Long before Columbus set foot in the Americas, tuberculosis was already present. This ancient adversary may be older than modern humans and has left its mark on our culture. John B. Stetson headed west in search of clean air after a tuberculosis diagnosis; his experiences led him to invent the iconic cowboy hat. In the late 19th century, thousands flocked to New Mexico’s dry climate and sanatoriums, turning the territory into a hub for “lungers” and shaping its economy. Today, antibiotics and vaccines let many in rich countries think TB is a disease of the past. Yet this curable disease remains the leading cause of death from an infectious agent, and the bacterium continues to co‑evolve with humans. The story of TB is far from over.