Still Not Whistling Past the Graveyard
Our Old Age Theme today is presented in the form of a book review. Unfortunately the topic is still the depressing one of old age and the concomitant one of death. Although the word 'concomitant' is used deliberately, I am aware that many of the elderly colleagues in my cohort are now beginning to think that old age can be dramatically extended until all the "natural causes" of death are eliminated --- or defeated by the rigid application of a spartan and healthy lifestyle. The question is, I suppose, how much of your life do you wish to sacrifice to delay death?
The book under review is Natural Causes by Barbara Ehrenreich. They are both pictured above. You are likely to recognize her name since she has authored many books. You are also likely to assume that she is a progressive cultural critic who perhaps tackles too many topical topics to be taken seriously. Only the first part of the assumption is correct.
From the Introduction we learn why she questions much medical advice and also that she has the credentials to do so. It was upsetting for her to learn that it has been discovered that "the immune system actually abets the growth and spread of tumors, which is like saying that the fire department is indeed staffed by arsonists." That such a "paradoxical" finding could be disturbing is understandable, particularly since she had studied the macrophages which are now seen to be sabotaging the immune system. They were the focus of her study when she earned a PhD in cellular immunology.
The title of the first chapter is, "Midlife Revolt" and from these sample sentences you will be able to figure out what she is revolting against. The first sentence is:
"In the last few years I have given up on the many medical measures -- cancer screenings, annual exams, Pap smears, for example -- expected of a responsible person with health insurance...."
Followed by:
"I knew I was going against my own long-bias in favor of preventive medical care as opposed to expensive and invasive high-tech curative interventions...."
"I also understood that I was going against the grain for my particular demographic. Most of my educated, middle-class friends had begun to double down on their health-related efforts at the onset of middle age, if not earlier...."
"I had a different reaction to aging: I gradually came to realize that I was old enough to die, by which I am not suggesting that each of us bears an expiration date...."
"Once I realized I was old enough to die, I decided that I was old enough not to incur any more suffering, annoyance, or boredom in the pursuit of a longer life.
She gives good reasons for the decision to avoid such procedures as a colonoscopy and points out that "there are even sizable constituencies for discredited tests."
If you are believer in "Successful Aging", then you shouldn't be reading this post and you definitely don't want to read the chapter about it in Natural Causes. The chapter title, "Successful Aging" is in quotes, because Ehrenreich realizes there is no such thing and she takes issue with drivel such as this, which is apparently found in a book with the title, Younger Next Year, under this subhead: "Normal Aging Isn't Normal:" The more I looked at the science, the more it became clear to me that such ailments and deterioration [heart attacks, strokes, the common cancers, diabetes, most falls, fractures] are not a normal part of growing old. They are an outrage.
Naturally, Ehrenreich disagrees with the above and asks: And who is responsible for this outrage? Well, each of us is individually responsible. All of the books in the successful aging literature insist that a long and healthy life is within the reach of anyone who will submit to the required discipline.
At this point, unfortunately I suppose, I believe it is far more likely that I will die of natural causes than it is that I will be younger next year, even if I work out much more and drink much less. Some reviews follow for those who wonder if I make all of this up:
The Opinions of Others:
"Ditch the Quest for Eternal Life and Just Enjoy the Days You Have, "By Rachel Newcomb, Washington Post, May 4, 2018.
Americans have a history of obsession with fads designed to help us live forever. But to what end? Death, notes Barbara Ehrenreich in her new book, “Natural Causes,” still awaits us all. In this lively cultural history of our attempts to control our fate, she details the extreme lengths we will go to keep from dying.
"Barbara Ehrenreich Urges Us to Accept, Accept the Dying of the Light," Parul Sehgal, New York Times, April 10, 2018.
Barbara Ehrenreich wants you to know that you are going to die. Get used to it, and get beyond it... 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.
"Your Body is a Teeming Battleground: It’s time to rethink the quest to control aging, death, and disease—and the fear of mortality that fuels it, "Victoria Sweet, The Atlantic, May 2018.
In her new book, Barbara Ehrenreich ventures into the fast-growing literature on aging, disease, and death, tracing her own disaffection with a medical and social culture unable to face mortality. She argues that what “makes death such an intolerable prospect” is our belief in a reductionist science that promises something it cannot deliver—ultimate control over our bodies. The time has come to rethink our need for such mastery, she urges, and reconcile ourselves to the idea that it may not be possible.
She starts by looking at the many preventive medical procedures we are encouraged, even badgered, to undergo—those regular physical exams, colonoscopies, blood tests, mammograms. She had always pretty much done what doctors advised (she underwent chemotherapy), figuring that it made sense to treat disease before illness overwhelmed the body. But after watching many fitness-obsessed people die early, and realizing that she herself is now “old enough to die,” she questions that premise. Where is the evidence that all the effort at prevention saves lives or delays death?
"Calm Down, We're All Going to Die, Lewis Jones, The Times, April 14, 2018.
Ehrenreich is on surer ground with her objections to the modern regime of needless, painful and even dangerous screening and testing, such as mammograms and colonoscopies (a "kinky procedure"), which appear to be chiefly for the benefit of insurance and drug companies. Those for thyroid cancer are particularly worrying. "An estimated 70 to 80 per cent of thyroid cancer surgeries performed on US, French and Italian women in the first decade of the 21st century," she tells us, "are now judged to have been unnecessary....Ehrenreich concludes her frankly dystopian survey by remarking that the diseases of ageing "clear up the clutter of biologically useless older people", and that without them "we might have to turn to euthanasia". Still, we should avoid the horrors of a "medicalised death". Some of the physicians who routinely inflict drastic end-of-life measures on their patients are so anxious to avoid them themselves that they get tattoos saying "DNR" (Do Not Resuscitate).
"A Scalpel-sharp Dissection of What it is to be Human; Barbara Ehrenreich Ambitiously Traverses the Sciences and the Humanities in Her Investigation of the Body and Human Nature," Paul D’Alton,
The Irish Times, May 26, 2018.
That said, this is a book that makes a fine contribution to an essential dialogue on what it means to be human. Such a dialogue is in itself both humanising and civilising. This type of dialogue is under threat in democratic societies where policy concerning complex social issues is reduced to pronouncements on Twitter, and where dialogue concerning what it means to be human is often dismissed as a liberal-elite indulgence.
Ehrenreich's capacity to consider the complexities, contradictions and paradoxes inherent in the human condition is significant and humbling. She displays a regard and appreciation for the intellectual ground she stands on. This ground, kindly gifted through the generous curiosity of our predecessors, is a form of intellectual inheritance. Ehrenreich also recognises the ephemeral nature of this intellectual knowing, but there is nothing romantic or vague about this: her grasp of the ephemeral is muscular and delicate.
"Natural Causes by Barbara Ehrenreich review – Wise Words on Real Wellness," Yvonne Roberts, The Observer, April 9, 2018.
You may view your body as a temple – particularly if you exercise ferociously, detox regularly, desist from alcohol, tobacco, sugar and all processed foods and positivity seeps out of every pore – but the indefatigable Barbara Ehrenreich has news for you. No amount of mindfulness, self-discipline and denial can spare you from your macrophages, the large white blood cells in your tissues that are found especially at the site of infection. They are out to get you. If they so choose, you will depart this world early and possibly painfully; control is an illusion....
This book is joyous. It is neither anti-medicine nor anti-prevention; it is pro-balance, pro-scepticism and pro-perspective. And it asks us to show a little humility. The gurus of Silicon Valley may believe they can become immortal – Ray Kurzweil, AI expert, is “reprogramming” his body by taking 150 pills a day – but death always trumps self-mastery. So, Ehrenreich argues, replace isolating self-absorption and the rejection of small pleasures with a collective celebration of what life, in all its arbitrariness, has to offer.
"Barbara Ehrenreich Contemplates Successful Aging in Her New Book Natural Causes,"
Alex Good, Toronto Star, July 13, 2018.
It may seem obvious to say that death is inevitable, but that hasn't stopped whole industries cropping up dedicated to forestalling death as long as possible and even trying, in some cases, to deny it entirely. Indeed finding a “cure for death” has become a hobby of American billionaires. It seems unfair that people with so much money should still have to die.
Despite being a bit of a gym rat herself, Ehrenreich sees a lot of these projects as misguided. Wellness has its limits. In the case of the spread of some cancers, for example, our own cells may be working against us. Most of Natural Causes is taken up with a discussion of these matters, and how wrong-headed it is to think of our bodies as holistic systems whose malfunctioning can be cured with better programming or technology.
"Living Longer a Miserable Undertaking, " Julie Kentner, Winnipeg Free Press, April 14, 2018.
Every day, people make choices to help them live longer, healthier lives. We run. We place restrictions on what we do and do not eat. We prescribe the ideal amount of sleep, take supplements and generally make living longer our life's work.
But is it truly possible for us to influence our own health against forces that deny the control we seek? “We would all like to live longer and healthier lives; the question is how much of our lives should be devoted to this project, when we all, or at least most of us, have other, often more consequential, things to do."
"Natural Causes by Barbara Ehrenreich Review – Against Health Sages and Fitness Gurus: A Great Iconoclast Has Written a Polemic About Ageing That Sends Up New Age Platitudes and is Full of Scepticism of the Wellness Industry, The Guardian, April 12, 2018.
“Old age isn’t a battle,” she says, quoting Philip Roth, “old age is a massacre.” In the past few years, she has given up on screenings and scans. Not that she is lazy or suicidal. But at 76, she considers herself old enough to die. All the self-help books aimed at her age group tell her otherwise; they talk of “active ageing”, “productive ageing”, “anti-ageing”, even “reverse-ageing”, with a long life promised to anyone who makes an effort, regardless of factors such as genetics or poverty. But to her, ageing is “an accumulation of disabilities”, which no amount of physical activity or rigorous self-denial can prevent. If she has symptoms, she’ll have them investigated. But when a doctor tells her there could be an undetected problem of some kind, she won’t play along.
Experience has taught her that standard health checks are at best invasive and at worst a scam. Over diagnosis has become an epidemic. Bone density scans, dental x-rays, mammograms, colonoscopies, CT scans: she questions them all."
Post Script:
Stay tuned. I plan to write soon about the more upbeat and scintillating subject of SUBTITLES. The book discussed above, for example, has two of them, which is not untypical. The U.S. version: Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer.
The U.K. version: Natural Causes: Life, Death and the Illusion of Control.
Why is that?
The Bonus:
This is not the first time that Ehrenreich has attempted to reduce the number of smiling emojis. Here is a review of her, Bright-Sided:
"Happy Days," Hanna Rosin, New York Times, Nov.5, 2009.
I must confess, I have waited my whole life for someone to write a book like “Bright-Sided.” When I was a young child, my family moved to the United States from Israel, where churlishness is a point of pride. As I walked around wearing what I considered a neutral expression, strangers would often shout, “What’s the matter, honey? Smile!” as if visible cheerfulness were some kind of requirement for citizenship.
Now, in Barbara Ehrenreich’s deeply satisfying book, I finally have a moral defense for my apparent scowl. All the background noise of America — motivational speakers, positive prayer, the new Journal of Happiness Studies — these are not the markers of happy, well-adjusted psyches uncorrupted by irony, as I have always been led to believe. Instead, Ehrenreich argues convincingly that they are the symptoms of a noxious virus infecting all corners of American life that goes by the name “positive thinking.”
(The Death of Elaine)
