“A Living: Working-Class Americans Talk to Their Doctor” by Michael D. Stein, M.D. c.2025, Melville House $26.99 202 pages
The pain is right between your shoulders.
It wraps around your spine and crawls up your neck to sit on your head, making it hard to lift, bend, walk, think, and carry – in short, it makes it hard to do your job. Fortunately, you have access to a doctor who’ll actually hear you. As you’ll see in “A Living” by Michael D. Stein, M.D., you’re not the only employee in your situation.
Like most physicians, in his normal workday, Dr. Michael D. Stein sees multiple patients – in his case, most are “frontline workers who remain hidden from top-income Americans…” We considered them “essential workers,” the people who clean, cook, and feed us, who make sure roads are cleared and infrastructure runs smoothly. Many of them are Black. Many of the jobs they do are the kind that “could potentially kill you.”
The Bookworm is Terri Schlichenmeyer. Terri has been reading since she was 3 years old and she never goes anywhere without a book. She lives on a prairie in Wisconsin with two dogs, one patient man, and 20,000 books.
Knowing that, in the aftermath of Covid-19, Stein says he began to ask his patients about their jobs. It matters because, “there can be no meaningful discourse about health divorced from where people work, how many hours… the amount of money they make.” They “blend formal training with handson experience” to “do the best work.”
His patient, Dennis, is a caretaker for another man who’s incapacitated. Dennis wasn’t trained to do that; he was a clammer once, and he had his own boat but life in general kept Dennis off the water. He misses it. Stein sometimes doesn’t know quite what to say about that.
A boat-builder tells Stein that the chemicals he works with every day are so sticky that at the end of each week, he throws his clothing away. A floor installer explains what made her the best at her job, “the only girl floor installer in all my years.” Another patient struggles with drugs. One worries about retirement. Falls happen, machines break, mental health bends, families fracture, businesses fail.
Says Stein, the clinic “rooms I’ve gotten to know are all filled to the brim with ghosts.”
It seems that Medicare and Medicaid are on everyone’s mind lately, and when the subject comes up, it’s important that we not ignore the stories doctors tell. “A Living” fully, heartbreakingly underscores why this is important.
And yet, this book isn’t all just sad stories of hard life. There’s a wonderful abundance of compassion here, some humor, keen admiration for working folks, and a surprisingly welcome, subtle acknowledgment that doctors can sometimes feel ineffectual. Author Michael D. Stein does this by presenting slivers of his patients’ lives, but he doesn’t always tell readers what jobs those patients do. That anonymity is appealing, like eavesdropping or finding a random journal page on the sidewalk, except that Stein makes readers see the storytellers as individuals, they’re real, and so are their day-todays. So are their struggles.
Quick chapters of one-tothree pages make this a powerful, impactful book, and if you care about the future of healthcare for the working class, you won’t want to miss it. Soon, today, put “A Living” between your hands.
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