Barbara Ehrenreich is an award-winning author, social commentator, and political activist. She has described herself as a ‘myth buster’. She has previously written about the difficulties of surviving on minimum wage in America after three months of undercover research. At the age of 76, the author decided she would have treatment if she became ill but had had enough of medical tests and preventative screenings for issues such as cholesterol or cancer.
In Natural Causes she investigates how ‘wellness’ has replaced ‘health’ (ie not being sick) – persuading us that we need to have regular check-ups and tests in spite of little or no scientific evidence to show there are any real benefits. Ehrenreich cites the America College of Physicians view that annual physicals and routine gynaecological examinations for women with no symptoms are unnecessary. This, of course has not diminished the number of annual exams which, in 2015, were estimated to cost $10 billion in the US. I wonder how different the situation is in Australia.
The book is written from a feminist perspective and the author describes how working out to build physical strength was seen as a serious political goal by second-wave feminists. Encouraged by videos from Hollywood stars such as Jane Fonda, millions of women took up aerobics which quickly moved away from building strength to looking attractive. This, apparently naturally, led to increased concern over what we were eating and a new low-fat lifestyle was heavily promoted.
Ehrenreich argues that it was this reduction in dietary fat which triggered the obesity epidemic in the western world. In hindsight it makes sense that if the fat is cut from the diet then the ‘feel good’ taste of fat needs to be replaced with some other ‘feel good’ taste, most often sugar in snacks like fat-free cookies. Plus, if they are fat-free, we can eat more, right?
The author herself still works out because she can feel the benefits of being more flexible and agile as she gets older and she enjoys it. It is part of her regular routine which allows her to spend time doing the things she wants to do, such as being with her granddaughter, and avoid the things she feels waste time, such as going for medical tests.
Drawing on her background in cellular biology, Ehrenreich discusses the latest research on the extent to which we have agency in regard to our minds and bodies at a microscopic level. Her early career research looked at the function of macrophages, the white blood cells which attack and destroy infections, viruses and the like. It is extremely disconcerting to discover these cells appear to have agency in their own right and, at times, ‘choose’ to assist in the growth of tumours while attacking other cells with devastating results.
Although the book appears to address a wide public social concern, its focus tends more to the author’s own private concerns about ageing and dying. I heartily agree that heroic efforts and horrible technological and medical interventions should not be used to needlessly prolong life but, when I’m 76, I hope I don’t think I’m old enough to die either.
Like Ehrenreich I’m in the privileged position of being able to make a choice. The obvious issue which is not addressed in this book is the millions of Americans who suffer because they have no access to basic health care, let alone preventative measures – just as there are many Australians in the same position.
Reviewed by Jan Kershaw
Rating out of 10: 9
Distributed by: Allen & Unwin
Released: May 2018