And Killing Ourselves to Live Longer - An Epidemic of Wellness

Having read several of Barbara Ehrenreich's previous works, and intrigued by the subject, I was delighted to be able to review this book. I was not disappointed.

Having been diagnosed with stage 3 cancer at Christmas 6 and a half years ago and being told I would most likely not live to see summer, I once faced the prospect of death head on, and Ms. Ehrenreich's book, especially the first sections, echoed many of the thoughts I had at the time. Why are we spending so much of our precious time fussing over trying to stay young instead of just enjoying the moments we have? It took facing death for me to learn that there is only so much time, and we better enjoy it because we arent going to escape in the end.

I don't find this morbid. This is a message of hope, and I believe this is the message to take away from the book. Life, it is relentless, it goes on, with or without us. So we need to LIVE while we are able!

The second part of the book did get a bit more science-y, and really dives pretty deep into cells and biology at one point, but it is not unreadable by any means. It I quite interesting and I learned things I had not known before. Always a plus.

Definitely a recommended read, especially good to help get the big picture priorities straight.

Thanks to NetGalley for this ARC in exchange for an honest review!

Natural Causes is like having two books in one. The beginning section discusses whether eating “right” and exercise will truly extend our life expectancy, or if those admonitions are erroneous. The author makes some good points, while others seem a bit dubious to me. Her writing is at times self-deprecating and humorous; other times erudite.

The second part of the book is a bit dry, as she delves into the philosophical side of what is “self”, and how we think about death and dying. There is also well written chapters about inflammation, cancer, and how we may be doomed to succumb despite positive thinking and the best efforts of our oncologists.

As a long distance runner, I felt an uncomfortable feeling as the author worked through debunking exercise “myths”. Did I agree with her or not? I agreed with the section on medical ritual, as explained by Stanford medical professor Abraham Verghese during one of his TED talks. He discusses a breast cancer patient who chooses a less prestigious facility over one with valet parking, a welcoming atrium, etc. The reason? The first facility actually gave her a physical exam, using touch and interaction. If I visit a doctor and do not get my eyes, ears, or lung sounds assessed, I feel cheated. Ritual displays, whether they are a placebo or not, satisfy and calm me. I also felt a kinship with the chapter on mindfulness and ADHD, as she discusses electronic addiction and how that is depleting our attention span.

As I read on I realized that I did not agree with her decision to shun yearly exams (her thoughts are that the doctors are “looking for problems that remain undetectable to me”). The author also discusses repetitive x-rays of the teeth, mammograms and their tendency towards false positives, and colonoscopy.

When she started noting the evidence of “overdiagnosing” due to the multitude of various health screenings available, I simultaneously agreed and disagreed. A 90-year old woman does not need a mammogram; a 30-year old should get Pap smears and yearly bloodwork.

The chapter entitled Cellular Treason was most interesting; explaining that perhaps all the steps we take to remain healthy may be for naught; our cells will do what they want regardless. It was at this point in the book that the writing became more scientific and less opinionated, and leaned towards the dry and almost dull. I rather enjoyed the cantankerous, tinfoil hat-like musings from the beginning.

Ehrenreich may be a detractor of medicine, but she is no dope. She is intelligent and can put a sentence together well. This book is certain to spark debate, which hopefully was her intent. Each chapter has the ability to appeal to a wide range of people, as well as invite criticism. I feel better prepared to face my doctor after reading it.

Want your own copy? Head over to the store and grab it!

In Barbara Ehrenreich's "Natural Causes," the author--who has a PhD in cellular immunology--discusses human biology; debunks conventional wisdom concerning health and aging; criticizes intrusive medical professionals who overprescribe and order unnecessary tests; and denounces our obsession with wellness, the mind-body connection, meditation, and exercise.

Ehrenreich, who has survived breast cancer, is fed up with mammograms ("a refined form of sadism"), colonoscopies ("an actual sexual assault"), bone density tests, and other screenings. She goes to the gym because she enjoys it, not because doing so is good for her. She believes that the notion that we can control our mental and physical well-being is an illusion fostered by the pharmaceutical, fitness, and food industries. We assume that taking care of our bodies will prolong our lives, make us feel stronger, and enable us to age more gracefully. Ehrenreich makes the case that, if we buy into all of this hype, we are living in a dream world.

"Natural Causes" could have been an interesting, provocative, and cautionary work of non-fiction. It convincingly shows that "the trappings of big science" that we use to diagnose illness and cure the sick are, in some cases, too expensive, stress-inducing, and even demeaning. To her credit, the author emphasizes the value of evidence-based medicine over meaningless rituals. Unfortunately, Ehrenreich puts a damper on her subject by adopting a tone of excessive negativity and avoiding all but a modicum of sardonic humor. (The bright yellow cover, featuring a sneakered Angel of Death working out on a treadmill, leads us to anticipate a far more entertaining reading experience.) This book is a bit over two-hundred pages, although it seemed longer. The style is frequently muddled and tedious, and the information Ehrenreich imparts could have been compressed into a long essay. To sum up, this book is a downer, and it is highly likely that many will disagree with the author's bleak and fatalistic perspective on disease prevention, nutrition, and end of life issues.

I've enjoyed Barbara Ehrenreich's writing for many years. This book is not one of her most satisfying works.

A couple things are missing. One is her biting wit. She's still amusing, but a lot of her comments come off as more cranky than funny.

Second, I'd hoped the book was more about the insanity we now have where people end up warehoused in homes, hospitals, and other medical facilities in a futile attempt to keep them alive as long as possible, with no regard to the quality of life. The result is a kind of torture that future Americans will look back on as a dark time in our history.

Instead, the book is made up of article-length essays. It feels like an anthology of magazine columns, cobbled together to produce a book (did Ehrenreich owe a book to someone?). The book often goes off on tangents, particularly about macrophages, a topic Ehrenreich knows lots about since it was the topic of her dissertation many years ago.

The result is an unsatisfying jumble.

People over fifty-five are now the fastest-growing demographic for gym membership. Taking care of our bodies is a great thing. But obsessing over our bodies isn't necessary. Don’t feel guilty that you will eventually die.

In this book, Barbara Ehrenreich shows us we don't have to be preoccupied with physical health. Keep it in perspective. Aging is a natural process; everybody that lives long enough will experience it.

She helps us release the blame that we often get from the medical establishment, the food industry, and the stay-young-forever advertisements, to try to live forever in a pristine body here on earth.

“We can, or think we can, understand the causes of disease in cellular and chemical terms, so we should be able to avoid it by following the rules laid down by medical science: avoiding tobacco, exercising, undergoing routine medical screening, and eating only foods currently considered healthy.
Anyone who fails to do so is inviting an early death. Or to put it another way, every death can now be understood as suicide.”

Ehrenreich argues against the obsession and the blame. She does not see every death as a suicide for failure to prevent itself.

While parts of the book sunk too deeply into minutiae for my tastes, overall the book was an encouraging read. It helps us understand that while we do have some control over our bodies, our lives, and our deaths, we don’t need to overly preoccupy ourselves with controlling every little thing.

My thanks to Net Galley for the review copy of this book.

As others have noted, this is not a personal exploration of issues surrounding aging and letting go gracefully. Well, it is, but there's a ton of other information and opinions in it. Ehrenreich is all over the place with this book. Instead of discussing aging in general and when to start saying no to routine (and expensive) tests and attempts to turn back the clock, she backtracks into youth and has plenty she disagrees with: having to disrobe for examinations is abusive, colonoscopies are sexual assaults, nearly all preventive exams are a waste of time, and so on.

Well, this is her book and not mine, so she can write what she pleases. But I found it hard to ignore the obvious classism (to her credit she does mention it). The dental exams and other tests she finds annoying are out of reach for millions of Americans due to poverty and our leaner, meaner workplaces. It's a little hard for me to get up in arms about absurdly wealthy people who think they can live forever when the reality -- which she is a fan of -- is that we have a lot more trouble with people who die prematurely or who have enormous difficulties managing chronic conditions.

Sometimes she gets deep into statistics and science, and sometimes she uses anecdotes to make her points. "Well, so-and-so died early and was a health nut, so it's all bunk." Oddly, she doesn't seem to spend much time on the quality of life people are hoping to achieve by observing basic self-care. I think we all know we are going to die, so this book isn't a revelation in that respect. Sometimes she writes, as though this is news.Well, there is a lot of foolishness out there, and we are going to get old and die.

She dismisses the rituals around modern healthcare, which is fair enough, but speaks with some nostalgia about the rituals surrounding smoking. (Yes, really.) People should not attempt to ride hard on poor people who smoke because it's often their only pleasure -- not a word about the desire of others to breathe or wondering about escaping poverty. She seems to have little use for people who are trying to watch their diets and exercise, but exercises herself regularly.

There are so many topics she brings up that are worthy of in-depth exploration, but they get kind of lost in this mix of science, culture, and general crankiness. Personally, I think the idea of checking out of the testing/monitoring routine at a certain age makes great sense. That idea alone would have been worth a long essay.

Barbara Ehrenreich’s Nickel and Dimed is one of my all-time favorite books, and I have recommended it to MANY people over the years. Several people have admitted to having their eyes opened enough that they began to see invisible workers such as hotel housekeeping staff as real people who should ALWAYS be tipped. So I happily received a copy of Natural Causes from Twelve Books and NetGalley in exchange for my honest review.

The subtitle (An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer) provides clues to her message. She is not a fan of “wellness,” none of us are getting out of here alive, and the things people do to try to extend their lives may not provide any benefit at all.

I was unaware of her PhD in cellular immunology, and TBH there was way more scientific information than I could either understand or appreciate, but she is definitely qualified to speak about the human body’s immune system and how it can turn against us (easing the way for cancer cells to proliferate, for example). I do appreciate her emphasis on acceptance of death as a natural process and her encouragement to live life to its fullest rather than focus on how we might extend our lives.

She takes a fairly rigorous stance against the medical establishment and the wellness industry, emphasizing her disdain for clinicians’ assumption that patients will automatically endure many tests and (redundant or unnecessary?) procedures. I confess I got lost in her seeming to attribute the spread of mindfulness to Silicon Valley entrepreneurs wanting to sell products, and while I tend to agree with her regarding religious ideas, it’s clear these two areas will not be popular among a number of readers.

While Natural Causes isn’t for everyone (and I definitely won’t be recommending it as widely as I have done with Nickel and Dimed), it’s still a fascinating read (even humorous in places!). Three stars.

Ph.D. in cellular immunology Ehrenreich makes total sense. Life becomes too heavy mentally when late in life becomes all about the food or exercise or "Yes, your heart most likely is going to kill you." I'm a non smoker, low cholesterol, low blood pressure, normal weight woman that at 60 had Heart failure. if I had not gone to the emergency room I most likely would have died that night. My only symptom I had was I couldn't breathe. So for the last 3 years I have been miserable thinking of the woulda, coulda, shoulda scenario. Ehrenreich has stated exactly what I have been thinking. It's about living now, not being stressed about living one minute longer as I choke down some kind of beverage that's no salt, low carb, kale laden, gluten free, no sugar, vegan substance.
Dr. Ehrenreich, thank you for allowing me to feel valid that I am doing the best I can for me.
Staying Joyful outweighs almost everything so I'll have my glass of Chardonnay tonight knowing that you are more versed in the science of my body than most of my Doctors. Thank you.

This starts out as a typical Ehrenreich skewering of a piece of idiocy of contemporary American culture: in this case the sense that death is an inconvenience that can be significantly postponed or even defeated. And Eisenreich is her typical funny and devastating self in obliterating these myths.

But what makes the book brilliant is that Ehrenreich is a Ph.D. biologist and a bit of a philosopher as well. She understands the complexities of cell and molecular biology. She shows that we can not achieve some kind of great biological harmony because the complex processes of the body are at war with each other and cannot be controlled. She is not in favor of us dispensing with all exercise and doctor's visits; she does not embrace the view of the 250 pound cynic who just loves it when some undernourished marathoner keels over from a heart attack. But she counsels against excessive colonscopies and mammography that carry real costs and that really do not bring much benefit, other than to a medical industrial complex.

As one New York Times journalist put it in talking about the themes of this book: Life is Short, but that's the point.

One of my favorite personal foibles involves living under the delusion that I have some control over my life. In a book titled, Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer, Barbara Ehrenreich explores how our lives and journey toward death are uncontrollable, down to the cellular level, and the extraordinary means taken by medical practitioners to prolong life are often not based in scientific evidence. Ehrenreich faces the certainty of her death with confidence and describes her decision to abandon preventive and diagnostic medical procedures now that she has reached an age (mid-seventies) when death is more probable than long life. Supported by her PhD in cell biology, she uses a long section of this short book to explore how cells behave and misbehave. Readers beyond middle age think about quality of life and certainty of death, or we should, and Ehrenreich may not provide answers to our questions, but she stimulates thinking about what we can control and how much is far beyond anyone’s control.

Rating: Four-star (I like it)

Ph.D. in cellular immunology Ehrenreich makes total sense. Life becomes too heavy mentally when late in life becomes all about the food or exercise or "Yes, your heart most likely is going to kill you." I'm a non smoker, low cholesterol, low blood pressure, normal weight woman that at 60 had Heart failure. if I had not gone to the emergency room I most likely would have died that night. My only symptom I had was I couldn't breathe. So for the last 3 years I have been miserable thinking of the woulda, coulda, shoulda scenario. Ehrenreich has stated exactly what I have been thinking. It's about living now, not being stressed about living one minute longer as I choke down some kind of beverage that's no salt, low carb, kale laden, gluten free, no sugar, vegan substance.
Dr. Ehrenreich, thank you for allowing me to feel valid that I am doing the best I can for me.
Staying Joyful outweighs almost everything so I'll have my glass of Chardonnay tonight knowing that you are more versed in the science of my body than most of my Doctors. Thank you.

This starts out as a typical Ehrenreich skewering of a piece of idiocy of contemporary American culture: in this case the sense that death is an inconvenience that can be significantly postponed or even defeated. And Eisenreich is her typical funny and devastating self in obliterating these myths.

But what makes the book brilliant is that Ehrenreich is a Ph.D. biologist and a bit of a philosopher as well. She understands the complexities of cell and molecular biology. She shows that we can not achieve some kind of great biological harmony because the complex processes of the body are at war with each other and cannot be controlled. She is not in favor of us dispensing with all exercise and doctor's visits; she does not embrace the view of the 250 pound cynic who just loves it when some undernourished marathoner keels over from a heart attack. But she counsels against excessive colonscopies and mammography that carry real costs and that really do not bring much benefit, other than to a medical industrial complex.

As one New York Times journalist put it in talking about the themes of this book: Life is Short, but that's the point.

One of my favorite personal foibles involves living under the delusion that I have some control over my life. In a book titled, Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer, Barbara Ehrenreich explores how our lives and journey toward death are uncontrollable, down to the cellular level, and the extraordinary means taken by medical practitioners to prolong life are often not based in scientific evidence. Ehrenreich faces the certainty of her death with confidence and describes her decision to abandon preventive and diagnostic medical procedures now that she has reached an age (mid-seventies) when death is more probable than long life. Supported by her PhD in cell biology, she uses a long section of this short book to explore how cells behave and misbehave. Readers beyond middle age think about quality of life and certainty of death, or we should, and Ehrenreich may not provide answers to our questions, but she stimulates thinking about what we can control and how much is far beyond anyone’s control.

Rating: Four-star (I like it)

Examining the excessive testing of the medical industry or the narcissism and class elitism of the 'wellness' or 'age-extension' industry are worthwhile goals, but this unfocused work wanders off into the terrain of a cranky opinion piece--strawmen arguments, tendentious reasoning, and consistently ignoring facts that don't fit with her narrative. For instance--sure, we have had too many useless fad diets, but there now is solid, consistent evidence that eating lots of vegetables extends your life and improves its quality. Likewise with exercise, smoking cessation, and some form of relaxation practice. But Ehrenreich keeps suggesting--unscientifically--that all attempts to improve our health are fundamentally selfish and useless, and we're at the mercy of our bodies, which in her view are a collection of dangerously individualistic, self-determined parts trying to kill us. While this could be seen as a useful corrective to the overly optimistic modern notion of being able to control every aspect of our lives, she is so determined to make this point that she veers into absurdity--arguing, for instance, that macrophages that become cancer-producing are making a 'decision' to do so and that these one-cell organisms somehow have agency. Worst of all, to support her fatalistic point, she uses anecdotes of health-practicing people who nonetheless died of diseases like cancer or heart disease--completely ignoring hundreds of studies and years of data that show clearly and unequivocally that certain personal health habits make these diseases statistically more, or less, likely. Despite her veneer of rationality and scientism, this just isn't rational or scientific. Certainly, in a book that purports to be nonfiction, it's grossly unbalanced. The fact that we don't yet fully understand what practices best support healthy aging, does not in any way indicate that our knowledge on best practices isn't, and hasn't, consistently improved over the years. Germ theory in its early stages was also primitive and took many steps back as well as forward. Sure modern medicine has become hubristic and money driven, sure life comes to a natural end and that cannot be changed. These points need to be made--but she throws the baby out with the bathwater.

From there, the book remarkably gets even worse, as she wanders into the terrain of spirituality, giving us a Cliff's Notes version of the totality of religious history in a few paragraphs, and ending by asserting confidently that our physical existence ends in personal annihilation and that the soul is a human fiction. I believe the soul is real and that there is a God, but the real difference between me and Ehrenreich is that I don't wrap myself in the fig leaf of scientism to justify my existential beliefs. She ends with a rousing recommendation of magic mushrooms (!) as a way of 'discovering' the quivering holistic animism hidden underneath the veil of the universe. Why is HER belief that one-celled macrophages have enduring sentience, more valid than my belief that human beings do?

She's written many important books--Nickel And Dimed will be read by future historians--but this is just plain bad, and it will make you feel that way, too.

"You can think of death bitterly or with resignation, as a tragic interruption of your life, and take every possible measure to postpone it. Or, more realistically, you can think of life as an interruption of an eternity of personal nonexistence, and seize it as a brief opportunity to observe and interact with the living, ever-surprising world around us."

This book is very hard to pin down. I had many people asking me about it while reading it, however i never had the words to fully describe it. There was definitely a lot of content and it was really informative with a lot of great opinions put forth by Barbara Ehrenreich. However, it felt essentially directionless. Ehrenreich is definitely knowledgeable, especially in her professional concentration of cellular biology. This made the second half of the book a lot more enjoyable as a scientific review rather than a testament to how we should live. As a personal trainer/nutrition enthusiast/former kinesiology student, her stance on health and wellness seemed extremely uninformed. Yes it is definitely overblown and turned easily to quick selling propaganda, but to dismiss the importance of a balanced diet (see: not restrictive or absent of indulgence) and a consistent physical activity is a bit foolish. I loved a lot of the book, but it had such a pessimistic and disdainful undertone that it read largely as opinion than evidence based thoughts. Her chapters on reproduction and an "over-doctored" society were definitely what made this book interesting for me. I'm interested to see what her other books are like seeing as they seem to be much more acclaimed.

I received a free copy of this book from Netgalley in exchange for an honest review.

I borrowed the book from the library and found some of the insights and absurdities Barbara pointed out to be amusing and eye opening. That said, as a long time RN I found her description of colonoscopies (sexual abuse) and pelvic exams to be hysterical in the least. By far, the vast majority of people who go into health care do it with a desire to help humanity. Sure there’s incompetence and occasionally evil because it’s a human endeavor, but over the years I’ve seen babies born, mothers survive, and other children and adults survive because of modern medicine. One hundred years ago many of these people would never have made it- people would have been permanently crippled by arthritic knees and hips that had no treatment. I’ve also seen people squeamish about Pap smears and colonoscopies die of very treatable conditions had they been found through early detection, so I think she does a horrible disservice equating these exams with sexual abuse. Like most medical people I don’t want a terminal condition prolonged with invasive treatments and I have seen doctors occasionally push their patients to keep trying- often because the doctor doesn’t want to admit defeat. I think we can strike a balance between vilifying all attempts at wellness and preventative care and prevent a lot of suffering from diseases that are clearly amenable to lifestyle changes such as diabetes and obesity - which are becoming the number one killers of younger and younger people.

The medical establishment has been the subject of much push back lately and this book will only reinforce that contrarian viewpoint. Ehrenreich has well founded arguments against: screening tests, wellness programs, mindfulness, and holistic medicine. There is no scientific evidence, she states, that any of these things work and in the case of screening tests, they may actually cause harm. Somewhat dull were the chapters towards the end of the book that focus on cell biology. It’s good stuff, about how our own cells may betray us by spreading cancer or triggering auto-immune diseases. It’s just a little too much detail for the non-scientific reader. Overall, I found Natural Causes to be enjoyable and worth my time and investment.

A very good read. I knew the first sections about her rejection of some of the offerings of modern medicine would rile up some readers, and I was not disappointed, as you will find in these reviews. I think the book is best read as a collection of separate essays with a common theme. I gave it four stars rather than five only because some of the chapters were not that interesting to me. Others, however, were fascinating. I was stunned to learn that my immune system could possibly be working against me. Ouch. I was also intrigued by the new attitude of science to the 'agency' to be found in perhaps all living things. I am encouraged to do some more reading on that topic. Overall, the book is well worth your time.

It seems that Ehrenreich discovered that whatever we do, we will all die; so it seems to her that everything related to health care, whether preventive measures such as good diet and exercise choices, screening tests, and treatment, is no good. Yes, there are problems such as bad advice, inappropriate treatment, etc. Always has been, always will be. And she's adding to it here by asserting that menstruation is some trauma and that poor people need to smoke, among other things. I couldn't finish it.

Having been a huge fan of Ehrenreich's earlier book Nickel and Dimed, I looked forward to reading this one. I greatly appreciated the attention that book brought to the plight of the working class in society. However, I've noticed that her work has taken a much different turn ever since her breast cancer diagnosis. I didn't keep up with her career after Bright-Sided, which was a somewhat disappointing work on an interesting topic. Perhaps if I had read her 2014 book, I wouldn't have been as surprised by the negative tone her latest work takes toward God.

I am open-minded and can consider different faith perspectives if the work is well-researched and presents a valid point of view to ponder. I was hopeful about the theme of this particular book because she's discussing how the aging Baby Boomers will approach the issue of their own dying. (I'm Gen X but I still find the sociology of aging and dying to be fascinating to research.) But unfortunately, Ehrenreich's work is not as insightful as it once was and the work overall seemed much sloppier. Instead of offering any useful anaylsis or relatable anecdotes, it just seemed like the point of her book was that getting old sucks and nothing happens after we die.

Overall, a very disappointing and poorly researched book. Rather than offering insight or suggested solutions, it was just negative and depressing.

A really interesting but not particularly coherent book.

It's basically a series of fascinating chapters that don't really tie into her central thesis in a logical fashion.

Her central thesis seems to be, I'm in my seventies and I'm not going to do any more of the things that medicine says might prolong my life. How exactly this ties into her fascinating chapters about the immune system and how it helps seed cancer metastases or a discussion of the history of the self is never exactly explained.

This book's contents have almost nothing to do with the title. Although the author is clearly highly intelligent, it's little more than pages and pages of her ranting about subjects I have no interest in. The invasive evils of gynecology and the devious attempts to portray menstruation as a natural function being two of them. She actually appears to support the notion menstruation exists to (paraphrasing here)"...shed the uterine lining of bacteria introduced by the penis." ??? I wanted to know more about the unnecessary screenings she advocates skipping, and getting bilked by the medical industry, not how much women should hate being women. There is some discussion of the corrupt world of medicine, but not nearly enough. Instead, it's one long format of opinions by a bitter old academic who disparages the very activities she once took part in (gym-going). Save yourself the $ and time and read Being Mortal instead.

A huge disappointment. I bought this book because of the way it was reviewed and described by others. I was interested in her views on life prolongation and the potentially negative aspects of it. Essentially, could be diminishing our quality of life when we just pursue maximum quantity. Instead, I found a very disorganized book with no clear-cut message or coherence. Her PhD is in cell biology and much of this book relates to our immune systems, particularly the role of macrophages. This might be a particular interest of hers, but she is not a great science writer, and there is little connection to the perceived theme of the book. In addition, her opinions on medicine are largely based on studies that she favors, as opposed to looking at the entire literature. I gave this 2 stars as opposed to just 1 because of the amount of research she did to write this book. And she can be entertaining although very caustic. However, I wouldn't advise reading it. I was tempted to quit at page 50 but decided to complete it to give her the benefit of the doubt. It wasn't worth it. I look forward to someone else writing a more coherent book about this very interesting topic.

This book was disappointing and really failed to deliver.

I was hoping to read an insightful response to so many health fads and takes on aging. Instead, the author relies on long, meandering rants and block quotes of other works, while offering very little reasoning or research.

Barbara Ehrenreich has some serious issues with medicine as it is practiced currently. She finds herself, as a patient, more of a research subject and an unwitting consumer, than a partner in her health. Upon reaching her mid-70’s, an age when she feels she has led a full life, she decides she is done with ‘preventative’ care, i.e. intrusive care for conditions that likely would result in a death beyond her own expected life span. She writes knowledgeable and witty prose to justify her thoughts and beliefs. She is persuasive. She adds in whole sections describing biology to justify what is mostly unknown about disease processes, another reason why preventive care is worthless while intrusive. The tests are merely bits of hope, not real. Time has shown she is largely correct.

But, here’s the thing: she didn’t need to wait until she was in her 70’s for this breakthrough action. It was no less true in her youth or middle age. The disease treatments are just as peculiar as the tests she declaims. She’s angry and this is her focus. It renders her arguments suspect because she doesn’t address her rage which is larger in scope than ‘health’ or ‘medicine.’ I received my copy from the publisher through NetGalley.

Misleading title says much about cellular biology and very little about why she declines medical care. Forced myself to finish hoping it would get interesting or at least thought provoking. Disappointed.

Where should I begin... First, I bought this book because of Nickel and Dimed. I was excited when I saw Ms. Ehrenreich had written another book about health and wellness. I am in the field of Exercise Science and Health Promotion so this seemed like it was right up my alley. I did have some doubts about the title, but I thought I would give it a shot anyway. So I started the book and right away I was concerned with what I was reading. Ms. Ehrenreich has written a very dangerous book for the health and wellness of anyone who reads it. She starts in with an attack on the entire medical field by pointing out that she thinks all preventative tests are useless wastes of money. One of her attacks is on Mammography in which she talks about the newest recommendations to get screened every two years after age 50. This was a very controversial recommendation because it put many women's lives at risk, especially minority women who tend to get earlier and more aggressive Cancers, and left insurance companies a way out of paying for the gold standard test. The biggest problem with this new recommendation, and her support of it, is that it is based on bad data. She very quickly points out how breast cancer survivors and physicians strongly opposed this recommendation. She does so in a snarky way that makes the survivors seem like alarmists and blind followers of the "criminal physicians" who dared to find their cancers. Since the advent of screening Mammography, radical surgical procedures and morbidity ridden treatment regimens have become less necessary because of early detection at an earlier stage. How does delaying screening Mammograms benefit the medical field? My own mother would have died a painful death had she not received regular screening Mammograms that discovered her cancer at an early stage. My mother had a double mastectomy to eliminate lethal cancer in her breasts and prevent from worrying about further cancer development in the future. Ms. Ehrenreich also suggests that the mastectomy is an unnecessary procedure that only disables and disfigures women. She makes no mention of the lives that are saved for this necessary procedure. After this chapter, I was extremely irritated about what I was reading, but I continued to see if the argument turned around at a later time. It did not. She proceeded to compare standard medical procedures where a doctor is allowed to see "our naked bodies" to fraternity hazing and ritualized sexual practices. She discusses how childbirth has turned into a demeaning process where women are unnecessarily cut to allow an infant to pass through the vagina. For those who do not know, the episiotomy is a procedure that prevents a significant amount of damage to the vagina during childbirth. This damage is the flesh being torn apart because the infant is larger than the opening will allow. This “barbaric” procedure was developed to prevent uncontrolled tearing by making a clean, stitchable incision that the doctor can repair easily. I have not finished the book at this point, but I suspect that it will continue this path based on what I have heard and what I see others have written. Ms. Ehrenreich mentions that she has a PhD in Cell Biology, but I question her scientific knowledge and critical thinking skills based on the poor arguments and inaccurate information presented in the first three chapters alone. I will not comment on any of Ms. Ehrenreich’s future publications as she has shown me all I need to know about her level of knowledge and petty attitude about accepted medical practices and knowledge. This book is no more than trash that won’t even serve as kindling because my copy is in digital format.

Speaking not only as someone in the medical field, but as someone with a daughter who has had chronic health issues, I am appalled and offended by Ehrenreich's classifications of medical procedures as being unnecessary. Although as a professional I can respect her degree, I simply cannot stand her acting like an MD and making claims that fall far beyond the narrow scope of her schooling. She operates as a healthy women in her later years who has come to terms with her mortality. Great. But what does she say to a child with cancer who wants nothing more than to live and grow up? She has already lived her life. How dare she interfere with others' desire to live their own with her baseless claims of topics she has no true understanding of. The lack of empathy she offers is astounding and points to an overwhelming failure of character.

I am not one to write reviews, but I feel this book is such a spreader of misinformation it had to be corrected.

Natural Causes by Barbara Ehrenreich is a free NetGalley ebook that I read in early April.

Straight-faced, stoic narration of intersects between Ehrenreich's physical condition and diagnosis. She also questions concepts, such as someone's life stages within the confines of medical procedure and what's expected from it versus what an individual requires; the grotesque and nearly inhumane; humanity amidst technology; advancements in mental health (Eastern meditation versus psychopathic medication); the social view of death over time; habits and lifestyle choices; imbalance between mind and body; and growing old & finding yourself.

Informative and interesting. I'd give it four stars except for the angry feminist rhetoric subsumed throughout the book. As a man, I felt slapped in the face every few paragraphs with blameful misandrist positions on how men are the cause every problem described in the book.

Mishmosh of pseudo science, distortion of facts and wild generalizations about everything, apparently using her clueless yuppie friends as evidence. Example: the ridiculous claim that reducing dietary fat somehow led to an "epidemic of obesity." (Here's a clue: the French fries that go with the soft drink she blames for obesity are cooked in fat.) No, Barbara, no one claims that genes have no part in longevity. No, Barbara, smoking and excessive drinking and overeating are not healthful. No, nutritious food does not cost more than junk food. No, one doesn't have to have a gym membership to stay fit. And no, Barbara, pointing out the facts does not make one biased against the poor.
Example of a condescending argument: " the war on smoking – which was always presented as an entirely benevolent effort – began to look like a war against the working class. When the break rooms offered by employers banned smoking, workers were forced outdoors, leaning against walls to shelter their cigarettes from the wind. When working-class bars went non-smoking, their clienteles dispersed to drink and smoke in private, leaving few indoor sites for gatherings and conversations."
The real bias against the poor is a patronizing yuppie approach like this one – based on the totally unwarranted assumption that poor people are just incapable of making sound choices, and that all aspects of their lives depend on unhealthy living. And that those of us who don't want to choke on second-hand smoke all day have been part of a "war against the working class" – even though we also work for a living.
"Why do people smoke? I once worked in a restaurant in the era when smoking was still permitted in break rooms, and many workers left their cigarettes burning in the common ashtray so they could catch a puff whenever they had a chance to, without bothering to relight. (I, too, worked in several restaurants during that era and never, ever witnessed anything like that.) Everything else they did was done for the boss or the customers; smoking was the only thing they did for themselves."
No, in reality smoking was something they did for Big Tobacco. And once they were hooked, they did it for their addiction.
Eat right, watch your weight, get good exercise outdoors or at home (gyms suck; your living room - or local beach or park or high school field - is better and it's free). Cut out the tobacco and the booze. It's simple and it works. And no, it's not a sacrifice. It's enjoyable. Maybe she should stop puffing on her coffin nails (and rationalizing) and give it a try. It's never too late to wake up.

Examining the excessive testing of the medical industry or the narcissism and class elitism of the 'wellness' or 'age-extension' industry are worthwhile goals, but this unfocused work wanders off into the terrain of a cranky opinion piece--strawmen arguments, tendentious reasoning, and consistently ignoring facts that don't fit with her narrative. For instance--sure, we have had too many useless fad diets, but there now is solid, consistent evidence that eating lots of vegetables extends your life and improves its quality. Likewise with exercise, smoking cessation, and some form of relaxation practice. But Ehrenreich keeps suggesting--unscientifically--that all attempts to improve our health are fundamentally selfish and useless, and we're at the mercy of our bodies, which in her view are a collection of dangerously individualistic, self-determined parts trying to kill us. While this could be seen as a useful corrective to the overly optimistic modern notion of being able to control every aspect of our lives, she is so determined to make this point that she veers into absurdity--arguing, for instance, that macrophages that become cancer-producing are making a 'decision' to do so and that these one-cell organisms somehow have agency. Worst of all, to support her fatalistic point, she uses anecdotes of health-practicing people who nonetheless died of diseases like cancer or heart disease--completely ignoring hundreds of studies and years of data that show clearly and unequivocally that certain personal health habits make these diseases statistically more, or less, likely. Despite her veneer of rationality and scientism, this just isn't rational or scientific. Certainly, in a book that purports to be nonfiction, it's grossly unbalanced. The fact that we don't yet fully understand what practices best support healthy aging, does not in any way indicate that our knowledge on best practices isn't, and hasn't, consistently improved over the years. Germ theory in its early stages was also primitive and took many steps back as well as forward. Sure modern medicine has become hubristic and money driven, sure life comes to a natural end and that cannot be changed. These points need to be made--but she throws the baby out with the bathwater.

From there, the book remarkably gets even worse, as she wanders into the terrain of spirituality, giving us a Cliff's Notes version of the totality of religious history in a few paragraphs, and ending by asserting confidently that our physical existence ends in personal annihilation and that the soul is a human fiction. I believe the soul is real and that there is a God, but the real difference between me and Ehrenreich is that I don't wrap myself in the fig leaf of scientism to justify my existential beliefs. She ends with a rousing recommendation of magic mushrooms (!) as a way of 'discovering' the quivering holistic animism hidden underneath the veil of the universe. Why is HER belief that one-celled macrophages have enduring sentience, more valid than my belief that human beings do?

She's written many important books--Nickel And Dimed will be read by future historians--but this is just plain bad, and it will make you feel that way, too.

After reading more self-help, positive thinking books than I care to admit, the store recommended this book to me. Like religion, meditation and positive thinking have just not worked for me. I completely relate to the author`s explanations of our reality of a nearly complete lack of control over pretty much everything.

The chapters that briefly express the complete lack of science behind many forms of medicine also seem to line up with reality.