Everything Is Tuberculosis: Chapter 6 Summary & Analysis

Culturally, it’s normal to accept certain deaths as being “natural,” such as the deaths due to disease that make up 90% of global deaths, as well as deaths that happen in old age. These ideas are, of course, just a social construct; in centuries past, a good death was one occurring immediately after prayer. Thus, conceptions of death are not set in stone. This idea is strengthened by the fact that, before the evolution of modern medicine, death of children was very normal. Even prior to modern medicine, however, it was abnormal for those in their early 20s to die. TB was the outlier in this regard, as it commonly killed those in that age range. These deaths were understood as being unnatural, as the diseased stole life from those who were normally safe from death.

As humans, however, we have both a deep sense of curiosity and a need to arrive at a “comprehensible conclusion.” Even with something as meaningless as a disease, humans can’t help but try to give it meaning. The meanings humans give disease subsequently affect how we respond to it. TB was often stigmatized as people saw it because of demonic possession, immorality, or overeating, but this stigma was complicated by the fact that even well-respected individuals died of TB. This dissonance necessitated action, “if not about the disease, then at least about our imagining of it.” As a result, the 18th and 19th centuries brought about a romanticization of TB, and though this may be seen as more positive than stigmatization, it is just as responsible for making those with TB alienated from society.

This romanticization stemmed from the fact that TB was understood to be a disease of the lungs (though it can affect other organs), and since breath is largely connected to the ethereal spirit, TB also became a disease of the spirit. It was believed to connect artists with their spirits by shrinking their physical bodies. This understanding of TB also meant that the disease came with other inherited traits, such as melancholy and an understanding of life’s brevity. The connection between creativity and TB was so great that, when TB rates lessened at the turn of the 19th century, there was fear for the future of art and culture. This consumptive spirit was often known as spes phthisica, and belief in it continued into the 20th century.

Such romanticization of consumption is present in contemporary literature, such as in Charles Dickens’s Nicholas Nickleby and Harriet Beecher Stowe’s Uncle Tom’s Cabin. In these works, consumptives were described as “loving, trustful, happy, soothing, bright, [and] mild.” Some artists found this romanticization to be ridiculous, but they couldn’t shift the cultural understanding of TB. John Keats, one of the most famous victims of TB, wrote about his experiences with the illness. After his body was autopsied, doctors discovered that his lungs were entirely gone; as one physician explained, death from TB is agonizing, a stark contrast from the romantic imagining of it. Outside Europe, similar fates faced young artists, such as Indian poet Sukanta Bhattacharya whose condition was worsened by the Bengal famine. Japanese poet Masaoka Shiki also wrote about his experience with TB, though he never romanticized it, instead presenting the simple and devastating truth of the illness.