The Happiness Lab with Dr. Laurie Santos - How to Confront the Things that Suck (Live with John Green)

Episode Date: April 18, 2025

Author and vlogger John Green looks around the world and sees a lot of things that suck. But rather than giving in to despair, he's trying to develop a sense of hope. He says the most "punk rock" thing to do is tackle our problems head-on.  John embraces the motto: "Human beings can be good news!" In a live discussion with Dr Laurie, he explains that if we work together we can decrease the suck in the world and increase the awesome.  This live event marked the publication of John's new book Everything is Tuberculosis - which argues that TB is a global disease that we can conquer right now if we put in a little bit of combined effort. Happiness Lab listeners have already raised tens of thousands of dollar to fight TB by donating to our appeal at GiveDirectly.org/tb. Get ad-free episodes to The Happiness Lab by subscribing to Pushkin+ on Apple Podcasts or Pushkin.fm. Pushkin+ subscribers can access ad-free episodes, full audiobooks, exclusive binges, and bonus content for all Pushkin shows.  Subscribe on Apple: apple.co/pushkinSubscribe on Pushkin: pushkin.fm/plusSee omnystudio.com/listener for privacy information.

Pushkin. TB is a disease we've been able to successfully treat for decades, and yet millions of people still die because of it. And that's partly because we won't hand over the relatively small amounts of money needed to pay for treatment. John thinks that's a scandal. And if you agree, we've launched an appeal to help send any cash you can spare to givedirectly.org.tb. That's givedirectly.org.tb. John's latest book, Everything is Tuberculosis, is all about this awful disease that's shaped

our world. But that disease won't go away until we put in some effort to fight it properly. John asked me to help him out at a launch event for the book in New York. And that's what you're about to hear. The evening started with John giving a short reading from Everything is Tuberculosis that explains how a visit to a clinic in West Africa and a meeting with a special young person sparked his interest in tackling TB. Special thanks to Symphony Space for allowing us to share this episode with you.

Hi everybody. Hello. Whoa. Hi. Thank you so much. Thank you so much. Thank you so much. It's so great to be here with you today.

It's such a gift to me to be here in New York City at Symphony Space for the official pub date, the launch of the book, Everything is Tuberculosis. So this is a little bit of my book from when I first visited LeCar Tuberculosis Hospital in 2019, when I didn't even know, to put it frankly, that tuberculosis was still a thing. When we arrived at LeCar, we were immediately greeted by a child who introduced himself as Henry. That's my son's name, I told him, and he smiled. Most Sierra Leoneans are

multilingual, but Henry spoke particularly good English, especially for a kid his age, which made it possible for us to have a conversation that went beyond my few halting phrases of Creo. I asked how he was doing, and he said, I am encouraged, sir. I am happy." He loved that word, encouraged, and who wouldn't? It's like courage is something we rouse ourselves and others into. My son Henry was nine then, and this Henry looked about the same age, a small boy with spindly legs and a big goofy smile.

He wore shorts and an oversized rugby shirt that reached nearly to his knees. Henry took hold of my T-shirt and began walking me around the hospital. He showed me the lab where a technician was looking through a microscope. Henry looked through the microscope and then asked me to, as the lab tech, a young woman from Freetown, explained that this sample contained tuberculosis even though the patient had been treated for several months with standard therapy.

The lab tech began to tell several months with standard therapy. The lab tech began to tell me about this standard therapy, but Henry was pulling on my shirt again. He walked me through the wards, a complex of poorly ventilated buildings that contained hospital rooms with barred windows, thin mattresses, and no toilets. There was no electricity in the wards and no consistent running water. To me, the rooms resembled prison cells. Before it was a TB hospital, La Cah was a leprosy isolation facility, and it felt like one. Inside each room, one or two patients lay on cots, generally on their side or back. A few sat on the edges of their beds, leaning forward, and all these men, the women were in a separate ward, were thin. Some were so emaciated that their

skin seemed wrapped tightly around bone. As we walked down a hallway between buildings, Henry and I watched a young man drink water from a plastic bottle and then immediately vomit a mix of blood and bile. I instinctively turned away, but Henry continued to stare at the man. I figured Henry was someone's kid, a doctor maybe, or a nurse, or one of the cooking or cleaning staff. Everyone seemed to know him, and everyone stopped their work to say hello and rub his head or squeeze his hand. I was immediately charmed by Henry.

He had some of the same mannerisms of my son, the same paradoxical mixture of shyness and enthusiastic desire for connection. Henry eventually brought me back to the group of doctors and nurses who were meeting in a small room near the entrance of the hospital, and then one of the nurses lovingly and laughingly shooed him away. Who is that kid? I asked. Henry? Answered a nurse. The sweetest boy. He's one of the patients we're worried about, said a physician who went by Dr. Michael.

He's a patient? I asked. Yes. He's such a cute little kid, I said. I hope he's going to be okay. Dr. Michael explained to me that Henry wasn't a little boy. He was 16. He was only so small because he'd grown up malnourished

and then the TB had further emaciated his body. He seems to be doing okay, I said. Lots of energy. He walked me all around the hospital. This is because the antibiotics are working, Dr. Michael explained. But we know they are not working well enough. We are almost certain they will fail.

And that is a big problem." He shrugged, tight-lipped. There was a lot I didn't understand. Thank you. Thank you so much. So it is now my honor to introduce my conversation partner for this evening. I'm so excited. I can barely contain my excitement that Dr. Laurie Santos is here.

I mean, Dr. Laurie Santos is a Yale professor and the host of one of my favorite podcasts, The Happiness Lab, where you can learn how to be happy, which like... So everybody, please welcome Laurie. I think the one thing John didn't mention is that I'm also a huge John Green fan. I love to hear that. Sitting up here like... I'm gonna try to hold it together. So John, because I'm a fan, when I got this invite

to come have this conversation with you, like my head did a little spinny thing, like this sort of head explosion emoji was like all over my kitchen. And I was like, oh my gosh, I get to talk to John Green about his new book. What's his new book about? And the organizers were like, tuberculosis.

And I was like, okay, cool, cool. I trust John Green with my attention span for anything. I'm gonna Green with my attention span for anything. I'm going to go with this. And I'm so happy I did, because as usual, you put your trust in John Green. And he tells you an amazing story that you didn't know that you needed to know already. And for those of you who haven't read the book yet,

you're in for a treat, because you, like me now, are going to become a complete TV information stan. We'd love to hear that. Yes. Yeah, I'm not going to become a complete TV information stand. We'd love to hear that. Yes. Yeah, I'm not going to do any spoilers, but tuberculosis, big pre-Victorian TikTok beauty trend before TikTok, tuberculosis, the cause of so many things historically, and so on.

As usual, tuberculosis for John Green has become not a disease, but a story, a story that shapes literature and and beauty, and public health policy, and I think for me here, even happiness, and some of the science of happiness that we're gonna get to talk about. But to start, I'm just curious, what made you wanna tell this particular story now?

We just met Henry, but beyond Henry, why tuberculosis now? Well, to me, tuberculosis is the exemplary disease of injustice. It is a disease that only exists because we allow it to exist. It follows the paths of injustice and inequity that we blaze for it. Overwhelmingly, the people who will get tuberculosis

are the people who are most oppressed, most marginalized, most left out by the systems that we've built, whether that's transportation systems or healthcare delivery systems. And so it's not just a disease, although it is a biomedical phenomenon, obviously, it's a bacterial infection, there are biomedical realities about tuberculosis, but it is also a social phenomenon. How we imagine and have imagined that disease throughout history matters so much because it doesn't just shape how people live and die of tuberculosis,

it also shapes who lives and dies of it. And so something I really found striking in your book, and I'm kind of embarrassed to admit before I read the book, I kind of feel like TB was this disease of the past. Totally. And the book reminds you, of course, that it's this ongoing struggle for millions of people. It reminded me of the Faulkner quote,

like, the past is not dead, the past is not even in the past. Like, TB not dead, also not in the past. Give me a sense of the scope of TB today and why it's a plight that we need to be paying attention to now. Well, the scope of TB today is very different from the scope of TB six weeks ago, unfortunately. And so last year, about 10 million people

got sick with tuberculosis. About 1.25 million died. The most recent estimates are that with the defunding of USAID, we can probably expect that to go up by about 30%, which is hundreds of thousands of human lives. Stephanie Nolan reported in the New York Times last week that hundreds of thousands of people have seen their treatment interrupted.

This is a catastrophe on an individual level because it means those people are very likely to die. Most of those people will die if they aren't promptly put back on treatment. And even if they are promptly put back on treatment, they're very likely to develop drug-resistant tuberculosis because even a brief period without access to treatment can lead to drug resistance. And so that's a catastrophe on an individual level. It's also a societal catastrophe because it means that there will be more complicated

forms of drug-resistant tuberculosis circulating in communities, potentially, you know, most terrifyingly leading to forms of tuberculosis that we simply have no tools to treat or cure, which is a threat to the entire world. I mean, of course, tuberculosis doesn't have a moral compass, it also doesn't have a geographical compass, it doesn't know about political borders. It will always strike the most vulnerable among us, but it isn't limited to impoverished communities. We have tuberculosis here in New York City, we have tuberculosis in the United States,

and so that's the size of the problem. We're going to lose at least 1.25 million people, probably more to tuberculosis this year. And all of those deaths, I want to be clear, are needless. When I asked Dr. K.J. Sung how many people should be dying of TB if everybody had access to healthcare, he seemed very confused. And then after a moment, he said, well, none. And that really struck me that all of those deaths are optional.

There's so many sucky, sucky things about TB. But one thing that the book describes in such a poignant way is that people don't just suffer from the disease, they suffer from the culture and the stigma around the disease. And sometimes they're not suffering from the microbes, they're suffering from our like crappy human minds and the way we think about disease. And so explain why this part of the disease is so painful and maybe share some parallels with how TB and other kinds of diseases that we think about today are very similar in this regard. Yeah, I mean tuberculosis is a highly stigmatized disease. Several TB

survivors have told me that surviving the stigma is harder than surviving the disease. People will be abandoned by their families. They're told that they're responsible for their own illness. They're told that they got TB because they were too poor or they got TB because they drank too much or they got TB for any number of reasons. The truth is that, of course, illness doesn't know about morality, right? Like my dad had cancer a couple times when I was a little kid in the 1980s. He had bladder cancer. And I saw

some of this up close that like in the 1980s it was still pretty commonly believed that like cancer was caused by like bottling up your emotions. And that became like a literal cancer that it makes a kind of somatic sense in the way that all these stigmatizing ways of thinking do but of course like we know that's not why my dad got bladder cancer just to be clear he's actually very expressive man very in touch with his emotions and even if he weren't he still didn't deserve to get cancer. There I was engaging in stigma. So it's devastating for people because it's already

difficult to live with disease. It already others you. You're already told by the social order that you're not a full person. You're already dehumanized in all kinds of ways when you're ill. And yet, this way of imagining the sick as less than fully human, as outside of the regular, you know, group of the social order, it just, it doubles the burden of being ill. And so, I think we really have to fight it. The problem with stigma is that

the best way to fight it is to make it curable, right? Like think about strep throat. We don't stigmatize strep throat. Nobody says like, oh, you got strep throat, like you must be a terrible person. We don't stigmatize strep throat because it's eminently curable. And that should be the case with tuberculosis and most other diseases of injustice. I think it's so fascinating though because I feel like even with strep throat it's kind of like well you went out to that restaurant. Yeah yeah we always want to have a reason why people got sick. Yes. There was this wonderful young woman named Casey Altman who died of cancer a few years ago and

she told me once that stigma is a way of saying, you deserved for this to happen, and I don't deserve for it to happen. And so for me not to have to worry about this happening to me, I have to have a reason why this happened to you. And that's what stigma is ultimately. And but it's so messed up that we make up this reason.

I mean, in some ways it's kind of good, right? You had this this quote in your book that I loved, we like to know why things happen, especially bad things, right? Our mind is just searching for explanations and the way we search for explanations for all kinds of scientific stuff. But in this case, we're like, well, if the explanation is, this disease just hits you indiscriminately, like I'm at risk to our brains can't handle that. Yeah, it's really overwhelming.

And so the other strategy we have for dealing with this in addition to stigma is romanticization, which sort of seems like the opposite of stigma when you first think about it, because instead of like dehumanizing someone, you're sort of putting them on a pedestal. But it serves the same function of casting someone out of the social order. Like I've experienced this a little bit because I have what the television commercials call moderate to severe obsessive compulsive disorder and that is my actual diagnosis. It's not actually a drug commercial up here. No, no this is real man. This is real life. And people both stigmatize OCD.

Some of the compulsive behaviors especially are highly stigmatized because they're seen as odd or off putting. But they also romanticize OCD. They act like having OCD comes with all these superpowers, makes you a brilliant detective like that guy on the television program, Monk. And that's just not my experience. I haven't found that it makes me good at anything other than worrying about the

very specific and totally irrational thing that I'm consumed with worry about. And it, I just, I think it's overrated, you know? And so romanticization, which happened a lot in the 18th and 19th centuries as a way of making sense of this disease, as a way of making understanding why a bad thing was happening, was just another strategy for saying, you deserve for this to happen and I don't. One of my favorite examples of this is John Keats, the great British romantic poet who died of tuberculosis in 1825. When he was dying, Percy Shelley wrote him a letter that was like,

hey, you know, this is a bummer. I'm paraphrasing. This is a bummer and everything. But this consumption does tend to strike people who write great verses as you have done, which is a very interesting thing for Percy Shelley to say because he also had consumption. So he was a little bit like, and I am also a great poet. Consumption flex, right?

Yeah, yeah, yeah. Consumption flex. Classic consumption flex. One soggy thing about TB is that we moralize it, we look for explanations, we stigmatize people. Another soggy thing about TB is that it ruins this thing that we so need to be healthy humans, which is our sense of connection. So a super sad part about this book

is that John tells all these stories of TB patients who have to get shipped off to some sanatorium. Henry is a wonderful case in point here. They just have little control over their lives. And the interesting thing I thought was so cool in your stories about TB is that this has kind of been a big theme of your work with fictional characters too, right? These folks who just want to be connected and just want to be part of the world, but they kind of can't for some reason.

And so I'm curious what you learned about isolation from TB and kind of connection broadly. Yeah, Henry has told me that his dream is to be a person in society, which I think is so beautiful because he just wants to be accepted as a full person in his society. And for so long that was denied to him because of tuberculosis, not because of the disease itself, but because of the way the disease is imagined by us, by the people around him, by his community. And it is really, really difficult, especially, you know, historically, like my great uncle died of tuberculosis in 1930, and he was in a sanatorium. He died in a sanatorium like so many millions of Americans.

And he was in a sanatorium. And in those sanatoria, people's lives were so highly controlled, they were told that they shouldn't cry, including children were told they shouldn't cry, including children were told they shouldn't cry because it would be an exciting cause of tuberculosis. They were often told they couldn't be visited by their families because that might excite them and lead to tuberculosis. They were told they couldn't stand up. They were told whether or not they were allowed to read, whether or not they were allowed to journal, and so on. They lived these very highly controlled lives.

And unfortunately, that's still the case for many people living with tuberculosis. We still emphasize control over care. I think this is something more broadly about disease. I mean, you've talked, you know, as you just did so nicely about your own mental health struggles. I think anybody facing any disease right now, it's kind of the loneliness connection part. So yeah, it's really hard to be isolated, right? And disease itself can be isolating because it makes us hard for it may, it's really hard to be isolated, right? And disease itself can be isolating because

it makes us hard for, it can make it hard for us to leave the house, it can, especially infectious disease can make it dangerous to be around other people. And that's really hard. Those interruptions to connections are so profound. And I think, I think it's safe to say that if Henry had been like most people and had been completely abandoned by his family the way so many people are, he probably wouldn't have survived. But he was very fortunate and is very fortunate to have an extraordinary mother who visited him almost every day of the three years that he was hospitalized and brought him extra food every chance that she got and loved him through that.

He wrote a beautiful poem about her that I quote in the book about how he said, you stand here when others ran away. And that switch of tense where he's talking about his mother standing in the present tense and everyone running away in the past tense has always been so meaningful to me. I mean, I think he's also really lucky that he's an amazing author that's bringing his tense and everyone running away in the past tense has always been so meaningful to me. I mean, I think he's also really lucky that he's an amazing author that's bringing his story to light here today. This is a part where he's just a clap for the past. You're listening to a special bonus episode with me talking live to author John Green about his book, Everything is Tuberculosis. It's time for a break, but we'll be back in a moment.

["Happy Hour"] Um, so I want to switch gears and talk a little bit about happiness, because that's... I love talking about happiness. That's what I talk about. What an easy time to talk about happiness, Lori. No, but this is why I'm so happy to be on stage with you talking about happiness, because

I think, you know, usually when we talk about happiness, we get it wrong. We're kind of in toxic positivity space, where it's like happiness is about ignoring all the terrible stuff in the world, and we're just going to be like, joy, joy, joy all the time. And I think you get happiness right from a scientific perspective because you realize that meaning comes not from avoiding suffering but from embracing it with a sense of duty, curiosity. You get that wonder can come from really mundane, weird stuff and we can kind of get positive emotion from that. And you get that in the face of like really terrible sucky stuff, the move is curiosity

and kindness. And so he's actually kind of happiness expert, I think, is really what we're getting at. Thank you. That is my reputation. So let's start with hope. You've said before that you don't like this idea of optimism, but prefer this concept of hope.

How do you define hope? And what has thinking so closely about TB taught you about hope? Hope, for me, is a belief that we can make the world better together. We can only do it together, but we can do it together. And it's also a belief that human beings can be good news. I'm not saying that we are good news. We're certainly not good news all the time.

I'm not saying we're good news. I'm saying we can be good news. We might not good news all the time. I'm not saying we're good news. I'm saying we can be good news. We might be good news. We can become good news. And we can be good news for each other. That is what I really believe. And I believe that because if I don't, like my life is in danger. Like despair for me is not some, it's not some abstract idea that feels very distant.

It's something that I struggle against every day. It's the thing that makes it hardest to get out of bed, you know, much more than fatigue. It's fear and despair and worrying and being consumed by those emotions. And if I don't have a measure of hope to combat that with, I'm in big, big trouble. And so I have spent a lot of time trying to develop my sense of hope and hold onto it and believe that it is the correct response

to the human condition, and I really do believe it. You had this quote that I love and wish I could just totally steal which is the most punk rock thing to do in the world right now is to embrace the current problems with earnestness and hope. Yeah, earnestness is so underrated, man. People like to, and I get it. I totally get it, especially if you're young. You've had an uncommonly crappy situation

that you've grown up in. If you're under the age of like 35, my, I'm sorry. And also, I feel a little responsible. Because like we did that. A lot of it, not all of it, some of it was done by infectious disease, but we did a bunch of it. And I'm sorry. Our bad.

We didn't do a good job of being good news for you a lot of times, and I'm genuinely sorry about that. And this is a really difficult time to grow up. But I think so many people use irony as a kind of armor, as a way of trying to protect themselves. And I absolutely understand wanting to protect yourself. Being earnest to the world is hard work. I think about it in terms of my dog,

who would, my old dog who's since passed away, he would run around and then he would get real tired and he would roll over and he would show his belly to us, the vulnerable part, the most vulnerable part of him, he would show it to us and trust us. And that's earnestness and it's hard, hard work, and it's hard work to be vulnerable, but I think it's worth it.

That's a nice transition because one of the things I absolutely love about your work is a kind of counterintuitive thing, which is that I know lots of your fans know that one of the goals of being a nerdfighter is we're gonna decrease the suck, You're ready to decreasing the suck in the audience, right? But the counterintuitive part is that to decrease the suck, you often have to actively point out the suck. Right. You need to find the hidden suck and drag it out into plain sight when no one's paying attention to tuberculosis. You're like, no, look at

the suck, look at it. You wave the suck in people's faces. And that must be hard. Like you're kind of the bearer of the suck in lots of ways. And I'm curious how you handle that. Well, the key for me is being able to handle that in community. I am not the only TB fighter in the world. There are thousands, maybe millions of TB fighters.

There are TB hunters in Lesotho right now actively finding cases of tuberculosis, not just waiting for people to come into the hospital when they're so sick that it's very hard to cure them. There are TB fighters in the back of the room right now who are partly responsible... Who are partly responsible for the fact that two million more gene expert tests are available than were last year because Danaher finally lowered the price of that test. And it's hard, hard work.

It's hard work for community health workers. It's hard work for doctors and nurses. It's hard work for us. It's hard work, but it's also really good work and to do it in community is fun. The last thing the great physician Paul Farmer ever said to me was, isn't this fun? Isn't it fun that we get to be friends in this work? And that's true. It was really fun to be friends with Paul. I mean, I think this is something

that we get wrong a lot, right? We think, you know, kind of avoiding discomfort rather than sort of embracing it in community is the path to a happy life, is the path to a more meaningful life, because you just kind of keep all the good emotions and get rid of the bad. But one thing I love that your work has done for me, your novels and this book,

is like it kind of puts it in your face and makes you think about it more. It also feels like this is something that you've done for a while. I know way back in the day you had time working as a student chaplain in children's hospitals. I feel like that maybe must have been some of the first spots you look closely at illness and death. So maybe you're really experienced with it, but a lot of us don't like looking at the suck like so close on. I'm curious how you learned to sit with discomfort rather than running from it.

And also just like how you did it for the book, right? You were trying to bring this out to community with your work, but there was a lot of times you were sitting with some pretty negative stuff writing this. and I'm just kind of curious how you tackle that. I wanted to write a hopeful book. I think that all good books, all true books, have to be hopeful because I think hope is, for lack of a better term, true. honest book and the honest truth is that tuberculosis is an unbelievably horrifying scourge that we've allowed to be with us now for the 70 years since it's been curable. And that says a lot about us. It says that we don't value all human lives equally even if we say we do. It says that we've built systems that exclude people, that exclude especially marginalized and racialized people. It says that we've failed to deliver cures to the people who need those cures the most.

It says that we've built systems that prioritize the creation of capital over the creation of saving human...the creation of human health. It says a lot of bad things about us. But it is also true, as I say in the book, that the year I graduated from college, 2.5 million people died of tuberculosis, and last year 1.25 million did. That's 1.25 million too many.

Nobody should die of tuberculosis. But that progress is real, and it's important to understand that it wasn't natural. It wasn't inevitable. It wasn't always going to happen. That progress happened because lots of people worked together to make it happen. And we devoted resources and attention to making it happen.

And so for me, the answer to that question is solidarity, solidarity, solidarity. The answer to that question is trying to find ways to be in community, to feel less alone. That is really the key for me. When I don't feel alone in my feelings or in the world, I feel happy. And when I do feel alone in my feelings or in the world, I feel scared. And so let's talk about how you've not felt alone in this process. I think one of the things that's amazing about your work is that you've used the power of

narrative to shape how a lot of people have viewed the situation. Thinking about it, maybe not with despair, but with like, this is sucky, but like we can put some agency in to fix this. I'm just curious what the response has been from your fans so far. Like, what have you heard about people learning about the TV crisis through this book and through your work? Well, it's pretty great. It's pretty amazing. So I just realized, just now in the last three seconds,

that there are probably some infectious disease doctors who thought they were coming to a talk about tuberculosis. I mean, we can go there if you want. I was going to stick with happiness. Yeah. No, I just totally forgot about them. And they must be like, who the hell is this guy?

Why are all these people laughing at these jokes? I don't understand. Why if I say it's not normal to sneeze? Will they have a reaction? So please don't feel excluded, please feel welcomed. I forgot your question because I got concerned about the infectious disease doctors. What's the reaction been like? The reaction has been incredible.

I mean it's been not that I'm reading every Goodreads review, but Which you should not do I know there are some authors in the room some author friends some some authors in the room Don't read your Goodreads reviews But I should I Should suffer You should not Do as I say not as I But no, the response has been incredible and really overwhelming. I mean, just the fact that like,

I mean, to your point that you made at the beginning of our conversation, the fact that people would be like, oh, this young adult novelist wrote a book about tuberculosis, I'm in. Is incredible. Like that is an incredible fact. What a gift to me. Thank you so, so much for believing in my work that much

and just being here today. So but this is just a theme with so much your work, at least my kind of interaction with your work, which is like your stuff always brings us into things that we do not face. And a big one for me, because I'm a huge fanataphobe, is that a lot of your work deals with the fragility of life. Fanataphobia is fear of death. By the way, probably a lot of you know this.

Oh, thank you. God, I was in trouble. Sorry. So I was dropping some Yale professor stuff right there. I apologize. I apologize. No, like your stuff may fall on our stuff. Like you just make us look at death. We are part of the natural world,

it's gonna happen to you too. We're mammals. Yes, but like we like to think of ourselves as animals. Like we don't like to look at the natural world and I think that has led to a lot of the stigma and the stuff we're talking about. And so the good news is that the science shows that you're right.

The more we focus on the fragility of life, the more you embrace it, the more you do generous stuff, the more you live well. But I'm just curious how you deal with that. What's gravitated you towards this? And what have you discovered personally by focusing on this so closely? Well, I just think it's a big deal.

I'm a little, like you, I'm a little confused. It's a thing. I'm a little confused why everyone else isn't thinking about it all the time. Yeah, yeah, yeah. Right? I texted my brother once. I was in an airport.

And I texted my brother, do you ever think about the fact that when you're in an airport, everybody who's in the airport will be gone in like seven or eight decades? And Hank, God bless him, wrote back, no. But I do, Laurie. I do. I don't know why. I don't know why I was put here to witness a lot of death and talk a lot about death, but I was. And that's the situation I ended up in. I am like you.

I don't know if I'm afraid of death so much as I'm deeply concerned about it. You know? I just think it's a very, very big deal. And that we should spend more time thinking and talking about it. Because when we don't, then when people are dying, or when people who are with people who are dying,

we kind of exclude them, we sort of push them to the side, and we're like, oh no, that's very inconvenient, like that's something I don't like thinking about, that's something I don't like being exposed to. And that makes it so much harder to die. It makes it so much harder to love someone who's dying. And so I think it's, I just think it's important and I think dying people and people who are loving people who are dying need to be fully embraced by the social order. And we need to remember that we can take agency to fix the parts of the social order that are hurting people, that are causing people to suffer.

Yeah. You have this love, there's so many good quotes in this book. You guys bring a highlighter when you start reading this because you're just going to want to go crazy, but here's another one that I think fits with this idea a lot. You note that when we know about suffering, when we are proximal to it, we are capable of great generosity.

That is the striking thing about your work, is that you make us care about life that's really fragile, but you somehow allow us to do it in a way that doesn't cause us to like, you know, shield our eyes, you cause us to react with generosity and helpfulness. And so I want you to tell some stories of generosity that have come out from this book. You know, what have the fans been able to do, these sort of TV fighters, that maybe wouldn't have happened if you hadn't written this?

So many TV fighters are taking actions. One of those actions is something like giving money to support TB charities who are trying to fill gaps that, I want to be clear, cannot be filled by anything but governments, but are desperately trying to fill whatever gaps they can. And that is itself a tremendously generous and helpful action.

Also, and I know this, I know you hear this all the time and it sounds like pitter patter, I totally understand, but people, like TV fighters regularly organize call-a-thons and email-a-thons to reach out to their representatives. And that matters. When I talk to people in Washington, I talked to someone a couple of days ago who was like,

I have been getting a lot of calls about tuberculosis. And I'm like, good. Wonder where that's coming from. Hope you're getting a lot of calls about other things as well. I hope you're getting a lot of calls about diseases of injustice like malaria and HIV and diabetes and heart disease.

And so I'd really think that matters and I am so inspired by them. They really lead me. They'll have a call-a-thon and I'll be like, oh God, all right, I'll call Todd Young. And Todd Young is a senator of mine who is a big believer in global health, has been a big supporter of global health, was been a big supporter of global health, was one of the sponsors of the NTB Now Act. But I right now need him to be more public in his support of global health. And so I just call him, you know?

And I let him know that. Speed Al. Speed Al. Speed Al. One of the reasons I'm so glad you bring this up, this is like me nerding about happiness science now, is that there's lots of evidence that one of the best things you can do to increase hope

is to actually take agency about something small. Like when you make that speed dial call to your senator or you do something to fight TB, it doesn't just like do good in the world, it actually changes your psychology. You kind of feel like, oh, there are ways to take action on these things. Like it's a funny kind of like spiral loop

that when we act in ways that are hopeful, we actually become more hopeful. And so I think that you're increasing hope in a couple of ways. One, just through the narrative, but second, just through getting people to get off their butt and do stuff. Yeah.

And they feel better. And it's really hard to get off your butt and do stuff. Especially right now, like the temptation to despair is so overwhelming and the sort of the horrors abound in so many directions for a lot of people that it's really difficult to even know where or what to respond to, where or what to take action. But those, on some level, you asked me earlier why I picked TB and on some level because I had to pick something, you know, there's a lot of problems

I could have picked one of the other ones, you know, I could have picked climate change. I could have picked malaria I mean, there's an endless number of problems, right? But I'm counting on y'all to solve some of those problems and then you count on me to try to deal with TB and then together Hopefully we make a better world. So, I'm going to just nerd out about more quotes in this book because my highlighter died when I was reading it, and so I'm just going to give you more. This one is related to what we were just talking about, this idea that when you act, you can overcome your despair. And you note that mere despair

never tells the whole human story, as much as despair would like to insist otherwise. And this was very comforting for me because it suggested that John, too, experiences despair about all this horrible stuff. He, I mean, that's like community, right? We were just talking about why this is so important. But you're able to approach these moments of despair in ways that truly show the

human story. And so I'm wondering with this book in particular, with Henry's story in particular, like how did you try to weave that in? Because you're like throwing the despair out there. What kind of like literary magic do you use to get us to like flip the switch and go towards joy and hope and so on? Well, I tried to draw that arc, right? The arc from despair to hope. On some level, that's the arc of lots of my books. It's the arc I tried to draw in the Anthropocene Review too, from going from a place of profound hopelessness and fear

and a feeling that there was no reason to get out of bed in the morning to a place of hope. There's individual essays that try to draw that arc, but the book itself also tries to draw that arc. And I wanted to draw that arc in this book too, because even though the size of the crisis is overwhelming, and this is just one crisis among many, right? Like tuberculosis is just one disease among many, health is just one issue among many. Even so, I still think that there is cause for hope. I still think that there is reason for hope. Not because things are gonna get better in the next year, but because like we have to fight for them to get less worse. Every person who doesn't die of tuberculosis, who would otherwise die, is a success for us. And unfortunately, the number of people

who are going to die of tuberculosis is going to go up because of decisions mostly made by my government, to some extent, decisions made by other governments, but mostly decisions made by my government. My job is to try to fight that every way I can, all along that journey, whether that's you know, legislatively, whether that's through the judicial branch, however that is, to fight

that every way I can. Another way I think you fight it really well, and this is something that I'm so grateful for your work for, is you often fight the sucky stuff with awe, the sense of wonder. Yeah, wonder is underrated, man. Oh my gosh. There's like a, oh my gosh, don't even get me started in a happiness science. It's like one of the positive emotions that is so easily

available to us, like literally in the people around us and the good things they're doing, or in like nerdy science, like just go on Blog Brothers and you'll see some awe for sure. But we don't realize it's such a powerful emotion. And so I wanted to ask you an awe question. In the whole TV story that you've told, what was the moment where you found the most wonder,

the most awe in thinking about this story? There's a moment where we, as a species, figured out that this wasn't an inherited disease, that this was a disease caused by a bacterium. And I was reading about this moment where Robert Koch is literally giving, like reading a paper at a scientific conference and the audience just falls completely quiet. And one member of the audience said, I hold that evening to be the most significant moment of my scientific life.

And that moment when we realized, okay, this isn't an inherited condition, this is an infectious condition which means that we need to be imagining it and understanding it and fighting it very differently, not just accepting it but trying to find ways to fight it, is a huge moment in human history. And it really is a moment of awe because it was the culmination of so many generations of people trying to understand the world around them, the culmination of people trying to develop microscopes to see smaller and smaller creatures. And eventually we see these wiggling rods that we discover cause tuberculosis. see these wiggling rods that we discover cause tuberculosis. I mean, it's such a beautiful story,

because it's like sciencey nerdy science awe. Like, oh my god, we figured out it was a microbe. But it was also a story of people tackling these interesting problems. You tell such great human stories about the scientists, too. Yeah, just trying to figure out how do you actually prove a chain of transmission.

Bad news for guinea pigs for sure. But how do you prove a chain of transmission? How do you prove that this little wiggly rod is actually what's causing the illness, not like just some coincidence or some byproduct of the illness? That's a really difficult problem and Robert Koch had a brilliant solution for it. Now later he would go on to cause tremendous harm and that's also part of the scientific story is that in the pursuit of scientific understanding we can cause a lot of harm especially if we're not careful and he wasn't adequately careful when it came to promoting what he believed was a solution to tuberculosis.

But that moment of discovery has always stuck with me because it's just so... Because it wasn't just about him, it was about thousands of people who'd contributed to that field. And so he gets all the credit, but think about all the people who had to follow down the wrong paths in order for Robert Koch to understand what the right path was. Think about the people who were editing the medical journals that Robert Koch read. Think about the people who were living with tuberculosis, who were, you know, pursuing their own treatments and understandings of the disease, all the doctors who were working on tuberculosis. This was really a collaboration of millions of people that led to this moment. It's time for a break, but we'll be back soon with more of John Green and his thoughts

on Suck, Awesome, and the End of Tuberculosis. Another theme that comes up in this book and in lots of your books is that even when you're facing these terrible situations, you can find these moments of like small joy. And it was one of the best things about the book is that you'll hear many of Henry's moments of small joy. I'm curious where you're getting your small moments of joy in this, not the worst of circumstances, but in a difficult time right now. People are always funny.

Like people are funny. Dying people always funny. People are funny. Dying people are funny. People are funny when they're suffering. People are funny. People are always funny. This is my favorite thing about us, is I love some gallows humor. I love some late night, everything is terrible, let's make a joke about it humor.

And I just think I find joy in that. I find joy in human connection. I find joy in getting to do this work together with y'all. Like to me, it goes back to what Paul said. Like isn't this fun? You know, despite everything. Despite the fact that we're trying to tackle the world's biggest problems and healthcare inequity and the legacies, the horrific legacies of colonialism. This being able to be in this work together is really very quite fulfilling. And so I find a

lot of joy in that. I find joy, for lack of a better term, in resistance. I love the humor point too, because I had to say even though it was a John Groome book, I really didn't think there was going to be a lot of humor in a book about tuberculosis. I squeezed a couple of jokes in. You know, it's there, it's there, I found it. But that's hard, like again, a kind of just nerdy literary question, right? Like how do you find ways to weave the humor into such a terrible story of suffering? Well, I mean, I would just say that Henry is a very funny person who suffered a lot. I have suffered some and yet am hilarious. Thank you for that thoroughly unearned applause.

Yeah like every, you know, life is funny. Books, Horace said 2100 years ago that poetry should instruct and delight. It's easy to instruct, it's hard to delight, it's especially hard to delight when you're instructing. And I did want this to be a book that at least had moments of delight because, you know, reading a book should be pleasurable. It shouldn't feel like work, it shouldn't feel like, oh, I've got this obligation. It should feel like a connection, a chance to, you know to connect with a story and connect with an author and kind of co-create something together.

So, we're tragically running out of time because this is like the coolest hour of my life to be up here with John. But we're not going to end on my questions. Different thing I forgot to tell you at the top of the show was that we're going to hear from you. You all have submitted questions in advance and I and John's folks have picked some of the best ones and we're gonna go through those But this is gonna be my last question. And so I wanted to end in the most nerd fight away possible. I Want to not forget to be awesome?

Come on, you've got folks. This is a problem, as you know. It can be easy to forget to be awesome when we're tackling hard topics, when it feels like the world is falling apart. I'm curious, how are you embracing awesome these days? Well, we talk about decreasing world suck and we talk about increasing world awesome, and I think they're both important. I think it's important to try to increase the overall worldwide level of awesome. You know what I've been doing recently? And this is ludicrous.

I've been playing this video game called FIFA. It's a soccer video game and I play as the team I sponsor in real life so that I can so that I can see my logo on the back of their shorts. It brings me great joy to see my own logo on the back of their shorts inside a video game and then people pay me to watch this ridiculousness. I'm not good at this game. I actually I did a sports podcast yesterday and this guy was talking to me about it and he said, you're really trash at FIFA. And I was like, thank you. I know. And, um, and people pay me for this. And then I use the money to buy a real life player for my soccer team.

to buy a real life player for my soccer team. Don't applaud this stupidity. This is a terrible use of resources. But I did it because it brings me a lot of joy. So yeah, just little things like finding a video game you like, playing Red Dead Redemption 2, whatever it is, just finding some joy. Love that. So now we're transitioning to your questions. Thank you all for your questions. Sorry we can't answer all of them. Okay. First one is from Olivia Marie from Birmingham, New York. Olivia, you still on?

Hi. You still on? Hi. This one? Binghamton, thank you. Sorry. Olivia Marie's question. We know you now connect a lot of things to tuberculosis, because tuberculosis is everything.

Can you connect tuberculosis to Taylor Swift? Yeah. Yeah. Hold on, I got to get on my phone. I don't want to miss the, I don't want to mess up. Yeah. Yeah. Hold on. I got to get on my phone. I don't want to miss the, I don't want to mess up the lyric. She's got a lyric about tuberculosis.

Hold on. Where is it? I almost want you to sing this lyric afterwards. I'm not going to sing it. OK, I can't find it. But it's something like, you know, like went to the Lake District. You know the line.

Where the poets went to die. The Lake District, where the poets went to die. Y'all heard that. Should we do a round of singing in the whole audience? That's about the British romantic poets who all died of tuberculosis. Legitimately, it is. It's not like a distant connection. She has written indirectly about TB.

Thank you, by the way. I am very grateful to my producing partner, Rosianna, who when we were reading that question backstage and I was like, I don't know if I could do it, Rosianna spun around and she was like, what do you mean you can't do it? And immediately produced that lyric in a way that I clearly cannot. Okay, we're like taking it down from Taylor Swift, because this is a tough one. This is from Anushree.

She notes, Anushree notes, I was diagnosed with spinal TB after years of pain when I visited a doctor in India. I had gone to dozens of doctors in the States to no avail. Wow. Given the popularity of global travel, TB no longer seems like a disease that is only localized to certain countries. Right. How do we encourage American doctors to consider TB, especially in its rare forms, as a possible diagnosis?

This is such an important question and thank you so much for asking it. So this is a huge problem. We have 10,000 cases of active TB in the US. It's going up and it will go up much more now. And yet we don't think of TB. A lot of times doctors, they have a phrase that I think is a very beautiful phrase. They say we have a low index of suspicion. Isn't index of suspicion a phenomenal phrase? I have a very high index of suspicion with almost everything. But they say they have a very high index of suspicion with almost everything. But they say they have a low index of suspicion with tuberculosis, you know, and they say like,

oh, when you hear hoof beats, think horses, not zebras. And I understand that, but we have quite a lot of TB here. And so, you know, the public health officials that I've talked to are always trying to educate the doctors and nurses in communities that tuberculosis is a diagnosis we should be thinking about, including, you know, tuberculosis with bone involvement like you had, which I know can be unbelievably painful. I mean, I've spoken to people who describe that pain to me in ways that just made me shudder. And so I'm so sorry that you had to go through that. I'm so grateful that you were eventually able to be diagnosed. But it doesn't surprise me that you were ultimately diagnosed in India, where there's lots of tuberculosis, where folks have a high index of suspicion,

rather than in the United States. But it is something that we need to work on with our public health departments, with doctors and nurses, with our hospital systems, to remind them to think of TB when they're thinking, when they're hearing from their patients. It also feels like if we're doing that more in the US, it just turns TB into more of a conversation here,

which hopefully can get people to care about it worldwide too. Absolutely. All right, here's one from Caitlin from New York City. Is there a story graph buddy read for everything'sberculosis? Should we create one? No and yes. I'm totally in.

What did you think I was going to say? No. Don't read this book in community. It would bum me out. No, please read it in community. Incredible. The best way to read is to have conversations. I married a person from a book club.

It was that we were in a two-person book club. We had no idea that we were interested in each other. We thought it was totally normal to start a two-person book club to read books together and then to meet and discuss those books over drinks. We thought that was just a completely platonic thing and then one day I was like, am I in love? We both highlighted, you want to hear something really cute? We both highlighted the same passage in a Philip Roth book, and the passage was,

the thing isn't owning the person, the thing is having another contender in the room with you. And Sarah has always been that contender in the room. That is the cutest thing ever, and I don't think you thought you were going to get dating advice from John Green on stage today. Start a two-person book club, that's my advice. I mean, apparently it worked. Yeah, it worked. And make sure you share each other's highlights in the books.

You can do it with a really good book here. But since you're getting personal, I'll jump to this question. This is one from Ellen Stearns from Larchmont, New York. How has being a parent changed you as a writer? So much. For one thing, it's slowed me down. But no, it's changed it so much. I could never have written The Fault in Our Stars or Turtles All the Way Down without

Henry and Alice because with The Fault in Our Stars, you know, having kids helped me to understand this deep fundamental truth about love, which is that love is stronger than death. Love survives death. As long as Henry and Alice or I am alive, I will be their dad and they will be my kids. And so love is stronger than death. And understanding that made it possible for me to write The Fault in Our Stars, I think.

And I never knew that until I was a parent myself. And then with Turtles All the Way Down, they helped me because they helped me get better. They helped me get better every day. I want to do a follow-up on that one you mentioned, Falling Our Stars, Turtles All the Way Down. I'm curious how being a parent helped you with this book. You shared the passage that one of the things that brought you to chat with Henry was that you shared a name with your son. Yeah, I'd never thought about that. But that's true, Henry.

If it weren't for you, there'd probably be no everything is tuberculosis. Or if we'd named you Atticus, as we thought about, might not exist, man. That's so weird. Life is so weird. So here's another cultural one. This one's from Molly from Jersey City.

If Moulin Rouge was more realistic, would Christian have caught TB from Satine? I don't know. Not necessarily. I mean, we forget. How long does that whole thing take place? Like five days? It's like a two-hour show. Yeah, it's wild though. Like a lot happens, but like it all takes place over the course of the development of one show. Maybe it's like six weeks. She gets sick very, it's not a super realistic portrayal of tuberculosis.

There are realistic portrayals of tuberculosis in media, but that is not, in my opinion, really one of them. What's your favorite? Red Dead Redemption 2, the video game. It's very realistic. OK, I just have to channel Connor from Brooklyn. I don't know if you're sitting here listening to this, but you actually wrote a question about Red Dead Redemption 2. So I'm going to read that one.

Connor notes, most of what I know about tuberculosis comes from the video game. Correct. Most of what I know about tuberculosis comes from the video game. Correct. I was wondering if you've ever played that game, Shaw. And if so, what do you think about his portrayal of the deceased? I thought it was great.

I thought I did a great job. He gets sick slowly over time. This is a spoiler for anybody who hasn't played this video game, but not that much of a spoiler. And it's a played this video game, but not that much of a spoiler. And it's a really fun video game. You have to kill a lot of people, which... I was trying to play with my son and I was like, is there a way for us not to kill so

many people? Can we just sort of negotiate? Seem to go straight to violence every time. You can't ever have a conversation where you're like, listen, wouldn't this be better if you just gave us half the money and kept the other half? But you're an outlaw. So I guess it's part of it. But it's a beautiful video game. It's just like very visually beautiful, very engaging and engrossing. And I thought the portrayal of TB was quite good.

Are there other video games that have portrayed TB? I only play FIFA and Red Dead Redemption 2. Okay. Now we're going to get to a tough one because you're bringing the tough ones. I think John can take it. Your work in so many of your books, Especially Fault in Our Stars, explores illness and the different ways it impacts our relationships with the world and with each other.

How has your own personal relationship with illness changed since Hank's cancer diagnosis? Yeah, it's an interesting question. I mean, I think it probably has changed in ways that I haven't totally settled on yet. Like, it feels like Hank just had cancer, and I know it was a year and a half ago, but... Can you, I mean, I'm sure all the fans...

Oh yeah, just for the infectious disease doctors in the room. I keep forgetting about them. My brother had cancer. Weird thing to laugh at. No, I'm just kidding. It's fine to laugh at it. My brother had cancer a few, two, two years ago. He had Hodgkin lymphoma, but we didn't know what kind of cancer he had for about three weeks, and that was the scariest three weeks of my life. We thought it might be a metastasis from another site or another kind of lymphoma that was much more serious.

And in the end, he had this very treatable, very curable form of cancer. And it's worth noting that nobody ever said, I'm not sure if treating your cancer is cost effective even though it cost 150 times more to cure Hank's cancer than it would have cost to cure Henry's TB. Nobody ever said that, nobody thought about that, it never came up, it was never a discussion. Hank got the kind of personalized tailored treatment that any of us would expect and that all of us deserve. And as a result, he survived and he's healthy today and doing great and it has changed the way

I think about illness. It's just a reminder that illness often comes quickly. What does he coming say? Spring is like a perhaps hand coming carefully out of nowhere and that feeling of something coming carefully out of nowhere can be wondrous and also terrifying. And it was a really hard thing for our family to go through.

But Hank was very well supported throughout, not just by us, but also by so many people in, I'm tall, I'll just, if I get emotional, but by so many people in this community, it made a huge difference for his ability to get through that. I mean, I think it just speaks to the power of community in ways that you don't even expect to the power of generosity and reaching out. I'm sure those of you who were in the audience and said good things about Hank helped Jonah

hang out during this time, you probably didn't maybe realize how much it was affecting both of them. Yeah, I think you probably didn't know how much your comments mattered and how much your outreach mattered and little gifts of all forms. But it really did matter. It was really overwhelming. I remember when Hank told me that he was gonna,

I was like, don't talk about it, just, you know, you don't have to talk about it, don't feel like you have to talk about it. And he was like, I think I want to. And then he texted me, guaranteed one out of 10 video. That meant that he knew he was gonna get a lot of views, which he did. That's a reminder, though, that even amid darkness, we can be very funny. That's a great example to me of being funny amid everything, finding ways to still be

— because we're still fully human. You don't stop being a person when you get really sick. That's really important to understand. So yeah, he's doing great and it has definitely changed the way I think, not just about illness but about everything. It's just a reminder of the precarity of all things, you know? We're only here for a little while. It was also really a theme in the book.

You know, you mentioned no one ever asked if Hank's cancer treatment was cost effective. These make it a final sort of happiness question, which is like, there's a lot in this book to get angry about, to get pissed off about. How do we channel that appropriately? I think we have to channel, like you said earlier, into action and community, into working together to try to make the world suck less. It all goes back to less suck, more awesome, I think.

Here's the last question I have from the audience. It's funny, it's going back to us being here in New York. I think the organizers really want us to pick a very New York-y question as John's last question. But it's actually a question from Alana Harris, who's from Tulsa, Oklahoma. Wow. From New York. Thanks for coming all this way.

She kindly points out Tulsa, Oklahoma, parentheses, the capital of Oklahoma. So Alana, some stuff came to mind. It is. Everybody knows that. But here's what Alana says. She says, hi, John. You spent some time living as a young artist.

You spent some time as a young artist living in New York City. Do you have a favorite piece of advice you received during that season of your life? Or do you have any hindsight to offer to the new generation moving to New York City for careers in the arts? Get a roommate. Maybe five. No, I think the best piece of advice I received during that time actually came from my editor, Julie Strauss-Gable, who's here. Who's been my editor for 22 years, since two years before Looking for Alaska was published. And when I was living here, I was writing paper towns, and I remember Julie said to

me, you're 29, you can't act like a little deer in headlights anymore. That was really good advice, because I was still acting like I was 22, you know, like I don't know anything. I'm just a little boy, you know. I'm just trying to make my way in the world and that's one thing that comes to mind. The other thing that comes to mind is another friend who's here tonight, Maureen Johnson, the great writer. I was writing a book with Maureen Johnson. She was writing Sweet Scarlet. I was writing Paper Towns. We're sitting across the table from each other and I was crying. She said, you know, you don't have to feel everything that they feel.

It's really good advice. That's really good advice. Right. Well, that was our last question. I want to end with another thing we know boosts happiness, which is gratitude. I'm going to do this without trying to cry. But John, thank you for bringing to light New Suck that I didn't know about, but found incredibly curious and incredibly hopeful, oddly. Thanks for giving me hope in my life. New Suck that I didn't know about, but found incredibly curious and incredibly hopeful,

oddly. Thanks for giving me hope in moments where I really needed it. And thanks for your curiosity, your courage, your kindness, and all your books. Keep them coming. Thank you so much. Dr. Laurie Santos, everybody. Thank you so much. One more time for Dr. Laurie. Thank you so much.

One more time for Dr. Laurie. Okay. I forgot. I have a mic over there. It's okay. So we're nearing the end of our time together tonight, but I don't blame you if you feel like we're also nearing the end of our time. In a more general sense, you may feel, as I sometimes do of late, that the world is

a little bit ending. Societal collapse is in the air, noted theologian Timothy Chalam, recently. He really said that. He's so beautiful and he's so pithy. We know that the world will end. It will end for each of us, for all of us, for our planet, but not today. Not yet. My friend Henry loves the verbs encourage and discourage. And right now, I confess that I am very discouraged. I feel that my courage is being dragged down by all sorts of forces, especially by those who argue or act as if some human lives are

more valuable than others. How can we respond, hopefully, to a moment where hope does not feel rewarded or justified? How can we imagine better to a moment where hope does not feel rewarded or justified? How can we imagine better worlds when so many power structures seem intent upon making worse ones? I mean one recent estimate holds that as I mentioned earlier, cutting all US-related tuberculosis funding will result in 3 million more cases of TB every year. It's easy to feel that this is the end of history, and I don't blame you if you feel it.

There's a dread about our historical moment, a general feeling that horror is here and worse is coming, and I feel that too. I mean, why are we even here? Just to suffer? Just to worry? Sometimes it feels that way. But I think we are in this not yet.

We are here to be with each other in the deepest sense, to help others feel less alone and to allow ourselves to help us feel less alone. I believe we are here to accompany each other through the joys and travails of humanness, through the wonder and the precarity. We do not live at the end of history. We live in the middle of history. I argue in the book that we're products of history, but we are also ourselves historical forces and together we can change the arc of our shared story. I've seen that happen. The year I graduated from high school, 12 million children died under the age of five, and last year fewer than five million did. That progress

wasn't natural or inevitable. It happened because millions of people, billions if you count all the taxpayers who contributed to it, worked together to make the world safer for children. And that is my hope. I know that today feels like the last day, the end of the story, because it's the last one we've lived through so far. But today is not the end of the story. Today is the middle of the story, and it falls to us to fight for a better end. My friend Amy Cross-Rosenthal, who died of cancer a few years ago, knew this better than

anyone I've ever met. Amy used to ask people to sing an old song from World War I, sung to the tune of that New Year's Eve song, Auld Lang Syne. British soldiers in the trenches, horrified by the pointlessness of war would sing, we're here because we're here because we're here because we're here. And Amy changed the meaning of that song without ever changing the words. She turned it into a kind of battle cry for hope. It's true that we can't say with certainty why we are here, but we can nonetheless celebrate being here, especially

being here together in community, because that song, when sung together, takes on an entirely different meaning, at least for me. And if you'll indulge me, I'd like to sing it together once now, hopefully with Dr. Laurie Santos. We're here because we're here because we're here because we're here. We're here because we're here because we're here because we're here. Thank you so much for being here with us tonight. Thank you. Thank you. Thank you.

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