Re:Thinking with Adam GrantJohn Green on solving big medical problems | ReThinking with Adam Grant
CHAPTERS
- 0:00 – 0:45
Permission to suck: Warm-up banter and lowering the stakes
John and Adam open with playful rapport about interviewing pressure and John’s tendency to self-edit. The exchange sets a candid tone that later connects to John’s creative process and vulnerability as a public figure.
- •John jokes about Adam being “unusually good” as an interviewer
- •Light teasing establishes the live-audience setting at Penn
- •Early hint of John’s self-editing and perfectionism tendencies
- 0:45 – 2:06
Why write a book about TB: the “exemplary disease of injustice”
Adam admits he wouldn’t normally read a book about tuberculosis, and John explains why he made TB the focus anyway. He frames tuberculosis as neglected despite being the world’s deadliest infectious disease, making it a case study in injustice and attention.
- •TB is the deadliest infectious disease, yet widely unknown/ignored
- •Neglect has deep historical roots and continues today
- •John’s goal: use storytelling to force attention toward TB
- 2:06 – 4:31
Meeting Henry in Sierra Leone: the story that made TB personal
John recounts visiting a tuberculosis hospital in Sierra Leone and meeting Henry, a patient who guided him through the facility. Learning Henry’s true age and prognosis transformed TB from a statistic into a lived reality, motivating John’s book.
- •John didn’t realize TB hospitals still exist
- •Henry (a patient) became the “mayor” of the hospital and a guide
- •Henry’s TB wasn’t responding well; limited tools in Sierra Leone
- •Henry looked 9 but was 17 due to malnutrition and TB
- •Reuniting in 2023 solidified John’s commitment to write the book
- 4:31 – 6:21
Why TB remains uncured: unequal value of human lives
Adam presses on the moral outrage: we know how to save people, yet don’t. John explains TB is curable but treatment is demanding, and the deeper problem is structural—health systems and markets don’t value all lives equally.
- •TB treatment requires months of daily antibiotics; drug-resistant cases take longer
- •Henry took 20,000+ pills over years
- •Comparisons to cancer highlight double standards around “cost-effective” care
- •Core diagnosis: systems of injustice determine who receives treatment
- 6:21 – 7:16
The real math: $25B/year and the choice not to act
John lays out the scale of investment needed to eradicate TB and argues humanity can afford it. The barrier isn’t resources but priorities—societies repeatedly choose inaction despite capability.
- •Eradication estimate: ~$25B/year for ~10 years
- •Global capacity exists; scarcity is not the limiting factor
- •Moral frustration: ability to act is present, but the will is missing
- 7:16 – 9:09
Taking on pharma: patents, profit incentives, and making drugs affordable
John describes engaging pharmaceutical companies, emphasizing people inside them aren’t “evil” but incentives skew toward profit. He explains advocacy tactics—private pressure first, public escalation when necessary—and points to a concrete win on bedaquiline pricing through patent changes and generics.
- •Market incentives reward profitable “lifestyle” drugs over TB tools
- •Advocacy focus: access at cost/near cost in impoverished communities
- •Private conversations are preferred; public pressure is sometimes required
- •Bedaquiline secondary patents dropped; price fell ~55% with generics
- 9:09 – 11:57
Public funding and USAID: treatment interruptions, resistance, and global risk
John argues public investment is irreplaceable, highlighting the consequences of foreign-aid cuts for TB. Interrupted treatment accelerates resistance, raising both individual death risk and broader societal danger, including the possibility of untreatable TB strains.
- •US foreign aid framed as high-impact, low-cost spending
- •USAID defunding and stock-outs disrupt multi-month TB regimens
- •Interrupted treatment increases drug resistance dramatically
- •Drug-resistant spread is a community-level catastrophe
- •Worst-case fear: TB with no effective tools, returning to pre-antibiotic eras
- 11:57 – 12:37
The one fight with Hank: conflict avoidance and sibling dynamics
A humorous detour: John recounts his only real argument with Hank during the first VidCon over a malfunctioning screen. The story underscores John’s discomfort with confrontation—relevant to his reluctance to publicly “name and shame” corporations.
- •A single argument in 20 years of collaboration
- •Miscommunication and tone (“Stop looking at me that way”)
- •Six-hour silence, quick repair and forgiveness
- •Reinforces John’s non-confrontational disposition
- 12:37 – 15:16
Writing as Marco Polo: creative solitude, response, and missing voices
John shares a metaphor for writing as calling “Marco” in the dark until readers respond “Polo.” He connects it to Shreya, a fan who died of drug-resistant TB, reflecting on attention, privilege, and the tragedy of not hearing urgent “Marco” calls sooner.
- •Writing as delayed feedback: solitude before connection
- •Internet shortens the loop but can flatten depth of engagement
- •Shreya reread The Fault in Our Stars while dying; fought for bedaquiline access
- •John reflects on privilege and the limitations of his information feed
- •Commitment to listen to marginalized voices, not only speak
- 15:16 – 17:22
OCD, disease fears, and why illness reveals injustice
John discusses living with OCD and acknowledges how his obsessive fears often revolve around disease. He also broadens the lens: disease follows paths of injustice, yet receives surprisingly little cultural attention compared to other harms.
- •OCD is irrational and not grounded in real-world probabilities
- •Possible link between personal preoccupation and interest in infectious disease
- •Disease kills most humans, yet is underwritten in literature and culture
- •Illness is both an injustice amplifier and a central human reality
- 17:22 – 18:29
Confronting irrational beliefs and conspiracy spirals
Adam asks about engaging people who hold irrational beliefs without recognizing them as such. John admits he struggles, especially with loved ones, and both reflect on how the internet’s information architecture makes it easier to get lost; Adam offers a practical debunking approach.
- •John finds it heartbreaking and difficult with family and friends
- •Internet dynamics can harden and deepen conspiratorial rabbit holes
- •Suggested tactic: ask what sources are credible and what would change their mind
- •Meeting people on their own criteria can open a door to dialogue
- 18:29 – 20:33
Banned books and the chilling effect on teachers, librarians, and authors
John describes the emotional and practical impact of book bans—less outrage than hurt and disbelief at being labeled a “pornographer.” He emphasizes that teachers and librarians bear the brunt, bans disproportionately target LGBTQ authors and authors of color, and the chilling effect now suppresses sales and access.
- •Book bans feel personally painful and culturally bizarre
- •Real “main characters” are teachers and librarians dealing with daily fallout
- •Disproportionate targeting of LGBTQ voices and authors of color
- •Chilling effect is increasing; banned books no longer reliably get a sales boost
- •Call to trust trained educators and librarians to do their jobs
- 20:33 – 23:40
Writing craft and creative meaning: starting badly, learning from bad books, and intrinsic value
Audience questions shift to process: John advises overcoming writer’s block by starting imperfectly and giving yourself permission to write badly. He highlights reading—especially reviewing bad books—as apprenticeship, and argues creative work must be rooted in intrinsic meaning rather than external validation.
- •“Coal miners don’t get coal miners block” isn’t helpful; permission to be bad is
- •John deletes 80–90% of first drafts; progress comes from starting
- •Reading (good and bad) teaches craft; bad books reveal mechanics
- •Creative work should be valuable in the making, not just reception
- •Avoid dependence on external validation; find meaning in the work itself
- 23:40 – 28:00
Hank’s inventions, humanity’s progress, and building relationships by making together
John answers playful and serious Hank questions: he recounts Hank’s unexpectedly successful “2D glasses” idea, then offers a powerful case for humanity’s worth using child mortality reduction as evidence of collective compassion. The conversation turns to sibling closeness and John’s advice: build bonds by making things together.
- •Hank’s “3D-to-2D” glasses became a surprising hit; John regrets not investing
- •Proof humanity is worth saving: dramatic decline in under-5 mortality since 1995
- •Progress isn’t inevitable; it’s the result of collective prioritization and policy
- •John and Hank’s relationship is sustained through collaboration and trust
- •Advice: make projects together (even privately) to deepen relationships
- 28:00 – 35:03
Motivational quotes, lightning round, and closing calls to action on TB and meaning
John defends even “cheesy” motivational quotes that capture something true, while Adam pokes at scientifically inaccurate aphorisms. In the lightning round John covers Twitter deletions, rethinking USAID, uncertainty about AI, and love for longform—then closes with concrete TB action steps and his view of life’s meaning: community and attention.
- •Motivational quotes can work if they’re true (and not technically wrong)
- •Lightning round: deletes tweets when they escape intended context; rethinking USAID; AI uncertainty; “long live longform”
- •Dr Pepper riff: taste as “the smell of an 1889 Waco pharmacy”
- •TB action: support orgs like Partners in Health; advocate to Congress/Senate for funding
- •Meaning of life: be with each other, pay attention, and help others notice what matters
