Barbara Ehrenreich is an award-winning writer, scientist and journalist who has written over 20 books. In her latest book, ‘Natural Causes’, she reflects on how we live and our relationship to death, arguing that we are now living longer rather than better. She questions the benefit of preventative medical screenings as well as concepts of wellness and mindfulness, dietary fads, and fitness culture.
Philip Connor Finn: The central premise of the book is that we make our lives worse in an attempt to make them longer. Partly we go through these health checks and treatments as rituals in order to feel like a responsible health conscious adults. Do we need to redefine what ‘health conscious’ is?
Barbara Ehrenreich: I think we pretty much agree on what “health conscious” means: aware of what’s going on in our bodies, insofar as we can be, and alert to possible threats to our physical health. I’m arguing that too many of us have become morbidly “health conscious” and sensitive to threats that may not exist (like the supposed danger of eating fats.) Maybe what we really need is to redefine the word “responsible.” If we are obsessed with our bodies and our health, we may not be sufficiently sensitive to the needs of others around us. We dash around the homeless people sitting on the sidewalks while we make our way to the yoga studio.
PCF: Is health the new ‘opiate of the masses’?
BE: The quest for health may be the new opiate of the masses, or at least of those who have the means to pursue it. Whether they actually achieve health is another matter. It may be more accurate to say that “self-care” is the new opiate, involving as it does multiple kinds of self-indulgence – anointments with skin products, meditation, carefully curated meals – all justified by their supposed contribution to health.
When I decided I was “old enough to die” I felt enormous relief. I still exercise and try to limit my unhealthful habits but without the same sense of obligation I felt when I was younger
PCF: If we’re living in a culture of over-prescription, over-screening, over-treatment, do we need to see drastic changes in the medical and health professions?
BE: First, we need to reverse the twisted priority of our (US) health system that concentrates so many resources on the elderly – often to no good effect – and neglects the young. Then, yes, we do need to change the medical profession. Current medical education tends to view the patient’s body as inert matter, devoid of agency. In fact both the body and of course the mind possess agency. We are much more than cadavers with a heart beat.
PCF: This ‘Epidemic of Wellness’ is spreading out from Silicon Valley, with its mindfulness, dietary fads, and quick fix apps. Is it just a fad and will it pass?
BE: You can’t blame Silicon Valley for everything. The “epidemic of wellness” is fanned by the countless people who make a living from it – e.g., fitness coaches, yoga teachers, authors of self-improvement books, and the many self-appointed gurus mentioned in my book.
PCF: A major topic in the book is about control, and our on-going obsession with having some agency over our bodies, and thus our deaths. Is there some freedom in letting go, and recognising any semblance of control is fleeting?
BE: Sure! When I decided I was “old enough to die” I felt enormous relief. I still exercise and try to limit my unhealthful habits but without the same sense of obligation I felt when I was younger. If I die – and I will – it was going to happen anyway.
PCF: There’s some quite startling facts in the book, like, ‘almost half the men over sixty-six being treated for prostate cancer are unlikely to live long enough to get the disease anyway’. What was the most alarming thing you learned during the writing?
BE: I was initially alarmed to find that so many of my misgivings about over-treatment and over-diagnosis were well-founded, as in the prostate cancer case. I was also both saddened and alarmed to learn that so many of the things we tend to take for granted, like annual physical exams and pelvic exams, are no longer recommended by physicians themselves. Yet people dutifully undergo these procedures as if their virtue was at stake.
We’re all going to die but the world does not die with us. The more we submerge ourselves into this undying world, the less we have to fear from our personal deaths
PCF: You mention not everyone was enthusiastic about this project and ‘specialist sometimes seemed to resent the intrusion of a mere writer into their fields’ – can you say more about that opposition and where you think it comes from?
BE: All right, I’ll give you an example. One of the scientists I was most eager to talk to is Frances Balkwill at Queen Mary University in London, who did some of the early work on the role of immune cells in promoting cancer metastasis. From what I could find out, she is something of a feminist, so I thought, as a former feminist cellular immunologist myself, we would have a lot in common. But she never answered my emails or took my phone calls. Maybe I’m wrong to read into this a certain contempt for journalists.
PCF: There’s lots of lessons in this book, but is there one thing you’d like people to take away from it?
BE: We’re all going to die but the world does not die with us. The more we submerge ourselves into this undying world, the less we have to fear from our personal deaths.
Barbara Ehrenreich’s ‘Natural Causes: Life, Death and the Illusion of Control‘, is published by Granta