Well, we have come to the end of our discusion. This has been a blast and I think it was one of the best #NephJCBookCLub Turnouts we have had. Thank you everyone for joining in. #NephJC
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Hashtag
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Remember to add #NephJC (and not #NephJCBookClub) to every post you want to be part of the discussion
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This #nephjc tweetorial masterclass from @hswapnil.medsky.social tells you everything you will need to know for the #nephjcbookclub #allhashtagsmatter
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This stat put the residential school trauma into much clearer perspective for me. Not only was residential schooling an attempt to eliminate first nations’ cultures, but it became a de facto attempt at eliminating the population altogether #nephjcbookclub
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SO @hswapnil.medsky.social did some great work posting with the hashtag #NephJCBookClub, we will be posting tonight with #NephJC as usual. Don't try to get fancy swap...and my eyes are on you too @jwaitz.bsky.social
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And poetry from @nephromommy-akshu.bsky.social
www.nephjc.com/news/2025/8/...
#NephJC #NephJCBookClub
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#NephJCBookClub will be on this week
Check out @kidneyboy.bsky.social take on 'Everything is TB' here
www.nephjc.com/news/2025/8/...
Hope @johngreensbluesky.bsky.social can join us tomorrow at 9 pm EST for the discussion
#NephJC
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Just finished ✅
#NephJCBookClub
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Screenshot from Audible app, showing end credits playing from Everything is Tuberculosis by John Green.
Everything is Tuberculosis
✍️&🎙️ John Green @johngreensbluesky.bsky.social
#NephJC 📚
#NephJCBookClub
#NephJCSummerBookClub
👉 www.nephjc.com/news/2025/6/...
@nephroseeker.medsky.social @brianrifkin.bsky.social @kidneyboy.bsky.social @hswapnil.medsky.social
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Popular books on booktok highlighted at the local Indigo, including Everything is TB
Can’t escape the #NephJCBookClub!
Everything is tuberculosis is everywhere! @johngreensbluesky.bsky.social
At the local book store
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Slightly off topic - but it seems he developed TB, did not take streptomycin, spent time in a TB sanatorium reading the ‘Magic Mountain’
Everything is TB after all #NephJCBookClub @johngreensbluesky.bsky.social
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Table 1. Incidence and RRs for Clustered TB (n = 218) and Nonclustered TB (n = 389) by Patient Demographics in Arkansas, 2010-2021 showing huge relative risks in Asian, Pacific Islanders and Black ethnicity
Arkansas does not have much TB, but when it does….look at that race/ethnicity relative risks 😱
jamanetwork.com/journals/jam... in @jama.com JNO
#NephJCBookClub on TB coming up in August
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Like J&J overpricing bedaquiniline, GeneXpert overprices the cartridges to diagnose drug resistance - allowing slower recognition, more spread, more deaths, see youtu.be/tSC06P9A5W4?...
As Dr Girum sez ‘That’s the point where you put down your stethoscope’ when drugs stop working
#NephJCBookClub
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In chapter 14 we delve into MDR-TB and XDR TB (there’s also TDR TB pubmed.ncbi.nlm.nih.gov/22190562/)
And the poignant case of Shreya Tripathi, who died at the age of 19 since the Indian Govt refused to allow bedaquiniline use in Patna m.thewire.in/article/heal...
#NephJCBookClub
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With many different stories, he deftly argues why the western, top-down DOTS doesn’t recognize the nuances of ground reality for many patients
It’s not wilful nonadherence and DOTS might make things harder?
#NephJCBookClub
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Chapter 13 deals with why we haven’t controlled the disease despite effective drugs
Compliance, adherence - they are dirty words in @johngreensbluesky.bsky.social view
DOTS (pioneered by the late Karel Styblo and others) is now viewed as paternalistic and problematic
#NephJCBookClub
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Streptomycin is ghastly apart from the side effects
As an intern in a public health unit in Mumbai we were assigned streptomycin duty (I did this a few times)
All day in a windowless room, injecting IM streptomycin in a few hundred TB patients throughout the day
#NephJCBookClub
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But many others made it
#NephJCBookClub
Gale Perkins from the earlier chapter
Vivian Leigh
And the voice of:
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George Orwell
Streptomycin didn’t help the best modern writer of the English language either
See pmc.ncbi.nlm.nih.gov/articles/PMC... from @hildabast.bsky.social
He developed severe side effects. PAS wasn’t enough either
#NephJCBookClub
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Then @johngreensbluesky.bsky.social pivots to therapeutics - PAS, then streptomycin quickly were almost miraculous in curing TB
For #EpiSky nerds, the MRC streptomycin trial is special for using random numbers + concealed allocation see pmc.ncbi.nlm.nih.gov/articles/PMC...
#NephJCBookClub
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The latitude-BCG efficacy is a fascinating aspect
I use this as a teaching example from meta regression to resolve heterogeneity in analyzing a meta analysis - see academic.oup.com/cid/article-...
#NephJCBookClub
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Dr Alan Hart, from his Wikipedia page
Chapter 12 The Cure has several points
Alan Hart - the trans doctor hounded from several hospitals (some things still haven’t changed) and pioneered use of XRC for diagnosis
BCG in TB? Developed from bovine TB bacteria with mixed effect is given a page only
#NephJCBookClub
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We also read about Gale Perkins friend (Angie’s experience) and Angie’s dad’s poignant letter writing story
Gale Perkins memoir; www.ccbpublishing.com/978192736014...
#NephJCBookClub
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The (faux in my case) Adirondacks chair was made for TB patients to recline in the sunshine at a TB sanatorium in the Adirondacks - see https://sites.middlebury.edu/adirondack/2021/10/24/adirondack-chairs-and-tuberculosis/
Chapter 11: with no cure, TB treatment was to provide rest, fresh air and sunshine - sanatoriums blossomed all over. Pasadena and Colorado Springs cities were established by this population growth in that direction
#NephJCBookClub
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This was exposed by ….Arthur Conan Doyle’s sleuthing www.arthur-conan-doyle.com/index.php?ti...
(A few years before his first Sherlock Holmes 🕵️♂️ story)
#NephJCBookClub
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In Chapter 10 we see German Koch’s attempt at emulating/upstaging the French Pasteur’s vaccines for anthrax and cholera with the tuberculin ‘Koch’s serum’
@bmj.com coverage from 1891 www.bmj.com/content/1/15...
He injected himself (and his mistress Hedwig) with this 🤦🏽♂️
#NephJCBookClub
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In Canada 🇨🇦 in 1930s or so
- white Canadians died of TB at rate of ~ 70/100,000
- the First Nations died at rate of ~ 700/100,000
And
Kids in residential school? At ~ 8,000 per 100,000
8% mortality, just from TB in residential schools 😱
#NephJCBookClub
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Chapter 9: previously blamed on genetics, air quality - the bacterial nature of TB changed its perception.
It became a disease of the poor with the stigma attached
Read this absolutely horrific essay blaming emancipation for all sorts of illnesses archive.org/details/effe...
#NephJCBookClub
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His wife Emma gifted him the 🔬- and he promptly had an affair with a teenage named Hedwig and eventually left Emma a few years later 😳
#NephJCBookClub
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