snowgall

[This is a revision of a review I first posted to 50books_poc on December 27th, 2010. It has been edited for clarity. Also interesting to note that in 2015 Cooper and her colleagues at the New York Times won the Pulitzer Prize for their reporting on the Ebola epidemic.]

Born in Liberia and descended from the nation's founders, Helene Cooper lived there for 14 years as a member of the wealthy elite. She knew her homeland—its unique history, its sights, its tastes, its scents, its joys and its dangers. When Liberia's bloody revolution finally came in 1980, Cooper had to leave a home she knew well. But as she would come to realize, she did not know it nearly so well as she thought she did.

I didn't know anything about Liberia before I started reading, but that was no barrier; Cooper weaves the story of her nation together with a vivid portrait of her own privileged childhood. Indeed, the two are inseparable. When a group of freeborn and formerly-enslaved Black Americans came to west Africa in 1821 in search of a better home (with the financial and logistical support of white Americans who thought America would be better off without free Blacks in it) they found that the place was inhabited by African people who did not want to be colonized, whether the colonists were white or Black. But the Americans had superior firepower, and they took the Africans' land by force. That was the beginning of Liberia.

The descendants of those Americans came to form Liberia's upper class, the so-called "Congo people." They were a minority who owned and controlled the majority of everything, while the native people of the area lived mostly in poverty. The goal was to create a new nation similar to the US, and the parallels are certainly striking, especially the patriotic propaganda that's fed to the kids about how the country came to be. As a child, Cooper was ignorant of her privilege as a Congo girl. The second half of the book, after her flight to the US, deals with her struggle to understand the privilege she'd enjoyed—and lost—and how it was at the very root of why Liberia as she knew it could not survive.

I think the first half of the book, her experiences before and during the coup, is the strongest. Much of her life in the US is skimmed over quickly; I would have been interested to hear much more about what it was like adjusting to a completely different culture and social position. She makes herself seem somewhat isolated by comparison to the highly interconnected world of her childhood, and I would have liked to see that delved into more. Nonetheless, I found it a good and eye-opening book. It made me think about how much information I'm missing about conflicts around the world, just seeing events in the news with little context or explanation provided.

John Green wants you to know three things:

1. Today, in 2025, the infectious disease that kills the most people worldwide is tuberculosis.
2. Tuberculosis has been curable since the 1950s.
3. The fact that over one million people are dying of this disease every year is a reflection of our collective choices, and if we start making different choices we can save their lives.

Tuberculosis has been part of human life for thousands of years at least, and this book describes how the ebb and flow of its prevalence and deadliness has tracked the changing course of human society, and how our attitudes toward it have in turn changed. The increased population densities of the industrial revolution created ideal conditions for TB to spread, ravaging all classes of society, including the elite. This may have contributed to the bizarre 19th century romanticization of "consumption" as a mark of the sensitive genius, the tragic poetic soul; TB's characteristic symptoms of pallor and bodily wasting were reimagined as delicate, waifish beauty.

But as the germ theory of disease became mainstream and antibiotics made effective treatment possible, romantic "consumption" turned into stigmatized tuberculosis, associated not with an artistic disposition but with poverty. It has become primarily a disease of the global south, where due to systemic inequities in health access, millions of people continue to die of TB today who could be cured by a course of the right antibiotics. Tuberculosis thrives where we do not bother to stop it.

Intertwined through this narrative is the story of Henry Reider, a 17-year-old TB patient who Green befriended in Sierra Leone. Henry puts a human face on a disease that most of us in rich countries no longer see in our daily lives, powerfully illustrating Green's point that we will change our priorities "only when we see one another in our full humanity, not as statistics or problems, but as people who deserve to be alive in the world."

This is not a comprehensive treatment of the history and science of TB, nor of global health policy—the book is only 200 pages long, after all—but more of a high-level overview with pointers to further reading and calls to action. If you've followed Green on YouTube over the past few years as he's gotten involved in health advocacy (and become obsessed with weird tuberculosis-related history facts) I don't think anything in this book will be new to you! But it is good to have it all in one clear and persuasive volume with a popular author's name on the cover to get the message out to as many people as possible. I think it's extremely admirable that he's using his platform and his novelist's flair for a turn of phrase to bring attention to these issues, and I hope it moves the needle.