Imagine a sharp pain between your shoulders. It wraps around your spine and creeps up your neck, making it hard to think, bend, or carry out your daily tasks. You’re not alone in this struggle. Many working-class Americans face similar challenges, and Dr. Michael D. Stein sheds light on their stories in his book, A Living: Working-Class Americans Talk to Their Doctor.

Dr. Stein sees patients who are often overlooked—those who clean, cook, and keep essential services running. Many are Black and take on jobs that can be dangerous. His approach changed after COVID-19; he began asking patients about their work lives because, as he points out, health is deeply intertwined with our jobs and income.
Take Dennis, for example. Once a clammer, he now serves as a caretaker but lacks formal training. He often reminisces about his days on the water. Meanwhile, a boat builder recounts the harsh chemicals he deals with weekly, throwing away clothes because they’re ruined. Another patient shares her pride in being the only female floor installer she’s known. These stories highlight the daily struggles of many working-class individuals—issues like mental health, financial insecurity, and workplace safety.
Stein poignantly notes that the clinic rooms are filled with unspoken stories. As Medicare and Medicaid debates heat up, it’s crucial to recognize the human element behind healthcare discussions. A Living captures this reality with both heartache and humor. Through short chapters, Stein presents an array of voices, keeping patients anonymous yet relatable. Their lives are complex, filled with both challenges and resilience.
Recent statistics show that about 60% of Americans work in jobs with high physical demands, often resulting in chronic pain and mental health issues. Understanding these workplace realities can inform better healthcare solutions. As Dr. Stein reveals, compassion must accompany medical care, reminding us that healthcare is not just about treatments but about understanding people’s lives.
This book is a powerful reminder of the struggles and strengths of working-class Americans. If you care about the future of healthcare and want to understand these vital perspectives, A Living is a must-read.
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