Barbara Ehrenreich

We tend to believe we have agency over our bodies, our minds and even our deaths. Yet emerging science challenges our assumptions of mastery: at the microscopic level, the cells in our bodies facilitate tumours and attack other cells, with life-threatening consequences. In this revelatory book, Barbara Ehrenreich argues that our bodies are a battleground over which we have little control, and lays bare the cultural charades that shield us from this knowledge. Challenging everything we think we know about life and death, she also offers hope - that we find our place in a natural world teeming with animation and endless possibility.

Life, Death and the Illusion of Control

Natural Causes

Bestselling author of Nickel and Dimed, Barbara Ehrenreich explores how we are killing ourselves to live longer, not better. A razor-sharp polemic which offers an entirely new understanding of our bodies, ourselves, and our place in the universe, NATURAL CAUSES 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. But NATURAL CAUSES goes deeper -- into the fundamental unreliability of our bodies and even our "mind-bodies," to use the fashionable term. Starting with the mysterious and seldom-acknowledged tendency of our own immune cells to promote deadly cancers, Ehrenreich looks into the cellular basis of aging, and shows how little control we actually have over it. 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 vitally important philosophical challenge of this book. Drawing on varied sources, from personal experience and sociological trends to pop culture and current scientific literature, NATURAL CAUSES examines the ways in which we obsess over death, our bodies, and our health. Both funny and caustic, Ehrenreich then tackles the seemingly unsolvable problem of how we might better prepare ourselves for the end -- while still reveling in the lives that remain to us.

An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer

Colleen

1 Star

**My #1 worst read of 2018**


ARC provided by Twelve Books via Netgalley in exchange for an honest review. And honest it shall be.


My expectations for this book were of an insightful, well-researched look at how society handles aging and death. Ehrenreich is a well-known author, successful, and educated. But Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer is one of the biased books I have ever read. It’s a hostile rant lacking in facts throughout which the author blatantly ignores any information that does not fit her own opinion. And her opinion is (if you want the short version): the entire medical field is a harmful hoax run by greed and sadism; and you are going to die anyway, so do what you want and then die, Dorothy, die. 

Even though there were some things that I agreed with (such as the corporate greed of the pharmaceutical industry or how some fad diets can do more harm than good), the author's tone was off-putting. It seemed to be one long, extremely bitter rant dressed up as fact. As eager as Ehrenreich was to allegedly debunk the entire medical profession, her own "facts" were often lacking in substantial information. That was particularly dangerous considering that Ehrenreich promotes completely abstaining from all medical treatments.

 It kind of makes it worse that she is highly educated yet put out something so prejudiced. She apparently has a doctorate in cellular immunology. Her chapter on microphages was about the only one that she managed to not sound like a raving lunatic. But she keeps mentioning the caveat that she respects science which in her opinion is completely separate from that “hoax” called medicine. Scientists are wonderful and smart but the minute you apply any of that to medicine it somehow become hooey according to her. Worse that than, she ironically is a cancer survivor telling people not to get any screenings or preventative care. 

In terms of the setup of the book, most of the chapters ended abruptly. There was no cohesion to the writing. This really did seem like the rant of a bitter, unstable person. Her animosity seems into everything. Even the chapters had names like "Rituals of Humiliation" and "The Veneer of Science" as examples of the author’s hostility. She overuses quotation marks to show sarcasm and skepticism and on very commonplace terms. For example, she would talk about the “doctor” pretending to “treat” a patient. 

There is a major lack of credible sources. References are often vague such as “one source said” which was a huge red flag. So I checked her references at the end of the book. I quickly realized that the few cases where she had even a semi-legitimate source she crowed it and spelled out everything short of the person’s social security number. But the rest were left vague. And sure enough, every time I checked those sources would turn out to be… shall we say, less credible. 

She uses outliers as if they represent the whole segment. I’m sorry that she felt harassed at by a single gynecologist in the 60’s, but that does not mean the entire field is harmful and/or unnecessary as the author claims. This is another example of making broad claims based on her own anecdotal “evidence.” In fact, gynecology is one of the medical fields where the U.S. has more female doctors than male doctors which really puts a damper on her theory about them all being rapists and sexual sadists. Not that there aren’t female perpetrators in the world, but there certainly is no evidence that men (or women) become gynecologists just to sexually abuse other people. Or that such occurrences are anywhere near as common as she states. Has there ever been a creepy gynecologist? Of course. But that does not mean that the entire field is some conspiracy of sexual sadism.

Overall, Natural Causes is a prejudiced rant where the author completely picks and chooses information and manipulates facts as they suit her. Anything that goes against her personal opinion is automatically a manipulative conspiracy by pharmaceutical companies and their sadistic partners (aka the entire medical field). This book is one long, paranoid rant lacking in facts and lucidity. I might agree with some of her broad assumptions, but she is so extreme that it is dangerous. She tells people not to get any preventative treatments (this includes everything from cancer screenings to basic healthy eating and exercise). She blathers on about if positive thinking does have any effect on your body then it will only be to make your cancer worse. There was some falderal about cells being sentient and intentionally causing cancer.

She compares doctors to shamans and clowns and claims that the masks doctors wear are part of the “ritual” and are meant to intimidate people and encourage worship and fear. Never mind that there are clear scientific reasons that medical professionals wear surgical masks. But no, Ehrenreich told you they are only for ritualistic purposes and if you don’t believe her then you must be part of the mindless masses. 

She accuses all doctors of violating person space and compares many medical procedures to sexual assault.

She uses far outdated medical practices as excuses of why modern medicine is terrible. Well, Crazy Lady, the same can be said of science: if you judged modern science by the many outdated, incorrect theories then you would conclude that science is full of hokum. 

She says you are better off seeking alternative choices although she immediately follows that up with more of her “debunking” to invalidate all of those as well. She does admit to exercising but emphasizes over and over that she only does because she likes to exercise but never, EVER for health reasons. 

She says that birthing practices are “rituals of domination” meant to demean and defeat women. 

It’s ironic that she complains about the few voices of “reason” (aka people who conform to her opinions) being discredited. But she really ties the noose herself when she does exactly that through her own rabid tirades. She does not need any conspiracies to discredit her. She is already one rant away from wearing a tinfoil hat. (But perhaps she has eschewed tinfoil hats as yet another example of alternative trends.) Ehrenreich’s own embitterment poisons every word of this book. I picture her pounding on her keyboard and clenching her teeth as she accuses all modern medicine of being pseudoscience – while using her own pseudoscience as evidence.

Now, it may seem that this review is an overreaction. So here are some quotes to demonstrate. At first, I was not going to include quotes in my review, because I thought they seem out of context. But by half way through the book, it was clear that any snippet from this book can unmistakably demonstrate the author’s distorted propaganda and disintegrating state of mind. 

About cells:


  “It turns out that many cells within the body are capable of what biologists have come to call ‘cellular decision making.’ Certain cells can ‘decide’ where to go and what to do next without any instructions from a central authority, almost as if they possessed ‘free will.’”

“Things I had been taught to believe are inert, passive or merely insignificant—like individual cells—are in fact capable of making choices, including very bad ones.”

About doctors:


   “Inevitably, a parallel was drawn between the healing rituals of supposedly primitive peoples and the procedures of modern Western medicine. The latter also take place in specifically designated spaced and are usually performed by costumed personnel, wearing white coast and sometimes masks, who also manipulate objects generally unavailable to the public at large.”

“Commenting on the occasional deployment of clowns to cheer up pediatric hospital patients, one canny observer noted the parallels between these newcomers to the medical scene, ‘primitive’ shamans, and the usual physicians, right down to the ‘unusual costumes,’ and even masks, worn by all of them. The patient undresses, the ‘healer’ (or clown or shaman) utters incantations and performs carious actions on the patient’s body. Then, in the medical case, comes the ‘confession,’ in which the patient is grilled as to his or her personal transgressions.”

“They are no more scientifically justified than the actions of a ‘primitive’ healer. They do not serve any physiological purpose, only what she calls ‘ritual purposes.’ The enema and shaving underscore the notion that the woman is an unclean and even unwelcome presence in the childbirth process. Anesthesia and the lithotomy position send ‘the message that her body is a machine,’ or as Davis-Floyd quotes philosopher Carolyn Merchant, “a system of dead, inert particles,’ in which the patient has no role to play. These are, in other words, rituals of domination, through which a woman at the very peak of biological power and fecundity is made to feel powerless, demeaned, and dirty.”

“In one sense, childbirth rituals ‘worked.’ The women giving birth were often traumatized, reporting to Davis-Floyd that they ‘felt defeated’ or ‘thrown into depression’: ‘You know, treating you like you’re not very bright, like you don’t know what’s going on with your own body.’ Yet, having submitted to so much discomfort and disrespect, they were expected to feel grateful to the doctor for a healthy baby. It was a perfect recipe for inducing women’s compliance with their accepted social role: rituals of humiliation followed by the fabulous ‘gift’ of a child.” 

On doctor examinations:


   “The interaction requires the patient to exhibit submissive behavior—to undress, for example, and be open to penetration of his or her bodily cavities. These are the same sorts of procedures that are normally undertaken by the criminal justice system, with its compulsive strip searches, and they are not intended to bolster the recipient’s self-esteem. Whether consciously or not, the physician and patient are enacting a ritual of domination and submission, much like the kowtowing required in the presence of a Chinese emperor.” 

If you read those quotes and still think this sounds like a good book… well, there’s nothing I can do for you. 


*Quotes are taken from the ARC and may not reflect the final published version.

RATING FACTORS:
Ease of Reading: 1 Star
Writing Style: 1 Star
Originality: 1 Star
Attention to Details: 1 Star
Plot Structure and Development: 1 Star
Objectivity: 1 Star

Riley

I picked it up because I agree with "embrace death when it comes" and I put it down because the author's "life is depressing and stressful stuck in waiting rooms for unnecessary tests your doctors pressure you to get" experience does not at all resonate with my "life is depressing and stressful with chronic illness and pain that I have to fight to have tested to be diagnosed for access to assistance" existence. Is this selfish of me? Yes. But in my selfishness, I'm doing work on broadening disability accessibility and understanding. In the author's selfishness, they wrote this book to justify enjoying their life without medical concern by belittling the preventative health approach of their able-bodied peers.

This book argues against:
preventative medical procedures
life-prolonging medical treatments
the current state of medical training 
patients being dismissed and demeaned
patients being coddled or offered peace of mind
the use of alternative practices for health
the absence of alternative medicine in clinical practice

Yes, most of those contradict each other. The premise is interesting but the book is so busy dumping on the most common social attitudes to medicine that it doesn't seem to realise it has no cohesive thesis, let alone room for broader approaches. It's like an obnoxious teen - too cool to care and utterly ignorant to the necessity of caring; blaming authority institutions without offering a single new idea or reason for change.

Nadine 

Interesting snarky commentary on our obsession with health and wellness that at times goes over the top and gets long winded but generally a good antidote to all the other books out there on a moralistic health high horse.

I.m. ruzz

I don't have a lot to say. Having fought with the medical establishment, but having also watched people go off the deep end about BIG MEDICINE and lose their lives because of it I think there's something to be said for finding a balance.

Parts of the book were enjoyable and though I don't think she quite captured the argument there is a book out there for someone to write about how our ideas about the sanctity of life, and how the human relationship to death and aging has shifted over the decades and continues to shift as we try to upend nature. 

this wasn't that book but I read it all the same and have no regrets.

Natural Causes Life, Death and the Illusion of Control

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