At first, the bump on my arm was small, maybe mosquito-bite-sized. Within a few hours, the bump had blown up to a lump that I couldn’t quit poking at. Lucky me: I had a positive TB skin test!
I was in college and had decided to sign up as a volunteer at my local Ronald McDonald House. One of the things I had to do before I could start volunteering was get a TB skin test…and, since my test came back positive, a lung X-ray. The X-ray came back clean and I was ultimately cleared to volunteer at Ronald McDonald House, but that positive TB skin test would dog me for the next several years, until I moved to California and my healthcare provider told me that their policy was to treat ALL TB cases, even latent ones like mine.
My personal history with TB led me to pick up a book on the subject at my local library last week: Catching Breath: The Making and Unmaking of Tuberculosis, by Kathryn Lougheed. While this book doesn’t shy away from being deeply science-y, don’t let that put you off: it was really interesting, and even fun.
Lougheed starts out way back in history, before humans left Africa but after the TB bacteria had already infected various animal species. Eventually, TB moved over to people, and when out-migration began from Africa TB went, too, dividing into various strains. This disease has been killing people for millennia, but its lethality really kicked in with the Industrial Revolution, as people began to crowd into cities.
TB raged through Europe. Many died. The disease thrived on overcrowded, malnourished, poverty-stricken populations. And then, scientists believe, the 1918 flu roared in and cleaned house. People sick with TB kicked the bucket. People who had the disease AND an immune system strong enough to keep it in check, survived. And the TB epidemic faded…until HIV.
But Catching Breath isn’t just a history of TB. It also looks at how TB drugs are made, how the TB bacteria survives in our bodies, how drug resistance can occur even in people who adhere completely to their drug regimen, and how TB’s ability to kill people is incredibly dependent on other social and health factors. There’s a lot of information, but Lougheed is a hilarious author, weaving jokes and puns in throughout the text, and her passionate curiosity for all things TB shines through.
One of the key things I took away from Catching Breath is that, even though I went through a nine-month course of TB antibiotics, it’s entirely possible that I could catch this disease again — there is no such thing as TB immunity. While that thought depresses me, of more concern is the enormous trouble TB causes for people who live in places where antibiotics are too expensive or non-existent, where the healthcare system is broken, and where other illnesses or malnutrition are rampant. As Lougheed points out again and again, we can treat TB…but that means spending lots of time, money, and effort on the health needs of people who don’t live in the Western world.
Whether you know a little or a lot about TB, Catching Breath provides an insightful and page-turning overview to a disease that’s been with humanity for, well, ever, and that’ll probably be with us for the foreseeable future.