Good morning, Hank, it's Tuesday.

So, I'm signing a hundred thousand copies of my new book, Everything is Tuberculosis. I sign these tip-in sheets – you can see about 45,000 of them behind you – and then they're sent to the printer in Virginia where they're bound into individual copies of the book during the printing process.

At this point, the whole thing is quite systematized: I sign and sign and sign over and over and over and over again until I have a stack of several hundred, at which point I get to use the greatest feat of engineering in human history, the Lectrojogger, that joggedy, joggedy, joggedy, joggedy, joggedies all the pages so that they're no longer chaotic, but instead, they're perfectly aligned.

So yeah, there's just one problem with this highly mechanized process which is that, uh, I turn out not to be a machine. Because about 50,000 sheets in, I started to have some pain in my wrist and especially in my shoulder, a- and it just, it just kept getting worse.

Quick sidenote: I've changed Sharpie colors approximately every ten-thousand signatures so you can know about when your copy was signed, like I signed the first 10,000 in green, and then I switched to blue, and then I switched to another blue called peacock, and then berry, and then purple, until eventually, I got to some weird Sharpie colors like "rocket fuel red" which I call "firecracker", and "intergalactic indigo", and "tiger-eye teal", and whatever this is, I can't even find a name for it!

Okay, end of sidenote. So right, the pain got worse and then I went to the doctor, and it got worse still. And I don't want to get into like all of the medical details of it, but the summary is that I just can't do it anymore. Like, I'm not allowed to.

So, yeah, I'm not gonna lie, it kind of sucks. Signing has been a significant part of my life for the last 12 years, ever since I signed the first printing of The Fault in Our Stars.

I will say, what helps with the loss is that when you do something and it hurts every single time you do it, it makes you want to do it less. I mean, over the course of my career, Hank, I've signed 700,000 tip-in sheets. I'm attached to this process. I love my Lectrojogger, and it's a little bit of a bummer that I just won't be able to after this.

Now, Hank, when you spend over a thousand hours of your life signing your name over and over again, you do learn certain things about the process. You learn, for instance, that while other people see very little difference in your signature variation, you see huge differences. You learn the causes of the French Revolution over the course of a 38-hour audiobook on the topic. You learn that on the other side of boredom, there's a kind of blissful flow state, and you learn at least something about why you're doing what you're doing because, you know, you have so much time to think about it.

Hank, for the first three years of my writing career, I never had more than six people show up to an event. I would have hour-long signing sessions at bookstores or book festivals where two or three people would come and the rest of the time I would just either stare into the middle distance or make polite conversation with the bookseller whose store was definitely losing money by hosting me. And this is quite common for authors, we all have horror stories about signings. In fact, there's a book collecting such stories called "Mortifications".

And I think one of the reasons I've signed so much over the last 13 years is that I'm trying to express my gratitude that, like, more than 
four people are interested in my signature. And I've wanted to make it so that anyone who wants an autographed book can get one without overpaying. In that sense, I've actually been quite successful. Currently on Amazon, the signed edition of Everything is Tuberculosis costs $7 less than the unsigned edition, meaning that my signature is technically worth negative seven dollars.

But there's also something else at play, to be honest, which is that I can be very driven and I don't like to get outworked. And so I want to do everything I can to make my books good, and then I want to do everything I can to help get my books to reach lots of readers, and signing helps with that. This somewhat relentless work-all-the-time thing has been quite beneficial to my work over the years, I think, but it hasn't been as beneficial to other parts of my life, including, apparently, my right shoulder. So yeah, this whole injury 
thing has not just made me think about my relationship with signing, it's also been making me think about my relationship with work in general.

Everything is Tuberculosis—the advanced readers’ copies just got here, by the way!—is the culmination of the last three years of my life and my obsession not just with tuberculosis, but with the ongoing prevalence of tuberculosis and what that says about the world we share.

And I'm super fortunate to be able to write and publish a book about tuberculosis. It means that I have not only support from my family, but also support from a community of readers that will believe in my work even when it's different from my previous work. And I don't want to take that for granted, Hank, I want to find ways to say thank you, ideally, ways to say thank you that are individualized. And that's what signing has always been for me. It's a literal page that was touched by both reader and author. And in that sense, it represents what reading is to me, this true deep co-mingling.

But in the future, I'm gonna have to find other ways both to support my work and to express that gratitude, because I can't do it anymore. In my family, we sometimes say that we're not growing old so much as we're just continuing to grow up. And uh, this is part of growing up. But for now, Hank, I still get to say Everything is Tuberculosis comes out March 18 and signed copies are available for pre-order now.

Hank, I'll see you on Friday.