that quote.
MJ: It's towards the end.
Daniella: But from you just saying that I felt like there were some religious undertones, obviously to his…
MJ: John Green is religious.
Daniella: …to his framing of things sometimes. That made me think of that as well. Okay.
MJ: It's not just me, right? Like
Daniella: calling feels very religious. I don't know. I did
MJ: pick up a few of those undertones, like in quotes like this when he's like, they were calling out to me, Marco, Marco, Marco, and I'm like. I don't know, man.
I feel like they were calling out to me. You know the Pope saying, God is telling me something. I don't know like that.
Daniella: Yeah.
MJ: Is this just me? Maybe it's just me. I didn't read too much into this
Daniella: No, that's some weird parts where I was like, eh, eh…
MJ: Yeah.
Daniella: A lot of colonialism was justified by “God told me to”,
MJ: like they were calling out to me.
Daniella: Yeah.
MJ: Did you have a particular place where you're like, this didn't really work?
Daniella: Mm, I'm just looking at my notes here. I did have one piece that I was confused about because I've seen pictures of him at his book signings where he is clearly like in spaces with a ton of people. I mean, we've talked about like the lack of conversations about transmission and airborne nature of diseases, but he also says in the book that he has.
Anxiety, particularly related to microbes and germs and like illnesses. And what was very interesting to me was how he's written a book about an airborne disease, has all these book sightings in the COVID era. Nobody is masked. He also in the book, talks about this weird relationship humans have with diseases where they like to be in control and they don't want to be controlled by infectious things. And I just, all of these things together made me really confused. I was like, well, your mental health has to do with germs. You've said that very plainly, but only some germs. Is COVID denialism stronger than like experiences with that? Like how is this compartmentalized to justify showing up in crowds where a lot of people are sick and not trying to like mitigate that?I was just confused by that. I don't understand how you separate that in your mind.
MJ: Yeah, I fully get your point. But also like people are weird. Like people are irrational and I think both of us are fully aware of how irrational people can be. So to some degree I'm like yeah, there's probably some cognitive dissonance there, right?
It's a very common psychological effect. He wrote a book about tuberculosis, says he is a microbe phobe and doesn't wear a mask at crowds. Honestly, of all the news I've read this week, this doesn't even crack like top 20 cognitive dissonance moments, you know?
Daniella: Okay. Yeah.
MJ: But I do get it. Like you would think an author of everything is tuberculosis would be a little bit more conscious about disease transmission, but you don't see that, or at least we don't see it in the media that he puts out to us. We haven't met him in person. Maybe he's very different in person.
Daniella: Mm-hmm.
MJ: Maybe he does wear a mask and he just takes it off for photos. Who knows? We don't have that person to person connection with him, but I get it.It is confusing. I fully agree with you. It's kind of weird.
Daniella: Yeah. One more thing. I appreciated him bringing up Canadian history and how that's connected to TB where for many Indigenous peoples across what we know as North America disease has been used as a tool. Colonization, whether it was intentional or not…
MJ: A weapon almost.
Daniella: Yeah. People have described it as biological warfare.
MJ: Yeah. Practically
Daniella: like smallpox, wiping out tons of Indigenous peoples. The history of Canada is so intertwined with tuberculosis and I, I did appreciate that he brought that up in the book too, that children who were stolen from their homes and their families were put into residential schools,
MJ: quote unquote schools, right?
Daniella: Quote unquote. And there were some numbers that he put in there that 8% of the children who were in those schools every year. Died from tuberculosis, like many of them never made it home. These are thousands and thousands of children who were taken to these institutions.
MJ: Kidnapped
Daniella: yeah, by a colonial government with the intent to like separate families, break bonds, colonize this land and tuberculosis has been such a long part of that.
And then TB sanatoria in Canada also kind of morphed into, because so many Indigenous people were getting TB from the impacts of colonization sort of morphed into quote unquote Indian hospitals, which is what they were called at the time, which was like completely segregated healthcare. People were in horrific conditions.The Canadian Medical Association actually last year had to apologize. They apologized for their history of treating Indigenous people awfully
MJ: in 2024.
Daniella: Yeah, right. And many people are like Okay, thanks. But that doesn't bring people back.
MJ:Can you give us reparations?
Daniella: Right. So I just wanted to say I did appreciate that because I think that's a not very well understood history in Canada and it's ongoing. Like Inuit, people in the north, some outrageous, I think it's like 400 times more likely to contract TV than white Canadians. And so yeah, it's ongoing too.
MJ: Absolutely. Again, this book isn't bad. I think this book overall is good and it does bring awareness to these pockets of history that people may not be aware about. I guess we'll shift to the last part of the episode, which is we are public health media club. What is the effect of this piece of media? And I do think overall, this book is a net positive. It does highlight those parts of history. He does talk about colonialization. I especially love the part where he talked about the racism of medicine.
Daniella: Mm-hmm.
MJ: Of like. Oh, Black people, they're too stupid to get TB. And then when they started to cure tb, they're like, oh, no, no. Only Black people can get TB because they're stupid as Yes.
Daniella: Yeah. Right. Like there was, he did point out the hypocrisy and the moving of the goalposts to make white supremacy work.
MJ: Yes, because white supremacists, they have to constantly do mental gymnastics to justify their ideology because their ideology is inherently flawed.
I think my overall conclusion of this book is if he just wrote this book as a book about the history of TB, I think this will be a great book. It's the, I went to Africa and I saw this stuff, like if that part wasn't in the book. I would enjoy this book a lot more. Do you know what I mean?
Daniella: Yeah. There were parts where I was like, please, why are we doing this?
MJ: Yeah.
Daniella: But there was so much interesting, I don't know, interesting stories, things I had no idea about, especially when it came to North America. Like there's a piece about how New Mexico became a state.
MJ: Yes, New Mexico was a sanatorium state
Daniella: Yeah, I didn't know that. That was very interesting.
MJ: Why talk about your experience as a relatively wealthy white person who visited Sierra Leone. Why bring that into it?
Daniella: You're right. It would've been a very interesting book. Without that, actually,
MJ: I think it would be the stronger book because then we don't have to think about, oh, is he tiptoeing the line between white savior and actually helping?
Then that elephant would not be in the room if he just wrote a book about the history of tv. I mean, he could talk about his experience of like. Oh, I learned about this because of my trip to Africa. And then he just had like a brief mention of it. I think that's fine. But he is overtly trying to play the game,
Daniella: placing himself in it?
MJ: Yeah. He is trying to play the, these people need our help game. And I'm glad he tried to not do that, but he did not get there. And I think that detractor from the book a lot. Hmm. The fact that he could not get there and to be fair, I don't know how he could have gotten there. Yeah. I just thought the book would've been fine if it was just a history book.
Daniella: Yeah, like it literally could have been, you don't need to change the cover. You don't need to change anything except extract yourself from it. Yeah. Interesting. I'm gonna say something, but we should probably cut it. I'm like, he just really wanted to show everyone he had a Black friend.
MJ: I'm so glad he brought this up because as a non-Black person, I don't want to be the person that brought this up. It does have the. I have a Black friend in Africa, undertone. I'm so glad you brought it up. This is staying in for sure.
Daniella: Do you have a number for it? On our scale?
MJ: Our scale that starts at negative one and goes to negative 10. I think this is a relatively minor offense compared to the first two that we did.
Daniella: Yeah,
MJ: I would say. Maybe negative one or negative two. This would be a great book if he just took himself out of it.
Daniella: Yeah, I would pretty much say the same thing. I really enjoyed reading it besides the only parts where I was like, ah,
MJ: don't. talk. about .
Daniella: were the places he inserted himself, where I don't think it was entirely necessary actually at all.
MJ: No, I don't think it was.
Daniella: So overall, I think if it's doing the job of getting people who would not otherwise think about or care about TB to think about and care about TB, I think you're right. Net positive. Why, why
MJ: are you in this book? You know? Like, I think this is a great book with an extra side plot that didn't need to be there.
Daniella: Yeah.
MJ: Um, final thoughts? Uh,
Daniella: I think I've, we've kind of covered it. I don't know if I have any final thoughts.
MJ: All right. In that case. Thank you so much for listening.
Daniella: Thank you for listening. This was awesome. I'm glad I made it through a book. I didn't expect to have a book so soon on our list, but you get to choose what's next.
MJ: I will and we will announce it when the next episode drop.
Daniella: Thanks everyone.
MJ: Thank you so much for listening.
Daniella: Bye.