These Vital Signs: A Doctor’s Notes on Life and Loss in Tweets

Title: These Vital Signs: A Doctor’s Notes on Life and Loss in Tweets

Authors: Sayed Tabatabai, MD

Publication Details: Harper, 2023, 192 pp., $24.99, hardcover

We have reached the point of the pandemic where the retrospective books are being published. If you are interested in the back story of how a small group of public health experts tried to implement the pandemic playbook from the early 2000s, Michael Lewis’s The Premonition is a great option. ¹ If you want to read about the efforts from libertarian groups to sway the public discourse around herd immunity, then read Jonathan Howard’s We Want Them Infected. ² But if you are a physician who is feeling a little burned out, tired, and wanting to recover a bit of humanity after a challenging past 3 years, then I highly recommend Sayed Tabatabai’s These Vital Signs.

If you don’t know and follow @TheRealDoctorT on Twitter, then you will be awed by his ability to tell meaningful stories in short-burst segments and limited numbers of characters. For those who have followed him for years, the book is a wonderful compilation that brings out the humanism we have seen over the years from his Twitter threads. Unlike the previous Twitter tweets turned into a book from @Medicalaxioms that highlighted quips and insights to practice medicine, ³ Tabatabai gives us a series of emotional short stories. Each one highlights the joys and challenges of being a doctor. I do not recommend reading the book in public, because you will be surprised how often you are moved to tears.

After a brief introduction to his inspirations, his two grandfathers (one a poet, the other a physician), the book highlights patient stories and learnings from Tabatabai’s early career. He writes of seeking out the doctors who truly exemplify the practice of the art of medicine, like the old surgeon who imparts on him the values of kindness, respect, and observation; and the cardiology fellow who had the skill to visualize the heart through EKG tracings. He then moves to stories from the early pandemic, focusing on the ICU setting and deftly depicting the tragic heroism of the physicians and patients. His descriptions of the interactions with the exhausted intensivists trying to cling to humanity are poignant. But the story about the therapy dog who just loves everyone really hit home for me. The only part of the book that I found less moving was the end, which was a look back at the pandemic through the eyes of his 80-year-old grandson in a dystopian future.

Family physicians have borne the brunt of low salaries, excess workload, and unwieldy electronic health records while working in a dysfunctional system that does not value primary care. As such, any burst of humanity that brings us back to the reasons we went into medicine is of value. And spending an afternoon reading These Vital Signs will help you regain some of the passion that inspired many of us to become physicians. We all need to reconnect to patients and our purpose, and Tabatabai’s book is a great way to do that.