Natural causes : life, death and the illusion of control

by Barbara Ehrenreich

Paper Book, 2019

Status

Available

Call number

304.64

Collection

Publication

London : Granta, 2019.

Description

Family & Relationships. Sociology. Nonfiction. HTML: From the celebrated 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… (more)

Media reviews

“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
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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.
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User reviews

LibraryThing member DavidWineberg
The Reductionist is IN

With too much time on our hands, we are obsessed with ourselves. Barbara Ehrenreich visits the catalog of diets, wellness, mindfulness, religion, movements, medicine and idiotic fads that preoccupy so many. Eternal youth, eternal life, and managed death are all symptoms.
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Taking the view from above, it is of course of no moment in the ongoing universe.

We want to think we can beat the odds and maybe even death. Certainly deterioration is ripe for conquering. So we work out, eat “right”, supplement and moisturize. And if we deteriorate, it must be our own fault. Between the fads, the trends, the diets and the studies, “every death can now be understood as suicide” she says in Natural Causes.

It begins with a jaundiced look at preventive healthcare. We insist on too many pointless checkups, too many pointless surgeries and too many pointless drugs. It has become a “ritual” that doctors perform for our comfort. That doctors have begun having themselves tattooed with “DNR” (Do Not Resuscitate) is a clue how extending life a few days or weeks in intensive care is of little benefit.

The book is a total pleasure of clear thinking, precision word choice and sober reflection. All of it relatable. Her thoughts are our thoughts, her appreciations our appreciations. Validated and justified and rationalized. Her job has been to collect it all here, and reduce it to its true value and worth. The conclusion she comes to at the very beginning is that life is just a short pause in the ongoing processes of the universe, so don’t torture yourself, and enjoy it while it lasts.

David Wineberg
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LibraryThing member Beamis12
Informative and Illuminating. This author has a doctorate in cellular immunology, so one can expect quite a bit on the role of the different cells within our bodies. Some of this was quite dense but I believe I did understand most of what she was explaining. That our cells have different functions
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and can also turn on us. This section of the book, which was in the last half, was not my favorite. I loved her explanation and witticisms on the self help industry, and the ways we are mislead, or handled as they say, by information and biases without any scientific background or explanation. The barrage of current, healthy diet plans, the constantly changing shoulds and shouldn'ts. The illusion that if people follow this or that, a happy, healthy, long life will be the result. But....maybe not, is it possible we are not fully in control of our own fate? That we can do everything we are supposed to, but have no guarantee?

She takes on the medical industry and there consistent insistence on screenings and tests? How valid are all these tests and if one has them what do the findings mean? Tests, leading to more tests, leading to medicines that have side effects that are almost worse then the disease. I was diagnosed with MS over fifteen years ago, after five years of incorrect diagnoses and two unneeded surgeries. My neurologist immediately started me on an antibiotic spasm medication, an antibiotic depressant, because this diagnosis was sure to cause depression and Avonex. Avonex is a weekly, self delivered shot, and I decided to do it on Fridays, as I would have the weekend to recover. from the very beginning the side effects were horrible. I spent Friday nights and most Saturdays with a high fever, shivering and shaking. Just awful. Stuck with it for a few months and quit. Since then, except for treatments for excerbations, the only meds for this I take is my antispasmodic. Luckily for me, I feel I am better off.

Anyway there is much information presented in this book, some I agree with, some I want to look into further. It does, though give me the chance or choice to make an informed decision, and made me think of my future health decisions.

ARC from Netgalley.
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LibraryThing member BibliophageOnCoffee
Disjointed, confusing in places, and overly cynical.
LibraryThing member JulieStielstra
Ehrenreich's brilliant and moving Nickel and Dimed should be required reading for anyone with even a shred of interest in the plight of the working poor. I loved her acerbic Bright-Sided, skewering the bullying and money-grubbing "positive thinking" industry. As a PhD in cell biology and a breast
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cancer survivor, she has the chops to take a hard look at medicine, and having worked in health care for 20 years, I was eager to hear what she has to say in that tough, informed, cynical voice about it. But...well, I ended up being glad the book wasn't any longer and some parts were a lot too long anyway, and so much left out besides.

Ehrenreich is at her best early on, describing her "mid-life revolt." She faces up squarely to mortality - including her own - in her sharp criticisms of the idea that if we only do all the "right" things (whatever those might be, according to whose lights), we can live almost literally "forever" (as some strange people with more money than sense have earnestly believed). Nope, sorry, folks - we are all going to die of something, even you. She prefers to make choices that will make her daily life pleasant, enjoyable and - yes, even healthy, and confesses to being a rather driven gym rat herself, but mostly because she is competitive and it feels good. There is plenty to criticize in medicine's wild swings of guidelines and recommendations, in "standards of practice" for treating nonstandardized human beings, and readers would do well to pay attention to this when their own physicians start plugging the tests and screenings. She chooses not to address Big Pharma and its abhorrent marketing, influencing, manipulating and outright gouging... maybe that's a whole book in itself, though.

And then we come to her beloved macrophages, the subject of her doctoral studies and research. They are important. They are tricky: they turn out not to be the stalwart guardians of our health that medicine believed they were for many years. But pages and pages and pages... lucidly enough described, but much too much of a mildly interesting side road.

There is some attention paid to the "mind-body" connection, with an appropriate amount of skepticism, and reminders that just because some celebrity or a single chick embryo study that got some press says something might be so, it may not be. The corporate co-opting of "mindfulness" exercises is pretty revolting.

And then it just kind of ends. It has the feel of several different magazine articles distended and stitched together, with macrophages slithering throughout. It's a patchy framework that hangs together only rather tenuously, with some good bits early on, but peters out. Worth a read for some chapters and skim the rest - definitely not her best, and overall rather disappointing when we know how good she can be.
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LibraryThing member Tytania
Some really great food for thought; sections where Ehrenreich shares her own perspective and personal experience are the best. She is well into her 70s, and has made the honorable and sane decision (IMHO) not to pursue any further medical tests or disease-related interventions. She also eats
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whatever she wants. You've heard it before: Exercise, eat right, die anyway. She still exercises, though.
Unfortunately, most of the book reads like a research paper, a style of non-fiction I don't enjoy. "Here's the point of this chapter. Here is every single bit of research I could find - here's a quote, here's another quote, but look at this quote." At one point I even felt she was contradicting her own self from a previous chapter; chapter 2 makes some really spot-on comparisons between the "rituals" of modern medical care and those of what we'd consider "primitive" healing ceremonies and techniques, a later chapter (I can't find it, I really need to keep stickies nearby when I'm reading) quotes with implicit outrage some new-agey source making the same comparison.
The chapters written from a personal perspective were very worthwhile. The book is short at barely 200 pages, so it's not a slog. A-OK.
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LibraryThing member APopova
Disjointed, not sure where she was going with the title. Not up to her usual incisive, fluid researched work.
LibraryThing member ritaer
This book wasn't exactly what I expected. Ehrenreich meditates on our cultures preoccupation with maintaining health into old age and the impossibility of avoiding eventual death. She aldo discusses recent research on the the human immune system that suggests that our own cells may turn against u.
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This leads to considerations of consciousness in the universe at large and the way in which modern science has scrubbed the material world clear of intelligence or will. Interesting.
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LibraryThing member splinfo
short and very readable. In essence the idea is that no one really can say which bits and pieces contribute to health and long life. Too many variables. "Somebody" is making money by promoting each health fad, exercise regiment, preventative test. Within reason accept the fact that aging is what it
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is, 50 is not the new 40. Make time for what matters to you as the years go by, be who you are, don't fill your life with regiments and appointments reputed to stave off the inevitable. This is a funny book, well written.
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LibraryThing member libraryhead
Starts off bracingly with a genuinely eye-opening approach to health, health care, and what it's all for -- namely that you don't have to do any of the things conventional wisdom and the women's magazines would require of you just for the privilege of carrying on another day. You don't have to
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submit to physicals and diagnostic tests. There's very little evidence that the "lifestyle changes" typically pushed do much of anything in either extending lifespan or improving subjective experience of health. Even those who dutifully reorder their lifestyle in the manner proscribed still sometimes die young. Take downs of "mindfulness" other forms of vapid self-involvement were similarly delicious. For there, however, the book veers off into a long, repetitive argument about the immune system and the paradoxical behavior of certain cell types which may play a role in promoting, rather than suppressing cancer and some autoimmune disease. The final chapters end up in a very different place, musing about the creation of the concept of self as the root of our fear of death, and the potential of psychedelics to alleviate it. Definitely would read more Ehrenreich, but this was not her best.
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LibraryThing member BookBuddies
Ehrenreich's personal polemic is a bit disjointed. Her main point is that death is a natural part of living and we need to accept that.
LibraryThing member Devil_llama
This was a real mesh of good and awful, with some mediocre tying it all together. First, whenever someone starts using the phrase "Western medicine", the thing is not likely to end well. When she follows up her assessment that clinical medicine doesn't have strong enough evidence to support it by
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praising the fact that many people are using homeopathy and alternative medicine (which has no evidence to back it up), you wonder if she has gone off the deep end. There are many good things in here, and her overall thesis, that there is no magic bullet to living forever, and in fact it isn't going to happen, so suck up and learn to deal with aging, is on the money. Some of the tangled ways she gets there? Not so much. And while I do agree with her that there were bad things in the medicalization of childbirth in the mid-20th century, medicine has pulled back from that a lot, and there is one more thing to say that she neglects: women rarely die in childbirth anymore. Infants usually live through to adulthood now, at least in the wealthy countries. Not so much in places where her beloved "traditional" medicine is the only choice. So, read it for what it's worth, don't assume she knows everything just because she regularly repeats that she has a Ph.D. in Biochemistry (impressive, but she did not work in the field, so is not really considered an expert after all these years), and be willing to brush of some of her goofier notions, and you can get the good pieces out of this slumgullion.
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LibraryThing member LivelyLady
Boring book on the commercialization of trying to not grow old and die.
LibraryThing member Susan.Macura
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
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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!
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LibraryThing member rivkat
This is a weird book. It’s half about our obsession with controlling our own bodies—and the resulting mind/body dualism, which makes our newer obsession with controlling our own “selves” a bit hard to parse; who’s doing the controlling? The other half is about our cells, like the
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macrophages that are important parts of the immune system but also help cancer spread and kill us. Rather than being a community of cells working in harmony, we are made up of competing and occasionally rogue cells, whose reasons for going one way rather than another are and may forever remain mysterious—just as we now understand pregnancy as in part a competition between mother and fetus, each with its own aims. Also, she spends a lot of time reminding us that no matter how much we try to control things, we will nonetheless die.
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LibraryThing member HendrikSteyaert
Interesting subjects but at the end of the book i was wondering: "What is her point? What is this book about?". Maybe i was misled by the Dutch title of the book.
LibraryThing member neurodrew
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,
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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.
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LibraryThing member writemoves
I enjoyed the perspectives and information presented within this book. The sections on the cellular basis of aging were a bit beyond me but I identified with the topics on medical tests, patient-doctor relationships and how to accept aging and dying. I have witnessed the slow decline of my parents
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and in-laws. I have seen the endless and merciless testing, probing and inconvenience they experienced. I do not want my final days to be like theirs...

Listed below are content from the book that caught my interest and provoked some thinking on my part:

The immune system actually abets the growth and spread of tumors, which is like saying that the fire department is indeed staffed by arsonists. We all know that the function of the immune system is to protect us, most commonly from bacteria and viruses, so it's expected response to cancer should be a concerted and militant defense.

You can think of death bed bitterly or with resignation, as a tragic interruption of your life, and take every possible measure to postpone it. Or, more realistically, you can think of life as an interruption of and eternity of personal nonexistence, and seize it as a brief opportunity to observe and interact with the living, ever surprising world around us.

Once I realized I was old enough to die, I decided that I was also old enough not to incur any more suffering, annoyance, or boredom in the pursuit of a longer life. As for medical care: I will see help for an urgent problem, but I am no longer interested in problems that remain undetectable to me.

Rather than being fearful of not detecting disease, both patients and doctors should fear healthcare. The best way to avoid medical errors is to avoid medical care. The default should be: I am well. Good way to stay that way is to keep making good choices – – not to have my doctor look for problems.

Not only do I reject the torment of a medicalized death, but I refuse to except a medicalized life, and my determination only deepens with age. As the time that remains to be shrinks, each month and day becomes too precious to spend in windowless waiting rooms and under the cold scrutiny of machines. Being old enough to die is an achievement, not a defeat, and the freedom it brings is worth celebrating.

One recent study found that almost half the man over 65 being treated for prostate cancer are unlikely to live long enough to get the disease anyway. They will, however, live long enough to suffer from the adverse consequences of their treatment.

The US Census Bureau reports that nearly 40% of people age 65 and older suffer from at least one disability, with 2/3 of them saying they have difficulty walking or climbing.
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LibraryThing member brett.sovereign
Short book that still occasionally seems padded or overly discursive with its criticism of modern medicine, science ( aspects of science historically rather), modern lifestyle trends in health and wellness, class consciousness, and so on. Much of this will be familiar to anyone who has read her
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most recent books.
I think this was patched together from articles. I did appreciate the reflections on aging and foregoing intrusive medical testing.
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LibraryThing member Venarain
This is hard book to review. Parts were compelling, parts were rambling and bitter. But ultimately, I would recommend reading.
LibraryThing member FormerEnglishTeacher
I’m not sure what I expected out of this book, but having finished it, I don’t think I got as much as I had hoped. Much of it is due to my own lack of science background. I am a humanities person who, while I took chemistry and physics as well as higher math in high school, didn’t go near any
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of it after that. I decided to watch an interview with Ehrenreich from 2014 on CSPAN thinking that hearing her (although not in reference to this book) talk about her work might help me with this book. Wrong. In fact, I felt much the same way after the interview that I do having finished this book. Again, like the girlfriend says to the boyfriend while breaking up: it’s not you; it’s me.
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LibraryThing member LibraryCin
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)
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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!?).
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LibraryThing member Dorothy2012
So well written and well researched. There is a lot to think about in this book. I will be buying my own copy.

Language

Original publication date

2018-04

Physical description

xv, 247 p.; 20 cm

ISBN

9781783782420

Barcode

91100000176677

DDC/MDS

304.64
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