Introduction
In her book "Natural Causes," Barbara Ehrenreich challenges our conventional wisdom about health, aging, and the medical industry. Drawing from her personal experiences and extensive research, Ehrenreich presents a compelling argument for reconsidering our approach to healthcare, especially as we grow older. This summary explores the key ideas presented in the book, offering a fresh perspective on how we view our bodies, medical interventions, and the aging process.
The Myth of Constant Medical Screening
Ehrenreich, now in her 70s, has made a bold decision to stop getting regular medical check-ups. This choice might seem irresponsible to many, especially those in her age group. However, she argues that after the age of 75, constant medical testing may not be as beneficial as we've been led to believe.
The Cost of Anxiety
One of Ehrenreich's personal experiences highlights the emotional toll of medical screenings. After receiving a false-positive result from a mammogram, she endured weeks of anxiety. This stress was so severe that it even led to her getting a ticket for distracted driving. This incident made her question the value of such screenings, especially in the later stages of life.
Letting Nature Take Its Course
Ehrenreich suggests that as we enter our twilight years, it might be more beneficial to let nature run its course rather than constantly intervening with medical treatments. She argues that making dramatic lifestyle changes to accommodate medical treatments like surgery or chemotherapy might not always be worth it, especially when considering the quality of life.
The Profit Motive in Healthcare
One of the most controversial points Ehrenreich raises is the role of profit in the healthcare industry. She argues that the main reason doctors continue to screen elderly patients is financial gain. The health sector profits from examinations that often lead to the discovery of potential complications, necessitating follow-up appointments, prescriptions, and further tests.
The Impact of Advanced Technology
The author points out that new, high-resolution equipment like CT scans, while capable of detecting abnormalities more effectively, also leads to more tests and interventions. This cycle of detection and treatment ultimately increases the overall profit of the health industry.
The Ritualization of Medical Procedures
Ehrenreich draws an interesting parallel between medical procedures and rituals. She argues that many medical practices, especially those surrounding childbirth, have become ritualized in ways that may not always benefit the patient.
The Case of Childbirth
The author takes a critical look at childbirth practices in the mid-twentieth century America. She describes how women in labor were routinely sedated or anesthetized, making it necessary for doctors to use forceps to deliver babies. Other practices included giving women enemas, cutting their vaginal openings, removing their pubic hair, and forcing them to lie on their backs for hours with their knees in the air.
Rituals of Humiliation
Ehrenreich argues that these practices were not carried out for the benefit of mother and child, but rather as a means of humiliating and dominating women during labor. She points out that many of these procedures were actually harmful:
- Using forceps could damage the baby's head
- Shaving pubic hair increased the risk of infection
- Cutting the vaginal opening prolonged recovery time
- The knees-up posture was riskier for both mother and baby
The author concludes that these procedures served no purpose other than to humiliate the mother, sending messages about her being "dirty" and depriving her of physical control.
The Questionable Value of Cancer Screenings
Ehrenreich challenges the widely held belief that regular cancer screenings are essential for health and longevity. She points out that in 2015, the United States healthcare system spent a staggering $10 billion on physical examinations. While this might seem like money well spent, the author argues that these tests are often traumatic and may not be as effective as we think.
Lack of Evidence for Effectiveness
Despite the emphasis placed on yearly mammograms and prostate screenings, Ehrenreich notes that there's little evidence to support their effectiveness in reducing mortality rates. She cites the lack of studies showing that yearly mammograms significantly lower breast cancer-related deaths. Similarly, a 2014 UCLA study found that almost half of men over 66 receiving treatment for early-stage prostate cancer were unlikely to live long enough for the cancer to become dangerous.
The Trauma of Screenings
Beyond questioning their effectiveness, Ehrenreich also highlights the emotional and psychological toll of these screenings. For instance, gynecological exams can be traumatic for some women due to the intimate nature of the examination. The author shares an anecdote about an acquaintance who needed anti-anxiety medication before visiting her gynecologist.
The Fitness Craze: A Reflection of Societal Competitiveness
Ehrenreich turns her critical eye to Western society's obsession with exercise and fitness. While acknowledging the health benefits of physical activity, she questions whether there might be other factors driving this fitness craze.
The Rise of the Fitness Industry
The author notes that Americans spend a whopping $26 billion on health clubs annually. This fitness obsession, she argues, started in the 1980s, coinciding with a period when Western society became increasingly ruthless and competitive.
Economic Factors
Ehrenreich draws a connection between the rise of the fitness craze and changes in the economic landscape. She points out that job security has decreased, traditional industries have become obsolete, and the middle class is shrinking. In this increasingly brutal and competitive environment, being fit has become a way to demonstrate one's ability to survive and thrive.
Fitness as a Status Symbol
The author also suggests that gym membership and physical fitness have become markers of social status. Being healthy and fit requires financial sacrifices, such as buying expensive organic foods. Conversely, behaviors associated with being unfit, like sitting on the couch and snacking, are often considered "low class."
The Declining Power of the Mind
Ehrenreich challenges the notion of "mind over matter," suggesting that in today's technological world, it has become increasingly difficult to rely on our mental abilities.
Shrinking Attention Spans
The author cites evidence showing a substantial drop in attention spans for both children and adults. A 2015 Microsoft-sponsored study found that between 2003 and 2015, the average adult's attention span fell from 12 seconds to just 8 seconds.
The Rise of Attention Disorders
This change in mental capacity has led to an increase in diagnoses of attention-deficit disorder (ADD) and attention-deficit hyperactivity disorder (ADHD). These have become the second most common pediatric diagnoses in America, after asthma.
Technology's Impact on Cognitive Powers
Ehrenreich points to modern technology as the culprit behind our weakening cognitive powers. The constant use of electronic devices has rewired our brains, leading to shorter attention spans and reduced sleep quality. Neuroscientists also report that constantly switching between tasks or jumping from one web link to another is harmful to our neural scaffolding, making it difficult to engage in deep thinking.
Rethinking Aging
In the final section of her book, Ehrenreich challenges society's negative view of aging and encourages readers to embrace the benefits that come with growing older.
The Myth of "Successful Aging"
The author criticizes the modern concept of "successful aging," which essentially means trying not to age at all. She argues that this view of aging as an abnormal and unacceptable process puts unnecessary pressure on older adults to maintain unrealistic standards of youth and vitality.
The Pressure to Stay Young
Ehrenreich points out that people over 50 are often told they need to exercise relentlessly and adhere to strict diets to age "successfully." She questions whether a life dominated by gym visits and calorie counting is truly worth living.
Embracing the Benefits of Aging
Despite society's negative messaging about old age, Ehrenreich highlights the many benefits that come with growing older. She cites authors and feminists who have found their later years to be a fulfilling period of life. For example, people often become more authentic as they age and care less about others' opinions. Artists often create their best work in the later stages of their lives.
Final Thoughts
Barbara Ehrenreich's "Natural Causes" challenges many of our deeply held beliefs about health, aging, and medical care. She encourages readers to question the necessity of constant medical screenings, especially in later life, and to be aware of the profit motives that may drive some medical practices.
The author also invites us to reconsider our obsession with fitness and youth, suggesting that these preoccupations may be more about societal competitiveness and status than actual health. She points out the toll that our technology-driven lifestyle is taking on our cognitive abilities and encourages us to be mindful of this impact.
Perhaps most importantly, Ehrenreich asks us to rethink our approach to aging. Instead of viewing it as something to be feared and fought against at all costs, she suggests embracing the positive aspects of growing older. This includes the wisdom, authenticity, and creative potential that often come with age.
In conclusion, "Natural Causes" offers a thought-provoking perspective on health and aging in modern society. While some of Ehrenreich's views may be controversial, they undoubtedly encourage readers to think critically about their own health choices and societal attitudes towards aging. The book serves as a reminder that life is short, and perhaps our time is better spent enjoying it rather than constantly worrying about prolonging it.