A review of Natural Causes: An Epidemic of Wellness, The Certainty of Dying, and Killing Ourselves to Live Longer, by Barbara Ehrenreich (New York: Hatchette Book Groups, Inc., 2019).
Two revered twentieth century philosophers summarize the problem Barbara Ehrenreich addresses in her most recent book, Natural Causes. “No matter how I struggle and strive,” wrote Fred Rose and Hank Williams, Sr., “I’ll never get out of this world alive.” She examines and finds wanting the contemporary obsession with delaying, detouring and denying death which drives so much personal and economic activity in our culture. “We would all like to live longer and healthier lives,” she writes in the introduction; “the question is how much of our lives should be devoted to this project, when we all, or at least most of us, have other, often more consequential things to do.” When, she asks herself and us, is enough really enough?
Ehrenreich is the author or co-author of twenty books and numerous articles on subjects ranging from a history of women healers to the role of sex workers in the new economy to what is probably her best known work, Nickel and Dimed–a firsthand account of living in poverty in America. Her title of choice for the current book was Old Enough to Die. She uses that line a couple of times in the book, and it captures the heart of her argument far better than the actual title. She notes that her publisher rejected her proposed title, suggesting that no one would give their aging mother a book called Old Enough to Die as a birthday present. So the cryptic title and the melodramatic subtitle are largely creations of the publisher. Of course, that anecdote illustrates one of the main points in her book–that our anxiety about death rules out most reasonable discourse about the topic.
This helps to explain why the book seems to take an unexpected direction. There’s plenty of critique regarding the folly and futility of pursuing immortality. The anti-aging industry, she asserts, is about creating the illusion of control over our bodies. In an age where we seem to be in charge of little else, we have settled for and are committed to controlling the one piece of real estate we each appear actually to own–our bodies and the minds that appear to come with them. Of course, the reality of death insists on destroying this illusion. No one, as our musical philosophers remind us, gets out of this world alive.
Ehrenreich begins her essay with a meditation on the treasonous nature of many of the cells that make up our bodies. In particular she discourses on the role of macrophages in the spread of cancer. Ehrenreich has a doctorate in cellular immunology and worked for a brief time in the field, so she knows whereof she speaks. In the first eight chapters she pursues this somatic betrayal and then extends it to the mind and the self. Ruling out physical and psychic immortality, she considers familial or cultural legacies and heritability. They too, she reminds us, will fail us.
She is anticipated by a few millennia by the Preacher in Ecclesiastes 2:18-19 (NRSV)–“I hated all my toil in which I had toiled under the sun, seeing that I must leave it to those who come after me,” the Preacher complains, “and who knows whether they will be wise or foolish? Yet they will be master of all for which I toiled and used my wisdom under the sun. This also is vanity”. My lifetime of accomplishments will be squandered by idiots and forgotten by fools. Even if I can find meaning in the general course of the universe, she notes, that too is futile. To paraphrase another poet, everything will end with a bang or a whimper.
Thankfully, the book takes a deeper dive, beginning in chapter nine, into the meaning and purpose of life. I am grateful for that direction and disappointed with the destination. Ehrenreich settles for a slippery combination of panpsychism and psychedelics as the exit from her existential dilemma. While that summary is too glib and dismissive by half, it captures her conclusions with reasonable accuracy. The title of chapter nine is a bit of a giveaway, “Tiny Minds.” Even though the cosmos is a ticking time bomb of mortality and finitude, it is filled with activity. It’s not quite life as such, she says, but everything has “agency, or the ability to initiate an action.” The cosmos is filled with a kind of life in which we can participate to find meaning and purpose.
That doesn’t forestall the reality of death for us as individuals. But it can provide some sense of proportion. Despite my doubts about her conclusions. I do appreciate her meditations on “being old enough to die.” She does provoke thinking about how much prevention, how much treatment, how much life is “enough.” She points to our cultural inability to determine the “enough.” Science, and particularly medicine, cannot tell us how much of anything is “enough.” In the absence of such advice and given our terror of dying, we have little incentive to make such a determination.
She charts the dysfunctions of gender, class, race and economics in this area. The wealthy are privileged to delay death and compress morbidity. They set the bar for what we now consider to be a “good death.” She describes this as the goal of “successful aging”–“a healthy, active life followed by a swift descent into death” (page 168). Many of us will not be privileged to experience such an ideal end. In fact, the delay of death industry and culture will condemn many of us, as Ehrenreich points out, to a greater number of years, concluding in an extended period of expensive and relatively pointless misery. As a culture we do need a conversation about what it means for us to be “old enough to die” and how to manage our conclusions.
Not only does the body betray us, the “self” is equally transient. We cannot overcome the problem of self-referential knowledge and agency. “The idea of a continuous chain of human experience and endeavor,” she asserts, disappoints us in the end as well. She describes her conclusion as a cruel paraphrase of Martin Luther King: “the arc of history is long, but it bends toward catastrophic annihilation” (page 196).
Having, as she admits, painted herself into a philosophical corner, she describes her dilemma. One wall of the corner is bounded by a “lifeless material world.” The other is bounded by the sacred self which cannot tolerate or even imagine the thought of death. God is a solution for some, but that asks too much of post-Enlightenment skeptics and cynics of Ehrenreich’s intellectual tribe. Scientism is not an answer for her either, with its “necrophiliac grip on our minds that must be loosened” (page 201).
The solution to the lifeless material world is an updated and secular version of panpsychism. The solution to the idolatry of the secular self is to be released from the tyrant by means of psilocybin. She refers to an article by Michael Pollan summarizing experimental work administering “magic mushrooms” to people terrified of their own demise. The solution, according to Ehrenreich, is a psychedelic experience which releases one from existential terror by diminishing the sense of self and increasing a sense of connection with the whole of a living universe. Thus the solution is a chemically induced mystic ecstasy.
Her gospel is summarized on page 208. “It is one thing to die into a dead world,” she writes, “and, metaphorically speaking, leave one’s bones to bleach on a desert lit only by a dying star. It is another thing to die into the actual world, which seethes with life, with agency other than our own, and, at the very least with endless possibility.” I agree. It is apparently possible to achieve such a state of spiritual peace “with or without drugs or religion.” But the author does not in the end specify how.
In her words I hear echoes of the Christian experience and gospel. “I have been crucified with Christ,” writes Paul in his letter to the Galatians. “It is no longer I who live, but Christ who lives in me.” Dying to self is essential to the Christian understanding. Gerard Manley Hopkins declares that all of Creation is charged with the grandeur of God. And Eastern Christianity describes all of Creation as an icon, showing forth the glory of the Creator and pulsing with that created life. I am not clear why the combination of panpsychism and psilocybin is a more credible path to peaceful death than is, for example, the Christian gospel.
“You can think of death bitterly or with resignation,” she says in her introduction, “as a tragic interruption of your life , and take every possible measure to postpone it.” That is the philosophical corner into which our culture has painted itself and which she so skillfully describes. “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” (page xv). Or perhaps you can consider that the mysteries of life and death are pathways to the deeper reality underlying it all. I think I’m old enough for that.
The Acedic Lutheran 