How Arthur Morgan Gets TB In Red Dead Redemption 2

Summary

Regardless of how it is played, Arthur Morgan contracts tuberculosis and dies by the end of Red Dead Redemption 2.
Tuberculosis was a deadly disease in the 1800s with limited treatment options.
Arthur catches tuberculosis during a mission when Thomas Downes coughs infected blood on him.

[Warning: The following story contains major spoilers for Red Dead Redemption 2.]

Regardless of how Red Dead Redemption 2 is played, Arthur Morgan always contracts tuberculosis and passes away by the end of the game. While this reveal does come later in the story, there is a specific scene that makes it clear exactly when Arthur catches this, but it may not be apparent during someone's first playthrough of the game.

Tuberculosis (commonly called TB) is an infection caused by bacteria that often targets the lungs or any other area in the body with a lot of blood and oxygen flowing through it.

Although there is treatment now for TB, there were barely any available options for people unfortunate enough to contract the sickness at the end of the 1800s when Red Dead Redemption 2 is set. Most people who were unlucky enough to become infected succumbed to their illness, and Arthur Morgan is an example of this, passing away from the infection by the end of Red Dead Redemption 2's story if he’s not killed off by Micah first.

The three protagonists of the Red Dead series - Red Harlow from Revolver, yelling and firing a revolver; John Marston from Redemption, pointing a sawed off shotgun; and Arthur Morgan, staring straight ahead.

Complete Red Dead Timeline Before RDR3 - Revolver, Redemption, & RDR2

Rockstar's acclaimed Red Dead series spans several decades in the Wild West with numerous protagonists across its three main Western titles.

When Does Arthur Contract Tuberculosis?

Arthur Catches TB Early In RDR2's Story

Throughout the second half of Red Dead Redemption 2, it becomes clear Morgan is sick thanks to his incessant coughing and pale color. A doctor in Saint Denis confirms Arthur Morgan's tuberculosis diagnosis, and Arthur gets slower and less agile as the game’s conclusion draws near, with the gameplay paralleling how his body and abilities would deteriorate in real life.

This reveal was set up very early in Red Dead Redemption 2's story, however, as Arthur gets TB during the Money Lending and Other Sins III mission. During the quest, the Van der Linde gang's loan shark, Leopold Strauss, tasks Arthur with collecting a debt from various people in a rather uncomfortable sequence that sees many of them begging for mercy as Arthur takes what little they have left to pay off the debt.

One of these people was Thomas Downes, like many other people who crossed the gang's path, made the mistake of borrowing money from Strauss, and Arthur finds him working in his garden when he comes to collect what’s due. It becomes clear that Downes is unwell as he can be seen coughing throughout their conversation, but the game forces Arthur into an interaction with Downes until Downes coughs blood and his family intervenes, begging for mercy and explaining that Downes isn't well until Arthur leaves, stating that the Van der Lindes "aren't a charity".

Canonically, Arthur beats Thomas Downes, as explained in a later conversation, but even if the player doesn’t attack him and just uses threats and intimidation, it’s impossible to prevent Downes from coughing on Arthur and giving him TB.

RDR2's Different Endings Explained: What The 2 Animals Mean

Rockstar Games' Red Dead Redemption 2 features different animals depending on how the player made Arthur act over the course of the game.

Arthur's TB Diagnosis Is Set Up Throughout RDR2's Story

Arthur's Death Is Inevitable

Arthur Morgan faces the sun as he lays dying

If players chose to have Arthur using violence during his interaction with Thomas Downes, the latter's coughing blood could be perceived as a result of his beating. However, coughing blood is also one of the major signs of TB. Arthur barely paid any mind to the blood spewed in his face at the time, but in hindsight, this moment set up that Downes had TB, and also confirms he gave it to Arthur, since coughing infected blood in someone’s face is a guaranteed way to give them tuberculosis in RDR2 as well as in real life.

Downes can also be heard coughing near the stables in Valentine while asking for donations for charity long before Arthur is sent to collect his debt, and to further show his good nature, he is also the man who breaks up the brawl in Valentine early in the game.

The next time Arthur returns to the Downes family home in Red Dead Redemption 2's story, he learns Thomas Downes has passed, having succumbed to his illness. While Arthur initially insists Thomas’ wife and son are responsible for the debt, later on in the game - when Arthur eventually sees the Downes widow working as a prostitute in town - the sight leads him to kick Leopold Strauss out of the Van der Linde gang for good, as he finally realizes the harm Strauss sows wherever he goes.

Unfortunately, despite showing some signs of redemption, by this point Arthur has already contracted tuberculosis, eventually paving the way for the game's conclusion. When he does eventually get his diagnosis from the doctor in Saint Denis, he is told that there is no way to cure tuberculosis, and Arthur will eventually die by the end of Red Dead Redemption 2, regardless of the player's actions. Whether he spends his final days being honorable or dishonorable, however, is up to the player, and those choices will decide whether Arthur's last minutes alive are violent or peaceful.