Content Warning: This section of the guide includes discussion of illness, death, child death, child abuse, ableism, and racism.

Green suggests that the phrase “natural death” is a misnomer since it implies that natural causes aren’t deterred by “unnatural” systems like healthcare. People accept the idea of a “natural death” because it is a psychological construction; when one is said to have died a natural death, they fulfill parameters that make the death feel more acceptable. Historically, child death was previously considered “natural” because of its frequency prior to modern healthcare. TB is one of the few diseases that killed sick people indiscriminately, no matter what stage of life they were in. This increased the terror around it.

Citing Kurt Vonnegut’s novel Cat’s Cradle, Green explains that the human relationship between understanding and fear is instinctive to humankind. People are driven to understand a disease both to empathize with others and to assure themselves that they are exempt from that pain. This symbolic understanding of disease impacts the human response to the general concept of disease.

TB was initially imagined as a disease that targeted moral failure. This shifted as TB spread, infecting the affluent. During the 18th century, TB was the overwhelming cause of human death.