"Nickel and Dimed: On (Not) Getting By in America" (Barbara Ehrenreich)

Last week, I was walking with one of my patient-centered mentors, David Sobel, MD, through one of my favorite museums in Washington, DC., The National Portrait Gallery. As I brought him to one of my favorite pieces, I asked him if he read this book, and he told me it was one of the most influential books he’s read. “Have you gotten to the Wal-Mart section yet?” he asked. I have, and I have to say I agree with his assessment.

This book preceded a more modern version of living among the corporate natives which I reviewed previously, Punching In, by Alex Frankel. Unlike Alex Frankel’s adventure, Barbara Ehrenrich goes completely native, adopting the lifestyle of a minimum wage worker, down to eating, living, and surviving (or attempting to) in several different American cities. Her jobs include being a server in several restaurants, a house cleaner for a large national franchise, and a stint in retail.

We learn some realities of these jobs - it’s never really okay to not always be doing something, even if there’s nothing to do. One of her places of employment calls this “time theft.” So there’s a constant flow to the work, some of it useful, some of it not. The profiles of her coworkers describes the conditions that the working poor must accept - not having first month’s rent and deposit may mean spending $60 a night in a motel, an irrational yet necessary way to survive. The quality of life that Ms. Ehrenrich accepts for her assignment is concerning bordering on dangerous - a single woman in an efficiency with no screen on the window on the ground floor.

As I read this with an interest in employer-based health, I also learned a lot.

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