Natural Causes (Barbara Ehrenreich)

OVERVIEW

Barbara Ehrenreich’s purpose in “Natural Causes” is to encourage you to “rethink the project of personal control over your body and your mind” – to challenge the assumption that you control the manner (or the inevitability) of your death. She lambasts society’s obsession with longevity and wellness, and opposes the cultural position that living longer always means living better. Ehrenreich herself is highly critical of the notion that she should spend her precious retirement trying not to age, and self-assuredly declares that she is “old enough to die.” I loved that bit. Ehrenreich is deeply interested in science and mortality, and she is a true skeptic at heart.

Here are some points I thought were great:

·         It’s okay to die – and it’s okay to feel you’re old enough to die

·         Aging has gone from being a normal part of our life cycle to a disease we’re responsible for curing. As you age, you’re told you must exercise and eat healthy… so as not to age. “The price of survival is endless toil,” says Ehrenreich. Successful aging is, at its core, not really aging at all.

·         Dying has become a moral failing, and one in need of a moral postmortem: Did she smoke? Did she butter her bread? Did she drink? Did she exercise? Wellness is a status symbol.

·         We should focus more on public health measures to reduce morbidity and mortality (e.g., equity in access to care, reducing pollution, ensuring access to clean drinking water, alleviating poverty, etc.).

·         Our bodies are full of semi-autonomous cells and bacteria; our “self” (a hard-to-pin-down entity) is hardly the only agent with agency in our flesh house. That’s kind of cool when you think about it.

·         Evolution didn’t make us perfect creatures; things break down and turn against us all the time. Even the immune system is being increasingly found to abet cancer (at least some of our immune cells seem to be complicit in the invasion). Autoimmune disease needs no introduction as a paradigm to the ways in which things can go haywire. Bodies fail… it’s normal for bodies to fail. Death and disease are not personal failings.

 

WHAT NOW? (actions for mortal atheists)

There’s really only one action I have as a takeaway. Here goes. Deep breath…

You could just… die.

Ehrenreich considers herself old enough to die (she was 76 at the time of writing). After a certain age she stopped getting physicals, pelvic exams, cancer screening tests, etc. In her words: “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 […]. As the time that remains to me 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.” This is radical death acceptance… an open rebellion. We can easily imagine the 100-year-old or the very ill terminal patient saying “that’s enough,” but a healthy 76-year old who doesn’t give two hoots about preventive medicine? That’s uncommon. Ehrenreich is living proof that anxious determination not to die is only one option among many.

 

IN SUM:

Is this book entirely secular? Yes.

If you had to describe the book in one sentence? A commentary on the epidemic of wellness in America.

Who should read this book? Folks who loved her other books and are intrigued by this topic.