NPI's Cascadia Advocate

Offering commentary and analysis from Washington, Oregon, and Idaho, The Cascadia Advocate is the Northwest Progressive Institute's unconventional perspective on world, national, and local politics.

Saturday, June 9th, 2018

Book Review: Barbara Ehrenreich is old enough to die, but still has plenty to say

Bar­bara Ehren­re­ich’s Nat­ur­al Caus­es is a short, sol­id piece of prose about what it means to suf­fer from age, accept­ing the real­i­ty of death, and the sorts of things a per­son ought to con­sid­er when weigh­ing both.

Natural Causes by Barbara Ehrenreich

Nat­ur­al Caus­es by Bar­bara Ehren­re­ich (Hard­cov­er, Twelve­Books)

At sev­en­ty-six, the jour­nal­ist and polit­i­cal activist says she’s real­ized that she’s now “old enough to die”, that is, her death will no longer be a sur­prise any­one or require any expla­na­tion beyond “nat­ur­al caus­es”.

There­fore, she isn’t going to waste what time she has left on doc­tors vis­its, check­ups, and exam­i­na­tions that have only a dubi­ous rela­tion­ship to longevi­ty and cer­tain­ly not to enjoy­able longevi­ty.

This real­iza­tion serves as a jump­ing-off point for her to explore — most­ly crit­i­cal­ly — all sorts of top­ics relat­ed to med­i­cine, aging, and death.

The sub­ti­tle is “An Epi­dem­ic of Well­ness, the Cer­tain­ty of Dying, and Killing Our­selves to Live Longer”, but that does­n’t come close to ful­ly describ­ing her scope.

Ehren­re­ich is like­ly known to most peo­ple for her 2001 book Nick­el and Dimed, and around that time was diag­nosed with breast can­cer.

Had she actu­al­ly been liv­ing off of Wal-Mart wages and its relat­ed health­care restric­tions instead of inves­ti­gat­ing what it’s like, she might not have dis­cov­ered the can­cer then or sur­vived it. But, as she says, cal­cu­la­tions about how one ought to spend their time change from your late-50s to your mid-70s.

I also read this short­ly after two stud­ies of inequal­i­ty and mor­tal­i­ty rates received more pub­lic­i­ty by way of a Wash­ing­ton Post analy­sis, most provoca­tive­ly titled “Seniors Are More Con­ser­v­a­tive Because the Poor Don’t Sur­vive to Become Seniors” when shared by New York Mag­a­zine.

This book also is not about that aspect of death and dying, although Ehren­re­ich touch­es on these relat­ed issues occa­sion­al­ly. Instead, it’s high­ly per­son­al and par­tic­u­lar to its author, suf­fer­ing no short­com­ings for that. Ehren­re­ich is very good at what she does, and writes with the con­fi­dence of some­one who knows it.

She’s engag­ing and easy-to-fol­low even as she explains com­pli­cat­ed con­cepts like cel­lu­lar immunol­o­gy — the field for which she orig­i­nal­ly earned her PhD—or when pro­vid­ing con­text to lit­er­ary ref­er­ences, from Philip Roth to Shake­speare.

She knows she’s get­ting old­er but still has worth­while things to say, and if she ever did tip-toe around say­ing them, she cer­tain­ly isn’t going to waste time doing it now. This is two hun­dred and sev­en pages of pithy, burly prose.

Tak­en as a whole, though, Nat­ur­al Caus­es comes across a bit like a writer who had a note­book full of sub­jects she was inter­est­ed in, and rather than pick one to focus on depth, she dumped them all into her next con­trac­tur­al project.

It reads as a series of essays loose­ly grouped much more than the sequen­tial chap­ters as labeled and vague­ly segued.

Ulti­mate­ly, I sus­pect Ehren­re­ich fol­lowed her own advice.

This is in no way slap­dash, but the amount of extra work it would have required to turn this into a more coher­ent, pol­ished prod­uct would­n’t have ele­vat­ed it that much more, and it was­n’t like­ly to push any of her ear­li­er life’s accom­plish­ments out of their place in the “obit­u­ary resume”, in any case.

Instead we got an enter­tain­ing look at some of her cur­rent con­cerns late in life:

  • the dis­re­gard of mod­ern med­i­cine for patients as peo­ple and dis­re­gard for wom­en’s pain in par­tic­u­lar;
  • the rel­a­tive mer­its of New Age quack­ery and sim­i­lar­i­ty of estab­lished med­i­cine to rit­u­al behav­ior;
  • exer­cise as a form of exert­ing con­trol over some­thing in a mad world and how smok­ing cig­a­rettes pro­vides a sim­i­lar func­tion for low-wage work­ers;
  • the agency of macrophages in fight­ing infec­tion but also spread­ing can­cers;
  • how the sense of con­scious­ness that evolved to be use­ful also turns against us;
  • and how ego-destroy­ing hal­lu­cino­gens can help make death less fright­en­ing.

She has a mind that’s not pre­dictable, so you’re nev­er sure just where she’s about to go or will end up.

If you squint, there’s a through-line in there, but it’s a mean­der­ing one.

Nat­ur­al Caus­es is delight­ful, some­times dis­gust­ing, often dis­qui­et­ing, and always thought-pro­vok­ing when­ev­er Ehren­re­ich is on the attack, which is her default. When it comes to solu­tions, she def­i­nite­ly has some­thing that works for her, at the age and place she is in life.

I don’t know how applic­a­ble it will be for oth­ers, but she also seems not to care to con­vince you of any­thing in par­tic­u­lar at this point in her life.

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