Natural Causes

I have no idea what I've just read. It began as I had expected: ranting against the American overtreat/overworry medical system and against the insane microoptimizations so many people obsess over in diet, exercise, “wellness”. Then... I'm not sure. Ehrenreich took me on a careening tour of medical history, molecular biology, comparative religions, and eventually metaphysical questions of self and facing death. Plus occasional detours to snipe at Silicon Valley. It was rather more than I was prepared for; in a good way, absolutely, but I was just not in the proper mindframe for it. If I'm still around in a year or two, I may want to reread this.

For the one or two people who might read my words: do read it, just, be prepared for what feel like digressions. The content is insightful, educational, even enjoyable. I gained new perspectives on subjects I thought myself informed about (scientific mindset, immunology, religion) and some I was and still am woefully ignorant of (a woman's-eye view of gynecology). I paused often to digest. This is worthwhile material, just, I had trouble figuring out what her central argument is. If you're reading this, you may be better prepared and may then get more out of the book. I hope you do.

Oh, and if anyone reading this happens to know Ehrenreich, I have a recommendation to pass along to her: I encourage her to find a trustworthy guide and to take one of the spiritual journeys she writes too briefly about. I think she could learn more than she can imagine right now, and I think she's prepared for it.

Barbara Ehrenreich, who has bravely taken on minimum wage in her classic book, Nickel and Dimed, now takes on all the buzz-worries of my Baby Boomer generation in her book, Natural Causes. I was fascinated with her take on screenings and annual exams: unnecessary, all. This is not just her opinion, mind you; this is what science is telling us. Fascinating. And why haven't I read this before now?

Probably just me, but I loved this sentence: “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.” Amen, sister.

I was intrigued by (but not entirely clear about, to be frank) the role of macrophages and inflammation and the body's own immune system in some of the biggest problems to our health. I would love to read more about these.

I was not as taken with chapters on mindfulness and cells. These felt like they were tossed into this book to beef it up, size-wise.

And, as much as I agree with her with her social system rants, they were rants, and I felt like these took away from her scientific approach to the book.

Overall, then, I liked it, but I didn't love it. I'd say to read the chapters you like and skip over the parts you don't.

This book is about the healthcare industry, medical care, and wellness, chiefly in an American context.

I should clarify that I personally, staunchly stand by scientific research in this regard, and am dismayed by the rise of anti-vaccination movements, and the general distrust of medicine during Covid. Having said that, I do understand that the way healthcare is structured in the US, and more globally, the history of discrimination on gender, race, and sexuality in health care, do provide grounds for doubting the industry as a whole. There's a tension between these two concepts in Ehrenreich's book that she can't quite resolve, so she goes back and forth between “the insurance companies are making you take medicines you don't need” to “stop believing junk you read on the internet”. I believe the goal was to establish nuance, but her style is very anecdotal, and so easy to be skeptical about in itself. Even when she's debunking points, her tendency to draw conclusions based on singular examples that range from op-eds to twitter posts is very disconcerting. I'm not saying all writing should be data-driven, but surely claims about scientific research should be somewhat better sourced.

On the plus side, there's a lot of interesting fact and detail in the book that I wanted to follow up on. In particular, she discussed the work of Robert Trivers, a scientist, member of the Black Panther Party (they later ex-communicated him), and one of the first to identify the genetic stakes in parenthood. She referenced his book, Wild Life: Adventures of an Evolutionary Biologist, which I immediately wanted to read. 

The book in general is quite glum. Her theme seems to be largely, ‘death is inevitable, why even bother'. Consider this excerpt: “So much then, for the hours - and years - you may have devoted to fitness. The muscles that have been so carefully sculpted and tone stiffen when calcium from the dead body leaks into them, causing rigor mortis, and loosening only when decomposition sets in. The organs we nurtured with superfoods and supplements abandon their appointed functions.....Everything devolves into a stinking pool, or what may sound even worse, a morsel in a rat's digestive system.” She wrote this book at 76, after surviving cancer, and deciding for herself that she was done with scans and checks and probes. I understand that she was tired. But this isn't a model for everyone, especially the young. While we are all going to die, we do have to live until death. The inevitability of death is no reason at all to give up on living, or living well. In an NYT review, Parul Sehgal wrote, “It???s reasonable, even honorable to so coolly make peace with the inevitable. But I confess wanting a bit more raging against the dying of the light.” I agree!