Everything is Tuberculosis: The book and the disease that killed my paternal grandfather
I am lucky enough to be a part of a monthly book club with a great group of friends. Every month we rotate who gets to choose the next book. The books are often genres or subject matter that I wouldn't necessarily choose for myself.
April's read is Everything is Tuberculosis by John Green. I was excited to read this book because I've found that I have a morbid curiosity about the history of death and disease.
"Everything Is Tuberculosis is a 2025 nonfiction book by John Green that explores the history, science, and social impact of tuberculosis (TB), arguing that it remains a deadly disease due to systemic inequality, not medical limitations. The book blends personal narrative, particularly the story of a young patient named Henry in Sierra Leone, with historical and scientific information to advocate for global health equity and awareness. It became a New York Times bestseller and is praised for its emotional storytelling and sharp reporting on a curable, preventable disease that kills over a million people annually."
Penguin Randomhouse
https://www.penguinrandomhouse.com/books/312472/everything-is-tuberculosis-by-john-green/
My paternal grandfather, Paul Richard Miller, whom I never had the honor of meeting, died on April 17, 1951, of acute miliary tuberculosis at the age of 35 in Lebanon County, Pennsylvania. He left behind a wife and three children. My father, Barry Dean Miller, was only three years old when his father succumbed to the disease.
Paul spent 34 months in the European Theater with the Army during World War II, where he likely contracted the disease. He probably had symptoms for a few years before finally succumbing to the disease in 1951.
In 1951, 1,482,099 people died of Tuberculosis in the United States. Twenty-one white men died of acute miliary tuberculosis, one of them was my grandfather Paul.
CDC - Vital Statistics of the United States, 1951
https://www.cdc.gov/nchs/data/vsus/VSUS_1951_2.pdf
Reading "Everything Is Tuberculosis" made me want to delve deeper into learning about this part of my family history. Most of my friends have both sets of grandparents still living. At 31, I have no living grandparents as of 2022. Having a grandparent who passed in 1951 from TB is a huge generational gap compared to some people. For many, TB seems like it is in the distant past, but for my family, it is only a generation away.
I didn't have a lot of people that I could speak to on this topic. My dad passed away four years ago, my uncle passed a year ago, and my aunt is hard to get in contact with. I went to my Ancestry.com account to see what information I had saved on Paul. Thankfully, I have his obituary and some documents from his military service. I also have some pictures of him with my grandmother, Dominish, Sr. Then I started looking into sanatoriums in central Pennsylvania.
"Tuberculosis (TB) is a contagious infection caused by the airborne bacteria Mycobacterium tuberculosis. TB most commonly affects the lungs (pulmonary TB), but it can spread to many organs through the blood.
Miliary TB is so named because the infection causes tiny spots to form typically in the lungs but also in other organs. The spots are the size of a millet, which is the small round seed in bird food.
Miliary TB may affect one organ or several organs or occur throughout the body. It most often affects the lungs and bone marrow but may affect any organ, including the tissues that cover the brain and spinal cord (meninges) and the two-layered membrane around the heart (pericardium)."
Merck Manual
https://www.merckmanuals.com/home/infections/tuberculosis-and-related-infections/miliary-tuberculosis-tb
Thanks to a research tip about Tuberculosis sanatoriums, I contacted the Department of Health in Lebanon County, Pennsylvania. They kept TB patient cards from about 1910 to 1965. They weren't able to find my grandfather's records, but they found his son's, my uncle's Paul Richard Miller Jr. I never knew that he had Tuberculosis or that he was hospitalized for it. The woman at the Health Department explained that she's not always able to locate the TB cards for research requests, but the cards will tell you the date of diagnosis and treatments rendered.
https://www.pennlive.com/news/2015/11/white_death_memories_from_pa_n.html
https://cambriamemory.org/cresson-sanatorium/medical-records/
During the 1940s and 1950s, while my grandfather battled his TB infection, the United States was making advances in TB treatment. Unfortunately, my grandfather was not one of the lucky people who were able to survive the infection. After diagnosis, likely due to coughing up blood, fever, shortness of breath, organ failure, and or weight loss, he would have been moved to a sanatorium or hospital. Since Paul was a WWII veteran, he was most likely isolated at the Lebanon VA Hospital for isolation. TB patients were isolated with other TB patients and sometimes completely by themselves to stop the spread of the disease.
My uncle had said that he remembered his father dying at home in bed, so my grandfather was most likely released to his home for the final days of his life. This could have been an act of compassion, due to overcrowding, or just a desire to forgo further treatment when it was clear that it wasn't working. His obituary says that he died at home and was "bedfast" for the last two weeks of his illness. This is consistent with the disease, which usually ends with the patient suffocating slowly as their lungs give out.
In 1951, when my grandfather passed from TB, the regular course of treatment was bed rest, fresh air, and limited antibiotics. Streptomycin was introduced in 1943, but an effective combination of drugs wasn't widely introduced until 1952, a year after Paul's death. My grandfather likely knew that he was facing a death sentence when he was diagnosed with the disease. Facing your death at just 35 years old with a wife and three young kids must have been absolutely terrifying.
It's these historical stories and experiences that make me so thankful for modern medicine. I'm reminded how lucky I am to have a job that provides me with health insurance and access to doctors and medications when I need them. Many aren't so lucky. Even today, millions die from Tuberculosis every year. We might view TB as a disease of the past, but it's very much alive and ravaging communities in poor countries.
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