ah you're probably sick maybe bleed about it ew are poor people worth making medicine for no what i'm going to disagree with you and John Green it gives you a sense of urgency to create that's enough of that so what book we doing today everything is tuberculosis thanks for holding it up totally did not stay up all night rushing a homework assignment or anything like that what page did you start at i was like about a third of the way last night took 3 hours that's it i guess that's how how long it took me to get through the bulk of the book it's not that long and it's really well written so it's really easy to read kudos to John Green oh and we should like talk about our background i have a neuroscience PhD used to work in the biotech and pharma industry and I am also a certified chaplain which John Green is awesome i was sick once that's my qualification to talk about tuberculosis i really like this idea that everything is X it's not just everything is tuberculosis everybody kind of has their own everything is X if you're like really into something you kind of see it in different parts of the world do you have something like that some sex of s sect cs sex there was this idea of interdependence being the root of everything you know everything is one and one is everything we are the cosmos i guess is a theme of the book in that sense we are part of everything i don't know if I buy that obviously everything is related in the sense that we have the pieces but if somebody says everything is interconnected it's implied that that is significant i do believe everything is significant i don't why because actually let me ask this a different way do you think everything is equally significant the ban of which things are significant is much more narrow for me compared to you do you say that in the sense that there's like a floor of everything is at least this significant or a ceiling that there's a max significance there is a much higher minimum threshold of significance and also there is a more flat threshold of significance got it so that could be the root of all of our frustrations with each other oh yeah maybe this is it it's time to answer the question is everything tuberculosis deep inside this book he actually has a whole disclaimer about how you cannot make this claim which I think is super nice cuz a lot of these pop science books don't disclaim against themselves however it's in the middle of the book and you watch his content he's produced to advertise the book it kind of contradicts itself because of course to make the hook you have to make it sound like everything is tuberculosis my everything is X is everything is Harvard or Ivy League ew i know this isn't a I think this is how it should be i grew up outside of this bubble of golden passport privilege got to it after the army and once I got there I learned all of the little dog whistles that people use to like communicate to other privileged wealthy people that they're wealthy without being rude in public conversation and now whenever I hear a company announcement or I see something in the news or hear something where I'm like ooh that smells like McKenzie speak in like a public statement I'm like okay let me do some digging and more often than not find the little LinkedIn of VP of whatever and it's a but doesn't it come back down to everything as relationships like rich people beget rich people because they are friends with each other i think that is minimizing what is actually happening it's not just a function of oh they know the person there institutionally the recruiting processes for all these companies feed from these places and that's not as simple as like oh I know the person there i'm going to call there there is a yearly schedule of making sure that this thing continues to happen i'm going to disagree with you and John Green i do think everything's tuberculosis oh yeah tell me more if you take it literally of course it's wrong duh that's not fun that's not why we're on the internet if we want literal stuff just go read a book or something that's what I did one thing that I didn't realize is most people across most time didn't even have a fraction of modern medicine he uses a very good narrative building device take a normal doc doctor's office and subtract everything that wasn't around before 1815 or whatever the stethoscope didn't exist the little hammer that hits your knee didn't exist all of these things that we use as the baseline to figure out medical treatment like your your arm pressure cuff just didn't exist and so medicine before then was basically just like ah you're probably sick maybe bleed about it tuberculosis was a disease that kind of took over humanity because it was an outlier disease in the sense that it didn't happen that fast for the most part you took a long time to die from it so more people experienced tuberculosis for longer culturally that means it's a disease that hurts you over time so you can sit and reflect within this disease and if you're like an artist type or a writer type you can write about it and other people can see you experiencing this thing and so by virtue of the physical properties of this disease it entered the cultural consciousness in a way that a lot of other illness doesn't cuz a lot of other illness just that's like severe just kills you and so you can't really write about it other people can write about you dying but that's like not the same thing as the person that's sick is communicating their story well they romanticized it and said that well it sucks that you have TB but you are a great artist and creative which in a practical way made sense because you know it's going to kill you much sooner right so you better get all your creative stuff out of the way now gives you a sense of urgency to create i highly recommend this book again Kristen I would recommend this book for anyone who wants to read something that's science related because the ability to weave factual things and a story narrative arc and getting you to care about someone is really a testament to the fact that he's a fantastic fiction author to make that super concrete he explicitly uses the narrative device of this person who is sicken that you are immediately sympathetic with it raises the question of is this person going to die or not and that is the thing that carries you through the entire narrative arc of the book while he talks about the history of tuberculosis he uses this patient's journey as a way to anchor the evolution of the process of identifying uh treating and ultimately deciding how to leverage treatments uh for sick TB patients in terms of the craft of writing it is kind of a masterclass in how you would ground a non-fiction potentially kind of dry book in exciting narrative what is your personal relationship to tuberculosis i think I wrote a report on it in like sixth grade i'm going to show you my scar i don't know what that is is that like a vaccine yes so in the book he does talk about a vaccine that's often given to kids in like developing countries i can tell right away that someone didn't grow up in the US is if they have the same scar for us it's a very formative thing that all kids remember and we will compare scar size and be like "Suck yours is humongous." I was born in Germany and then grew up in the US i don't have that scar my closest parallel is in the army i got all my vaccines twice because they lost my records i had to get the anthrax vaccine that was pretty painful v we'll get to those questions it's a book about the interconnection between agency and luck it's a story of people that had things happen to them getting tuberculosis in a in a world where there was no cure or anything like that and then people in that world deciding that they were going to do something about it a lot of them not even career medical folks but you connect it with people that now live in a world where they have the poor fortune to be born into a place where they can still get this disease which is eminently curable if the right logistical supply chain and benevolence happens and there's people with varying levels of agency that they choose to have and that they are privileged to have deciding how to use it across these various contexts and I think that's really interesting as far as a book discussion goes there's a lot of things that are going right for this book to be an interesting and compelling and useful uh piece of literature cuz medical stuff is a microcosm of life mhm you know what I mean we like medical stuff because it inherently comes with stakes and a lot of things in our life don't really come with stakes beyond is this person going to be upset with me but if you deal with a life or death situation it's a life or death situation and there's inherently more drama in that and so we care about it more and obviously it could affect us uh actually v's question about uh systemic inequalities in the choices we make does the narrative fit the science science is doing a lot of lifting in that sentence there's very clear differences between countries that had different colonial histories gdp is one measure of that john Green makes a really compelling case about infrastructure development in Sierra Leone being oriented around extracting resources from the country that's really enlightening to me the short version all of the railroads and transportation infrastructure of Sierra Leone and a lot of other formerly colonized countries they were oriented around getting resources out of the country where other areas of the world they oriented their public transportation around making it easier to move within that space and making the country itself like a stronger entity and if everything is oriented around resources leaving the country and then the people that are extracting it leave well guess what the only thing that that country is set up to be successful at is by further depleting its resources and moving them out of the country as opposed to any of the other things like US leading in innovation and drug development like they can't just start doing that because there's hundreds of years of history that make that uniquely possible in places like the US for now systemic inequality is one piece of a larger picture but like John Green does have an example of success to to show that if you solve for inequality it it turns into a virtuous cycle i think I like the fact that there was already an actual positive case study it's not just like naive optimism like we've done it before we can do it again i went to Harvard Business School i'll tell you straight up the discussion are poor people worth making medicine for because they can't pay you enough happens explicitly does the math follow that sometimes not always sometimes there's communities with needs that the quantity of people that pay for it it ends up being a lucrative thing the existence of that conversation would freak a lot of people out it's so interesting you phrase it that way because it reminds me of the whole creator fremium model that the Green Brothers actually use they have put out a lot of free content whole idea of the model which they've explicitly said before is like worth money give more than it helps everyone else get a share of the content and I feel like it's the same here frankly in the US we pay a lot more for the same drug this like differential is often times what's theoretically funding a lot of research the John Green argument is they did end up dropping the price and things are still okay to be clear they dropped the price because people lobbyed and got put public pressure on them to drop the price they didn't just decide to yeah yeah yeah exactly which I think is a perfectly legit market dynamics issue yeah are you sure it's not terrorism well you were a researcher during your PhD what are your thoughts on US subsidizing research for the rest of the world that's like a altruistic reason and a practical reason right like if you are the first to invent something you get to make the most money from it so they weren't doing it just to help the rest of the world but that fundamentally is what happens i benefited from that right my research was funded by NIH grants i'm very thankful for the opportunity i just think that if governments understand like how much money you can actually make through research then they would be much more willing to fund that it's a very asymmetrical bet to do research because most things just don't pan out but when you do it does it's almost like venture capital in some way the ability to continue to fund that is really important lot of this book also mentions other characters besides Henry doctors and healthcare providers this gets into the idea of meaningful work what do you consider as meaningful work i'm discovering my definition of meaningful work i've had bits and pieces of it throughout my life in high school I worked at a Steak and Shake as a waiter i found that to be some parts meaningful in the sense that I learned a lot about the world that I didn't know beforehand additionally I made a good you know 150 200 bucks which as like a you know 16 17-year-old that filled up my car for a month my definition of meaningful with that it was pretty fulfilled as I got older I spent time in the military i got a deep sense of I'm doing a good thing because that's kind of what's inculcated in you as you do that uh as I got deeper into it I had more complex feelings about that and I still generally agree broad strokes uh and disagree with I would say a lot of the specifics of it speaking of military there was one part that reminded me of you i quote from World War I there is nothing more glorious than like dying for your country it is extremely useful and convenient for the state to convince young men that dying patriotically is a good thing that was something that in the army you were taught kind of yes asterisk the martyrdom aspect of it isn't really explicitly pushed because the US doesn't want you to die based on what's happening to the VA you could argue that maybe it's more convenient for veterans to die than to get taken care of dying comes with the territory not that it's the point was it something that they explicitly drill into you in boot camp there's not like a sweet little info session where you get everybody in auditorium and be like "Hey just so you know you might die." Honestly that's liberal fantasy it's more about redefining your baseline stakes for your day-to-day decisions if you do something like you don't pack your bag correctly the corrective process is you didn't bring the ammunition you were supposed to bring you run out of bullets halfway through this fight and you kill everybody on your team your death doesn't matter but other people's deaths matter a lot and that's like the basis of brotherhood or connection in a lot of military a lot of team context in general just like with different stakes but it's like less about the die for your country that's glorious and more about you are in a profession of bringing legitimate violence to these places and what comes with that is the stakes and responsibility of thinking about death wow convincing young men to die for rich politician causes is a chain that has lasted thousands of years what is our rating for the book using our unique scale triple Cameron C gotch Christian C got chat chat when this video goes live go ahead and drop a comment c or no C if you like it or you don't like it or you would recommend it you don't recommend it we're still figuring out what that scale actually means i do like the book the most powerful idea in the book that he goes back to a little bit but he like mentions early on and then it threads throughout the entire book is that we experience events but live life as a process and tuberculosis is where you get sick and that's like the event but the experience of tuberculosis is a long-term process that plays out over weeks months and years and as a result the way that we process it is different from the things we kind of experience as events we anchor on events that we experience quickly they make more sense to us they are easier to understand because they usually have like a clear start and stop and our brains are just better suited to deal with like an instantaneous or like a very short time frame thing versus a big longitudinal oh you know it could happen but there's some nuance in here and it's changing as we go and we try something and it works a little bit but then I get sicker in a different way it's honestly very related to our previous book that we talked about how learn definitely check that one out this book does a better job of doing the thing I liked about the last book as a result I will give this a C it's fun it's heavy in parts it kind of argues that Tim Burton's entire aesthetic is the result of tuberculosis which is like a crazy thing to even comprehend yeah and Barbie and it has this glimmer of hope at the end of we could figure out a way to do this if we decide it's important enough all of those coales for me to be a very firm C so I recommend this what about you oh very firm C for me as well it's a master class in good writing is a great study of how to make a narrative arc happen while also weaving in the different components of facts without boring everyone to death there's actually so many more points we haven't even gotten to because of times very easy to read i want like my friends who are still in the pharmaceutical and biotech industry to read it if this can affect drug pricing in some way by getting into the right hands I would love to be a part of that related to that you said you like to anchor on the person who is the best person to speak about a thing for people that watch stuff i was thinking about what responsibility do we have as viewers and fans of things on the internet because we're all participants in the global internet community whether you comment or not you are helping drive algorithms and I actually really do think we all have the responsibility to make the right person famous it's a really hard thing to define but when you find somebody and you're like I think that is a person with integrity i respect how they think about things how they solve problems like what they advocate for the way that you participate in the internet shapes whether or not that person gets to do more of the thing that you think is a good thing for yourself in society that idea of working to make the right person famous I'll selfishly say by engaging with their stuff but at the very least being conscious about oh this is a person that I'd like to be saying more of the things that I think that they're saying i think the internet would be a little bit better if if we all did that i agree this is where sometimes I wish the energy towards boycots can be transferred into energy towards support and it's just like a basic rule of effectiveness you don't just bring up a problem you need to have a solution that is at least your first suggestion about what people should do if you're going to boycott buying book from Amazon here's a link to the place where you should buy books instead it's really not hard to do that kind of stuff in general if that's how you're so inclined our book for next week is the death of Ivan Illich ilich ilick sad boy tool to Toltoy sad boy Toltoy say that five times fast sad boy Toltoy sad boy Toltoy why did we pick this book because I'm sad no uh it is a short story and I didn't want to read another full book this week it was a lot that was quite a lot this is on topic of the theme of reflecting on death and it's about deciding how you want to live a good life unfortunately for Yvon he is reflecting at the end of his life perhaps we can reflect a little bit earlier than that and make some decisions that make our lives better as a Back To Top