Michael D. Stein’s A Living: Working-Class Americans Talk to Their Doctor affirms the dignity of work while refusing to reduce workers to transactions.
Michael D. Stein’s A Living: Working-Class Americans Talk to Their Doctor is a human-centric depiction of labor and identity. The book is a collection of vignettes based on conversations between Dr. Stein and his patients. Stein’s book serves as both a tribute to workers and a critique of the narratives that frequently devalue their labor.
For example, he states that “sometimes their work leaves fingers broke, knees swollen…or it takes away years. But I’ve also seen my patients hurt by not working – this is its affliction with a particular emotional toll. Work can heal them too”. Accordingly, A Living creates spaces for the voices of those who do demanding work and intensive manual labor, yet are often excluded from broader discussions informing labor practices and policies. A Living emphasizes how work is deeply intertwined with individual self-worth and purpose.
A Living provides a crucial rebuttal to the derogatory narratives reflecting deeply ingrained prejudices. Stein identifies that “one of the oldest prejudices, at least among the upper classes in many societies, has been against physical work”. As narratives evolved, that prejudice grew to decry the individual rather than change the exploitative system. This recalls the contemporary missive that no one wants to work, a belief that misidentifies the problem as the individual’s rejection of work. Stein’s patients dismantle these prejudices as they tell us how work defines their sense of purpose.
For example, there is Elaine, a floorer, who “at the end of the day, I’d think: I did this. Look how beautiful this is”. Or there’s Keith, who desires to be self-employed because if he experiences a “bout of depression, don’t show up, and I’m fired. I’m reliable to myself though”. Even as they grapple with physical and mental strain and economic precarity, work, in many ways, signifies their identity. Stein’s patients do not reject work. They unequivocally show readers that work informs their dignity while bringing meaning to their identities.
A Living showcases over 100 unique stories. Accordingly, the range of perspectives is vast. The only patient Stein devotes several entries to is Dennis, a clammer by trade. Dennis and Stein have a deep connection, as both openly demonstrate vulnerability, fatigue, and understanding when in conversation. Dennis is also the ideal archetype for A Living. Even as physical, emotional, and economic challenges pose barriers to clamming, he still exhibits a “bursting feeling of success when he would come into [Stein’s] office with a burlap bag stuffed with fifty clams…”
Dennis’ story is a stark counterpoint to the capitalist tendency to reduce work to a mere economic transaction. He exemplifies how work can be a point of pride, even when it takes a toll on the body and mind or barely provides enough financially to make ends meet. A Living captures a fundamental truth: people want to contribute, but they also want to be treated and paid fairly. They want to earn a living in a just professional environment.
Yet the vignette formatting creates additional limitations. While the sheer quantity of workers’ voices in A Living is empowering, it also creates a palpable din. The multitude of perspectives, while valuable, can be overwhelming. Few narratives stand out because of the brevity and quantity of the passages, which feel like their voices are speaking simultaneously. While the snapshots are compelling, they lack continuity except for Dennis’ story. The reader is left wanting more context and deeper dives into the lives of these Americans.
While A Living astutely humanizes workers and gives them a voice, it occasionally falls short in its structural critique. Stein’s focus is inconsistent here. Accordingly, Stein’s role is as a physician foremost and a documenter second. At no point does he self-identify as an activist.
On one hand, he mentions that A Living is not “about the quality of work or the inequality of workers”. Yet on the other hand, their stories are sandwiched between what Stein calls “interruptions”. These are breaks between sections where he inserts historical and contemporary American policies affecting workers. So, readers, should we disconnect their stories from broader social and political systems, or should we make those connections ourselves? This is a question A Living leaves unaddressed.
One of A Living’s limitations is its tendency to accept workers’ perspectives at face value without questioning them or critically examining the systems that create and perpetuate their struggles. While centering workers’ voices is essential, Stein does not deconstruct their narratives. Nor do we know the prompt or questioning that led to the published dialogue. There is no way to discern objectivity on Stein’s part or white coat bias from his patients.
Despite these critiques, A Living is an undeniably progressive work. It’s reminiscent of the Works Progress Administration’s (WPA) Arts Project, documenting workers’ stories, histories, and perspectives. Stein’s portrayal of his patients’ struggles and aspirations evokes calls for policies that value human labor beyond productivity and profit.
A Living affirms the dignity of work while refusing to reduce workers to mere transactions. The book implicitly argues for reforms for livable wages, universal healthcare, and stronger labor protections. While Stein does not explicitly advocate for these policies, his patients’ experiences make the necessity of such measures undeniable. Their narratives demonstrate that labor injustice is not an abstract concept but a lived reality.