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Blue Collar, Blue Scrubs: The Making of a Surgeon

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It looked for a while like Michael Collins would spend his life breaking concrete and throwing rocks for the Vittorio Scalese Construction Company. He liked the work and he liked the pay. But a chance remark by one of his coworkers made him realize that he wanted to involve himself in something bigger, something more meaningful than crushing rocks and drinking beer.


In his acclaimed first memoir, Hot Lights, Cold Steel, Collins wrote passionately about his four-year surgical residency at the prestigious Mayo Clinic. Blue Collar, Blue Scrubs turns back the clock, taking readers from his days as a construction worker to his entry into medical school, expertly infusing his journey to become a doctor with humanity, compassion and humor. From the first time he delivers a baby to being surrounded by death and pain on a daily basis, Collins compellingly writes about how medicine makes him confront, in a very deep and personal way, the nature of God and suffering--and how delicate life can be.

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First published May 26, 2009

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About the author

Michael J. Collins

3 books114 followers
Mike's highly successful first two books, Hot Lights, Cold Steel and Blue Collar, Blue Scrubs have become standards in the field of medical memoir.

His latest work, All Bleeding Stops, was released in 2021. What does a doctor do when he thinks his best is not good enough? All too often, the sensitivity that leads young men and women to a career in medicine becomes the instrument of their own destruction. They simply care too much. Nowhere is this cruel irony more clearly seen than in the setting of war.

Matthew Barrett, fresh out of residency, is sent to Vietnam as a combat surgeon in 1967 at the height of the Vietnam war. Sensitive and caring to a fault, he is ill-prepared for the onslaught of pain and suffering with which he must deal. Only the love of Therese Hopkins, a nurse, keeps him from falling apart. But can their love survive the horrors of war?

In the end, it is Therese who helps Matthew realize that love and compassion are the only things that can make all bleeding stop.



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Displaying 1 - 30 of 132 reviews
Profile Image for India M. Clamp.
311 reviews
October 8, 2023
From an Irish-Catholic construction worker downing beer, cursing and throwing rocks to becoming an orthopedic surgeon. Dr. Michael J. Collins (the oldest of 8 Irish-boys) delineates how his Mother “made a deal with God” to gain him admission to Loyola Medical School. Use of “rat” and putting stuff in it some could describe as unholy?

“They are gods...I want to...blithely throw off phrases like BUN/creatinine ratio...aortic insufficiency...do important things like delivering quadruplets/repairing ruptured aneurysms. I want to be anything but a rock thrower on Battaglia's breakout crew.”
---Michael J. Collins, MD

From dying babies and old ladies had me reciting Ovid's’ “Curando fieri quaedam majora videmus vulnera” which illuminated something sacred to stop the tears. Reading “Blue Collar, Blue Scrubs: The Making of a Surgeon” is a comic filled rant with no promise of clean words, yet its masterful in delivering the truth with cerebrospinal spinal fluid clarity.

This is literary “schatz” by Dr. Collins divergent to his “Hot Lights, Cold Steel” (2005). In the midst of chaos and death of babies he exposes the clandestine acumen imparted from suffering---even after his intern commits suicide. All this and courtship of the lady who would become his wife. Raw, candid and brilliant read.
This entire review has been hidden because of spoilers.
Profile Image for Sonja Arlow.
1,237 reviews7 followers
March 2, 2022
When I am unsure of what I want to read, more often than not I gravitate towards medical memoirs, and this is an author I have read about before with Hot Lights, Cold Steel: Life, Death and Sleepless Nights in a Surgeon's First Years.

This is the author's origin story, so to speak. Of how he went from a blue collar, concrete throwing, cab driving, day laborer to a qualified medical doctor. I like this author, he has an authentic voice even if there were sections I found slightly boring (sorry) because I came for the medicine and not the bar brawls and construction worker banter.

It was a good filler I sped through in 2 days but if you are looking for a hard hitting medical memoir showing life on the ground as an intern then perhaps rather consider The Real Doctor Will See You Shortly: A Physician's First Year or my favourite This is Going to Hurt: Secret Diaries of a Junior Doctor
2 reviews14 followers
August 5, 2009
Inspiring is just one of the many words I would use to describe such a detailed and powerful memoir of a simple yet hardworking man on the road to becoming a doctor. For those of us that are even remotely interested in medicine, this is a MUST read. I was truly intrigued by the comedic and brash dialogue that is used from someone who has an "M.D" next to their name other than the typical mindset of someone who thinks like a scientist.
Profile Image for Mazola1.
253 reviews13 followers
August 25, 2009
In his first book, Dr. Michael Collins wrote about his training as an orthopedic surgeon at the Mayo Clinic. That book was gritty, real and human. When I picked up his second book, I thought it would be about his experiences in private practice. Surprisingly, it is not. It is about his life as a blue collar worker before medical school, and his years as a medical student and young husband. Dr. Collins has a fresh and original way of writing about something that has been written about many, many times before. His description of medical school is at once less detailed and less graphic but more insightful and revealing than any I have read before. Perhaps because Dr. Collins entered medical school later in life than most med students, and had more varied life experiences, he was often able to look at his medical training and the whole system of medical care from a different perspective. He questioned and wondered about things I'm sure would never have occurred to most of his classmates.

The part of the book about Dr. Collins' life pre med school is equally interesting and thoughtful. Dr. Collins worked on a crew that broke up and hauled away concrete sidewalks and gutters that were to be replaced. His job was to throw hundred pound chucks of concrete into a truck. Collins eventually decided to leave that line of work, and even while doing this work, he also took piano lessons and read Shakespeare. Nonetheless, his book describes the satifaction and enjoyment that hard physical work gave him, and treats blue collar work and workers with a dignity and respect not often found in non fition literature.

Dr. Collins' blue collar experiences are clearly still an essential part of his psyche and helped to shape the doctor he became, engaged in one of the most physically demanding of the medical specialties, while maintaining real human contact with his patients. They say orthopedic surgeons are the jocks of the medical world, and to some extent that is true. Even Collins admits that his work often involves more force than finesse. Still, it is easy to picture him as a doctor equally comfortable with a hammer and chisel in his hands, or a good book. And indeed, Blue Collar Blue Scrubs is itself a good book.
426 reviews1 follower
July 23, 2017
4.5, personally a 5, due to my special interest in medicine. While reading this book, I smiled, I laughed, and also had tears come to my eyes. A non-fiction account of a young man's journey into the medical profession. Beautifully written, very very funny accounting about his Chicago Irish extended family. And a heartfelt account of a young man's journey through medical school and internship. Loved it.
1 review
January 24, 2024
Loved this book. Great mixture of funny and serious. Related big time to the author. Solid read
Profile Image for Melissa Jetzt.
9 reviews22 followers
August 5, 2013
I loved this book. Some successful pre-med (now med student) recommended this to me and I think it really did open my eyes to some things I never would have considered with all his philosophical "garble". At times I thought it was silly for him to bother mentioning that stuff since, in medicine, you've gotta do what you've gotta do. Not that anyone should be an egotistical grouch to get it done. I just certainly had some appreciation regarding his compassion for all the patients he discussed. I suppose one of the only problems with this book is something that can't be changed, and that is his "rags to riches" sort of story. I say this because a lot of pre-meds are already so clueless about what it takes (myself included) and this book could end up giving some people false confidence. My advice is to take it with a grain of salt and to not only realize that he was just very lucky, but that times have changed and medical school only gets more competitive. A very engaging and insightful read, for sure. Glad I chose this book to restart the reading habit!
12 reviews1 follower
May 3, 2010
With much self-deprecating humor, Michael Collins, recounts the events that led him down the highly unlikely path to becoming a top-notch orthopedic surgeon. Without preaching, without self-aggrandizement, he shares the secrets of becoming a doctor--drive, unbelievable hard work, and sacrifice. He doubts himself every step of the way, endearing himself to the reader as he allows us into his private thoughts and shares the concoctions of his overactive imagination when the going gets tough, proof that he is just like the rest of us.

Note: Blue Collar, Blue Scrubs, is actually the second book from Michael Collins. The first, Hot Lights, Cold Steel, recounts his four years of residency at the Mayo Clinic in Rochester, Mn. I am currently reading this first book and am happy to have read them out of order, thus following the continuum of his career in medicine. So far, I am not at all disappointed...in fact, it just gets better and better.
Profile Image for Katie.
1,243 reviews71 followers
September 14, 2011
This book is the "prequel" to Collins' previous book about his years as a resident at the Mayo Clinic. This book starts off when he's still a construction worker and spends some time with him during that phase of his life (this was the least interesting part of the book to me--I wanted to get to the medical stuff. Although it did illustrate how different his daily life, job, and circle of friends was during this phase of his life). Like his last book, this book is full of humor, only turning serious at times.

The book then explores his decision to go to medical school and all the work it took to get there, given that he was a construction worker with none of the educational prerequisites. It then follows him through his medical school years though graduation, where his first book begins.

The strength of both of these books, to me, was Collins' gift at describing just how inexperienced and stupid he felt most of the time (which is probably common, as a medical student and then resident, since you are at the bottom of the totem pole). It really humanizes the profession and demystifies a lot of it.
98 reviews2 followers
July 8, 2009
Dr. Collins is one of the best doctor/writers whose work I have had the pleasure to read. In his most recent book, Blue Collar, Blue Scrubs", Dr. Collins pens his process of deciding to pursue medicine as well as the challenges of this endeavor and the requisite schooling. In addition, he mentions his personnel life to add depth to the circumstances surrounding his experiences. I found myself laughing at several points as he described the interactions with his brother and wife. Overall, I dare to say that this is the best "doc lit" book I have read this far!

If you liked this book, I would also suggest reading his other book, "Hot Lights, Cold Steel." In it, he picks up where this book left off and chronicles the trials and tribulations of his residency at the prestigious Mayo Clinic.
Profile Image for Ross Pennie.
Author 6 books48 followers
August 5, 2009
I just finished this wonderful memoir that chronicles the transformation of a grunting, beer-drinking labourer into a full-of-heart medical doctor who ends up as a surgeon at the world-famous Mayo Clinic. Wow! What a wonderful read. The author's turn of phrase is masterful: personal, charming, vivid, self-deprecating; perfect use of simile and metaphor. I didn't want it to end. The recurrent motif of beer-drinking, and the theme of overriding financial hardship, kept the protagonist real and grounded. Plenty of tension on every page to keep the pages turning. The young protagonist comes across more multidimensional than any classic surgeon, so much more human than the senior doctors he meets along the way. And the book has enough frank talk, free of political correctness, to give it an edge. Great scenes of labourers breaking up the streets of Chicago. Five Stars.
Profile Image for David.
13 reviews
May 28, 2017
Being a Dr. I love medical books like this. This was the best I have read since some of Atul Gawande's books. I immediately bought Mike's other books. What I liked was 1) the writing is EXCELLENT, 2) the reality of the human side of medicine which is often lost in books like this, 3) the honesty, 4) the blue collar aspect - I did similar work but not to this extent.

This reads almost like a Rocky story - you are always rooting for Mike. The family stories are very funny as well.

My only criticism is the brief story of the patient with an AAA - I have seen a lot of them and 0% of these patients recover 100% as the book said - I am sure this was just missed in the editing. Just a pet peeve, nothing usually is 100% better after surgery, I don't like that phrase.

This book makes me want to be better - an inspiration. 5 stars for sure.
Profile Image for Wendy.
946 reviews
August 7, 2009
This was a great story...kind of a "rags to riches" tale of an unlikely candidate for medical school who has a desire that drives him past every roadblock to achieve his dream. The author was a construction worker with little direction in his life, when he makes the decision to become a doctor. The book outlines his experiences before and during medical school. There is a lot of medical details, and if you are at all squeamish, this might not be a comfortable read. Beyond that is the lesson of following your dreams and overcoming adversity to reach a goal. This is a quick read, and I'd love to meet Dr Collins, to see if he still possesses the traits of the "regular guy" he was before he became a doctor. If he does, his patients are really lucky to have him as their physician.
Profile Image for Erika.
80 reviews5 followers
September 28, 2012
I was particularly interested in this book because this man's journey to becoming a surgeon is so similar to my husband's-construction worker who realizes that he wanted to involve himself in something bigger, something more meaningful and fulfilling, and wanting to do good. I was hooked. I laughed. I cried. I was shocked. I gained a new appreciation for my husband and gained new insight. This book breathed new life into me as the wife of a medical student, because let's face it, the road is long and hard with very little breaks in between, not only for the student but for the wife and kids. I now face each day with a new excitement for what my husband gets to go do, and somehow now the third year seems a little less painful.
Profile Image for Ishta.
62 reviews19 followers
July 30, 2020
Inspirational !
This book is hilarious and empowering at the same time. You can relate to a lot of stories that Micheal told if you are /were a medical student - and I did.
His story is different yet so similar. In his journey, Michael had many experiences that left him introspecting.I have same conflicts over so many things, and it was comforting to know that I was not alone.
His story telling is quite remarkable. You will feel all the highs and the lows.
His diligence towards his goal was impressive. He crushed his goals brutally and I really liked that.
This book has inspired me to become a better person and an even better doctor !!
748 reviews
July 9, 2011
The beginning of the book with its crass language and drinking,was not to my liking. It does depict a certain blue collar element that may seem stereotypical, however I encountered these attitudes while working in a paper mill and also a plastics factory job, as well as having to walk by mill workers on their cigarette breaks as I walked home from school 7th through 12 grades and faced whistles and comments. You had to admire this guys determination to get into medical school as an underdog and older student. This is a reserved recommendation.
Profile Image for Katherine.
Author 1 book
July 30, 2014
Interesting story. He's now a doctor in Hinsdale, so I could probably look him up. Many interesting stories within each chapter. Recommended reading, especially resonates with people who live in Chicago and recognize some of the places where he spent time working or getting together with friends.
Profile Image for sam favre.
48 reviews
October 3, 2023
a memoir about a cab driver/construction worker (rock thrower) turned med student and eventual orthopedic surgeon! 10/10 recommend for anyone in medicine or close to people who will or have gone through med school. This excerpt is from my favorite chapter, where he discusses wishing he had time to ponder the philosophical side of life and death, but at this time - that would only be a distraction keeping him from making a good grade on his anatomy exam. So he has to put that all aside and focus on the task at hand.

"I know there are issues here. I know there are metaphors and symbols. I know it would be nice if I could take time to think about them. There are truths to be gleaned, wisdoms to be gained, and I'd like to do those things. But for the love of God, I can't. I can pass gross anatomy without having a firm grasp on the significance of life and death, but I can't pass gross anatomy if I don't get a firm grip on the vascularity of the liver. I would like to take a few hours, hell, a few weeks, to ponder the human condition. I would like to re-read Wordsworth and Shakespeare in light of the things I have seen and done this first year of medical school. I would love to sit with my friends and discuss what life is all about, what purpose medicine actually serves, and in whose vineyard we ultimately toil? I look down at the row of cadavers stretching away into the darkness. I know you have important things to tell me. I know I must be careful not to lose my perspective, not to lose my sensibility. I would like to listen to you, but I really can't. I can't… I would rather be an unenlightened medical student than an insightful rock thrower. This is not how I envisioned medical school. I somehow imagined that all my practical learning would come wrapped in a generous coating of philosophy and serious, rational discourse. Yes, I would learn hepatic vascularity, but I would learn it in the context of that which makes it greater than itself. What I am finding is that I have to choose between the two. There isn't time for both; there seems to be an assumption that medical students should be taught the mechanics of medicine, but the spirit of medicine they should learn on their own… All these thoughts run through my head, and yet I instantly realize them for what they are: not superfluous, but distracting."
Profile Image for Nancy.
1,429 reviews23 followers
June 29, 2025
Mike Collins worked as a rock thrower for a Chicago construction company. But he yearned to do more, to leave his mark on society, to be remembered for something higher. So he decided to go to medical school. But he had taken no science classes in getting his Bachelor's degree, so he had to start at the basics and learn chemistry, biology, and physics in college before he could even apply for medical school. He wasn't even certain he would get accepted into medical school. This is his story.

This is a prequel of his first book, Hot Lights, Cold Steel in which he writes about becoming an Orthopedic resident. I think I liked this one better, because he writes about how he got started going to school, living in poverty, having to make some hard decisions, and making friends with the girl who he rode to school with. The story is set almost entirely in the 1980's in Chicago, with some forays into Minnesota. It is told entirely from his limited, first person point of view. I liked this book and am giving it five stars.
1,357 reviews2 followers
April 20, 2021
Very enjoyable first part of the author's biography books. This one talks about his life doing manual labour and finding himself thinking more about the long run of goals in life. He found his fascination with medicine and wanted to become a doctor. The sheer determination he showed by taking science classes in order to get into med school after years of working was admirable. Very strong minded and goal oriented. He knew only straight As will do to give him any chance to get into med school and he ensured he did all he could to achieve that. Throughout his time he felt like an outsider amongst people who knew who they were and had the funding and upbringing that led them there. He, working his fingers to the bone and barely sleeping between work and studies, with a wife and a kid, trying to have enough to put food on the table.. Very fascinating and the story of a regular bloke on a mission so easily identifiable with him.
147 reviews6 followers
February 17, 2025
An inspiring story on its own but infinitely better because I know of most places and locations in the book with a special nod to Durty Dick’s Pub in Austin and O’Neill’s Bar on North Avenue along with serious places like St. Giles and Loyola Medical Center. The characters in the book are real and some well known in the area. The highlight was the perfect infusion of humor throughout the book. It was quite a successful journey!
Profile Image for Alex.
3 reviews
August 20, 2024
I read this after his first book and as a medical student, I learned a lot of lessons from this book. Incredible
Profile Image for Pasang Pakhrin.
142 reviews15 followers
June 12, 2024
4.5 stars
Loved it, it’s a good mix of funny and serious - may have cried in few chapters. I just wished he had explored more into his decision to go to medical school. The crash language in the first quarter of the book was not to my liking but it got toned down later.
Profile Image for Talha Kareem.
13 reviews22 followers
April 5, 2019
The book is a practical demonstration of keeping your belief alive at all times. It shows that whatever happens, it is never too late to change your life for the better. Having said that, the writing style was good and smooth. Made me nostalgic regarding my own medical school time. A must read and especially for medical personnel.
Profile Image for Rebecca Abbott.
156 reviews
April 2, 2019
Beautifully written by a doc who came from a non traditional background, worked his ass off even to qualify for med school due to his lack of science classes because he was busy breaking concrete and slinging rocks for a construction company. Amazingly, he liked the work, but came to a realization one day after a fellow worker challenged him about his future that there was more to life than slinging rocks. After all, he had been to college and the urge to become a doctor was growing.
Insightful , humorous and honest.
Profile Image for Sabrina Rose.
25 reviews16 followers
April 14, 2018
Funny, well written book with a clear narrative. However, I was expecting a lot more. Particularly, I wanted to read so much more of his transformation from construction worker to doctor. After all, the book is called Blue Collar, Blue Scrubs. Though he grapples with the difference between himself and the typical premed student and the things that he witnesses which shape the type of doctor and person he wants to be, something was lacking. This book reads more as a synopsis of things that happen in medical school than a deep look at an individual transformation. He does things, and interesting things are happening, but his growth and development through these events was disjointed and shallow.
The stories are a good read and he brings up some serious things to think about during his explanation of rotations. I continued reading this book even when I realized what I was hoping to read about wasn't going to be delivered because Collins tells great stories. He and his family are down right hilarious and I often found myself laughing during this book.
Some last thoughts, I read this book before his book Hot Lights and Cold Steel because I was hoping to see his progression. But I think it is clear from the writing that his is the second book that he wrote. The patient stories are written with the type of clarity that a person has because of years of clinical experience. This experience was great for parts of the book but I think it's also the reason that I found his explanation to change his life to be lacking. Simply, it may have been too long since these events happened to write with perfect clarity regarding those motivations. One day he is working construction and the next day, with minimal explanation, he wants to be a doctor.
Profile Image for Christian Acosta.
10 reviews2 followers
December 3, 2017
I thoroughly enjoyed this book.
Dr. Collins describes his journey from working as a rock-thrower at a construction company to his overnight shifts as an Orthopedic Surgery resident with humor and humbling sincerity.
The overall message is a resounding one: Do not give up! Imagine being a 24-year old man straight out of college, and working 12-hour shifts rebuilding the highways of Chicago. Every day begins at 4:30 am; work officially begins at 7:00 am, but you are breaking concrete at 6:00 am 'giving to the church,' a euphemism for working without pay. Evenings consist of hanging out at a local Irish pub, drinking beer and enjoying youth. In the corner of the pub, you see older men who never chased their dreams, and an uneasy feeling settles on your chest because you find yourself following their footsteps. You take another swig, and ignore it.
The rest of the book is based on this premise, and makes for a worthwhile read. Dr. Collins is a capable writer; he does not overwhelm the reader with too much technical information or boring recollection of events. His sense of humor is apparent throughout the book; there is a joke in almost every page, and he presents emotionally difficult topics with maturity and a positive tone.
This book is for everyone. It is a must-read for students considering careers in medicine. College students who work will relate especially closely to this book.
Profile Image for DW.
548 reviews9 followers
October 14, 2017
Wow, this guy is amazing. Not only did he transform himself from a manual laborer into a surgeon by working non-stop for five years, but he is also a thoughtful, compassionate person and an excellent author. I laughed out loud at his deadpan descriptions of his family and his prodigious appetite. Those descriptions are the epitome of "show don't tell". His dialog, from everybody from the rock throwers and bartenders to esteemed surgeons, is on the nose. This book is inspiring for anybody who wants to change careers.

Some things I wonder: does rock throwing even still exist as a job? Wouldn't they just use a backhoe or other large machinery? How did he survive staying out drinking until 1 am and then getting up for work at 4:30? Disturbing thoughts: very sick babies and toddlers who have to undergo many painful medical procedures without understanding why.

I think this author is more famous for "Hot Lights, Cold Steel", about his time as a resident, but it is hard to imagine that book being more entertaining than this book. And I will just have to imagine for now because my library only has this book. :-P

My favorite quote: p120 [On medical school] "It's like I'm trapped in a trivia game for idiot savants."
Also: p50 "I'm the octopus who wants to fly - it's not like he has a lot of other flying octopuses he can go to for advice."
Profile Image for Fredric.
Author 4 books1 follower
May 10, 2016
Some fascinating insights into the making of a physician. Collins starts the memoir with a cheerful accounting of his days in the construction trades as a laborer. He doesn't make it clear why a young man with a Bachelor's degree is making his living tossing chunks of broken concrete into a truck and some explanation would have helped give the narrator credibility. The writing style is crisp and frequently humorous but I was anxious for the story to develop more quickly.

When it does take the major turn, it is almost too quick. The decision to abandon manual labor for medicine is so abrupt as to be suspect. I don't think the author really tells us his motivation.

Once we get to the medical training the pace picks up and this reader's interest intensified. His analysis of the moral and ethical dimension of his education and of the profession are insightful and the examples he cites are moving.

The last three fourths of the book are interesting, touching, and funny. Really a good read.
Profile Image for Marto Mugss.
14 reviews7 followers
July 18, 2018
A succinctly laid out yet inspiring read about Collins, a former casual laborer in a construction site and later a medical school student.
He is the oldest of eight boys in a closely knit Irish-Catholic family. During his stint as a casual laborer, he felt vague if not pressing yearning for something more meaningful in his life which eventually coalesced into his lifelong dream of becoming a medical doctor, albeit as what many would call a 'late bloomer'.
Being in the medical field, I could relate to his reality check upon enrolling at Loyola at the prime age of 26; the rote memorization of med school, petty if not mundane tasks assigned to an on-call medical student, and the utter shock of finding his intern dead from suicide!
To cap his roller coaster rendezvous ride in medicine, he finally found himself right at home with the 'ORTHOPODS' who in a way are devoid of the pretension of other surgical specialists.
I would aptly surmise this book as a perceptive, unpretentious memoir of a surgeon who succeeds by dint of hard work and smart brains!
Priceless read!
Displaying 1 - 30 of 132 reviews

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