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Natural Causes: An Epidemic of Wellness, the…

Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and…

by Barbara Ehrenreich

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Natural Causes
Barbara Ehrenreich
March 13, 2019
Subtitled "An epidemic of wellness, the certainty of dying, and killing ourselves to live longer"
I read this book quickly, because the prose is very smooth, and easy to read. I had to return to it again to digest its philosophical and practical points, because it is really very dense with good ideas. The first part explores medical screening, concentrating on PAP smears and mammograms, and points out how invasive these are to women. The subsequent sections of the first half of the book deal with annual examinations, over diagnosis of marginal conditions like ADHD, and eventually about the fear of death.
The concept of "holism" "Everything - mind, body, and spirit, diet and attitude - is connected and must be brought into alignment for maximum effectiveness, whether to achieve "power" and "personal renewal" or just to lose a few pounds." Ehrenreich has a PhD in cell biology, and based on her studies of macrophages, she points out that the common condition of the body is a competition among cells, and even cooperation between cancer cells and macrophages to facilitate metastasis.
Ehrenreich is a sharp, incisive author, with a different perspective on medicine and medical rituals. I will subject some of my professional medical recommendations to greater scrutiny, and criticism. ( )
  neurodrew | Mar 17, 2019 |
We can depend on Barbara Ehrenreich on to write incisive, well-argued and trenchant commentary and criticism of American culture. She is especially noteworthy for bringing to us the larger view connecting cultural, political and sociological trends to economic realities, just as she showed us in her book Nickle and Dimed: On (Not) Getting By in America. In this most recent book, Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer, she challenges our ongoing efforts to resist death at all costs, even if it means quality of life has to suffer.

The first section of the book addresses medical care as an industry. As we age, we are subjected to increasing levels of humiliation and shame due to the medical paradigm that living longer is the greatest goal. But at what cost? I am reminded of my friend Jerry who decided against more chemo when he was being treated for cancer. The doctors made it clear that they might be able to get him six more months of life if he underwent further chemo treatments. He decided that six months of throwing up wasn’t for him. He said no to chemo because his quality of life was more important to him than extending his life.

Ehrenreich makes it clear that, “Not only do I reject the torment of a medicalized death, but I refuse to accept a medicalized life, and my determination only deepens with age."

She makes the economic connection here, too, as in this quote: “What could be more ridiculous than an inner-city hospital that offers a hyperbaric chamber but cannot bestir itself to get out in the neighborhood and test for lead poisoning?” Obviously, serving those who can pay for a hyperbaric chamber is more important than PREVENTING a health disaster in the general population.

Ehrenreich then takes on the cultural notion we seem to be suffering under now – that death is avoidable and that if we just beat our bodies into submission, we can stay alive. This section will make a lot of us devoted to “healthy living” really uncomfortable, especially those regular denizens of the spa, the gym, the “this” diet and the “that” diet, and the shops that sell “alternative” health care products. And if we don’t eat right and exercise enough, then we guilt-trip ourselves for any health problems we might have acquired, even age-related problems. That’s because we suffer the false notion that the body is capable of living a lot longer than we ever knew, if not living forever. In fact, she writes about the view of some Silicon Valley denizens who see poor health and death as technical problems to be solved technically.

There is a long section in this book in which the reader learns about cellular biology and how the body’s cells can sometimes betray us – or more accurately, betray our idea of how those cells are supposed to behave. Ehrenreich has a PhD in cell biology so we get into the biology weeds here. I happen to have been lucky enough to learn about this kind of thing before reading her book so I already knew the meaning of words like “macrophage” and “telomere,” and I could understand her commentary. I enjoyed reading about her struggle to understand her own experience of cancer, how the macrophages were not behaving in a “friendly” way, and coming to the rather radical conclusion that these cellular parts may have a mind of their own and will do as they wish.

This brings us to the final section of the book which is the most philosophical and, for me, the best section of the book. She takes on the existential meaning of death to a species that is all about “self” these days, from “self-improvement” to taking “selfies.” How do we come to terms with the disappearance of a personal self, aka death?

Ultimately, Ehrenreich gets to that place in her last chapter that Buddhist monks seek, that is, “Killing the Self, Rejoicing in a Living World.” She does it through a far different method than what I’m accustomed to because I am far more familiar with Buddhist philosophy than I am with the nitty gritty of cell biology. In fact my only criticism of this book is that Ehrenreich seems quite unfamiliar with eastern culture and philosophy. She traces the meaning of “self” back to the ancient Greeks and she quotes more modern existentialists struggling with the concept of death. However, there’s almost nothing about an ancient tradition in China that provides a considerable amount of insight into the notions of self, the meaning of life, and the meaning and acceptance of death. Meditation and mindfulness existed as practices long before they were taken up as half-assed fads in the west. Too bad Ehrenreich isn’t familiar with the real deal. ( )
  C.J.Shane | Feb 21, 2019 |
3.5 stars

The author has a PhD in cellular immunology. In this book she looks at ways humans try to prolong their lives, and whether or not they are or can be effective.

This was interesting, though a few chapters that went a little bit deeper into the biology (chapters that talked more about cells) kind of “lost” me just a little bit. I still got the gist of those chapters, though. There was also a couple of chapters that were a little heavier on philosophy that wasn’t quite as interesting for me (the cells were of more interest). But, most of the other chapters (including on exercise, meditation, medical industry) were good. Thinking back, I probably will remember some of the information on cells when it comes to cancer (do those cells help fight disease, or are they helping the cancer spread!?). ( )
  LibraryCin | Feb 18, 2019 |
This book was interesting in some places, puzzling in others, and could probably have ended even earlier than it did. The concept of the book is a good one: examining our attitudes toward health and aging in the 21st century, specifically the thought that we are masters of our own health and getting sick is our own fault—even when it isn’t. I liked the parts that talked about the body’s biology and the discoveries that have been made at the cellular level, where cells do things that could almost be seen as “agency” or making their own decisions (such as helping a tumour grow). These bits felt stronger and more interesting than the philosophical digressions about the self (which I thought could have been cut, and didn’t really go with the amusing cover of the Grim Reaper on a treadmill). And while I largely agree with the idea that death has become medicalized and modern health care is largely a matter of testing and lab analysis, I preferred Atul Gawande’s treatment of the subject in Being Mortal.

From the acknowledgements it appears that parts of Natural Causes were published elsewhere as articles. Maybe marketing the book as a collection of articles would have made it feel more coherent, in a way—if you know it’s a collection of articles, it puts you in the mindset of dipping in and out *or* reading straight through, whereas a regular non-fiction book suggests reading straight through. If this book interests you, I’d read it from the library. ( )
1 vote rabbitprincess | Jan 5, 2019 |
There is one fact we all have in common - each of us is going to die no matter what we do to prevent it. The author takes this fact and runs with it. She believes, as I do, that too many of us are taking part in too many medical tests as a preventative measure, but in fact often do little to find what might turn up mere weeks after the test is done. She describes how often it is our body itself that causes the conditions that lead to death - such as our macrophages assisting in tumor growth. She makes a compelling argument for good food, exercise and living well but in not stopping living because too often it does not matter and life is too short not to enjoy it! ( )
  Susan.Macura | Dec 24, 2018 |
Showing 1-5 of 20 (next | show all)
“Natural Causes” is peevish, tender and deeply, distinctively odd — and often redeemed by its oddness. Ehrenreich is so offended by the American conflation of health with virtue and offers charming contrarian essays on the “defiant self-nurturance” of cigarette smoking, for example, and the dangers of eating fruit. The pleasures of her prose are often local, in the animated language, especially where scientific descriptions are concerned. Her description of cells rushing to staunch a wound is so full of wonder and delight that it recalls Italo Calvino.
added by melmore | editNew York Times, Parul Sehgal (Apr 10, 2018)
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Barbara Ehrenreich explores how we are killing ourselves to live longer, not better. She describes how we over-prepare and worry way too much about what is inevitable. One by one, Ehrenreich topples the shibboleths that guide our attempts to live a long, healthy life, from the importance of preventive medical screenings to the concepts of wellness and mindfulness, from dietary fads to fitness culture. We tend to believe we have agency over our bodies, our minds, and even over the manner of our deaths. But the latest science shows that the microscopic subunits of our bodies make their own "decisions," and not always in our favor. We may buy expensive anti-aging products or cosmetic surgery, get preventive screenings and eat more kale, or throw ourselves into meditation and spirituality. But all these things offer only the illusion of control. How to live well, even joyously, while accepting our mortality -- that is the philosophical challenge of this book.… (more)

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