Let's have a little bit of a real talk for a second. Normally I'm... a "little" dramatic.
I say things are terrifying, when they definitely aren't.
Nobody is legitimately scared of Pokémon evolution, (1) Mario's fists, Steve or Alex's biceps.
Or any other, "thing" that I've yelled about.
Nobody's ever pissed the bed because the water in Fallout is "super radioactive"
Nobody's gone to therapy because Spider-Man is murdering folk
and nobody's been put on medication because the Giants in Skyrim are living bombs.
But what I'm talking about today, this is the real stuff.
I'm talking about things that affect (2) real people, every day, across the world.
I'm talking about the most deadly threat to human existence,
something that's been stalking and killing us ever since our birth as a species.
A predator that's been growing alongside us,
evolving and killing more of us than any other single cause of death.
One that's been able to learn over time how to become immune to our best and strongest weapons against it.
It's currently (3) the most deadly disease on planet Earth, and it killed Arthur Morgan.
I'm talking, of course, of the disease tuberculosis.
So, if you're easily frightened or have a heart condition,
now's your warning to turn this video off.
Because for the first time ever on this show,
it's time for us to step out of the world of video games and into real life.
Where real people die every single day. (4)
Are you ready?
Then let's go.
[Music]
I decided to do this video because, honestly, the more I read about tuberculosis,
the more amazed I was.
It's the kind of thing that when you start trailing down the Wikipedia article for a summary,
if you live in the United States,
your eyes grow WIDE.
Phrases like "the number one cause of death from an infectious disease"
float across your eyes and you wonder, (5)
"Can that be right? What's the source on that? Oh, the World Health Organization! Holy Crap!"
Today's a bit of a... weird episode for me.
I tried to write this section in particular probably a dozen times and just could NOT get it right.
But I think I finally, kinda, sorta have it.
We're going to go over Arthur Morgan's case, piece by piece, and paint a picture of his prognosis,
what he could have done to increase his chances (6) of survival,
And conclude, wether or not, his death, AKA, his redemption, was inevitable.
So, first things first,
What is Tuberculosis?
Tuberculosis, known specifically as Mycobacterium Tuberculosis, is really, REALLY old.
It's not known with any degree of certainty whether it or leprosy is older,
but given that they're both from the same genus, Mycobacterium, and both work (7) somewhat similarly,
it doesn't really matter which of them actually came first.
Our most accurate estimate suggests
that Tuberculosis evolved some time between 50,000 and 70,000 years ago,
back when the human population could have been as small as 1,000.
So, this is a disease that's been hunting us basically as long we've existed.
And, in all likelihood, co-evolved alongside us.
You can track (8) Tuberculosis when the bacteria reaches the pulmonary alveolus,
the end point of the branches of your bronchi responsible for gas exchange.
Where, they then begin to replicate immediately.
M. Tuberculosis replicates slower than most bacteria, but it makes up for this by being incredibly rugged.
And as few as ten Tuberculosis bacteria can replicate into active infection. (9)
People are introduced to the illness exactly like Arthur Morgan is,
by being coughed on.
Each cough or sneeze can release tens of thousands of droplets of blood and mucus
that each carry the disease, and breathing them in can spell disaster.
And in the time and day of Read Dead Redemption 2, there would have been like signs like these
that would have been warning people to avoid coughing and spitting to reduce the spread of the disease.
(10) Anyway! Back to the lungs!
M. Tuberculosis is covered in a thin waxy coating on its cell surface that's made up of micolic acid chains,
and it's these acid chains that are the key to its resilience,
and, horrifyingly, its dependence on our immune system to multiply.
Like HIV, tuberculosis turns our own body's defences against us.
As soon as our body detects the presence of M. Tuberculosis in our system,
(11) it sends what's known as macrophages out to destroy them.
Macrophages are the shock troops of the immune system,
and they basically eat stuff that's not supposed to be in our body.
However, when macrophages attempt to eat tuberculosis in a process known as
phagocytosis, from the Greek phagein, meaning "to devour",
and kytos, meaning "presence in blood"...
Wait, okay, no, that's the wrong show. And, the wrong translation.
(12) Kytos, just means "cell". So, literally, "cell that eats".
Anyway, what happens is the macrophage envelops M. Tuberculosis,
throws it in a bag filled with oxygen and acid in an attempt to basically melt it to death,
but the waxy micolic acid chains protect the tuberculosis bacteria from disintegration,
like its own personal Darth Vader.
And it's here that things start to get out of control,
because the bacteria (13) just lives inside the macrophage and replicates over and over
and over until it literally PUNCHES its way out like an alien chest-burster,
spreading hundreds of new tuberculosis cells throughout your body.
It's here that we cross the point of no return.
Once the bacteria has entered your pulmonary alveoli, and burst out of a macrophage,
your chance of dying skyrockets to 66%. (14)
You now have an active infection and the clock is ticking.
But believe it or not, while you may think Arthur Morgan was doomed the instant he got coughed on
by Mr. Downes, that's not actually true!
You see, before tuberculosis progresses to an active stage, it has a latency period
where it can stay for YEARS.
A TON of people have tuberculosis and are asymptomatic,
because the bacteria never gets to the alveolar air sacks. (15)
Up to 90% of people who get infected with Tuberculosis
NEVER progressed to active state.
So what made Arthur Morgan so "lucky"?
Or I guess, "unlucky"?
...
His life...
[Music in background]
Everything he chose to do with his life
was a risk factor for disease,
and pretty much guaranteed that the instant
he was exposed to the bacteria,
he was going to NOT only get infected, but... (16)
die.
The mortality rate for untreated
active tuberculosis is at LEAST
50% but can be as HIGH as two-thirds of patients!
But there are a lot of things that increase your risk factors.
People who smoke for example double their risk of tuberculosis infection
and Arthur is an avid smoker.
A lot of it is up to player choice,
but it's shown multiple times that he smokes on his own.
Arthur also drinks QUITE A BIT, (17)
with an entire mission
(easily, the best part of the game)
being dedicated to getting black-out drunk.
This isn't an anomaly,
and it in fact would be much more surprising
if Arthur Morgan WASN'T a "bon vivant".
In the 1800s, the average man consumed 7 gallons of ethanol.
PURE ETHANOL AMOUNTS, mind you, PER YEAR!
Which translates into over 4 and a half beers per day,
(18) or over 1659 bottles of beer per year
Over 155 gallons of beer per year,
and you wonder why prohibitionists existed!
Cigarettes and alcoholism both increase the risk of progression
by a HUGE amount
because... well,
cigarettes cause direct damage to your lungs,
and alcohol can weaken your immune system
and cause dehydration.
In fact, all sorts of immune-compromising conditions (19)
can increase your chances of tuberculosis progression.
HIV is a major factor, but this wasn't a problem
in America at the time of Read Dead Redemption 2,
and probably wasn't a thing at all until the early 20th century.
HOWEVER, there's one BIG fat event that happens
in Arthur Morgan's life that utterly and completely dooms him.
And it's when he's shot,
kidnapped,
and tortured by the O'driscol gang (20)
in chapter 3.
Being shot with a gun and not being properly
fed for days means he's going to be suffering
from physical trauma and malnutrition.
Both of which increase the likelihood that his tuberculosis will progress.
Malnutrition suppresses the immune system and physical trauma,
(even MEDICAL trauma, from surgery!)
greatly increases your chance of getting all kinds
of secondary infections - (21) what's know as the "two-hit response".
It's HERE, at this moment, that Arthur Morgan's fate is solidified.
And it's telling that the first real cough that you see from him
is after this point in the game.
This means that Arthur 100% caused his own death.
No, he didn't know that smoking would make things worse,
and everybody at the time was drinking like a fish,
but it was his LIFE that put him in this position (22) in the first place.
His LIFE, his CHOICES - those put him in harm's way, and made his death inevitable.
This is the core thesis of the Red Dead Redemption series;
That choices have consequences,
and a life of murder, violence, and crime has a price tag that can't be avoided.
Attention must be paid.
And if he wasn't an outlaw enforcer
for a loan shark, he wouldn't have been
been exposed to tuberculosis.
If he wasn't living a risky life of constant violence,
with no time to rest at all, it's possible he could have recovered from his infection,
or possibly not even progressed into "active tuberculosis" at all.
Choices have consequences.
And it's this realization that a life lived a certain way has a price, that drives
Arthur's decisions and motivations after his diagnosis, to try to leave a legacy behind,
to try to lift up other people out of this life.
He knows his fate, he knows that the life he leads,
one that doesn't allow for rest, or peace, does not put
him in the 34% survival bracket. From his diagnosis on,
he knows what's going to happen to him, and he accepts it...
thats his redemption.
[music]
It's fitting that they used to call tuberculosis
the "romantic disease."
And it's a fitting end for an outlaw, who led a -kinda- gray life.
What's less romantic, is that right now, every single day,
people on Earth, our real world, die horrifically from tuberculosis.
It's the single most deadly disease on our planet.
It kills more people than HIV every single year.
Through out history, it's killed an estimated 10.7 BILLION people total.
More than every war ever fought, HIV, Ebola, The Black Death, car crashes, snake bites, and falling deaths COMBINED.
Right now, 25% of the entire human population is infected,
and over 1.3 million of them will die.
Le-Let me put this into a real number that you'll understand at a
glance. You see that counter that's been on the screen for this whole video?
That's how many people have died from tuberculosis while you've been watching this.
Twenty-seven people.
Real people. Because while tuberculosis has largely been eradicated in the United States,
with only 9,093 new cases in 2017, due to vaccines and antibiotics, most of the world
does not have access to these treatments. In large sections of the world,
if you get tuberculosis, you have no choice but to deal with it.
And in some cases, even medication won't help because tuberculosis has many antibiotic resistant
strains now. Meaning, our one tool for combating it has become obsolete.
This revelation blew my mind. 1.3 million -MILLION- deaths every year, mostly children, and the elderly,
and those infected with HIV. That is absolutely horrible. And I, honestly, haven't been aware of how lucky I am
to live in the United States in a long time, than by learning this fact alone.
Tuberculosis is one of the number one causes of human death, and is THE number one cause,
depending upon how you count, and is absolutely the number one cause in our entire human history.
And I don't hear about it. Ever.
This is likely the first time you have heard about it. People get infected and can suffer in waves,
for months, as their body heals a bit, recovers, and relapses, until, eventually their lungs
just stop working because they're to damaged, and they suffocate. But, there actually is hope.
Every day, people like TB Alliance are fighting to find more effective treatments for tuberculosis,
to hopefully undo the damage its growing immunity to antibiotics is causing, while
charities like TB a!lert, and the Bill and Melinda Gates Foundation try to bring existing treatments
to people in need on the ground. Links to all three of these charities that I personally vetted
myself, are in the description. And if you can give money, I definitely recommend you do so.
Even as little as a dollar can save a life, either today by getting treatment to those who need it,
or ten years from now when a new treatment is discovered, because we're all humans,
on this planet together. We should do what we can to help those of us who are in need,
like Arthur Morgan trying to forge a future for his adopted family. We should do
what we can to help those of us who are in need. It doesn't take a lot, a little bit from a lot of people
goes a long, long way to making a better world. Not just a better world for
us, but for those who are gonna come after we're gone.
Just something to think about.
Sincerely, Austin.
[music]