Blue Jeans

By Omar Metwally, MD

August 4th 2021

This is a photo of Salt Lake City, Utah on April 3rd, 2020.

At the end of March 2020, I drove from the San Francisco Bay Area, my home of eight years, back to my home state of Michigan to volunteer in medical units overflowing with patients who were sick with the novel coronavirus. My puppy and my few personal belongings, which had consolidated over the years after frequent moves from one city apartment to the next, are packed into my Honda Civic, the rest of my belongings left behind in an apartment I quickly fled to avoid state border closures. Every fleck of my skin, from my face and lips to my toes, is swollen, red, and painful — a farewell gift from a patch of poison oak that my puppy discovered during one of our last hikes through the East Bay’s eucalyptus forests. I am on fire.

I drove from California to Michigan via interstate highways that traverse the heart of America with prescriptions for steroids to treat my case of fulminant poison oak hypersensitivity and an aloe plant on my lap. As I spent the better part of four days behind the wheel cutting off aloe leaves[1] and rubbing them on my skin to relieve the intense burning that pushed me to the limits of patience, I reflected on how quickly life had changed in such a short period of time: the perpetual line of masked people in front of the deli where I used to walk a block over to pick up a sandwich for lunch and carry home fresh produce; the panic of trying to hunt down dog food after all the local pet stores shuttered their doors indefinitely; driving an hour and a half to Sonoma County in pursuit of milk; the tense, heavy atmosphere at my hospital as it filled up with seriously ill patients – and the limited therapeutic options doctors had at their disposal at the start of the pandemic.

Many people lost their lives and their livelihoods during the pandemic, which continues to take its toll around the world.

This is a photo of Salt Lake City, which I did not take because it wasn’t how I wanted to remember the capital of one of the most beautiful states in America.

After a few hours rest in a nearly-deserted hotel, I wake to continue our journey east. Except for a police patrol and a homeless man, there isn’t a soul on the streets of downtown Salt Lake City, as I walk my dog in search of a cup of coffee. This is not how a city should ever look, except in Cormac McCarthy’sThe Road. Even the national coffee chains one could previously count on were closed, and I resorted to brewing my daily cup of joe on the side of the road with the aid of a propane-powered camping stove.

Michigan was hit early and hard by the COVID-19 pandemic, but finding food for puppy and milk for me was still easier outside of California’s dense urban areas. When the State of California issued the first stay-at-home order in March 2020, it felt like standing on a beach watching tsunami waves roll toward land. While those tsunami waves are just now making landfall in certain countries that managed to dodge the first pandemic wave by means of fast, coordinated action, the aftershocks are being felt acutely by all. Personal loss and economic damage on such a large scale will take time to heal. The cost of basic provisions, from groceries to building materials, has increased markedly in just a few months, and the future is more uncertain now than it was in the pre-pandemic world.

Despite the great difficulty of finding a sewing machine and fabric in the spring of 2020, I managed to purchase my first sewing machine and learned to sew face masks with the help of a tutorial on the CDC’s website. The linen masks I created were far more comfortable and breathable than surgical masks, and I felt empowered to create something that had become as indispensable to daily life as a smart phone, especially at a time when masks were expensive and hard to come by. Just a few months before moving back to Michigan, I was taking my shorts to alterations shops to replace buttons, and I would have never imagined operating a sewing machine myself.

Learning how to sew gave me the knowledge and skills to harness an ancient technology – textiles – to create functional and beautiful things that can’t be made using 3D printers. After using the remaining linen to sew window drapes for our home, my next challenge was denim. A pair of jeans is both a tool and a lasting work of art. Subject to areas of extremely high tensile forces, jeans hold things together to keep us warm while serving as a physical barrier between our bodies and the world. Denim adapts to the shape of our bodies over time, and we hardly notice a comfortable, well-fitting pair of jeans as we go about our business. Jeans have front and back pockets to hold our keys, phones and wallets, and jeans take on a uniquely cool look with each wash, tear, fray and stain.

U.S. Patent Number 139,121 (“Improvement in fastening pocket-openings”) for using rivets to reinforce pockets awarded to Levi Strauss and Jacob Davis on May 20th, 1873.

Levi Strauss of San Francisco and his business partner, Jacob Davis, a tailor from Reno, Nevada, were awarded U.S. Patent Number 139,121 (“Improvement in fastening pocket-openings”) for using rivets to reinforce pockets on May 20th, 1873 [2]. There is a big difference between sewing trousers and sewing a durable garment that can withstand years of vigorous use. Strauss and Davis’ invention helped improve the longevity of jeans as a tool, a garment worn by people to help them work hard, and a garment that also happens to look nice!

As with face masks, I began sewing jeans out of necessity. Shopping for clothes to replace the wardrobe I left behind in California was impossible or extremely challenging for many months. Even before the pandemic, happening across a well-fitting pair of jeans involved visits to several outfitters and spending a day trying on jeans. If I was lucky enough to find a pair that fit, I didn’t have say in the properties of the denim I would bring home to break in: the fabric color, weight, style and stretch.

Jeans have become staples in apparel and are worn by people of every rank and file all over the world. The mass production methods necessary to achieve the current market prices rely on the sweat and lifeblood of factory workers who specialize in one small step in a complex process overseen by the proprietor. What surprised me most about learning how to sew jeans was the remarkable fine motor skills and intensity of labor which the process entails. With my wife’s help, we can together create a pair of jeans in three days: one day to take measurements, draft a pattern, cut fabric and serge the pieces; another day to sew the pieces; and a third day to add trimmings and hem. The price tags on store-bought jeans betray the immense skill and effort involved in creating a pair of shiny new blue jeans, but there is no price on the joy of achievement.

Whether I’m rounding in the hospital or under the hood of my car, I enjoy wearing a pair of hand-sewn jeans as a reminder that sewing jeans, like the practice of medicine, requires both knowledge and skill, a fruitful marriage of theory and practice. Creating a well-fitting pair of jeans requires a good grasp of human anatomy and the theory of pattern design. It requires an appreciation for how movement – walking, running, sitting and squatting – impart forces on the fabric, and how manufacturing techniques can reinforce these high-stress areas. Sewing jeans also requires appreciation for how denim is woven and dyed, and how its properties can be modulated to yield a certain feel and look. The theory of jeans-making must be combined with outstanding sewing skills to produce an awesome pair of jeans. Learning to work with a heavy fabric like denim takes a lot of practice and patience.

Even if I had an endlessly long list of customers, a mom-and-pop jeans shop operating in the United States cannot compete head-to-head with a jeans factory that outsources its operations to places where the cost of labor is significantly lower. And while I can’t pretend to be an expert seamster as far as sewing jeans is concerned, practice makes perfect.

A pair of custom Ox Jeans made using a computer program that algorithmically generates jeans sewing patterns from a handful of body measurements

My offering:

  • Custom, algorithmically-generated jeans sewing pattern. Includes:
    • Full-size printout containing all pieces for a custom-sized pair of jeans, based on your body measurements
    • 3 business day turn-around
    • Cost: $50
  • A custom-tailored pair of jeans. Includes:
    • Hand-sewn pair of jeans made with 100% American denim
    • Constructed using the algorithmically-generated sewing pattern (above)
    • Cost: $600

A pattern can be purchased separately from the jeans so that people with sewing skills can create their own jeans at home.

To purchase a custom jeans pattern and/or a pair of custom-tailored jeans, request an order form by emailing me ( with “Ox Jeans Order Form” in the subject line.


  1. Aloe vera: a review of toxicity and adverse clinical effects. Guo X and Mei N. J Environ Sci Health C Environ Carcinog Ecotoxicol Rev. 2016 Apr 2; 34(2): 77–96.
  2. U.S. Patent Number 139,121. “Improvement in fastening pocket-openings.” Jacob Davis of Reno, NV, and Levis Strauss & Company of San Francisco, CA.