BLUE COLLAR, BLUE SCRUBS: THE MAKING OF A SURGEON
By Michael J. Collins, M.D.
Published by St. Martin’s Griffin, $14.99
Michael Collins is a Catholic orthopedic surgeon with an unusual background. He graduated from college without knowing what he wanted to do with his life.
He went to work as a day laborer, breaking up concrete sidewalks in extreme heat and cold, and driving a cab at night. The fun in his life consisted of perpetuating his high school enthusiasm for hockey and softball, and frequenting the many pubs that dotted the neighborhood of his childhood.
His memoir tells the story of his transformation from factotum to physician. But a subtext of these 291 pages is the meaning of manhood. Though at the start of the story he is a recent graduate of the University of Notre Dame, the early chapters impress upon the reader the virility of physical labor and the unsavory character of true manliness.
The book opens with the author being tardy to work because he “slept late,” until 5a.m. The chronic sleep deprivation that dogs him through the book turns out to be good training for his medical career. But the physical demands define demolition work.
He writes, “At one time I thought I was pretty hot stuff, but I didn’t know what tough was until I started working here. Not one man in a hundred walking the streets of Chicago would last a day out here throwing rocks, but Scalese [Construction Company] has a dozen of them: young, strong, intemperate, spoiling for a fight, ready to accept any challenge. There are guys here who stand five foot six, weigh 140 pounds, and can outwork, outdrink, outswear, and outfight me and 10 guys like me any day of the week.” In other words, these are real men.
It’s not just the muscles and the talent for drinking that defines these men. Their world is filled with every kind of assault on the senses. It’s in the abrasive sounds at 6 in the morning (“the roar of the compressor, the thunder of the jackhammer, the bellowing of the foreman ...”), the corrosive sights (driving a truck called “The Rat,” littered with cigarette butts, beer cans, hamburger wrappers, etc.), and the emotional toll of the stories these men share about the struggle for survival in their neighborhoods.
Then there’s the pain in the work. “All day long they drive us. They drive us until the heat sears our lungs and each breath rasps the back of our throats. They drive us until we pant like dogs and our tongues hang from our mouths like hams on a curing hook. They drive us until our sweat dries up and black blood congeals between the cracked calluses on our hands. They drive us until we cramp up so bad we can’t stand up straight and we stagger back and forth like a crew of hunchbacks working the mines of hell.”
There is a cultural Catholicism in the background throughout the story.
“There is no clock in the yard. The yard birds know it is quitting time when the church bells over on Fullerton Avenue begin to chime. As we file out of the yard, Fred tells us that listening for the church bells at quitting time is the only time any of us pays attention to religion all week.”
Collins makes only rare references to the role that God actually plays in his life. But suddenly, at one point early in the story, he decides that his hardscrabble life isn’t meant to be his final destination.
His catharsis is never really explained, but he writes, “I’m not sure what God has in mind for me, but I’m pretty sure it isn’t throwing rocks for the rest of my life.”
As the pages turn, the privations of the laborer give way to the hardship of medical training, and the author has a love/hate relationship with both.
Never mind his Notre Dame education, he tries to impress the reader with how uninformed he was on many fronts in life. A conflict seems to exist between manliness and intellectualism. For example, he says that he began meeting with medical school deans without having known that med schools have premed admissions requirements. He complains about the uselessness of the information disseminated in inorganic chemistry, and almost boasts about his lack of curiosity toward the material. Describing his preparation for med school at night, he says, “This is war. This is an all-out, full-scale, no-holds-barred battle for survival, and I’m going at it full bore.”
After the years of premed courses, he describes the guilt of borrowing money to get through five years of classes, and the uncertainty of whether he’ll get into medical school or train at the residency program of his choice. But the word-for-word profanity-laced conversations that he recalls from the work yards are replaced by the more refined vocabulary of the medical wards. The drinking at night yields to the satisfaction of meeting and marrying the girl of his dreams, and embarking together on the adventure of parenthood.
Now, 35 years later, he is a father of 12 children, and a respected orthopedic surgeon. Many doctors view orthopedists as the most stalwart and muscular of physicians because of the physicality of their work. But unspoken in Blue Collar, Blue Scrubs is the author’s realization that he acquired a different set of manly values as he “grows up”: Maturity replaces youthful pranksmanship, supporting a family supplants the self-pitying nightly trips to the bars, and artful self-expression overcomes the expletive instincts in conversation.
The pain that one voluntarily takes on one’s own shoulders in life is a reminder that manhood mostly means setting aside the comfortable life that’s dependent on the hard work of others, in order to cultivate two very Catholic virtues: making the most of one’s own abilities, and finding some avenue of service to the well-being of others.
[Patrick Whelan is a rheumatologist at the MassGeneral Hospital for Children in Boston, a teacher at Harvard Medical School, and serves on the board of the National Catholic Reporter.]