Two recent books about our flawed bodies and the ultimate pointlessness of trying to control them…
Natural Causes: Life, Death and the Illusion of Control by Barbara Ehrenreich
A decade ago, Barbara Ehrenreich discovered a startling paradox through a Scientific American article: the immune system assists the growth and spread of tumors, including in breast cancer, which she had in 2000. It was an epiphany for her, confirming that no matter how hard we try with diet, exercise and early diagnosis, there’s only so much we can do to preserve our health; “not everything is potentially within our control, not even our own bodies and minds.” I love Ehrenreich’s Smile or Die (alternate title: Bright-Sided), which is what I call an anti-self-help book refuting the supposed health benefits of positive thinking. In that book I felt like her skeptical approach was fully warranted, and I could sympathize with her frustration – nay, outrage – when people tried to suggest she’d attracted her cancer and limited her chances of survival through her pessimism.
However, Natural Causes is so relentlessly negative and so selective in the evidence it provides that, even though it’s sure to be considered for next year’s Wellcome Book Prize longlist, I would be unlikely to recommend it. In the first chapter, “Midlife Revolt,” which has been excerpted at Literary Hub and is worth reading, Ehrenreich writes of her decision to give up routine medical screening after a false positive mammogram caused undue stress. She decided once she passed 70 she was old enough to die without accepting a “medicalized life.” Moreover, she believes there’s an epidemic of “overdiagnosis,” especially in the USA, where there can be a profit motive behind testing. (This is certainly not the case in the UK, where the NHS doesn’t pester me about getting cervical smear tests to line any pockets; no, it’s about saving taxpayers money by catching cancer early and thus minimizing treatment costs.)
Ehrenreich goes on to argue that many medical procedures are simply rituals to establish patient trust, that cancer screening is invasive and ineffective, that there is little evidence that meditation does any good, and that fitness has become a collective obsession that probably doesn’t help us live any longer. It’s uncomfortable to hear her dismiss early detection techniques as worthless; no one whose doctor found cancer in the early stages would agree. The author also seems unwilling to confront her own personal prejudices (e.g. against yoga).
Although she uses plenty of statistics to back up her points, these usually come from newspapers and websites rather than peer-reviewed journals; only in two chapters about how macrophages ‘betray’ the body by abetting cancer does she consult the scientific literature, in keeping with her PhD in cellular immunology. Her most bizarre example of how our bodies aren’t evolutionarily fit for purpose is copious menstruation. Overall, the book is a strange mixture of hard science, social science, and, in later chapters, philosophy, as Ehrenreich asks about the nature of the self and the soul and what survives of us after death. As usual, her work is very readable, but this doesn’t match up to many other mind/body books I’ve read.
Favorite lines:
“The only cure for bad science is more science, which has to include both statistical analysis and some recognition that the patient is not ‘just a statistic,’ but a conscious, intelligent agent, just as the doctor is.”
“The objection raised over and over to any proposed expansion of health insurance was, in so many words: Why should I contribute to the care of those degenerates who choose to smoke and eat cheeseburgers? … we persist in subjecting anyone who dies at a seemingly untimely age to a kind of bio-moral autopsy: Did she smoke? Drink excessively? Eat too much fat and not enough fiber? Can she, in other words, be blamed for her own death?”
My rating: 
Natural Causes was published in the UK by Granta on April 12th. My thanks to the publisher for the free copy for review.
Human Errors: A Panorama of Our Glitches, from Pointless Bones to Broken Genes by Nathan H. Lents
Lents is a biology professor at John Jay College, City University of New York, and in this, his second book, he explores the ways in which the human body is flawed. These errors come in three categories: adaptations to the way the world was for early humans (to take advantage of once-scarce nutrients, we gain weight quickly – but lose it only with difficulty); incomplete adaptations (our knees are still not fit for upright walking); and the basic limitations of our evolution (inefficient systems such as the throat handling both breath and food, and the recurrent laryngeal nerve being three times longer than necessary because it loops around the aorta). Consider that myopia rates are 30% or higher, the retina faces backward, sinuses drain upwards, there are 100+ autoimmune diseases, we have redundant bones in our wrist and ankle, and we can’t produce most of the vitamins we need. Put simply, we’re not a designer’s ideal. And yet this all makes a lot of sense for an evolved species.
My favorite chapter was on the inefficiencies of human reproduction compared to that of other mammals. Infertility and miscarriage rates are notably high, and gestation is shorter than it really needs to be: because otherwise their heads would get too big to pass through the birth canal, all babies are effectively born premature, so are helpless for much longer than other newborn mammals. I also especially liked the short section on cancer, which would eventually get us all if we only lived long enough. As it is, “evolution has struck an uneasy balance with cancer. Mutations cause cancer, which kills individuals, but it also brings diversity and innovation, which is good for the population.”
Lents writes in a good conversational style and usually avoids oversimplifying the science. In places his book reminded me of Kathryn Schulz’s Being Wrong and Mark O’Connell’s To Be a Machine. It’s a wry and gentle treatment of human weakness; the content never turns depressing or bitter. Recommended for all curious readers of popular science.
Favorite lines:
“While lithopedions [“stone babies”] and abdominal pregnancies are quite rare, they are also 100 percent the result of poor design. Any reasonable plumber would have attached the fallopian tube to the ovary, thereby preventing tragic and often fatal mishaps like these.”
“to call our immune system perfectly designed would be equally inaccurate. There are millions of people who once happily walked this planet only to meet their demise because their bodies simply self-sabotaged. When bodies fight themselves, there can be no winner.”
My rating: 
Human Errors was published in the UK by Weidenfeld & Nicolson on May 3rd. My thanks to the publisher for the free copy for review.
Career: For part of his mourning year, Marshall worked on the Agony television program as an “agony uncle.” He took a break from Relate counseling, but continued to write freelance articles, many of them touching on illness and death, and contributed a “Revelations” celebrity profile column to the Independent, in which he interviewed authors and pop stars about life’s turning points. Two of my favorite moments in the book arise from this: Jim Crace (promoting Quarantine) tells how he realized the emptiness of atheism when burying his father; and Carol Shields’s Larry’s Party provides Marshall’s gateway into literary fiction, which he’d never attempted before.
After I got back to the States from my year abroad, I spent a few years doing some intensive reading about progressive Christianity (it was sometimes also called the emergent church) and other religions, trying to decide if it was worth sticking with the faith I’d grown up in. Although I still haven’t definitively answered this for myself, and have drifted in and out of lots of churches over the last 12 years, two authors were key to me never ditching Christianity entirely: Brian McLaren and Marcus Borg.
McLaren founded the church we attend whenever we’re back in Maryland and is the author of over a dozen theology titles, including the New Kind of Christian trilogy of allegorical novels. For me his best book is A New Kind of Christianity, which pulls together all his recurrent themes. Borg, who died in 2015, wrote several books that made a big impression on me, but none more so than The Heart of Christianity, which is the best single book I’ve found about what Christianity can and should be, going back to Jesus’ way of peace and social justice and siphoning off the unhelpful doctrines that have accumulated over the centuries.
Any number of other Christian books and authors have been helpful to me over the years (Secrets in the Dark by Frederick Buechner, How (Not) to Speak of God by Peter Rollins, Falling Upward by Richard Rohr, An Altar in the World by Barbara Brown Taylor, Without Buddha I Could Not be a Christian by Paul Knitter, Unapologetic by Francis Spufford, and various by Kathleen Norris, Rowan Williams, Richard Holloway and Anne Lamott), reassuring me that it’s not all hellfire/pie in the sky mumbo-jumbo for anti-gay Republicans, but Borg and McLaren were there at the start of my journey.
Reading is my primary means of examining society as well as my own life, so it’s no wonder that I have turned to books to learn from some gender pioneers. Hanne Blank’s accessible social history Straight (2012) is particularly valuable for its revelation of the surprisingly short history of heterosexuality as a concept – the term has only existed since the 1860s. But the book that most helped me adjust my definitions of gender and broaden my tolerance was Conundrum by Jan Morris (1974).
James Morris, born in 1926, was a successful reporter, travel writer, husband and father. Yet all along he knew he was meant to be female; it was something he had sensed for the first time as a young child sitting under the family piano: “I was three or perhaps four years old when I realized that I had been born into the wrong body, and should really be a girl … the conviction was unfaltering from the start.” In 1954 he began taking hormones to start his transition to womanhood, completed by a sex reassignment surgery in Morocco in 1972. This exceptional memoir of sex change evokes the swirl of determination and doubt, as well as the almost magical process of metamorphosing from one thing to another. Morris has been instrumental in helping me see sexuality as a continuum rather than a fixed entity.
The fact that I still haven’t completely given up meat is proof of how difficult it is to change, even once you’ve been convicted. We’ve gone from eating meat occasionally to almost never, and then mostly when we’re guests at other people’s houses. But if I really reminded myself to think about where my food was coming from, I’m sure we’d be even more hardline. Foer didn’t answer all my questions – what about offal and wild game, and why not go all the way to veganism? – but I appreciated that he never characterizes the decision to be vegetarian as an easy one. He recognizes the ways food is bound up with cultural traditions and family memories, but still thinks being true to one’s principles outweighs all. (He’s brave enough to suggest to middle America that it’s time to consider a turkey-free Thanksgiving!)
There’s nothing more routine than brushing your teeth, and I never thought I would learn a new way to do it at age 32! But that’s just what Ignore Your Teeth and They’ll Go Away by Sheldon Dov Sydney gave me. He advises these steps: (1) brushing with a dry brush to remove bits of food and plaque, (2) flossing, and (3) brushing with toothpaste as a polish and to freshen breath. It takes a little bit longer than your usual quick brush and thus I can’t often be bothered to do it, but it does always leave my mouth feeling super-clean.
I frequently succumb to negative self-talk, thinking “I can’t cope” or “There’s no way I could…” Feel the Fear and Do It Anyway by Susan Jeffers helped me see that I need to be more positive in my thought life. Originally published in 1987, the self-help classic says that at the base of every fear is a belief that “I can’t handle it.” Our fears are either of things that can happen to us (aging and natural disasters) or actions we might take (going back to school or changing jobs). You can choose to hold fear with either pain (leading to paralysis) or power (leading to action). This is still a struggle for me, but whenever I start to think “I can’t” I try to replace it with Jeffers’ mantra, “Whatever it is, I’ll handle it.”
