Michael D. Stein, a physician, is the author of the new book A Living: Working-Class Americans Talk to Their Doctor. His other books include Me vs. Us. He is the chair and professor of Health Law, Policy & Management at th Boston University School of Public Health.
Q: What inspired you to write A Living?
A: I am a primary care physician in a small urban community. What makes my group of patients unique is that the great majority do demanding manual labor. Very few have the luxury of working remotely, or seated.
The work a person does has been under-rated in its effects on health, both physical and mental, and yet work is what most of most of us do during most of our adult days. Manual labor has not been written about much lately and I am fortunate enough to have a special vantage.
I find the way my patients often talk about work inspiring. I’ve always admired people who are good at things I am not, and I am hopelessly unmechanical.
A Living was also Inspired by Studs Terkel's classic Working, which is celebrating its 50th anniversary and describes a different set of jobs in the last century. I hope that A Living, my 15th book, offers a new look at what it's like to have to work long hours at physical jobs for a paycheck in 2025 America.
Q: The author and physician Gavin Francis said of the book, “A Living is a generous, gracious and ultimately hopeful book about the reality of life and work in America today.” What do you think of that description?
A: Gavin Francis is a very kind man. A Living is composed of vignettes, snapshots of working lives, offering the dramas, disappointments, and frustrations people have with their colleagues, family co-workers, and supervisors.
I divide the book into five parts: identity, losses, connections, survival, structure, trying to capture the sense of accomplishment and satisfaction, the opportunities for initiative and self-expression that come from doing intricate work with one's hands.
Many of those working in harsh conditions doing tough physical labor or apparently unpleasant jobs actually find it rewarding, even when it is not highly valued monetarily.
Listening to patients speak about work is, for me, a way of looking for the emotional narrative of illness, the psychological explanation, the personal history, which, by nature, always interest me, and these understandings can also explain how the body breaks. Caring for the broken mind and body is my job, my daily work, where I go for meaning, belonging, and continuity.
Q: How was the book's title chosen, and what does it signify for you?
A: The people I care for are “working class.” But what defines a working-class life? The way you live, the amount of money you make, the nature of the work, the culture you are part of?
To me, working class means simply: not poor. Working class means that you are making a living and the phrase “to make a living” I suppose gets at the hardship of working, thus my title.
The time we spend at work is a large part of the time we spend living. At work we make friends, exert power, avoid certain people, discuss lunch, get bored, resist bosses, stay late, study new techniques, talk about winning the lottery, plan for the next job. Living and working, includes having routines and rituals, being part of something greater than yourself, being part of a community.
Q: Especially given today’s politics, what do you hope readers take away from the book?
A: In our divided political world, differences in the kind of work we do can also be a divide. There may be a tension between our virtual lives led in the blue glow of screens and the reality of embodied labor (digging, carrying, harvesting, pouring, sewing, scrubbing, hauling, delivering). Physical work also generally pays badly, dividing us.
In A Living I alert the reader to some important facts. Certain work is dangerous. Five thousand workers die on the job annually, with injuries sustained by nearly 3 million more.
In addition, when there is no work, pain reappears. Alan Krueger, chair of President Obama’s Council of Economic Advisers, calculated in 2017 that nearly half of all nonworking men were taking pain medication on a daily basis and argued that the increased prescribing of opioids could explain a lot of the decline in the male labor force.
Opioid overdose rates are highest among occupations with the greatest physical work demands and least access to paid sick leave. Sick leave policy is necessarily political.
With A Living I want to encourage conversation between people about what they do all day and why. Manual labor is often dirty, exhausting, tedious, unpleasant. There are good reasons to avoid it. But there are also reasons people actually find it deeply rewarding. Having these truthful conversations is how we begin to trust each other again in this politically fraught moment.
Finally, I believe the dignity of work is important to a healthy democracy because it enables everyone to contribute to the common good and to win honor and recognition for doing so.
Q: What are you working on now?
A: I have nearly completed a new project tentatively entitled Observing Science: On the workings of science, its limitations, and its promise. This is a set of short essays not only about the ideas and philosophy of science, but also about the forms and mechanics of modern biomedical science.
The goal is to help lay readers better understand the workings of science and to highlight the social and political fevers of 2025 and how they are making a spectacle of science itself, and its interpretation.
--Interview with Deborah Kalb. Here's a previous Q&A with Michael D. Stein.
No comments:
Post a Comment