An unhealthy ob­ses­sion

Bar­bara Ehren­re­ich wants you to stop fight­ing the in­evitabil­ity of death

The Jerusalem Post - The Jerusalem Post Magazine - - BOOKS - • MARY ANN GWINN

Bar­bara Ehren­re­ich wants you to know that you are go­ing to die. Get used to it, and get be­yond it. That’s the cen­tral mes­sage of Ehren­re­ich’s new book, Nat­u­ral Causes: An Epi­demic of Well­ness, the Cer­tainty of Dy­ing, and Killing Our­selves to Live Longer. Ehren­re­ich, an in­ves­tiga­tive jour­nal­ist, mem­oirist and au­thor of 23 books (in­clud­ing Nickel and Dimed), mounts an in­tel­lec­tual as­sault on Amer­ica’s ob­ses­sion with youth, anti-ag­ing and the de­nial of death. It’s short, more a col­lec­tion of linked es­says than a com­plete work of re­portage. It’s a form that cre­ates some prob­lems, though it doesn’t ob­scure the fi­nal and most per­ti­nent mes­sage.

Ehren­re­ich has an un­usual com­bi­na­tion of tools at her dis­posal – she’s a polemi­cist who is also a scholar and sci­en­tist (she has a PhD in cel­lu­lar im­munol­ogy). The polemi­cist dom­i­nates the early chap­ters, in which she lac­er­ates the con­tem­po­rary ob­ses­sion with ag­ing well and putting off death in­def­i­nitely.

Tar­gets in­clude un­nec­es­sary med­i­cal tests, notably an­nual phys­i­cal ex­ams. The fit­ness craze is an easy mark – though she her­self is a gym rat, Ehren­re­ich looks askance at work­outs that suck hours of valu­able time out of a per­son’s day and, longevity wise, have a low cost-ben­e­fit ra­tio. Ever alert to is­sues of class in Amer­ica, Ehren­re­ich writes that “work­ing out is an­other form of con­spic­u­ous consumptio­n: Af­flu­ent peo­ple do it and, es­pe­cially if mus­cu­lar ex­er­tion is al­ready part of their job, lower-class peo­ple tend to avoid it.” An­other longevity-based regime, “well­ness” and its sub­set, “mind­ful­ness,” have lit­tle sci­en­tific ba­sis and have be­come profit cen­ters for preda­tory cor­po­ra­tions.

Each of these early chap­ters could be a book, and in the name, per­haps, of mov­ing things along, some­times Ehren­re­ich at­tempts a rhetor­i­cal knock­out punch. She writes of the war on smok­ing: “As more af­flu­ent peo­ple gave up the habit, the war on smok­ing – which was al­ways pre­sented as an en­tirely benev­o­lent ef­fort – be­gan to look like a war on the work­ing class.”

How can elim­i­nat­ing lung can­cer be bad for the work­ing class? Ehren­re­ich tar­gets ex­or­bi­tant ci­garette taxes and the de­cline of work­ing-class smok­ing places (break rooms, ci­garette-friendly bars) as ev­i­dence. Cer­tainly these anti-smok­ing strate­gies have out­sized im­pact on poor peo­ple, but lung can­cer is lung can­cer, no mat­ter how much or lit­tle money you’re mak­ing. These ver­bal left hooks dis­tract from more as­tute ob­ser­va­tions, such as the likely rea­sons for work­ing-class smok­ing: for the eco­nom­i­cally strug­gling, sur­viv­ing in the US’s win­ner-take-all so­cial sys­tem is a pre­scrip­tion for 24-hour stress.

But Ehren­re­ich is an in­spired science writer, and in the lat­ter part of the book she de­flates the con­cept that hu­mans can ever con­trol their bi­ol­ogy and their fate.

Her Ex­hibit A is the macrophage. It’s a cel­lu­lar en­tity once thought of as one of the body’s happy war­riors, ded­i­cated to clean­ing up dis­eased or bro­ken cells. In re­cent years macrophage­s have been ex­posed as bi­o­log­i­cal dou­ble agents for their role in can­cer and dev­as­tat­ing au­toim­mune dis­eases.

These cel­lu­lar ac­tivists have a dis­turb­ing ten­dency to go their own way. They were once thought to mass at tu­mor sites for an as­sault on the tu­mor’s growth, but sci­en­tists have dis­cov­ered that in­stead, they en­cour­age the can­cer cells “to con­tinue on their re­pro­duc­tive ram­page.” Macrophage­s have been im­pli­cated in in­flam­ma­tory dis­eases such as ath­er­o­scle­ro­sis, arthri­tis, Alzheimer’s dis­ease, di­a­betes and os­teo­poro­sis.

Macrophage­s up­end the premise that the body is a “smooth-run­ning ma­chine in which each part obe­di­ently per­forms its tasks for the com­mon good,” Ehren­re­ich writes. “It is at best a con­fed­er­a­tion of parts – cells, tis­sues, even thought pat­terns – that may seek to ad­vance their own agen­das, whether or not they are de­struc­tive of the whole.”

And here is her most salient point. Cells and viruses and sub­atomic par­ti­cles don’t have “con­scious­ness, de­sires or per­son­al­i­ties. What they pos­sess is agency, or the abil­ity to ini­ti­ate an ac­tion.” The nat­u­ral world is not dead, but “swarm­ing with ac­tiv­ity, some­times per­haps even... in­ten­tion­al­ity.”

Ehren­re­ich’s com­plex ex­pla­na­tion boils down to a sim­ple pre­scrip­tion, though the medicine may be hard to take.

“You can think of death bit­terly and with res­ig­na­tion... and take ev­ery pos­si­ble mea­sure to post­pone it,” she writes. “Or, more re­al­is­ti­cally, you can think of life as an in­ter­rup­tion of an eter­nity of per­sonal nonex­is­tence, and see it as a brief op­por­tu­nity to ob­serve and in­ter­act with the liv­ing, ever-sur­pris­ing world around us.” (News­day/TNS)

(Den­nis Balogh/TNS)

THE AU­THOR be­lieves that prac­tices of ‘well­ness’ and ‘mind­ful­ness’ have lit­tle sci­en­tific ba­sis.

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